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Arnberg, Filip, Docent i klinisk psykologiORCID iD iconorcid.org/0000-0002-1317-2093
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Publications (10 of 58) Show all publications
Thoresen, S., Birkeland, M. S., Arnberg, F., Wentzel-Larsen, T. & Blix, I. (2019). Long-term mental health and social support in victims of disaster: Comparison with a general population sample. BJPsych Open, 5(1), 1-6, Article ID e2.
Open this publication in new window or tab >>Long-term mental health and social support in victims of disaster: Comparison with a general population sample
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2019 (English)In: BJPsych Open, E-ISSN 2056-4724, Vol. 5, no 1, p. 1-6, article id e2Article in journal (Refereed) Published
Abstract [en]

Background

Trauma and traumatic bereavement have well-known consequences for mental health, but little is known about long-term adjustment, particularly with respect to health-protective factors.

Aims

To assess the levels of anxiety/depression and perceived social support among the survivors and the bereaved 26 years after the Scandinavian Star ferry disaster compared with expected levels from the general population.

Method

Anxiety/depression and social support were assessed in face-to-face interviews with the survivors and the bereaved (N = 165, response rate 58%). Expected scores were calculated for each participant based on the means and proportions for each age and gender combination from a general population sample. We computed the ratio between expected and observed scores, standardised mean differences with 95% confidence intervals and standardised effect sizes.

Results

We found an elevated level of anxiety/depression symptoms in the victims (Mdiff = 0.28, 95% CI 0.18, 0.38; effect size 0.43, 95% CI 0.31, 0.55) and a significant excess of individuals with a clinically significant level of symptoms. The observed level of perceived social support was significantly lower than that expected (Mdiff = −0.57, 95% CI −0.70, −0.44; effect size −0.73, 95% CI −0.89, −0.57). This was the case for both survivors and those who were bereaved and for both men and women.

Conclusions

This study reveals that disaster survivors and the bereaved reported elevated levels of anxiety and depression symptoms 26 years after the event. They also reported a markedly reduced level of social support. Traumas and post-traumatic responses may thus cause lasting harm to interpersonal relationships.

Keywords
Disaster, mental health, social functioning, long term
National Category
Psychology Psychiatry
Research subject
Psychology; Psychiatry
Identifiers
urn:nbn:se:uu:diva-372096 (URN)10.1192/bjo.2018.74 (DOI)000454205600002 ()
Available from: 2019-01-05 Created: 2019-01-05 Last updated: 2019-02-04Bibliographically approved
Hensler, I., Sveen, J., Cernvall, M. & Arnberg, F. (2019). PTSD Coach Sweden: A Self-Management App for Trauma-Related Symptoms: A RCT study protocol evaluating a self-help app for posttraumatic stress in a Swedish community sample. Paper presented at ESTSS2019 (European Society for Traumatic Stress Studies), Rotterdam, Netherlands, 14-16 June 2019. European Journal of Psychotraumatology, 10(S1), Article ID 4–010.
Open this publication in new window or tab >>PTSD Coach Sweden: A Self-Management App for Trauma-Related Symptoms: A RCT study protocol evaluating a self-help app for posttraumatic stress in a Swedish community sample
2019 (English)In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 10, no S1, article id 4–010Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Resources to administer evidence-based care for PTSD and trauma-related complications are scarce, especially in particular geographical areas, during mass casualty situations and for individuals with subclinical symptoms as clinics prioritize more severe cases. Effective interventions for PTSD through technical platforms could disseminate information and self-management strategies to decrease individual suffering and societal costs. Assessment at multiple time points can elucidate which aspects of an intervention that are effective, in addition to the evolution of intervention use and well-being over time. 

Objective: Evaluate an app-administered self-help intervention (PTSD Coach Sweden) aiming to reduce and manage PTSD symptoms and other related complications. 

Method: In this trial, 200 participants from Sweden who have experienced a traumatic event in the past two years and who report posttraumatic stress symptoms will be randomized to three months use of the app or waitlist. The primary endpoint is self-rated PTSD symptom severity at three months, with follow-up at six and nine months. Secondary outcomes include depressive symptoms, physical symptoms, functional impairment and health care use. Ecological momentary assessment of health status and use of strategies corresponding to app content is used for 21 days during the first three months.

Results: Lessons learned and recommendations from the preparations of app-based intervention trials are presented. Available data from the primary endpoint are presented. 

Conclusions: App-based interventions hold promise to increase outreach, but further trials are needed. Several challenges introduced when preparing an app-based intervention are discussed.

Keywords
PTSD, posttraumatic stress, app intervention
National Category
Psychiatry
Research subject
Psychiatry; Psychology
Identifiers
urn:nbn:se:uu:diva-391388 (URN)10.1080/20008198.2019.1613837 (DOI)
Conference
ESTSS2019 (European Society for Traumatic Stress Studies), Rotterdam, Netherlands, 14-16 June 2019
Available from: 2019-08-22 Created: 2019-08-22 Last updated: 2019-08-26Bibliographically approved
Bondjers, K., Roberts, N., Bisson, J., Hyland, P., Willebrand, M. & Arnberg, F. (2019). Reliability and validity of the Swedish international trauma interview for posttraumatic stress disorders in the ICD-11. In: European Journal of Psychotraumatology: Trauma in Transition: Building Bridges. Paper presented at The 16th ESTSS Conference, 14-16 June 2019, Rotterdam, Netherlands. , 10, Article ID 1613836.
Open this publication in new window or tab >>Reliability and validity of the Swedish international trauma interview for posttraumatic stress disorders in the ICD-11
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2019 (English)In: European Journal of Psychotraumatology: Trauma in Transition: Building Bridges, 2019, Vol. 10, article id 1613836Conference paper, Oral presentation with published abstract (Refereed)
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-391173 (URN)10.1080/20008198.2019.1613836 (DOI)
Conference
The 16th ESTSS Conference, 14-16 June 2019, Rotterdam, Netherlands
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-20
Song, H., Fang, F., Arnberg, F., Mataix-Cols, D., Fernández de la Cruz, L., Almqvist, C., . . . Valdimarsdóttir, U. A. (2019). Stress related disorders and risk of cardiovascular disease: population based, sibling controlled cohort study. BMJ. British Medical Journal, 365, Article ID l1255.
Open this publication in new window or tab >>Stress related disorders and risk of cardiovascular disease: population based, sibling controlled cohort study
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2019 (English)In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 365, article id l1255Article in journal (Refereed) Published
Abstract [en]

Objective To assess the association between stress related disorders and subsequent risk of cardiovascular disease.

Design Population based, sibling controlled cohort study.

Setting Population of Sweden.

Participants 136 637 patients in the Swedish National Patient Register with stress related disorders, including post-traumatic stress disorder (PTSD), acute stress reaction, adjustment disorder, and other stress reactions, from 1987 to 2013; 171 314 unaffected full siblings of these patients; and 1 366 370 matched unexposed people from the general population.

Main outcome measures Primary diagnosis of incident cardiovascular disease—any or specific subtypes (ischaemic heart disease, cerebrovascular disease, emboli/thrombosis, hypertensive diseases, heart failure, arrhythmia/conduction disorder, and fatal cardiovascular disease)—and 16 individual diagnoses of cardiovascular disease. Hazard ratios for cardiovascular disease were derived from Cox models, after controlling for multiple confounders.

Results During up to 27 years of follow-up, the crude incidence rate of any cardiovascular disease was 10.5, 8.4, and 6.9 per 1000 person years among exposed patients, their unaffected full siblings, and the matched unexposed individuals, respectively. In sibling based comparisons, the hazard ratio for any cardiovascular disease was 1.64 (95% confidence interval 1.45 to 1.84), with the highest subtype specific hazard ratio observed for heart failure (6.95, 1.88 to 25.68), during the first year after the diagnosis of any stress related disorder. Beyond one year, the hazard ratios became lower (overall 1.29, 1.24 to 1.34), ranging from 1.12 (1.04 to 1.21) for arrhythmia to 2.02 (1.45 to 2.82) for artery thrombosis/embolus. Stress related disorders were more strongly associated with early onset cardiovascular diseases (hazard ratio 1.40 (1.32 to 1.49) for attained age <50) than later onset ones (1.24 (1.18 to 1.30) for attained age ≥50; P for difference=0.002). Except for fatal cardiovascular diseases, these associations were not modified by the presence of psychiatric comorbidity. Analyses within the population matched cohort yielded similar results (hazard ratio 1.71 (1.59 to 1.83) for any cardiovascular disease during the first year of follow-up and 1.36 (1.33 to 1.39) thereafter).

Conclusion Stress related disorders are robustly associated with multiple types of cardiovascular disease, independently of familial background, history of somatic/psychiatric diseases, and psychiatric comorbidity.

National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-381773 (URN)10.1136/bmj.l1255 (DOI)000464944100002 ()30971390 (PubMedID)
Funder
EU, European Research Council, 726413Swedish Research Council, 340-2013-5867
Available from: 2019-04-12 Created: 2019-04-12 Last updated: 2019-05-09Bibliographically approved
Cernvall, M., Sveen, J., Bergh Johannesson, K. & Arnberg, F. (2018). A pilot study of user satisfaction and perceived helpfulness of the Swedish version of the mobile app PTSD Coach. European Journal of Psychotraumatology, 9(Suppl 1), Article ID 1472990.
Open this publication in new window or tab >>A pilot study of user satisfaction and perceived helpfulness of the Swedish version of the mobile app PTSD Coach
2018 (English)In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 9, no Suppl 1, article id 1472990Article in journal (Refereed) Published
Abstract [en]

Background: There is a need for accessible interventions in the aftermath of traumatic events with documented efficacy for preventing or reducing negative mental health consequences. The PTSD Coach is a mobile app that has shown to be effective in reducing symptoms of posttraumatic stress (PTSS). Objective: The purpose of the current study was to evaluate the user satisfaction, perceived helpfulness and potential reductions of PTSS and symptoms of depression among participants using the Swedish version of the PTSD Coach. Method: This was an uncontrolled pre-test post-test open trial including participants recruited from the community via advertisement and from an ongoing observational study who had experienced a potentially traumatic event in the last five years. Participants had access to the Swedish PTSD Coach app for four weeks. Results: Eleven participants (mean age = 38.6, female = 8) completed the study. Nine of the participants met criteria for full or partial PTSD. Results from the PTSD Coach Survey indicated that participants found the app slightly to moderately helpful and were slightly to moderately satisfied with the app. Nominal but not statistically significant reductions of medium effect sizes in PTSS (PCL-5) and depression (PHQ-9) from pre- to post-assessment were found. In interviews, participants indicated that they found elements such as learning about PTSD, breathing exercises and monitoring symptoms helpful in managing symptoms. However, several participants indicated that they had not used the app as much as they had intended to. Participants also had suggestions for improvements such as enhanced app structure and better guidance regarding how to use the app. Conclusions: The perceived helpfulness and user satisfaction were slightly lower compared to research on the original version of the app. Experiences from the study are discussed and a future controlled study of the Swedish version of the PTSD Coach is suggested.

Keywords
PTSD Coach, Posttraumatic stress, mobile apps, mobile phone intervention, smartphones, • Participants found the Swedish version of the PTSD Coach slightly to moderately helpful.• There were nominal but statistically non-significant reductions of symptoms of PTSD and depression with medium effect sizes.• Participants had suggestions for improvement of the app.
National Category
Psychiatry
Research subject
Psychiatry; Psychology
Identifiers
urn:nbn:se:uu:diva-357141 (URN)10.1080/20008198.2018.1472990 (DOI)000469464200001 ()29805783 (PubMedID)
Funder
Swedish National Board of Health and Welfare
Available from: 2018-08-13 Created: 2018-08-13 Last updated: 2019-08-19Bibliographically approved
Bondjers, K., Willebrand, M. & Arnberg, F. (2018). A Prospective Study of ICD-11 and DSM-5 PTSD, Functional Disability and Quality of Life. In: : . Paper presented at The International Society for Traumatic Stress Studies 34th Annual Meeting, Washington D.C., USA, November 8-10.
Open this publication in new window or tab >>A Prospective Study of ICD-11 and DSM-5 PTSD, Functional Disability and Quality of Life
2018 (English)Conference paper, Oral presentation only (Refereed)
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-382954 (URN)
Conference
The International Society for Traumatic Stress Studies 34th Annual Meeting, Washington D.C., USA, November 8-10
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-05-07
Song, H., Fang, F., Tomasson, G., Arnberg, F., Mataix-Cols, D., Fernández de la Cruz, L., . . . Valdimarsdóttir, U. A. (2018). Association of Stress-Related Disorders With Subsequent Autoimmune Disease. Journal of the American Medical Association (JAMA), 319(23), 2388-2400
Open this publication in new window or tab >>Association of Stress-Related Disorders With Subsequent Autoimmune Disease
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2018 (English)In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 319, no 23, p. 2388-2400Article in journal (Refereed) Published
Abstract [en]

Importance: Psychiatric reactions to life stressors are common in the general population and may result in immune dysfunction. Whether such reactions contribute to the risk of autoimmune disease remains unclear.

Objective: To determine whether there is an association between stress-related disorders and subsequent autoimmune disease.

Design, Setting, and Participants: Population- and sibling-matched retrospective cohort study conducted in Sweden from January 1, 1981, to December 31, 2013. The cohort included 106 464 exposed patients with stress-related disorders, with 1 064 640 matched unexposed persons and 126 652 full siblings of these patients.

Exposures: Diagnosis of stress-related disorders, ie, posttraumatic stress disorder, acute stress reaction, adjustment disorder, and other stress reactions.

Main Outcomes and Measures: Stress-related disorder and autoimmune diseases were identified through the National Patient Register. The Cox model was used to estimate hazard ratios (HRs) with 95% CIs of 41 autoimmune diseases beyond 1 year after the diagnosis of stress-related disorders, controlling for multiple risk factors.

Results: The median age at diagnosis of stress-related disorders was 41 years (interquartile range, 33-50 years) and 40% of the exposed patients were male. During a mean follow-up of 10 years, the incidence rate of autoimmune diseases was 9.1, 6.0, and 6.5 per 1000 person-years among the exposed, matched unexposed, and sibling cohorts, respectively (absolute rate difference, 3.12 [95% CI, 2.99-3.25] and 2.49 [95% CI, 2.23-2.76] per 1000 person-years compared with the population- and sibling-based reference groups, respectively). Compared with the unexposed population, patients with stress-related disorders were at increased risk of autoimmune disease (HR, 1.36 [95% CI, 1.33-1.40]). The HRs for patients with posttraumatic stress disorder were 1.46 (95% CI, 1.32-1.61) for any and 2.29 (95% CI, 1.72-3.04) for multiple (≥3) autoimmune diseases. These associations were consistent in the sibling-based comparison. Relative risk elevations were more pronounced among younger patients (HR, 1.48 [95% CI, 1.42-1.55]; 1.41 [95% CI, 1.33-1.48]; 1.31 [95% CI, 1.24-1.37]; and 1.23 [95% CI, 1.17-1.30] for age at ≤33, 34-41, 42-50, and ≥51 years, respectively; P for interaction < .001). Persistent use of selective serotonin reuptake inhibitors during the first year of posttraumatic stress disorder diagnosis was associated with attenuated relative risk of autoimmune disease (HR, 3.64 [95% CI, 2.00-6.62]; 2.65 [95% CI, 1.57-4.45]; and 1.82 [95% CI, 1.09-3.02] for duration ≤179, 180-319, and ≥320 days, respectively; P for trend = .03).

Conclusions and Relevance: In this Swedish cohort, exposure to a stress-related disorder was significantly associated with increased risk of subsequent autoimmune disease, compared with matched unexposed individuals and with full siblings. Further studies are needed to better understand the underlying mechanisms.

National Category
Psychiatry
Research subject
Psychiatry
Identifiers
urn:nbn:se:uu:diva-357140 (URN)10.1001/jama.2018.7028 (DOI)000435564100018 ()29922828 (PubMedID)
Funder
EU, European Research Council, 726413Swedish Research Council, 340-2013-5867
Available from: 2018-08-13 Created: 2018-08-13 Last updated: 2018-09-04Bibliographically approved
Åslund, L., Arnberg, F., Kanstrup, M. & Lekander, M. (2018). Cognitive and Behavioral Interventions to Improve Sleep in School-Age Children and Adolescents: A Systematic Review and Meta-Analysis. Journal of Clinical Sleep Medicine (JCSM), 14(11), 1937-1947
Open this publication in new window or tab >>Cognitive and Behavioral Interventions to Improve Sleep in School-Age Children and Adolescents: A Systematic Review and Meta-Analysis
2018 (English)In: Journal of Clinical Sleep Medicine (JCSM), ISSN 1550-9389, E-ISSN 1550-9397, Vol. 14, no 11, p. 1937-1947Article, review/survey (Refereed) Published
Abstract [en]

STUDY OBJECTIVES: Sleep problems are common in children and adolescents and can aggravate comorbid disorders. This meta-analysis examined the effect of cognitive and behavioral sleep interventions (with four or more treatment sessions) from randomized controlled trials on school-age children and adolescents.

METHODS: In a systematic literature search, six randomized controlled trials were identified (n = 528; mean age = 14.6 years; female = 63%) that reported total sleep time (TST), sleep onset latency (SOL), wake after sleep onset, and daytime sleepiness from ratings and actigraphy.

RESULTS: After intervention, no effect was seen on self-reported TST, but when measured with actigraphy, an effect favoring the intervention group was observed (+11.47 minutes, P = .05). SOL decreased in the intervention group compared to the control group after intervention as measured by both sleep diaries (-9.31 minutes, P = .007) and actigraphy (-19.48 minutes, P < .0001). Effect sizes ranged from small to large. No effect was found for wake after sleep onset or daytime sleepiness. Short-term (4 to 8 weeks) follow-up data from four studies indicated maintained positive effects on SOL: sleep diaries -15.85 minutes (P = .01) and actigraphy -23.67 minutes (P < .0001). At follow-up, the effects on wake after sleep onset from ratings (-14.41 minutes, P = .001) and actigraphy (-7.54 minutes, P = .01) were significant, favoring the intervention group (moderate to large effect sizes). No effect on TST was indicated.

CONCLUSIONS: Cognitive and behavioral sleep interventions are indicated to improve sleep in school-age children and adolescents. However, because treatment protocols were heterogeneous and risk of bias high, results should be interpreted with caution. Large and rigorous trials are needed.

Keywords
adolescence, cognitive behavioral therapy, insomnia, intervention, meta-analysis, school-age children, sleep, sleep disorder, systematic review
National Category
Psychiatry Neurology
Identifiers
urn:nbn:se:uu:diva-366967 (URN)10.5664/jcsm.7498 (DOI)000461414800015 ()30373682 (PubMedID)
Available from: 2018-11-27 Created: 2018-11-27 Last updated: 2019-03-29Bibliographically approved
Thordardottir, E., Song, H., Fang, F., Arnberg, F., Valdimarsdottir, U. & Hauksdóttir, A. (2018). Hypnotic Medication Use among Swedish Survivors of the 2004 Southeast Asia Tsunami. In: : . Paper presented at The International Society for Traumatic Stress Studies 34th Annual meeting, Washington D.C., USA, November 8-10.
Open this publication in new window or tab >>Hypnotic Medication Use among Swedish Survivors of the 2004 Southeast Asia Tsunami
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2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-382956 (URN)
Conference
The International Society for Traumatic Stress Studies 34th Annual meeting, Washington D.C., USA, November 8-10
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-05-07
Song, H., Fang, F., Arnberg, F., Almqvist, C., Fall, K. & Valdimarsdottir, U. (2018). Psychiatric Reactions to Severe Stress and Risk of Cardiovascular Disease. In: : . Paper presented at The International Society for Traumatic Stress Studies 34th Annual meeting, Washington D.C., USA, November 8-10.
Open this publication in new window or tab >>Psychiatric Reactions to Severe Stress and Risk of Cardiovascular Disease
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2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-382961 (URN)
Conference
The International Society for Traumatic Stress Studies 34th Annual meeting, Washington D.C., USA, November 8-10
Available from: 2019-05-07 Created: 2019-05-07 Last updated: 2019-05-07
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1317-2093

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