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  • 1.
    Ahlstedt, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Moberg, Linda
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
    Brulin, Emma
    Karolinska Inst, Inst Environm Med, Unite Occupat Med, Solna, Sweden..
    Nyberg, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health equity and working life.
    Do illegitimate tasks matter for registered nurses' work motivation?: A cross-sectional study based on a nationally representative sample of Swedish nurses2023In: International Journal of Nursing Studies Advances, E-ISSN 2666-142X, Vol. 5, article id 100159Article in journal (Refereed)
    Abstract [en]

    Background: A challenge in Western countries is the growing need for registered nurses (RNs') in hospitals, primary care and home healthcare. Decreasing illegitimate tasks and strengthening RNs' work motivation are some strategies to address this challenge.

    Objective: Our overall aim was to explore the association between RNs' experiences of illegitimate tasks and work motivation operationalised as four dimensions: work engagement, opportunities to provide high-quality care, employer satisfaction and intention to remain at the workplace. To address this aim, three specific research questions were asked: (1) Is there an association between illegitimate tasks and work motivation? (2) Do the levels of reported illegitimate tasks differ between RNs working in hospitals and those working in primary care or home healthcare settings? (3) Do associations between illegitimate work tasks and work motivation differ with type of workplace?

    Design: A cross-sectional design.

    Methods: We used responses from a stratified population of RNs in Sweden, n = 2,333, working either in hospitals, primary care or home healthcare. Calibrating weights were applied in all analyses to ascertain the generalisability of the findings. Illegitimate tasks were measured with the Bern Illegitimate Tasks Scale. Data were analysed using chi-squared tests and linear or logistic regression analysis. Interaction was measured on the multiplicative scale by adding an interaction term to the fully adjusted models.

    Results: Overall, approximately 25 % of RNs reported frequently experiencing illegitimate tasks. There were statistically significant associations between higher perceptions of illegitimate tasks and lower ratings in the four dimensions of work motivation: work engagement [beta coefficient [beta] = -0.14, confidence interval [CI] 95 % = -0.18; -0.10], opportunities to provide highquality care [beta = -0.46, CI 95 % = -0.51; -40] and employer satisfaction [beta = -0.60, CI 95 % = -0.67; -0.54]. Experiencing higher levels of illegitimate tasks also related to a decreased intention to remain at the workplace [illegitimate tasks: odds ratio = 0.32, CI 95 % = 0.27; 0.29]. RNs who worked in home healthcare reported higher levels of illegitimate tasks than RNs who worked in hospitals.

    Conclusions: Reducing the amount of illegitimate tasks may contribute to counteracting the shortage of RNs by increasing work motivation and willingness to remain at the workplace.

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  • 2.
    Ahmed Pihlgren, Sara
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Karolinska Inst, Dept Clin Neurosci, Div Psychol, Stockholm, Sweden.;Uppsala Univ, Dept Psychol, Box 1225, S-75142 Uppsala, Sweden..
    Johansson, Lotta
    Sahlgrens Univ Hosp, Neurosurg Intens Care Unit, Gothenburg, Sweden.;Univ Gothenburg, Inst Hlth & Caring Sci, Sahlgrenska Acad, Gothenburg, Sweden..
    Holmes, Emily A.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Karolinska Inst, Dept Clin Neurosci, Div Psychol, Stockholm, Sweden..
    Kanstrup, Marie
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Karolinska Inst, Dept Clin Neurosci, Div Psychol, Stockholm, Sweden.;Karolinska Univ Hosp, Med Unit Med Psychol, Theme Womens Hlth & Allied Hlth Profess, Solna, Sweden..
    Exploring healthcare workers' experiences of a simple intervention to reduce their intrusive memories of psychological trauma: an interpretative phenomenological analysis2024In: European Journal of Psychotraumatology, ISSN 2000-8198, E-ISSN 2000-8066, Vol. 15, no 1, article id 2328956Article in journal (Refereed)
    Abstract [en]

    Background: Many healthcare workers (HCWs) endured psychologically traumatic events at work during the coronavirus disease 2019 (COVID-19) pandemic. For some, these events are re-experienced as unwanted, recurrent, and distressing intrusive memories. Simple psychological support measures are needed to reduce such symptoms of post-traumatic stress in this population. A novel intervention to target intrusive memories, called an imagery-competing task intervention (ICTI), has been developed from the laboratory. The intervention includes a brief memory reminder cue, then a visuospatial task (Tetris (R) gameplay using mental rotation instructions for approximately 20 min) thought to interfere with the traumatic memory image and reduce its intrusiveness. The intervention has been adapted and evaluated in a randomized controlled trial (RCT) with Swedish HCWs (ClinicalTrials.gov identifier: NCT04460014).

    Objective: We aimed to explore how HCWs who worked during the COVID-19 pandemic experienced the use of a brief intervention to reduce their intrusive memories of work-related trauma.

    Method: Interpretative phenomenological analysis was used for in-depth understanding of the lived experiences of HCWs who used the intervention. Seven participants from the RCT were interviewed by an independent researcher without prior knowledge of the intervention. Interviews were conducted via telephone and transcribed verbatim.

    Results: Four general themes were generated: 'Triggers and troublesome images', 'Five Ws regarding support - what, when, why, by/with who, for whom', 'Receiving it, believing it, and doing it' and 'The intervention - a different kind of help'; the last two included two subthemes each. The results reflect participants' similarities and differences in their lived experiences of intrusive memories, support measures, and intervention impressions and effects.Conclusion: HCWs' experiences of the novel ICTI reflect a promising appraisal of the intervention as a potential help measure for reducing intrusive memories after trauma, and gives us a detailed understanding of HCWs' needs, with suggestions for its adaption for future implementation.Trial registration: ClinicalTrials.gov identifier: NCT04460014. Many healthcare workers experience images or 'flashbacks' of traumatic experiences from their work during the COVID-19 pandemic.To ensure that individual needs are met, there is a need to tailor and refine current psychological support measures and their use for healthcare workers.The imagery-competing task intervention was perceived as acceptable, indicating its potential utility as a help measure to reduce intrusive memories after trauma. Antecedentes: Los trabajadores de la salud (HCW, por sus siglas en ingles) sufrieron eventos psicologicamente traumaticos en el trabajo durante la pandemia por COVID-19. Para algunos, estos acontecimientos se vuelven a experimentar como recuerdos intrusivos no deseados, recurrentes y angustiosos. Se necesitan medidas simples de apoyo psicologico para reducir estos sintomas de estres postraumatico en esta poblacion. En el laboratorio se ha desarrollado una nueva intervencion para abordar los recuerdos intrusivos, conocida como Intervencion de Tareas Competitivas de Imagenes (ICTI, por sus siglas en ingles). La intervencion incluye una breve senal de recordatorio de la memoria, luego una tarea visoespacial (juego de Tetris (R) que utiliza instrucciones de rotacion mental durante aproximadamente 20 minutos) que se cree que interfiere con la imagen de la memoria traumatica y reduce su intrusion. La intervencion se ha adaptado y evaluado recientemente en un ECA (ensayo controlado aleatorizado) con trabajadores sanitarios suecos (identificador de ClinicalTrials.gov: NCT04460014). Aqui nuestro objetivo es explorar como los participantes del ECA experimentaron la nueva intervencion.Objetivo: Explorar como los trabajadores sanitarios que trabajaron durante la pandemia por COVID-19 experimentaron el uso de una intervencion breve para reducir sus recuerdos intrusivos del trauma relacionado con el trabajo.Metodo: Se utilizo un analisis fenomenologico interpretativo para comprender en profundidad las experiencias vividas por los trabajadores sanitarios que utilizaron la intervencion. Siete participantes del ECA fueron entrevistados por un investigador independiente sin conocimiento previo de la intervencion. Las entrevistas se realizaron por telefono y se transcribieron palabra por palabra.Resultados: Se generaron cuatro temas generales, 'Desencadenantes e imagenes problematicas', 'Cinco preguntas sobre el apoyo: que, cuando, por que, por/con quien, para quien', 'Recibirlo, creerlo y hacerlo' y 'La intervencion. - una ayuda diferente', los dos ultimos incluian dos subtemas cada uno. Los resultados reflejan similitudes y diferencias de los participantes en sus experiencias vividas de recuerdos intrusivos, medidas de apoyo e impresiones y efectos de la intervencion.

    Conclusion: Las experiencias de los trabajadores sanitarios con el nuevo ICTI reflejan una evaluacion prometedora de la intervencion como una posible medida de ayuda para reducir los recuerdos intrusivos despues del trauma, y nos brinda una comprension detallada de las necesidades de los trabajadores sanitarios, con sugerencias sobre como adaptarse para una implementacion futura.

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  • 3.
    Akerblom, Sophia
    et al.
    Skane Univ Hosp, Dept Pain Rehabil, Lund, Sweden.;Lund Univ, Dept Psychol, Lund, Sweden..
    Perrin, Sean
    Lund Univ, Dept Psychol, Lund, Sweden..
    Rivano Fischer, Marcelo
    Skane Univ Hosp, Dept Pain Rehabil, Lund, Sweden.;Lund Univ, Dept Hlth Sci, Lund, Sweden..
    McCracken, Lance M
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Predictors and mediators of outcome in cognitive behavioral therapy for chronic pain: the contributions of psychological flexibility2021In: Journal of behavioral medicine, ISSN 0160-7715, E-ISSN 1573-3521, Vol. 44, no 1, p. 111-122Article in journal (Refereed)
    Abstract [en]

    There is now a consensus in the literature that future improvements in outcomes obtained from cognitive behavioral therapy (CBT) for chronic pain will require research to identify patient and treatment variables that help explain outcomes. The first aim of this study was to assess whether pre-treatment scores on measures of psychological (in)flexibility, acceptance, committed action, cognitive (de)fusion, and values-based action predict outcomes in a multidisciplinary, multicomponent, group-based CBT program for adults with chronic pain. The second aim was to assess whether change scores on these same measures mediate outcomes in the treatment program. Participants were 232 people attending treatment for chronic pain. Of the psychological flexibility measures, only pre-treatment scores on the psychological inflexibility scale predicted outcomes; higher scores on this measure were associated with worse outcomes. However, change scores on each of the psychological flexibility measures separately mediated outcomes. The efficacy of CBT for chronic pain may be improved with a greater focus on methods that increase psychological flexibility.

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  • 4.
    Alexius, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Law, Department of Law. Stockholms universitet, Institutionen för socialt arbete - Socialhögskolan.
    Hollander, Anna
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Law, Department of Law. Stockholms universitet, Institutionen för socialt arbete - Socialhögskolan.
    Barns behov och vilja vid tvångsvård till följd av omsorgsbrist2014In: Barnrätt: en antologi / [ed] Ann-Christin Cederborg & Wiweka Warnling-Nerep, Stockholm: Norstedts Juridik AB, 2014, p. 21-38Chapter in book (Other academic)
    Abstract [sv]

    Vid omhändertaganden av barn ska barnets bästa vara avgörande för de beslut som fattas. I den praktiska tillämpningen innefattar begreppet ofta tolkningar av barns behov, såsom dessa definieras av kompetenta vuxna, och barnets vilja, såsom denna uttrycks av barnet eller uttolkas av vuxna. I denna studie undersöks uttrycken barns behov och vilja samt hur barns behov och vilja bedöms i sociala utredningar och domar som rör tvångsomhändertaganden till följd av omsorgssvikt av barn i familjer där någon förälder har intellektuell funktionsnedsättning.

  • 5.
    Alfonsson, Sven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Psychology in Healthcare.
    Treatment Adherence in Internet-Based CBT: The Effects of Presentation, Support and Motivation2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Homework assignments that patient work with between sessions is a key component in both face-to-face and Internet-based Cognitive Behavior Therapy (CBT). However, adherence to assignments is often low and it is largely unclear what factors predict or affect treatment adherence, and in the end, treatment outcomes. The overall aim of this thesis was to investigate if treatment presentation and therapist support can affect adherence and treatment outcome in internet-based CBT, whether adherence can be predicted by motivation variables and to compare differences in face-to-face and online conditions in this regard.

    A randomized controlled trial with a brief online relaxation program for people with stress and anxiety symptoms was conducted (n = 162). Participants in the enhanced support conditions completed a larger proportion of the online treatment but adherence was not affected by enhanced treatment presentation (Study I). Participants reported reduced symptoms of stress and anxiety after the relaxation program but there were no significant additional effects of enhanced presentation or support (Study II). Participants who adhered to the prescribed assignments reported lower symptom levels at study end, regardless of treatment conditions. Adherence to the online treatment was predicted by subject factors such as treatment credibility prior to the treatment and intrinsic motivation during the treatment (Study III). To further elucidate how motivation may affect adherence, an experiment with a one-session psychotherapy model was subsequently conducted (n = 100). Participants who were randomized to the face-to-face condition reported higher motivation for the assignment and completed significantly more of the homework compared to participants in the online condition (Study IV). Self-reported intrinsic motivation could predict adherence in both conditions while new motivational variables were identified specifically for the online condition.

    The results from these studies confirm that adherence to assignments in Internet-based CBT is difficult to affect with treatment features but can be predicted early in treatment by subject factors such as treatment credibility and motivation. How such motivational variables can be affected to improve treatments is still unclear.

    List of papers
    1. Is online treatment adherence affected by presentation and therapist support?: A randomized controlled trial
    Open this publication in new window or tab >>Is online treatment adherence affected by presentation and therapist support?: A randomized controlled trial
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    2016 (English)In: Computers in human behavior, ISSN 0747-5632, E-ISSN 1873-7692, Vol. 60, p. 550-558Article in journal (Refereed) Published
    Abstract [en]

    In both face to face and Internet based Cognitive Behavior Therapy, patients' adherence can be improved by different means such as by using motivational techniques or automatic reminders. The main aim of this study was to investigate whether enriched treatment material presentation and/or increased frequency and quality of support would increase participants' adherence to an online relaxation program. One hundred and sixty-two participants with mild to moderate symptoms of stress or worry were included in this study. Participants were randomized to either Normal or Enhanced intervention presentation and Normal or Enhanced support in a full factorial design. Main outcome variables were progress through the online intervention and adherence to prescribed exercises. Participants in the Enhanced support group progressed further through the program than participants in the Normal support group (Z = 2.11, p = .035, r = .17) but there were no significant differences found between the Normal and Enhanced presentation groups. Participants registered a mean of 60% of the prescribed exercises with no significant differences between groups. This study shows that adherence to online interventions can be increased by increased frequency and quality of therapeutic contact. Future studies may investigate how to increase adherence to prescribed homework assignments and whether parts of the therapeutic support may be substituted with automatic systems with retained effects.

    Keywords
    Internet; Psychotherapy; Stress; Adherence
    National Category
    Psychology Engineering and Technology
    Identifiers
    urn:nbn:se:uu:diva-279739 (URN)10.1016/j.chb.2016.01.035 (DOI)000375811900056 ()
    Available from: 2016-03-03 Created: 2016-03-03 Last updated: 2017-11-30Bibliographically approved
    2. The effects of therapist support and treatment presentation on the clinical outcomes of an Internet based applied relaxation program
    Open this publication in new window or tab >>The effects of therapist support and treatment presentation on the clinical outcomes of an Internet based applied relaxation program
    2015 (English)In: Internet Interventions, ISSN 2214-7829, Vol. 2, no 3, p. 289-296Article in journal (Refereed) Published
    Abstract [en]

    Symptoms of stress are common in the general population and associated with health risks and economic costs. Applied relaxation training has shown to be effective for reducing stress and worry both as a self-help treatment and as an internet-based intervention with therapist support. However, what factors may affect the outcome of internet based relaxation training is unclear. The aims of the present study were to investigate the effect of a brief internet based relaxation program for people with symptoms of stress or worry and to assess whether enhancing the quality of intervention presentation or therapist support had an impact on outcomes.

    Participants were randomized in a full factorial design to either Normal or Enhanced treatment Presentation and either Normal or Enhanced therapist Support in a four-week online program with applied relaxation. The main outcome measures were self-report instruments of stress and worry.

    A total of 162 participants were included in the study and 94 and 84 participants completed the post and follow-up measurements respectively. Participants in all conditions improved significantly on the main outcome measures, and the different levels of Presentation or therapist Support did not significantly affect treatment outcome. Registered number of completed exercises was a predictor of better treatment outcome, but this effect was independent of treatment condition. Enhancing internet based interventions by improving presentations and the quality of support may thus not be the best way to further improve the effect of internet based interventions. More specific knowledge of the mechanisms that affect outcomes in online psychotherapy is needed.

    National Category
    Psychology
    Identifiers
    urn:nbn:se:uu:diva-260069 (URN)10.1016/j.invent.2015.07.005 (DOI)
    Available from: 2015-08-14 Created: 2015-08-14 Last updated: 2017-12-04Bibliographically approved
    3. Motivation and Treatment Credibility Predicts Dropout, Treatment Adherence, and Clinical Outcomes in an Internet-Based Cognitive Behavioral Relaxation Program: A Randomized Controlled Trial.
    Open this publication in new window or tab >>Motivation and Treatment Credibility Predicts Dropout, Treatment Adherence, and Clinical Outcomes in an Internet-Based Cognitive Behavioral Relaxation Program: A Randomized Controlled Trial.
    2016 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 18, no 3, article id e52Article in journal (Refereed) Published
    Abstract [en]

    Background: In previous research, variables such as age, education, treatment credibility, and therapeutic alliance have shown to affect patients' treatment adherence and outcome in Internet-based psychotherapy. A more detailed understanding of how such variables are associated with different measures of adherence and clinical outcomes may help in designing more effective online therapy.

    Objective: The aims of this study were to investigate demographical, psychological, and treatment-specific variables that could predict dropout, treatment adherence, and treatment outcomes in a study of online relaxation for mild to moderate stress symptoms.

    Methods: Participant dropout and attrition as well as data from self-report instruments completed before, during, and after the online relaxation program were analyzed. Multiple linear and logistical regression analyses were conducted to predict early dropout, overall attrition, online treatment progress, number of registered relaxation exercises, posttreatment symptom levels, and reliable improvement.

    Results: Dropout was significantly predicted by treatment credibility, whereas overall attrition was associated with reporting a focus on immediate consequences and experiencing a low level of intrinsic motivation for the treatment. Treatment progress was predicted by education level and treatment credibility, whereas number of registered relaxation exercises was associated with experiencing intrinsic motivation for the treatment. Posttreatment stress symptoms were positively predicted by feeling external pressure to participate in the treatment and negatively predicted by treatment credibility. Reporting reliable symptom improvement after treatment was predicted by treatment credibility and therapeutic bond.

    Conclusions: This study confirmed that treatment credibility and a good working alliance are factors associated with successful Internet-based psychotherapy. Further, the study showed that measuring adherence in different ways provides somewhat different results, which underscore the importance of carefully defining treatment adherence in psychotherapy research. Lastly, the results suggest that finding the treatment interesting and engaging may help patients carry through with the intervention and complete prescribed assignments, a result that may help guide the design of future interventions.

    National Category
    Psychology (excluding Applied Psychology)
    Identifiers
    urn:nbn:se:uu:diva-279736 (URN)10.2196/jmir.5352 (DOI)000380777800004 ()26957354 (PubMedID)
    External cooperation:
    Available from: 2016-03-03 Created: 2016-03-03 Last updated: 2024-01-17Bibliographically approved
    4. Differences in motivation and adherence to a prescribed assignment after face-to-face and online psychoeducation: A randomized experiment
    Open this publication in new window or tab >>Differences in motivation and adherence to a prescribed assignment after face-to-face and online psychoeducation: A randomized experiment
    2017 (English)In: BMC Psychology, E-ISSN 2050-7283, Vol. 5, no 1, article id 3Article in journal (Refereed) Published
    Abstract [en]

    Background: Adherence to treatment homework is associated with positive outcomes in behavioral psychotherapy but compliance to assignments is still often moderate. Whether adherence can be predicted by different types of motivation for the task and whether motivation plays different roles in face-to-face compared to online psychotherapy is unknown. If models of motivation, such as Self-determination theory, can be used to predict patients’ behavior, it may facilitate further research into homework promotion. The aims of this study were, therefore, to investigate whether motivation variables could predict adherence to a prescribed assignment in face-to-face and online interventions using a psychotherapy analog model. Methods: A total of 100 participants were included in this study and randomized to either a face-to-face or online intervention. Participants in both groups received a psychoeducation session and were given an assignment for the subsequent week. The main outcome measurements were self-reported motivation and adherence to the assignment. Results: Participant in the face-to-face condition reported significantly higher levels of motivation and showed higher levels of adherence compared to participants in the online condition. Adherence to the assignment was positively associated with intrinsic motivation and intervention credibility in the whole sample and especially in the online group. Conclusions: This study shows that intrinsic motivation and intervention credibility are strong predictors of adherence to assignments, especially in online interventions. The results indicate that intrinsic motivation may be partly substituted with face-to-face contact with a therapist. It may also be possible to identify patients with low motivation in online interventions who are at risk of dropping out. Methods for making online interventions more intrinsically motivating without increasing external pressure are needed.

    Keywords
    Adherence, Motivation, Psychoeducation, Internet, Homework assignments
    National Category
    Applied Psychology
    Identifiers
    urn:nbn:se:uu:diva-280799 (URN)10.1186/s40359-017-0172-5 (DOI)28126022 (PubMedID)
    Available from: 2016-03-15 Created: 2016-03-15 Last updated: 2018-05-08Bibliographically approved
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  • 6.
    Alfonsson, Sven
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Psychology in Healthcare. Centre for Psychiatry Research, Department of Clinical Neuroscience Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Sweden.
    Johansson, Karin
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Uddling, Johan
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Hursti, Timo
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Differences in motivation and adherence to a prescribed assignment after face-to-face and online psychoeducation: A randomized experiment2017In: BMC Psychology, E-ISSN 2050-7283, Vol. 5, no 1, article id 3Article in journal (Refereed)
    Abstract [en]

    Background: Adherence to treatment homework is associated with positive outcomes in behavioral psychotherapy but compliance to assignments is still often moderate. Whether adherence can be predicted by different types of motivation for the task and whether motivation plays different roles in face-to-face compared to online psychotherapy is unknown. If models of motivation, such as Self-determination theory, can be used to predict patients’ behavior, it may facilitate further research into homework promotion. The aims of this study were, therefore, to investigate whether motivation variables could predict adherence to a prescribed assignment in face-to-face and online interventions using a psychotherapy analog model. Methods: A total of 100 participants were included in this study and randomized to either a face-to-face or online intervention. Participants in both groups received a psychoeducation session and were given an assignment for the subsequent week. The main outcome measurements were self-reported motivation and adherence to the assignment. Results: Participant in the face-to-face condition reported significantly higher levels of motivation and showed higher levels of adherence compared to participants in the online condition. Adherence to the assignment was positively associated with intrinsic motivation and intervention credibility in the whole sample and especially in the online group. Conclusions: This study shows that intrinsic motivation and intervention credibility are strong predictors of adherence to assignments, especially in online interventions. The results indicate that intrinsic motivation may be partly substituted with face-to-face contact with a therapist. It may also be possible to identify patients with low motivation in online interventions who are at risk of dropping out. Methods for making online interventions more intrinsically motivating without increasing external pressure are needed.

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  • 7.
    Alfonsson, Sven
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare. Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden; Stockholm Hlth Care Serv, Ctr Psychiat Res, Stockholm, Sweden.
    Lundgren, Tobias
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden; Stockholm Hlth Care Serv, Ctr Psychiat Res, Stockholm, Sweden.
    Andersson, Gerhard
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden; Stockholm Hlth Care Serv, Ctr Psychiat Res, Stockholm, Sweden; Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden.
    Clinical supervision in cognitive behavior therapy improves therapists' competence: a single-case experimental pilot study2020In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 49, no 5, p. 425-438Article in journal (Refereed)
    Abstract [en]

    Clinical supervision is a cornerstone in psychotherapists' training but there are few empirical evaluations on the effects of supervision on therapists' competencies. The aim of this study was therefore to evaluate the effects of standardized supervision on rater-assessed competency in Cognitive Behavior Therapy (CBT). Six therapists with basic training in CBT were provided with protocol-based clinical supervision in CBT in a single-case experimental multiple baseline design. The supervision focused on specific CBT competencies and used experiential learning methods such as role-play. Each therapist recorded weekly treatment sessions during phases without and with supervision. The therapists' CBT competence was assessed by third-party raters using the Revised Cognitive Therapy Scale (CTS-R). Statistical analyses showed that the therapists' CTS-R scores increased significantly during the phase with supervision with a mean item increase of M = 0.71 (range = 0.50-1.0) on the supervision focus areas. This is one of the first empirical studies that can confirm that supervision affect CBT competencies. The results also suggest that supervision can be manualized and that supervisees have a positive perception of more active training methods. Further studies are needed to replicate the results and to find ways to improve the impact of supervision.

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  • 8.
    Alfonsson, Sven
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare. Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden; Stockholm Hlth Care Serv, Stockholm, Sweden.
    Parling, Thomas
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden; Stockholm Hlth Care Serv, Stockholm, Sweden.
    Spännargård, Åsa
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden; Stockholm Hlth Care Serv, Stockholm, Sweden.
    Andersson, Gerhard
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden; Stockholm Hlth Care Serv, Stockholm, Sweden; Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden.
    Lundgren, Tobias
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden; Stockholm Hlth Care Serv, Stockholm, Sweden.
    The effects of clinical supervision on supervisees and patients in cognitive behavioral therapy: a systematic review2018In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 47, no 3, p. 206-228Article, review/survey (Refereed)
    Abstract [en]

    Clinical supervision is a central part of psychotherapist training but the empirical support for specific supervision theories or features is unclear. The aims of this study were to systematically review the empirical research literature regarding the effects of clinical supervision on therapists’ competences and clinical outcomes within Cognitive Behavior Therapy (CBT). A comprehensive database search resulted in 4103 identified publications. Of these, 133 were scrutinized and in the end 5 studies were included in the review for data synthesis. The five studies were heterogeneous in scope and quality and only one provided firm empirical support for the positive effects of clinical supervision on therapists’ competence. The remaining four studies suffered from methodological weaknesses, but provided some preliminary support that clinical supervision may be beneficiary for novice therapists. No study could show benefits from supervision for patients. The research literature suggests that clinical supervision may have some potential effects on novice therapists’ competence compared to no supervision but the effects on clinical outcomes are still unclear. While bug-in-the-eye live supervision may be more effective than standard delayed supervision, the effects of specific supervision models or features are also unclear. There is a continued need for high-quality empirical studies on the effects of clinical supervision in psychotherapy.

  • 9.
    Alfonsson, Sven
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Psychology in Healthcare.
    Sewall, Anna
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Lidholm, Henning
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Hursti, Timo
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    The meal pattern questionnaire: A psychometric evaluation using the eating disorder examination2016In: Eating Behaviors, ISSN 1471-0153, E-ISSN 1873-7358, Vol. 21, p. 7-10Article in journal (Refereed)
    Abstract [en]

    Objective

    Meal pattern is an important variable in both obesity treatment and treatment for eating disorders. Momentary assessment and eating diaries are highly valid measurement methods but often cumbersome and not always feasible to use in clinical practice. The aim of this study was to design and evaluate a self-report instrument for measuring meal patterns.

    Method

    The Pattern of eating item from the Eating Disorder Examination (EDE) interview was adapted to self-report format to follow the same overall structure as the Eating Disorder Examination Questionnaire. The new instrument was named the Meal Patterns Questionnaire (MPQ) and was compared with the EDE in a student sample (n = 105) and an obese sample (n = 111).

    Results

    The individual items of the MPQ and the EDE showed moderate to high correlations (rho = .63–89) in the two samples. Significant differences between the MPQ and EDE were only found for two items in the obese sample. The total scores correlated to a high degree (rho = .87/.74) in both samples and no significant differences were found in this variable.

    Discussion

    The MPQ can provide an overall picture of a person's eating patterns and is a valid way to collect data regarding meal patterns. The MPQ may be a useable tool in clinical practice and research studies when more extensive instruments cannot be used. Future studies should evaluate the MPQ in diverse cultural populations and with more ecological assessment methods.

  • 10.
    Alfonsson, Sven
    et al.
    Stockholm Cty Council, Karolinska Inst & Stockholm Hlth Care Serv, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden.
    Winai, Ebba
    Reg Stockholm, Psychiat Northwest, Sollentuna, Sweden.
    Collin, Emelie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala Univ Hosp, Eating Disorder Unit Adults, Uppsala, Sweden.
    Isaksson, Martina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Wolf-Arehult, Martina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
    The Self-Compassion Scale-Short Form: Psychometric evaluation in one non-clinical and two clinical Swedish samples2023In: Clinical Psychology and Psychotherapy, ISSN 1063-3995, E-ISSN 1099-0879, Vol. 30, no 3, p. 631-642Article in journal (Refereed)
    Abstract [en]

    Background: Self-compassion has been defined as the ability to be with one's feelings of suffering in a warm and caring way. Research has shown a negative association between self-compassion and mental illness, and that low self-compassion can make psychotherapeutic effects less likely. The ability to measure a patient's self-compassion in a fast and reliable way is therefore important in investigating effects of psychotherapies. The aim of the present study was to evaluate the psychometric properties of the Swedish version of the Self-Compassion Scale-Short Form (SCS-SF) in both non-clinical (NC) and clinical samples.

    Methods: Cross-sectional data were gathered in a NC community sample (n = 1,089), an eating disorder (ED) sample (n = 253) and a borderline personality disorder (BPD) sample (n = 151). All participants were asked to complete a number of questionnaires, including the SCS-SF, and 121 participants in the NC sample repeated the assessment after 2 weeks for test-retest analysis.

    Results: Confirmatory factor analyses supported the first-order model suggested in previous research. Good internal consistency (Cronbach's alpha = 0.78-0.87) and test-retest reliability (intra-class correlation = 0.84) were demonstrated for the entire scale. Results also showed good convergent validity, demonstrating moderate negative associations between self-compassion and mental illnesses, as expected, and acceptable divergent validity, demonstrating weak positive associations between self-compassion and quality of life and mindfulness.

    Discussion: The correlations between the SCS-SF and the instruments used for validation were weaker in the clinical samples than the NC sample. This may be due to difficulties measuring these constructs or that the associations differ somewhat between different populations, which could warrant further research. The results added some support to the assumption that self-compassion may overlap with mindfulness yet still represents a distinct construct.

    Conclusions: Analyses of the SCS-SF provided evidence of adequate to good psychometric properties, supporting use of the scale's total sum score and a first-order factor structure. This is in accordance with previous evaluations of the SCS-SF, suggesting that it is a reliable and time-efficient instrument for measuring a general level of self-compassion. This may be important when evaluating psychotherapy and investigating self-compassion and its influence on psychiatric illness.

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  • 11.
    Allvin, Michael
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Movitz, Fredrik
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. Stockholms universitet, Stockholm, Sweden.
    Whose Side is Technology on Really?: On the Interdependence of Work and Technology.2017In: An Introduction to Work and Organizational Psychology: An International Perspective / [ed] N. Chmiel, F. Fraccaroli, & M. Sverke, Chichester, West Sussex: Wiley-Blackwell, 2017, 3, p. 121-136Chapter in book (Refereed)
  • 12.
    Alozkan Sever, C
    et al.
    Section for Science of Complex Systems, Medical University of Vienna, Vienna, Austria.
    Cuijpers, P
    Department of Clinical, Neuro and Developmental Psychology, VU Amsterdam, Amsterdam, Netherlands.
    Bryant, R
    UNSW Traumatic Stress Clinic, University of New South Wales, Sydney, Australia.
    Dawson, K
    School of psychology, University of New South Wales, Sydney, Australia.
    Mittendorfer-Rutz, E
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Holmes, E
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Sijbrandi, M
    Faculty of Behavioural and Movement Sciences, VU Amsterdam, Amsterdam, Netherlands.
    Adaptation of the Problem Management Plus programme for Syrian, Eritrean and Afghan refugee youth2020In: The European Journal of Public Health, ISSN 1101-1262, Vol. 30, no Supplement_5Article in journal (Refereed)
  • 13.
    Anderson, Madeleine
    et al.
    Guys & St Thomas NHS Fdn Trust, INPUT Pain Unit, London, England..
    McCracken, Lance M.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Scott, Whitney
    Guys & St Thomas NHS Fdn Trust, INPUT Pain Unit, London, England.;Kings Coll London, Hlth Psychol Sect, Inst Psychiat Psychol & Neurosci, London, England..
    An investigation of the associations between stigma, self-compassion, and pain outcomes during treatment based on Acceptance and Commitment Therapy for chronic pain2024In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 15, article id 1322723Article in journal (Refereed)
    Abstract [en]

    Introduction: Stigma adversely affects people with chronic pain. The qualities within self-compassion may be particularly useful for buffering the impact of stigma on people with pain. In the context of an Acceptance and Commitment Therapy-based (ACT) treatment for chronic pain, this study investigated the association between changes in stigma and self-compassion and pain outcomes, and the potential moderating role of self-compassion on the association between stigma and pain outcomes.

    Materials and methods: Five-hundred and nineteen patients completed standardized self-report questionnaires of stigma, self-compassion, psychological flexibility, pain intensity and interference, work and social adjustment, and depression symptoms at the start of an interdisciplinary ACT-based treatment for chronic pain. The same measures were completed at post-treatment (n = 431).

    Results: The results indicated that key pain outcomes and self-compassion significantly improved during treatment, but stigma did not. Changes in stigma and self-compassion were significantly negatively correlated and changes in these variables were associated with improvements in treatment outcomes. There were significant main effects of stigma and self-compassion for many of the pre- and post-treatment regression models when psychological flexibility was not controlled for, but self-compassion did not moderate the association between stigma and pain outcomes. Stigma remained significant when psychological flexibility variables were controlled for, while self-compassion did not.

    Discussion: The findings add to our conceptual understanding of the inter-relationships between stigma, self-compassion, and psychological flexibility and can contribute to treatment advancements to optimally target these variables.

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  • 14.
    Andersson, Claes
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Department of Criminology, Malmö University, Malmö, Sweden.
    Bendtsen, Marcus
    Lindfors, Petra
    Molander, Olof
    Lindner, Philip
    Topooco, Naira
    Engström, Karin
    Berman, Anne H.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden.
    Does the management of personal integrity information lead to differing participation rates and response patterns in mental health surveys with young adults?: A three-armed methodological experiment.2021In: International Journal of Methods in Psychiatric Research, ISSN 1049-8931, E-ISSN 1557-0657, Vol. 30, no 4, article id e1891Article in journal (Refereed)
    Abstract [en]

    Objectives This study evaluates whether initiation rates, completion rates, response patterns and prevalence of psychiatric conditions differ by level of personal integrity information given to prospective participants in an online mental health self-report survey.

    Methods A three-arm, parallel-group, single-blind experiment was conducted among students from two Swedish universities. Consenting participants following e-mail invitation answered the World Health Organization (WHO) World Mental Health-International College Student (WMH-ICS) mental health self-report survey, screening for eight psychiatric conditions. Random allocation meant consenting to respond (1) anonymously; (2) confidentially, or (3) confidentially, where the respondent also gave consent for collection of register data.

    Results No evidence was found for overall between-group differences with respect to (1) pressing a hyperlink to the survey in the invitation email; and (2) abandoning the questionnaire before completion. However, participation consent and self-reported depression were in the direction of higher levels for the anonymous group compared to the two confidential groups.

    Conclusions Consent to participate is marginally affected by different levels of personal integrity information. Current standard participant information procedures may not engage participants to read the information thoroughly, and online self-report mental health surveys may reduce stigma and thus be less subject to social desirability bias.

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  • 15.
    Andersson, Claes
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Department of Criminology, Malmö University, Malmö, Sweden..
    Bendtsen, Marcus
    Molander, Olof
    Granlund, Lilian
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Topooco, Naira
    Engström, Karin
    Lindfors, Petra
    Berman, Anne H.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet.;Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden..
    Associations between compliance with covid-19 public health recommendations and perceived contagion in others: a self-report study in Swedish university students2021In: BMC Research Notes, E-ISSN 1756-0500, Vol. 14, article id 429Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: During the COVID pandemic, government authorities worldwide have tried to limit the spread of the virus. Sweden's distinctive feature was the use of voluntary public health recommendations. Few studies have evaluated the effectiveness of this strategy. Based on data collected in the spring of 2020, this study explored associations between compliance with recommendations and observed symptoms of contagion in others, using self-report data from university students.

    RESULTS: Compliance with recommendations ranged between 69.7 and 95.7 percent. Observations of moderate symptoms of contagion in "Someone else I have had contact with" and "Another person" were markedly associated with reported self-quarantine, which is the most restrictive recommendation, complied with by 81.2% of participants. Uncertainty regarding the incidence and severity of contagion in cohabitants was markedly associated with the recommendation to avoid public transportation, a recommendation being followed by 69.7%. It is concluded that students largely followed the voluntary recommendations implemented in Sweden, suggesting that coercive measures were not necessary. Compliance with recommendations were associated with the symptoms students saw in others, and with the perceived risk of contagion in the student's immediate vicinity. It is recommended that voluntary recommendations should stress personal relevance, and that close relatives are at risk.

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  • 16.
    Andersson, Claes
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Department of Criminology, Malmö university, Malmö, Sweden.
    Bendtsen, Marcus
    Department of Health, Medicine and Caring Sciences, Linköping university, Linköping, Sweden.
    Molander, Olof
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden.
    Lindner, Philip
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden.
    Granlund, Lilian
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Topooco, Naira
    Department of Behavioural Sciences and Learning, Linköping university, Linköping, Sweden.
    Engström, Karin
    Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
    Lindfors, Petra
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Berman, Anne H.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden.
    Academic self-efficacy: Associations with self-reported COVID-19 symptoms, mental health, and trust in universities’ management of the pandemic-induced university lockdown2022In: Journal of American College Health, ISSN 0744-8481, E-ISSN 1940-3208, p. 1-6Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate perceived changes in academic self-efficacy associated with self-reported symptoms of COVID-19, changes in mental health, and trust in universities’ management of the pandemic and transition to remote education during lockdown of Swedish universities in the spring of 2020. Methods: 4495 participated and 3638 responded to self-efficacy questions. Associations were investigated using multinomial regression. Results: Most students reported self-experienced effects on self-efficacy. Lowered self-efficacy was associated with symptoms of contagion, perceived worsening of mental health and low trust in universities’ capacity to successfully manage the lockdown and transition to emergency remote education. Increased self-efficacy was associated with better perceived mental health and high trust in universities. Conclusion: The initial phase of the pandemic was associated with a larger proportion of students reporting self-experienced negative effects on academic self-efficacy. Since self-efficacy is a predictor of academic performance, it is likely that students’ academic performance will be adversely affected.

  • 17.
    Andersson, Erik
    et al.
    Karolinska Inst, Dept Clin Neurosci, Div Psychol, Stockholm, Sweden.;Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Hedman, Erik
    Karolinska Inst, Dept Clin Neurosci, Div Psychol, Stockholm, Sweden.;Karolinska Inst, Dept Clin Neurosci, Osher Ctr Integrat Med, Stockholm, Sweden..
    Enander, Jesper
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Djurfeldt, Diana Radu
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Ljotsson, Brjann
    Karolinska Inst, Dept Clin Neurosci, Div Psychol, Stockholm, Sweden..
    Cervenka, Simon
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Isung, Josef
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Svanborg, Cecilia
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Mataix-Cols, David
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Kaldo, Viktor
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Andersson, Gerhard
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden.;Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden..
    Lindefors, Nils
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Ruck, Christian
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    D-Cycloserine vs Placebo as Adjunct to Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder and Interaction With Antidepressants A Randomized Clinical Trial2015In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 72, no 7, p. 659-667Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE It is unclear whether D-cycloserine (DCS), a partial N-methyl-D-aspartate agonist that enhances fear extinction, can augment the effects of exposure-based cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD). OBJECTIVES To examine whether DCS augments the effects of CBT for OCD and to explore (post hoc) whether concomitant antidepressant medication moderates the effects of DCS. DESIGN, SETTING, AND PARTICIPANTS A 12-week, double-blind randomized clinical trial with 3-month follow-up conducted at an academic medical center between September 4, 2012, and September 26, 2013. Participants included 128 adult outpatients with a primary diagnosis of OCD and a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of 16 or higher. Concurrent antidepressant medication was permitted if the dose had been stable for at least 2 months prior to enrollment and remained unchanged during the trial. The main analysis was by intention-to-treat population. INTERVENTIONS All participants received a previously validated Internet-based CBT protocol over 12 weeks and were randomized to receive either 50 mg of DCS or placebo, administered 1 hour before each of 5 exposure and response prevention tasks. MAIN OUTCOMES AND MEASURES Clinician-administered Y-BOCS score at week 12 and at 3-month follow-up. Remission was defined as a score of 12 or lower on the Y-BOCS. RESULTS In the primary intention-to-treat analyses, DCS did not augment the effects of CBT compared with placebo (mean [SD] clinician-rated Y-BOCS score, DCS: 13.86 [6.50] at week 12 and 12.35 [7.75] at 3-month follow-up; placebo: 11.77 [5.95] at week 12 and 12.37 [6.68] at 3-month follow-up) but showed a significant interaction with antidepressants (clinician-rated Y-BOCS, B = -1.08; Z = -2.79; P = .005). Post hoc analyses revealed that antidepressants significantly impaired treatment response in the DCS group but not the placebo group, at both posttreatment and follow-up (clinician-rated Y-BOCS: t(62) = -3.00; P = .004; and t(61) = -3.49; P < .001, respectively). In the DCS group, a significantly greater proportion of antidepressant-free patients achieved remission status at follow-up (60% [95% CI, 45%-74%]) than antidepressant-medicated patients (24% [95% CI, 9%-48%]) (P = .008). Antidepressants had no effect in the placebo group (50% [95% CI, 36%-64%] remission rate in both groups). CONCLUSIONS AND RELEVANCE The findings suggest that antidepressants may interact with DCS to block its facilitating effect on fear extinction. Use of DCS may be a promising CBT augmentation strategy but only in antidepressant-free patients with OCD.

  • 18.
    Andersson, Gerhard
    et al.
    Linkoping Univ, S-58183 Linkoping, Sweden.
    Carlbring, Per
    Stockholm Univ, S-10691 Stockholm, Sweden.
    Holmes, Emily A.
    MRC Cognit & Brain Sci Unit, Cambridge, England.
    Special Issue in Honour of Lars-Goran Ost2013In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 42, no 4, p. 259-259Article in journal (Other academic)
  • 19.
    Andersson, Gerhard
    et al.
    Linkoping Univ, Dept Behav Sci & Learning, SE-58183 Linkoping, Sweden;Linkoping Univ, Swedish Inst Disabil Res, SE-58183 Linkoping, Sweden;Karolinska Inst, Dept Clin Neurosci, Psychiat Sect, Stockholm, Sweden.
    Holmes, Emily A.
    MRC Cognit & Brain Sci Unit, Cambridge, England.
    Carlbring, Per
    Stockholm Univ, Dept Psychol, S-10691 Stockholm, Sweden.
    Lars-Goran Ost2013In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 42, no 4, p. 260-264Article in journal (Refereed)
    Abstract [en]

    Lars-Goran ost is one of the most eminent clinical researchers in the field of cognitive behaviour therapy (CBT) and a founder of CBT in Sweden. He has recently retired from his position as professor in clinical psychology at Stockholm University, Sweden. In this paper, we sketch a brief description of the body of work by ost. Examples of his innovative and pioneering new treatment methods include the one-session treatment for specific phobias, as well as applied relaxation for a range of anxiety disorders and health conditions. While ost remains active in the field, he has contributed significantly to the development and dissemination of CBT in Sweden as well as in the world.

  • 20.
    Andersson, Mathias
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Department of Game Design.
    Teinler, Emelie
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Department of Game Design.
    “Oh I died… Let’s play again!”: Permanent Death in Single-Player Games2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In recent years, there has been an increased popularity in games with permanent death. This thesis investigates what mechanics makes the player return after continuously losing in permanent death games. The mechanics of four bestselling games featuring permanent death, which implies the complete restart of the game each time the player avatar dies, are played for six hours and analysed. The games analysed are Binding of Isaac: Rebirth, Spelunky, Rogue Legacy and Don‟t Starve.  

    Based on the mechanics found in the games and using Raph Kosters definition of fun, “if games stop teaching us they become boring”, it is established that a number of different reasons exist to bring a player back, not just necessarily only the mechanics themselves.

  • 21.
    Andersson, Sanna
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Gerbrand, Anton
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Låt inte stress hindra dig!: Hur övningar i perspektivtagande inspirerade av ACT kan öka psykologisk flexibilitet i arbetslivet samt minska stressresponsens skadeverkningar2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Stressade medarbetare kostar pengar, sänker produktivitet och bidrar till ohälsa. Genom perspektivtagande kan vi ändra förhållningssätt till vårt psykologiska innehåll. ”Självet-som-kontext” ingår i ”psykologisk flexibilitet” och innebär att ta perspektiv till sitt psykologiska innehåll. ”Prosocialt hjälpbeteende” är att ta ett nytt perspektiv till andra. Vår studie undersöker om interventioner i självet-som-kontext och prosocialt hjälpbeteende har effekt på psykologisk flexibilitet i arbetslivet, självupplevd stress samt självet-som-kontext. Även sambandet mellan beroendevariablerna undersöktes. Vi använde en mixad AB-design med intervention. Resultatet visade på minskad självupplevd stress (p=.005) utan effekt av interventionerna (p=.771). Vi fann skillnad mellan interventionerna på psykologisk flexibilitet i arbetslivet (p=.037), men förändringen var inte signifikant (p=.597) Effektstorleken för samtliga skillnader var låg (η2p = .1). Samtliga beroendevariabler korrelerar signifikant (p=<.001).

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  • 22.
    Arving, Cecilia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness.
    Assmus, Jörg
    Thormodsen, Inger
    Berntsen, Sveinung
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness.
    Nordin, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness.
    Early rehabilitation of cancer patients: An individual randomized stepped-care stress-management intervention.2019In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 28, no 2, p. 301-308Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the effects of an individual stepped-care stress-management intervention for cancer patients on cancer-related stress reactions (intrusion/avoidance), and secondarily on psychological distress (anxiety/depression) and emotional reactivity (impatience/hostility).

    METHODS: Consecutively 291 cancer patients were included in a randomized controlled intervention study. Patients randomized to the intervention who did not report clinically significant stress levels (n = 72) after the first counseling session participated in only one counseling session and a follow-up (Step 1). The remaining patients (n = 66) received an additional three to eight sessions, depending on individual needs (Step 2). The intervention used techniques derived from cognitive behavioral therapy (CBT) such as daily registration of events and behaviors as well as scheduled behavioral and physical activity, along with short relaxation exercises. The intervention was completed within 26 weeks of inclusion. The Impact of Event Scale, Hospital Anxiety and Depression Scale, and Everyday Life Stress Scale were used to evaluate effects for 2 years.

    RESULTS: The linear mixed effects model analysis showed a difference between the randomization groups in favor of the intervention for avoidance and intrusion after the first 6 weeks (P = 0.001 and P = 0.003) and for emotional reactivity after 17 weeks (P = 0.007). There were no differences in psychological distress. Decreases in cancer-related stress reactions and depression were noted for the Step 2 intervention.

    CONCLUSIONS: An individual stepped-care stress-management intervention for cancer patients, performed by specially educated health professionals using techniques derived from CBT, seems beneficial for cancer patients and may therefore be a realistic complement to routine cancer care.

  • 23.
    Asplund, Robert Persson
    et al.
    Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden.;Linköping Univ, Dept Behav Sci & Learning, Campus Valla,I huset,3, S-58183 Linköping, Sweden..
    Asplund, Sofia
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    von Buxhoeveden, Helene
    Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden..
    Delby, Hanna
    Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden..
    Eriksson, Karin
    Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden..
    Gerhardsson, Maurits Svenning
    Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden..
    Palm, Joachim
    Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden..
    Skyttberg, Thea
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Torstensson, Julia
    Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden..
    Ljotsson, Brjann
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Carlbring, Per
    Stockholm Univ, Dept Psychol, Stockholm, Sweden..
    Andersson, Gerhard
    Linköping Univ, Dept Behav Sci & Learning, Linköping, Sweden.;Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden..
    Work-Focused Versus Generic Internet-Based Interventions for Employees With Stress-Related Disorders: Randomized Controlled Trial2023In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 25, article id e34446Article in journal (Refereed)
    Abstract [en]

    Background: In recent decades, stress-related disorders have received more attention, with an increasing prevalence, especially within the working population. The internet provides new options for broad dissemination, and a growing body of evidence suggests that web-based interventions for stress might be effective. However, few studies have examined the efficacy of interventions in clinical samples and work-related outcomes.

    Objective: The aim of this study was to evaluate the efficacy of an internet-based cognitive behavioral intervention for stress-related disorders integrating work-related aspects (work-focused and internet-based cognitive behavioral therapy [W-iCBT]), compared with a generic internet-based cognitive behavioral therapy (iCBT) group and a waitlist control (WLC) group.

    Methods: In this trial, 182 employees, mainly employed in the health care, IT, or educational sector, who fulfilled the criteria for a stress-related disorder, were randomized to a 10-week W-iCBT (n=61, 33.5%), generic iCBT (n=61, 33.5%), or WLC (n=60, 33%). Self-rated questionnaires on perceived stress, burnout, exhaustion, and other mental health- and work-related outcomes were administered before and after the treatment and at 6- and 12-month follow-ups.

    Results: Compared with the WLC group, participants of the W-iCBT and iCBT groups showed an equal and significant reduction in the primary outcome (Shirom-Melamed Burnout Questionnaire [SMBQ]) from pretreatment to posttreatment assessment (Cohen d=1.00 and 0.83, respectively) and at the 6-month follow-up (Cohen d=0.74 and 0.74, respectively). Significant moderate-to-large effect sizes were also found in the secondary health- and work-related outcomes. The W-iCBT was the only group that exhibited significant effects on work ability and short-term sickness absence. Short-term sickness absence was 445 days lower than the WLC group and 324 days lower than the iCBT intervention group. However, no significant differences were found in terms of work experience or long-term sick leave.

    Conclusions: The work-focused and generic iCBT interventions proved to be superior compared with the control condition in reducing chronic stress and several other mental health-related symptoms. Interestingly, effects on work ability and short-term sickness absence were only seen between the W-iCBT intervention and the WLC groups. These preliminary results are promising, indicating that treatments that include work aspects may have the potential to accelerate recovery and reduce short-term sickness absence because of stress-related disorders.

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  • 24.
    Asplund, Robert Persson
    et al.
    Linkoping Univ, Dept Behav Sci & Learning, S-58183 Linkoping, Sweden..
    Dagoo, Jesper
    Linkoping Univ, Dept Behav Sci & Learning, S-58183 Linkoping, Sweden..
    Fjellstrom, Ida
    Karolinska Inst, Div Psychol, Dept Clin Neurosci, Stockholm, Sweden..
    Niemi, Linnea
    Karolinska Inst, Div Psychol, Dept Clin Neurosci, Stockholm, Sweden..
    Hansson, Katja
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Zeraati, Forough
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Ziuzina, Masha
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Geraedts, Anna
    Vrije Univ Amsterdam, Dept Clin Psychol, Amsterdam, Netherlands..
    Ljotsson, Brjann
    Karolinska Inst, Div Psychol, Dept Clin Neurosci, Stockholm, Sweden..
    Carlbring, Per
    Stockholms Univ, Dept Psychol, Stockholm, Sweden..
    Andersson, Gerhard
    Linkoping Univ, Dept Behav Sci & Learning, S-58183 Linkoping, Sweden.;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Internet-based stress management for distressed managers: results from a randomised controlled trial2018In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 75, no 2, p. 105-113Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of this randomised controlled trial (RCT) was to evaluate the efficacy of a guided internet-based stress management intervention (iSMI) among distressed managers compared with a attention control group (AC) with full access to treatment-as-usual.

    Method

    A total sample of 117 distressed managers, mainly employed in the healthcare, IT, communication and educational sector, were randomised to either iSMI (n=59) or an AC group (n=58). The iSMI consisted of eight modules including cognitive behavioural stress management and positive management techniques. Participants received a minimal and weekly guidance from a psychologist or master-level psychology student focusing on support, feedback and adherence to the intervention. Self-report data were assessed at pre, post and 6 months after the intervention. The primary outcome was perceived stress (Perceived Stress Scale-14). The secondary outcomes included mental and work-related health outcomes.

    Results

    Participants in the iSMI intervention reported significantly less symptoms of perceived stress (d=0.74, 95% CI 0.30 to 1.19) and burnout (d=0.95, 95% CI 0.53 to 1.37) compared with controls, at postassessment. Significant medium-to-large effect sizes were also found for depression, insomnia and job satisfaction. Longterm effects (6 months) were seen on the mental health outcomes.

    Conclusion

    This is one of the first studies showing that iSMIs can be an effective, accessible and potentially time-effective approach of reducing stress and other mental-related and work-related health symptoms among distressed managers. Future studies are needed addressing distressed managers and the potential of indirect effects on employee stress and satisfaction at work.

  • 25.
    Aucouturier, Jean-Julien
    et al.
    Univ Paris 06, IRCAM, CNRS, STMS,UMR9912, F-74005 Paris, France..
    Johansson, Petter
    Uppsala University, The Swedish Collegium for Advanced Study in the Social Sciences (SCASSS). Lund Univ, Lund Univ Cognit Sci, S-22100 Lund, Sweden..
    Hall, Lars
    Lund Univ, Lund Univ Cognit Sci, S-22100 Lund, Sweden..
    Segnini, Rodrigo
    Siemens Healthcare, Tokyo 1418644, Japan..
    Mercadie, Lolita
    Nippon Telegraph & Tel NTT Corp, Commun Sci Labs, Yokohama, Kanagawa 2430198, Japan.;Univ Bourgogne, CNRS, LEAD, UMR5022, F-21000 Dijon, France..
    Watanabe, Katsumi
    Waseda Univ, Fac Sci & Engn, Dept Intermedia Art & Sci, Tokyo 1698555, Japan.;Univ Tokyo, Res Ctr Adv Sci & Technol, Tokyo 1538904, Japan..
    Covert digital manipulation of vocal emotion alter speakers' emotional states in a congruent direction2016In: Proceedings of the National Academy of Sciences of the United States of America, ISSN 0027-8424, E-ISSN 1091-6490, Vol. 113, no 4, p. 948-953Article in journal (Refereed)
    Abstract [en]

    Research has shown that people often exert control over their emotions. By modulating expressions, reappraising feelings, and redirecting attention, they can regulate their emotional experience. These findings have contributed to a blurring of the traditional boundaries between cognitive and emotional processes, and it has been suggested that emotional signals are produced in a goal-directed way and monitored for errors like other intentional actions. However, this interesting possibility has never been experimentally tested. To this end, we created a digital audio platform to covertly modify the emotional tone of participants' voices while they talked in the direction of happiness, sadness, or fear. The result showed that the audio transformations were being perceived as natural examples of the intended emotions, but the great majority of the participants, nevertheless, remained unaware that their own voices were being manipulated. This finding indicates that people are not continuously monitoring their own voice to make sure that it meets a predetermined emotional target. Instead, as a consequence of listening to their altered voices, the emotional state of the participants changed in congruence with the emotion portrayed, which was measured by both self-report and skin conductance level. This change is the first evidence, to our knowledge, of peripheral feedback effects on emotional experience in the auditory domain. As such, our result reinforces the wider framework of self-perception theory: that we often use the same inferential strategies to understand ourselves as those that we use to understand others.

  • 26.
    Axelsson, Anton
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Knowledge elicitation as abstraction of purposive behaviour2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Researchers use knowledge elicitation methods to document expert knowledge for the primary purpose of understanding cognitive processes and with this understanding, technical solutions to resolve human factors issues can be produced. This dissertation offers a novel perspective on knowledge elicitation as an abstraction process. Such a theoretical framework has emerged by consolidating the ecological approach of Brunswikian psychology with the ideas of tacit and personal knowledge of Polanyian epistemology. Traditionally, knowledge elicitation has been considered an extraction process in which knowledge can be readily transferred from one individual to another. Here, this traditional position is rejected in favour of Polanyi’s premise that much of the knowledge individuals possess is tacit in nature, which implies that it cannot be documented easily, expressed in explicit form or explained. In this dissertation, knowledge is characterised as a personal process of knowing, highlighting context as a subjective knowledge structure of personal experiences that is formulated implicitly and indirectly over time through a dynamic interaction with the environment. Therefore, tacit knowledge cannot be articulated or shared; however, learners can be inspired by observing other individuals' purposive (i.e., goal-directed) behaviours and thus shape their own tacit knowledge once they practise the observed skills and develop conceptual understanding through reasoning about the learning process. Knowledge elicitation thereby makes use of observations, questions, or more structured process tracing methods in environments familiar to the observed individuals to elicit purposive behaviour from them. Accordingly, functional descriptions can be produced in this process that further conceptual understanding of a particular domain. Knowledge elicitation procedures are a powerful set of methods for reaching such functional descriptions. Moreover, by understanding the resulting knowledge elicitation data as an abstraction derived from multiple collection points in the same environment, the focus shifts from purely subjective mental constructs to the impact of environmental constraints.

    List of papers
    1. Eliciting strategies in revolutionary design: exploring the hypothesis of predefined strategy categories
    Open this publication in new window or tab >>Eliciting strategies in revolutionary design: exploring the hypothesis of predefined strategy categories
    2018 (English)In: Theoretical Issues in Ergonomics Science, ISSN 1463-922X, E-ISSN 1464-536X, Vol. 19, no 1, p. 101-117Article in journal (Refereed) Published
    Abstract [en]

    Introducing automation in a human-machine system changes the tasks performed by human operators. It is difficult to analyse systems for which there are no experienced operators. This issue emerged within a project with the aim to develop a human–machine interface for a highly automated long-haul vehicle. To handle the problem, a formative strategies analysis method with promises to enable desktop analyses through predefined strategy categories was adopted. The method was used to investigate strategies for controlling the future long haul vehicle by conducting workshops with today's drivers. The method was shown to be a valuable asset in eliciting strategies for revolutionary design.

    Keywords
    Cognitive work analysis, strategies analysis, automation, revolutionary systems design, long haul trucks
    National Category
    Human Computer Interaction
    Identifiers
    urn:nbn:se:uu:diva-292799 (URN)10.1080/1463922X.2017.1278805 (DOI)000428728900006 ()
    Projects
    MODAS
    Funder
    VINNOVA, 2012-03678
    Available from: 2017-01-27 Created: 2016-05-09 Last updated: 2020-01-08Bibliographically approved
    2. Collegial verbalisation — the value of an independent observer: an ecological approach
    Open this publication in new window or tab >>Collegial verbalisation — the value of an independent observer: an ecological approach
    2015 (English)In: Theoretical Issues in Ergonomics Science, ISSN 1463-922X, E-ISSN 1464-536X, Vol. 16, no 5, p. 474-494Article in journal (Refereed) Published
    National Category
    Human Computer Interaction Psychology (excluding Applied Psychology)
    Identifiers
    urn:nbn:se:uu:diva-249009 (URN)10.1080/1463922X.2015.1027322 (DOI)000212945700002 ()
    Available from: 2015-04-07 Created: 2015-04-09 Last updated: 2021-06-08Bibliographically approved
    3. On the importance of mental time frames: A case for the need of empirical methods to investigate adaptive expertise
    Open this publication in new window or tab >>On the importance of mental time frames: A case for the need of empirical methods to investigate adaptive expertise
    2018 (English)In: Journal of Applied Research in Memory and Cognition, ISSN 2211-3681, E-ISSN 2211-369X, Vol. 7, no 1, p. 51-59Article in journal (Refereed) Published
    National Category
    Human Computer Interaction
    Identifiers
    urn:nbn:se:uu:diva-352734 (URN)10.1016/j.jarmac.2017.12.004 (DOI)000429489400010 ()
    Funder
    Swedish Transport Administration
    Available from: 2018-03-03 Created: 2018-06-07 Last updated: 2019-01-09Bibliographically approved
    4. Experience and Visual Expertise: A First Look at Eye Behaviour in Train Traffic Control
    Open this publication in new window or tab >>Experience and Visual Expertise: A First Look at Eye Behaviour in Train Traffic Control
    (English)In: Article in journal (Refereed) Submitted
    Abstract [en]

    The present study investigated differences in visual expertise across levels of proficiency in train traffic control during a simulated scenario. Eye tracking metrics found to correlate with expertise reported in a meta-analysis on visual expertise were used. The aim of the study was to investigate whether the same results found in the meta-study could be obtained in the less controlled and dynamic work environment of train traffic control. Studies of this character are rare and also notoriously difficult to conduct due to a high level of potential noise. Results of the study indicates that eye behaviour seemed to correlate with years of experience also in a more naturalistic setting, but it did not correlate with expert ranking by instructors or a post-hoc measure of proactivity in task performance. A discussion is provided where a delineation of experience and expertise is made in light of differences between eye movement behaviour and cognitive aspects of problem-solving.

    Keywords
    visual expertise, eye tracking, experience, train traffic control, rail human factors
    National Category
    Human Computer Interaction
    Identifiers
    urn:nbn:se:uu:diva-372696 (URN)
    Funder
    Swedish Transport Administration
    Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-09
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  • 27.
    Axelsson, Anton
    et al.
    Lund University Cognitive Science.
    Anderberg, Erik
    Lund University Cognitive Science.
    Haake, Magnus
    Lund University Cognitive Science.
    Can preschoolers profit from a teachable agent based play-and-learn game in mathematics?2013In: Artificial Intelligence in Education: 16th International Conference, AIED 2013, Memphis, TN, USA, July 9-13, 2013. Proceedings / [ed] H. C. Lane, K. Yacef, J. Mostow & P. Pavlik, Springer Berlin/Heidelberg, 2013, Vol. 7926 LNAI, p. 289-298Conference paper (Refereed)
    Abstract [en]

    A large number of studies carried out on pupils aged 8-14 have shown that teachable agent (TA) based games are beneficial for learning. The present pioneering study aimed to initiate research looking at whether TA based games can be used as far down as preschool age. Around the age of four, theory of mind (ToM) is under development and it is not unlikely that a fully developed ToM is necessary to benefit from a TA’s socially engaging characteristics. 10 preschool children participated in an experiment of playing a mathematics game. The participants playing a TA-version of the game engaged socially with the TA and were not disturbed by his presence. Thus, this study unveils exciting possibilities for further research of the hypothesised educational benefits in store for preschoolers with regard to play-and-learn games employing TAs. 

  • 28.
    Axelsson, Carl-Anton Werner
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Educational Sciences, Department of Education.
    Jansson, Anders
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Exploring visual maturity: A first look at eye behavior in train traffic control2022In: Journal of Expertise, ISSN 2573-2773, Vol. 5, no 2-3, p. 58-71Article in journal (Refereed)
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  • 29.
    Axford, Nick
    et al.
    University of Plymouth.
    Bjornstad, Gretchen
    University of Exeter Medical School.
    Matthews, Justin
    University of Exeter.
    Heilmann, Sarah
    Erasmus University Rotterdam.
    Raja, Anam
    University of Oxford.
    Ukoumunne, Obioha
    University of Exeter.
    Berry, Vashti
    University of Exeter.
    Wilkinson, Tom
    Devon Partnership NHS Trust.
    Timmons, Luke
    Stand Together.
    Hobbs, Tim
    Dartington Service Design Lab.
    Eames, Tim
    University of Exeter.
    Kallitsoglou, Angeliki
    University of Roehampton.
    Blower, Sarah
    University of York.
    Warner, Georgina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    The effectiveness of a therapeutic parenting program for children aged 6–11 years with behavioral or emotional difficulties: Results from a randomized controlled trial2020In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 117, article id 105245Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of the study was to evaluate the implementation and effectiveness of a therapeutic parenting program that targets parents of children aged 6 to 11 years identified as having behavioral and emotional difficulties. The intervention comprises two parts, delivered sequentially: a 10–12-week group-based program for all parents, and one-to-one sessions for up to 12 weeks with selected parents from the group-based element.

    Methods/Design

    In a randomized controlled trial, 264 participants were allocated to the Inspiring Futures program (intervention) or services as usual (control) arms with follow-up assessments at 16 (post-group program) and 32 (post-one-to-one sessions) weeks. The primary outcome was the parent-rated Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score at 32 weeks. Secondary outcomes included parent-rated SDQ subscales, parent coping strategies, empathy in parenting and parenting skills.

    Results

    All 264 participants were included in outcome analyses. There was no statistically significant effect on SDQ Total Difficulties (standardized mean difference: −0.07; 95% CI: −0.30 to 0.16; p = 0.54). There were no sub-group effects. Only 1 of 40 comparisons between the trial arms for secondary outcomes across both follow-ups was statistically significant at the 5% level. The mean number of group sessions attended by intervention arm participants was 6.1 (out of 10 to 12) and only 1 in 20 intervention arm participants received one-to-one support. Independent observation indicated scope to improve fidelity in terms of adherence, quality and participant responsiveness.

    Conclusions

    The intervention is not more effective than services as usual at improving targeted outcomes. This may be related, in part, to implementation issues but arguably more to the inability of a non-behavioral intervention to improve caregiving adequately, particularly when it is not targeted at new parents who have experienced trauma or deprivation early in life or subsequently.

  • 30.
    Axford, Nick
    et al.
    University of Plymouth.
    Bjornstad, Gretchen
    University of Exeter Medical School.
    Matthews, Justin
    University of Exeter.
    Whybra, Laura
    Dartington Service Design Lab.
    Berry, Vashti
    University of Exeter.
    Ukoumunne, Obioha
    University of Exeter.
    Hobbs, Tim
    Dartington Service Design Lab.
    Wrigley, Zoe
    Cardiff University.
    Brook, Lucy
    Devon Partnership NHS Trust.
    Taylor, Rod
    University of Exeter Medical School.
    Eames, Tim
    University of Exeter Medical School.
    Kallitsoglou, Angeliki
    University of Roehampton.
    Blower, Sarah
    University of York.
    Warner, Georgina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    The Effectiveness of a Community-Based Mentoring Program for Children Aged 5–11 Years: Results from a Randomized Controlled Trial2020In: Prevention Science, ISSN 1389-4986, E-ISSN 1573-6695Article in journal (Refereed)
    Abstract [en]

    The study, a two-arm, randomized controlled, parallel group, superiority trial, aimed to evaluate the implementation and effectiveness of a 12-month one-to-one volunteer mentoring program designed to improve behavioral and emotional outcomes in children aged 5 to 11 years who have teacher- and parent/carer-reported behavioral difficulties. Participants were 246 children (123 intervention, 123 control; mean age 8.4 years; 87% boys) in five sites in London, UK, scoring in the “abnormal” range on the teacher-rated Strengths and Difficulties Questionnaire (SDQ) Total Difficulties measure and in the “borderline” or abnormal range on the parent-rated SDQ Total Difficulties measure. Randomization on a 1:1 ratio took place using a computer-generated sequence and stratifying by site. Data collectors and statisticians were blind to participant allocation status. Outcome measures focused on parent- and teacher-rated child behavior and emotions, and child-rated self-perception and hope. Intention-to-treat analysis on all 246 randomized participants (using imputed data where necessary) showed that at post-intervention (16 months after randomization), there were no statistically significant effects on the primary outcome—parent-rated SDQ Total Difficulties (adjusted standardized mean difference = − 0.12; 95% CI: −0.38 to 0.13; p = 0.33)—or any secondary outcomes. Results from complier average causal effect (CACE) analysis using the primary outcome indicated the intervention was not effective for children who received the recommended duration of mentoring. Exploratory analyses found no sub-group effects on the primary outcome. The article concludes that the mentoring program had no effect on children’s behavior or emotional well-being, and that program content needs revising to satisfactorily address key risk and protective factors.

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  • 31. Axford, Nick
    et al.
    Warner, Georgina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Hobbs, Tim
    Heilmann, Sarah
    Raja, Anam
    Berry, Vashti
    Ukoumunne, Obioha C
    Matthews, Justin
    Eames, Tim
    Kallitsoglou, Angeliki
    Blower, Sarah
    Wilkinson, Tom
    Timmons, Luke
    Bjornstad, Gretchen
    The effectiveness of the Inspiring Futures parenting programme in improving behavioural and emotional outcomes in primary school children with behavioural or emotional difficulties: study protocol for a randomised controlled trial.2018In: BMC Psychology, E-ISSN 2050-7283, Vol. 6, no 1, article id 3Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a need to build the evidence base of early interventions promoting children's health and development in the UK. Malachi Specialist Family Support Services ('Malachi') is a voluntary sector organisation based in the UK that delivers a therapeutic parenting group programme called Inspiring Futures to parents of children identified as having behavioural and emotional difficulties. The programme comprises two parts, delivered sequentially: (1) a group-based programme for all parents for 10-12 weeks, and (2) one-to-one sessions with selected parents from the group-based element for up to 12 weeks.

    METHODS/DESIGN: A randomised controlled trial will be conducted to evaluate Malachi's Inspiring Futures parenting programme. Participants will be allocated to one of two possible arms, with follow-up measures at 16 weeks (post-parent group programme) and at 32 weeks (post-one-to-one sessions with selected parents). The sample size is 248 participants with a randomisation allocation ratio of 1:1. The intervention arm will be offered the Inspiring Futures programme. The control group will receive services as usual. The aim is to determine the effectiveness of the Inspiring Futures programme on the primary outcome of behavioural and emotional difficulties of primary school children identified as having behavioural or emotional difficulties.

    DISCUSSION: This study will further enhance the evidence for early intervention parenting programmes for child behavioural and emotional problems in the UK.

    TRIAL REGISTRATION: Current Controlled Trials ISRCTN32083735 . Retrospectively registered 28 October 2014.

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  • 32. Baglioni, Chiara
    et al.
    Altena, Ellemarije
    Bjorvatn, Bjørn
    Blom, Kerstin
    Bothelius, Kristoffer
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Devoto, Alessandra
    Espie, Colin A.
    Frase, Lukas
    Gavriloff, Dimitri
    Tuuliki, Hion
    Hoflehner, Andrea
    Högl, Birgit
    Holzinger, Brigitte
    Järnefelt, Heli
    Jernelöv, Susanna
    Johann, Anna F.
    Lombardo, Caterina
    Nissen, Christoph
    Palagini, Laura
    Peeters, Geert
    Perlis, Michael L.
    Posner, Donn
    Schlarb, Angelika
    Spiegelhalder, Kai
    Wichniak, Adam
    Riemann, Dieter
    The European Academy for Cognitive Behavioural Therapy for Insomnia: An initiative of the European Insomnia Network to promote implementation and dissemination of treatment2020In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 29, no 2, article id e12967Article in journal (Refereed)
    Abstract [en]

    Insomnia, the most prevalent sleep disorder worldwide, confers marked risks for both physical and mental health. Furthermore, insomnia is associated with considerable direct and indirect healthcare costs. Recent guidelines in the US and Europe unequivocally conclude that cognitive behavioural therapy for insomnia (CBT-I) should be the first-line treatment for the disorder. Current treatment approaches are in stark contrast to these clear recommendations, not least across Europe, where, if any treatment at all is delivered, hypnotic medication still is the dominant therapeutic modality. To address this situation, a Task Force of the European Sleep Research Society and the European Insomnia Network met in May 2018. The Task Force proposed establishing a European CBT-I Academy that would enable a Europe-wide system of standardized CBT-I training and training centre accreditation. This article summarizes the deliberations of the Task Force concerning definition and ingredients of CBT-I, preconditions for health professionals to teach CBT-I, the way in which CBT-I should be taught, who should be taught CBT-I and to whom CBT-I should be administered. Furthermore, diverse aspects of CBT-I care and delivery were discussed and incorporated into a stepped-care model for insomnia.

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  • 33.
    Baraldi, Enrico
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Industrial Engineering & Management.
    Ingemansson Havenvid, Malena
    NTNU, Norway.
    Linné, Åse
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Industrial Engineering & Management.
    Öberg, Christina
    Örebro University and The Ratio Institute, Sweden.
    Start-ups and networks: Interactive perspectives and a research agenda2019In: Industrial Marketing Management, ISSN 0019-8501, E-ISSN 1873-2062, Vol. 80, p. 58-67Article in journal (Other academic)
    Abstract [en]

    This article introduces Industrial Marketing Management's special issue on start-ups and networks. To begin with, we stress the relevance of understanding the context wherein entrepreneurship unfolds – a context filled with social, technical and economic connections to which the start-up needs to relate. We also present and confront three network perspectives which bring different insights to the interplay between start-ups and networks: Social Network (SN) theory, the Industrial Marketing & Purchasing (IMP) view, and Actor-Network Theory (ANT). Next, we introduce the 12 papers of this special issue and place them on a continuum covering a start-up's process of network embedding and including the three periods of establishment, consolidation and stabilization. We conclude with a research agenda suggesting five avenues for further research: (1) tracing start-ups' process of network embedding, (2) mapping the connections between the different networks affecting a start-up, (3) grasping the negative effects of networks on start-ups, (4) making longitudinal case studies on start-ups and networks more comparable via common analytical tools, and (5) investigating how policy influences the complex interplay between start-ups and networks.

  • 34.
    Bartels, Sara Laureen
    et al.
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Johnsson, Sophie, I
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Boersma, Katja
    Örebro Univ, Ctr Hlth & Med Psychol CHAMP, Sch Law Psychol & Social Work, Örebro, Sweden..
    Flink, Ida
    Örebro Univ, Ctr Hlth & Med Psychol CHAMP, Sch Law Psychol & Social Work, Örebro, Sweden..
    McCracken, Lance
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Petersson, Suzanne
    Linnaeus Univ, Dept Med & Optometry, Kalmar, Sweden.;Maastricht Univ, Alzheimer Ctr Limburg, Sch Mental Hlth & Neurosci, Maastricht, Netherlands..
    Christie, Hannah L.
    Maastricht Univ, Dept Psychiat & Neuropsychol, Sch Mental Hlth & Neurosci, Maastricht, Netherlands..
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Simons, Laura E.
    Stanford Univ, Dept Anaesthesiol Perioperat & Pain Med, Sch Med, Stanford, CA USA..
    Onghena, Patrick
    Katholieke Univ Leuven, Res Grp Methods Individual & Cultural Differences, Leuven, Belgium..
    Vlaeyen, Johan W. S.
    Katholieke Univ Leuven, Res Grp Hlth Psychol, Leuven, Belgium.;Maastricht Univ, Res Grp Expt Hlth Psychol, Maastricht, Netherlands..
    Wicksell, Rikard K.
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.;Capio St Goran Hosp, Pain Clin, Stockholm, Sweden..
    Development, evaluation and implementation of a digital behavioural health treatment for chronic pain: study protocol of the multiphase DAHLIA project2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 4, article id e059152Article in journal (Refereed)
    Abstract [en]

    Introduction: Chronic pain affects about 20%-40% of the population and is linked to mental health outcomes and impaired daily functioning. Pharmacological interventions are commonly insufficient for producing relief and recovery of functioning. Behavioural health treatment is key to generate lasting benefits across outcome domains. However, most people with chronic pain cannot easily access evidence-based behavioural interventions. The overall aim of the DAHLIA project is to develop, evaluate and implement a widely accessible digital behavioural health treatment to improve well-being in individuals with chronic pain.

    Methods and analysis: The project follows the four phases of the mHealth Agile Development and Evaluation Lifecycle: (1) development and pre-implementation surveillance using focus groups, stakeholder interviews and a business model; (2) iterative optimisation studies applying single case experimental design (SCED) method in 4-6 iterations with n=10 patients and their healthcare professionals per iteration; (3) a two-armed clinical randomised controlled trial enhanced with SCED (n=180 patients per arm) and (4) interview-based post-market surveillance. Data analyses include multilevel modelling, cost-utility and indicative analyses. In October 2021, inter-sectorial partners are engaged and funding is secured for four years. The treatment content is compiled and the first treatment prototype is in preparation. Clinical sites in three Swedish regions are informed and recruitment for phase 1 will start in autumn 2021. To facilitate long-term impact and accessibility, the treatment will be integrated into a Swedish health platform (www.1177.se), which is used on a national level as a hub for advice, information, guidance and e-services for health and healthcare.

    Ethics and dissemination: The study plan has been reviewed and approved by Swedish ethical review authorities. Findings will be actively disseminated through peer-reviewed journals, conference presentations, social media and outreach activities for the wider public.

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  • 35.
    Bartusch, Cajsa
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Civil and Industrial Engineering, Industrial Engineering and Management.
    Juslin, Peter
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Stikvoort, Britt
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Yang-Wallentin, Fan
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Statistics.
    Öhrlund, Isak
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Civil and Industrial Engineering, Industrial Engineering and Management.
    Opening the black box of demand response: Exploring the cognitive processes2024In: Renewable & sustainable energy reviews, ISSN 1364-0321, E-ISSN 1879-0690, Vol. 189, article id 113925Article in journal (Refereed)
    Abstract [en]

    Evaluations of price-based demand response programs tend to focus on users' electricity use patterns and/or their practical experiences. Less is known about the effects that price-based demand response programs have on cognitive drivers and barriers to energy-using behaviors and habits, or how well these predict timing of households' electricity use. This study seeks to address this gap by evaluating the effects of a mandatory demand-based time-of-use distribution tariff, using electricity-meter and questionnaire data in an intervention and a reference area, and a structural equation model following the theory of planned behavior. Although no effect was found of the tariff on the actual proportion of peak-hour use, there were significant effects on users’ intentions and motivations to shift electricity use to off-peak hours. The absence of effect on the proportion of peak-hour use seems explained by the facts that only a minority of consumers were aware of their tariffs, and by the (at least partially correct) beliefs that consumers used very little electricity and most of it was already used in off-peak hours. The relationships between intentions, drivers and the actual proportion of peak-hour use were stronger in the intervention area, compared to the reference area. Interestingly, this was true not only for the motivation targeted by the tariff, economic savings, but also for sustainability concerns and social norms. This suggests that effects of the tariff may partly run via other non-monetary motivators.

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  • 36.
    Baur, Elena
    et al.
    LWL Massregelvollzugsklin, Herne, Germany..
    Forsman, Mats
    Swedish Prison & Probat Serv, Res & Evaluat Unit, POB 44015, S-10073 Stockholm, Sweden.;Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Långström, Niklas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry. Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm.
    Response to Joyal's (2016) "Linking Crime to Paraphilia: Be Careful with Label"2017In: Archives of Sexual Behavior, ISSN 0004-0002, E-ISSN 1573-2800, Vol. 46, no 4, p. 867-868Article in journal (Other academic)
  • 37.
    Baylis, Rebecca
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ekdahl, Johanna
    Mid Sweden Univ, Dept Psychol, Ostersund, Sweden..
    Haines, Helen
    Univ Melbourne, Dept Rural Hlth, Melbourne, Vic, Australia..
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Obstetrics and Reproductive Health Research. Lund Univ, Fac Med, Dept Hlth Sci, Box 188, S-22100 Lund, Sweden..
    Women's experiences of internet-delivered Cognitive Behaviour Therapy (iCBT) for Fear of Birth2020In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 33, no 3, p. E227-E233Article in journal (Refereed)
    Abstract [en]

    Background: Fear of Birth is common in pregnant women and associated with negative physical and mental health. There is a clear comorbidity with anxiety and depression. Internet-delivered Cognitive Behaviour Therapy has been suggested as a treatment option for Fear of Birth and a randomized controlled trial comparing internet-delivered Cognitive Behaviour Therapy with midwifery led counselling as standard care has been conducted.

    Objective: The aim of this study was to describe women's experiences of guided internet-delivered Cognitive Behaviour Therapy for Fear of Birth and to describe the content of their fear.

    Methods: The present study is a qualitative, follow-up interview study following the randomized controlled trial, the U-CARE Pregnancy Trial. In total 19 women allocated to internet-delivered Cognitive Behaviour Therapy for Fear of Birth were interviewed by telephone. A semi-structured interview guide was used and the transcripts were analyzed with thematic analysis.

    Results: The women's descriptions of Fear of Birth differed, however their fear was most often associated with fear of losing control, fear for the baby's life or health or own life threatening events. The experiences of internet-delivered Cognitive Behaviour Therapy for Fear of Birth varied, some women were positive to its flexibility although most women preferred a face-to face meeting. The treatment did not pin-point their fears, it was challenging to maintain motivation and to work with the treatment in solitude.

    Conclusions: Women's descriptions of Fear of Birth varied. Most women undergoing internet-delivered Cognitive Behaviour Therapy would have preferred a face-to-face meeting which they imagined would have soothed their fear. Internet-delivered Cognitive Behaviour Therapy for Fear of Birth may be an alternative for some women. 

  • 38.
    Beckman, Maria
    et al.
    Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services Stockholm County Council Stockholm Sweden.
    Alfonsson, Sven
    Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services Stockholm County Council Stockholm Sweden.
    Rosendahl, Ingvar
    Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services Stockholm County Council Stockholm Sweden.
    Berman, Anne H.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services Stockholm County Council Stockholm Sweden.
    Lindqvist, Helena
    Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services Stockholm County Council Stockholm Sweden.
    A behaviour-based coding tool for assessing supervisors' adherence and competence: Findings from a motivational interviewing implementation study2022In: Clinical Psychology and Psychotherapy, ISSN 1063-3995, E-ISSN 1099-0879, Vol. 29, no 6, p. 1942-1949Article in journal (Refereed)
    Abstract [en]

    Supervision seems to be an essential part of therapist training and thus also of implementing evidence-based practices. However, there is a shortage of valid and reliable instruments for objective assessment of supervision competence that include both global measures and frequency counts of behaviour—two essential aspects of supervisory competence. This study tests the internal consistency and inter-rater reliability of an assessment tool that includes both these measures. Additionally, strategies and techniques used by 10 supervisors in 35 Motivational interviewing supervision sessions are described. Codings were conducted after two separate coding training sessions. The internal consistency across the global measures was acceptable (α = 0.70; 0.71). After the second training, the inter-rater reliabilities for all frequency counts were in the moderate to good range, except for two that were in the poor range; inter-rater reliability for one of the four global measures was in the moderate range, and three were in the poor range. A prerequisite for identifying specific supervisor skills central to the development of therapist skills, teaching these skills to supervisors and performing quality assurance of supervision, is to create instruments that can measure these behaviours. This study is a step in that direction.

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  • 39.
    Beier, Susanne
    et al.
    Heidelberg University.
    Eib, Constanze
    Stockholm University.
    Oehmann, Verena
    Heidelberg University.
    Fiedler, Peter
    Heidelberg University.
    Fiedler, Klaus
    Heidelberg University.
    Influence of judges’ behaviors on perceived procedural justice2014In: Journal of Applied Social Psychology, ISSN 0021-9029, E-ISSN 1559-1816, Vol. 44, no 1, p. 46-59Article in journal (Refereed)
    Abstract [en]

    The influence of judges’ behavior on procedural justice was analyzed in a field study, observing the judges’ behavior during n = 129 trials and assessing the defendants’ and the audiences’ justice perceptions. The observed judicial behavior was unrelated to the defendants’ justice perceptions. However, the more respectful the judge treated the defendants, the fairer the audience perceived the trial. In general, the effect size of the relationship between observational measures and subjective justice ratings was small in comparison to the relationship within defendants’ or audiences’ ratings. There were striking differences in the justice perception between the two data sources, namely defendants and audience. Thus, the source matters and, to avoid a same-source bias, should be taken into account when analyzing justice perceptions.

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  • 40.
    Bendelin, Nina
    et al.
    Linkoping Univ, Pain & Rehabil Ctr, SE-58185 Linkoping, Sweden..
    Björkdahl, Pär
    Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden..
    Risell, Mimmi
    Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden..
    Nelson, Karin Zetterqvist
    Linkoping Univ, Dept Themat Studies Child Studies, Linkoping, Sweden..
    Gerdle, Björn
    Linkoping Univ, Pain & Rehabil Ctr, SE-58185 Linkoping, Sweden..
    Andersson, Gerhard
    Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden.;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Buhrman, Monica
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Patients' experiences of internet-based Acceptance and commitment therapy for chronic pain: a qualitative study2020In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 21, article id 212Article in journal (Refereed)
    Abstract [en]

    Background: Chronic pain is a globally widespread condition with complex clusters of symptoms within a heterogeneous patient group. Internet-delivered Acceptance and Commitment Therapy (IACT) has shown promising results in the treatment of chronic pain. How IACT is experienced by patients is less well known. Qualitative studies of patients' experiences are needed to further understand factors behind both engagement and negative effects. The aim of this study was to explore how IACT was experienced by chronic pain patients who had participated in a controlled trial.

    Methods: Through an open and exploratory approach this study aimed to investigate how IACT was experienced when delivered as a guided self-help program to persons with chronic pain. Eleven participants were interviewed over telephone after completing IACT.

    Results: Qualitative analysis based on grounded theory resulted in 2 core categories and 8 subcategories. In treatment: Physical and cognitive restraints, Time and deadline, Therapist contact, and Self-confrontation. After treatment: Attitude to pain, Image of pain, Control or Command, and Acting with pain. Individual differences as well as specific conditions of the treatment may explain variations in how the treatment was approached, experienced and what consequences it led to. Therapist guidance and deadlines for homework play complex roles in relation to autonomy and change.

    Conclusions: Adjusting treatment content and format based on participants' characteristics, such as expectations, motivation and restraints, might positively affect engagement, autonomy and change. Further research on attrition and negative effects of treatment might clarify what enables chronic pain patients to benefit from IACT.

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  • 41.
    Berg, Ida
    et al.
    Stockholm Univ, Dept Psychol, Stockholm, Sweden..
    Hovne, Vera
    Stockholm Univ, Dept Psychol, Stockholm, Sweden..
    Carlbring, Per
    Stockholm Univ, Dept Psychol, Stockholm, Sweden.;Stockholm Univ, Dept Psychol, SE-10691 Stockholm, Sweden..
    Bernhard-Oettel, Claudia
    Stockholm Univ, Dept Psychol, Stockholm, Sweden..
    Oscarsson, Martin
    Stockholm Univ, Dept Psychol, Stockholm, Sweden..
    Mechler, Jakob
    Stockholm Univ, Dept Psychol, Stockholm, Sweden..
    Lindqvist, Karin
    Stockholm Univ, Dept Psychol, Stockholm, Sweden..
    Topooco, Naira
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology. Uppsala Univ, Dept Psychol, Uppsala, Sweden.;Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden..
    Andersson, Gerhard
    Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden.;Linkoping Univ, Dept Biomed & Clin Sci, Linkoping, Sweden.;Karolinska Inst, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Philips, Bjorn
    Stockholm Univ, Dept Psychol, Stockholm, Sweden..
    ?Good job!?: Therapists' encouragement, affirmation, and personal address in internet-based cognitive behavior therapy for adolescents with depression2022In: Internet Interventions, ISSN 2214-7829, Vol. 30, article id 100592Article in journal (Refereed)
    Abstract [en]

    Internet-delivered interventions are generally effective for psychological problems. While the presence of a clinician guiding the client via text messages typically leads to better outcomes, the characteristics of what constitutes high-quality communication are less well investigated. This study aimed to identify how an internet therapist most effectively communicates with clients in internet-delivered cognitive behavioral therapy (ICBT). Using data from a treatment study of depressed adolescents with a focus on participants who had a positive outcome, messages from therapists were analyzed using thematic analysis. The study focused on the therapist's 1) encouragement and 2) affirmation, and how the therapists used 3) personal address. The analysis resulted in a total of twelve themes (Persistence Wins, You Are a Superhero, You Make Your Luck, You Understand, Hard Times, You Are Like Others, My View on the Matter, Time for a Change, Welcome In, Let Me Help You, You Affect Me, and I Am Human). Overall, the themes form patterns where treatment is described as hard work that requires a motivated client who is encouraged by the therapist. The findings are discussed based on the cognitive behavioral theoretical foundation of the treatment, prior research on therapist behaviors, and the fact that the treatment is provided over the internet.

  • 42.
    Berggren, Mathias
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Akrami, Nazar
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Bergh, Robin
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Harvard Univ, Dept Psychol, 33 Kirkland St, Cambridge, MA 02138 USA.
    Ekehammar, Bo
    Stockholm Univ, Dept Psychol, Stockholm, Sweden.
    Motivated Social Cognition and Authoritarianism: Is It All About Closed-Mindedness?2019In: Journal of Individual Differences, ISSN 1614-0001, E-ISSN 2151-2299, Vol. 40, no 4, p. 204-212Article in journal (Refereed)
    Abstract [en]

    The domain of motivated social cognition includes a variety of concepts dealing with a need to seek structure and avoid ambiguity, and several of these concepts are also powerful predictors of social attitudes, such as authoritarianism. It is possible though that these relations are due to certain facets reoccurring in the different scales. In this paper, we tested the notion that authoritarianism is predicted specifically by rigidity in beliefs (closed-mindedness), rather than broader cognitive styles. Thus, we initially identified items in the motivated social cognition scales that are specifically measuring closed-mindedness. These items included the closed-mindedness facet of the need for closure scale and items from intolerance of ambiguity and need for cognition. We used these items to predict right-wing authoritarianism, social dominance orientation, and their common factor authoritarianism (generalized). In line with our prediction, two studies showed that the motivated social cognition scales did not provide a significant prediction of authoritarianism beyond the closed-mindedness items. We conclude that the relation between motivated social cognition and authoritarianism is captured entirely by the former's closed-mindedness component.

  • 43.
    Berlin, Lisa
    et al.
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Psychology. Development psychology.
    Bohlin, Gunilla
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Psychology. Development psychology.
    Response inhibition, hyperactivity, and conduct problems among preschool children2002In: Journal of clinical child and adolescent psychology, ISSN 1537-4416, Vol. 31, no 2, p. 242-251Article in journal (Refereed)
    Abstract [en]

    Investigated the relation among response inhibition, hyperactivity, and conduct problems in a nonclinical sample of 115 preschool children, using 2 different types of go/no-go tasks well as a Stroop-like task. In line with the assumption that hyperactivity is related to disinhibition, the results showed that it was the measures of response inhibition, and not other performance measures, that were related to teacher ratings of hyperactivity. There was also a significant relation between response inhibition and conduct problems. Interestingly, the correlation between response inhibition and conduct problems was not significant when partialling out the effect of hyperactivity, whereas the correlation between inhibition and hyperactivity did remain significant when controlling for conduct problems. Although the association between inhibition, hyperactivity, and conduct problems appeared to be partly different for boys and girls, these differences were not statistically significant.

  • 44.
    Berna, Chantal
    et al.
    Univ Oxford, Dept Psychiat, Oxford OX1 2JD, England.
    Lang, Tamara J.
    Univ Oxford, Dept Psychiat, Oxford OX1 2JD, England.
    Goodwin, Guy M.
    Univ Oxford, Dept Psychiat, Oxford OX1 2JD, England.
    Holmes, Emily A.
    Univ Oxford, Dept Psychiat, Oxford OX1 2JD, England.
    Developing a measure of interpretation bias for depressed mood: An ambiguous scenarios test2011In: Personality and Individual Differences, ISSN 0191-8869, E-ISSN 1873-3549, Vol. 51, no 3, p. 349-354Article in journal (Refereed)
    Abstract [en]

    The tendency to interpret ambiguous everyday situations in a relatively negative manner (negative interpretation bias) is central to cognitive models of depression. Limited tools are available to measure this bias, either experimentally or in the clinic. This study aimed to develop a pragmatic interpretation bias measure using an ambiguous scenarios test relevant to depressed mood (the AST-D).(1) In Study 1, after a pilot phase (N = 53), the AST-D was presented via a web-based survey (N = 208). Participants imagined and rated each AST-D ambiguous scenario. As predicted, higher dysphoric mood was associated with lower pleasantness ratings (more negative bias), independent of mental imagery measures. In Study 2, self-report ratings were compared with objective ratings of participants' imagined outcomes of the ambiguous scenarios (N = 41). Data were collected in the experimental context of a functional Magnetic Resonance Imaging scanner. Consistent with subjective bias scores, independent judges rated more sentences as negatively valenced for the high versus low dysphoric group. Overall, results suggest the potential utility of the AST-D in assessing interpretation bias associated with depressed mood. (C) 2011 Elsevier Ltd. All rights reserved.

  • 45.
    Berna, Chantal
    et al.
    Univ Oxford, Warneford Hosp, Dept Psychiat, EPACT Grp, Oxford OX3 7JX, England;Univ Oxford, Ctr Funct Magnet Resonance Imaging Brain FMRIB, Dept Clin Neurol, Oxford OX3 7JX, England;Univ Oxford, Nuffield Dept Anaesthet, Oxford OX3 7JX, England.
    Vincent, Katy
    Univ Oxford, Ctr Funct Magnet Resonance Imaging Brain FMRIB, Dept Clin Neurol, Oxford OX3 7JX, England;Univ Oxford, Nuffield Dept Anaesthet, Oxford OX3 7JX, England;Univ Oxford, Nuffield Dept Obstet & Gynaecol, John Radcliffe Hosp, Oxford OX3 7JX, England.
    Moore, Jane
    Univ Oxford, Nuffield Dept Obstet & Gynaecol, John Radcliffe Hosp, Oxford OX3 7JX, England.
    Tracey, Irene
    Univ Oxford, Ctr Funct Magnet Resonance Imaging Brain FMRIB, Dept Clin Neurol, Oxford OX3 7JX, England;Univ Oxford, Nuffield Dept Anaesthet, Oxford OX3 7JX, England.
    Goodwin, Guy M.
    Holmes, Emily A.
    Presence of Mental Imagery Associated with Chronic Pelvic Pain: A Pilot Study2011In: Pain medicine (Malden, Mass.), ISSN 1526-2375, E-ISSN 1526-4637, Vol. 12, no 7, p. 1086-1093Article in journal (Refereed)
    Abstract [en]

    Objective. To ascertain whether a small sample of patients with chronic pelvic pain experienced any pain-related cognitions in the form of mental images. Patients. Ten women with chronic pelvic pain consecutively referred from a tertiary referral center by the physicians in charge of their treatment. Outcome measures. An interview was used to determine the presence, emotional valence, content, and impact of cognitions about pain in the form of Inventory (BPI), Pain Catastrophizing Scale (PCS), Spontaneous Use of Imagery Scale (SUIS), and Hospital Anxiety and Depression Scale (HADS) were completed. Results. In a population of patients with a prolonged duration of pain and high distress, all patients reported experiencing cognitions about pain in the form of mental images. For each patient, the most significant image was both negative in valence and intrusive. The associated emotional-behavioral pattern could be described within a cognitive behavioral therapy framework. Eight patients also reported coping imagery. Conclusion. Negative pain-related cognitions in the form of intrusive mental imagery were reported by women with chronic pelvic pain. Targeting such imagery has led to interesting treatment innovation in the emotional disorders. Thus, imagery, hitherto neglected in pain phenomenology, could provide a novel target for cognitive behavioral therapy in chronic pain. These exciting yet preliminary results require replication and extension in a broader population of patients with chronic pain.

  • 46.
    Bernhard-Oettel, Claudia
    et al.
    Stockholm University, Sweden.
    Eib, Constanze
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Stockholm University, Sweden.
    Griep, Yannick
    University of Calgary, Canada; Stockholm University, Sweden.
    Leineweber, Constanze
    Stockholm University, Sweden.
    How do job insecurity and organizational justice relate to depressive symptoms and sleep difficulties: a multilevel study on immediate and prolonged effects in swedish workers2020In: Applied Psychology: an international review, ISSN 0269-994X, E-ISSN 1464-0597, Vol. 69, no 4, p. 1271-1300Article in journal (Refereed)
    Abstract [en]

    Drawing on stress and justice literature, we argue that perceptions of job insecurity induce feelings of low procedural justice, which has immediate and prolonged negative effects on health (depressive symptoms, sleep difficulties). Moreover, we explore whether the strength of the job insecurity–justice relationship differs between individuals as a function of their average level of job insecurity over time. Finally, we explore whether the procedural justice–health relationship differs between individuals as a function of variability in justice perceptions over time. We analyzed Swedish panel data from permanent workers over four consecutive waves (with a two‐year time lag between waves) using multilevel analysis, separating within‐ and between‐person variance. Results showed that job insecurity associated negatively with procedural justice at the same time point for all waves. Prolonged effects were less stable. We found immediate (but not prolonged) indirect effects of job insecurity on health outcomes via procedural justice. Average levels in job insecurity over time moderated the within‐person job insecurity–justice relationship. However, variability in procedural justice over time did not moderate the within‐person justice–health relationship. In conclusion, disentangling within‐ and between‐person variability of job insecurity and justice perceptions contributes to the understanding of health effects.

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  • 47.
    Björck, Caroline
    Statens institutionsstyrelse (SiS), Solna, Sverige.
    Stepwise BUP: Verksamhetsutveckling genom systematisk registrering som stöd för kvalitetsarbete, patientsäkerhet och uppföljning2015Report (Other academic)
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  • 48.
    Björnsdotter, Annika
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Enebrink, Pia
    Karolinska Institutet.
    Ghaderi, Ata
    Karolinska Institutet.
    Family Check-Up and iComet: a Randomized Controlled Trial in Sweden2013Conference paper (Other academic)
  • 49.
    Björnsdotter, Annika
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Enebrink, Pia
    Karolinska Inst, Div Psychol, Dept Clin Neurosci, SE-17177 Stockholm, Sweden.
    Ghaderi, Ata
    Karolinska Inst, Div Psychol, Dept Clin Neurosci, SE-17177 Stockholm, Sweden.
    Psychometric properties of online administered parental Strengths and Difficulties Questionnarie (SDQ), and normative data based on combined online and paper-and-pencil administration2013In: Child and Adolescent Psychiatry and Mental Health, E-ISSN 1753-2000, Vol. 7, article id 40Article in journal (Refereed)
    Abstract [en]

    Objective

    To examine the psychometric properties of the online administered parental version of the Strength and Difficulties Questionnaire (SDQ), and to provide parental norms from a nationwide Swedish sample.

    Methods

    A total of 1443 parents from of a national probability sample of 2800 children aged 10-13 years completed the SDQ online or as usual (i.e., using paper-and-pencil).

    Results

    The SDQ subscales obtained from the online administration showed high internal consistency (polychoric ordinal alpha), and confirmatory factor analysis of the SDQ five factor model resulted in excellent fit. The Total Difficulties score of the SDQ and its other subscales were significantly related to the Disruptive Behavior Disorders (DBD) rating scale. Norms for the parent version of SDQ obtained from the Internet were identical to those collected using paper-and-pencil. They were thus combined and are presented sorted by child gender and age.

    Conclusions

    The SDQ seems to be a reliable and valid instrument given its high internal consistency, clear factor structure and high correlation with other instruments capturing the intended constructs. Findings in the present study support its use for online data collection, as well as using norms obtained through paper-and-pencil-administration even when SDQ has been administrated online.

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  • 50.
    Björnsdotter, Annika
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Enebrink, Pia
    Karolinska Institutet.
    Ghaderi, Ata
    Karolinska Institutet.
    The Importance of Parental Knowledge2013Conference paper (Other academic)
    Abstract [en]

    Poor parenting is an important risk factor for development of conduct problems in children and adolescents. Inadequate parental monitoring is an example of a negative parenting behavior that has been shown to predict child conduct problems Findings from previous research on parental monitoring has been mixed due to the use of inconsistent and vague definitions. However, later research suggests that it is "parental knowledge" rather than "parental monitoring" that is associated with child and adolescent conduct problems. In the present study, we used an existing questionnaire that measures three possible sources of parental knowledge: child disclosure, parental solicitation and parental control. Our aims were to 1) examine the factor structure of a parenting monitoring/knowledge scale, 2) analyze if a high level of child disclosure and parental control as well as a low level of parental solicitation were associated to low conduct problems, 3) examine if a measure of family warmth correlates with child disclosure, and 4) whether parental knowledge mediates the relation between parental warmth and conduct problems. Parents of a national probability sample of 2800 children aged 10-13 years old were asked to complete a survey including these different scales. A total of 1446 parents completed the questionnaires. Brief description Analysis of the importance of parental knowledge regarding child disruptive behavior using an existing questionnaire that measures parental knowledge through three possible sources: child disclosure, parental solicitation and parental control.

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