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  • 1.
    Arnberg, Filip K
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital.
    Bergh Johannesson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital.
    Michel, Per-Olof
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, Ulleråker, University Hospital.
    Prevalence and Duration of PTSD in Survivors Six Years After a Natural Disaster2013In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 27, no 3, p. 347-352Article in journal (Refereed)
    Abstract [en]

    The present study aimed to examine the prevalence of posttraumatic stress disorder (PTSD) in survivors with low levels of risk factors for PTSD. The sample included 142 adults (58% women, 54% university education, 93% employed/students/retired) on vacation in Southeast Asia during the 2004 Indian Ocean disaster. Semi-structured clinical interviews (SCID-I) were performed after 6 years including PTSD, depression, specific phobia, and alcohol abuse. The 6-year prevalence of PTSD was 11.3% and the current prevalence was 4.2%, with onset mainly within 1 month and remission within 3 years post-disaster. Suicidal ideation and comorbidity were common in PTSD cases. Lifetime prevalence of depression was 19%, specific phobia 7%, and alcohol abuse 4%. The findings suggest elevated levels of PTSD but not other disorders as compared with general population samples, but still lower levels than other disaster samples. Despite benign circumstances, however, the course and burden of PTSD were comparable to similar studies.

  • 2.
    Arnberg, Filip K
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Michel, Per-Olof
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Bergh Johannesson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Properties of Swedish Posttraumatic Stress Measures after a Disaster2014In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 28, no 4, p. 402-409Article in journal (Refereed)
    Abstract [en]

    This study evaluated the properties of Swedish versions of self-report measures of posttraumatic stress disorder (PTSD), with emphasis on the Impact of Event Scale–Revised (IES-R). Survey data from adult survivors 1, 3, and 6 years after the 2004 Indian Ocean tsunami (n = 1506) included the IES-R (from which the IES-6 was derived) and the 12-item General Health Questionnaire (GHQ-12). The PTSD Checklist (PCL) was included in one survey. A structured clinical interview was performed after 6 years (n = 142). Factor analyses of the IES-R and PCL indicated that a dysphoric-arousal model provided good fit invariant across assessments. Both measures were accurate in excluding PTSD while all measures provided poorer positive predictive values. The IES-R, but not the IES-6 and GHQ-12, evidenced stability across assessments. In conclusion, the Swedish IES-R and PCL are sound measures of chronic PTSD, and the findings illustrate important temporal aspects of PTSD assessment.

  • 3.
    Bergh Johannesson, Kerstin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    Arinell, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Arnberg, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    Six years after the wave: Trajectories of posttraumatic stress following a natural disaster2015In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 36, p. 15-24Article in journal (Refereed)
    Abstract [en]

    Background

    The characteristics of long-term trajectories of distress after disasters are unclear, since few studies include a comparison group. This study examines trajectories of recovery among survivors in comparison to individuals with indirect exposure.

    Methods

    Postal surveys were sent to Swedish tourists, repatriated from the 2004 Indian Ocean tsunami (= 2268), at 1, 3, and 6 years after the tsunami to assess posttraumatic stress (PTS) and poor mental health. Items were used to ascertain high and moderate disaster exposure groups and an indirect exposure comparison group.

    Results

    Long-term PTS trajectories were best characterized by a resilient (72.3%), a severe chronic (4.6%), a moderate chronic (11.2%) and a recovering (11.9%) trajectory. Trajectories reported higher levels of PTS than the comparison group. Exposure severity and bereavement were highly influential risk factors.

    Conclusions

    These findings have implications regarding anticipation of long-term psychological adjustment after natural disasters and need for interventions after a single traumatic event with few secondary stressors.

  • 4. Dagoo, Jesper
    et al.
    Asplund, Robert Persson
    Bsenko, Helene Andersson
    Hjerling, Sofia
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Holmberg, Anna
    Westh, Susanne
    Oberg, Louise
    Ljotsson, Brjann
    Carlbring, Per
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Andersson, Gerhard
    Cognitive behavior therapy versus interpersonal psychotherapy for social anxiety disorder delivered via smartphone and computer: A randomized controlled trial2014In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 28, no 4, p. 410-417Article in journal (Refereed)
    Abstract [en]

    In this study, a previously evaluated guided Internet-based cognitive behavior therapy for social anxiety disorder (SAD) was adapted for mobile phone administration (mCBT). The treatment was compared with a guided self-help treatment based on interpersonal psychotherapy (mIPT). The treatment platform could be accessed through smartphones, tablet computers, and standard computers. A total of 52 participants were diagnosed with SAD and randomized to either mCBT (n = 27) or mIPT (n = 25). Measures were collected at pre-treatment, during the treatment, post-treatment and 3-month follow-up. On the primary outcome measure, the Liebowitz Social Anxiety Scale - self-rated, both groups showed statistically significant improvements. However, mCBT performed significantly better than mIPT (between group Cohen's d = 0.64 in favor of mCBT). A larger proportion of the mCBT group was classified as responders at post-treatment (55.6% versus 8.0% in the mIPT group). We conclude that CBT for SAD can be delivered using modern information technology. IPT delivered as a guided self-help treatment may be less effective in this format.

  • 5. Dahl, Alv A.
    et al.
    Dahl, Christian Falk
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Are there gender differences in impairment associated with high social anxiety?: A community-based study2010In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 24, no 5, p. 487-493Article in journal (Refereed)
    Abstract [en]

    This comparative, cross-sectional community-based study examines sex differences in associations between various types of impairment and high level of social phobia/anxiety symptoms (SPAS) in adults aged 30, 40, and 45 years and their controls Men with high SPAS had higher rates of non-paired relationships, alcohol problems, low intake of fruit/vegetables, risk for future fatal cardiac events, but lower rate for low annual income than women The pattern of differences in impairment variables cases and controls did not show sex differences. Stepwise multivariate logistic regression analysis showed that the socio-demographic and lifestyle impairment steps made significant contributions to the model which explained 41.6% of the variance The individual variables significant at the last step were lower level of education, more smokers, less alcohol problems and lower risk of fatal cardiac events in women compared to men In conclusion, few significant sex differences concerning impairment were observed in individuals with high SPAS.

  • 6.
    Kleberg, Johan L.
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology. Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden.
    Hanqvist, Cornelia
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden.
    Serlachius, Eva
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden.
    Högström, Jens
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden.
    Pupil dilation to emotional expressions in adolescent social anxiety disorder is related to treatment outcome2019In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 65, p. 26-33Article in journal (Refereed)
    Abstract [en]

    Atypical attention to potential social threats, such as emotional faces, may be one of the core mechanisms underlying social anxiety disorder (SAD). Pupil dilation is an index of locus coreuleus-noradrenergic activity, and closely linked to attention. In the present study, pupil dilation was studied in adolescents with SAD (N = 26; 22 Female) before the onset of a 12-week cognitive behavioral treatment, and in healthy controls (N = 23). Stimuli were faces with angry or happy emotional expressions. Contrary to our hypothesis, the SAD group did not show hyper-responsiveness to angry compared to happy faces. Instead, an atypical time course of the pupil dilation response was found, resulting in an attenuated response during late time stages. Larger pupil dilation amplitude to happy faces before treatment was related to worse treatment response. These results contribute significantly to our understanding of the mechanisms underlying adolescent SAD.

  • 7. Lindner, Philip
    et al.
    Miloff, Alexander
    Fagernäs, Simon
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Andersen, Joel
    Sigeman, Martin
    Andersson, Gerhard
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Carlbring, Per
    Therapist-led and self-led one-session virtual reality exposure therapy for public speaking anxiety with consumer hardware and software: A randomized controlled trial2019In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 61, p. 45-54Article in journal (Refereed)
    Abstract [en]

    Public speaking anxiety (PSA) is a common condition which can be treated effectively with exposure therapy. However, inherent difficulties in stimuli presentation and control limits dissemination and the therapeutic potential. Virtual Reality (VR) technology has the potential to resolve these issues and provide a scalable platform for self-help interventions. No previous study has examined whether this can be achieved using the first generation of consumer VR hardware and software. In the current trial, n = 25 + 25 participants were randomized to either one-session therapist-led VR exposure therapy for PSA followed by a four-week internet-administered VR to in-vivo transition program, or a waiting-list. Linear mixed effects modeling revealed significant, large (within Cohen’s d = 1.67) decreases in self-reported PSA. The waiting-list was then given access to an internet-administered, self-led version of the same VR exposure therapy to be conducted at home, followed by the same transition program. Dual-slope mixed effects modeling revealed significant, large (d = 1.35) decreases in self-reported PSA. Results were maintained or improved at six- and twelve-month follow-ups. We show for the first time that low-cost, off-the-shelf consumer VR hardware and software can be used to conduct exposure therapy for PSA, both in the traditional, previously impractical one-session format, and in a novel self-led, at-home format.

  • 8.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Low, Aili
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Dyster-Aas, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Gerdin, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns2010In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 24, no 6, p. 618-622Article in journal (Refereed)
    Abstract [en]

    The Impact of Event Scale (IES) and the Impact of Event Scale-Revised (IES-R) are often used as self-reportinstruments for symptoms of post-traumatic stress disorder (PTSD). However, there are few validationsof the IES and the IES-R against structured clinical interviews. In this study the two scales, together withthe three subscales of the IES-R, were assessed for their agreement with a diagnosis of PTSD in patientswith burns 1 year after injury. Sixty patients with burns were evaluated 1 year after injury using theStructured Clinical Interview for the DSM-IV Axis I (SCID-I) psychiatric disorders and a Swedish versionof the IES-R. The total score of the IES-R had the best discriminant ability (0.89) with a sensitivity of 1.0and a specificity of 0.78. In conclusion, the total IES-R had good properties as a screening tool for PTSDand subsyndromal PTSD 1 year after burn injury.

  • 9. Tillfors, Maria
    et al.
    Furmark, Tomas
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Carlbring, Per
    Andersson, Gerhard
    Risk profiles for poor treatment response to internet-delivered CBT in people with social anxiety disorder2015In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 33, p. 103-109Article in journal (Refereed)
    Abstract [en]

    In social anxiety disorder (SAD) co-morbid depressive symptoms as well as avoidance behaviors have been shown to predict insufficient treatment response. It is likely that subgroups of individuals with different profiles of risk factors for poor treatment response exist. This study aimed to identify subgroups of social avoidance and depressive symptoms in a clinical sample (N=167) with SAD before and after guided internet-delivered CBT, and to compare these groups on diagnostic status and social anxiety. We further examined individual movement between subgroups over time. Using cluster analysis we identified four subgroups, including a high-problem cluster at both time-points. Individuals in this cluster showed less remission after treatment, exhibited higher levels of social anxiety at both assessments, and typically remained in the high-problem cluster after treatment. Thus, in individuals with SAD, high levels of social avoidance and depressive symptoms constitute a risk profile for poor treatment response. (C) 2015 Elsevier Ltd. All rights reserved.

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