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  • 151. O'Mahen, H A
    et al.
    Richards, D A
    Woodford, Joanne
    Wilkinson, E
    McGinley, J
    Taylor, R S
    Warren, F C
    Netmums: a phase II randomized controlled trial of a guided Internet behavioural activation treatment for postpartum depression.2014Inngår i: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 44, nr 8, s. 1675-89Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Despite the high prevalence of postnatal depression (PND), few women seek help. Internet interventions may overcome many of the barriers to PND treatment use. We report a phase II evaluation of a 12-session, modular, guided Internet behavioural activation (BA) treatment modified to address postnatal-specific concerns [Netmums Helping With Depression (NetmumsHWD)].

    METHOD: To assess feasibility, we measured recruitment and attrition to the trial and examined telephone session support and treatment adherence. We investigated sociodemographic and psychological predictors of treatment adherence. Effectiveness outcomes were estimated with the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder-7, Work and Social Adjustment Scale, Postnatal Bonding Questionnaire, and Social Provisions Scale.

    RESULTS: A total of 249 women were recruited via a UK parenting site, Netmums.com. A total of 83 women meeting DSM-IV criteria for major depressive disorder were randomized to NetmumsHWD (n = 41) or treatment-as-usual (TAU; n = 42). Of the 83 women, 71 (86%) completed the EPDS at post-treatment, and 71% (59/83) at the 6-month follow-up. Women completed an average of eight out of 12 telephone support sessions and five out of 12 modules. Working women and those with less support completed fewer modules. There was a large effect size favouring women who received NetmumsHWD on depression, work and social impairment, and anxiety scores at post-treatment compared with women in the TAU group, and a large effect size on depression at 6 months post-treatment. There were small effect sizes for postnatal bonding and perceived social support.

    CONCLUSIONS: A supported, modular, Internet BA programme can be feasibly delivered to postpartum women, offering promise to improve depression, anxiety and functioning.

  • 152.
    O'Neill, Lucy
    et al.
    Univ Leeds, Leeds Inst Hlth Sci, Leeds, W Yorkshire, England;Leeds Teaching Hosp NHS Trust, Dept Clin & Hlth Psychol, Leeds, W Yorkshire, England.
    Latchford, Gary
    Univ Leeds, Leeds Inst Hlth Sci, Leeds, W Yorkshire, England;Leeds Teaching Hosp NHS Trust, Dept Clin & Hlth Psychol, Leeds, W Yorkshire, England.
    McCracken, Lance M.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Kings Coll London, Inst Psychiat Psychol & Neurosci, London, England.
    Graham, Christopher D.
    Univ Leeds, Leeds Inst Hlth Sci, Leeds, W Yorkshire, England;Queens Univ Belfast, Dept Psychol, David Keir Bldg, Belfast BT7 1NN, Antrim, North Ireland.
    The development of the Acceptance and Commitment Therapy Fidelity Measure (ACT-FM): A delphi study and field test2019Inngår i: Journal of Contextual Behavioral Science, ISSN 2212-1447, Vol. 14, s. 111-118Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Being able to assess whether psychological therapies are delivered according to their own principles is helpful for assuring treatment quality in research and training. We aimed to develop and preliminarily test a measure of therapist fidelity to Acceptance and Commitment Therapy (ACT) that is concise in measuring key therapist behaviours, reliable, practicable and potentially applicable across therapy contexts. This measure was developed via expert consensus in a Delphi study (Study 1). Here, thirteen expert ACT practitioners (average of 11 years' experience with ACT, including 6 ACBS Peer Reviewed ACT Trainers) participated in three iterative rounds of online questionnaires. A preliminary draft of the measure was used to initiate discussion. In the first two rounds, participants rated and commented on existing items, the manual, and structure of the measure, and generated new items for consideration. In a third round, participants commented on the emergent draft of The ACT Fidelity Measure (ACT-FM). The Delphi study resulted in a 24-item measure with items structured around the three-part model of psychological flexibility ("Tri-flex") alongside Therapist Stance. Eighty-three percent of the chosen items met the specified criteria for consensus. In Study 2, to investigate usability and preliminary psychometric properties of the ACT-FM, a separate group of nine clinicians used the ACT-FM to rate a video of an ACT therapy session. Inter-rater reliability was moderate to excellent. Based on clinician feedback, the measure was expanded to 25 items. To reach the stated aims, further work is required particularly evaluating the utility of the ACT-FM across therapy contexts.

  • 153.
    Osman, Fatumo
    et al.
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm.; Dalarna Univ, Sch Educ Hlth & Social Studies, Falun.
    Salari, Raziye
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin/CHAP.
    Klingberg-Allvin, Marie
    Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm.; Dalarna Univ, Sch Educ Hlth & Social Studies, Falun.
    Schön, Ulla-Karin
    Dalarna Univ, Sch Educ Hlth & Social Studies, Falun.
    Flacking, Renée
    Dalarna Univ, Sch Educ Hlth & Social Studies, Falun.
    Effects of a culturally tailored parenting support programme in Somali-born parents' mental health and sense of competence in parenting: a randomised controlled trial2017Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, nr 12, artikkel-id e017600Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To evaluate the effectiveness of a culturally tailored parenting support programme on Somali-born parents’ mental health and sense of competence in parenting.

    Design: Randomised controlled trial.

    Setting: A city in the middle of Sweden.

    Participants: Somali-born parents (n=120) with children aged 11–16 years and self-perceived stress in their parenting were randomised to an intervention group (n=60) or a waiting-list control group (n=60).

    Intervention: Parents in the intervention group received culturally tailored societal information combined with the Connect parenting programme during 12 weeks for 1–2 hours per week. The intervention consisted of a standardised training programme delivered by nine group leaders of Somali background.

    Outcome: The General Health Questionnaire 12 was used to measure parents’ mental health and the Parenting Sense of Competence scale to measure parent satisfaction and efficacy in the parent role. Analysis was conducted using intention-to-treat principles.

    Results: The results indicated that parents in the intervention group showed significant improvement in mental health compared with the parents in the control group at a 2-month follow-up: B=3.62, 95% CI 2.01 to 5.18, p<0.001. Further, significant improvement was found for efficacy (B=−6.72, 95% CI −8.15 to −5.28, p<0.001) and satisfaction (B=−4.48, 95% CI −6.27 to −2.69, p<0.001) for parents in the intervention group. Parents’ satisfaction mediated the intervention effect on parental mental health (β=−0.88, 95% CI −1.84 to −0.16, p=0.047).

    Conclusion: The culturally tailored parenting support programme led to improved mental health of Somali-born parents and their sense of competence in parenting 2 months after the intervention. The study underlines the importance of acknowledging immigrant parents’ need for societal information in parent support programmes and the importance of delivering these programmes in a culturally sensitive manner.

    Clinical trial registration: NCT02114593.

    Fulltekst (pdf)
    fulltext
  • 154. Pahnke, Johan
    et al.
    Lundgren, Tobias
    Hursti, Timo
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Hirvikoski, Tatja
    Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: A quasi-experimental pilot study2014Inngår i: Autism, ISSN 1362-3613, E-ISSN 1461-7005, Vol. 18, nr 8, s. 953-964Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Autism spectrum disorder is characterized by social impairments and behavioural inflexibility. In this pilot study, the feasibility and outcomes of a 6-week acceptance and commitment therapy-based skills training group were evaluated in a special school setting using a quasi-experimental design (acceptance and commitment therapy/school classes as usual). A total of 28 high-functioning students with autism spectrum disorder (aged 13-21 years) were assessed using self- and teacher-ratings at pre- and post-assessment and 2-month follow-up. All participants completed the skills training, and treatment satisfaction was high. Levels of stress, hyperactivity and emotional distress were reduced in the treatment group. The acceptance and commitment therapy group also reported increased prosocial behaviour. These changes were stable or further improved at the 2-month follow-up. Larger studies are needed to further evaluate the benefits of acceptance and commitment therapy for autism spectrum disorder.

  • 155.
    Pauksztat, Birgit
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Företagsekonomiska institutionen.
    Effects of job demands and social interactions on fatigue in short sea cargo shipping2017Inngår i: Maritime Policy & Management, ISSN 0308-8839, E-ISSN 1464-5254, Vol. 44, nr 5, s. 623-640Artikkel i tidsskrift (Fagfellevurdert)
  • 156.
    Pauksztat, Birgit
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Företagsekonomiska institutionen.
    Informal relations and communication about work-related problems in two multilingual crewsInngår i: Marine Policy, ISSN 0308-597X, E-ISSN 1872-9460Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Although multilingual crews are common in international merchant shipping, there is concern that they may have negative effects on informal relations and communication on board, with implications for wellbeing and safety. This study examines how diversity in crew members' first language and their proficiency in English and other languages affect informal relations (friendship) and communication about work-related problems (discussing problems; making suggestions; pointing out problems) on board. Data came from longitudinal surveys on two cargo ships, and were analysed using stochastic actor-oriented modeling. Findings indicated that first language and language proficiency had different effects. Having the same first language increased the likelihood of friendship, which, in turn, increased the likelihood of discussing problems, making suggestions and pointing out problems. Proficiency in English increased the likelihood of discussing problems, which in turn increased the likelihood of making suggestions and pointing out problems. Implications for promoting informal relations and open communication in multilingual crews are discussed.

  • 157.
    Pauksztat, Birgit
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Företagsekonomiska institutionen.
    'Only work and sleep': Seafarers' perceptions of job demands of short sea cargo shipping lines and their effects on work and life on board2017Inngår i: Maritime Policy & Management, ISSN 0308-8839, E-ISSN 1464-5254, Vol. 44, nr 7, s. 899-915Artikkel i tidsskrift (Fagfellevurdert)
  • 158.
    Pauksztat, Birgit
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Företagsekonomiska institutionen.
    Salin, Denise
    Department of Management & Organization, Hanken School of Economics, Helsinki, Finland.
    Targets' social relationships as antecedents and consequences of workplace bullying: A social network perspective2020Inngår i: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 10, artikkel-id 3077Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Research on workplace bullying has largely focused on individual and organizational factors that place individuals in a vulnerable position. Although theorists have highlighted social aspects of workplace bullying and its antecedents, the role of individuals’ social relations with other members of their organization has rarely been examined empirically. Drawing on insights from social network research and research on social rejection, the purpose of this study was to examine the relationship between exposure to bullying and employees’ informal social relationships (here: friendships; negative relationships) with other members of their organization. Data from two waves of surveys among 249 employees in eight organizations in Finland were analyzed using stochastic actor-oriented modeling. We found that employees’ centrality (i.e., the number of their relationships) had no effect on exposure to bullying. However, exposure to bullying affected targets’ perceptions of their relationships with colleagues: employees who had experienced bullying subsequently reported significantly more friendship relationships, but not significantly more negative relationships, suggesting that aggressive or antisocial responses may be more muted in field settings than in experimental settings. Our study contributes to research on workplace bullying by providing a more detailed understanding of the relationship between workplace bullying and employees’ social relations, and by offering insights about the consequences of workplace bullying for targets’ social relations.

    Fulltekst (pdf)
    fulltext
  • 159.
    Pauksztat, Birgit
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Företagsekonomiska institutionen.
    Salin, Denise
    Workplace Bullying:: A Social Network Perspective2019Inngår i: Concepts, Approaches and Methods.: Handbooks of Workplace Bullying, Emotional Abuse and Harassment, vol. 1 / [ed] D'Cruz P., Noronha E., Notelaers G., Rayner C., Singapore: Springer Nature , 2019Kapittel i bok, del av antologi (Fagfellevurdert)
    Abstract [en]

    This chapter introduces a social network perspective on workplace bullying, emotional abuse and harassment. As a type of interpersonal interaction, bullying behaviours can be conceptualized as interpersonal ties, and the bullying ties among a set of individuals can be considered a social network. Moreover, many of the antecedents and consequences of bullying, such as social relationships and various types of interactions, are usefully understood and analysed as social networks. Adopting a social network perspective will not only provide new perspectives for theory development but will allow researchers to take advantage of well-established methods, thus improving our understanding of the social dynamics of workplace bullying.

  • 160.
    Pearson, David G.
    et al.
    Univ Aberdeen, Sch Psychol, Aberdeen AB24 3FX, Scotland.
    Deeprose, Catherine
    Univ Plymouth, Sch Psychol, Plymouth PL4 8AA, Devon, England.
    Wallace-Hadrill, Sophie M. A.
    MRC Cognit & Brain Sci, Cambridge, England.
    Heyes, Stephanie Burnett
    Univ Oxford, Dept Expt Psychol, Oxford OX1 2JD, England.
    Holmes, Emily A.
    MRC Cognit & Brain Sci, Cambridge, England.
    Assessing mental imagery in clinical psychology: A review of imagery measures and a guiding framework2013Inngår i: Clinical Psychology Review, ISSN 0272-7358, E-ISSN 1873-7811, Vol. 33, nr 1, s. 1-23Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Mental imagery is an under-explored field in clinical psychology research but presents a topic of potential interest and relevance across many clinical disorders, including social phobia, schizophrenia, depression, and post-traumatic stress disorder. There is currently a lack of a guiding framework from which clinicians may select the domains or associated measures most likely to be of appropriate use in mental imagery research. We adopt an interdisciplinary approach and present a review of studies across experimental psychology and clinical psychology in order to highlight the key domains and measures most likely to be of relevance. This includes a consideration of methods for experimentally assessing the generation, maintenance, inspection and transformation of mental images; as well as subjective measures of characteristics such as image vividness and clarity. We present a guiding framework in which we propose that cognitive, subjective and clinical aspects of imagery should be explored in future research. The guiding framework aims to assist researchers in the selection of measures for assessing those aspects of mental imagery that are of most relevance to clinical psychology. We propose that a greater understanding of the role of mental imagery in clinical disorders will help drive forward advances in both theory and treatment. (C) 2012 Elsevier Ltd. All rights reserved.

  • 161.
    Pettersson, Torsten
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Historisk-filosofiska fakulteten, Litteraturvetenskapliga institutionen.
    Drömmar om verkligheten - skönlitteraturens potential för existentiell psykoterapi2008Inngår i: Bara detta liv: Texter i existentiell psykologi och psykoterapi, 2008Kapittel i bok, del av antologi (Fagfellevurdert)
  • 162.
    Pictet, Arnaud
    et al.
    Univ Oxford, Dept Psychiat, Oxford OX1 2JD, England.
    Coughtrey, Anna E.
    Univ Oxford, Dept Psychiat, Oxford OX1 2JD, England.
    Mathews, Andrew
    Univ Calif Davis, Dept Psychol, Davis, CA 95616 USA.
    Holmes, Emily A.
    Univ Oxford, Dept Psychiat, Oxford OX1 2JD, England.
    Fishing for happiness: The effects of generating positive imagery on mood and behaviour2011Inngår i: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 49, nr 12, s. 885-891Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Experimental evidence using picture-word cues has shown that generating mental imagery has a causal impact on emotion, at least for images prompted by negative or benign stimuli. It remains unclear whether this finding extends to overtly positive stimuli and whether generating positive imagery can increase positive affect in people with dysphoria. Dysphoric participants were assigned to one of three conditions, and given instructions to generate mental images in response to picture word cues which were either positive, negative or mixed (control) in valence. Results showed that the positive picture-word condition increased positive affect more than the control and negative conditions. Participants in the positive condition also demonstrated enhanced performance on a behavioural task compared to the two other conditions. Compared to participants in the negative condition, participants in the positive condition provided more positive responses on a homophone task administered after 24 h to assess the durability of effects. These findings suggest that a positive picture-word task used to evoke mental imagery leads to improvements in positive mood, with transfer to later performance. Understanding the mechanisms underlying mood change in dysphoria may hold implications for both theory and treatment development. (C) 2011 Elsevier Ltd. All rights reserved.

  • 163. Pérez-Aranda, Adrián
    et al.
    Feliu-Soler, Albert
    Montero-Marín, Jesús
    García-Campayo, Javier
    Andrés-Rodríguez, Laura
    Borràs, Xavier
    Rozadilla-Sacanell, Antoni
    Peñarrubia-Maria, Maria T
    Angarita-Osorio, Natalia
    McCracken, Lance
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Luciano, Juan V
    A randomized controlled efficacy trial of mindfulness-based stress reduction compared with an active control group and usual care for fibromyalgia: the EUDAIMON study.2019Inngår i: Pain, ISSN 0304-3959, E-ISSN 1872-6623Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Fibromyalgia (FM) syndrome represents a great challenge for clinicians and researchers because the efficacy of currently available treatments is limited. This study examined the efficacy of mindfulness-based stress reduction (MBSR) for reducing functional impairment as well as the role of mindfulness-related constructs as mediators of treatment outcomes for people with FM. Two hundred twenty-five participants with FM were randomized into 3 study arms: MBSR plus treatment-as-usual (TAU), FibroQoL (multicomponent intervention for FM) plus TAU, and TAU alone. The primary endpoint was functional impact (measured with the Fibromyalgia Impact Questionnaire Revised), and secondary outcomes included "fibromyalginess," anxiety and depression, pain catastrophising, perceived stress, and cognitive dysfunction. The differences in outcomes between groups at post-treatment assessment (primary endpoint) and 12-month follow-up were analyzed using linear mixed-effects models and mediational models through path analyses. Mindfulness-based stress reduction was superior to TAU both at post-treatment (large effect sizes) and at follow-up (medium to large effect sizes), and MBSR was also superior to FibroQoL post-treatment (medium to large effect sizes), but in the long term, it was only modestly better (significant differences only in pain catastrophising and fibromyalginess). Immediately post-treatment, the number needed to treat for 20% improvement in MBSR vs TAU and FibroQoL was 4.0 (95% confidence interval [CI] = 2.1-6.5) and 5.0 (95% CI = 2.7-37.3). An unreliable number needed to treat value of 9 (not computable 95% CI) was found for FibroQoL vs TAU. Changes produced by MBSR in functional impact were mediated by psychological inflexibility and the mindfulness facet acting with awareness. These findings are discussed in relation to previous studies of psychological treatments for FM.

  • 164.
    Rad, Alexander
    et al.
    Mittuniversitetet, Avdelningen för ekonomivetenskap och juridik.
    Wahlberg, Olof
    Mittuniversitetet, Avdelningen för ekonomivetenskap och juridik.
    Öhman, Peter
    Mittuniversitetet, Avdelningen för ekonomivetenskap och juridik.
    How Lending Officers Construe Assessments of Small and Medium-Sized Enterprise Loan Applications: A Repertory Grid Study2013Inngår i: Journal of constructivist psychology, ISSN 1072-0537, E-ISSN 1521-0650, Vol. 26, nr 4, s. 262-279Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Repertory grid technique and principal component analysis were used to map and analyze how 75 lending officers (LOs) viewed their assessments of small and medium-sized enterprises’ loan applications in one bank and region. A standard set of elements and constructs, derived during pre- and pilot studies, was used. Analysis of individual grids demonstrated that the principal components indicated the existence of similarities in LOs’ construing at an aggregated level. Analysis of the mean grid of all respondents indicated that the LOs were encouraged by the bank's lending strategy and supporting system(s) to perform “procedural lending” with a focus on hard and future-oriented information. At the same time, the LOs deemphasized relationship lending, in particular, personal relationships.

  • 165.
    Raune, D
    et al.
    Univ London Royal Holloway & Bedford New Coll, Dept Psychol, London NW1 4NS, England;MRC, Cognit & Brain Sci Unit, Cambridge, England.
    MacLeod, A
    Univ London Royal Holloway & Bedford New Coll, Dept Psychol, London NW1 4NS, England;MRC, Cognit & Brain Sci Unit, Cambridge, England.
    Holmes, Emily A.
    MRC Cognition and Brain Sciences Unit, Cambridge, UK.
    The simulation heuristic and visual imagery in pessimism for future negative events in anxiety2005Inngår i: Clinical Psychology and Psychotherapy, ISSN 1063-3995, E-ISSN 1099-0879, Vol. 12, nr 4, s. 313-325Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A salient feature of clinical anxiety and its disorders is an elevated subjective probability judgement that future negative events will happen to the individual. A neglected area of research is the cognitive mechanisms that might underlie this judgement in patient populations. First, we investigated the ease of being able to simulate imaginary negative events happening to the individual ('the simulation heuristic'). Second, we conducted the first investigation to our knowledge into the possible role of visual imagery characteristics on subjective probability for negative events. Twenty-six patients who had a clinical level of anxiety and 26 low-anxiety control participants simulated mentally and also formed visual images of future negative events. They then rated the likelihood of the events happening to them. As predicted, with anxious patients the simulation heuristic was correlated with subjective probability, and they reported increased access to their simulations compared to control participants. The visual image results were more complex: anxious patients' ease of image formation was correlated with subjective probability but did not differ from that of the control participants, and vividness and dismissibility were enhanced in anxious patients but did not correlate with subjective probability. Clinically, helping anxious patients to improve their access to simulations of why events will not happen may help lower their subjective probability. Future research could seek to confirm this experimentally in a clinical intervention study, as well as isolate further the different roles particular visual image characteristics may play in specific aspects of clinical anxiety. Copyright (c) 2005 John Wiley & Sons, Ltd.

  • 166.
    Rautalinko, Erik
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Directiveness in psychotherapy: A phenomenological-narrative study of therapist attitudes2017Inngår i: Psychology and Psychotherapy: Theory, Research and Practice, ISSN 1476-0835, E-ISSN 2044-8341, Vol. 90, nr 4, s. 600-616Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives

    This study of directiveness draws on the literature on patient–therapist matching, neutrality, and resistance. Our aim was to investigate how psychotherapists conceptualize directiveness as an attitude, with a focus on pantheoretical aspects of directiveness.

    Design and methods

    Our data are narratives from 18 interviews with psychotherapists of different theoretical orientations (cognitive-behavioural, family-systems, humanistic-experiential, and psychodynamic), and from focus-group discussions with six other psychotherapists.

    Results

    The analysis yielded four general themes: expression of directiveness (behaviour, agency, structure), its presence (depending on phase of and goals for therapy), its positive and negative outcomes (for patients and therapists, respectively), and therapist awareness (initial and shifting, depending on theoretical orientation).

    Conclusions

    Directiveness may be construed as an attitude. It supposedly increases via certain responses, but only a few of these are considered positive by therapists at large. Directiveness may be more present in early and late phases of therapy, and more warranted with patients that function poorly. There are both positive and negative outcomes of directiveness, but therapists are more prone to disclose the former.

    Practitioner points

    • Therapist directiveness supposedly increases via advice, questions, clarifications, steering to topics, goal setting, self-disclosure, and session management. Directiveness is seen as more present in early and late phases of therapy.
    • Directing is more warranted with patients who function poorly. Possible positive outcomes of directiveness are clarity, feeling of security, and saving time; negative outcomes are decrease of agency, increase of resistance, and less patient self-attribution of improvement.
    • It is unlikely that therapists disclose adverse directive behaviours. Those who do, attribute them to psychotherapy structure if their attitudes are negative, and to personal choice if they are positive. This may hamper therapists managing their own level of directiveness.
  • 167.
    Rautalinko, Erik
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Mellanfasen av handledning2013Inngår i: Handledningens ABC: Klinisk handledning ur ett KBT-perspektiv / [ed] Elisabeth Breitholtz, Lund: Studentlitteratur, 2013, 1, s. 169-191Kapittel i bok, del av antologi (Annet (populærvitenskap, debatt, mm))
  • 168.
    Rautalinko, Erik
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Samtalsfärdigheter: Stöd, vägledning och ledarskap2007 (oppl. 1)Bok (Annet (populærvitenskap, debatt, mm))
  • 169.
    Rautalinko, Erik
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Samtalsfärdigheter: Stöd, vägledning och ledarskap2013 (oppl. 2)Bok (Annet (populærvitenskap, debatt, mm))
  • 170.
    Renner, Fritz
    et al.
    Univ Cambridge, MRC, Cognit & Brain Sci Unit, Cambridge, England.
    Ji, Julie L.
    Univ Cambridge, MRC, Cognit & Brain Sci Unit, Cambridge, England.
    Pictet, Arnaud
    Univ Geneva, Dept Clin Psychol, Geneva, Switzerland.
    Holmes, Emily A.
    Univ Cambridge, MRC, Cognit & Brain Sci Unit, Cambridge, England;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Blackwell, Simon E.
    Univ Cambridge, MRC, Cognit & Brain Sci Unit, Cambridge, England;Ruhr Univ Bochum, Dept Psychol, Mental Hlth Res & Treatment Ctr, Massenbergstr 9-13, D-44787 Bochum, Germany.
    Effects of Engaging in Repeated Mental Imagery of Future Positive Events on Behavioural Activation in Individuals with Major Depressive Disorder2017Inngår i: Cognitive Therapy and Research, ISSN 0147-5916, E-ISSN 1573-2819, Vol. 41, nr 3, s. 369-380Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Depression is associated with decreased engagement in behavioural activities. A wide range of activities can be promoted by simulating them via mental imagery. Mental imagery of positive events could thus provide a route to increasing adaptive behaviour in depression. The current study tested whether repeated engagement in positive mental imagery led to increases in behavioural activation in participants with depression, using data from a randomized controlled trial (Blackwell et al. in Clin Psychol Sci 3(1):91-111, 2015. doi:10.1177/2167702614560746). Participants (N = 150) were randomized to a 4-week positive imagery intervention or an active non-imagery control condition, completed via the internet. Behavioural activation was assessed five times up to 6 months follow-up using the Behavioural Activation for Depression Scale (BADS). While BADS scores increased over time in both groups, there was an initial greater increase in the imagery condition. Investigating mental imagery simulation of positive activities as a means to promote behavioural activation in depression could provide a fruitful line of enquiry for future research.

  • 171.
    Renner, Fritz
    et al.
    Univ Freiburg, Dept Clin Psychol & Psychotherapy, Freiburg, Germany;Univ Cambridge, MRC Cognit & Brain Sci Unit, 15 Chaucer Rd, Cambridge CB2 7EF, England;Univ Freiburg, Inst Psychol, Dept Clin Psychol & Psychotherapy, Engelbergerstr 41, D-79106 Freiburg, Germany.
    Murphy, Fionnuala C.
    Univ Cambridge, MRC Cognit & Brain Sci Unit, 15 Chaucer Rd, Cambridge CB2 7EF, England.
    Ji, Julie L.
    Univ Western Australia, Sch Psychol Sci, Nedlands, WA, Australia.
    Manly, Tom
    Univ Cambridge, MRC Cognit & Brain Sci Unit, 15 Chaucer Rd, Cambridge CB2 7EF, England.
    Holmes, Emily A.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Univ Cambridge, MRC Cognit & Brain Sci Unit, 15 Chaucer Rd, Cambridge CB2 7EF, England.
    Mental imagery as a "motivational amplifier" to promote activities2019Inngår i: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 114, s. 51-59Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Facilitating engagement in rewarding activities is a key treatment target in depression. Mental imagery can increase engagement in planned behaviours, potentially due to its special role in representing emotionally salient experiences. The present study tested the hypothesis that mental imagery promotes motivation and engagement when planning pleasant and rewarding activities. Participants were recruited from a community volunteer panel (N = 72). They self-nominated six activities to complete over the following week, and were randomized to either: a) a single-session Motivational Imagery condition (N = 24); b) an Activity Reminder control condition (N = 24); or c) a No-Reminder control condition (N = 24). As predicted, relative to control groups, the Motivational Imagery group reported higher levels of motivation, anticipated pleasure, and anticipated reward for the planned activities. The Motivational Imagery group also completed significantly more activities than the Activity Reminder group, but not more than the No-Reminder group. Relevance of results to behavioural activation approaches for depression are discussed.

    Fulltekst (pdf)
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  • 172. Riva, Roberto
    et al.
    Forinder, Ulla
    Arvidson, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Mellgren, Karin
    Toporski, Jacek
    Winiarski, Jacek
    Lindahl Norberg, Annika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Psykosocial onkologi och stödjande vård. Karolinska Institutet.
    Patterns of psychological responses in parents of children that underwent stem cell transplantation2014Inngår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 23, nr 11, s. 1307-1313Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Hematopoietic stem cell transplantation (HSCT) is curative in several life-threatening pediatric diseases but may affect children and their families inducing depression, anxiety, burnout symptoms, and post-traumatic stress symptoms, as well as post-traumatic growth (PTG). The aim of this study was to investigate the co-occurrence of different aspects of such responses in parents of children that had undergone HSCT.

    METHODS: Questionnaires were completed by 260 parents (146 mothers and 114 fathers) 11-198 months after HSCT: the Hospital Anxiety and Depression Scale, the Shirom-Melamed Burnout Questionnaire, the post-traumatic stress disorders checklist, civilian version, and the PTG inventory. Additional variables were also investigated: perceived support, time elapsed since HSCT, job stress, partner-relationship satisfaction, trauma appraisal, and the child's health problems. A hierarchical cluster analysis and a k-means cluster analysis were used to identify patterns of psychological responses.

    RESULTS: Four clusters of parents with different psychological responses were identified. One cluster (n = 40) significantly differed from the other groups and reported levels of depression, anxiety, burnout symptoms, and post-traumatic stress symptoms above the cut-off. In contrast, another cluster (n = 66) reported higher levels of PTG than the other groups did.

    CONCLUSIONS: This study shows a subgroup of parents maintaining high levels of several aspects of distress years after HSCT. Differences between clusters might be explained by differences in perceived support, the child's health problems, job stress, and partner-relationship satisfaction.

  • 173.
    Rondung, Elisabet
    et al.
    Mid Sweden Univ, Dept Psychol, S-83145 Ostersund, Sweden.
    Ekdahl, Johanna
    Mid Sweden Univ, Dept Psychol, S-83145 Ostersund, Sweden.
    Hildingsson, Ingegerd
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Mid Sweden Univ, Dept Nursing, Ostersund, Sweden.
    Rubertsson, Christine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning. Lund Univ, Dept Hlth Sci, Fac Med, Lund, Sweden.
    Sundin, Orjan
    Mid Sweden Univ, Dept Psychol, S-83145 Ostersund, Sweden.
    Heterogeneity in childbirth related fear or anxiety2018Inngår i: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 59, nr 6, s. 634-643Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Many pregnant women experience fear, worry or anxiety relating to the upcoming childbirth. The aim of this cross-sectional study was to investigate possible subgroups in a sample of 206 pregnant women (mean age 29.4 years), reporting fear of birth in mid-pregnancy. Comparisons were made between nulliparous and parous women. In a series of cluster analyses, validated psychological instruments were used to cluster women based on their psychological profiles. A five-cluster solution was suggested, with the clusters characterized by: overall low symptom load, general high symptom load, medium symptom load with high performance-based self-esteem, blood- and injection phobic anxiety, and specific anxiety symptoms. Nulliparous women were more likely to report clinically relevant levels of blood- and injection phobia (OR = 2.57, 95% CI 1.09-6.01), while parous women more often reported previous negative experiences in health care (OR 1.93, 95% CI 1.09-3.39) or previous trauma (OR 2.90, 95% CI 1.58-5.32). The results indicate that women reporting fear of birth are a heterogeneous group. In order to individualize treatment, psychological characteristics may be of greater importance than parity in identifying relevant subgroups.

  • 174. Rose, Michael
    et al.
    Norton, Sam
    King's College London.
    Chiari, V
    Edwards, C
    McCracken, Lance
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Graham, C
    Radunovic, A
    Chalder, T
    King's College London.
    Acceptance and Commitment Therapy for MuScle Disease (ACTMuS): Protocol for a two-arm randomized controlled trial of a brief guided self-help ACT programme for improving quality of life in people with muscle diseases2018Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, nr 10Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction In adults, muscle disease (MD) is often a chronic long-term condition with no definitive cure. It causes wasting and weakness of the muscles resulting in a progressive decline in mobility, alongside other symptoms, and is typically associated with reduced quality of life (QoL). Previous research suggests that a psychological intervention, and in particular Acceptance and Commitment Therapy (ACT), may help improve QoL in MD. ACT is a newer type of cognitive behavioural treatment that aims to improve QoL by virtue of improvement in a process called psychological flexibility. The primary aim of this randomised controlled trial (RCT) is to evaluate the efficacy of a guided self-help ACT programme for improving QoL in people with MD. Main secondary outcomes are mood, symptom impact, work and social adjustment and function at 9-week follow-up.

    Methods and analysis Acceptance and Commitment Therapy for Muscle Disease is an assessor-blind, multicentre, two-armed, parallel-group RCT to assess the efficacy of ACT plus standard medical care (SMC) compared with SMC alone. Individuals with a diagnosis of one of four specific MDs, with a duration of at least 6 months and with mild to moderate anxiety or depression (Hospital Anxiety and Depression Scale score ≥8) will be recruited from UK-based MD clinics and MD patient support organisations. Participants will be randomised to either ACT plus SMC or SMC alone by an independent randomisation service. Participants will be followed up at 3, 6 and 9 weeks. Analysis will be intention to treat, conducted by the trial statistician who will be blinded to treatment allocation.

    Ethics and dissemination The study has received full ethical approval. Study results will be disseminated via peer-reviewed publications, conference presentations and journal articles. Data obtained from the trial will enable clinicians and health service providers to make informed decisions regarding the efficacy of ACT for improving QoL for patients with MD.

    Trial registration number NCT02810028.

    Fulltekst (pdf)
    fulltext
  • 175.
    Roshanai, Afsaneh
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicinsk epidemiologi.
    Janeslätt, Gunnel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna.
    Suzanne, White
    Suny Downstate Med Ctr, Brooklyn, NY USA.
    Kajsa, Lidstrom Holmqvist
    Örebro Univ, Fac Med & Hlth, Univ Hlth Care Res Ctr, Örebro, Sweden.
    Time management skills in relation to general self-efficacy and parental sense of competence in individuals with and without cognitive disabilities2019Inngår i: COGENT PSYCHOLOGY, ISSN 2331-1908, Vol. 6, nr 1, artikkel-id 1655981Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of the study was to investigate to what extent time management skills are associated with general self-efficacy and parental sense of competence, and if there are any differences between individuals with and without cognitive disabilities in these aspects.

    Material and Methods: The study had a comparative cross-sectional design. Totally 86 individuals with cognitive disabilities (of whom 31 were parents), and 154 without disabilities (of whom 68 were parents) were included (N = 240). The Swedish versions of the Assessment of Time Management Skills (including time management, organisation & planning, and regulation of emotion subscales), General Self-Efficacy, and Parental Sense of Competence scale (including satisfaction, efficacy, and interest subscales) were used to collect data.

    Results: There were significant differences (p < .001) between individuals with and without cognitive disabilities in all three subscales of Assessment of Time Management Skills and in General Self-Efficacy. Overall, individuals with a cognitive disability scored lower than persons without cognitive disabilities.

    A significant difference was observed between parents in all three subscales of time management skills after controlling for age and education (p < .0005). Parents with cognitive disabilities, compared to parents without cognitive disability, scored significantly lower in all measured scales, except for the interest subscale. In parents with a cognitive disability, there was a significant correlation between all three subscales of Time Management Skills and satisfaction. Among parents without a cognitive disability there was a significant correlation between time management; and organisation & planning subscales; and efficacy, and between General Self-Efficacy and time management.

    Conclusions: Poor time management, planning and organisational skills, as well as a deficit in regulation of emotions may have a negative impact on general self-efficacy and parental sense of competence.

    Fulltekst (pdf)
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  • 176.
    Rångtell, Frida H
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.
    Karamchedu, Swathy
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.
    Andersson, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.
    Liethof, Lisanne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.
    Bucaro, Marcela Olaya
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.
    Lampola, Lauri
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.
    Schiöth, Helgi B.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.
    Cedernaes, Jonathan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.
    Benedict, Christian
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Funktionell farmakologi.
    A single night of sleep loss impairs objective but not subjective working memory performance in a sex-dependent manner2019Inngår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 28, nr 1, artikkel-id e12651Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Acute sleep deprivation can lead to judgement errors and thereby increases the risk of accidents, possibly due to an impaired working memory. However, whether the adverse effects of acute sleep loss on working memory are modulated by auditory distraction in women and men are not known. Additionally, it is unknown whether sleep loss alters the way in which men and women perceive their working memory performance. Thus, 24 young adults (12 women using oral contraceptives at the time of investigation) participated in two experimental conditions: nocturnal sleep (scheduled between 22:30 and 06:30 hours) versus one night of total sleep loss. Participants were administered a digital working memory test in which eight-digit sequences were learned and retrieved in the morning after each condition. Learning of digital sequences was accompanied by either silence or auditory distraction (equal distribution among trials). After sequence retrieval, each trial ended with a question regarding how certain participants were of the correctness of their response, as a self-estimate of working memory performance. We found that sleep loss impaired objective but not self-estimated working memory performance in women. In contrast, both measures remained unaffected by sleep loss in men. Auditory distraction impaired working memory performance, without modulation by sleep loss or sex. Being unaware of cognitive limitations when sleep-deprived, as seen in our study, could lead to undesirable consequences in, for example, an occupational context. Our findings suggest that sleep-deprived young women are at particular risk for overestimating their working memory performance.

    Fulltekst (pdf)
    FULLTEXT01
  • 177.
    Salari, Raziye
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Division of Psychology, Department of Clinical Neuroscience and Stockholm Brain Institute, Karolinska Institutet, Stockholm, Sweden.
    Bohlin, Gunilla
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Rydell, Ann-Margret
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Thorell, Lisa
    Division of Psychology, Department of Clinical Neuroscience and Stockholm Brain Institute, Karolinska Institutet, Stockholm, Sweden.
    Neuropsychological functioning and attachment representations in early school age as predictors of ADHD symptoms in late adolescence2017Inngår i: Child Psychiatry and Human Development, ISSN 0009-398X, E-ISSN 1573-3327, Vol. 48, nr 3, s. 370-384Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study aimed to examine relations between parent and child attachment representations and neuropsychological functions at age 8, as well as relations between these constructs and ADHD symptoms over a 10-year period. A community-based sample of 105 children (52 boys) participated. Measures of attachment representations and a range of neuropsychological functions were collected at age 8. Parents rated emotion dysregulation and ADHD symptoms at age 8 and ADHD symptoms again at age 18. Significant, although modest, relations were found between disorganized attachment and some aspects of neuropsychological functioning in childhood. When studying outcomes in late adolescence and controlling for early ADHD symptom levels, spatial working memory and disorganized attachment remained significant in relation to both ADHD symptom domains, and one measure of inhibition remained significant for hyperactivity/impulsivity. When examining independent effects, spatial working memory and disorganized attachment were related to inattention, whereas spatial working memory and dysregulation of happiness/exuberance were related to hyperactivity/impulsivity. Our findings showing that disorganized attachment is longitudinally related to ADHD symptoms over and above the influence of both neuropsychological functioning and early ADHD symptom levels highlights the importance of including measures of attachment representations when trying to understand the development of ADHD symptoms. If replicated in more “at-risk” samples, these findings could also suggest that parent–child attachment should be taken into consideration when children are referred for assessment and treatment of ADHD.

  • 178.
    Salari, Raziye
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin/CHAP.
    Enebrink, Pia
    Karolinska Institutet.
    Role of universal parenting programs in prevention2018Inngår i: Handbook of parenting and child development across the lifespan, Springer, 2018, s. 713-743Kapittel i bok, del av antologi (Fagfellevurdert)
  • 179.
    Salari, Raziye
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Filus, Ania
    Center for Self-Report Science, University of Southern California, Los Angeles USA; Department of Psychology, The University of Queensland, Brisbane, Australia.
    Using the Health Belief Model to Explain Mothers’ and Fathers’ Intention to Participate in Universal Parenting Programs2017Inngår i: Prevention Science, ISSN 1389-4986, E-ISSN 1573-6695, Vol. 18, nr 1, s. 83-94Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Using the Health Belief Model (HBM) as a theoretical framework, we studied factors related to parental intention to participate in parenting programs and examined the moderating effects of parent gender on these factors. Participants were a community sample of 290 mothers and 290 fathers of 5- to 10-year-old children. Parents completed a set of questionnaires assessing child emotional and behavioral difficulties and the HBM constructs concerning perceived program benefits and barriers, perceived child problem susceptibility and severity, and perceived self-efficacy. The hypothesized model was evaluated using structural equation modeling. The results showed that, for both mothers and fathers, perceived program benefits were associated with higher intention to participate in parenting programs. In addition, higher intention to participate was associated with lower perceived barriers only in the sample of mothers and with higher perceived self-efficacy only in the sample of fathers. No significant relations were found between intention to participate and perceived child problem susceptibility and severity. Mediation analyses indicated that, for both mothers and fathers, child emotional and behavioral problems had an indirect effect on parents’ intention to participate by increasing the level of perceived benefits of the program. As a whole, the proposed model explained about 45 % of the variance in parental intention to participate. The current study suggests that mothers and fathers may be motivated by different factors when making their decision to participate in a parenting program. This finding can inform future parent engagement strategies intended to increase both mothers’ and fathers’ participation rates in parenting programs.

    Fulltekst (pdf)
    fulltext
  • 180.
    Salari, Raziye
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Fängström, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Uppsala Triple P trial: A cluster randomised control trial to evaluate dissemination of Positive Parenting Program at preschools2012Inngår i: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 19, nr S1, s. S77--S78Artikkel i tidsskrift (Annet vitenskapelig)
  • 181.
    Salari, Raziye
    et al.
    Parenting and Family Support Centre, School of Psychology, The University of Queensland.
    Ralph, Alan
    Parenting and Family Support Centre, School of Psychology, The University of Queensland.
    Sanders, Mathhew
    Parenting and Family Support Centre, School of Psychology, The University of Queensland.
    An efficacy trial: Positive Parenting Program for parents of teenagers2014Inngår i: Behaviour change, ISSN 0813-4839, E-ISSN 2049-7768, Vol. 31, nr 1, s. 34-52Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Studies on the efficacy of parent training programs have mostly been conducted with preadolescents, with only a few studies investigating family treatment models in adolescents. In this article, a study is described that evaluates Standard Teen Triple P (Positive Parenting Program), a behavioural family intervention for parents of 11- to 16-year-old teenagers. Participants were 46 families with a teenager who was experiencing detectable behavioural and emotional problems. Compared to parents in the waitlist control condition, parents participating in the intervention condition reported decreased levels of teen disruptive behaviours and parent adolescent conflict, as well as a reduction in the use of ineffective parenting strategies and conflict over child-rearing issues. These positive changes were maintained at the 3-month follow-up. Results suggest that Standard Teen Triple P is a promising parenting intervention for tackling adolescent externalising problems.

  • 182.
    Sarkadi, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin/CHAP.
    Bjärtå, Anna
    Mid Sweden Univ, Fac Human Sci, Dept Psychol, Ostersund, Sweden.
    Leiler, Anna
    Mid Sweden Univ, Fac Human Sci, Dept Psychol, Ostersund, Sweden.
    Salari, Raziye
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin/CHAP.
    Is the Refugee Health Screener a Useful Tool when Screening 14- to 18-Year-Old Refugee Adolescents for Emotional Distress?2019Inngår i: The Journal of Refugee Studies, ISSN 0951-6328, E-ISSN 1471-6925, Vol. 32, nr Special issue 1, s. 141-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The high number of asylum seekers in Sweden has highlighted the need for structured assessment tools to screen for refugee mental health problems in clinical services. We examined the utility of the Refugee Health Screener (RHS) in refugee adolescents, aged 14-18, attending routine clinical examinations or staying in group homes/refugee centres (N = 29). Participants completed a survey, including the RHS, administered through iPads in their native language. The RHS showed excellent internal consistency (alpha = 0.96) and correlated moderately with symptoms of post-traumatic stress disorder (r = 0.41, p = 0.025). Mean scores and prevalence rates were comparable to a study of adult refugees in Sweden. Unaccompanied refugee minors (URMs) scored significantly higher (M = 32.0, SD = 12.9) compared to youth staying with their families (M = 7.5, SD = 8.2, p<0.001, d = 2.27). Our findings confirm that the RHS can be used in the adolescent population in Sweden. These findings moreover suggest that URMs are a particularly vulnerable group with a large burden of mental health problems.

  • 183.
    Schéle, Ingrid
    et al.
    Umeå universitet, Institutionen för psykologi.
    Hedman, Leif
    Umeå universitet, Institutionen för psykologi.
    Hammarström, Anne
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    The psychosocial work environment affects female dental students more than maleInngår i: Journal of Dental Education, ISSN 0022-0337, E-ISSN 1930-7837Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Dental students are often described as stressed, and the stress has, among other things, been connected to inconsistent feedback. We hypothesised that the psychosocial work environment of the dentistry programme influences the stress and satisfaction of dental students, and that tolerance for ambiguity shields the students from stress.

    A web-survey was sent to the entire Swedish dental student population in clinical training (P ≈ 805), of which 40 percent participated.

    The SEM-model contains four main constructs: psychosocial work environment, tolerance for ambiguity, perceived stress, and student satisfaction (χ2 = 402.638, df = 264, p<0.000, Normed χ2 = 1.525, RMSEA = 0.041, CFI = 0.97). Psychosocial work environment influenced both perceived stress and satisfaction. Psychosocial work environment accounted for almost all of the explained variance in perceived stress for women, while about half of the variance for the men was explained by tolerance for ambiguity.

    We conclude that about 40 percent of the total perceived stress of female dental students is related to their psychosocial work environment. Tolerance for ambiguity shields men, but not women, from stress. Improved psychosocial work environment at the dentistry programme would decrease the stress of both male and female dental students.

  • 184.
    Scott, Whitney
    et al.
    Kings Coll London, Inst Psychiat Psychol & Neurosci, Hlth Psychol Sect, London, England; Guys & St Thomas NHS Fdn Trust, INPUT Pain Management, London, England.
    Chilcot, Joseph
    Kings Coll London, Inst Psychiat Psychol & Neurosci, Hlth Psychol Sect, London, England.
    Guildford, Beth
    Guys & St Thomas NHS Fdn Trust, INPUT Pain Management, London, England.
    Daly-Eichenhardt, Aisling
    Guys & St Thomas NHS Fdn Trust, INPUT Pain Management, London, England.
    McCracken, Lance
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Kings Coll London, Inst Psychiat Psychol & Neurosci, Hlth Psychol Sect, London, England; Guys & St Thomas NHS Fdn Trust, INPUT Pain Management, London, England.
    Feasibility randomized‐controlled trial of online Acceptance and Commitment Therapy for patients with complex chronic pain in the United Kingdom2018Inngår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 22, nr 8, s. 1473-1484Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Acceptance and Commitment Therapy (ACT) has growing support for chronic pain. However, more accessible treatment delivery is needed. This study evaluated the feasibility of online ACT for patients with complex chronic pain in the United Kingdom to determine whether a larger trial is justified.

    Methods: Participants with chronic pain and clinically meaningful disability and distress were randomly assigned to ACT online plus specialty medical pain management, or specialty medical management alone. Participants completed questionnaires at baseline, and 3‐ and 9‐month post‐randomization. Primary feasibility outcomes included recruitment, retention and treatment completion rates. Secondary outcomes were between‐groups effects on treatment outcomes and psychological flexibility.

    Results: Of 139 potential participants, 63 were eligible and randomized (45% recruitment rate). Retention rates were 76–78% for follow‐up assessments. Sixty‐one per cent of ACT online participants completed treatment. ACT online was less often completed by employed (44%) compared to unemployed (80%) participants. Fifty‐six per cent of ACT online participants rated themselves as ‘much improved’ or better on a global impression of change rating, compared to only 20 per cent of control participants. Three‐month effects favouring ACT online were small for functioning, medication and healthcare use, committed action and decentring, medium for mood, and large for acceptance. Small‐to‐medium effects were maintained for functioning, healthcare use and committed action at 9 months.

    Conclusions: Online ACT for patients with chronic pain in the United Kingdom appears feasible to study in a larger efficacy trial. Some adjustments to treatment and trial procedures are warranted, particularly to enhance engagement among employed participants.

    Significance: This study supports the feasibility of online Acceptance and Commitment Therapy for chronic pain in the United Kingdom and a larger efficacy trial. Refinements to treatment delivery, particularly to better engage employed patients, may improve treatment completion and outcomes.

  • 185. Scott, Whitney
    et al.
    Yu, Lin
    Patel, Shrina
    McCracken, Lance M
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Measuring Stigma in Chronic Pain: Preliminary Investigation of Instrument Psychometrics, Correlates, and Magnitude of Change in a Prospective Cohort Attending Interdisciplinary Treatment.2019Inngår i: Journal of Pain, ISSN 1526-5900, E-ISSN 1528-8447, artikkel-id S1526-5900(19)30700-XArtikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Chronic pain is a potentially stigmatizing condition. However, stigma has received limited empirical investigation in people with chronic pain. Therefore, we examined the psychometric properties of a self-report questionnaire of stigma in people with chronic pain attending interdisciplinary treatment. Secondarily, we undertook an exploratory examination of the magnitude of change in stigma associated with interdisciplinary treatment in a prospective observational cohort. Participants attending interdisciplinary treatment based on acceptance and commitment therapy completed the Stigma Scale for Chronic Illness 8-item version (SSCI-8; previously developed and validated in neurological samples), and measures of perceived injustice, pain acceptance, and standard pain outcomes before (n = 300) and after treatment (n = 247). A unidimensional factor structure and good internal consistency were found for the SSCI-8. Total SSCI-8 scores were correlated with pain intensity, indices of functioning, and depression in bivariate analyses. Stigma scores were uniquely associated with functioning and depression in multiple regression analyses controlling for demographic factors, pain intensity, pain acceptance, and perceived injustice at baseline. SSCI-8 total scores did not significantly improve after treatment, although an exploratory subscale analysis showed a small improvement on internalized stigma. In contrast, scores on perceived injustice, pain acceptance, and pain outcomes improved significantly. Taken together, these data support the reliability and validity of the SSCI-8 for use in samples with chronic pain. Further research is needed optimize interventions to target stigma at both the individual and societal levels. PERSPECTIVE: This study supports the use of the SSCI-8 to measure stigma in chronic pain. Stigma is uniquely associated with worse depression and pain-related disability. Research is needed to identify how to best target pain-related stigma from individual and societal perspectives.

  • 186. Sieverding, Monika
    et al.
    Eib, Constanze
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Neubauer, Andreas B
    Stahl, Thomas
    Can lifestyle preferences help explain the persistent gender gap in academia? The "mothers work less" hypothesis supported for German but not for U.S. early career researchers2018Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, nr 8, artikkel-id e0202728Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Do lifestyle preferences contribute to the remaining gender gap in higher positions in academia with highly qualified women-especially those with children-deliberately working fewer hours than men do? We tested the "mothers work less" hypothesis in two samples of early career researchers employed at universities in Germany (N = 202) and in the US (N = 197). Early career researchers in the US worked on average 6.3 hours more per week than researchers in Germany. In Germany, female early career researchers with children had drastically reduced work hours (around 8 hours per week) compared to male researchers with children and compared to female researchers without children, whereas we found no such effect for U.S. researchers. In addition, we asked how long respondents would ideally want to work (ideal work hours), and results revealed similar effects for ideal work hours. Results support the "mothers work less" hypothesis for German but not for U.S. early career researchers.

    Fulltekst (pdf)
    fulltext
  • 187.
    Sjöström, Andrea
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    KBT vid bipolär sjukdom - idag och i framtiden: Intervjuer med psykologer på Sveriges specialistmottagningar2016Independent thesis Advanced level (professional degree), 10 poäng / 15 hpOppgave
    Fulltekst (pdf)
    fulltext
  • 188.
    Slofstra, Christien
    et al.
    Univ Groningen, Dept Clin Psychol & Expt Psychopathol, Groningen, Netherlands.
    Nauta, Maaike H.
    Univ Groningen, Dept Clin Psychol & Expt Psychopathol, Groningen, Netherlands.
    Holmes, Emily A.
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.
    Bos, Elisabeth H.
    Univ Groningen, Dept Dev Psychol, Groningen, Netherlands.
    Wichers, Marieke
    Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat UCP, Interdisciplinary Ctr Psychopathol & Emot Regulat, Groningen, Netherlands.
    Batalas, Nikolaos
    Eindhoven Univ Technol, Dept Ind Design, Eindhoven, Netherlands.
    Klein, Nicola S.
    Univ Groningen, Dept Clin Psychol & Expt Psychopathol, Groningen, Netherlands.
    Bockting, Claudi L. H.
    Univ Groningen, Dept Clin Psychol & Expt Psychopathol, Groningen, Netherlands;Univ Utrecht, Dept Clin Psychol, Utrecht, Netherlands.
    Exploring the relation between visual mental imagery and affect in the daily life of previously depressed and never depressed individuals2018Inngår i: Cognition & Emotion, ISSN 0269-9931, E-ISSN 1464-0600, Vol. 32, nr 5, s. 1131-1138Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Previously depressed individuals experience disturbances in affect. Affective disturbances may be related to visual mental imagery, given that imagery-based processing of emotional stimuli causes stronger affective responses than verbal processing in experimental laboratory studies. However, the role of imagery-based processing in everyday life is unknown. This study assessed mental imagery in the daily life of previously and never depressed individuals. Higher levels of visual mental imagery was hypothesised to be associated with more affective reactivity to both negatively and positively valenced mental representations. This study was the first to explore mental imagery in daily life using experience sampling methodology. Previously depressed (n = 10) and matched never depressed (n = 11) individuals participated in this study. Momentary affect and imagery-based processing were assessed using the "Imagine your mood" smartphone application. Participants recorded on average 136 momentary reports over a period of 8 weeks. The expected association between visual mental imagery and affective reactivity was not found. Unexpectedly, in both previously and never depressed individuals, higher levels of imagery-based processing of mental representations in daily life were significantly associated with better momentary mood and more positive affect, regardless of valence. The causality of effects remains to be examined in future studies.

  • 189.
    Soenen, Guillaume
    et al.
    EMLYON Business School.
    Eib, Constanze
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. University of East Anglia, Norwich Business School, Norwich Research Park, Norwich, UK.
    Torrès, Olivier
    Montpellier University.
    The cost of injustice: overall justice, emotional exhaustion, and performance among entrepreneurs: do founders fare better?2019Inngår i: Small Business Economics, ISSN 0921-898X, E-ISSN 1573-0913, Vol. 53, nr 2, s. 355-368Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this paper, we build on the allostatic load model, developed in stress research, to explore the impact of entrepreneurs’ overall justice perceptions on emotional exhaustion and firm performance. Results revealed that the relationship between overall justice and emotional exhaustion was mediated by rumination about work. Further, building on recent work by Baron et al. (Journal of Management, 42(3), 742–768, 2016), which highlighted that company founders have more resources to deal with stress, we hypothesized that the relationship between rumination about work and emotional exhaustion was moderated by whether the entrepreneur was the founder of the venture or not. Results revealed that indeed founders appeared to be immune to the consequences of rumination about work elicited by injustice at work, while non-founders suffered from it. Moreover, emotional exhaustion was related to the monthly firm performance. Implications for research and practice are discussed.

    Fulltekst (pdf)
    fulltext
  • 190.
    Ssegonja, Richard
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin.
    Pihl, Charlotte
    Natl Board Hlth & Welf Socialstyrelsen, Stockholm, Sweden..
    Zethraeus, Niklas
    Karolinska Inst, Dept Learning Informat Management & Eth LIME, Stockholm, Sweden..
    Langenskiöld, Sophie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälsoekonomi.
    How Robust are Economic Evaluations of Parenting Programs for Managing Conduct Disorder?: A Systematic Literature Review2017Inngår i: Journal of Mental Health Policy and Economics, ISSN 1091-4358, E-ISSN 1099-176X, Vol. 20, nr S1, s. S31-S32Artikkel i tidsskrift (Annet vitenskapelig)
  • 191.
    Stehlik, Romana
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Bothelius, Kristoffer
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Smärta och sömn2019Inngår i: Smärta i klinisk praxis / [ed] Annica Rhodin, Lund: Studentlitteratur AB, 2019, 2, s. 249-264Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 192.
    Storm, Sigrid
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Westling, Jens
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Fyra problemorienterande samtal: En manualiserad behandling med fokus på reflekterande förmåga2014Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
    Abstract [sv]

    Det finns ett behov av korta behandlingsinsatser som kan minska samhälleliga kostnader såväl som vårdköer. En sådan behandlingsmetod är problemorienterande samtal. Denna studie baseras på en manualiserad form av metoden. Syftet var att undersöka metodens eventuella koppling till förändringar av självskattningar av depressionssymptom och generell psykisk hälsa mellan för- och eftermätning. Samtalsmetoden syftar särskilt till att uppmuntra deltagarnas reflekterande förmåga, varför även detta mättes med självskattningar. Dessutom undersöktes samband mellan processmåttet terapeutisk allians och förändringar av depressionssymptom och generell psykisk hälsa. Fyra problemorienterande samtal genomfördes med 20 deltagare i åldrarna 20-32 år. Resultatet visade på en minskning gällande depressionssymptom och en ökning av generell psykisk hälsa hos deltagarna, vilket går i linje med tidigare studier. Inga samband påträffades mellan terapeutisk allians och dessa mått. Reflekterande förmåga uppvisade en förändring på den ena av två subskalor, resultaten är dock osäkra. Generellt finns en viss osäkerhet gällande resultaten från alla studiens mätningar, såtillvida att inga kausala samband kan dras på grund av studiens design.

  • 193.
    Strömbom, Ylva
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Frequent attenders in primary care: Patient characteristics, help seeking patterns and cognitive behavioral therapy2019Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Frequent attenders consist of a small proportion of the total population seek-ing health care non-proportionally often for various symptoms. This hetero-genic group of patients requires special attention as symptoms often cannot be explained medically and influence both physical and psychological well-being.

    The overall aim was to describe characteristics and health issues that insti-gate help seeking behavior among frequent attenders and to piece together a treatment program addressing heterogeneous health problems with the pur-pose to reduce psychological distress, enhance quality of life and reduce visiting rates at general practitioners. Study I aimed to characterize frequent attenders in primary care with respect to symptomatology and utilization of health care resources. Data was collected from medical journals and compar-isons were made between frequent attenders and a comparison group. Among frequent attenders proportionally more women than men visited the health care system and both sexes had a large diversity and amount of health complaints and utilized health care staff resources more frequently. In study II health related quality of life was examined in relation to frequent attend-ance. Questionnaires were sent out to frequent attenders and a comparison. Results show a substantially reduced life quality among frequent attenders affecting almost all facets of life and individual differences in complaints translated into corresponding areas of reduced life quality. Cognitive behav-ior therapy given in a group format was performed and evaluated in study III. Improvements of illness symptoms and negative affect were found and remained over a year, but visits to health care did not diminish.

    In summation, frequent attenders used more health care resources and dis-played more health complaints as compared to non-frequent attenders. The nature of complaints was relatively independent suggesting symptom speci-ficity. They also experienced lower health related quality of life and symp-tom profiles matched domains with reduced life quality. Group CBT may be an efficient way to deal with some aspects related to health issues connected to frequent attenders. Generally, a biopsychosocial model seemed to account better for data than a purely biological model.

    Delarbeid
    1. Frequent attendersreport a higher number of symptoms and utilise more primary health care resources
    Åpne denne publikasjonen i ny fane eller vindu >>Frequent attendersreport a higher number of symptoms and utilise more primary health care resources
    (engelsk)Manuskript (preprint) (Annet vitenskapelig)
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-381970 (URN)
    Tilgjengelig fra: 2019-04-16 Laget: 2019-04-16 Sist oppdatert: 2019-04-16
    2. Health-related quality of life among frequent attenders in Swedish primary care: a cross-sectional observational study
    Åpne denne publikasjonen i ny fane eller vindu >>Health-related quality of life among frequent attenders in Swedish primary care: a cross-sectional observational study
    2019 (engelsk)Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, nr 7, s. 1-7, artikkel-id e026855Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objectives The aim was to examine health-related quality of life (HRQoL), patient characteristics and reasons for visits to general practitioners (GPs) by frequent attenders (FAs) and a comparison group (CG) in primary care.

    Methods Patients aged 18–64 years were eligible for the study. Medical records were scrutinised concerning reasons for visits. Questionnaires including short-form health survey (SF-36) were mailed to 331 FAs (≥5 visits at GPs during 2000) and 371 patients in a CG randomly selected from two healthcare centres and returned by 49% and 57%, respectively. FAs’ SF-36 health profiles were compared both to CG and general Swedish population norms.

    Results FAs report lower HRQoL than CG and below the general Swedish population norms in all eight SF-36 domains including both mental and physical component summary scores (MCS and PCS). Effect sizes (ESs) for differences between FAs and norms ranged from 0.79 to 1.08 for specific domains and was 0.94 for PCS and 0.71 for MCS. ESs of FAs versus CG ranged between 0.60 and 0.95 for the domains and was 0.76 for PCS and 0.49 for MCS. There were no significant differences between the FAs and CG with regard to sex, being married or cohabiting, number of children in household or educational level. FAs were more often unemployed, obese, slightly older and used complementary medicine more frequently. Except for injuries, all health complaints as classified in 10 categories were more common among FAs than CG, particularly musculoskeletal pain and psychosocial distress related to compromised HRQoL.

    Conclusion The HRQoL is compromised in FAs, both when compared with patients who do not often seek care and to general Swedish population norms. Commonly reported reasons for visiting GPs among FAs were musculoskeletal pain and psychosocial distress. Thus, perceived ill health, particularly pain and distress, seems important for high utilisation of healthcare resources.

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-381971 (URN)10.1136/bmjopen-2018-026855 (DOI)000485269700046 ()
    Tilgjengelig fra: 2019-04-16 Laget: 2019-04-16 Sist oppdatert: 2019-10-22bibliografisk kontrollert
    3. Cognitive behavioral therapy for frequent attenders in primary care
    Åpne denne publikasjonen i ny fane eller vindu >>Cognitive behavioral therapy for frequent attenders in primary care
    Vise andre…
    2018 (engelsk)Inngår i: Health Science Reports, ISSN Online ISSN 2398-8835Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    AbstractAim:The aim of the study is to investigate if cognitive behavioral therapy given in agroup setting affects anxiety and depression, stress, pain, coping strategies duringdaily life, and health‐related quality of life (HRQoL), among frequent attenders (FAs)in primary care.Methods:Cognitive behavioral therapy was offered to 331 FAs between 18 and65 years of age, of whom 89 accepted and 54 completed all steps in the protocol;patients were assigned to 1 of 3 groups: 0, 6, and 12‐month waiting time. The therapyconsisted of 12 sessions administered in group format. Outcome measures wereBeck's Anxiety Inventory (BAI), Beck's Depression Inventory (BDI), Hospital Anxietyand Depression Scale (HADS), Everyday Life Stress (ELS), Coping Strategy Question-naire, Multidimensional Pain Inventory‐Swedish version, and Short Form‐36.Results:Mean age among patients who completed cognitive behavioral therapywas 49.9 years, with a female majority (79.6%). Anxiety and depression scores werereduced after treatment (BAI 16.7 vs 13.6; BDI 16.3 vs 15.7; HADS‐Anxiety 8.41 vs6.05; HADS‐Depression 7.09 vs 5.69). Because waiting time itself did not affectsymptoms, differences reflect treatment effects. Stress ratings were not affected bytreatment. Use of nonadaptive coping strategies likepraying and hopingandcatastrophizingdecreased. Frequent attenders experienced a higher sense of lifecontrol. Frequent attenders reported significantly lower HRQoL than general Swedishpopulation norms in all 8 Short Form‐36 domains including mental and physicalcomponent summary scores (MCS and PCS), and all domains were unaffected bytreatment.Conclusion:Cognitive behavioral therapy exerts some beneficial effects in FAs.Content of treatment addressed musculoskeletal pain, stress, anxiety, and depression.This broad approach resulted in reduced anxiety, depression, and impact of painbecause of enhanced life control.

    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-381960 (URN)10.1002/hsr2.80 (DOI)
    Tilgjengelig fra: 2019-04-16 Laget: 2019-04-16 Sist oppdatert: 2019-09-02bibliografisk kontrollert
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  • 194.
    Strömbom, Ylva
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Gustavsson, Sara
    Melin, Lennart
    Frequent attendersreport a higher number of symptoms and utilise more primary health care resourcesManuskript (preprint) (Annet vitenskapelig)
  • 195.
    Strömbom, Ylva
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Karlsson, Jan
    Fredrikson, Mats
    Melin, Lennart
    Magnusson, Peter
    Cognitive behavioral therapy for frequent attenders in primary care2018Inngår i: Health Science Reports, ISSN Online ISSN 2398-8835Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AbstractAim:The aim of the study is to investigate if cognitive behavioral therapy given in agroup setting affects anxiety and depression, stress, pain, coping strategies duringdaily life, and health‐related quality of life (HRQoL), among frequent attenders (FAs)in primary care.Methods:Cognitive behavioral therapy was offered to 331 FAs between 18 and65 years of age, of whom 89 accepted and 54 completed all steps in the protocol;patients were assigned to 1 of 3 groups: 0, 6, and 12‐month waiting time. The therapyconsisted of 12 sessions administered in group format. Outcome measures wereBeck's Anxiety Inventory (BAI), Beck's Depression Inventory (BDI), Hospital Anxietyand Depression Scale (HADS), Everyday Life Stress (ELS), Coping Strategy Question-naire, Multidimensional Pain Inventory‐Swedish version, and Short Form‐36.Results:Mean age among patients who completed cognitive behavioral therapywas 49.9 years, with a female majority (79.6%). Anxiety and depression scores werereduced after treatment (BAI 16.7 vs 13.6; BDI 16.3 vs 15.7; HADS‐Anxiety 8.41 vs6.05; HADS‐Depression 7.09 vs 5.69). Because waiting time itself did not affectsymptoms, differences reflect treatment effects. Stress ratings were not affected bytreatment. Use of nonadaptive coping strategies likepraying and hopingandcatastrophizingdecreased. Frequent attenders experienced a higher sense of lifecontrol. Frequent attenders reported significantly lower HRQoL than general Swedishpopulation norms in all 8 Short Form‐36 domains including mental and physicalcomponent summary scores (MCS and PCS), and all domains were unaffected bytreatment.Conclusion:Cognitive behavioral therapy exerts some beneficial effects in FAs.Content of treatment addressed musculoskeletal pain, stress, anxiety, and depression.This broad approach resulted in reduced anxiety, depression, and impact of painbecause of enhanced life control.

    Fulltekst (pdf)
    fulltext
  • 196.
    Strömbom, Ylva
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Magnusson, Peter
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Gävleborg.
    Karlsson, Jan
    Fredrikson, Mats
    Health-related quality of life among frequent attenders in Swedish primary care: a cross-sectional observational study2019Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, nr 7, s. 1-7, artikkel-id e026855Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives The aim was to examine health-related quality of life (HRQoL), patient characteristics and reasons for visits to general practitioners (GPs) by frequent attenders (FAs) and a comparison group (CG) in primary care.

    Methods Patients aged 18–64 years were eligible for the study. Medical records were scrutinised concerning reasons for visits. Questionnaires including short-form health survey (SF-36) were mailed to 331 FAs (≥5 visits at GPs during 2000) and 371 patients in a CG randomly selected from two healthcare centres and returned by 49% and 57%, respectively. FAs’ SF-36 health profiles were compared both to CG and general Swedish population norms.

    Results FAs report lower HRQoL than CG and below the general Swedish population norms in all eight SF-36 domains including both mental and physical component summary scores (MCS and PCS). Effect sizes (ESs) for differences between FAs and norms ranged from 0.79 to 1.08 for specific domains and was 0.94 for PCS and 0.71 for MCS. ESs of FAs versus CG ranged between 0.60 and 0.95 for the domains and was 0.76 for PCS and 0.49 for MCS. There were no significant differences between the FAs and CG with regard to sex, being married or cohabiting, number of children in household or educational level. FAs were more often unemployed, obese, slightly older and used complementary medicine more frequently. Except for injuries, all health complaints as classified in 10 categories were more common among FAs than CG, particularly musculoskeletal pain and psychosocial distress related to compromised HRQoL.

    Conclusion The HRQoL is compromised in FAs, both when compared with patients who do not often seek care and to general Swedish population norms. Commonly reported reasons for visiting GPs among FAs were musculoskeletal pain and psychosocial distress. Thus, perceived ill health, particularly pain and distress, seems important for high utilisation of healthcare resources.

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    Fulltekst (pdf)
    fulltext
  • 197.
    Ståhlberg, Gustaf
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Teologiska fakulteten, Teologiska institutionen.
    Om kvalitetssäkring - för terapeutens skull1996Inngår i: Salubladet (Kontaktorgan för sammanslutning av Lukas-utbildade)Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 198.
    Sundström, Felicia
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Evidence-based policy2019Inngår i: Behavioral Insights for Public Policy: Concepts and Cases / [ed] Kai Ruggeri, New York and London: Routledge , 2019, 1, s. 17-40Kapittel i bok, del av antologi (Fagfellevurdert)
  • 199.
    Thorsell Cederberg, Jenny
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Acceptance for persons suffering from pain: Evaluation of acceptance-based interventions for adults with chronic pain and children with cancer experiencing acute pain2017Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    It is increasingly clear that pain and emotions are closely interconnected. Pain does not only cause psychological distress, but psychological distress also amplifies pain through neurological mechanisms. Treatment of both chronic and acute pain would benefit from acknowledging the psychological mechanisms of pain neurophysiology. Psychological acceptance predicts increased pain tolerance and decreased pain intensity and discomfort in experimentally induced pain and improved physical and psychosocial functioning for persons with chronic pain.

    The overall aim of this thesis was to evaluate acceptance-based interventions for persons suffering from pain.

    In Study I the effect of a manualised ACT-based self-help intervention for adults with chronic pain was evaluated in an RCT (n=90). The results showed improvements in satisfaction with life, physical functioning and pain intensity for the ACT group. Both the ACT and the control group improved regarding depression and anxiety. In Study II the mediating effect of acceptance for treatment change was evaluated, using data from Study I (n=64). The results showed indirect effects of treatment via acceptance for physical functioning but not for satisfaction with life. In Studies III and IV, instruments to measure psychological flexibility in relation to pain were developed for children with cancer, and their parents respectively, using factor analysis. The results showed that a two-factor solution for the child scale (n=61) and a three-factor solution for the parent scale (n=243), best represented the data. In Study V, an acceptance-based intervention was preliminarily evaluated in a single-subject study (n=5) for children reporting pain during cancer treatment. The intervention consisted of an approximately 15-minute long pain exposure exercise. All participants reported reduced discomfort of pain, and three of the participants reported reduced pain intensity.

    The results suggest that a manualised ACT-based self-help intervention is a valuable addition to the treatment repertoire for persons with chronic pain and that acceptance may mediate the effect of treatment on physical functioning. Furthermore, instruments to measure acceptance in the context of acute pain in children with cancer are now available, although further validation is needed. Lastly, the results indicate that an acceptance-based intervention may help children undergoing cancer treatment to cope with pain.

    Delarbeid
    1. A Comparative Study of 2 Manual-based Self-Help Interventions, Acceptance and Commitment Therapy and Applied Relaxation, for Persons With Chronic Pain
    Åpne denne publikasjonen i ny fane eller vindu >>A Comparative Study of 2 Manual-based Self-Help Interventions, Acceptance and Commitment Therapy and Applied Relaxation, for Persons With Chronic Pain
    Vise andre…
    2011 (engelsk)Inngår i: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 27, nr 8, s. 716-723Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objective: The aim of this study was to compare 2 self-help-based interventions; a coping-oriented approach, applied relaxation (AR) and an acceptance-oriented approach, acceptance and commitment therapy (ACT), for persons with chronic pain. Method: This study is a randomized control trial (N = 90) with a mixed between-within participants design with repeated measures. Interventions in both conditions comprised an initial face-to-face session, a 7-week manual-based self-help intervention including weekly therapist telephone support and a concluding face-to-face session. Outcome measures included satisfaction with life, depression, anxiety, acceptance of chronic pain, level of function, and pain intensity. Effects were measured at preintervention and postintervention and at 6 and 12 months after the end of intervention. Results: The results show that the ACT condition increased their level of acceptance significantly compared with the AR condition. There was also a marginally significant interaction effect regarding satisfaction with life in which the ACT condition had improved in comparison to the AR condition. Further, the ACT condition reported a higher level of function and decreased pain intensity compared with the AR condition. Both conditions improved significantly regarding depression and anxiety. Conclusions: A manual-based self-help intervention with weekly therapist support in an ACT format adds value to the treatment repertoire for persons suffering with chronic pain.

    Emneord
    chronic pain, manual-based, self-help, acceptance and commitment therapy, acceptance, satisfaction with life
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-159223 (URN)10.1097/AJP.0b013e318219a933 (DOI)000294709700009 ()
    Tilgjengelig fra: 2011-09-27 Laget: 2011-09-26 Sist oppdatert: 2018-02-20bibliografisk kontrollert
    2. Acceptance as a Mediator for Change in Acceptance and Commitment Therapy for Persons with Chronic Pain?
    Åpne denne publikasjonen i ny fane eller vindu >>Acceptance as a Mediator for Change in Acceptance and Commitment Therapy for Persons with Chronic Pain?
    Vise andre…
    2016 (engelsk)Inngår i: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, nr 1, s. 21-29Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background Cognitive behavior therapy (CBT) is considered effective for chronic pain, but little is known about active treatment components. Although acceptance correlates with better health outcomes in chronic pain patients, no study has examined its mediating effect in an experimental design. Purpose The aim of the present study is to investigate acceptance as a mediator in acceptance and commitment therapy (ACT), a third wave CBT intervention, for chronic pain. Method A bootstrapped cross product of coefficients approach was used on data from a previously published RCT evaluating ACT for chronic pain. To address the specificity of acceptance as a mediator, anxiety and depression were also tested as mediators. Outcome variables were satisfaction with life and physical functioning. Two change scores, preassessment to 6-month follow-up (n=53) and pre-assessment to 12-month follow-up (n=32), were used. Results Acceptance was found to mediate the effect of treatment on change in physical functioning from pre-assessment to follow-up at 6 months. Further, a trend was shown from pre-assessment to follow-up at 12 months. No indirect effect of treatment via acceptance was found for change in satisfaction with life. Conclusion This study adds to a small but growing body of research using mediation analysis to investigate mediating factors in the treatment of chronic pain. In summary, the results suggest that acceptance may have a mediating effect on change in physical functioning in ACT for persons with chronic pain. However, given the small sample size of the study, these findings need to be replicated.

    Emneord
    Acceptance, Acceptance and commitment therapy, Chronic pain, Mediation analysis, Physical functioning, Satisfaction with life
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-256448 (URN)10.1007/s12529-015-9494-y (DOI)000370243400003 ()26041582 (PubMedID)
    Tilgjengelig fra: 2015-06-23 Laget: 2015-06-23 Sist oppdatert: 2018-02-20bibliografisk kontrollert
    3. Parents’ relationship to pain during children's cancer treatment – a preliminary validation of the Pain Flexibility Scale for Parents
    Åpne denne publikasjonen i ny fane eller vindu >>Parents’ relationship to pain during children's cancer treatment – a preliminary validation of the Pain Flexibility Scale for Parents
    2017 (engelsk)Inngår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 10, s. 507-514Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objectives: Pain is one of the most frequent and burdensome symptoms for children with cancer. Psychological acceptance has been shown to be beneficial in chronic pain. Acceptance-based interventions for experimentally induced pain have been shown to predict increased pain tolerance and decreased pain intensity. An acceptance-based pilot study for children with cancer experiencing pain has shown promising results. Further, parental acceptance has been shown to predict decreased child distress. To date, no instruments measuring acceptance in the context of acute pain in children are available. The aim of this study was to develop and evaluate an instrument to measure acceptance in parents of children experiencing pain during cancer treatment. Methods: A test version of the Pain Flexibility Scale for Parents (PFS-P) was sent to parents of all children undergoing cancer treatment in Sweden at the time of the study. Exploratory factor analysis (n=243) examined numerous solutions. Internal consistency, test-retest reliability and convergent validity were calculated. Results: A three-factor Promax solution best represented the data. The subscales were pain resistance, valued action and pain fusion. Internal consistency was good (alpha=0.81-0.93), and the total scale and the subscales demonstrated temporal stability (r=0.76-0.87) and good convergent validity (-0.40 to -0.84). Discussion: The PFS-P measuring acceptance in parents of children experiencing pain during cancer treatment is now available, enabling evaluation of acceptance in the context of acute pain in children. The scale shows good psychometric properties but needs further validation.

    sted, utgiver, år, opplag, sider
    Dovepress, 2017
    Emneord
    acute pain, children, parents, acceptance, psychological flexibility, factor analysis
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-316716 (URN)10.2147/JPR.S127019 (DOI)000396320600001 ()
    Forskningsfinansiär
    Swedish Childhood Cancer Foundation, PR2013-0058Swedish Cancer Society, CAN2013/749
    Tilgjengelig fra: 2017-03-06 Laget: 2017-03-06 Sist oppdatert: 2018-02-20bibliografisk kontrollert
    4. Children’s and adolescents’ relationship to pain during cancer treatment: a preliminary validation of the Pain Flexibility Scale for Children
    Åpne denne publikasjonen i ny fane eller vindu >>Children’s and adolescents’ relationship to pain during cancer treatment: a preliminary validation of the Pain Flexibility Scale for Children
    2017 (engelsk)Inngår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 10, s. 1171-1178Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Objectives: Children with cancer often suffer from pain. Pain is associated with psychological distress, which may amplify the pain experience. In chronic pain, it has been shown that psychological acceptance is helpful for both adults and children. For experimentally induced pain, interventions fostering psychological acceptance have been shown to predict increases in pain tolerance and reductions in pain intensity and discomfort of pain. A single subject study aiming to nurture psychological acceptance for children with cancer experiencing pain has shown promising results. No instruments measuring psychological acceptance in acute pain are yet available. The aim of the current study was to develop and preliminarily evaluate an instrument to measure psychological acceptance in children experiencing pain during cancer treatment.

    Methods: A test version of the Pain Flexibility Scale for Children was sent to all children aged 7–18 years undergoing cancer treatment in Sweden at the time of the study. Exploratory factor analysis was used. Internal consistency, test–retest reliability, and convergent validity were examined.

    Results: Sixty-one children participated in the study. A two-factor solution with Promax rotation was found to best represent the data. Internal consistency was good to excellent (a =0.87–0.91). The total scale and the subscales demonstrated temporal stability (Intraclass correlation coefficient =0.56–0.61) and satisfactory convergent validity (r=−0.27 to −0.68).

    Discussion: The Pain Flexibility Scale for Children measuring psychological acceptance in children with cancer experiencing pain is now available for use. This enables the evaluation of acceptance as a mediator for treatment change in the context of acute pain in children with cancer, which in turn is a step forward in the development of psychological treatments to help children cope with the pain during these difficult circumstances. The scale shows good psychometric properties but needs further validation, particularly considering the small sample size.

    sted, utgiver, år, opplag, sider
    Dove Medical Press, 2017
    Emneord
    Acute pain, children, acceptance, psychological flexibility, factor analysis, Akut smärta, barn och ungdomar, acceptans, psykologisk flexibilitet, faktoranalys
    HSV kategori
    Forskningsprogram
    Psykologi
    Identifikatorer
    urn:nbn:se:uu:diva-322391 (URN)10.2147/JPR.S137871 (DOI)000401610300001 ()
    Forskningsfinansiär
    Swedish Childhood Cancer Foundation, FTJH11/002 och PR2013/0058Swedish Cancer Society, CAN2013/749
    Tilgjengelig fra: 2017-05-22 Laget: 2017-05-22 Sist oppdatert: 2018-02-20bibliografisk kontrollert
    5. An acceptance-based intervention for children and adolescents with cancer experiencing acute pain - a single-subject study
    Åpne denne publikasjonen i ny fane eller vindu >>An acceptance-based intervention for children and adolescents with cancer experiencing acute pain - a single-subject study
    2017 (engelsk)Inngår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 10, s. 2195-2203Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: Children and adolescents with cancer report pain as one of their most recurrent and troublesome symptoms throughout the cancer trajectory. Pain evokes psychological distress, which in turn has an amplifying effect on the pain experience. Acceptance-based interventions for experimentally induced acute pain predict increased pain tolerance, decreased pain intensity and decreased discomfort of pain. The aim of this study was to preliminarily evaluate an acceptance-based intervention for children and adolescents with cancer experiencing acute pain, with regard to feasibility and effect on pain intensity and discomfort of pain. Methods: This is a single-subject study with an AB design with a nonconcurrent multiple baseline. Children and adolescents aged four to 18 years undergoing cancer treatment at the Children's University Hospital, Uppsala, Sweden, reporting sustained acute pain were offered participation. Pain intensity and discomfort of pain were measured during baseline and at post-intervention. The intervention consisted of a pain exposure exercise lasting approximately 15 minutes. Results: Five children participated in the study. All participants completed the intervention and reported that it had helped them to cope with the pain in the moment. All participants reported decreased discomfort of pain at post-measurement, three of whom also reported decreased pain intensity. Conclusion: The results suggest that an acceptance-based intervention may help children and adolescents with cancer to cope with the pain that is often associated with cancer treatment in spite of pharmacological pain management. The results are tentative but promising and warrant further investigation.

    Emneord
    acute pain, acceptance, pain intensity, discomfort of pain
    HSV kategori
    Identifikatorer
    urn:nbn:se:uu:diva-335543 (URN)10.2147/JPR.S139087 (DOI)000409405400001 ()28919815 (PubMedID)
    Forskningsfinansiär
    Swedish Childhood Cancer Foundation, FTJH11/002, PR2013/0058Swedish Cancer Society, CAN2013/749
    Tilgjengelig fra: 2017-12-06 Laget: 2017-12-06 Sist oppdatert: 2018-02-28bibliografisk kontrollert
    Fulltekst (pdf)
    fulltext
    Download (jpg)
    presentationsbild
  • 200.
    Thorsell Cederberg, Jenny
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Weineland Strandskov, Sandra
    Dahl, JoAnne
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Ljungman, Gustaf
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Children’s and adolescents’ relationship to pain during cancer treatment: a preliminary validation of the Pain Flexibility Scale for Children2017Inngår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 10, s. 1171-1178Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Children with cancer often suffer from pain. Pain is associated with psychological distress, which may amplify the pain experience. In chronic pain, it has been shown that psychological acceptance is helpful for both adults and children. For experimentally induced pain, interventions fostering psychological acceptance have been shown to predict increases in pain tolerance and reductions in pain intensity and discomfort of pain. A single subject study aiming to nurture psychological acceptance for children with cancer experiencing pain has shown promising results. No instruments measuring psychological acceptance in acute pain are yet available. The aim of the current study was to develop and preliminarily evaluate an instrument to measure psychological acceptance in children experiencing pain during cancer treatment.

    Methods: A test version of the Pain Flexibility Scale for Children was sent to all children aged 7–18 years undergoing cancer treatment in Sweden at the time of the study. Exploratory factor analysis was used. Internal consistency, test–retest reliability, and convergent validity were examined.

    Results: Sixty-one children participated in the study. A two-factor solution with Promax rotation was found to best represent the data. Internal consistency was good to excellent (a =0.87–0.91). The total scale and the subscales demonstrated temporal stability (Intraclass correlation coefficient =0.56–0.61) and satisfactory convergent validity (r=−0.27 to −0.68).

    Discussion: The Pain Flexibility Scale for Children measuring psychological acceptance in children with cancer experiencing pain is now available for use. This enables the evaluation of acceptance as a mediator for treatment change in the context of acute pain in children with cancer, which in turn is a step forward in the development of psychological treatments to help children cope with the pain during these difficult circumstances. The scale shows good psychometric properties but needs further validation, particularly considering the small sample size.

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