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  • 1.
    Arnberg, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Long-Term Posttraumatic Stress in Survivors from Disasters and Major Accidents2012Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Disasters and major accidents are a significant cause of distress worldwide. High levels of posttraumatic stress can become chronic after severe and prolonged psychological trauma, raising concerns about the extent of adverse long-term consequences after single events. The present thesis aimed to describe the course and burden of posttraumatic stress in survivors from a ferry disaster in the Baltic Sea, an airliner crash-landing in Gottröra, Sweden, and a bus accident involving Swedish 6th grade schoolchildren in Måbødalen, Norway.

    The participants were surveyed 1 month to 4 years after the events and again after 14 to 20 years. The follow-up surveys included 33 ferry disaster survivors, 70 airline survivors, and 7 surviving schoolchildren with a comparison group from the same school (n = 33). Short- and long-term changes in posttraumatic stress were estimated separately in generalised regression models refined by linear splines. In-depth interviews were conducted with 22 ferry survivors 15 years after the disaster, including structured clinical interviews and thematic analysis of survivors’ descriptions of consequences of the event and social support.

    Approximately half of all survivors experienced significant posttraumatic stress at the initial assessments. Significant long-term distress was noted in one fourth of the ferry survivors and one sixth of the airline survivors. The bus crash was not associated with significant long-term posttraumatic stress. A poorer long-term outcome was noted in women and in bereaved survivors.

    The thematic analysis revealed that long-term consequences not only included negative aspects but also positive ones, including personal growth and existential awareness. There was ample availability of social support, although the need for support extended over a period of several years. Barriers to support from significant others were described in detail by the survivors.

    The results extend previous research by providing a comprehensive account of long-term consequences of disasters and major accidents in light of early reactions. The interviews provide some new insights into features of social support that warrant further study. Important future challenges include evaluating whether timely attention to survivors at risk for chronic distress and significant others can facilitate recovery.

    Delarbeid
    1. Traumatic bereavement, acute dissociation, and posttraumatic stress: 14 years after the MS Estonia disaster
    Åpne denne publikasjonen i ny fane eller vindu >>Traumatic bereavement, acute dissociation, and posttraumatic stress: 14 years after the MS Estonia disaster
    2011 (engelsk)Inngår i: Journal of Traumatic Stress, ISSN 0894-9867, E-ISSN 1573-6598, Vol. 24, nr 2, s. 183-190Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    This prospective longitudinal study aimed to examine posttraumatic stress in survivors 14 years after a ferry disaster, and estimate short- and long-term changes in stress associated with traumatic bereavement and acute dissociation. There were 852 people who perished in the disaster, 137 survived. The 51 Swedish survivors were surveyed with the Impact of Event Scale-Revised (IES-R) at 3 months, 1, 3, and 14 years (response rates 82%, 65%, 51%, and 69%). Symptoms decreased from 3 months to 1 year; no change was found thereafter. After 14 years, 27% reported significant symptoms. Traumatic bereavement, but not acute dissociation, was associated with long-term symptom elevation. Chronic posttraumatic stress can persist in a minority of survivors, and traumatic bereavement appears to hinder recovery.

    Emneord
    posttraumatic stress disorder, bereavement, dissociation, disasters, survivors, Estonia prospective studies, posttraumatisk stress, förlustdrabbade, dissociation, katastrof, överlevande, Estonia
    HSV kategori
    Forskningsprogram
    Psykiatri; Psykologi
    Identifikatorer
    urn:nbn:se:uu:diva-151374 (URN)10.1002/jts.20629 (DOI)000289528300006 ()21442665 (PubMedID)
    Prosjekter
    Long-term posttraumatic stress in survivors from disasters and major accidents
    Tilgjengelig fra: 2011-04-11 Laget: 2011-04-11 Sist oppdatert: 2017-12-11bibliografisk kontrollert
    2. Fifteen years after a ferry disaster: Clinical interviews and survivors’ self-assessment of their experience
    Åpne denne publikasjonen i ny fane eller vindu >>Fifteen years after a ferry disaster: Clinical interviews and survivors’ self-assessment of their experience
    2013 (engelsk)Inngår i: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 4, s. 20650-Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background:

    Disasters yield increased rates of psychological disorders decades later. Other consequences, however, have received little attention in the past.

    Objective:

    We aimed to examine diagnostic status and survivors’ views on disaster-related consequences and social support.

    Methods:

    A mixed-methods approach was used with 22 survivors (of 49 eligible) 15 years after a ferry disaster. Data collection included audiotaped interviews with open-ended questions and diagnostic assessment of Axis-I disorders.

    Results:

    The post-disaster incidence was 54% (12/22) for Axis-I disorders, and 45% (10/22) for full or subsyndromal posttraumatic stress disorder. Thematic analysis revealed that survivor perception of the longterm consequences included positive (character change) and negative aspects (being ascribed a survivor identity). Participants’ sought social support for several years, yet many felt hindered by experiential dissimilarity and distress of significant others.

    Conclusions:

    Axis-I disorders were prevalent, but not salient to survivors’ perceptions in the long-term. Postdisaster interventions need to attend to common barriers to support.

    Emneord
    posttraumatic stress disorder, survivors, diagnosis, social support, posttraumatic growth, mixed methods, PTSD, överlevande, posttraumatisk stress, socialt stöd, Estonia
    HSV kategori
    Forskningsprogram
    Psykiatri; Psykologi
    Identifikatorer
    urn:nbn:se:uu:diva-169280 (URN)10.3402/ejpt.v4i0.20650 (DOI)000332099200001 ()
    Prosjekter
    Long-term posttraumatic stress in survivors from disasters and major accidents
    Tilgjengelig fra: 2012-02-27 Laget: 2012-02-27 Sist oppdatert: 2017-12-07bibliografisk kontrollert
    3. Posttraumatic stress in survivors 1 month to 19 years after an airliner emergency landing
    Åpne denne publikasjonen i ny fane eller vindu >>Posttraumatic stress in survivors 1 month to 19 years after an airliner emergency landing
    2015 (engelsk)Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 3, artikkel-id e0119732Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Posttraumatic stress (PTS) is common in survivors from life-threatening events. Little is known, however, about the course of PTS after life threat in the absence of collateral stressors (e.g., bereavement, social stigma, property loss) and there is a scarcity of studies about PTS in the long term. This study assessed the short- and long-term course of PTS, and the influence of gender, education and age on the level and course of PTS, in survivors from a non-fatal airliner emergency landing caused by engine failure at an altitude of 1 km. There were 129 persons on board. A survey including the Impact of Event Scale was distributed to 106 subjects after 1 month, 4 months, 14 months, and 25 months, and to 95 subjects after 19 years (response rates 64–83%). There were initially high levels of PTS. The majority of changes in PTS occurred from 1 to 4 months after the event. There were small changes from 4 to 25 months but further decrease in PTS thereafter. Female gender was associated with higher levels of PTS whereas gender was unrelated to the slope of the short- and long-term trajectories. Higher education was related to a quicker recovery although not to initial or long-term PTS. Age was not associated with PTS. The present findings suggest that a life-threatening experience without collateral stressors may produce high levels of acute posttraumatic stress, yet with a benign prognosis. The findings further implicate that gender is unrelated to trajectories of recovery in the context of highly similar exposure and few collateral stressors.

    Emneord
    Aviation disasters, Posttraumatic stress, Longitudinal studies, Long-term studies
    HSV kategori
    Forskningsprogram
    Psykiatri; Psykologi
    Identifikatorer
    urn:nbn:se:uu:diva-169279 (URN)10.1371/journal.pone.0119732 (DOI)000350314700063 ()25734536 (PubMedID)
    Prosjekter
    Long-term posttraumatic stress in survivors from disasters and major accidents
    Tilgjengelig fra: 2012-02-27 Laget: 2012-02-27 Sist oppdatert: 2017-12-07bibliografisk kontrollert
    4. A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident
    Åpne denne publikasjonen i ny fane eller vindu >>A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident
    2011 (engelsk)Inngår i: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, Vol. 5, nr 8Artikkel i tidsskrift (Fagfellevurdert) Published
    Abstract [en]

    Background: Although road traffic accidents (RTA) are a major cause of injury and a cause of posttraumatic stress (PTS) in the aftermath, little is known about the long-term psychological effects of RTA.

    Methods: This prospective longitudinal study assessed long-term PTS, grief, and general mental health after a bus carrying 23 sixth-grade schoolchildren crashed on a school outing and 12 children died. Directly affected (i.e., children in the crash) and indirectly affected children (i.e., all pupils in the sixth grade who were not in the crash) were surveyed at 9 months (N = 102), 4 years (N = 51), and 20 years (N = 40) after the event. Psychological distresswas assessed by single items, including sadness, avoidance, intrusions, and guilt. After 20 years, PTS was assessed by the Impact of Event Scale–Revised.

    Results: Stress reactions were prevalent 9 months after the event, with sadness (69%) and avoidance (59%) being highly represented in both directly and indirectly affected groups, whereas, nightmares (60%) and feelings of guilt (50%) were only frequent in those directly affected. The frequency of sadness and avoidance decreased after 4 years in the indirectly exposed (ps < .05). After 20 years, the directly affected had a higher prevalence of PTS (p = .003), but not decreased general mental health (p = .14), than those indirectly affected.

    Conclusions: The limitations preclude assertive conclusions. Nonetheless, the findings corroborate previous studies reporting traumatic events are associated with long-term PTS, but not with decreased general mental health.

    sted, utgiver, år, opplag, sider
    London: BioMed Central, 2011
    Emneord
    road traffic accidents, posttraumatic stress, children, adolescents, disasters
    HSV kategori
    Forskningsprogram
    Psykiatri; Psykologi; Barn- och ungdomspsykiatri; Psykologi
    Identifikatorer
    urn:nbn:se:uu:diva-150258 (URN)10.1186/1753-2000-5-8 (DOI)
    Tilgjengelig fra: 2011-04-09 Laget: 2011-03-28 Sist oppdatert: 2012-04-19bibliografisk kontrollert
  • 2.
    Arnberg, Filip
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Cernvall, Martin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Bergh Johannesson, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Development and Pilot-testing of the Swedish Version of the PTSD Coach2016Konferansepaper (Fagfellevurdert)
    Abstract [en]

    In Sweden, four out of five people have smartphones, indicating the potential to increase the reach of low- intensity support after trauma via smartphone-apps to aid recovery. While there are many apps in the mental health field available to the general public, their effects are rarely evaluated. The PTSD Coach smartphone-app was developed by the VA ́s National Center for PTSD—Dissemination and Training Division. A Swedish version was developed by using existing code while making adjustment to the content for a Swedish context with a view for use by both civilians and veterans. A pilot study is underway and the findings will be used to inform a larger efficacy study. To date, 31 participants have been recruited to the pilot study, in which they use the Swedish version of the PTSD Coach for four weeks. Pre- and post- assessments include a structured clinical interview (MINI), PCL-5, PHQ-9 and the Swedish version of the PTSD Coach Survey. The participants’ experiences with using the app are explored in focus groups. During this presentation, the adaptation for the Swedish PTSD Coach will be outlined and experiences from the development and pilot study of the Swedish version will be described. 

  • 3.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Alaie, Iman
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Parling, Thomas
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Jonsson, Ulf
    Karolinska institutet; Statens beredning för medicinsk utvärdering.
    Recent randomized controlled trials of psychological interventions in healthcare: A review of their quantity, scope, and characteristics2013Inngår i: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 75, nr 5, s. 401-408Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Objective: This study aimed to describe the quantity, scope, and fundamental characteristics of recently published randomized controlled trials (RCTs) of psychological interventions.

    Methods: We queried two major databases (PsycINFO and PubMeD) for primary reports published in 2010 of RCTs of psychological interventions for participants with a medical condition. We collected data on the characteristics of the trials, participants, interventions, outcomes, and reports.

    Results: Of 3,696 retrieved reports 295 primary publications were included. About half (53%) of trials included participants with a mental disorder and more than half evaluated interventions based on a cognitive behavioral therapy (CBT) framework. A majority of trials recruited participants in North America and Europe (79%). A minority of the trials focused on children and adolescents (17%) or the elderly (8%). The median sample size of the intervention arm was n = 41. Thirty-nine percent of trials reported solely patient-reported outcomes. Only 5% of reports indicated funding from for-profit organizations. The median 2010 impact factor of the journals in which reports were published was 2.96.

    Conclusion: This snapshot of the research on psychological interventions suggests that the evidence base for psychological interventions is expanding mainly for CBT interventions for adults in high-income countries. Although the restrictive inclusion criteria limit the generalizability of these results, researchers and funding agencies might be advised to strive for greater diversity regarding interventions, geographical/cultural settings and age groups. Regularly updated reviews of this research field, with gradually refined methodology and increased scope, may further inform funders and researchers.

  • 4.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Bergh Johannesson, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Melin, Lennart
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Differences in social support between groups of tsunami survivors and the correlation between social support and posttraumatic stress after 14 months2009Konferansepaper (Fagfellevurdert)
  • 5.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Bergh Johannesson, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Melin, Lennart
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Is Social Support Equally Important for Both Directly and Indirectly Affected Disaster Victims?2011Inngår i: European Journal of Psychotraumatology: Volume 2 Supplement 1, 2011, s. 72-72Konferansepaper (Fagfellevurdert)
    Abstract [en]

    There has been much research on social support and its association with both general mental and physical health, and social support is an important salutogenic factor after traumatic events. Still, the magnitude of the effect of social support on posttraumatic stress (PTS) is not fully understood. In particular, the importance of social support after disasters may be contingent on exposure severity. In a survey of Swedish tourists 14 months after the tsunami in Southeast Asia (N4910), in which the survivors were exposed to few post-disaster adversities, detailed information on exposure severity allowed for an examination of the effect of the interaction between social support and exposure severity on PTS. Social support was assessed by the Crisis Support Scale and PTS by the Impact of Event Scale-Revised. Preliminary analyses will be presented, and the size and significance of the effect will be discussed.

  • 6.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Bergh Johannesson, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Prevalence and Duration of PTSD in Survivors Six Years After a Natural Disaster2013Inngår i: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 27, nr 3, s. 347-352Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 7.
    Arnberg, Filip K.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Bondjers, Kristina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sveen, Josefin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Panel discussion: early interventions after traumatic events2015Inngår i: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 6, artikkel-id 28636Artikkel i tidsskrift (Annet vitenskapelig)
  • 8.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Eriksson, Nils-Gustaf
    Mariehamn, Åland, Finland.
    Hultman, Christina M
    Institutionen för medicinsk epidemiologi och biostatistik, Karolinska Institutet.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    A longitudinal study of posttraumatic stress: from 3 months to 14 years after the m/s Estonia disaster2009Konferansepaper (Fagfellevurdert)
  • 9.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Eriksson, Nils-Gustaf
    Mariehamn, Åland, Finland.
    Hultman, Christina M
    Institutionen för medicinsk epidemiologi och biostatistik, Karolinska Institutet.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Traumatic bereavement, acute dissociation, and posttraumatic stress: 14 years after the MS Estonia disaster2011Inngår i: Journal of Traumatic Stress, ISSN 0894-9867, E-ISSN 1573-6598, Vol. 24, nr 2, s. 183-190Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This prospective longitudinal study aimed to examine posttraumatic stress in survivors 14 years after a ferry disaster, and estimate short- and long-term changes in stress associated with traumatic bereavement and acute dissociation. There were 852 people who perished in the disaster, 137 survived. The 51 Swedish survivors were surveyed with the Impact of Event Scale-Revised (IES-R) at 3 months, 1, 3, and 14 years (response rates 82%, 65%, 51%, and 69%). Symptoms decreased from 3 months to 1 year; no change was found thereafter. After 14 years, 27% reported significant symptoms. Traumatic bereavement, but not acute dissociation, was associated with long-term symptom elevation. Chronic posttraumatic stress can persist in a minority of survivors, and traumatic bereavement appears to hinder recovery.

  • 10.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Fang, Fang
    Karolinska Institutet.
    Hultman, Christina M
    Karolinska Institutet.
    Valdimarsdottir, Unnur A
    University of Iceland.
    Can a Natural Disaster Lead to Suicide Attempts and Psychiatric Disorders in Adults? A 5-Year Matched Cohort Study2015Konferansepaper (Fagfellevurdert)
  • 11.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Gudmundsdottír, Ragnhildur
    University of Iceland.
    Valdimarsdottír, Unnur
    University of Iceland; Harvard School of Public Health.
    Can a Natural Disaster Increase the Risks of Suicide Attempts and Psychiatric Disorders in Children and Adolescents? A 5-Year Matched Cohort Study2014Konferansepaper (Fagfellevurdert)
  • 12.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Stress Research Institute, Stockholm University.
    Gudmundsdóttir, Ragnhildur
    Butwicka, Agnieszka
    Fang, Fang
    Lichtenstein, Paul
    Hultman, Christina M
    Valdimarsdóttir, Unnur A
    Psychiatric disorders and suicide attempts in Swedish survivors of the 2004 southeast Asia tsunami: a 5 year matched cohort study2015Inngår i: The Lancet Psychiatry, ISSN 2215-0366, Vol. 2, nr 9, s. 817-824Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Survivors of natural disasters are thought to be at an increased risk of psychiatric disorders, however the extent of this risk, and whether it is linked to pre-existing psychopathology, is not known. We aimed to establish whether Swedish survivors of tsunamis from the 2004 Sumatra–Andaman earthquake had increased risks of psychiatric disorders and suicide attempts 5 years after repatriation.

    Methods

    We identified Swedish survivors repatriated from southeast Asia (8762 adults and 3742 children) and 864 088 unexposed adults and 320 828 unexposed children matched for sex, age, and socioeconomic status. We retrieved psychiatric diagnoses and suicide attempts from the Swedish patient register for the 5 years after the tsunami (from Dec 26, 2004, to Jan 31, 2010) and estimated hazard ratios (HRs), then adjusted for pre-tsunami psychiatric disorders, and, for children, for parental pre-tsunami disorders.

    Findings

    Exposed adults were more likely than unexposed adults to receive any psychiatric diagnosis (547 [6.2%] vs 47 734 [5.5%]; adjusted HR 1.21, 95% CI 1.11–1.32), particularly stress-related disorders (187 [2.1%] vs 8831 [1.0%]; 2.27, 1.96–2.62) and suicide attempts (38 [0.43%] vs 2752 [0.32%]; 1.54, 1.11–2.13), but not mood or anxiety disorders. Risk of psychiatric diagnoses did not differ between exposed and unexposed children and adolescents (248 [6.6] vs 22 081 [6.9%]; 0.98, 0.86–1.11), although exposed children and adolescents had a higher risk for suicide attempts with uncertain intent (1.43; 1.01–2.02) and stress-related disorders (1.79; 1.30–2.46), mainly during the first 3 months after the tsunami.

    Interpretation

    The 2004 tsunami was, independently of previous psychiatric morbidity, associated with an increased risk of severe psychopathology, mainly stress-related disorders and suicide attempts, in children and adults. Survivors of natural disasters should be targeted with early interventions and active long-term follow-up to prevent, detect, and alleviate psychiatric disorders that might follow.

  • 13.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Hultman, Christina M
    Institutionen för medicinsk epidemiologi och biostatistik, Karolinska Institutet.
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Fifteen years after a ferry disaster: Clinical interviews and survivors’ self-assessment of their experience2013Inngår i: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 4, s. 20650-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Disasters yield increased rates of psychological disorders decades later. Other consequences, however, have received little attention in the past.

    Objective:

    We aimed to examine diagnostic status and survivors’ views on disaster-related consequences and social support.

    Methods:

    A mixed-methods approach was used with 22 survivors (of 49 eligible) 15 years after a ferry disaster. Data collection included audiotaped interviews with open-ended questions and diagnostic assessment of Axis-I disorders.

    Results:

    The post-disaster incidence was 54% (12/22) for Axis-I disorders, and 45% (10/22) for full or subsyndromal posttraumatic stress disorder. Thematic analysis revealed that survivor perception of the longterm consequences included positive (character change) and negative aspects (being ascribed a survivor identity). Participants’ sought social support for several years, yet many felt hindered by experiential dissimilarity and distress of significant others.

    Conclusions:

    Axis-I disorders were prevalent, but not salient to survivors’ perceptions in the long-term. Postdisaster interventions need to attend to common barriers to support.

  • 14.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Hultman, Christina M
    Institutionen för medicinsk epidemiologi och biostatistik, Karolinska Institutet.
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Social support moderates posttraumatic stress and general distress after disaster2012Inngår i: Journal of Traumatic Stress, ISSN 0894-9867, E-ISSN 1573-6598, Vol. 25, nr 6, s. 721-727Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Social support buffers the negative impact of stressful events. Less, however, is known about the characteristics of this association in the context of disaster and findings have been discrepant regarding direct and buffering effects. This study tested whether the protective effects of social support differed across levels of exposure severity (i.e., buffered distress) and assessed whether the buffering effect differed between event-specific and general distress. Participants were 4,600 adult Swedish tourists (44% of invited; 55% women) repatriated within 3 weeks after the 2004 Indian Ocean tsunami. A survey 14 months after the disaster included the Crisis Support Scale, the Impact of Event Scale-Revised (IES-R), and the General Health Questionnaire (GHQ-12). Social support buffered the negative impact of exposure on both outcomes. The support and distress association ranged from very small in participants with low exposure to moderate in those with high exposure (ηp2 = .004 to .053). The buffering effect was not found to differ between the IES-R and GHQ-12, F(2, 4589) = 0.87, p = .42. The findings suggest that social support moderates the stressor-distress relationship after disasters. This study might help explain discrepant findings and point to refinements of postdisaster interventions.

  • 15.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Hultman, Christina M
    Institutionen för medicinsk epidemiologi och biostatistik, Karolinska Institutet.
    Rydelius, Per-Anders
    Karolinska institutet.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Prospective longitudinal long-term studies 14-20 years after three disasters2011Inngår i: European Journal of Psychotraumatology: Volume 2 Supplement 1, 2011, s. 72-72Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Although clinical experience and past research have shown that posttraumatic stress (PTS) can last for decades after a disaster, long-term follow-ups are scarce and little is known about predictors of chronic PTS. In this presentation, long-term consequences of disasters will be described by a summary of the findings from three surveys of man-made/technological disasters with 2-4 assessments during the first 34-4 years and with a long-term assessment of PTSD and general mental health after 14-20 years (Ns = 33-57). Similarities and dissimilarities in the course of PTS between the disasters will be presented. The influence of traumatic bereavement, psychological or pharmacological treatment, and additional negative life events on long-term PTS will be discussed, and experiences form conducting long-term studies will be communicated.

  • 16.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Sstressforskningsinstitutet, Stockholms universitet.
    Hultman, Christina M
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Valdimarsdottir, Unnur A
    Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland; Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.
    Registration and definitions of mental disorders in Swedish survivors of the 2004 southeast Asia tsunami: – Authors' response2015Inngår i: Lancet psychiatry, ISSN 2215-0374, E-ISSN 2215-0366, Vol. 2, nr 11, s. 962-963Artikkel i tidsskrift (Fagfellevurdert)
  • 17.
    Arnberg, Filip K.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Johannesson, Kerstin Bergh
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Posttraumatisk stress: Vad vi bör göra efter allvarliga händelser2013Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, nr 3, s. 95-98Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [sv]

    I Sverige och Norden finns en god infrastruktur för psykosociala insatser i det tidiga skedet efter allvarliga händelser. Tillgången till senare adekvat psykologisk behandling är dock bristfällig.

    Akuta insatser bör ha tyngdpunkten på att främja de drabbades egen förmåga till återhämtning.

    Det är ineffektivt att förebygga posttraumatisk stress genom tidiga terapeutiska interventioner till alla drabbade oavsett symtomgrad.

    I Norden används fortfarande insatser som forskning avråder från.

    Traumafokuserad psykologisk behandling bör vara förs­tahandsval vid posttraumatiskt stressyndrom.

    Flera läkemedel kan lindra posttraumatisk stress, men effekten är liten.

  • 18.
    Arnberg, Filip K.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden..
    Lekander, Mats
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.;Karolinska Inst, Osher Ctr Integrat Med, Stockholm, Sweden..
    Morey, Jennifer N.
    Univ Kentucky, Dept Psychol, 125 Kastle Hall, Lexington, KY 40506 USA..
    Segerstrom, Suzanne C.
    Univ Kentucky, Dept Psychol, 125 Kastle Hall, Lexington, KY 40506 USA..
    Self-rated health and interleukin-6: Longitudinal relationships in older adults2016Inngår i: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 54, s. 226-232Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Both self-rated health (SRH) and inflammation are implicated in chronic diseases and premature mortality. Better SRH is associated with lower proinflammatory cytokines, but there is little evidence about whether this relationship is more stable or dynamic. Objective: To study the between- and within-person associations between SRH and IL-6. Methods: Older adults (N = 131; M-age = 75 years) rated their health and provided blood samples for analysis of IL-6 at separate occasions every 6 months over a period up to 5 years. Age, sex, BMI, neuroticism, and statin use were examined as covariates in multilevel models. Results: In bivariate models, better SRH, lower BMI, younger age, and female sex correlated with lower IL-6. In multilevel models, stable SRH (between-person differences; p < .001) but not dynamic SRH (within-person changes; p = .93) correlated with IL-6. The stable relationship persisted with demographic and health covariates in the model. Conclusions: Better stable SRH but not dynamic SRH was robustly associated with lower IL-6 among older adults, lending support to previous cross-sectional findings on the relation between inflammatory markers and SRH. The findings suggest that trait-like mechanisms, rather than changes over a time scale of 6-month waves, govern this association. To further investigate the mechanisms behind the SRH-IL-6 association, studies with different measurement frequencies, higher within-person variability, and experimental approaches are warranted.

  • 19.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Linton, Steven J
    Hultcrantz, Monica
    Heintz, Emelie
    Jonsson, Ulf
    Internet-delivered psychological treatments for mood and anxiety disorders: a systematic review of their efficacy, safety, and cost-effectiveness2014Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, nr 5, s. e98118-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Greater access to evidence-based psychological treatments is needed. This review aimed to evaluate whether internet-delivered psychological treatments for mood and anxiety disorders are efficacious, noninferior to established treatments, safe, and cost-effective for children, adolescents and adults.

    METHODS: We searched the literature for studies published until March 2013. Randomized controlled trials (RCTs) were considered for the assessment of short-term efficacy and safety and were pooled in meta-analyses. Other designs were also considered for long-term effect and cost-effectiveness. Comparisons against established treatments were evaluated for noninferiority. Two reviewers independently assessed the relevant studies for risk of bias. The quality of the evidence was graded using an international grading system.

    RESULTS: A total of 52 relevant RCTs were identified whereof 12 were excluded due to high risk of bias. Five cost-effectiveness studies were identified and three were excluded due to high risk of bias. The included trials mainly evaluated internet-delivered cognitive behavioral therapy (I-CBT) against a waiting list in adult volunteers and 88% were conducted in Sweden or Australia. One trial involved children. For adults, the quality of evidence was graded as moderate for the short-term efficacy of I-CBT vs. waiting list for mild/moderate depression (d = 0.83; 95% CI 0.59, 1.07) and social phobia (d = 0.85; 95% CI 0.66, 1.05), and moderate for no efficacy of internet-delivered attention bias modification vs. sham treatment for social phobia (d = -0.04; 95% CI -0.24, 0.35). The quality of evidence was graded as low/very low for other disorders, interventions, children/adolescents, noninferiority, adverse events, and cost-effectiveness.

    CONCLUSIONS: I-CBT is a viable treatment option for adults with depression and some anxiety disorders who request this treatment modality. Important questions remain before broad implementation can be supported. Future research would benefit from prioritizing adapting treatments to children/adolescents and using noninferiority designs with established forms of treatment.

  • 20.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    A Longitudinal Study of Survivors from an Airliner Crash: Gender Differences and Trajectories of Posttraumatic Stress2013Konferansepaper (Fagfellevurdert)
  • 21.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Melin, Lennart
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Can Demographic and Exposure Characteristics Predict Levels of Social Support in Survivors from a Natural Disaster?2013Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, nr 6, s. e65709-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective Lack of social support is a strong predictor for poor mental health after disasters. Psychosocial post-disaster interventions may benefit from targeting survivors at risk oflow support, yet it is unknown whether demographic and disaster exposure characteristics are associated with social support. This study assessed if age, gender, educational status, cohabitation, and disaster exposure severity predicted aspects of informal social support in a cohort of Swedish survivors from the 2004 Southeast Asian tsunami.

    Methods The participants were 3,536 disaster survivors who responded to a mail survey 14 months after the disaster (49% response rate). Their perceptions of present emotional support, contact with others, tangible support, negative support and overall satisfaction with informal support were assessed with the Crisis Support Scale and analysed in five separate ordinal regressions.

    Results Demographic factors and exposure severity explained variation in social supports although the effect size and predictive efficiency were modest. Cohabitation and female gender were associated with both more positive and more negative support. Single-household men were especially at risk for low emotional support and younger women were more likely to perceive negative support. Higher education was associated with more positive support, whereas no clear pattern was found regarding age as a predictor. Disaster exposure severity was associated with more negative support and less overall support satisfaction.

    Conclusions After a disaster that entailed little disruptions to the community the associations between demographic characteristics and social support concur with findings in the general population. The findings suggest that psychosocial disaster interventions may benefit from targeting specific groups of survivors.

  • 22.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Michel, Per-Olof
    Utvärdering av Stockholms läns landstings katastrofmedicinska insatser vid attentatet på Drottninggatan den 7 april, 2017: Del II - En utvärdering av SLL:s krisstödsinsatser2017Rapport (Annet vitenskapelig)
  • 23.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Bergh Johannesson, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Properties of Swedish Posttraumatic Stress Measures after a Disaster2014Inngår i: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 28, nr 4, s. 402-409Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 24.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset. Stressforskningsinstitutet, Stockholms universitet.
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Posttraumatic stress in survivors 1 month to 19 years after an airliner emergency landing2015Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 3, artikkel-id e0119732Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Posttraumatic stress (PTS) is common in survivors from life-threatening events. Little is known, however, about the course of PTS after life threat in the absence of collateral stressors (e.g., bereavement, social stigma, property loss) and there is a scarcity of studies about PTS in the long term. This study assessed the short- and long-term course of PTS, and the influence of gender, education and age on the level and course of PTS, in survivors from a non-fatal airliner emergency landing caused by engine failure at an altitude of 1 km. There were 129 persons on board. A survey including the Impact of Event Scale was distributed to 106 subjects after 1 month, 4 months, 14 months, and 25 months, and to 95 subjects after 19 years (response rates 64–83%). There were initially high levels of PTS. The majority of changes in PTS occurred from 1 to 4 months after the event. There were small changes from 4 to 25 months but further decrease in PTS thereafter. Female gender was associated with higher levels of PTS whereas gender was unrelated to the slope of the short- and long-term trajectories. Higher education was related to a quicker recovery although not to initial or long-term PTS. Age was not associated with PTS. The present findings suggest that a life-threatening experience without collateral stressors may produce high levels of acute posttraumatic stress, yet with a benign prognosis. The findings further implicate that gender is unrelated to trajectories of recovery in the context of highly similar exposure and few collateral stressors.

  • 25.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Rydelius, Per-Anders
    Institutionen för kvinnors och barns hälsa, Karolinska Institutet.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident2011Inngår i: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, Vol. 5, nr 8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Although road traffic accidents (RTA) are a major cause of injury and a cause of posttraumatic stress (PTS) in the aftermath, little is known about the long-term psychological effects of RTA.

    Methods: This prospective longitudinal study assessed long-term PTS, grief, and general mental health after a bus carrying 23 sixth-grade schoolchildren crashed on a school outing and 12 children died. Directly affected (i.e., children in the crash) and indirectly affected children (i.e., all pupils in the sixth grade who were not in the crash) were surveyed at 9 months (N = 102), 4 years (N = 51), and 20 years (N = 40) after the event. Psychological distresswas assessed by single items, including sadness, avoidance, intrusions, and guilt. After 20 years, PTS was assessed by the Impact of Event Scale–Revised.

    Results: Stress reactions were prevalent 9 months after the event, with sadness (69%) and avoidance (59%) being highly represented in both directly and indirectly affected groups, whereas, nightmares (60%) and feelings of guilt (50%) were only frequent in those directly affected. The frequency of sadness and avoidance decreased after 4 years in the indirectly exposed (ps < .05). After 20 years, the directly affected had a higher prevalence of PTS (p = .003), but not decreased general mental health (p = .14), than those indirectly affected.

    Conclusions: The limitations preclude assertive conclusions. Nonetheless, the findings corroborate previous studies reporting traumatic events are associated with long-term PTS, but not with decreased general mental health.

  • 26.
    Arnberg, Filip K
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Rydelius, Per-Anders
    Institutionen för kvinnors och barns hälsa, Karolinska Institutet.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Twenty years later: a follow-up study after the Måbødalen school-bus accident, August 15th, 19882009Konferansepaper (Fagfellevurdert)
  • 27.
    Bergh Johannesson, Kerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Traumatiska minnen kan behandlas effektivt med EMDR2007Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 104, nr 10, s. 782-783Artikkel i tidsskrift (Annet vitenskapelig)
  • 28.
    Bergh Johannesson, Kerstin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Arinell, Hans
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Arnberg, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Six years after the wave: Trajectories of posttraumatic stress following a natural disaster2015Inngår i: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 36, s. 15-24Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

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

    Methods

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

    Results

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

    Conclusions

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

  • 29.
    Bergh Johannesson, Kerstin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Arnberg, Filip K
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Svenskarna som överlevde tsunamin mår relativt bra: Uppföljning sex år efter katastrofen 20042012Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, nr 37, s. 1607-1609Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [sv]

    Hälsoläget i hela den undersökta populationen av överlevande svenskar sex år efter flodvågskatastrofen 2004 ter sig relativt gott.

    Jämfört med den förra undersökningen tre år efter tsunamin finns indikationer på en viss fortsatt återhämtning.

    Kvinnor visar besvär i något större utsträckning än män.

    En minoritet har fortfarande problem, i synnerhet de som var utsatta för livshot. Fördjupade studier kommer att belysa faktorer av betydelse för olika vägar till återhämtning.

  • 30.
    Bergh Johannesson, Kerstin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Fröjd, Thomas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Hultman, Christina M
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Tsunami-exposed tourist survivors: Signs of recovery in an 3-year perspective2011Inngår i: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 199, nr 3, s. 162-169Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Long-term follow-up after disaster exposure indicates increased rates of psychological distress. However, trajectories and rates of recovery in large samples of disaster-exposed survivors are largely lacking. A group of 3457 Swedish survivors temporarily on vacation in Southeast Asia during the 2004 tsunami were assessed by postal questionnaire at 14 months and 3 years after the tsunami regarding post-traumatic stress reactions (IES-R) and general mental health (GHQ-12). There was a general pattern of resilience and recovery 3 years postdisaster. Severe exposure and traumatic bereavement were associated with increased post-traumatic stress reactions and heightened risk for impaired mental health. The rate of recovery was lower among respondents exposed to life threat and among bereaved. Severe trauma exposure and bereavement seem to have considerable long-term impact on psychological distress and appear to slow down the recovery process. Readiness among health agencies for identification of symptoms and provision of interventions might facilitate optimal recovery.

  • 31.
    Bergh Johannesson, Kerstin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Hultman, Christina M.
    Fröjd, Thomas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Prolonged Grief Among Traumatically Bereaved Relatives Exposed and Not Exposed to a Tsunami2011Inngår i: Journal of Traumatic Stress, ISSN 0894-9867, E-ISSN 1573-6598, Vol. 24, nr 4, s. 456-464Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Numerous studies on the mental health consequences of traumatic exposure to a disaster compare those exposed to those not exposed. Relatively few focus on the effect of the death of a close relative caused by the disaster-suffering a traumatic bereavement. This study compared the impact on 345 participants who lost a close relative in the 2004 Indian Ocean tsunami, but who were themselves not present, to 141 who not only lost a relative, but also were themselves exposed to the tsunami. The focus was on psychological distress assessed during the second year after the sudden bereavement. Findings were that exposure to the tsunami was associated with prolonged grief (B = 3.81) and posttraumatic stress reactions (B 665), and doubled the risk for impaired mental health. Loss of children increased the risk for psychological distress (prolonged grief B = 692; The Impact of Event Scale-Revised: B = 610; General Health Questionnaire-12: OR = 2.34). Women had a higher frequency of prolonged grief For men, loss of children presented a higher risk for prolonged grief in relation to other types of bereavement (B = 636 vs. loss of partner). Further long-term follow-up could deepen the understanding of how recovery after traumatic loss is facilitated.

  • 32.
    Bergh Johannesson, Kerstin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Hultman, Christina M.
    Department of Medical Epimediology and Biostatistics, Karolonska Institutet.
    Lindam, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Dyster-Aas, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Arnberg, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    The effect of Traumatic Bereavement on Tsunami-Exposed Survivors2009Inngår i: Journal of Traumatic Stress, ISSN 0894-9867, E-ISSN 1573-6598, Vol. 22, nr 6, s. 497-504Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Fourteen months after the 2004 tsunami, mental health outcome was assessed in 187 bereaved relatives, 308 bereaved friends, and in 3,020 nonbereaved Swedish survivors. Of the bereaved relatives, 41% reported posttraumatic stress reactions and 62% reported impaired general mental health. Having been caught or chased by the tsunami in combination with bereavement was associated with increased posttraumatic stress reactions. Complicated grief reactions among relatives were almost as frequent as posttraumatic stress reactions. The highest levels of psychological distress were found among those who had lost children. Traumatic bereavement, in combination with exposure to life danger, is probably a risk factor for mental health sequelae after a natural disaster.

  • 33.
    Bergh Johannesson, Kerstin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Specialistteam för traumarelaterade störningar -en bristvara i Sverige: Både resurser och effektiva behandlingsmetoder saknas, visar enkätstudie2005Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, nr 47, s. 3532-3536Artikkel i tidsskrift (Fagfellevurdert)
  • 34.
    Bergh Johannesson, Kerstin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Michel, Per-Olof
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Hultman, Christina M
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.
    Lindam, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Arnberg, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Impact of Exposure to Trauma on Posttraumatic Stress Disorder Symptomatology in Swedish Tourist Tsunami Survivors2009Inngår i: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 197, nr 5, s. 316-323Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim was to examine long-term mental health and posttraumatic stress symptomatology in a Swedish tourist population after exposure to the 2004 Southeast Asian tsunami. Data from 4822 returned questionnaires 14 months after the disaster were analyzed. Respondents were categorized into 3 subgroups: (1) danger-to-life exposure group (having been caught or chased by the waves), (2) nondanger-to-life exposure group (exposed to other disaster-related stressors), and (3) low exposure group. Main outcome measures were General Health Questionnaire-12 and Impact of Event Scale-22-Revised. Danger-to-life exposure was an important factor in causing more severe posttraumatic stress symptoms and in affecting mental health. Female gender, single status, and former trauma experiences were associated with greater distress. Other factors related to more severe symptoms were loss of relatives, physical injuries, viewing many dead bodies, experiencing life threat, and showing signs of cognitive confusion. Disaster exposure has a substantial impact on survivors, which stresses the need for long-lasting support.

  • 35.
    Bergh Johannesson, Kerstin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Stefanini, Stefano
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Lundin, Tom
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Ulleråker, Akademiska sjukhuset.
    Anchisi, Roberto
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Impact of bereavement among relatives in Italy and Sweden after the Linate airplane disaster2006Inngår i: International Journal of Disaster Medicine, ISSN 1503-1438, E-ISSN 1755-4713, Vol. 4, nr 3, s. 110-117Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives

    Victims of major disasters are at risk for development of posttraumatic stress disorder (PTSD). The aim of this study was to compare two groups of bereaved relatives from Italy and Sweden, and to examine the role of psychosocial support and psychological reactions 18 months after traumatic bereavement.

    Method

    153 bereaved relatives of deceased victims in the Milano/Linate air plane crash were assessed through a questionnaire. Reactions of psychological distress were measured by the Impact of Event Scale-Revised (IES-R).

    Results

    In the total group 53, 2 % showed symptoms indicating that they might meet the DSM-IV criteria for PTSD. The frequency was higher among the Italian relatives (58.7%) compared to the Swedish (42, 6 %). Females compared to males showed more signs of posttraumatic reactions in the total population as did spouses and parents within the Italian group. The general health status, measured by subjective evaluation, was significantly affected in both groups as a result of the disaster. A significant recovery after 18 months was reported, although not to the pre-accident level. The Swedish relatives had a pattern of using more psychotherapy compared to the Italians among whom it was more common to use medication both for anxiety and sleeping problems. The need for psychotherapy and medication was related to higher scores on IES-R.

    Conclusions: (1) Traumatic losses deeply affect bereaved relatives. Health is affected and a large group of these relatives develop strong symptoms of post-traumatic stress. (2) Swedish bereaved relatives seem to be more apt to ask for professional help, e.g. psychotherapy, while in Italy it is more common to rely on family, friends and medication. (3) Acute organized psychosocial support in the aftermath can possibly facilitate for victims to handle a traumatic loss but it does not prevent the development of strong post-traumatic reactions. Future investigations may show how it is possible to optimize the help with more specific interventions of support and treatment.

  • 36.
    Bondjers, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Arnberg, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    DSM-5 and ICD-11 symptom profiles in a diverse sample of trauma victims2017Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Introduction: Research suggest different trajectories of posttraumatic stress symptoms over time (e.g., resilient, recovering, and chronic) among survivors from natural disasters. It is not known, however, if disaster survivors present with distinct symptom profiles and, if so, whether these profiles are related to severity, recovery and exposure characteristics.Methods and Results: This study aims to investigate symptom profiles among Swedish survivors of the 2004 Indian Ocean tsunami using latent profile analysis. Participants include adult survivors who were pulled into the waves and responded to postal surveys 1 and 3 years after the disaster (n=2009). Posttraumatic stress symptoms were assessed with the Impact of Event Scale-Revised (IES-R). The symptom profiles generated from the first year survey will be compared with regard to established predictors of posttraumatic stress, such as disaster exposure, bereavement, perceived social support as well as posttraumatic stress and general distress at three years.Discussion: The presentation will shed light on whether there are distinct symptom profiles among disaster survivors. We will discuss the implications for psychosocial care after natural disasters. The results are relevant for victims of natural disasters in general, and increases knowledge about the characteristics of posttraumatic stress and may improve psychosocial services after traumatic events.

  • 37.
    Bondjers, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Arnberg, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Screening for chronic PTSD after disasters: The gap between self-reported posttraumatic stress and PTSD cases in psychiatric services2017Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Introduction: Screening disaster survivors for mental health problems after initial recovery may detect unrecognized cases of chronic PTSD. This presentation compares published findings of PTSD prevalence after the 2004 tsunami among exposed Swedish adult survivors.

    Method: Register data were collected for psychiatric diagnoses made in specialized healthcare for 8762 Swedish adults with various levels of disaster exposure. Posttraumatic stress (PTS) was assessed and exposure established for 2268 individuals who filled out the Impact of Event Scale–Revised (IES-R) in surveys at 1, 3, and 6 years post-disaster. A subset of directly exposed participants (n=142) were assessed for current and post-disaster PTSD with SCID interviews.

    Results: In the survey sample, 5% of participants reported very high and 11% reported high levels of PTS across all surveys. The post-disaster prevalence of PTSD was 11.3% in the interview sample. In healthcare services, the 5-year incidence was 0.5% for PTSD and 2.1% for any stress-related disorder. Findings suggested that the IES-R possessed good screening properties, e.g., sensitivity ≥ 0.92.

    Discussion: These studies indicate large differences between the PTS load among survivors and the number of PTSD cases in healthcare services, making a case for individual symptom screening. Yet, screening for chronic PTSD with current methods will yield a substantial numbers of incorrectly classified survivors (640 false positives in this sample), providing challenges to psychosocial follow-up services.

    Part of symposium: Screening for mental health after trauma in children and adults: importance, instruments, & innovations

  • 38.
    Bondjers, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Arnberg, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Symptom profiles of posttraumatic stress among Swedish survivors of a natural disaster and their prospective value to long-term distress2017Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Introduction: Research suggest different trajectories of posttraumatic stress symptoms over time (e.g., resilient, recovering, and chronic) among survivors from natural disasters. It is not known, however, if disaster survivors present with distinct symptom profiles and, if so, whether these profiles are related to severity, recovery and exposure characteristics.Methods and Results: This study aims to investigate symptom profiles among Swedish survivors of the 2004 Indian Ocean tsunami using latent profile analysis. Participants include adult survivors who were pulled into the waves and responded to postal surveys 1 and 3 years after the disaster (n=2009). Posttraumatic stress symptoms were assessed with the Impact of Event Scale-Revised (IES-R). The symptom profiles generated from the first year survey will be compared with regard to established predictors of posttraumatic stress, such as disaster exposure, bereavement, perceived social support as well as posttraumatic stress and general distress at three years.Discussion: The presentation will shed light on whether there are distinct symptom profiles among disaster survivors. We will discuss the implications for psychosocial care after natural disasters. The results are relevant for victims of natural disasters in general, and increases knowledge about the characteristics of posttraumatic stress and may improve psychosocial services after traumatic events.

  • 39.
    Bondjers, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Ekselius: Psykiatri.
    Hyland, Philip
    Department of Psychology, Maynooth University, Kildare, Ireland.
    Roberts, Neil P.
    Cardiff & Vale University Health Board, Cardiff, United Kingdom; UK School of Medicine, Cardiff University, Cardiff, United Kingdom.
    Bisson, Jonathan I.
    UK School of Medicine, Cardiff University, Cardiff, United Kingdom.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Ekselius: Psykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Arnberg, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Ekselius: Psykiatri.
    Validation of a clinician-administered diagnostic measure of ICD-11 PTSD and Complex PTSD: the International Trauma Interview in a Swedish sample2019Inngår i: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 10, nr 1, artikkel-id 1665617Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The recently published ICD-11 includes substantial changes to the diagnosis of posttraumatic stress disorder (PTSD) and introduces the diagnosis of Complex PTSD (CPTSD). The International Trauma Interview (ITI) has been developed for clinicians to assess these new diagnoses but has not yet been evaluated.

    Objectives: To evaluate the psychometric properties of the Swedish translation of the ITI by examining the interrater agreement, latent structure, internal consistency, and convergent and discriminant validity.

    Methods: In a prospective study, 186 adults who had experienced a potentially traumatic event were assessed with the ITI and answered questionnaires for symptoms of posttraumatic stress, other psychiatric disorders, functional disability, and quality of life (QoL).

    Results: The diagnostic rate was 16% for PTSD and 6% for CPTSD. Interrater agreement was satisfactory (α = .76), and confirmatory factor analysis indicated that a two-factor second-20 order model consistent with the ICD-11 model of CPTSD provided acceptable fit to the data. Composite reliability analysis demonstrated that the ITI possessed acceptable internal reliability, and associations with measures of other psychiatric disorders, insomnia, functional disability, and QoL supported the concurrent validity of the ITI.

    Conclusion: Swedish ITI shows promise as a clinician-administered instrument to assess and diagnose ICD-11 PTSD and CPTSD.

  • 40.
    Bondjers, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Roberts, Neil
    Cardiff and Vale University Health Board, Cardiff, Wales, UK.
    Bisson, Jonathan
    Cardiff University School of Medicine, Cardiff, Wales, UK.
    Hyland, Philip
    Department of Psychology, Maynooth University, Ireland.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Arnberg, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.
    Reliability and validity of the Swedish international trauma interview for posttraumatic stress disorders in the ICD-112019Inngår i: European Journal of Psychotraumatology: Trauma in Transition: Building Bridges, 2019, Vol. 10, artikkel-id 1613836Konferansepaper (Fagfellevurdert)
  • 41.
    Bondjers, Kristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Kunskapscentrum för katastrofpsykiatri.