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  • 1.
    Ahren-Moonga, Jennie
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Holmgren, Sven
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    von Knorring, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    af Klinteberg, Britt
    Personality traits and self-injurious behaviour in patients with eating disorders2008Ingår i: European eating disorders review, ISSN 1072-4133, E-ISSN 1099-0968, Vol. 16, nr 4, s. 268-275Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The interest in different aspects of personality and the neuropsychological basis for behaviour in eating disorder patients has increased over the last decade. The present study aims at exploring personality traits, self-injurious behaviour (SIB) and suicide attempts in a group of severely ill eating disorder patients. Patients with eating disorders (N = 38) and age-matched controls (N = 67) were examined concerning self-reported personality traits by means of the Karolinska scales of personality (KSP). Psychosocial history and SIB was collected from medical records. Depression was rated by means of the Beck Depression Inventory (BDI). Results indicated significantly higher anxiety-related and detachment traits in both anorexia nervosa (AN) and bulimia nervosa (BN) patients and higher hostility in BN patients than controls. No specific personality traits could be defined as typical for self-injurious or suicidal behaviour. The AN group was lower than the BN group on scales measuring impulsivity, guilt and anxiety. Furthermore, presence of SIB and suicide attempts was more frequent among the BN patients.

  • 2.
    Alenius, Malin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Hammarlund-Udenaes, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Hartvig, Per
    Sundquist, Staffan
    Lindström, Leif
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Treatmentresponse in psychotic patients classified according to social and clinical needs, drug side effects, and previous treatment; a method to identify functional remission2009Ingår i: Comprehensive Psychiatry, ISSN 0010-440X, E-ISSN 1532-8384, Vol. 50, nr 5, s. 453-462Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Various approaches have been made over the years to classify psychotic patients according to inadequate treatment response, using terms such as treatment resistant or treatment refractory. Existing classifications have been criticized for overestimating positive symptoms; underestimating residual symptoms, negative symptoms, and side effects; or being to open for individual interpretation. The aim of this study was to present and evaluate a new method of classification according to treatment response and, thus, to identify patients in functional remission. METHOD: A naturalistic, cross-sectional study was performed using patient interviews and information from patient files. The new classification method CANSEPT, which combines the Camberwell Assessment of Need rating scale, the Udvalg for Kliniske Undersøgelser side effect rating scale (SE), and the patient's previous treatment history (PT), was used to group the patients according to treatment response. CANSEPT was evaluated by comparison of expected and observed results. RESULTS: In the patient population (n = 123), the patients in functional remission, as defined by CANSEPT, had higher quality of life, fewer hospitalizations, fewer psychotic symptoms, and higher rate of workers than those with the worst treatment outcome. CONCLUSION: In the evaluation, CANSEPT showed validity in discriminating the patients of interest and was well tolerated by the patients. CANSEPT could secure inclusion of correct patients in the clinic or in research.

  • 3.
    Appel, Lieuwe
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för onkologi, radiologi och klinisk immunologi.
    Michelgård, Åsa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Linnman, Claes
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Fernandez, Manuel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Furmark, Tomas
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Langström, Bengt
    von Knorring, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Fredrikson, Mats
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Altered NK1-receptor availability in patients with post traumatic stress disorder2009Ingår i: [Biological Psychiatry 2009, 65(8), Suppl. 1, 118S, no. 394], 2009, s. 118S-Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Posttraumatic stress disorder (PTSD) is an anxiety disorder that can develop after one or more traumatic events causing extreme stress or grave physical harm. The neurokinin-1 (NK1) receptor is the primary receptor for substance P (SP); a neuropeptide suggested being involved in anxiety and depression. The present study investigated differences in NK1-receptor availability between PTSD patients and healthy controls, using positron emission tomography (PET). Methods: Eleven male refugee patients (age: 41±10) with DSM-IV defined PTSD and nine healthy male control subjects (age: 33±10) were investigated using the PET-tracer [11C]GR205171, supplied by Uppsala Imanet. GR205171 is a highly selective NK1-receptor antagonist. Scans were performed during 60 minutes in the resting state. Parametric images were generated using the graphical reference Patlak method assuming irreversible binding of [11C]GR205171 from 20-60 minutes and having cerebellum as reference region. Exploratory whole brain analyses were performed using the statistical parametric mapping (SPM2) software. Results: PTSD patients had lower [11C]GR205171 binding compared to controls, in frontal cortical clusters encompassing bilaterally insula and left Brodmann area 11, reflecting lower NK1-receptor availability. No areas were found in which PTSD patients had higher [11C]GR205171 binding. Conclusions: This is the first study reporting differences in NK1-receptor availability in PTSD patients relative to controls. A tentative conclusion is that PTSD patients have a down regulation of the NK1-receptor system, which could be either a risk factor or due to emotional trauma processing.

  • 4.
    Arakelian, Erebouni
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Laurssen, Emma
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Öster, Caisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Older Patients' Worries in Connection With General Anesthesia and Surgery - A Qualitative Study2018Ingår i: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, nr 6, s. 822-833Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To examine anxiety and what older patients worry about related to anesthesia and colorectal surgery, and their perceptions regarding nurses' ability to ease preoperative worry.

    Design: Qualitative individual face-to-face interviews.

    Methods: The study included 18 patients aged between 62 and 91 years with lower abdominal tumors. The study was conducted in two day-surgery wards in Sweden. Interview data were analyzed with Malterud's systematic text condensation.

    Findings: Four themes were identified: (1) losing control of one's body, leaving one's life in someone else's hands, and the feeling that there is no going back, (2) claustrophobia and anticipated pain in an unknown environment, (3) unknown and frightening vocabulary concerning the surgery, and (4) what can happen if something goes wrong.

    Conclusions: Patients worry about a number of things. If preoperative worry could be identified, actions taken to reduce worry could be personalized and patients' own strategies to reduce worries may be helpful for them.

  • 5. Archer, Trevor
    et al.
    Fredriksson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Delayed Exercise-Induced Functional and Neurochemical Partial Restoration Following MPTP2012Ingår i: Neurotoxicity research, ISSN 1029-8428, E-ISSN 1476-3524, Vol. 21, nr 2, s. 210-221Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In two experiments, MPTP was administered to C57/BL6 mice according to a single-dose weekly regime (MPTP: 1 x 30 mg/kg on the fifth day of the week, Friday, over 4 weeks) with vehicle group (Vehicle: 1 x 5 ml/kg) treated concurrently. Exercise schedules (delayed) were introduced either at the beginning of the week after the second MPTP injection (MPTP + Exercise(2) group), or at the beginning of the week after the fourth MPTP injection (MPTP + Exercise(4) group). Wheel-running was provided on the first 4 days of each week (Monday-Thursday) more than 30-min periods. In Experiment I, wheel-running exercise was introduced either after 2 or 4 weeks after MPTP/Vehicle. MPTP and Vehicle groups not provided access to the running wheels were placed in single cages within the wheel-running room over 30-min concomitantly with the wheel-running groups. In Experiment II, wheel-running exercise was introduced 2 weeks after MPTP/Vehicle but a no-exercise control group with non-revolving wheel included (MPTP-Wheel). In both experiments, spontaneous motor activity tests during 60-min intervals were performed at the end (Fridays) of weeks 1, 2, 3, 4, 6, 8, and 10, where the week on which the first injection of MPTP was the first week; in the case of weeks 1-4, this was immediately before MPTP/Vehicle injections. It was observed that the introduction of the exercise schedule after the second MPTP injection, but not after the fourth injection, restored motor activity that had been markedly elevated by the end of the tenth week. Subthreshold administration of l-dopa tests was performed after the spontaneous motor activity tests 6, 8 and 10; these indicated significant effects of exercise, MPTP + Exercise(2) group, on Tests 6 and 8, but not Test 10. The physical exercise schedule in that group also showed markedly attenuated loss of dopamine (DA). Restoration of MPTP-induced motor activity deficits and DA loss was a function of the point at which exercise was introduced, in the present case after two administrations of the neurotoxin. In Experiment II, physical exercise markedly attenuated the hypokinesic effect of MPTP in the exercise condition, MPTP-exercise, but not in the non-exercise conditions, MPTP-Cage and MPTP-Wheel, for both spontaneous motor activity and l-dopa-induced activity. MPTP-induced loss of DA was also attenuated by exercise.

  • 6. Archer, Trevor
    et al.
    Fredriksson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    The Yeast Product Milmed Enhances the Effect of Physical Exercise on Motor Performance and Dopamine Neurochemistry Recovery in MPTP-Lesioned Mice2013Ingår i: Neurotoxicity research, ISSN 1029-8428, E-ISSN 1476-3524, Vol. 24, nr 3, s. 393-406Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Both clinical and laboratory studies have demonstrated that different types of physical exercise may alleviate Parkinsonism yet evidence for complete restoration of motor function and biomarker integrity are difficult to identify. MPTP (1 x 30 mg/kg, s.c., 4 groups) or saline (vehicle 1 x 5 ml/kg, s.c., 1 group) were administered in a single dose regime over three consecutive weeks on Fridays. Three MPTP groups were given four 30-min periods/week (Mondays to Thursdays), of these two groups, MPTP + Exer + M(i) and MPTP + Exer + M(ii); the former were introduced to exercise and Milmed (oral injection) on the week following the 1st MPTP injection and the latter on the Monday prior to the 1st injection of MPTP onwards. One MPTP group, MPTP + Exer, was given access to exercise (running wheels) from the week following the 1st MPTP injection onwards. The fourth MPTP group, MPTP-NoEx, and the Vehicle group were only given access to exercise on a single day each week (Wednesdays, exercise test) from the week following the 1st MPTP injection onwards. The exercise/exercise + Milmed regime was maintained for a further 9 weeks. It was observed that exercise by itself ameliorated MPTP-induced deficits regarding motor function and dopamine loss only partially whereas in the groups combining exercise with twice weekly dosages of Milmed the MPTP-induced deficits were abolished by the 10th week of the intervention. The three main conclusions that were drawn from correlational analyses of individual mice were: (i) that DA integrity was observed to be a direct function of ability to express running exercise in a treadmill wheel-running arrangement, and (ii) that DA integrity was observed to be a direct function of the capacity for motor performance as measured by spontaneous motor activity and subthreshold l-Dopa (5 mg/kg) induced activity in the motor activity test chambers, and (iii) that the extent to which running exercise in a running wheel was predictive of later motor performance in the activity test chambers was highly convincing.

  • 7. Archer, Trevor
    et al.
    Garcia, Danilo
    Fredriksson, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Restoration of MPTP-induced deficits by exercise and Milmed (R) co-treatment2014Ingår i: PeerJ, ISSN 2167-8359, E-ISSN 2167-8359, Vol. 2, s. e531-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) induces permanent neurochemical and functional deficits. Following the administration of either two or four injections of the dopamine neurotoxin, MPTP, at a dose of 40 mg/kg, C57/BL6 mice were given access to running-wheels (30-min sessions, four times/week, Monday-Thursday) and treatment with the treated yeast, Milmed (R) (four times/week, Monday-Thursday), or simply running-wheel exercise by itself, over ten weeks. It was observed that the combination of physical exercise and Milmed (R) treatment, the MPTP + Exercise + Yeast (MC) group [MPTP + Exercise + Milmed (R) (MC)], restored spontaneous motor activity markedly by test day 10, restored completely subthreshold L-Dopa-induced activity, and dopamine concentration to 76% of control values, in the condition wherein two administrations of MPTP (2 x 40 mg/kg) were given prior to initiation of exercise and/or Milmed (R) treatment. Physical exercise by itself, MPTP + Exercise (MC) group, attenuated these deficits only partially. Administration of MPTP four times (i.e., 40 mg/kg, s.c., once weekly over four weeks for a total of 160 mg/kg, MPTP + Exercise + Yeast (MC) group [MPTP + Exercise + Milmed (R) (SC)] and MPTP + Exercise (SC), induced a lesioning effect that was far too severe for either exercise alone or the exercise + Milmed (R) combination to ameliorate. Nevertheless, these findings indicate a powerful effect of physical exercise reinforced by Milmed (R) treatment in restoring MPTP-induced deficits of motor function and dopamine neurochemistry in mice.

  • 8.
    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 Accidents2012Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Allvarliga händelser som katastrofer eller stora olyckor kan leda till svår psykisk belastning på kort sikt. Svåra posttraumatiska stressreaktioner kan bli beständiga efter svår traumatisering som omsorgssvikt eller övergrepp. Det är därför angeläget att undersöka omfattningen av psykologiska konsekvenser efter enskilda händelser som katastrofer och stora olyckor. Denna avhandling syftade till att beskriva utvecklingen av posttraumatisk stress på lång sikt hos överlevande efter förlisningen av MS Estonia 1994, nödlandingen av ett passagerarflygplan i Gottröra 1991 och efter en olycka med en skolbuss medförande en skolklass från årskurs sex.

    De överlevande tillskickades enkäter 1 månad till 4 år efter händelsen, samt efter 14 till 20 år. Långtidsenkäterna besvarades av 33 överlevande från färjekatastrofen, 70 från flygolyckan samt 7 överlevande från bussolyckan och 33 personer från parallellklasserna. Intervjuer genomfördes med 22 överlevande 15 år efter färjekatastrofen.

    Ungefär hälften av alla överlevande upplevde betydande posttraumatiska stressreaktioner vid tidpunkten för den första enkäten. Frekventa stressreaktioner fanns kvar hos 27 % fjorton år efter färjekatastrofen, medan andelen var 16 % nitton år efter flygolyckan. Tjugo år efter bussolyckan upplevde de nu drygt trettioåriga svarande låga nivåer av posttraumatisk stress. Förlustdrabbade överlevande upplevde i genomsnitt en mindre återhämtning under det första året och hade också svårare reaktioner efter många år. Kvinnor upplevde i genomsnitt svårare reaktioner än män såväl på kort sikt som på lång sikt, medan återhämtningen inte skiljde sig åt mellan män och kvinnor.

    Konsekvenser på lång sikt innefattade enligt de överlevande negativa men också positiva aspekter som personlig mognad och existentiell medvetenhet. De flesta intervjuade hade upplevt gott om stöd från närstående, dock kunde ett visst behov av stöd kvarstå i flera år efter händelsen. Många berättade om hinder för att söka stöd, t.ex. att den närstående var känslomässigt belastad.

     Avhandlingen utvidgar det som hittills varit känt om posttraumatisk stress hos överlevande efter katastrofer och stora olyckor. Intervjuerna pekar på viktiga aspekter av socialt stöd att utforska vidare. Resultaten visar att dessa händelser är förknippade med övergående stressreaktioner hos majoriteten av de överlevande. Vidare forskning behövs för att bättre förstå den naturliga återhämtningen och närmare vilka insatser till överlevande och anhöriga som kan underlätta återhämtning.

    Delarbeten
    1. Traumatic bereavement, acute dissociation, and posttraumatic stress: 14 years after the MS Estonia disaster
    Öppna denna publikation i ny flik eller fönster >>Traumatic bereavement, acute dissociation, and posttraumatic stress: 14 years after the MS Estonia disaster
    2011 (Engelska)Ingår i: Journal of Traumatic Stress, ISSN 0894-9867, E-ISSN 1573-6598, Vol. 24, nr 2, s. 183-190Artikel i tidskrift (Refereegranskat) 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.

    Nyckelord
    posttraumatic stress disorder, bereavement, dissociation, disasters, survivors, Estonia prospective studies, posttraumatisk stress, förlustdrabbade, dissociation, katastrof, överlevande, Estonia
    Nationell ämneskategori
    Psykiatri Psykologi
    Forskningsämne
    Psykiatri; Psykologi
    Identifikatorer
    urn:nbn:se:uu:diva-151374 (URN)10.1002/jts.20629 (DOI)000289528300006 ()21442665 (PubMedID)
    Projekt
    Long-term posttraumatic stress in survivors from disasters and major accidents
    Tillgänglig från: 2011-04-11 Skapad: 2011-04-11 Senast uppdaterad: 2017-12-11Bibliografiskt granskad
    2. Fifteen years after a ferry disaster: Clinical interviews and survivors’ self-assessment of their experience
    Öppna denna publikation i ny flik eller fönster >>Fifteen years after a ferry disaster: Clinical interviews and survivors’ self-assessment of their experience
    2013 (Engelska)Ingår i: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 4, s. 20650-Artikel i tidskrift (Refereegranskat) 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.

    Nyckelord
    posttraumatic stress disorder, survivors, diagnosis, social support, posttraumatic growth, mixed methods, PTSD, överlevande, posttraumatisk stress, socialt stöd, Estonia
    Nationell ämneskategori
    Psykiatri Psykologi
    Forskningsämne
    Psykiatri; Psykologi
    Identifikatorer
    urn:nbn:se:uu:diva-169280 (URN)10.3402/ejpt.v4i0.20650 (DOI)000332099200001 ()
    Projekt
    Long-term posttraumatic stress in survivors from disasters and major accidents
    Tillgänglig från: 2012-02-27 Skapad: 2012-02-27 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
    3. Posttraumatic stress in survivors 1 month to 19 years after an airliner emergency landing
    Öppna denna publikation i ny flik eller fönster >>Posttraumatic stress in survivors 1 month to 19 years after an airliner emergency landing
    2015 (Engelska)Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 3, artikel-id e0119732Artikel i tidskrift (Refereegranskat) 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.

    Nyckelord
    Aviation disasters, Posttraumatic stress, Longitudinal studies, Long-term studies
    Nationell ämneskategori
    Psykiatri Psykologi
    Forskningsämne
    Psykiatri; Psykologi
    Identifikatorer
    urn:nbn:se:uu:diva-169279 (URN)10.1371/journal.pone.0119732 (DOI)000350314700063 ()25734536 (PubMedID)
    Projekt
    Long-term posttraumatic stress in survivors from disasters and major accidents
    Tillgänglig från: 2012-02-27 Skapad: 2012-02-27 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
    4. A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident
    Öppna denna publikation i ny flik eller fönster >>A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident
    2011 (Engelska)Ingår i: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, Vol. 5, nr 8Artikel i tidskrift (Refereegranskat) 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.

    Ort, förlag, år, upplaga, sidor
    London: BioMed Central, 2011
    Nyckelord
    road traffic accidents, posttraumatic stress, children, adolescents, disasters
    Nationell ämneskategori
    Psykiatri
    Forskningsämne
    Psykiatri; Psykologi; Barn- och ungdomspsykiatri; Psykologi
    Identifikatorer
    urn:nbn:se:uu:diva-150258 (URN)10.1186/1753-2000-5-8 (DOI)
    Tillgänglig från: 2011-04-09 Skapad: 2011-03-28 Senast uppdaterad: 2012-04-19Bibliografiskt granskad
  • 9.
    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 Coach2016Konferensbidrag (Refereegranskat)
    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. 

  • 10.
    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 characteristics2013Ingår i: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 75, nr 5, s. 401-408Artikel, forskningsöversikt (Refereegranskat)
    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.

  • 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.
    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 months2009Konferensbidrag (Refereegranskat)
  • 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.
    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?2011Ingår i: European Journal of Psychotraumatology: Volume 2 Supplement 1, 2011, s. 72-72Konferensbidrag (Refereegranskat)
    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.

  • 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.
    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 events2015Ingår i: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 6, artikel-id 28636Artikel i tidskrift (Övrigt vetenskapligt)
  • 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.
    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 disaster2009Konferensbidrag (Refereegranskat)
  • 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.
    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 disaster2011Ingår i: Journal of Traumatic Stress, ISSN 0894-9867, E-ISSN 1573-6598, Vol. 24, nr 2, s. 183-190Artikel i tidskrift (Refereegranskat)
    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.

  • 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.
    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 Study2015Konferensbidrag (Refereegranskat)
  • 17.
    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 Study2014Konferensbidrag (Refereegranskat)
  • 18.
    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 study2015Ingår i: The Lancet Psychiatry, ISSN 2215-0366, Vol. 2, nr 9, s. 817-824Artikel i tidskrift (Refereegranskat)
    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.

  • 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.
    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 experience2013Ingår i: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 4, s. 20650-Artikel i tidskrift (Refereegranskat)
    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.

  • 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.
    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 disaster2012Ingår i: Journal of Traumatic Stress, ISSN 0894-9867, E-ISSN 1573-6598, Vol. 25, nr 6, s. 721-727Artikel i tidskrift (Refereegranskat)
    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.

  • 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, 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 disasters2011Ingår i: European Journal of Psychotraumatology: Volume 2 Supplement 1, 2011, s. 72-72Konferensbidrag (Refereegranskat)
    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.

  • 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. 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' response2015Ingår i: Lancet psychiatry, ISSN 2215-0374, E-ISSN 2215-0366, Vol. 2, nr 11, s. 962-963Artikel i tidskrift (Refereegranskat)
  • 23.
    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 händelser2013Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, nr 3, s. 95-98Artikel i tidskrift (Refereegranskat)
    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.

  • 24.
    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 adults2016Ingår i: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 54, s. 226-232Artikel i tidskrift (Refereegranskat)
    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.

  • 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, 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-effectiveness2014Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, nr 5, s. e98118-Artikel i tidskrift (Refereegranskat)
    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.

  • 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.
    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 Stress2013Konferensbidrag (Refereegranskat)
  • 27.
    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 (Övrigt vetenskapligt)
  • 28.
    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 Disaster2014Ingår i: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 28, nr 4, s. 402-409Artikel i tidskrift (Refereegranskat)
    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.

  • 29.
    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, 19882009Konferensbidrag (Refereegranskat)
  • 30. Asherson, P.
    et al.
    Stes, S.
    Nilsson, Maria Markhed
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Berggren, L.
    Svanborg, P.
    Kutzelnigg, A.
    Deberdt, W.
    The effects of atomoxetine on emotional control in adults with ADHD: An integrated analysis of multicenter studies2015Ingår i: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 30, nr 4, s. 511-520Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To investigate the effects of atomoxetine on emotional control in adults with ADHD. Methods: We performed an integrated analysis using individual patient data pooled from three Eli Lilly-sponsored studies. An integrated analysis can be viewed as a meta-analysis of individual patient-level data, rather than study-level summary data. Results: Two populations were identified: a large sample of patients with pre-treatment baseline data (the "overall population''; n = 2846); and a subset of these patients with placebo-controlled efficacy data from baseline to 10 or 12 weeks after initiating treatment (the "placebo-controlled population''; n = 829). At baseline, in the overall population, similar to 50% of ADHD patients had BRIEF-AS (Behavior Rating Inventory of Executive Function-Adult Version Self-Report) Emotional control subscores between 21 and 30, compared with similar to 10% of normative subjects in the BRIEF-A manual. At endpoint, in the placebo-controlled population, atomoxetine led to a small (effect size 0.19) but significant (P = 0.013) treatment effect for emotional control. The effect size was 0.32 in patients with BRIEF-AS Emotional control scores > 20 at baseline. Improvements in emotional control correlated with improvements in the core ADHD symptoms and quality-of-life. Discussion: As deficient emotional control is associated with impaired social, educational and occupational functioning over and above that explained by core ADHD symptoms alone, improvements in emotional control may be clinically relevant. Conclusion: At baseline, adults with ADHD were more likely to have impaired emotional control than normative subjects. In the adult ADHD patients, atomoxetine treatment was associated with improvements in emotional control, as well as in core ADHD symptoms and quality-of-life.

  • 31.
    Axfors, Cathrine
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Anxious personality traits in pregnant women: Associations with postpartum depression, delivery complications and health care use2018Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Anxious personality traits, including those encompassed by negative emotionality (neuroticism) and the tendency to worry about close relationships (attachment anxiety) during pregnancy were the focus of this thesis. The overall aim was to examine perinatal correlates of these characteris-tics in terms of psychiatric and obstetric health as well as antenatal care (ANC).

    Papers I-II were part of a large population-based project on pregnant women in Uppsala in 2009-2012 (n=2160). Papers III-IV adjoined participants from several projects in 2005-2011, on oral contraceptive use, infertility, induced abortion, premenstrual mood disorder, and perina-tal depression (n=2819). The participants reported on the Swedish universities Scales of Per-sonality for neuroticism (papers II-IV) and the Attachment Style Questionnaire (ASQ) for attachment anxiety (papers I-II). The participants also answered the Edinburgh Postnatal De-pression Scale on depressive symptoms (paper II). In paper III, information on obstetric com-plications for primiparous women with singleton pregnancies (n=1969) was extracted from Swedish national health registers. In paper IV, ANC use was derived from medical records of obstetric low-risk women residing in Uppsala (n=1052).

    The ASQ had similar psychometric properties in pregnant women (n=1631) as in previous reports (paper I). In non-depressed pregnant women (n=1431), the combination of neuroticism and attachment anxiety was the best risk indicator of postpartum depressive symptoms (paper II). Whereas high neuroticism was not related to obstetric complications (paper III), it was associated with higher use of ANC (paper IV).

    Summarized, this thesis illustrates how anxious personality traits may predispose for post-partum depression and higher use of ANC in the absence of obstetric complications. Future development of these findings should be to evaluate individual and societal benefits of a greater emphasis on psychological support in ANC.

    Delarbeten
    1. Psychometric properties of the attachment style questionnaire in Swedish pregnant women: short and full versions
    Öppna denna publikation i ny flik eller fönster >>Psychometric properties of the attachment style questionnaire in Swedish pregnant women: short and full versions
    2017 (Engelska)Ingår i: Journal of Reproductive and Infant Psychology, ISSN 0264-6838, E-ISSN 1469-672X, Vol. 35, nr 5, s. 450-461Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objectives: (i) To evaluate the reliability and factor structure of the Attachment Style Questionnaire – Short Form (ASQ-SF) for use in pregnant women and (ii) to compare the reliability and factor structure of the short- and full version-ASQ among pregnant women. Background: Adult attachment insecurity is currently included as a major risk factor in studies of perinatal health. None of the self-report measures with a Swedish translation have been psychometrically evaluated in a pregnant cohort.

    Methods: A population-based cohort of 1631 pregnant women answered the ASQ in late pregnancy. Internal consistency (item- subscale correlations, Cronbach’s α, and α if item deleted) was evaluated for the seven available subscales. Con rmatory factor analysis (CFA) was run to examine the factor structure of the short form compared with the full-version. Test–retest correlations were assessed in a subgroup (n = 48).

    Results: All mean item-subscale correlations for the ASQ-SF were > 0.30. Cronbach’s α’s for ASQ-SF dimensions were as follows: Avoidance (0.87); Anxiety (0.89); Discomfort with Closeness (0.85); Relationships as Secondary (0.54); Con dence (0.83); Need for Approval (0.76); and Preoccupation with Relationships (0.77). No item removal substantively increased subscale α’s. The CFA demonstrated better model t for the ASQ-SF than for the full-version ASQ, while other reliability measures were similar. Test–retest correlations ranged from 0.65 to 0.84.

    Conclusion: The ASQ-SF showed similar psychometric properties in pregnant women as in the general population and had good reliability, but the optimal factor structure needs to be studied further. Results support the usage of the ASQ-SF in pregnant cohorts. 

    Ort, förlag, år, upplaga, sidor
    Routledge, 2017
    Nyckelord
    adult attachment, attachment style questionnaire, reliability, pregnancy
    Nationell ämneskategori
    Klinisk medicin
    Forskningsämne
    Psykiatri
    Identifikatorer
    urn:nbn:se:uu:diva-342268 (URN)10.1080/02646838.2017.1342786 (DOI)000416753300003 ()
    Forskningsfinansiär
    Vetenskapsrådet, 521-2013-2339
    Tillgänglig från: 2018-02-19 Skapad: 2018-02-19 Senast uppdaterad: 2018-10-24Bibliografiskt granskad
    2. Adult attachment's unique contribution in the prediction of postpartum depressive symptoms, beyond personality traits
    Öppna denna publikation i ny flik eller fönster >>Adult attachment's unique contribution in the prediction of postpartum depressive symptoms, beyond personality traits
    2017 (Engelska)Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 222, s. 177-184Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background:

    Personality traits such as neuroticism can help identify pregnant women at risk of postpartum depressive symptoms (PPDS). However, it is unclear whether attachment style could have an additional contribution to this risk elevation. This study aimed to examine the overlap of adult attachment insecurity and neuroticism/trait anxiety as PPDS predictors, taking into account baseline depressive symptoms.

    Methods:

    A Swedish population-based sample of pregnant women reported on adult attachment and either neuroticism (n = 1063) or trait anxiety (n = 555). Depressive symptoms were assessed at baseline, and at six weeks and six months postpartum. Correlations between attachment and neuroticism/trait anxiety were calculated. Generalized linear models of PPDS tested the effect of attachment anxiety and avoidance, adjusting for neuroticism/trait anxiety and baseline depression. Logistic regression models with combined high attachment anxiety and-neuroticism/trait anxiety visualized their value as risk factors beyond antenatal depression.

    Results:

    Attachment and neuroticism/trait anxiety were highly correlated (r = .55.77). Attachment anxiety exerted a partially independent effect on PPDS at six weeks (p < .05) and at six months (p < .05) adjusting for neuroticism. Among antenatally non-depressed, combined high attachment anxiety and high neuroticism or trait anxiety was predictive of PPDS at both assessment points. Limitations: Low acceptance rate, exclusive use of self-reports.

    Conclusions:

    Beyond personality, attachment anxiety had a small independent effect on the risk of PPDS. Combining items of adult attachment and neuroticism/trait anxiety could prove useful in antenatal screening for high risk of PPDS.

    Nyckelord
    Adult attachment, Neuroticism, Trait anxiety, Personality, Pregnancy, Postpartum depression
    Nationell ämneskategori
    Psykiatri
    Identifikatorer
    urn:nbn:se:uu:diva-333735 (URN)10.1016/j.jad.2017.07.005 (DOI)000407657100027 ()28709025 (PubMedID)
    Tillgänglig från: 2017-11-20 Skapad: 2017-11-20 Senast uppdaterad: 2018-10-24Bibliografiskt granskad
    3. Neuroticism is not independently associated with adverse obstetric or neonatal outcomes: An observational study
    Öppna denna publikation i ny flik eller fönster >>Neuroticism is not independently associated with adverse obstetric or neonatal outcomes: An observational study
    Visa övriga...
    (Engelska)Ingår i: Artikel i tidskrift (Refereegranskat) Submitted
    Nationell ämneskategori
    Psykiatri Reproduktionsmedicin och gynekologi
    Forskningsämne
    Psykiatri; Obstetrik och gynekologi
    Identifikatorer
    urn:nbn:se:uu:diva-361592 (URN)
    Tillgänglig från: 2018-09-25 Skapad: 2018-09-25 Senast uppdaterad: 2018-10-24
    4. Neuroticism is associated with higher antenatal care utilization in obstetric low-risk women
    Öppna denna publikation i ny flik eller fönster >>Neuroticism is associated with higher antenatal care utilization in obstetric low-risk women
    Visa övriga...
    (Engelska)Ingår i: Artikel i tidskrift (Refereegranskat) Submitted
    Ort, förlag, år, upplaga, sidor
    Uppsala:
    Nationell ämneskategori
    Reproduktionsmedicin och gynekologi
    Forskningsämne
    Obstetrik och gynekologi
    Identifikatorer
    urn:nbn:se:uu:diva-364260 (URN)
    Tillgänglig från: 2018-10-24 Skapad: 2018-10-24 Senast uppdaterad: 2018-10-24
  • 32.
    Axfors, Cathrine
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Eckerdal, Patricia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Volgsten, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Wikström, Anna-Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk obstetrik.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ramklint, Mia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Barn- och ungdomspsykiatri.
    Sundström Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Neuroticism is not independently associated with adverse obstetric or neonatal outcomes: An observational studyIngår i: Artikel i tidskrift (Refereegranskat)
  • 33.
    Axfors, Cathrine
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Hellgren, Charlotte
    Volgsten, Helena
    Skoog Svanberg, Agneta
    Ekselius, Lisa
    Wikström, Anna-Karin
    Ramklint, Mia
    Skalkidou, Alkistis
    Sundström Poromaa, Inger
    Neuroticism is associated with higher antenatal care utilization in obstetric low-risk womenIngår i: Artikel i tidskrift (Refereegranskat)
  • 34.
    Axfors, Cathrine
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Hellgren, Charlotte
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Volgsten, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Skoog Svanberg, Agneta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Wikström, Anna-Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk obstetrik.
    Ramklint, Mia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk och reproduktiv hälsoforskning.
    Sundström-Poromaa, Inger
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Reproduktiv hälsa.
    Neuroticism is associated with higher antenatal care utilization in obstetric low-risk women.2018Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Elevated neuroticism is associated with higher health care utilization in the general population. This study aimed to investigate the association between neuroticism and the use of publicly financed antenatal care in obstetric low-risk women, taking predisposing and need factors for health care utilization into consideration.

    MATERIAL AND METHODS: Participants comprised 1052 obstetric low-risk women (no chronic diseases or adverse pregnancy conditions) included in several obstetrics/gynecology studies in Uppsala, Sweden. Neuroticism was self-rated on the Swedish universities Scales of Personality. Medical records of their first subsequent pregnancy were scanned for antenatal care use. Associations between antenatal care use and neuroticism were analyzed with logistic regression (binary outcomes) or negative binomial regression (count outcomes) comparing the 75th and 25th neuroticism percentiles. Depending on the Akaike information criterion the exposure was modeled as either linear or with restricted cubic splines. Analyses were adjusted for predisposing (sociodemographic and parity) and need factors (body mass index and psychiatric morbidity).

    RESULTS: After adjustment, women with higher neuroticism had more fetal ultrasounds (incidence rate ratio = 1.09, 95% confidence interval (CI) 1.02-1.16), more emergency visits to an obstetrician/gynecologist (incidence rate ratio = 1.22, 95% CI 1.03-1.45) and were more likely to visit a fear-of-childbirth clinic (odds ratio = 2.71, 95% CI 1.71-4.29). Moreover, they more often consulted midwives in specialized antenatal care facilities (significant J-shaped association).

    CONCLUSIONS: Neuroticism was associated with higher utilization of publicly financed antenatal care in obstetric low-risk women, even after adjusting for predisposing and need factors. Future studies should address the benefits of interventions as a complement to routine antenatal care programs to reduce subclinical anxiety.

  • 35.
    Axfors, Cathrine
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sylvén, Sara
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ramklint, Mia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Skalkidou, Alkistis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Obstetrisk forskning.
    Adult attachment's unique contribution in the prediction of postpartum depressive symptoms, beyond personality traits2017Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 222, s. 177-184Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Personality traits such as neuroticism can help identify pregnant women at risk of postpartum depressive symptoms (PPDS). However, it is unclear whether attachment style could have an additional contribution to this risk elevation. This study aimed to examine the overlap of adult attachment insecurity and neuroticism/trait anxiety as PPDS predictors, taking into account baseline depressive symptoms.

    Methods:

    A Swedish population-based sample of pregnant women reported on adult attachment and either neuroticism (n = 1063) or trait anxiety (n = 555). Depressive symptoms were assessed at baseline, and at six weeks and six months postpartum. Correlations between attachment and neuroticism/trait anxiety were calculated. Generalized linear models of PPDS tested the effect of attachment anxiety and avoidance, adjusting for neuroticism/trait anxiety and baseline depression. Logistic regression models with combined high attachment anxiety and-neuroticism/trait anxiety visualized their value as risk factors beyond antenatal depression.

    Results:

    Attachment and neuroticism/trait anxiety were highly correlated (r = .55.77). Attachment anxiety exerted a partially independent effect on PPDS at six weeks (p < .05) and at six months (p < .05) adjusting for neuroticism. Among antenatally non-depressed, combined high attachment anxiety and high neuroticism or trait anxiety was predictive of PPDS at both assessment points. Limitations: Low acceptance rate, exclusive use of self-reports.

    Conclusions:

    Beyond personality, attachment anxiety had a small independent effect on the risk of PPDS. Combining items of adult attachment and neuroticism/trait anxiety could prove useful in antenatal screening for high risk of PPDS.

  • 36.
    Axfors, Cathrine
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sylvén, Sara