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  • Whitehead, Paul D., et al. (författare)
  • Heavy-Tailed Distribution of Seclusion and Restraint Episodes in a State Psychiatric Hospital
  • 2011
  • Ingår i: The journal of the American Academy of Psychiatry and the Law. - 1093-6793. ; 39:1, s. 93-99
  • Tidskriftsartikel (refereegranskat)abstract
    • Regulations that govern oversight of seclusion and/or restraint episodes (SREs) in the United States are relatively uniform and may assume that such events are normally distributed within the population generating them. This study illustrates that the distribution of patients who required one or more SREs within one state psychiatric hospital setting is heavy-tailed-that is, a small group of patients generated a disproportionate majority of the events: 20 percent of patients with the most SREs accounted for approximately 75 percent of the total number of SREs; 10 percent of patients accounted for 61 percent, and 1 percent of patients accounted for 21 percent. Characteristic features of heavy-tailed distributions are described and discussed in relation to the feasibility of eliminating SREs in mental health settings and the governance of SREs by uniform regulations. Attempts are made to model and subtype the distribution, and commentary is made as to potential clinical and policy relevance of the findings.
  • Widerberg, Stefan, et al. (författare)
  • Gendering of day center occupations as perceived by people with psychiatric disabilities in Sweden
  • 2017
  • Ingår i: Scandinavian Journal of Occupational Therapy. - Taylor & Francis. - 1103-8128. ; s. 1-10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The aim was to explore the experiences and views of people attending day centers for people with psychiatric disabilities concerning the occurrence and nature of gendering of the occupations performed there. Methods: Twenty-five day center attendees were interviewed regarding occupational choices at the day centers, whether they would describe day center occupations as gendered, and if so what the consequences were of the gendering of occupations. The transcribed texts were analyzed by thematic analysis. Results: Three main themes were identified: Thinking and doing gender; Understandings of gendering of day center occupations; and Consequences of gendered occupation. The participants were more open-minded in their reasoning than in what they were doing. They understood gendering to be a result of traditions, role models from childhood, ideas about typically male and female innate capacities, lack of knowledge and low self-confidence. Doing seemed to reproduce gender, but being in a group of the same sex could shape unity and a relaxed atmosphere. Conclusions: The findings could be understood as a set of gender frames, which might prevent either of the sexes from developing their full potentials and transgress into e.g. the employment market. Gendering should be highlighted and debated in psychosocial rehabilitation.
  • Widinghoff, Carolina, et al. (författare)
  • Gambling Disorder in Male Violent Offenders in the Prison System : : Psychiatric and Substance-Related Comorbidity
  • 2019
  • Ingår i: Journal of gambling studies. - Springer. - 1050-5350. ; 35:2, s. 485-500
  • Tidskriftsartikel (refereegranskat)abstract
    • Gambling disorder is an addiction that can cause major suffering, and some populations seem to be more vulnerable than others. Offender populations have a remarkably high prevalence of gambling problems and they are also over-represented in a number of diagnoses related to gambling disorder, like substance use disorders and antisocial personality disorder. Yet, there are few studies investigating gambling disorder prevalence and related psychiatric comorbidity in this group. This study aims to investigate the prevalence of, and association between, gambling disorder and other psychiatric diagnoses in a sample of young, male violent offenders. Two hundred and sixty-four male offenders, all serving sentences for violent crimes (recruited between 2010 and 2012) participated in this study and went through comprehensive psychiatric evaluation, including assessment for Diagnostic and Statistical Manual of Mental Disorders 4th Edition criteria. Sixteen percent of the participants met criteria for gambling disorder. Antisocial personality disorder, cannabis, cocaine and anabolic steroids abuse were significantly more common among participants with gambling disorder. The gambling disorder group also showed significantly lower educational attainment. Cocaine abuse and failure to graduate elementary and middle school in expected time were independently associated with gambling disorder in a regression analysis. This study confirms the previously described high prevalence of gambling disorder in offenders. The psychiatric comorbidity was high and the problems had started early, with lower educational attainment in the gambling disorder group. The findings stress the importance of increased awareness of gambling problems among convicted offenders and of gambling research on young people with delinquent behavior. There is a need of more research to investigate this further, in order to develop preventive strategies and treatment.
  • Widinghoff, Carolina, et al. (författare)
  • Spelberoende är en högaktuell diagnos - Snabba internetspel om pengar har stor beroendepotential – KBT ger god effekt
  • 2018
  • Ingår i: Läkartidningen. - Swedish Medical Association. - 0023-7205. ; 115
  • Tidskriftsartikel (refereegranskat)abstract
    • Gambling disorder is a serious condition and a current issue in Sweden. The national prevalence of problem gambling is 2 %, including 0.4 % meeting criteria for gambling disorder, but the incidence numbers are substantially higher due to the dynamic pattern of the disorder with people moving into and out of the problem gambling group. Rapid internet games, such as internet casinos and sports betting, cause a predominant share of the gambling problems, and the market has shown an unrestrained growth for years. New public amendments are upcoming and from the 1st of January 2018, healthcare and social services have a pronounced obligation to offer investigations and treatment (mainly CBT) for gambling disorder. The psychiatric comorbidity is high, and the risk of suicide is clearly elevated among people with gambling disorder. There are quick, evidence-based screening tools that can easily be used in clinical work, as initial steps of investigations. The need for implementing effective national strategies and further research in the area is considerable.
  • Widmark, Catharina, et al. (författare)
  • Parents' experiences of collaboration between welfare professionals regarding children with anxiety or depression - an explorative study
  • 2013
  • Ingår i: International Journal of Integrated Care. - 1568-4156. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Well-functioning collaboration between professionals in the welfare sector has a strong influence on the contacts with parents of children and adolescents suffering from mental illness, and it is a precondition for the availability of support for these parents. This paper describes how such parents perceive collaboration between professionals in mental health care, social services, and schools. Methods: This was a small-scale qualitative study. Data were collected by in-depth interviews with seven parents of children and adolescents diagnosed with anxiety and depression. The families were selected from the Child and Adolescent Mental Health patient records kept by the Stockholm County Council (Sweden), and they all lived in a catchment area for Child and Adolescent Mental Health outpatient services in Stockholm. Results and discussion: Our results suggest that when the encounter between parents and professionals is characterised by structure and trust, it is supportive and serves as a holding environment. Parents think that communication links and coordination between professionals from different organisations are needed in the collaboration, along with appropriately scheduled and well-performed joint meetings to create structure in the parent-professional encounter. Parents also think that establishment of trust in this interaction is promoted by individual professionals who are available, provide the parents with adequate information, are skilled, and show empathy and commitment.
  • Wiggs, Kelsey K., et al. (författare)
  • A Family-Based Study of the Association Between Labor Induction and Offspring Attention-Deficit Hyperactivity Disorder and Low Academic Achievement
  • 2017
  • Ingår i: Behavior Genetics. - Springer. - 0001-8244. ; 47:4, s. 383-393
  • Tidskriftsartikel (refereegranskat)abstract
    • The current study examined associations between labor induction and both (1) offspring attention-deficit hyperactivity disorder (ADHD) diagnosis in a Swedish birth cohort born 1992-2005 (n = 1,085,008) and (2) indices of offspring low academic achievement in a sub-cohort born 1992-1997 (n = 489,196). Associations were examined in the entire sample (i.e., related and unrelated individuals) with adjustment for measured covariates and, in order to account for unmeasured confounders shared within families, within differentially exposed cousins and siblings. We observed an association between labor induction and offspring ADHD diagnosis and low academic achievement in the population. However, these associations were fully attenuated after adjusting for measured covariates and unmeasured factors that cousins and siblings share. The results suggest that observed associations between labor induction and ADHD and low academic achievement may be due to genetic and/or shared environmental factors that influence both mothers' risk of labor induction and offspring neurodevelopment.
  • Wigren, Margareta, et al. (författare)
  • Excessive picking in Prader-Willi Syndrome: A pilot study of phenomenological aspects and comorbid symptoms
  • 2001
  • Ingår i: International journal of disability, development and education. - 1034-912X. ; 48:2, s. 129-142
  • Tidskriftsartikel (refereegranskat)abstract
    • Skin picking constitutes a minor diagnostic criterion for Prader-Willi syndromeand is considered to be a syndrome speciŽ c behaviour and part of a behaviouralphenotype. This study surveyed different aspects and patterns of skin picking as well asrelated picking and pulling behaviours and compulsive and impulsive–aggressive symptoms.Parents of 37 individuals with PWS, aged 12 to 30 years, participated by completingquestionnaires specially designed for the purpose of capturing speciŽ c features relevant to theclinical PWS picture. Two-thirds of the sample displayed skin picking with a frequencyranging from chronic to transient, episodic symptoms. Many individuals with skin pickingalso exhibited comorbid picking behaviours and individuals with excessive skin picking alsohad additional problems with frequent tantrums and violent outbursts.
  • Wijana, Moa Bråthén, et al. (författare)
  • Preliminary evaluation of an intensive integrated individual and family therapy model for self-harming adolescents
  • 2018
  • Ingår i: BMC Psychiatry. - BioMed Central. - 1471-244X. ; 18:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: To investigate the outcome of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) in terms of reducing suffering and increasing functional adjustment among self-harming and/or suicidal adolescents with high symptom loads and their families. METHODS: Forty-nine self-harming and/or suicidal adolescents, Mage = 14.6, of predominantly Swedish origin and female gender (85.7%) participated with their parents. The study had a within group design with repeated measures at pre- and post-treatment, as well as six- and twelve-months follow-ups. Self-reports were used for the main outcomes; self-harm rates, suicide attempts, parent-reported days of inpatient/institutional care, internalized and externalized symptoms, perceived stress, emotion regulation, school hours and adjustment. Secondary outcomes were levels of reported expressed emotions within family dyads, as well as parental anxiety, depression and stress. RESULTS: From pre- to post-assessment, the adolescents reported significant reductions of self-harm (p = .001, d = 0.54) and suicide attempts (p < .0001, d = 1.38). Parent-reported days of inpatient/institutional care were reduced, as well as parent- and adolescent-reported internalizing and externalizing symptoms. Furthermore, school attendance and adjustment were improved, and the adolescents reported experiencing less criticism while parents reported less emotional over-involvement. The results were maintained at follow-ups. CONCLUSIONS: The adolescents and the parents reported improvements for the main outcomes. This treatment appears promising in keeping the families in treatment and out of hospital, suggesting that an integrative approach may be beneficial and feasible for this group. TRIAL REGISTRATION: This study has been approved 19/12 2011, by the regional review board in Stockholm (Dnr 2011/1593-31/5).
  • Wijk, Linda, et al. (författare)
  • A pilot for a computer-based simulation system for risk estimation and treatment of mentally disordered offenders
  • 2009
  • Ingår i: Informatics for Health and Social Care. - Informa Healthcare. - 1753-8157. ; 34:2, s. 106-115
  • Tidskriftsartikel (refereegranskat)abstract
    • Risk/need analysis and treatment of mentally disordered offenders (MDOs) take place in constrained clinical settings, but violence has to be considered in a context where both social and cultural factors are of significance. One way to improve treatment and risk/need analysis of MDOs could be to develop simulation systems where users interact with video-based scenarios. The objective of this study was to develop and pilot test a simulation system to be used as a tool to study MDOs and possibly also to play a part in their rehabilitation. Collaboration between simulation and forensic psychiatry experts and a professional film team was set up. A simulation system called 'Reactions on Display' (RoD) was developed and a pilot study with eight patients and 13 staff members was carried out. Results from the study showed that RoD's interface and design were well received by patients and staff. Participants indicated that they found the video sequences realistic and the system enjoyable to use. The pilot study of RoD was positive, but further research should study possible clinical outcomes of the system. However, we believe that RoD could provide an advance in treatment and risk/need analysis of MDOs.
  • Wikgren, Mikael, et al. (författare)
  • APOE ε4 is associated with longer telomeres, and longer telomeres among ε4 carriers predicts worse episodic memory
  • 2012
  • Ingår i: Neurobiology of Aging. - Elsevier. - 0197-4580. ; 33:2, s. 335-344
  • Tidskriftsartikel (refereegranskat)abstract
    • Both leukocyte telomere length and the apolipoprotein epsilon4 allele have been associated with mortality, cardiovascular disease, cognition, and dementia. The authors investigated whether leukocyte telomere length was associated with APOE genotype or cognitive abilities in the context of APOE genotype. The setting for this cross-sectional study was 427 nondemented individuals aged 41-81 yr. The authors found that epsilon4 carriers overall exhibited significantly longer telomeres compared with non-carriers (difference of 268 bp, p = 0.001). This difference was greatest at the lower limit of the age span and nonsignificant at the upper limit, which translated into a significantly higher telomere attrition rate (p = 0.049) among epsilon4 carriers (37 bp/years) compared with non-carriers (21 bp/year). Further, longer telomeres among epsilon4 carriers significantly predicted worse performance on episodic memory tasks. No significant associations were found on tasks tapping semantic and visuospatial ability, or among epsilon3/epsilon3 carriers. In conclusion, APOE epsilon4 carriers had longer telomeres compared with non-carriers, but higher rate of attrition. Among them, longer telomeres predicted worse performance on episodic memory tasks. These observations suggest that the epsilon4 allele is associated with abnormal cell turnover of functional and possibly clinical significance.
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