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1.
  • Elfström, Magnus, et al. (creator_code:aut_t)
  • Validation of the Swedish version of the clinical outcomes in routine evaluation outcome measure (CORE-OM)
  • 2013
  • record:In_t: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 20:5, s. 447-455
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • The purpose of this study was to perform an initial validation of a Swedish translation of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM). The CORE-OM is a broad self-report instrument of psychological problems, designed as an outcome measure for evaluating the effects of psychological therapy. Participants included a non-clinical group of 229 university students and a clinical group of 619 persons from four primary care sites. The Swedish CORE-OM showed excellent acceptability, high internal consistency and test-retest reliability, as well as acceptable convergent validity. There was strong differentiation of the clinical and non-clinical samples, with the clinical group scoring significantly more psychological problems than the non-clinical group. Sensitivity to change was demonstrated in psychological treatments in primary care. Overall, the psychometric characteristics of the Swedish CORE-OM were very similar to the original UK data. Nevertheless, the validity of the Swedish version needs to be examined more in detail, in larger and more diverse samples. Our results so far, however, provide support for using the Swedish CORE-OM as a psychological problems measure. To our knowledge, there are few other relatively short measures in Swedish that are free to reprint that meet the demands for psychometric properties and utility in primary care settings in which patients typically present a broad range of psychological problems.
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2.
  • Abrahamsson, Kajsa H., 1956, et al. (creator_code:aut_t)
  • Phobic avoidance and regular dental care in fearful dental patients: a comparative study.
  • 2001
  • record:In_t: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 16, s. 188-196
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • The present investigation was a comparative study of 169 highly fearful dental patients, some of whom received regular dental care (n = 28) and some who never, or only when absolutely necessary, utilized dental care (n = 141). It was hypothesized that phobic avoidance is related to anticipatory stress and anxiety reactions, negative oral health effects, psychological distress, and negative social consequences. Background factors (sex, age, education, and dental attendance pattern), dental anxiety, general fears, general state and trait anxiety, mood states, depression, and quality of life effects were studied. Data were analyzed with descriptive statistics and with exploratory factor and multiple logistic regression analysis. It was shown that dental anxiety is significantly higher among the avoiders and this is in particular evident for anticipatory dental anxiety. Oral health differed between the groups, and it was shown that avoiders had significantly more missing teeth, whereas regular attenders had significantly more filled teeth. The avoiders reported a stronger negative impact on their daily life, whereas there were no significant differences between the groups with regard to general emotions. The logistic regression analysis showed that phobic avoidance was predicted only by anticipated dental anxiety and missing teeth. It was concluded that differences between high dental fear patients with regular dental care and phobic avoidance were mainly related to anticipated fear and anxiety, oral health effects, and concomitant negative life consequences. These results are discussed in terms of subjective stress, negative cognitions, social support, and coping-strategies.
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3.
  • Abrahamsson, Kajsa H., 1956, et al. (creator_code:aut_t)
  • The importance of dental beliefs for the outcome of dental-fear treatment.
  • 2003
  • record:In_t: European journal of oral sciences. - : Wiley. - 0909-8836 .- 1600-0722. ; 111:2, s. 99-105
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • This study investigated the importance of dental beliefs and the predictive value of the Dental Belief Survey (DBS) in dental-fear treatment. The sample comprised 117 adult patients seeking treatment at a dental-fear clinic. Pretreatment data were collected during a screening procedure, including two visits to the dentist. Outcome measurements were completed after treatment. The dentist rated successful/unsuccessful treatment outcome. Patients unsuccessful in treatment (n = 48) reported more initial negative dental beliefs, while patients successful in treatment (n = 69) showed a larger decrease in negative beliefs between the first and second visit to the dentist. However, these differences were small. There was a significant difference between the groups at visit two. Thus, patients unsuccessful in treatment reported more negative beliefs about how dentists communicate. Regression analyses showed that improved dental beliefs during the first two visits to the dentist predicted dental-fear reduction, while longer avoidance time, female gender, low engagement in treatment, and depressed mood increased the risk of unsuccessful treatment outcome. Our results suggest that the DBS provides valuable information, and that patients' subjective perceptions about how dentists communicate are important for treatment outcome. However, initial dental beliefs were not found to predict clinical treatment outcome.
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4.
  • Berggren, Ulf, 1948, et al. (creator_code:aut_t)
  • Assessment of patients with direct conditioned and indirect cognitive reported origin of dental fear.
  • 1997
  • record:In_t: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 105:3, s. 213-20
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • This study investigated the reported conditioned or cognitive origin of dental phobia in 100 adult patients at a specialized dental phobia clinic. It was shown that a majority of patients reported a conditioned background to their dental fear. Patients' avoidance time and level of dental anxiety corresponded to previously reported data for fearful groups. Individuals with an arousal conditioning etiology of dental fear reported significantly longer avoidance time as compared to individuals with a cognitively learned reaction. With the exception of an elevated level of general fears, most psychometrically assessed emotional reactions were well within normal ranges. However, patients with a non-conditioned, cognitive etiology reported significantly higher levels of trait anxiety and fear of embarrassment. In addition, a separate analysis among women revealed a greater fear of physical injuries among patients with cognitive etiology.
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5.
  • Berggren, Ulf, 1948, et al. (creator_code:aut_t)
  • Assessment of patients with phobic dental anxiety.
  • 1997
  • record:In_t: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 55:4, s. 217-22
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • This study investigated a screening procedure for psychologic distress in adult patients with dental phobia before treatment of dental fear. The screening procedure was performed among 191 individuals in consecutive steps and included a medical/dental history, psychologic interviewing, and testing. Data collected during this process were analyzed and compared with SCL-90(R) data. The screening process was successful in selecting individuals without major psychologic distress problems. Among the excluded patients 91% had general symptoms scores on the SCL-90(R) exceeding a normative population mean, and 95% of included patients had a mean lower than an average for psychiatric outpatients. There were statistically significant differences between included and excluded patients on all subdimensions of the SCL-90. Thus, excluded patients had higher levels of psychologic distress, poorer psychosocial background, and more psychosomatic symptoms. This was accompanied by higher levels of negative attitudes toward dentists and their performance of dentistry, whereas no significant differences were found among the dental fear measures used.
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6.
  • Berggren, Ulf, 1948, et al. (creator_code:aut_t)
  • Factor analysis and reduction of a Fear Survey Schedule among dental phobic patients.
  • 1995
  • record:In_t: European journal of oral sciences. - 0909-8836 .- 1600-0722. ; 103:5, s. 331-8
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • A fear survey instrument, based on the Fear Survey Schedule-II and five additional fear items, was administered to 109 patients (70 women and 39 men) on a waiting list at a specialized dental fear clinic. The fear survey was analyzed to identify its factorial structure. Five fear factors, explaining 54% of the total variance, were identified concerning areas of "illness and death", "failures and embarrassment", "social situations", "physical injuries", and "animals and natural phenomena". An ad hoc reduction of items was carried out to form a shorter, more practical to use questionnaire, which resulted in factors of four or five items with loadings greater than 0.50. The factors intercorrelated significantly (rp varying between 0.33 and 0.59) and "illness and death" correlated highly with "physical injuries" (rp = 0.59) and "animals and natural phenomena" (rp = 0.56), while "failures and embarrassment" correlated highly to "social situations" (rp = 0.54). Statistically significant, but generally lower correlations were found between each factor and the dental fear measures. The highest correlations were found between fear of "physical injuries" and dental fear. There was also a high and significant correlation between sex and fear of "animals and natural phenomena".
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7.
  • Berggren, Ulf, 1948, et al. (creator_code:aut_t)
  • Relaxation vs. cognitively oriented therapies for dental fear.
  • 2000
  • record:In_t: Journal of dental research. - 0022-0345 .- 1544-0591. ; 79:9, s. 1645-51
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Cognitive therapy has been reported for the treatment of dental phobia, but comparisons with other behavioral treatments are scarce. This study investigated the outcome of two modes of treatment for phobic dental fear. Relaxation and cognitively oriented therapy were compared in a sample of 112 adult fearful dental patients. The patient made questionnaire assessments of background and outcome variables, and the specialist dentist rated successful/non-successful outcome. It was shown that a higher number of patients who received cognitively oriented therapy completed the treatment program, while anxiety was more reduced among patients who received relaxation-oriented therapy. Dropout during the initial phobia therapy with a psychologist was related to lower motivation (willingness to engage in treatment), while failures during dental treatment after the completion of therapy were related to higher levels of general fear and anxiety. A multiple logistic regression model explaining 67% of the variance revealed that the risk of failure was only slightly increased by general fears, while patients with low (below median) motivation ran a 3.6-times-higher risk of dropping out. In conclusion, it was shown that the two treatment methods were both effective in reducing dental phobic reactions. However, while cognitively oriented therapy resulted in a higher number of patients completing therapy, relaxation-oriented treatment generally resulted in a more significant reduction in dental fear as well as in general anxiety and fear. Motivation was found to be a significant predictor of successful treatment outcome.
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8.
  • Carlsson, Sven G., 1935, et al. (creator_code:aut_t)
  • Dental anxiety - a joint interest for dentists and psychologists.
  • 2013
  • record:In_t: European journal of oral sciences. - : Wiley. - 1600-0722 .- 0909-8836. ; 121:3 Pt 2, s. 221-224
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • This introductory article to the Symposium on Behavioral and Community Dentistry aims to describe the development of research and clinical work on dental anxiety, and includes a discussion of the historical background and the evolution since the 1970s. In view of its pioneering activities in this regard, special focus is placed on research and development at the Institute of Odontology of the University of Gothenburg, Sweden.
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9.
  • Hakeberg, Magnus, 1954, et al. (creator_code:aut_t)
  • A 10-year follow-up of patients treated for dental fear.
  • 1990
  • record:In_t: Scandinavian journal of dental research. - 0029-845X. ; 98:1, s. 53-9
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Different types of treatment have been used in trying to reduce dental anxiety in adult patients with severe fear and avoidance behavior. However, there is an obvious shortage in long-term treatment follow-up. The present investigation reports results over a period of 10 yr of 14 patients treated for dental fear in a specialized dental fear treatment and research clinic. The aims of this project were to evaluate patients' regularity in dental behavior between 1977 and 1987, changes in and present level of dental fear and other long-standing positive/negative effects of the respective initial treatments. The 14 dental phobic patients were assigned to two treatment groups, one receiving Systematic Desensitization and one Premedication with valium before dental treatment. Pre- and posttreatment status as well as the 10-yr follow-up were evaluated by psychometric (Corah's Dental Anxiety Scale and a Mood Adjective Checklist) and physiological (Skin Conductance Response) measurements. A majority of patients (100% SD, 63% P) reported regular dental care during the period 1977-87. Positive side-effects were reported by seven patients. A significant reduction of dental fear (DAS) was found with a better effect for the SD-group. This was paralleled by a rise in mood (MACL). The SCR figures were non-significant. In conclusion, the results revealed long-standing effects with regard to a high degree of regular dental care and reduction of dental fear. In addition, positive side-effects were reported.
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10.
  • Hakeberg, Magnus, 1954, et al. (creator_code:aut_t)
  • Long-term effects on dental care behavior and dental health after treatments for dental fear.
  • 1993
  • record:In_t: Anesthesia progress. - 0003-3006 .- 1878-7177. ; 40:3, s. 72-7
  • swepub:Mat_article_t (swepub:level_refereed_t)abstract
    • Three different treatments for dental fear were tested in a long-term perspective study. Twenty-nine patients with severe dental anxiety and avoidance behavior were assigned to Behavioral Therapy (BT, n = 12), PRemedication with bensodiazepine (PR, n = 8) or dental treatment under General Anesthesia (GA, n = 9). Ten years after initial treatment the patients were reexamined. Changes in dental anxiety and dental care attendance were reported. Patients' dental health status was assessed by radiographic survey. Regular dental attendance was reported by 19 patients (65.5%), with a significantly better result for the BT group (91.6%) compared to the GA group (33.3%). Reported level of dental anxiety, as measured by the Dental Anxiety Scale, revealed a significant reduction during the 10-yr period except among GA patients and those reporting irregular dental attendance behavior. A rise in mood as assessed by the Mood Adjective Checklist was revealed in the total group, with a better effect in the BT and PR groups as well as in patients who reported regular dental attendance. A substantial general improvement in oral health was seen during the 10-yr period, especially among patients receiving regular dental care. Thus, for a majority of patients in this study, directed treatment for dental anxiety and avoidance behavior made it possible to maintain regular dental care behavior during a 10-yr period.
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