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- Elwin, Marie, 1953-
(författare)
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Description and measurement of sensory symptoms in autism spectrum
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Unusual responses to sensory stimuli have been reported in nearly all children with autism spectrum conditions (ASC). A few studies on adults indicate that the sensory and perceptual problems persist into adulthood. Sensory symptoms have not been included in the diagnostic criteria for ASC but in the new diagnostic manual (DSM-5, 2013) hyper- or hyporeactivity or unusual sensory interests were included in the diagnostic criteria for ASC. Sensory phenomena are mostly investigated in studies involving children and the scales used to measure sensory reactivity have been constructed on the basis of the scientific literature and parents’ reports. The experiences of adults with ASC are not well understood and have not been systematically used to develop measures.The overall aim of the thesis was to capture the first-hand experiences of and perspectives on sensory reactivity and translate them into a self-rating scale. To fulfil this overarching aim the personal sensory experiences of adults with ASC were investigated and the variations and range of atypical sensory phenomena explored and described in two qualitative studies (study I and II). The analyses of the firstperson descriptions enabled the development of items for a scale. These were reduced in steps and the final scale which was named the Sensory Reactivity in Autism Spectrum scale (SR-AS) comprised 32 items in four subscales: high awareness/ hyperreactivity, low awareness/hyporeactivity, strong sensory interests and sensory/motor. The SR-AS was validated using content and factor analyses. Its discriminative validity was then investigated as well as its reliability in the form of internal consistency (study III). In the final step the scale was used to identify clusters of atypical sensory functioning in adults with ASC by hierarchical cluster analysis (study IV). Three different sensory clusters were found.The main contribution of this thesis is its presentation of individual experience and perspectives and the creation of an clinical tool to measure atypical sensory reactivity frequently experienced by people with ASC. The ways in which the SR-AS can be used comprise assessment of individual sensory patterns for self-knowledge and awareness, to enable the development of coping strategies and to provide information on environmental adjustments required. In diagnostic processes where other criteria for ASC are fulfilled the SR-AS can be used for assessing sensory symptoms according to the DSM-5.
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| 2. |
- Selvin, Mikael, 1978-
(författare)
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Patient participation and quality of forensic psychiatric care
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aims of this thesis were to investigate the quality of forensic psychiatric care, to describe the concept of patient participation from a patient and health care professional perspective, and to initiate the development of an instrument for measuring participation from a patient perspective.Forensic psychiatric care is a specialized form of care where patients who have committed a crime that would normally have led to prison, instead are treated for a serious mental disorder. In study I patients’ and professionals’ experiences of quality of forensic psychiatric care were measured, and one of the findings was that questions regarding participation was rated as low by both patients and staff. In Study II the patients perceived the concept of patient participation as: Influence by having good communication and being involved; Confidence by mutual trust and trusting the care; Own responsibility by taking part in activities and to take own initiative. The findings in Study III highlights the importance as a professional to create prerequisites for patient participation by using good communication and inviting the patient to be involved, whilst at the same time adjusting for the forensic psychiatric conditions by taking professional responsibility and assessing the patients’ current capacity. If used correctly, patient participation encourages the patient to become more independent. In study IV, the initial development of an instrument for measuring participation in forensic care from a patient perspective was described. The findings contribute with important knowledge that can encourage reflection and accordingly help mental health professionals and decision makers to create an environment that promotes patient participation in forensic psychiatric care. Further research should investigate the longterm effects of increasing the participation, such as cost effectiveness, treatment times and risk of committing new crimes.
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