| 1. |
- Ahorsu, Daniel Kwasi, et al.
(författare)
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Testing an app-based intervention to improve insomnia in patients with epilepsy : A randomized controlled trial
- 2020
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Ingår i: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 112
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Insomnia has adverse effects on people with epilepsy. We aimed to test a novel cognitive behavioral therapy for insomnia (CBT-I) app-based intervention on insomnia symptoms and social psychological factors in people with epilepsy and to examine the possible mechanisms among the factors.Methods: Participants were recruited from neurology clinics in Iran and comprised individuals diagnosed with epilepsy and having moderate to severe insomnia. A two-arm randomized controlled trial design was used, consisting of a treatment group (CBT-I; n = 160) and control group (patient education; n = 160). Primary outcomes were self-reported sleep quality, insomnia severity, and sleep hygiene behavior and objective sleep characteristics measured by actigraphy. Secondary outcomes were attitude, perceived behavioral control, intention, action planning, coping planning, behavioral automaticity, self-monitoring, anxiety, depression, and quality of life (QoL). All outcomes were measured at baseline, and at one, three, and six months postintervention, except objective sleep, which was assessed at baseline, and one and six months postintervention. Data were analyzed using linear mixed models.Results: Current findings showed that sleep quality, insomnia severity, sleep hygiene behavior, and sleep onset latency were significantly improved in the CBT-I group compared with the patient education group at all measurement points. Also, the CBT-I group had significantly improved anxiety, depression, and QoL compared with the patient education group. Mediation analyses showed that attitude, intention, coping planning, self-monitoring, and behavioral automaticity significantly mediated the effect of the intervention on sleep outcomes.Conclusion: Results support the use of the CBT-I app to improve sleep outcomes among people with epilepsy.
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| 2. |
- Buhrman, Monica, 1974-, et al.
(författare)
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Treating perfectionism using internet-based cognitive behavior therapy : A study protocol for a randomized controlled trial comparing two types of treatment
- 2020
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Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Perfectionism is characterized by setting high standards and striving for achievement, sometimes at the expense of social relationships and wellbeing. Despite sometimes being viewed as a positive feature by others, people with perfectionism tend to be overly concerned about their performance and how they are being perceived by people around them. This tends to create inflexible standards, cognitive biases, and performance-related behaviors that maintain a belief that self-worth is linked to accomplishments. Cognitive behavior therapy has been shown to be a viable treatment for perfectionism, both in terms of reducing levels of perfectionism and improving psychiatric symptoms. Furthermore, a number of recent studies indicate that it can be successfully delivered via the Internet, both with regular support and guidance on demand from a therapist. In the present study protocol, a clinical trial for perfectionism is described and outlined. In total, 128 participants will be recruited and randomized to either a treatment that has already been demonstrated to have many benefits, Internet-based Cognitive Behavior Therapy for perfectionism (iCBT-P), or an active comparison condition, Internet-based Unified Protocol (iUP), targeting the emotions underlying depression and anxiety disorders. The results will be investigated with regard to self-reported outcomes of perfectionism, psychiatric symptoms, self-compassion, and quality of life, at post-treatment and at six- and 12-month follow-up. Both iCBT-P and iUP are expected to have a positive impact, but the difference between the two conditions in terms of their specific effects and adherence are currently unknown and will be explored. The clinical trial is believed to lead to a better understanding of how perfectionism can be treated and the specificity of different treatments.
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| 3. |
- Dahlin, Mats, 1975-
(författare)
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Development and evaluation of an internet-based treatment for generalized anxiety disorder : An acceptance-based approach
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Generalized anxiety disorder (GAD) is a chronic condition characterized by an excessive and uncontrollable worry. GAD has a highly negative impact on all aspects of life, and the costs for society are considerable. Cognitive behaviour therapy (CBT), delivered face-to- face or online, has been shown to be effective in treating GAD. However, there are still room for improvement, with treatment content and format of delivery being two areas to further investigate. Internet-based treatments are often based on a generic CBT model of GAD and include treatment strategies such as cognitive restructuring and relaxation. Furthermore, the impact of therapist support has shown inconclusive results.Overall, this thesis aimed to evaluate the effects of a new internet-based treatment for GAD, based on acceptance, mindfulness, and valued action, delivered with different types of support. Study I was a small pilot trial with a within-group design. The study included 16 participants diagnosed with GAD who received the newly developed treatment program with weekly therapist support. Statistically significant and large effect sizes were observed on self-rated worry at post-treatment, and the effects were maintained at a three-months follow-up. Study II included 103 participants diagnosed with GAD who were randomized to nine weeks of treatment with the treatment program and weekly support, or a waiting-list control group. Statistically significant moderate to large effects were observed on primary and secondary outcomes in favour of the treatment. The exception was a measure of quality of life, with no significant difference between the two groups. The treatment effects were maintained at a six-months follow-up. Study III was a pilot trial including 33 participants diagnosed with GAD. A within-group design was used to investigate the effects of the treatment program delivered with automated messages and support on demand. Significant and large within-group effects were observed on all outcome measures at post-treatment with the exception of quality of life, for which there was a small effect. Study IV was a pilot factorial design trial that compared the acceptance-based treatment program against a self-tailored treatment, as well as two types of support: scheduled support and support on demand. The study included 85 participants with GAD randomized to four different treatment groups. Significant moderate to large effects were observed in all treatment groups, with no statistically significant differences between the groups on self-rated outcome measures. Receiving scheduled support was rated as more positive than support on demand, and self-tailored treatment was rated as more positive than the acceptance-based treatment. Treatment satisfaction was high in all studies.In conclusion, the studies indicate that an internet-based treatment based on acceptance, mindfulness, and valued action is a viable option in the treatment of GAD.
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| 4. |
- Dahlin, Mats, 1975-, et al.
(författare)
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Internet-based self-help using automatic messages and support on demand for generalized anxiety disorder : an open pilot study
- 2020
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Ingår i: Digital Psychiatry. - : Taylor & Francis. - 2575-517X. ; 3:1, s. 12-19
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Tidskriftsartikel (refereegranskat)abstract
- Generalized anxiety disorder (GAD) is a disabling and often chronic condition. Internet-based treatments for GAD have been shown to be effective, but many studies include weekly contact with a therapist with the aim to increase adherence and clinical outcomes. The current study evaluated a less therapist-intensive alternative: support on demand and automatic messages. Thirty-three participants with GAD went through a self-help program targeting excessive worry. Treatment lasted 9 weeks and consisted of seven modules. Participants received short messages with reminders and encouragement. Therapist support was given when asked for. The intervention led to significant and large within-group effects on the primary outcome, Penn State Worry Questionnaire (PSWQ; Cohen’s d = 1.17), as well as on secondary outcomes such as Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV; Cohen’s d = 2.71) and Patient Health Questionaire-9 (PHQ-9; Cohen’s d = 1.05). The exception was a small effect on quality of life (d = −0.34). Twenty-four (74.9%) were satisfied with the treatment and one dropped out. Therapist support was used by 65.6%. Limitations include lack of control condition and a small sample. While preliminary, the findings suggest that self-guided internet interventions can work and be acceptable when automated messages and support on demand is provided.
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| 5. |
- Elling, Devy Lysandra, et al.
(författare)
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Effectiveness of Combining Organizational Alcohol Policy and Skills Training for Managers to Reduce Hazardous Alcohol Consumption in Swedish Workplaces : Study Protocol for a Cluster Randomized Study
- 2020
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Ingår i: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 9:8
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Tidskriftsartikel (refereegranskat)abstract
- Background: High alcohol consumption poses risks to individual health and society. Previous alcohol interventions have mainly focused on high-risk consumers or young adults in school-based settings. Since the majority of the adult population is in the workforce, the workplace can be considered a favorable arena for implementing interventions.Objective: This protocol describes a project aimed at increasing knowledge of the effectiveness of combining the implementation of an organizational alcohol policy with skills training for managers as a workplace alcohol prevention program, by evaluating the intervention and exploring managers’ perceptions of the intervention.Methods: Organizations with at least 100 employees were invited to take part in the project. A total of 11 organizations (744 managers and 11,761 employees) were included in the project. Data are collected through self-administered online surveys at baseline, 12 months, and 24 months. The primary outcome is managers’ inclination to initiate an early alcohol intervention (eg, by initiating a dialogue) when concern regarding employees’ hazardous alcohol consumption arises. The secondary outcomes of interest are managers’ and employees’ organizational alcohol policy knowledge and changes in alcohol consumption, as measured using the Alcohol Use Disorder Identification Test (AUDIT) score. A linear mixed-model framework will be used to model variability on different levels. Primary analysis will follow an intention-to-treat approach. Additionally, managers’ responses from semistructured interviews will be analyzed using thematic analysis to explore managers’ experiences regarding the prevention program.Results: This study is ongoing. The overall study start was on January 2018, and the study is planned to end in December 2020. Baseline and 12-month follow-up measurements have been collected.Conclusions: This project is designed to evaluate the effectiveness of an alcohol prevention program regarding higher inclination to initiate early alcohol interventions after policy implementation and skills training among managers, compared to the usual practices in the workplace. The results from this study can contribute to increased knowledge about alcohol interventions and future prevention programs in the workplace.Trial Registration: ISRCTN17250048; http://www.isrctn.com/ISRCTN17250048International Registered Report Identifier (IRRID): DERR1-10.2196/17145
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| 6. |
- Forsström, David, 1981-, et al.
(författare)
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Dropouts’ usage of a responsible gambling tool and subsequent gambling patterns
- 2020
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Ingår i: Cogent Psychology. - : Informa UK Limited. - 2331-1908. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Responsible gambling measures are mainly implemented by the gambling industry to reduce excessive gambling and gambling-related harm. These measures include responsible gambling tools that target online gamblers, typically through behavior tracking, feedback, and, in some cases, advice on how to reduce gambling. Playscan is a responsible gambling tool implemented at gambling sites in several countries with many users in Norway and Sweden. Previous studies have indicated that these tools have limited repeated use. Also, the tools have shown to have a low effect on decreasing gambling behavior. Our aim has been to investigate usage and effect of Playscan among Norwegian gamblers (N = 835) that began to use Playscan and then opted out. These gamblers had a high initial use, but extensive lack of repeated use of the functions included in the tool (secondary data was used). The majority of the gamblers used Playscan for a short period of time. The results indicate that the participants did not gamble less after using Playscan (gambling data analyzed using ANOVA). A hypothesis that can be suggested is that short-term use of Playscan do not decrease the level of gambling for this sample. Also, low-risk gamblers seems to have increased their gambling after using Playscan. The results implies that level of use and length of use needs to be taken into account when evaluating the effect of responsible gambling tools. The low level of use in this sample and in other studies implies that strategies to increase is needed.
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| 7. |
- Forsström, David, et al.
(författare)
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GamTest : Psychometric Evaluation in a Low-Gambling General Population
- 2020
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Ingår i: Journal of Gambling Issues. - Toronto : Concurrent Disorders Society Press. - 1910-7595. ; 44, s. 77-102
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Tidskriftsartikel (refereegranskat)abstract
- Instruments that investigate different aspects of gambling activities are needed to distinguish negative consequences. Because gambling is a complex activity that occurs both offline and online, different questionnaires are necessary for screening and risk classification. GamTest, an instrument used by several gambling companies, was designed to cover different aspects of gambling: money and time spent, as well as social, financial, and emotional consequences. This study explores GamTest’s psychometric properties in a general population. A total of 2,234 Swedish respondents completed an online survey containing demographic questions, the questionnaire (GamTest), and the Problem Gambling Severity Index (PGSI). A confirmatory factor analysis was performed and GamTest’s reliability and validity tested. The confirmatory factor analysis yielded an inclusive fit. The internal consistency (omega) for the five factors was high (.79–.91), indicating good reliability, and a high positive correlation with the PGSI supported the validity of the GamTest. The inclusive fit of the confirmatory factor analysis can be explained by the low endorsement of negative consequences of gambling in the sample. However, GamTest seems to have good reliability and validity. The utility of GamTest is discussed in relation to its psychometric properties and its use in the responsible gambling tool Playscan.
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| 8. |
- Ivanova, Ekaterina, 1987-
(författare)
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Responsible provision of online gambling : Effects, usability and gamblers’ experiences of protective measures implemented in online gambling environments
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Problem gambling is considered a public health problem in many countries and is associated with serious financial and health-related harms for both problem gamblers and significant others. It is possible to create gambling environments that would promote sustainable gambling behaviors and prevent excessive gambling. However, research on the effectiveness of tools for responsible provision of gambling is scarce and the quality of the research is low. Also, there exists a conflict of interest between making a profit when providing gambling and protecting vulnerable customers. The general aim of the project was to study the effects, usability and gamblers’ experiences of tools for responsible provision of online gambling. Study I evaluated the effects of a prompt to set voluntary deposit-limit of optional size among 4,328 customers of an online gambling platform. During the data collection period, all customers from Finland registering an account on the gambling platform were randomized into being prompted to set a deposit-limit either 1) at-registration, 2) before their first deposit, 3) after their first deposit or 4) to an unprompted control group. Gambling intensity, measured with aggregated net loss, was tracked during 90 days after registration. No differences in gambling intensity between the intervention and control groups were found neither on the whole-group level (B (95% CI) =-0.080 (-0.229-0.069), p=.291), nor in the subgroup of the most involved gamblers (B (95% CI) =0.042(-0.359-0.442), p=.838). Study II aimed at predicting gaming freeze (as a proxy parameter for problem gambling) in online gamblers. For the sample of N=2,618 (N=1,309 freezers), a total of 105 predictors were created based on the data tracked by the gambling platform. The analysis was carried out using the machine learning method Random Forest. The predictive accuracy of the model applied to the dataset was 0.615, with a specificity of 0.686 and a sensitivity of 0.543. Study III aimed at investigating non-problem gamblers’ experiences of protective measures. A total of N=10,200 active customers of an online gambling platform were asked to rate their previous experiences of protective tools, their inclination to abandon a gambling service due to perceived overexposure to protective measures and answer questions on their symptoms of problem gambling. N=1,223 responded to the questionnaire, with the majority of the sample being moderate-risk gamblers (38.5%), followed by low-risk gamblers (26.8%), non-problem gamblers (18.9%) and problem gamblers (15.8%). In general, non-problem gamblers were not more disturbed by protective measures than other categories of gamblers. More problem gamblers have previously abandoned a gambling service due to perceived overexposure to protective measures compared to non-problem gamblers (OR(95% CI)= 7.17(3.61-14.23), p<.001). In conclusion, a prompt to set a voluntary deposit-limit of optional size did not appear to be effective in decreasing gambling intensity in online gamblers, indicating the need of evaluating alternative designs. Predicting gaming freezes in the current project resulted in a low accuracy, indicating that gaming freeze is not suitable as a proxy measurement for problem gambling and suggesting the need for collecting subjective data on symptoms of problem gambling. The results of Study III suggest that protective measures can be tested and implemented without the risk of disturbing recreational gamblers.
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| 9. |
- Jonsson, Jakob, et al.
(författare)
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Reaching out to big losers leads to sustained reductions in gambling over 1 year: a randomized controlled trial of brief motivational contact
- 2020
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Ingår i: Addiction. - : Wiley. - 0965-2140 .- 1360-0443. ; 115:8, s. 1522-1531
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims A previous randomized controlled trial demonstrated that telephone- and letter-based motivational interventions with high-expenditure gamblers had significant short-term positive effects on gambling and use of responsible gambling tools. This post-trial follow-up examined outcomes in gambling expenditure over 12 months. Design Observational study following a three-arm randomized controlled trial. Setting Customers of Norsk Tipping (NT) gambling platforms, Norway. Participants A total of 1003 statistical triplets from the top 0.5% of customers based upon annual expenditure, matched on sex, age and net losses. Mean age was 53.4 years; 19% were women, mean yearly loss for 2016 was 88 197 NoK. Interventions and comparator Feedback intervention by telephone, letter or a no-contact control condition. Measurements Primary outcome measure was gambling theoretical loss, derived from the NT customer database. Secondary outcomes were responsible gambling customer actions and whether or not the participant was retained as an NT customer. Findings Per-protocol analyses of triplets who received the telephone call or letter as randomly assigned (n = 596) showed a positive and sustained effect over 12 months: the telephone group showed a 30% reduction in theoretical loss (d = 0.44) and the letter group 13% (d = 0.18), both outperforming the control group with a 7% reduction (d = 0.11). The telephone condition was superior to both the letter and control conditions in per-protocol (P < 0.001) and to control condition in intention-to-treat analyses (ITT) (P < 0.001). Individuals in the telephone condition took more responsible gambling actions. The letter condition had better outcomes than the control in the ITT-only analysis (P < 0.001). More than 93% were still customers a year after the intervention. Conclusions Personal contact with high-expenditure gambling customers in Norway that provided individualized feedback on expenditures was associated with reduced theoretical losses and greater use of responsible gambling tools over a 12-month period, compared with no contact. Telephone intervention with customers had a larger impact than a mailed letter.
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| 10. |
- Kim, Hwan, et al.
(författare)
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Assessing procrastination in Korean : A study of the translation and validation of the Pure Procrastination Scale and a reexamination of the Irrational Procrastination Scale in a student and community sample
- 2020
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Ingår i: Cogent Psychology. - : Informa UK Limited. - 2331-1908. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Procrastination refers to voluntarily delay an intended course of action despite expecting that it might have negative consequences. It is usually assessed by self-reports, and the two most frequently used scales are the Pure Procrastination Scale (PPS) and the Irrational Procrastination Scale (IPS). The current study sought to investigate the reliability and validity of the two scales in Korean by translating the PPS from English and to reexamine a previous translation of the IPS. The aim is to promote further research on procrastination and to enhance a cross-cultural comprehension of the construct in different contexts. Hence, confirmatory factor analyses were conducted using data from 551 participants in a student and community sample. Convergent and discriminant validity, internal consistency, and test-retest reliability were also assessed. A three-factor solution exhibited an adequate fit for the PPS; decisional procrastination, implemental procrastination, and timeliness and promptness, although a one-factor solution with only the implemental part performed equally well. Meanwhile, a one-factor solution exhibited a reasonable fit for the IPS. Both scales correlated moderately with anxiety, r = .36-.37, depression, r = .37-.38, self-efficacy, r= .-34 to −.38, and quality of life, r = −.32 to −.34, all in the expected directions, but not so for perfectionism, r =.09-.10. Internal consistencies, Cronbach’s α = .93 (the PPS) and.85 (the IPS), and test-retest reliabilities (two weeks), r = .88 (the PPS) and.83 (the IPS), were good. The findings indicate that the Korean versions might be reliable and valid for researching procrastination.
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