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- Andersson, Gerhard, et al.
(författare)
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Internet-based psychodynamic versus cognitive behavioral guided self-help for generalized anxiety disorder : A randomized controlled trial
- 2012
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Ingår i: Psychotherapy and Psychosomatics. - Basel, Switzerland : Karger. - 0033-3190 .- 1423-0348. ; 81:6, s. 344-355
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Tidskriftsartikel (refereegranskat)abstract
- Background: Guided Internet-based cognitive behavior therapy (ICBT) has been tested in many trials and found to be effective in the treatment of anxiety and mood disorders. Generalized anxiety disorder (GAD) has also been treated with ICBT, but there are no controlled trials on guided Internet-based psychodynamic treatment (IPDT). Since there is preliminary support for psychodynamic treatment for GAD, we decided to test if a psychodynamically informed self-help treatment could be delivered via the Internet. The aim of the study was to investigate the efficacy of IPDT for GAD and to compare against ICBT and a waiting list control group.Method: A randomized controlled superiority trial with individuals diagnosed with GAD comparing guided ICBT (n = 27) and IPDT (n = 27) against a no treatment waiting list control group (n = 27). The primary outcome measure was the Penn State Worry Questionnaire.Results: While there were no significant between-group differences immediately after treatment on the main outcome measure, both IPDT and ICBT resulted in improvements with moderate to large within-group effect sizes at 3 and 18 months follow-up on the primary measure in the completer analyses. The differences against the control group, although smaller, were still significant for both PDT and CBT when conforming to the criteria of clinically significant improvement. The active treatments did not differ significantly. There was a significant group by time interaction regarding GAD symptoms, but not immediately after treatment.Conclusions: IPDT and ICBT both led to modest symptom reduction in GAD, and more research is needed.Copyright (C) 2012 S. Karger AG, Basel
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- Anderzén, Ingrid, et al.
(författare)
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Psychophysiological reactions to international adjustment : Results from a controlled, longitudinal study
- 1999
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Ingår i: Psychotherapy and Psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 68:2, s. 67-75
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Tidskriftsartikel (refereegranskat)abstract
- Background: This controlled prospective study examines psychophysiological reactions in employees during their first and second year abroad to identify individual as well as work-related factors predictive of positive adjustment. Methods: Employees (n = 47) relocating from Sweden to a foreign country on a work-related assignment were followed. The subjects completed a questionnaire before relocation and after 1 and 2 years abroad. Blood samples were collected for determination of the stressor-related hormones prolactin, cortisol and testosterone. A matched non-moving reference group of employees (n = 35) responded to the questionnaire at similar time periods, and also provided blood samples. Results: During the years abroad, the expatriate employees experienced increased psychosocial stress as well as negative adjustment as reflected in circulating levels of prolactin and testosterone, worse mental well-being and worsening subjective work environment, as compared with the non-moving group. The greatest change occurred during the first year. Individual factors such as social support, internal locus of control, self-esteem and sense of coherence modified the stress response and predicted employees’ ability to adjust to foreign assignments. Negative changes in the psychosocial work environment explained to a large degree the decrease in work adjustment during the first year and these findings were also reflected in physiological stress indicators. Conclusions: The study emphasises the importance for multinational organisations to look at these individual characteristics before sending employees abroad. They also need to get more involved in supporting employees to manage stressors characteristic of the first year of foreign work.
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- Arnetz, Bengt, et al.
(författare)
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Leadership, Mental Health, and Organizational Efficacy in Health Care Organizations : Psychosocial Predictors of Healthy Organizational Development Based on Prospective Data from Four Different Organizations
- 2007
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Ingår i: Psychotherapy and Psychosomatics. - : S. Karger AG. - 0033-3190 .- 1423-0348. ; 76:4, s. 242-248
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Tidskriftsartikel (refereegranskat)abstract
- Background: Only a few studies of psychosocial determinants of employee health and organizational development have been prospective, involving more than one organization and applying standardized assessment tools. This limits the ability of providing evidence-based guidance as how to carry out healthy organizational transformations. Methods: A total of 6,000 employees responded twice to a validated psychosocial-leadership questionnaire within a 2-year period. The assessment focused on changes over time in the three outcome measures - mental health, efficacy, and leadership, determined to be important indicators of a healthy organization. Changes within and between organization were assessed statistically using regular t tests and general linear modeling. Results: There were major differences between organizations in psychosocial measures, both at the baseline and over time. At the organizational level, changes between study periods in management performance feedback, participatory management, and work tempo were the most consistent predictors of improvements over time in the three outcome measures. Conclusions: Performance feedback and participatory management might be two common predictors of healthy workplaces. Some of the psychosocial determinants of healthy organizations suggested in previous research might not be universally valid. It is suggested that future research should to a larger degree make use of multiple departments and organizations in studies of psychosocial determinants of healthy organizations.
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- Blom, Kerstin, et al.
(författare)
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Psychological Treatment of Comorbid Insomnia and Depression : A Double-Blind Randomized Placebo-Controlled Trial
- 2024
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Ingår i: Psychotherapy and Psychosomatics. - : S. Karger. - 0033-3190 .- 1423-0348.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Insomnia and depression are highly prevalent disorders and commonly occur together. Cognitive behavioral therapy for insomnia, CBT-I, has been shown to be effective in treating insomnia and also comorbid depression. However, it is unclear whether effects of CBT-I on depression are specific or nonspecific. Also, depressive symptoms often remain too high after CBT-I, indicating a need for improved treatments. The objective was to determine whether combining CBT-I with CBT for depression, without increasing treatment length, reduces both insomnia and depression more than CBT for depression with a placebo insomnia intervention. Methods: A 12-week double-blind randomized controlled trial with a 6-month follow-up in a psychiatric setting using therapist-guided internet-delivered treatments was conducted. Patients (N = 126) were diagnosed with insomnia disorder and major depression by physicians. Primary outcome measures were as follows: self-rating scales Insomnia Severity Index (ISI) and Montgomery-angstrom sberg Depression Rating Scale (MADRS-S). Results: The combined treatment showed specific effects on insomnia severity over the control treatment (p = 0.007) but was not more effective in reducing depression severity. Within-group effects (Cohen's d) at post and at 6 months were as follows: ISI 1.40 and 1.42 (combined treatment), 0.95 and 1.00 (control); MADRS-S 0.97 and 1.12 (combined), 0.88 and 0.89 (control). Conclusions: CBT-I shows large specific effects on insomnia severity and is superior to control in this regard. Both treatments had similar effects on depression severity, i.e., combining CBT-I with CBT for depression did not enhance outcomes on depression compared to control. We suggest CBT-I should always be offered to patients with insomnia and depression comorbidity, possibly as the first-hand choice. Combining it with a psychological treatment for depression could be too burdening and may not be beneficial.
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