| 1. |
- Anniko, Malin, 1981-
(författare)
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Stuck on repeat : Adolescent stress and the role of repetitive negative thinking and cognitive avoidance
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stress and stress-related mental health problems such as anxiety and depressive symptoms are common in adolescents and seem to be increasing, especially in mid- to late-adolescent girls. Although adolescence, as a period of rapid growth and profound change, is often marked by an increase in normal stressors (e.g. conflicts with parents, fitting in with peers, increased academic demands), most adolescents do not develop more persis-tent problems with stress. To be able to develop effective preventive interventions there is a need to understand both what adolescents are ascribing their stress to, how different stressor domains relate to outcomes, and why some adolescents go on to develop stress-related mental health problems while others do not. This dissertation aimed to answer some of these questions by investigating the role of cognitive avoidance and repetitive negative thinking (RNT) in the development of stress-related mental health problems (Study I & III). It also aimed to develop and validate a shortened version of a questionnaire designed to measure stressor load within different life domains in adolescence (Study II). Findings show that the shortened version of the Adolescents Stress Questionnaire seems to be a valid measure of stressor load within different domains in adolescence. School-related stressors were the most prevalent sources of stress, but social stressors seem to have a stronger link to increases in mental health symptoms. Also, adolescents who report higher levels of distress and stressor load tend to increase their engagement in cognitive avoidance and RNT over time which in turn predicts further increases in mental health symptoms. This suggests that cognitive avoidance and RNT may be important mechanisms in the development of stress-related mental health problems in adoles-cence.
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| 2. |
- Carstens Söderstrand, Johan, 1979-
(författare)
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Communication in the context of acute pain : Persuasion or validation?
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Historically, the dominating theoretical framework for communication in the context of acute pain is reassurance. An inherent assumption of this framework is that the person in pain needs to have their fears and doubts removed and be educated, or persuaded, that the pain problem is not dan-gerous. This is then thought to lead to a shift in beliefs that later explain future beneficial outcomesIn later years, another communication technique known as validation has started to gain traction in the pain field. This technique focuses on le-gitimizing the thoughts and emotions of pain patients and is instead thought to influence outcomes through better emotion regulation.The overall aim of this dissertation is to extend current knowledge on effective communication in the context of acute pain. In one observational study a variable supposedly sensitive to shifts in beliefs was observed in a cohort of acute pain patients over the course of the first three months after pain onset. Also, in two controlled experiments we explored the impact of validating communication on pain relevant variables while investigating if this effect was due to improved emotion regulation.Taken together, this dissertation indicates that validating communica-tion shows promise as a form of effective communication in the context of acute pain, in that it influences both pain catastrophizing and recall. The dissertation does not give support to either changes in beliefs nor emotion regulation being the mechanism of change for effective communication. Thus, this dissertation propose a new model of effective communication based both on previous research highlighting the effectiveness of infor-mation and the research presented in this dissertation, more focused on the role of psychological processes such as pain catastrophizing.
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| 3. |
- Golovchanova, Nadezhda, 1983-
(författare)
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Older and Feeling Unsafe? Unravelling the Role of Perceived Unsafety in the Well-being of Older Adults Residing in Senior Apartments
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Feeling safe in one’s place of residence is important for the well-being of older adults when ageing in place; in contrast, feeling unsafe is likely to have negative consequences for well-being while ageing. Although substantial knowledge of perceived unsafety has been accumulated within various disciplines, there are certain knowledge gaps related to perceived unsafety in older age. What perceived reasons for feeling unsafe are the most central to older adults? Can emotion regulation strengthen or buffer the negative effects of perceived unsafety on the well-being of older people? What differences exist among older adults regarding why they feel unsafe?This dissertation aimed to address these questions while investigating perceived unsafety and its associations with well-being in the context of ageing, focusing on senior apartment residents. This dissertation adopted an interdisciplinary approach integrating knowledge of perceived unsafety from psychology, gerontology, and criminology. The findings suggest that perceived unsafety in advanced age is a multifaceted phenomenon. Specifically, perceived unsafety could be explained by different perceived reasons (i.e., fear of crime, unattractive social climate in the neighbourhood, and inconvenient infrastructure at home; Study I). Furthermore, maladaptive cognitive emotion regulation strategies were associated with fear of crime and strengthened its negative association with life satisfaction (Study II). Moreover, distinct profiles of older adults could be identified based on compromises in their key life domains. Older adults belonging to different profiles differed in their perceived unsafety and well-being (Study III).Overall, this dissertation findings indicate that feeling unsafe is associated with being less satisfied with life, experiencing more anxiety and depressive feelings, and relying on more maladaptive emotion regulation strategies. Therefore, safety-promotion efforts are considered an important investment in the quality of life of older adults living in senior apartments.
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| 4. |
- Wurm, Matilda, 1975-
(författare)
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Understanding Comorbid Pain and Emotions : A transdiagnostic approach
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Experiencing pain, including an emotional reaction, is part of being human. Emotional comorbidity is common in pain patients, and correlated to higher symptomatology and worse treatment outcome. The shared vulnerability model suggests that many vulnerability and maintaining factors may be involved in both pain and emotional problems. Hence, they may be transdiagnostic. Since our knowledge about these shared factors is lacking, potential targets for risk assessment, prevention, and treatment are likely underutilized. The overarching aim of this dissertation was to further our understanding of comorbid musculoskeletal pain and emotional problems by investigating the role of transdiagnostic factors. Specifically, it was studied if levels of shared vulnerabilities (negative affect and anxiety sensitivity) and symptomatology covary in pain patients depending on the occurrence of comorbid social anxiety symptoms (Study I); if peer-related stress predicts musculoskeletal pain problems over time in adolescents, and if this is mediated by worry and moderated by gender (Study II); and if symptomatology can be decreased in pain patients with comorbid emotional problems by using an internet delivered unified protocol for emotional disorders (Study III). Results show that vulnerabilities covaried with comorbid pain and social anxiety. Also, peer-related stress predicted musculoskeletal pain problems in adolescents and was mediated by worry for girls. However, the internet-delivered unified protocol did not unequivocally decrease symptomatology. In sum, the studies in this dissertation provide partial support for the role of transdiagnostic factors in comorbid musculoskeletal pain and emotional problems. A transdiagnostic approach may offer a parsimonious understanding of the development and maintenance of this comorbid symptomatology.
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| 5. |
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| 6. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Adolescents' sleep trajectories over time : school stress as a potential risk factor for the development of chronic sleep problems
- 2019
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Ingår i: Sleep Medicine. - : Elsevier. - 1389-9457 .- 1878-5506. ; 64:Suppl. 1, s. S27-S27
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Sleep is a complex behavior affected by biological, psychosocial and contextual factors typically present during adolescent development (Becker, Langberg, & Byars, 2015), including increasing autonomy from parents, increasing school demands, and socializing more with peers. However, these normative changes do not explain temporary vs chronic sleep disturbances. Who are the adolescents at risk for developing chronic sleep problems? Some risk factors have been identified as crucial, such as poor sleep hygiene and family stressors, others are not as clear, such as technology use (Bartel et al., 2015). The impact of another important stressor for youths other than family, the school context, has received less attention (Meldrum, 2018). The aim of this study was twofold; first, we explored sleep trajectories from early to mid-adolescence to be able to identify a risk group showing persistent sleep problems (including insomnia and short sleep duration); then, we investigated the role of school stressors (i.e., conflicts with teachers, performance, school-leisure conflict, attendance), controlling for well-established risk factors, in the development of chronic sleep problems in a large cohort of adolescents.Materials and methods: We used three longitudinal waves of questionnaire data collected annually from a sample of Swedish adolescents (n = 1457; Mage = 13.2 [range: 12- 15 years], SD = .43; 52.7% boys). We collected the data from all schools in three communities in central Sweden, during school hours. Using established measures, the students reported on their sleep duration (calculated from reported bedtime, wake-time, and sleep onset latency; SSHS [Wolfson & Carskadon, 1998]), insomnia symptoms (ISI; Morin, 1993), sleep hygiene (ASHS; LeBourgeois, Giannotti, Cortesi, Wolfson, & Harsh, 2005), technology use, and perceived stress (including school, home and peer related stress) (ASQ; Byrne, Davenport, & Mazanov, 2007).First we used latent class analysis (LCA) to identify adolescents' sleep trajectories, then we used regression analyses to predict the risk-group trajectory of chronic insomnia and short sleep duration, controlling for gender.Results: We found four trajectories for adolescents' insomnia; 1) low-stable (69%), 2) low-increasing (18%), 3) high-decreasing (8%), 4) high-increasing (5%; 'risk-group'). For sleep duration, we found two trajectories; 1) ∼8 h slightly decreasing (79%), 2) ∼7 h decreasing (21%; 'risk-group').School stressors including stress of fitting in with peers, stress of schoolwork leaving too little leisure time, a stressful home environment, poor sleep hygiene, and being female were risk factors for chronic insomnia symptoms. Conflicts with teachers, poor sleep hygiene, and being female were risk-factors for chronic insufficient sleep.Conclusions: Over and above well-known risk-factors for poor sleep, such as poor sleep hygiene, (Bartel et al., 2015), school-related stress was a significant predictor of persistent sleep problems in adolescents. Therefore, helping adolescents to handle school stress might be a promising strategy to improve sleep health in this population.
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| 7. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Trajectories of insomnia symptoms and insufficient sleep duration in early adolescents : associations with school stress
- 2022
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Ingår i: SLEEP Advances. - : Oxford University Press. - 2632-5012. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Study Objectives: We examined how adolescents’ sleep patterns (i.e. insomnia symptoms and sleep duration) change from early- to mid-adolescence and whether adolescents follow different trajectories. Furthermore, we also examined the characteristics of adolescents within different trajectories, with a specific focus on the role of school-related stress.Methods: We used three longitudinal waves of questionnaire data collected annually from a sample of Swedish adolescents (n = 1294; Mage = 13.2 [range: 12–15 years], SD = .42; 46.8% girls). Using established measures, the students reported on their sleep duration, insomnia symptoms, and perceived school-stress (including stress of school performance, peer and teacher relations, attendance, and school-leisure conflict). We used latent class growth analysis (LCGA) to identify adolescents’ sleep trajectories, and the BCH method to describe the characteristics of the adolescents in each trajectory.Results: We found four trajectories for adolescents’ insomnia symptoms; (1) low insomnia (69%), (2) low-increasing (17%, ‘emerging risk-group’), (3) high-decreasing (9%), (4) high-increasing (5%; ‘risk-group’). For sleep duration, we found two trajectories; (1) ~8 h sufficient-decreasing (85%), (2) ~7 h insufficient- decreasing (15%; ‘risk-group’). Adolescents in risk-trajectories were more likely to be girls and consistently reported higher levels of school stress, particularly regarding school performance and attending school.ConclusionsSchool stress was prominent among adolescents suffering from persistent sleep problems, especially insomnia, and deserves further attention.
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| 8. |
- Bayram Özdemir, Sevgi, 1981-, et al.
(författare)
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How Does Adolescents' Openness to Diversity Change Over Time? The Role of Majority-Minority Friendship, Friends' Views, and Classroom Social Context
- 2021
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Ingår i: Journal of Youth and Adolescence. - : Plenum Publishing. - 0047-2891 .- 1573-6601. ; 50:1, s. 75-88
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Tidskriftsartikel (refereegranskat)abstract
- Young people are growing up in increasingly “super-diverse” societies, and show variations in how they approach diversity and embrace differences. Developing a good understanding of why some youth appreciate and value diversity whereas others do not is crucial in identifying ways to promote social interactions among different groups in broader society. The current study examined whether adolescents follow different trajectories in their views on diversity, and identified possible factors behind how they change over time. The sample included 1362 adolescents residing in Sweden (Mage = 13.18, SD = 0.43, 48% girls). Adolescents reported on their openness to diversity and classroom social climate. The peer nominations method was used to measure majority-minority friendship, and friends’ views on diversity. Latent growth analysis showed that adolescents, on average, became more open to diversity over time, but with clear heterogeneity. Three distinct trajectories were identified as: high-increasing, average-increasing, and average-declining. Relative to the high-increasing group, the other two were more likely to be male and immigrant. Relative to the high-increasing group, adolescents on the average-increasing trajectory perceived their classroom climate as less cooperative, while the adolescents on the average-declining trajectory were less likely to have friends with positive views on diversity. The findings suggest that schools may serve as a shared ground for promoting openness to diversity.
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| 9. |
- Elvén, Maria, 1973-, et al.
(författare)
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Assessing clinical reasoning in physical therapy : discriminative validity of the Reasoning 4 Change instrument
- 2022
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Ingår i: Physiotherapy. - : Elsevier BV. - 0031-9406 .- 1873-1465. ; 117, s. 8-15
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate discriminative validity of the Reasoning 4 Change (R4C) instrument by investigating differences in clinical reasoning skills between first semester, final semester physical therapy students and physical therapy experts.Design:Cross-sectional designSetting: University and physical therapy practiceParticipantsStudents from the first (n = 87) and final semester (n = 47) of an entry-level physical therapy program and experts in physical therapy with a behavioral medicine approach (n = 14).Methods: The students and experts answered the web-based R4C instrument on one occasion. The R4C instrument includes four domains designed to assess physical therapists’ clinical reasoning skills with a focus on supporting clients’ behavior change and has demonstrated acceptable content validity, convergent validity and reliability. Data was analyzed with one-way analysis of variance and Games-Howell post hoc test.Results: Differences in all domains and subscale scores were found between the three groups. Pairwise comparisons demonstrated that experts scored higher (better clinical reasoning skills) than first semester students in all domains and subscales; and higher scores than final semester students, except for two subscales. Final semester students scored higher than first semester students, except for one subscale.Conclusions: The findings highlight differences in clinical reasoning skills focusing on clients’ behavior change among physical therapy students with different degrees of training and education in clinical reasoning and physical therapists with extensive experience and expertise. The results provide evidence for the discriminative validity of the R4C instrument which support the use of the R4C instrument in education, research and clinical practice.
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| 10. |
- Ponten, Moa, et al.
(författare)
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Association between expectations and clinical outcomes in online v. face-to-face therapy - an individual participant data meta-analysis
- 2024
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Ingår i: Psychological Medicine. - : Cambridge University Press. - 0033-2917 .- 1469-8978. ; 54:6, s. 1207-1214
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Tidskriftsartikel (refereegranskat)abstract
- Background. Online treatments are increasing in number and are currently available for a wide range of clinical problems. To date little is known about the role of treatment expectations and other placebo-like mechanisms in online settings compared to traditional face-to-face treatment. To address this knowledge gap, we analyzed individual participant data from randomized clinical trials that compared online and face-to-face psychological interventions.Methods. MEDLINE (Ovid) and PsycINFO (Ovid) were last searched on 2 February 2021. Randomized clinical trials of therapist guided online v. face-to-face psychological interventions for psychiatric or somatic conditions using a randomized controlled design were included. Titles, abstracts, and full texts of studies were independently screened by multiple observers. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. Authors of the matching trials were contacted for individual participant data. Ratings from the Credibility and Expectancy Questionnaire and the primary outcome measure from each trial were used to estimate the association between expectation ratings and treatment outcomes in online v. face-to-face interventions, using a mixed-effects model.Results. Of 7045 screened studies, 62 full-text articles were retrieved whereof six studies fulfilled the criteria and provided individual participant data (n = 491). Overall, CEQ ratings predicted clinical outcomes (beta = 0.27) at end of treatment with no moderating effect of treatment modality (online v. face-to-face).Conclusions. Online treatment appears to be equally susceptible to expectancy effects as face-to-face therapy. This furthers our understanding of the importance of placebo-like factors in online treatment and may aid the improvement of healthcare in online settings.
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