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- Alfonsson, Sven, 1977-, et al.
(författare)
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Differences in motivation and adherence to a prescribed assignment after face-to-face and online psychoeducation : A randomized experiment
- 2017
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Ingår i: BMC Psychology. - : Springer Science and Business Media LLC. - 2050-7283. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adherence to treatment homework is associated with positive outcomes in behavioral psychotherapy but compliance to assignments is still often moderate. Whether adherence can be predicted by different types of motivation for the task and whether motivation plays different roles in face-to-face compared to online psychotherapy is unknown. If models of motivation, such as Self-determination theory, can be used to predict patients’ behavior, it may facilitate further research into homework promotion. The aims of this study were, therefore, to investigate whether motivation variables could predict adherence to a prescribed assignment in face-to-face and online interventions using a psychotherapy analog model. Methods: A total of 100 participants were included in this study and randomized to either a face-to-face or online intervention. Participants in both groups received a psychoeducation session and were given an assignment for the subsequent week. The main outcome measurements were self-reported motivation and adherence to the assignment. Results: Participant in the face-to-face condition reported significantly higher levels of motivation and showed higher levels of adherence compared to participants in the online condition. Adherence to the assignment was positively associated with intrinsic motivation and intervention credibility in the whole sample and especially in the online group. Conclusions: This study shows that intrinsic motivation and intervention credibility are strong predictors of adherence to assignments, especially in online interventions. The results indicate that intrinsic motivation may be partly substituted with face-to-face contact with a therapist. It may also be possible to identify patients with low motivation in online interventions who are at risk of dropping out. Methods for making online interventions more intrinsically motivating without increasing external pressure are needed.
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2. |
- Andersson, Erik, et al.
(författare)
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Internet-Based Extinction Therapy for Worry : A Randomized Controlled Trial
- 2017
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Ingår i: Behavior Therapy. - : ASSOC ADV BEHAVIOR THERAPY. - 0005-7894 .- 1878-1888. ; 48:3, s. 391-402
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Tidskriftsartikel (refereegranskat)abstract
- Worry is a common phenotype in both psychiatric patients and the normal population. Worry can be seen as a covert behavior with primary function to avoid aversive emotional experiences. Our research group has developed a treatment protocol based on an operant model of worry, where we use exposure -based strategies to extinguish the catastrophic worry thoughts. The aim of this study was to test this treatment delivered via the Internet in a large-scale randomized controlled trial. We randomized 140 high-worriers [PSWQ]) to either Internet-based extinction therapy (IbET) or to a waiting-list condition (WL). Results showed that IbET was superior to WL with an overall large between-group effect size of d 1.39 (95% confidence interval [1.04,1.73]) on the PSWQ. In the IbET group, 58% were classified as responders. The corresponding figure for WL participants was 7%. IbET was also superior to the WL on secondary outcome measures of anxiety, depression, meta-cognitions, cognitive avoidance, and quality of life. Overall treatment results were maintained for the IbET group at 4- and 12-month follow-up. The results from this trial are encouraging as they indicate that worry can be targeted with an accessible and novel intervention for worry. Replication trials with active control group are needed.
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- Folke, Fredrik, et al.
(författare)
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Exploring the relationship between activities and emotional experience using a diary in a mental health inpatient setting
- 2018
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Ingår i: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 27:1, s. 276-286
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Tidskriftsartikel (refereegranskat)abstract
- Mental health inpatient milieus have repeatedly been found to be associated with passivity, social disengagement, and low levels of interaction with staff. However, little is known about patients' experiences related to different ward activities. In the present study, we aimed to study the reports of activities and associated experiences of patients admitted to acute psychiatric inpatient wards. Disengaged, inactive, and solitary activities were hypothesized to be associated with less reward and more distress than their counterparts. We also aimed to investigate if such activities predicted distress, and if they were associated with clinical severity. Participants (n = 102) recorded their activities along with concurrent ratings of reward and distress in a structured 1-day diary, and nurses provided clinical severity ratings. On average, 3.74 of the 11 hours assessed (34%) were spent doing nothing, only 0.88 hours (8%) were spent with staff, and most of the time was spent in solitude. Doing nothing, being alone, and passivity were associated with the greatest levels of distress and lowest levels of reward, whereas informal socializing demonstrated the opposite pattern. Distress was not predicted by activity or reward when adjusting for baseline distress. Clinical severity was not associated with the amount of time spent alone or the experience of reward during activity. In conclusion, the risk for passivity and social disengagement during admission prevails. This activity pattern could have detrimental emotional consequences and warrants action, but more studies are needed to determine if activity actually precedes emotional experience.
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5. |
- Myhr, Peter, et al.
(författare)
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Can the Attention Training Technique Reduce Stress in Students? : A Controlled Study of Stress Appraisals and Meta-Worry
- 2019
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Ingår i: Frontiers in Psychology. - : FRONTIERS MEDIA SA. - 1664-1078. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- The present study tested the impact of attention training on cognition; secondary appraisal of perceived stress, and on metacognition; meta-worry in stressed students. Theoretically derived from the Self-Regulatory Executive Function model (S-REF model; Wells and Matthews, 1994a, 1996), the attention training technique (ATT; Wells, 1990) is intended to promote flexible, voluntary external attention and has been shown to reduce symptoms of psychological distress. The present experimental study explored the effects of ATT on cognitive and metacognitive levels of appraisal, namely perceived stress (primary outcome) and meta-worry (secondary outcome). Stressed students were randomized to an experimental ATT group (n = 23) or a control group (n = 23). The ATT group attended an initial training session followed by 4 weeks of individual (12 min) daily ATT practice. The control group waited for 4 weeks before receiving the intervention. The outcomes were scores on the Perceived Stress Scale 14 (PSS-14) and the Meta-Worry Questionnaire (MWQ) frequency and belief subscales at post study. Both measures decreased significantly following ATT with large pre- to post-effect sizes but there were minimal changes in the control group. The between-group differences were statistically significant. The results add to the literature on the potential effects of ATT by demonstrating effects on the content of cognitive stress appraisals and on meta-worry in an academic setting in a stressed student sample.
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6. |
- Nissling, Linnea, 1991, et al.
(författare)
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Effectiveness of and processes related to internet-delivered acceptance and commitment therapy for adolescents with anxiety disorders : a randomized controlled trial
- 2023
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Ingår i: RESEARCH IN PSYCHOTHERAPY-PSYCHOPATHOLOGY PROCESS AND OUTCOME. - : PAGEPress Publications. - 2499-7552 .- 2239-8031. ; 26:2
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Tidskriftsartikel (refereegranskat)abstract
- Early access to evidence-based help is crucial for adolescents with anxiety disorders. Internet-delivered acceptance and commitment therapy (iACT) may offer adolescents increased access to care and more flexibility in engaging with treatment when and how they prefer. Process-based therapies, such as ACT, focus on the-oretically derived and empirically tested key mechanisms in treat-ment that enable change. This study aimed to investigate the effectiveness of iACT for adolescents with anxiety disorders. The study also assessed the relationship between psychological flexi-bility and treatment outcomes and the relationship between par-ticipating adolescents' and therapists' perceived alliance and treatment outcomes. This was a randomized controlled trial com-paring a 10-week intervention group with a wait-list control group. The 52 participants, aged 15 to 19, were recruited from all over Sweden. The treatment was effective in increasing quality of life and psychological flexibility, with moderate between-group effect sizes based on observed values. Changes in psychological flexibility was associated with changes in anxiety symptoms. The results further showed a statistically significant between-group difference in post-treatment diagnoses. No significant time per group interaction was found for anxiety symptoms, as both groups improved. Working alliance was rated as high by both participat-ing adolescents and therapists but showed no significant relation-ship with treatment outcomes. Participants found the treatment an acceptable intervention. This study shows promising results for iACT in treating adolescents with anxiety disorders. The results suggest the model of psychological flexibility as an important process of change in treatment outcomes. Future research should validate these findings in larger samples and clinical contexts.
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7. |
- Olatunji, Bunmi O., et al.
(författare)
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Confirming the Three-Factor Structure of the Disgust Scale-Revised in Eight Countries
- 2009
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Ingår i: Journal of Cross-Cultural Psychology. - : SAGE Publications. - 0022-0221 .- 1552-5422. ; 40:2, s. 234-255
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Tidskriftsartikel (refereegranskat)abstract
- The current study evaluates the factor structure of the Disgust Scale–Revised (DS-R) in eightcountries: Australia, Brazil, Germany, Italy, Japan, the Netherlands, Sweden, and the UnitedStates (N = 2,606). Confirmatory factor analysis is used to compare two different models of the DS-R and to investigate the invariance of the factor structure of the DS-R across countries and gender. A three-factor solution consisting of three different but interrelated disgust factors (a 12-item core disgust factor, an 8-item animal-reminder disgust factor, and a 5-item contamination disgust factor) best accounted for the data in all countries except the Netherlands. Relative to the United States, the three-factor solution is invariant in Australia, Brazil, and Japan but not in Germany, Italy, the Netherlands, and Sweden. The three-factor solution is also invariant across gender in most countries. The implications of these cross-cultural findings for promoting a morevalid and reliable assessment of disgust dimensions, as assessed by the DS-R, are discussed.
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- Rajalin, Mia, et al.
(författare)
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Dialectical behavior therapy-based skills training for family members of suicide attempters
- 2009
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Ingår i: Archives of Suicide Research. - : Routledge. - 1381-1118 .- 1543-6136. ; 13:3, s. 257-263
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Tidskriftsartikel (refereegranskat)abstract
- This pilot study evaluated the effect of Family Connections (FC), a Dialectical Behavior Therapy-based manualized skills training program, for family members of suicide attempters. The DBT-based skills training program aims to enhance the knowledge of wide range research based aspects of suicidal behavior and treatment recommendations. Furthermore it includes skills training for interpersonal relationships and also offers family members an opportunity to share their experiences. Thirteen participants completed the 9-week program with pre- and post self-report questionnaires. The results showed significant reduction in burden, improved psychic health and an increase in well-being regarding the relation with the patient. These results provide support for the need and importance of a DBT-based skills training program addressed specifically to family members of suicide attempters.
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9. |
- Salberg, Johanna, et al.
(författare)
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Staff experiences related to implementation of a recovery-oriented nursing programme in psychiatric inpatient care
- 2022
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Ingår i: International Journal of Mental Health Nursing. - : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 31:3, s. 731-742
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Tidskriftsartikel (refereegranskat)abstract
- Nursing in psychiatric inpatient care is peripheral to a dominating biomedical model of care. Efforts are being made to implement nursing models based on core values and theories for nursing, such as recovery-oriented practices. The aim of the study was to explore experiences of a recovery-oriented nursing programme (Steps Towards Recovery, STR) among nursing staff in psychiatric inpatient care and their ratings of stress (Maslach Burnout Inventory scores), quality of care (Quality of Psychiatric Care - Inpatient staff scores) and satisfaction with nursing care (Satisfaction with Nursing Care and Work scale scores), before and after the implementation-and compare with ratings from reference wards. A quasi-experimental and prospective, pretest-post-test design was used. Specific questions about the nursing programme were answered by staff at the intervention wards. Staff reported predominantly positive experiences of the nursing programme. At follow-up, higher ratings were reported in two dimensions of quality of care in the STR group, and lower ratings in one dimension of stress were evident in the reference group. No differences in ratings between the STR and reference wards were found. Staff members' positive experiences of STR and higher ratings regarding participation and secure environment after implementation suggest that STR is a well-accepted and promising nursing programme. It is important to implement and evaluate recovery-oriented interventions in psychiatric inpatient care, where a focus on symptom relief still prevails. The results indicate that there is potential for further exploration of STR in this context.
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10. |
- Wallin, Emma, et al.
(författare)
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Self-stigma and the intention to seek psychological help online compared to face-to-face
- 2018
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Ingår i: Journal of Clinical Psychology. - : Wiley. - 0021-9762 .- 1097-4679. ; 74:7, s. 1207-1218
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The present study aims to investigate the impact of helpseeking self-stigma on the preference and intention to seek psychologicaltreatment delivered online compared to face-to-face.Design: This study uses survey data from two Swedish samples.Sample 1 consists of 267 students (78.7% women) with a mean ageof 24.5 (SD = 6.1). Sample 2 consists of 195 primary care patients(56.9% women) with a mean age of 45.3 (SD = 17.7).Results: The number of participants who preferred online treatmentwas higher if seeking psychological help for a perceived stigmatized problem compared to mental health problems in general. The oddsratios for choosing treatment online over face-to-face were 6.41,95% CI [4.05, 10.14] in Sample 1 and 11.19, 95% CI [5.29, 23.67]in Sample 2. In addition, findings suggest that higher levels of helpseeking self-stigma predicted higher intention to seek treatmentonline compared to face-to-face.Conclusions: Our results suggest that online interventions may facilitatehelp-seeking among individuals deterred by stigma.
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