| 1. |
- Alfonsson, Sven, et al.
(författare)
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Factor structure and validity of the Depression Anxiety and Stress Scale-21 in Swedish translation
- 2017
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - : Wiley. - 1351-0126 .- 1365-2850. ; 24:2-3, s. 154-162
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Tidskriftsartikel (refereegranskat)abstract
- Introduction There is a constant need for theoretically sound and valid self-report instruments for measuring psychological distress. Previous studies have shown that the Depression, Anxiety and Stress Scale-21 (DASS-21) is theoretically sound, but there have been some inconsistent results regarding its factor structure. Aims The aim of the present study was to investigate and elucidate the factor structure and convergent validity of the DASS-21. Methods A total of 624 participants recruited from student, primary care and psychotherapy populations. The factor structure of the DASS-21 was assessed by confirmatory factor analyses and the convergent validity by investigating its unique correlations with other psychiatric instruments. Results A bifactor structure with depression, anxiety, stress and a general factor provided the best fit indices for the DASS-21. The convergent validity was adequate for the Depression and Anxiety subscales but more ambiguous for the Stress subscale. Discussion The present study overall supports the validity and factor structure of the DASS-21. Implications for practice The DASS-21 can be used to measure symptoms of depression and anxiety as well as overall distress. It can be useful for mental health nurses, and other first-line psychiatric professionals, in need of a short, feasible and valid instrument in everyday care
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| 2. |
- Alfonsson, Sven, et al.
(författare)
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Interformat Reliability of Digital Psychiatric Self-Report Questionnaires : A Systematic Review
- 2014
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 16:12, s. 86-97
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Research on Internet-based interventions typically use digital versions of pen and paper self-report symptom scales. However, adaptation into the digital format could affect the psychometric properties of established self-report scales. Several studies have investigated differences between digital and pen and paper versions of instruments, but no systematic review of the results has yet been done.OBJECTIVE: This review aims to assess the interformat reliability of self-report symptom scales used in digital or online psychotherapy research.METHODS: Three databases (MEDLINE, Embase, and PsycINFO) were systematically reviewed for studies investigating the reliability between digital and pen and paper versions of psychiatric symptom scales.RESULTS: From a total of 1504 publications, 33 were included in the review, and interformat reliability of 40 different symptom scales was assessed. Significant differences in mean total scores between formats were found in 10 of 62 analyses. These differences were found in just a few studies, which indicates that the results were due to study effects and sample effects rather than unreliable instruments. The interformat reliability ranged from r=.35 to r=.99; however, the majority of instruments showed a strong correlation between format scores. The quality of the included studies varied, and several studies had insufficient power to detect small differences between formats.CONCLUSIONS: When digital versions of self-report symptom scales are compared to pen and paper versions, most scales show high interformat reliability. This supports the reliability of results obtained in psychotherapy research on the Internet and the comparability of the results to traditional psychotherapy research. There are, however, some instruments that consistently show low interformat reliability, suggesting that these conclusions cannot be generalized to all questionnaires. Most studies had at least some methodological issues with insufficient statistical power being the most common issue. Future studies should preferably provide information about the transformation of the instrument into digital format and the procedure for data collection in more detail.
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| 3. |
- Maathz, Pernilla, et al.
(författare)
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A feasibility trial of online Acceptance and Commitment Therapy for women with provoked vestibulodynia
- 2023
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Ingår i: Scandinavian Journal of Pain. - : De Gruyter Open. - 1877-8860 .- 1877-8879. ; 23:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Acceptance and Commitment Therapy (ACT) is an established treatment for chronic pain. However, it is a form of treatment that have not yet been applied much in the treatment of persistent vulvar pain disorders. This study examines the feasibility and preliminary effects of online ACT for patients with provoked vestibulodynia.Methods Women diagnosed with provoked vestibulodynia were assigned randomly either to online ACT or to a waitlist control group. Feasibility was assessed in terms of recruitment potential, treatment credibility, completions rates, retention in trial, and data quality. Participants completed measures of pain with sexual activity, sexual functioning, emotional and relational adjustment, and potential treatment processes before and after treatment.Results Of the 111 women who were invited to participate in the study, 44 were included (39.6% recruitment rate). Thirty seven participants (84.1%) completed the pre-treatment assessment. Participants who received online ACT rated treatment credibility positively, and completed on average 4.31 (SD = 1.60) of the six treatment modules. Of participants, 34 provided post treatment data, giving a trial retention rate of 77%. Effects of online ACT, as compared to waitlist, were large for pain acceptance and quality of life, medium for anxiety and pain catastrophizing, and small for sexual satisfaction, pain with sexual activity, and relationship adjustment.Conclusions With some adjustments to recruitment procedures, a full scale randomized controlled trial of online ACT for provoked vestibulodynia appears feasible.
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| 4. |
- Maathz, Pernilla
(författare)
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Application of the psychological flexibility model in the context of vulvar pain and sexual dysfunction
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Psychological processes are known to influence the development and impact of chronic pain. Moreover, psychological treatments have been shown to reduce the suffering that people with chronic pain experience. Still, limited work has considered the role of psychological processes in vulvar pain, and many aspects of vulvar pain remain largely unexplored. Given the relevance of psychological flexibility and ACT in chronic pain, the applicability of the psychological flexibility model to vulvar pain appears worth exploring. The overarching aim of this thesis was to explore the psychological flexibility model in the context of vulvar pain and develop an intervention based on this model, for women living with vulvodynia. Study I aimed specifically to examine the contribution of psychological inflexibility to sexual dysfunction over time, among women with vulvar pain. Findings demonstrated that psychological inflexibility predicted later sexual dysfunction. The aim of Study II was to examine the contribution of mindfulness during sexual activity to sexual wellbeing among women who experience pain with sexual activity as compared to women who do not. Study II found that higher levels of mindfulness during sexual activity was associated with better sexual functioning and less sexual distress. Additionally, the contribution of mindfulness to sexual function and distress was similar in the two groups. Study III aimed specifically to examine the feasibility of a larger trial investigating the efficacy of online ACT for vulvodynia and conduct a preliminary examination of the effects of the intervention. Findings largely suggest that a full scale randomized controlled trial is feasible and indicate that women with provoked vestibulodynia could potentially benefit from receiving ACT.This thesis contributes to the understanding of vulvar pain and sexual dysfunction by demonstrating that psychological flexibility is associated with the personal impact of pain. It provides initial evidence of the potential value of the psychological flexibility model in the context of vulvodynia, and encourage further studies entailing a contextual behavioural approach.
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| 5. |
- Maathz, Pernilla, et al.
(författare)
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Psychological Inflexibility as a Predictor of Sexual Functioning Among Women with Vulvovaginal Pain : A Prospective Investigation
- 2020
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Ingår i: Pain medicine (Malden, Mass.). - : Oxford University Press (OUP). - 1526-2375 .- 1526-4637. ; 21:12, s. 3596-3602
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivePersistent vulvovaginal pain affects many women and often has adverse effects on sexual functioning. Psychological inflexibility related to pain is associated with distress and functional disability across different types of chronic pain conditions, but little is known about the role of psychological inflexibility in vulvovaginal pain. The present study examines psychological inflexibility related to pain as a predictor of sexual functioning over time among women with vulvovaginal pain.MethodsQuestionnaires including measures of psychological inflexibility, pain severity, and sexual functioning were administered to female university students at two points in time. One hundred thirty women with vulvovaginal pain responded to the questionnaire at baseline and at follow-up after 10 months. A multiple regression model was used to explore psychological inflexibility and pain severity as predictors of sexual functioning at follow-up.ResultsHigher levels of psychological inflexibility and more severe pain at baseline were associated with poorer sexual functioning 10 months later. In analysis adjusting for baseline levels of sexual functioning, psychological inflexibility was the only significant predictor of sexual functioning at follow-up.ConclusionsThe findings provide preliminary evidence that psychological inflexibility is associated with sexual adjustment over time among women with vulvovaginal pain and point to the relevance of further examinations of the psychological inflexibility model in the context of vulvovaginal pain.
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| 6. |
- Maathz, Pernilla, et al.
(författare)
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Women, Painful Sex, and Mindfulness
- 2022
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Ingår i: Mindfulness. - : Springer Nature. - 1868-8527 .- 1868-8535. ; 13:4, s. 917-927
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Mindfulness-based approaches to treatment of sexual dysfunction associated with vulvar pain appear promising, but little is known about the specific processes of mindfulness in sexual interactions or if mindfulness may be of particular benefit to women who experience pain associated with sexual activity. This study aimed to examine the associations between sexual mindfulness and sexual function and distress among women who currently experience pain with sexual activity as compared to women who do not. Methods: Women over the age of 18 were invited to complete an online survey, including measures of mindfulness in sexual activity, pain associated with sexual activity, sexual function, and sexual distress. Of the participants, 134 (42.1%) were experiencing pain and 184 (57.9%) were pain free.Results: Higher levels of mindfulness during sexual activity were associated with greater sexual functioning and less sexual distress both among women with and without pain. However, the associations between Observing skills and sexual functioning among women with pain was weaker if the capacity for nonreactivity was low. Sexual mindfulness contributed significantly to the explanation of sexual function and distress in both groups. Of the mindfulness facets, Acting with awareness consistently contributed, beyond the other facets, to the explanation of sexual outcomes.Conclusions: The capacity to stay mindful in sexual interactions appear to be important to sexual functioning both among women who experience pain with sexual activity and among women who do not. These findings encourage further examination of the role of mindfulness and its facets in sexual outcomes.
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| 7. |
- 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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| 8. |
- Zetterqvist, Vendela, et al.
(författare)
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Pain avoidance predicts disability and depressive symptoms three years later in individuals with whiplash complaints
- 2017
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Ingår i: Acta Anaesthesiologica Scandinavica. - : John Wiley & Sons. - 0001-5172 .- 1399-6576. ; 61:4, s. 445-455
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Tidskriftsartikel (refereegranskat)abstract
- Background Longstanding symptoms due to whiplash are commonly associated with decreased levels of emotional and physical functioning. To date, there is strong empirical support for the relationship between psychological in/flexibility and pain-related functioning, but the predictive role for future health is largely unknown. Hence, the aim of this study was to investigate if psychological in/flexibility (i.e. avoidance and cognitive fusion) predicted pain disability and depressive symptoms 3 years later in individuals with whiplash complaints. Methods Data were collected at baseline and at a 3 year follow-up from 368 members of a national patient organization for people with whiplash-associated disorder. In a series of hierarchical regression analyses, background variables, pain related variables, psychological distress and psychological inflexibility at baseline were evaluated as predictors of levels of pain disability and depressive symptoms at follow-up. Results Results showed that psychological inflexibility, and more specifically avoidance, was a unique predictor of pain disability and depressive symptoms, also when controlling for background variables, pain related variables and psychological distress. Level of education was also found to predict both pain disability and symptoms of depression. Lastly, pain variability predicted pain disability, and anxiety predicted depressive symptoms. Conclusion Pain avoidance significantly predicted pain disability and depressive symptoms 3 years later. Although tentative, results warrant more studies to further explore the importance of pain avoidance for future health.
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