| 1. |
- Gusic, Sabina, et al.
(författare)
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Adolescents’ Dissociative Experiences: the Moderating Role of Type of Trauma and Attachment Style
- 2016
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Ingår i: Journal of Child & Adolescent Trauma. - : Springer Science and Business Media LLC. - 1936-1521 .- 1936-153X. ; 9, s. 341-351
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Tidskriftsartikel (refereegranskat)abstract
- This cross-sectional study evaluated the selfreportedattachment style of 239 Swedish adolescents (ages13 to 20) and investigated the relation between dissociation,attachment, and potentially traumatic events (PTEs). We hadhypothesized that specific PTEs, including family-relatedemotional and physical abuse, sexual abuse, and emotionalabuse by non-relatives such as bullying, would interact withinsecure attachment styles leading to higher levels of dissociation.Results show that insecure attachment styles predicteddissociative experiences (DE) independently of PTE exposure.Dissociative experiences related more strongly to PTEexposure when the adolescent had an anxious attachmentstyle. Our results also suggest that higher rates of DE arerelated to an interaction between insecure attachment stylesand the experience of verbal harassment and bullying, mainlyby peers in school. We conclude that the relation betweentrauma and dissociation is complex, with both type of traumaand attachment style interacting with dissociative phenomena.
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| 2. |
- Gušić, Sabina, et al.
(författare)
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Dissociative Experiences and Trauma Exposure Among Newly Arrived and Settled Young War Refugees
- 2017
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Ingår i: Journal of Aggression, Maltreatment and Trauma. - : Informa UK Limited. - 1092-6771 .- 1545-083X. ; 26:10, s. 1132-1149
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Tidskriftsartikel (refereegranskat)abstract
- War-traumatized refugee adolescents are a vulnerable and understudied group. This study of two different groups of war-traumatized youth (N = 77) resettled in Sweden (newly arrived refugee adolescents, n = 42, 13–19 years, and settled students with childhood war experiences, n = 35, 11–18 years) evaluated their war experiences, refugee journey, general trauma exposure, posttraumatic stress symptoms, and dissociative experiences. Both groups had experienced many traumas and a substantial proportion reported levels consistent with posttraumatic stress (71% in the newly arrived group and 34% among the settled students) and dissociation (36% and 23%, respectively). The study also provides information about the type of adverse events experienced by war-refugee adolescents, including their own subjective appraisals of the worst events. The results show that the extent of trauma exposure and posttraumatic and dissociative symptomatology among refugee adolescents are considerable even after a period of resettlement, a finding that has educational, clinical, and social implications.
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| 3. |
- Andersson, Sven-Olof, et al.
(författare)
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Adverse Childhood Experiences are associated with choice of partner, both partners' relationship and psychosocial health as reported one year after birth of a common child : A cross-sectional study
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Adverse Childhood Experiences (ACEs) are common and known to have consequences for individuals' adult health, leading to a higher risk of illness. The aims of the study were to investigate the ACEs in couples, to examine the extent of assortative mating and to investigate the association between the relationship of the load of ACEs within couples and health outcomes, one year after the birth of a common child. At antenatal clinics in Sweden 818 couples were recruited and investigated one year after the birth of a common child answering a questionnaire including the exposure to ten ACE categories and several outcome variables. In total, 59% of both mothers and partners reported exposure to at least one of the ten ACE categories. Among the mothers 11% and among the partners 9% reported exposure to ≥4 ACE categories (p = 0.12). There was a correlation between the numbers of ACE categories reported by the mothers and their partners (Spearman's ρ = 0.18, p<0.001). This association pertained to six of the ten ACE categories. In multiple logistic regression analyses, there were associations between the ACE exposure load and unfavourable outcomes among the mothers, the partners and within the couples. Unfavourable outcomes concerning health were most prominent in couples where both members reported exposures to ≥4 ACE categories (self-rated bad health (OR 13.82; CI 2.75-69.49), anxiety (OR 91.97; CI 13.38-632.07), depression (OR 17.42; CI 2.14-141.78) and perceived stress (OR 11.04; CI 2.79-43.73)). Mothers exposed to ACEs tend to have partners also exposed to ACEs. Exposure to ACEs was associated with bad health and unfavourable life conditions within the couples, especially among couples where both members reported exposure to multiple ACEs. These results should stimulate incentives to find, to support and to treat individuals and couples where both members report multiple ACEs. The consequences for the children should be further studied as well as how these families should be treated in health care and society.
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| 4. |
- Arnberg, Filip, 1981-
(författare)
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Long-Term Posttraumatic Stress in Survivors from Disasters and Major Accidents
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Disasters and major accidents are a significant cause of distress worldwide. High levels of posttraumatic stress can become chronic after severe and prolonged psychological trauma, raising concerns about the extent of adverse long-term consequences after single events. The present thesis aimed to describe the course and burden of posttraumatic stress in survivors from a ferry disaster in the Baltic Sea, an airliner crash-landing in Gottröra, Sweden, and a bus accident involving Swedish 6th grade schoolchildren in Måbødalen, Norway. The participants were surveyed 1 month to 4 years after the events and again after 14 to 20 years. The follow-up surveys included 33 ferry disaster survivors, 70 airline survivors, and 7 surviving schoolchildren with a comparison group from the same school (n = 33). Short- and long-term changes in posttraumatic stress were estimated separately in generalised regression models refined by linear splines. In-depth interviews were conducted with 22 ferry survivors 15 years after the disaster, including structured clinical interviews and thematic analysis of survivors’ descriptions of consequences of the event and social support. Approximately half of all survivors experienced significant posttraumatic stress at the initial assessments. Significant long-term distress was noted in one fourth of the ferry survivors and one sixth of the airline survivors. The bus crash was not associated with significant long-term posttraumatic stress. A poorer long-term outcome was noted in women and in bereaved survivors. The thematic analysis revealed that long-term consequences not only included negative aspects but also positive ones, including personal growth and existential awareness. There was ample availability of social support, although the need for support extended over a period of several years. Barriers to support from significant others were described in detail by the survivors. The results extend previous research by providing a comprehensive account of long-term consequences of disasters and major accidents in light of early reactions. The interviews provide some new insights into features of social support that warrant further study. Important future challenges include evaluating whether timely attention to survivors at risk for chronic distress and significant others can facilitate recovery.
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| 5. |
- Blomstrand, Eva, et al.
(författare)
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Exercise training induces similar elevations in the activity of oxoglutarate dehydrogenase and peak oxygen uptake in the human quadriceps muscle.
- 2011
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Ingår i: Pflügers Archiv. - : Springer Science and Business Media LLC. - 0031-6768 .- 1432-2013. ; 462:2, s. 257-65
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Tidskriftsartikel (refereegranskat)abstract
- During exercise involving a small muscle mass, peak oxygen uptake is thought to be limited by peripheral factors, such as the degree of oxygen extraction from the blood and/or mitochondrial oxidative capacity. Previously, the maximal activity of the Krebs cycle enzyme oxoglutarate dehydrogenase has been shown to provide a quantitative measure of maximal oxidative metabolism, but it is not known whether the increase in this activity after a period of training reflects the elevation in peak oxygen consumption. Fourteen subjects performed one-legged knee extension exercise for 5-7 weeks, while the other leg remained untrained. Thereafter, the peak oxygen uptake by the quadriceps muscle was determined for both legs, and muscle biopsies were taken for assays of maximal enzyme activities (at 25°C). The peak oxygen uptake was 26% higher in the trained than in the untrained muscle (395 vs. 315 ml min(-1) kg(-1), respectively; P<0.01). The maximal activities of the Krebs cycle enzymes in the trained and untrained muscle were as follows: citrate synthase, 22.4 vs. 18.2 μmol min(-1) g(-1) (23%, P<0.05); oxoglutarate dehydrogenase, 1.88 vs. 1.54 μmol min(-1) g(-1) (22%, P<0.05); and succinate dehydrogenase, 3.88 vs. 3.28 μmol min(-1) g(-1) (18%, P<0.05). The difference between the trained and untrained muscles with respect to peak oxygen uptake (80 ml min(-1) kg(-1)) corresponded to a flux through the Krebs cycle of 1.05 μmol min(-1) g(-1), and the corresponding difference in oxoglutarate dehydrogenase activity (at 38°C) was 0.83 μmol min(-1) g(-1). These parallel increases suggest that there is no excess mitochondrial capacity during maximal exercise with a small muscle mass.
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| 6. |
- Ekstedt, Mirjam, et al.
(författare)
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Disturbed sleep and fatigue in occupational burnout
- 2006
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 32:2, s. 121-31
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The purpose of this study was to investigate sleep with polysomnography and self-ratings and the diurnal pattern of sleepiness and fatigue in a group suffering from severe occupational burnout.METHOD: Twelve white-collar workers on long-term sick leave (>3 months) and 12 healthy controls with high and low scores on the Shirom Melamed Burnout Questionnaire (SMBQ) were included. A 1-night polysomnographic recording (after habituation) was carried out at home, and sleepiness and mental fatigue were rated at different times of the day for weekdays and the weekend. Precipitating factors at the time of the illness at work and real life were considered, and different dimensions of occupational fatigue were described. A repeated-measures analysis of variance using two or three within group factors was used to analyze the data.RESULTS: The main polysomnographic findings were more arousals and sleep fragmentation, more wake time and stage-1 sleep, lower sleep efficiency, less slow wave sleep and rapid eye movement sleep, and a lower delta power density in non-rapid eye movement sleep in the burnout group. The burnout patients showed pronounced sleepiness and mental fatigue at most times of the day for weekdays without reduction during weekends. The precipitating factor was occupational stress (psychiatric interview), and work stress indicators were increased.CONCLUSIONS: Occupational burnout is characterized by impaired sleep. It is suggested that impaired sleep may play a role in the development of fatigue or exhaustion in burnout.
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| 7. |
- Elofsson, Ulf, et al.
(författare)
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Physiological correlates of eye movement desensitization and reprocessing.
- 2008
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Ingår i: J Anxiety Disord. - : Elsevier. - 0887-6185 .- 1873-7897. ; 22:4, s. 622-34
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Physiological correlates of eye movement desensitization and reprocessing.Elofsson UO, von Schèele B, Theorell T, Söndergaard HP.National Institute for Psychosocial Factors and Health (IPM) & Karolinska Institutet, Stockholm, Sweden.'Eye movement desensitization and reprocessing (EMDR) is an established treatment for post-traumatic stress disorder (PTSD). However, its working mechanism remains unclear. This study explored physiological correlates of eye movements during EMDR in relation to current hypotheses; distraction, conditioning, orienting response activation, and REM-like mechanisms. During EMDR therapy, fingertip temperature, heart rate, skin conductance, expiratory carbon dioxide level, and blood pulse oximeter oxygen saturation, were measured in male subjects with PTSD. The ratio between the low and high frequency components of the heart rate power spectrum (LF/HF) were computed as measures of autonomic balance. Respiratory rate was calculated from the carbon dioxide trace. Stimulation shifted the autonomic balance as indicated by decreases in heart rate, skin conductance and LF/HF-ratio, and an increased finger temperature. The breathing frequency and end-tidal carbon dioxide increased; oxygen saturation decreased during eye movements. In conclusion, eye movements during EMDR activate cholinergic and inhibit sympathetic systems. The reactivity has similarities with the pattern during REM-sleep.
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| 8. |
- Möller, Anna Sofia, et al.
(författare)
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Patterns of Injury and Reported Violence Depending on Relationship to Assailant in Female Swedish Sexual Assault Victims
- 2012
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Ingår i: Journal of Interpersonal Violence. - Thousand Oaks, CA : Sage Publications. - 0886-2605 .- 1552-6518. ; 27:16, s. 3131-3148
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Tidskriftsartikel (refereegranskat)abstract
- Earlier studies have explored the differences between known-assailant sexual assaults and stranger assaults and reported the stranger assaults as being more violent. Only a few studies have discriminated between sexual assaults by intimate partners from assaults by other known assailants when comparing with assaults by strangers. In this study, we explored differences in the extent of violence and physical injury in sexual assaults committed by intimate partners compared with assaults by strangers and acquaintances. Medical and forensic records of 690 consecutive women attending a sexual assault center in Stockholm, Sweden were reviewed. The final sample included in the analysis consisted of 503 patients. Our results showed that women sexually assaulted by their intimate partners more frequently reported physical violence (OR = 4.1) than women assaulted by strangers (OR = 2.0) and acquaintances (OR = 1.0). Genital injuries were not found to be related to the victim-assailant relationship in this study. Extragenital injuries showed a tendency toward being more frequently found after intimate partner assaults compared with stranger and acquaintance assaults; however, this was not found to be significant in adjusted analyses. Previous history of sexual assault was more common, and seeking medical care within 72 hr as well as being under the influence of alcohol during the assault was less frequent among intimate partner victims. These results support the conclusion that sexual assaults committed by intimate partners, contradictory to earlier studies, are likely to involve more physical violence and result in injuries just as often as assaults committed by strangers.
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| 9. |
- Möller, Anna Tiihonen, et al.
(författare)
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Identifying risk factors for PTSD in women seeking medical help after rape
- 2014
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:10, s. e111136-
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Rape has been found to be the trauma most commonly associated with Posttraumatic Stress Disorder (PTSD) among women. It is therefore important to be able to identify those women at greatest risk of developing PTSD. The aims of the present study were to analyze the PTSD prevalence six months after sexual assaults and identify the major risk factors for developing PTSD. Methods: Participants were 317 female victims of rape who sought help at the Emergency Clinic for Raped Women at Stockholm South Hospital, Sweden. Baseline assessments of mental health were carried out and followed up after six months. Results: Thirty-nine percent of the women had developed PTSD at the six month assessment, and 47% suffered from moderate or severe depression. The major risk factors for PTSD were having been sexually assaulted by more than one person, suffering from acute stress disorder (ASD) shortly after the assault, having been exposed to several acts during the assault, having been injured, having co-morbid depression, and having a history of more than two earlier traumas. Further, ASD on its own was found to be a poor predictor of PTSD because of the substantial ceiling effect after sexual assaults. Conclusions: Development of PTSD is common in the aftermath of sexual assaults. Increased risk of developing PTSD is caused by a combination of victim vulnerability and the extent of the dramatic nature of the current assault. By identifying those women at greatest risk of developing PTSD appropriate therapeutic resources can be directed.
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| 10. |
- Rudstam, Gabriella, et al.
(författare)
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Psychophysiological assessment of trauma-focused Group Music and Imagery therapy for women with PTSD or CPTSD using script-driven imagery. A randomised controlled study
- 2023
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Ingår i: European Journal of Trauma & Dissociation. - : Elsevier. - 2468-7499. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn posttraumatic stress disorder (PTSD), physiological reactions during trauma scripts have been anchored to the diagnosis. According to the construct of research domain criteria, physiological reactions and self-rating scales could be used to evaluate treatment effects.ObjectiveIn the present study, self-rated PTSD symptoms combined with physiological reactions during trauma script were used as outcome measurements in the domain of arousal/regulatory systems in a controlled randomised study of Group Music and Imagery (GrpMI) treatment for females with PTSD or complex posttraumatic stress disorder (CPTSD) related to violence and/or sexual abuse.Methods45 traumatised women were randomised to 12 weeks of active treatment or waiting. Before and after the intervention, an assessment was done using physiological measurements during script-driven imagery (SDI) procedures. Subjective Units of Distress (SUD) were collected immediately after the trauma script (TS). Reactions during the SDI procedure were reported using the Responses to Script Driven Imagery (RSDI) scale, measuring re-experiencing, avoidance, and dissociation. Self-reported PTSD symptoms were accessed using the PTSD checklist for DSM-5 (PCL-5). Heart rate (HR), heart rate variability (HRV), and electrodermal activity were sampled during the baseline (BL) and TS conditions of the SDI procedure. As a measure of trauma-related reactivity, the difference between TS and BL was used for statistical calculations. HRV measures included high (HF; 0.15-0.4 Hz) and low (LF; 0.03-0.15 Hz) frequency band power, the LF/HF ratio, and the root mean square of successive inter-beat differences (RMSSD). Measures of electrodermal activity included skin conductance levels (SCL) and frequencies of non-specific skin conductance responses (NS-SCR). Further, correlations between self-rated PTSD symptoms and physiological reactivity measures were analysed.ResultsDuring the TS, the absolute levels of HR, LF/HF-ratio, and NS-SCR, as well as the trauma-related reactivity of HR, RMSSD, HF, LF/HF-ratio, SCL, and NS-SCR, showed significant changes indicating decreased arousal during trauma script after treatment. Compared to the waitlist control, an interaction analysis showed significant treatment effects in the BL level of HR, the absolute TS level of HR and HF, and the trauma-related reactivity of RMSSD and HF, suggesting an improvement of vagal function in the treatment group. Significant treatment-related reductions were found in symptoms of PTSD, re-experiencing and avoidance, as well as SUD. The changes pre- to post-treatment in HR reactivity and self-rated PTSD symptoms correlated significantly. Furthermore, the initial HR reactivity predicted treatment outcome as measured with PCL-5.ConclusionIn the evaluation of treatment methods for PTSD, a combination of self-report and physiological measures seems to be feasible. The physiological measures, in combination with a robust decrease in self-rated PTSD symptoms, indicate that trauma-focused GrpMI is a promising treatment for PTSD or CPTSD. More studies are needed to confirm the results, and further research comparing with other active treatments is necessary to establish the precise role of the treatment.
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