| 1. |
- Granberg, Åke, 1945-, et al.
(författare)
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Self-image pattern and treatment outcome in severely disturbed psychiatric patients
- 2001
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The relationship between patients’ initial ratings of their self-image and theoutcome of long-term psychiatric treatment was studied in a five -year followupstudy. The subjects were severely disturbed psychiatric patients, mainlyschizophrenics, treated in small treatment homes. A comparison was madebetween patients with a psychotic personality organization (PPO patients) anda non-psychotic personality organization (non-PPO patients), classifiedaccording to Kernberg’s (1981) criteria. Self-image was assessed with theintroject surface of Benjamin’s SASB (Structural Analysis of Social Behavior)model and two self-image patterns were computed: a positive-negative patternand a control-autonomy pattern. Two outcome measures (expressed as EffectSize) were used: subjective outcome was a combination of self-rated methods andjudged outcome was a combination of observer ratings. The relationshipbetween the two self-image patterns and outcome depended both on thepatients’ diagnosis and type of outcome. Judged outcome could not bepredicted from the self-image for the PPO patients; for the non-PPO patientsmore improvement was related to more self-control. For both patient groupssubjective outcome was related to a more negative self-image; however, thisrelationship was much stronger in the non-PPO group.
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| 2. |
- Armelius, Bengt-Åke, 1944-, et al.
(författare)
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Combination rules in multiple-cue probability learning : II, performance, confidence and development of rules
- 1976
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Armelius, B-Å., and Armelius, K. Combination rules in multiple-cue probability learning. II. Performance, confidence and development of rules. Umeå Psychological Reports No. 101, 1976. - Subjects' use of combination rules was studied in five two-cue multiple-cue probability learning tasks with varying degrees of predictability. Subjects were asked to state how they made their predictions at different times during the experiment. 70 % of the subjects formulated systematic and consistent combination rules, while the remaining 30 % formur lated rules that were incomplete or inconsistent. The verbal statements were found to account for the subject's actual judgments in 86 % of the cases. About 50 % of the rules were single rules, with one rule coveming the complete cue matrix and the rest were multiple rules with different rules being used for different parts of the cue matrix. Performance and confidence were higher for subjects who had formulated systematic combination rules. The results of the experiment were analyzed in terms of a two-stage model for inference behavior. According to this model subjects sample their first combination rule from a hierarchy of hypotheses about relations between cues and criterion. Frequent hypotheses in that hierarchy seem to be average, sum and difference of the two cue values. In the second stage subjects test their hypotheses or develop them through their experience with the task. In the present experiment there was some evidence that subjects using multiple rules construct their rules on the basis of their experience with the task, especially in tasks with high predictability.
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| 3. |
- Armelius, Bengt-Åke, 1944-, et al.
(författare)
-
Combination rules in multiple-cue probability learning : I, relation to task charateristics and performance
- 1976
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Armelius, B-Å., and Armelius, K. Combination rules in multiple cue probability learning I. Relation to task characteristics and performance. Umeå Psychological Reports No. 99, 1976. - The rules used by subjects in multiple cue probability learning (MCPL) was investigated by means of verbal reports given by subjects at the end of learning of a two cue MCPL-task. Eight tasks varied factorially with respect to task predictability, cue-criterion correlations and the sign of the cue intercorre-lation. In addition there were two orthogonal tasks. 47 of the 100 subjects gave verbal descriptions that were classified as inconsistent or incomplete, 7 were classified as a single rule i.e., the same rule was used for all cue combinations, and 4-6 were classified as multiple rulesi.e., different rules were used for different parts of the cue matrix 77 % of the 53 combination rules were found to account for the systematic variance in subjects responses. While performance was related to the characteristics of the tasks, the frequency of combination rules was not. Subjects with multiple rules reached the highest level of performance and subjects with a single rule the lowest. It was concluded that the formulation of combination rules is important for performance in MCPL. Futher developments of the method to extract combination rules were discussed.
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| 4. |
- Armelius, Bengt-Åke, 1944-, et al.
(författare)
-
Confidence and performance in probabilistic inference tasks with intercorrelated cues
- 1976
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Armelius, B-Å, and Amelius, K. Confidence and performance in probabilistic inference tasks with intercorrelated cues. Umeå Psychological Reports No. 96, 1976. - The relation between confidence and subjects' beliefs about their performance as well as their actual performance was studied in five two-cue MCPL-tasks. The tasks varied with respect to task predictability. The results were that confidence was strongly related to believed performance, but not to actual performance. The lack of relation between believed and actual performance was interpreted as support for the notion that subjects know very little about their performance in MCPL-tasks. Confidence was also perfectly related to task predictability, while performance was not. This may in certain tasks cause an illusion of achievement, i.e. subjects feel more confident than their performance allows them to.
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| 5. |
- Armelius, Bengt-Åke, 1944-, et al.
(författare)
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Detection of cue intercorrelation and cue validities in a multiple-cue judgment task with a suppressor cue
- 1973
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Arnelius, B., & Armelius, K. Detection of cue inter correlation and cue validities in a multiple-cue judgment task with a suppressor cue. Umeå Psychological Reports No. 74, 1973. - The subjects detection of cue intercor-relation, rij, and cue validities, rei, was tested after completion of a learning task with three levels of rij (.00, .40 and .80). The detection was tested by means of reproduction of rij in one test condition and rei in another. The reproduced rij values in the two redundant conditions closely matched the values of the learning tasks. There were, however, no differences among reproduced rij values which was explained as a positive set in the rij = .00 condition. The reproduced rij values were generally close to the rei values of the task with the exception of the non-valid cue for the rij = .00 condition, which was greatly overestimated. The conclusion was that the poor performance in suppressor variable tasks is due to the subjects inability to adjust the weights given to the cues, rather than to poor learning of rij and rei.
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| 6. |
- Armelius, Bengt-Åke, 1944-, et al.
(författare)
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En naturalistisk studie av 14000 svenska missbruksklienter baserad på Addiction Severity Index
- 2011
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Ingår i: Missbruket, kunskapen, vården. - Stockholm : Fritzes. - 9789138235256 ; , s. 97-167
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Studien bygger på 14 000 grundintervjuer och 3 000 uppföljningsintervjuer med klienter vid 50 olika enheter för missbruksvård i Sverige, som har intervjuats med ASI-intervjun. Intervjuarskattningar av problem visar att problemen är störst med alkohol, följt av problem med psykisk hälsa, narkotika, arbete/försörjning, familj/umgänge, fysisk hälsa och kriminalitet. Dominerande problemdrog är alkohol (57 procent), narkotika (37 procent) och båda (6 procent). Indikationer på tungt missbruk och svår psykisk störning togs fram för ASI-data och enligt dessa uppvisar 17 procent av klienterna tungt narkotikamissbruk, 13 procent tungt alkoholmissbruk och 2 procent både tungt narkotika- och tungt alkoholmissbruk. Svår psykisk störning indikeras av 28 procent av klienterna. Skillnader mellan män och kvinnor är små. Yngre missbrukare har en betydligt sämre social situation, mer narkotikaproblem och mer problem med psykisk hälsa. Klienterna har delats in i tre åtskilda men homogena problemprofiler. En knapp tredjedel av klienterna har fått behandling för sitt missbruk någon gång medan drygt hälften har fått behandling i psykiatrin. Behandling för alkoholproblem är något vanligare för män, medan behandling för psykiska problem är vanligare för kvinnor. Klienter med tungt missbruk eller svår psykisk störning har fått behandling oftare än andra. Drygt 20 procent av klienterna har följts upp efter ca ett år. Störst förbättring sker inom alkohol där nästan hälften av klienterna uppvisar en reliabel förbättring. Inom psykisk hälsa är det drygt 40 procent och inom narkotika drygt 30 procent som förbättras.
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| 7. |
- Armelius, Bengt-Åke, 1944-, et al.
(författare)
-
Integration rules in a multiple-cue probability learning task with intercorrelated cues
- 1975
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Armelius, B., and Armelius, K. Integratici miles in a multiple-cue probability learning task with intercorrelated cues. Umeå Psychological Reports No. 80, 1975. - The question of hew the subjects use the cues in multiple-cue probability learning tasks was studied by having the subjects fill in a questionnaire asking than to describe how they had made their predictions. The questionnaire was given after the subjects had completed their learning of a two-cue suppressor variable task for 100 trials. For 19 of the subjects it was possible to formulate a model on the basis of their verbal report. The models were classified as a) linear models b) configurai models or c) estimated weights models. The correlation between the responses generated by the model and the actual responses was computed for each subject. Goodness of fit of the models was found to be quite satisfactory. The results of the learning phase shewed that ten subjects reached a performance higher than that expected if they only utilized the information provided by the cue criterion correlations. Performance was highest for subjects using a linear model, while the achievement was low for subjects using an estimated weights model due to the low consistency. The performance of subjects using configurai models was relatively poor due to the low validity of the configurai models in the present task. When •the validity of the models was taken into account, however, the configurai nodels were found to be as easy to follow as the linear models. The conclusions were that it is possible to use the verbal reports given by the subjects to study the strategies employed by the subjects in MCPL tasks, and that it is necessary to do so since very different psychological processes may be expressed in the game mathematical model.
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| 8. |
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| 9. |
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| 10. |
- Armelius, Kerstin, 1944-, et al.
(författare)
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Confidence in multiple-cue judgments as a function of cue intercorrelation and task predictability
- 1975
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Armelius, K., & Armelius, B-Å. The hypothesis that the subjects' confidence is a direct function of the cue intercorrelation, rij, in a pure judgmental task, was tested in a two-cue MCPL experiment where the cue interearrelation and total task predictability, Re2, were inversely related. The hypothesis was supported.When the subjects received no feedback confidence was determined by rij. However, when the subjectsreceived feedback the effects of rij. on confidence was, as predicted, reduced in the direction of Re2 .
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| 11. |
- Armelius, Kerstin, 1944-, et al.
(författare)
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Detection of cue intercorrelation in multiple-cue probability learning
- 1975
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Armelius, K., and Armelius, B-Å. Detection of cueintercorrelation in multiple cue probability learning.Umeå Psychological Reports No. 84, 1975. - Detection of cue intercorrelation, rij, was tested in ten twocueMCPL tasks after completion of a Learning stage.The values of rij ranged from -.8O to .80. The cuecriterion correlations, rei, and the predictability of the tasks, Re2, were factorially combined. The results showed a positive linear relation between the subjective and the objective values of rij. The values of rij were, however, underestimated by about 50%. These results were consistent with previous studies on thedetection of rij. There was no relation between detection of rij and performance or any of the task parameters rei or Re2.
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| 12. |
- Armelius, Kerstin, 1944-, et al.
(författare)
-
Note on the effects of cue-criterion correlations, cue intercorrelation and the sign of the cue intercorrelation on confidence in multiple-cue probability learning
- 1975
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Armelius, K., and Armelius, B-Å. Note on the effects of cue-criterion correlations, cue intercorrelation and the sign of the cue intercorrelation on confidence in multiple-cue probability learning. Umeå Psychological Reports, No. 83, 1975. - The subjects' confidence in the correctness of their judgments was investigated in a two-cue MCPL-experiment, where the cue-criterion correlations,as well as the sign and magnitude of the intercorrelation between the cues were systematically varied. The results showed that even though the subjects' performance was influenced by the task parameters, their confidence was not. The subjects' confidence was low, and there were no differences among conditions. In view of the finding that performance was generally low and that all tasks were considered as equally difficult, an explanation for the result might be that the five-point rating scale used to measure confidence was too insensitive and that the criterion for correctness was too strict.
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| 13. |
- Armelius, Kerstin, 1944-, et al.
(författare)
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Redundancy and inference behavior
- 1976
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Armelius, K., and Armelius, B-Å. Redundancy and inference behavior. Umeå Psychological Reports No. 102, 1976. -Within MCPL research redundancy has been treated as synonymous with intercorrelation among cues. As shown in the present paper this definition of redundancy is inadequate, and a definition of redundancy based on Brunswik' s conceptual frame-work and made in analogy with the definition of redundancy in information theory was proposed. Redundancy was defined as the difference between the sum of all squared correlations and the squared multiple correlation. That is, when the intercorrelation between cues does not contribute to the predictable variance in the criterion the task is redundant. When the cue intercorrelation does contribute to the predictable variance in the criterion the task was defined as a suppressor task. Some implications of this view of probabilistic inference tasks for research were discussed in the paper.
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| 14. |
- Armelius, Kerstin, 1944-, et al.
(författare)
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The effect of cue-criterion correlations, cue intercorrelations and the sign of the cue intercorrelation on performance in suppressor variable tasks
- 1975
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Arraelius, K., and Armelius, B. The effect of cue-criterion correlations, cue intercorrelations and the sign of the cue intercorrelation on performance in suppressor variable tasks. Umeå Psychological Reports No. 81, 1975. - The subjects' performance was investigated in a two-cue MCPL-experiment with a 2 (Cue-criterion correlations, rel = .60 and .80) a 2 (Total task predictability, Re2 = 1.00 and .70) x 2 (Sign of rij) x 5 (Blocks) factorial design. The difference in in Re2 was due entirely to an increase in the cue2intercorrelation, rij. Effects of Re2 on performance were therefore interpreted as effects of the cueintercorrelation. Two control conditions, with orthogonal cues and the same values of rei as in the experimental conditions, were included in the design. Subject consistency was directly related to the cue-criterion correlations and the cue-judgment beta-weights were directly related to the magnitude of thecue intercorrelation. The sign of rij determined the level of consistency.
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| 15. |
- Lundgren, Lena, et al.
(författare)
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Integrating addiction and mental health treatment within a national addiction treatment system : Using multiple statistical methods to analyze client and interviewer assessment of co-occurring mental health problems
- 2014
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Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 31:1, s. 59-79
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Tidskriftsartikel (refereegranskat)abstract
- AIMS - For a Swedish national sample of 12,833 individuals assessed for a substance use disorder (SUD) (2002-2008) in the Swedish welfare system, client self-report and clinical staff Addiction Severity Index (ASI) assessment data were used to assess mental health problem severity and needs. METHODS - Analysis of client self-report data using regression methods identified demographic characteristics associated with reporting significant mental health problems. Clinical staff assessment data from the ASI Interviewer Severity Rating (ISR) score were used to develop a K-means cluster analysis with three client cluster profiles: Narcotics (n=4795); Alcohol (n=4380); and Alcohol and Psychiatric Problems (n=3658). Chi-square and one-way ANOVA analyses identified self-reported mental health problems for these clusters. RESULTS - 44% of clients had a history of using outpatient mental health treatment, 45% reported current mental health symptoms, and 19% reported significant mental health problems. Women were 1.6 times more likely to report significant mental health problems than men. Staff assessed that 74.8% of clients had current mental health problems and that 13.9% had significant mental health problems. Client and staff results were congruent in identifying that clients in the Alcohol profile were less likely (5%) to report having significant mental health problems compared to the other two profiles (30% each). CONCLUSIONS - About 19% of clients with SUDs reported significant mental health problems, need integrated addiction and mental health treatment, and these clients are clustered in two population groups. An additional 25% of the addiction treatment population report current mental health symptoms and have at some point used mental health treatment. This national level assessment of the extent and severity of co-occurring disorders can inform decisions made regarding policy shifts towards an integrated system and the needs of clients with co-occurring disorders.
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| 16. |
- Lundgren, Lena M, et al.
(författare)
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Beskriving av tre klientprofiler inom svensk missbruksvård
- 2012
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Ingår i: Socialvetenskaplig tidskrift. - Umeå : Förbundet för forskning i socialt arbete (FORSA). - 1104-1420 .- 2003-5624. ; 19:3/4, s. 200-216
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Tidskriftsartikel (refereegranskat)abstract
- En klusteranalys av intervjuarskattningar från ASI-intervjuns sju olika livsområden för 12833 klienter visade att klienterna kan delas in i tre olika klientprofiler: Narkotikaprofil, Avgränsade alkoholproblem och Alkohol och psykiska problem. I artikeln jämförs de tre profilerna med avseende på missbruksmönster, demografiska faktorer, sociala och psykiska problem, hälsa och immigrationsstatus.
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| 17. |
- Padyab, Mojgan, 1976-, et al.
(författare)
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Is Clinical Assessment of Addiction Severity of Individuals with Substance UseDisorder, Using the Addiction Severity Index, A Predictor of Future InpatientMental Health Hospitalization? A Nine-Year Registry Study
- 2018
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Ingår i: Journal of Dual Diagnosis. - : Taylor & Francis. - 1550-4263 .- 1550-4271. ; 14:3, s. 187-191
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Tidskriftsartikel (refereegranskat)abstract
- Objective: In Sweden, the Addiction Severity Index (ASI) is the Swedish National Board of Health and Welfare's recommended substance use disorder assessment tool and used routinely for patient intakes. Our study of 213 individuals assessed for substance use disorder with the ASI used nine years of the National Patient Register and examined whether clinical social workers' assessments of addiction severity at baseline were associated with later hospitalizations for mental health disorder (MHD). Methods: ASI composite scores and interviewer severity rating were used to measure clients' problems in seven areas (mental health, family and social relationships, employment, alcohol, drug use, health, and legal) at baseline. A stepwise regression method was used to assess the relative importance of ASI composite scores, MHD hospitalization two years prior to baseline, age, and gender for MHD hospitalization seven years post-baseline. Results: Almost two-thirds of the individuals (63%) were hospitalized at least once for MHD in the seven years post-baseline. At the multivariable level, MHD hospitalization prior to baseline was the strongest predictor of future MHD hospitalization, followed by ASI composite scores for drug use, employment, mental health and, last, male gender. Conclusions: A key finding is that higher ASI composite scores for drug use and mental health are predictors of future need for MHD treatment. Future studies will replicate this effort with a national population of individuals with substance use disorder.
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| 18. |
- Armelius, Bengt-Åke, 1944-, et al.
(författare)
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Borderline diagnosis from hospital records : reliability and validity of Gunderson's diagnostic interview for Borderlines (DIB)
- 1985
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Ingår i: Journal of Nervous and Mental Disease. - 0022-3018 .- 1539-736X. ; 173:1, s. 32-4
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Tidskriftsartikel (refereegranskat)abstract
- Two trained and experienced clinical psychologists and two nontrained students rated the sections in Gunderson's Diagnostic Interview for Borderlines (DIB) on the basis of hospital records for 16 patients (DIB-R). The results showed that both reliability and validity, i.e., correlations with an actual interview, were unexpectedly high, around .80 for the trained judges and around .55 for the nontrained judges. The conclusion is that the DIB may be used for retrospective diagnosis of borderline patients from hospital records.
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| 19. |
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| 20. |
- Armelius, Bengt-Åke, 1944-
(författare)
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Oxford textbook of psychotherapy
- 2006
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Ingår i: Acta Psychiatrica Scandinavica. - : Blackwell Munksgaard. - 0001-690X .- 1600-0447. ; 113, s. 159-
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Recension (refereegranskat)
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| 21. |
- Armelius, Bengt-Åke, 1944-, et al.
(författare)
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Personality organization defined by DMT and the structural interview
- 1990
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 31:2, s. 81-8
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Tidskriftsartikel (refereegranskat)abstract
- The psychoanalytic concept of Personality Organization (PO) may be operationalized by means of a Structural Interview as well as by means of psychological tests. The present study utilized the Structural Interview and a projective test called the Defence Mechanism Test (DMT) to operationalize the PO concept on a sample of 50 psychiatric inpatients. The reliability of the PO judgements were found to be acceptable for both the Structural Interview and the DMT. The validity, which was estimated as the correlation between the two methods, was also found to be substantial. The conclusion is that the concept of PO may be reliably operationalized for psychiatric patients and seems to have concurrent validity. Both the DMT and the Structural Interview may be used for differential diagnosis of PO.
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| 22. |
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| 23. |
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BiB 2010 - bedömningsinstrument inom behandling och forskning för missbruks- och beroendevården
- 2010
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- BiB 2010 är en sammanställning av information om bedömningsinstrument med relevans för behandling och forskning inom missbruks- och beroendevården. Gemensamt för alla instrument i boken är att de är översata till eller utvecklade på svenska. Redan 1998 publicerades en första sammanställning, BIB 1998, som svar på ett uttryckt behov av en översikt över användbara mätmetoder och bedömningsinstrument inom fältet. Behovet har inte minskat med åren, tvärt om. Att antalet instrument som inkluderats i denna utgåva är betydligt större jämfört med BIB 1998 vittnar om både ett större utbud och en minst lika stor efterfrågan efter strukturerade mätmetoder och skattningsverktyg. Samtidigt har också bredden i de instrument som anses relevanta för missbruks- och beroendevården ökat. Därför innehåller BiB 2010 både instrument som tydligt inriktar sig på missbruk eller beroende och instrument som fokuserar på exempelvis personlighet, kognitiva funktioner eller sociala relationer. BiB 2010 innehåller information om knappt 90 instrument för bedömning av individer, beskrivningar av insatser och organisatoriska förhållanden, skattning av utfall samt uppföljning av vård och behandling. Vår förhoppning är att boken ska bidra till ytterligare använding och utveckling av befintliga instrument samt att fler instrument översätts och anpassas för svenska förhållanden.
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| 24. |
- Buianina, Tatiana, et al.
(författare)
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Measuring irrational beliefs with the idea inventory : a proposed revision
- 2010
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Ingår i: Journal of School Psychology. - Oradea. - 1844-1815. ; 3:6, s. 72-81
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Tidskriftsartikel (refereegranskat)abstract
- This paper focuses on the measurement properties of the Idea Inventory(Kassinove et al, 1993) which was designed to asses 11 types of irrationalbeliefs described by Ellis. The original 11 subscales were found to lackinternal consistency although the full 33 items showed a Cronbach’s Alphaof 0, 84. We therefore developed a new set of subscales based on the latentstructure of the items and the content of the items. The outcome was arelatively reliable set of five subscales that were also consistent with theoriginal ideas of Ellis. However, there seems to be a need for furtherrevision since many of the items seems to measure emotional reactions toirrational beliefs rather than to the irrational beliefs themselves
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| 25. |
- Börjesson, Josefine, 1973-
(författare)
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Psychometric studies of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis describes studies into the psychometric properties of a Swedish language version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument. The psychometric properties of this instrument have been examined in two previous studies: an American study was conducted by the developers of the interview, Friedman and Utada (1989), and a Swiss study was undertaken by Bolognini et al. (2001). The American and the French (as used in the Swiss study) versions of ADAD exhibit good validity and reliability, in the form of both interrater reliability and the internal consistency of the composite scores. Study I evaluated the psychometric properties of the Swedish version of the ADAD interview in normal adolescents and adolescents with antisocial problems. It was found that the instrument has good interrater reliability, that the composite scores exhibit moderate internal consistency, and that the concept validity was acceptable and similar to that of the American and Swiss versions. The results also showed that the problem areas of ADAD produced meaningful correlations. The interviewer ratings, the adolescent’s ratings and the composite scores were compared and discussed. Some problems concerning the composite scores were discovered and will need to be analyzed in future studies. Study II investigated the utility and problems associated with the composite scores in the ADAD within and between normal adolescents and adolescents with antisocial problems. When comparing interviewer severity ratings and composite scores within the two groups, the composite scores were found to behave differently to the interviewer ratings. For normal adolescents, the composite scores are generally higher than the interviewer ratings, but for the adolescents with antisocial problems the reverse is true. The interviewer severity ratings seem to be the most appropriate outcome when the objective is to separate antisocial and normal groups of adolescents from each other. The difference between the two groups is smaller as measured by composite scores. The composite scores appear to function as viable indicators of current problems in all areas except for Medical and Alcohol problem area. The critical items within the Medical and Alcohol composite scores are explored and discussed. Study III investigated the concurrent and predictive validity of the ADAD Psychological status and problem area. Concurrent validity was demonstrated by significant correlations between the ADAD, Youth Self Report (YSR) and Beck Depression Inventory (BDI) scores. The predictive validity of this problem area of the ADAD was tested by exploring its correlations with the YSR, BDI, and DICA problem ratings; moderate correlations were observed, suggesting that in clinical practice, the ADAD Psychological status and problem area may be a useful tool for the assessment and measurement of current psychological problems. The utility obtained by making decisions using the test is substantial. Overall, the results of these studies indicate that the Swedish version of ADAD appears to be a psychometrically good instrument for assessing the severity of adolescents’ problems and their need for treatment, but there are some problems with the Medical and Alcohol composite scores.
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| 26. |
- Börjesson, Josefine, 1973-, et al.
(författare)
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The psychometric propeerties of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD)
- 2007
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 61:3, s. 225-232
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Tidskriftsartikel (refereegranskat)abstract
- The psychometric properties of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument were evaluated in two adolescent groups. The participants in the Normal group comprised 121 adolescents aged 15-17 years and the participants in the group of adolescents with antisocial problems comprised 1168 youths aged 10-21 years detained under the Swedish Care of Young Persons Act in special youth homes. The ADAD instrument produced good interrater reliability; the subscales showed moderate internal consistency and concept validity was satisfactory and comparable with American and Swiss versions. Finally, the ADAD subscales produced meaningful correlations. The interviewer rating, the adolescent’s rating and the composite scores are compared and discussed. The Swedish version of ADAD appears to be a psychometrically good instrument for assessing the severity of adolescent problems and their need for treatment. However, the composite scores need to be reconstructed to be useful in future research.
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| 27. |
- Dennhag, Inga, 1969-, et al.
(författare)
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Baseline training in cognitive and psychodynamic psychotherapy during a psychologist training program : Exploring client outcomes in therapies of one or two semesters
- 2012
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Ingår i: Psychotherapy Research. - : Routledge. - 1050-3307 .- 1468-4381. ; 22:5, s. 515-526
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Tidskriftsartikel (refereegranskat)abstract
- This effectiveness study explored the outcomes of 187 clients seen by 187 students undergoing baseline training in psychotherapy. Clients reduced their symptoms (SCL-90) and increased their positive self-image (SASB introject) during the therapy. Multiple regression analyses showed no differences between the cognitive and the psychodynamic training approaches and no differences between one and two semesters duration of the therapies. However, 2 - 3% of variance in end states was accounted for by the interaction between the variables, indicating a moderating effect of duration in the two approaches. Outcomes for clients in the cognitive training approach were significantly better with two semesters than with one semester, while there was no such difference in the psychodynamic approach. Consequences for baseline training are discussed.
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| 28. |
- Dennhag, Inga, 1969-
(författare)
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Learning psychotherapy : An effectiveness study of clients and therapists
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Many psychotherapy studies with trainees have been conducted, but few have investigated how effective baseline trainee-led psychotherapies are. Baseline trainee-led psychotherapies are often provided by a professional education, and the therapists are often young, untrained and inexperienced. The present study was conducted at the Clinical Psychology Program at Umeå University, in Sweden. The psychology students were in their fourth or fifth year of, in total, five years, and few had practiced therapy before. Clients, students and education providers are interested in the outcome of trainee-led psychotherapies because clients want an effective treatment, and students and the educators want the best education. In research, there is an interest in knowing more about training, how training influences clients’ benefits of therapy, and how training works in regular activity. In the present thesis, we investigate questions related to outcome and how different training factors affect outcome. The overall purpose of the present thesis was to examine 1) the effectiveness of trainee-led therapies in a psychology education setting and 2) if clients’ self-image patterns would predict the outcome 3) if different training conditions covary with treatment outcome 4) how novices develop in their professional characteristics and work involvement styles.Methods and Result The current thesis utilized data from the Swedish naturalistic study Effects of Student Therapies (EUT) at Umeå University. The EUT is a naturalistic psychotherapist research project, which comprises client data from 2003 to 2012. The present study included 235 clients. The mean age of the clients was 31 years (SD = 9.66), and 69% of the clients were women. The clients had mixed psychological symptoms and were well functioning. Psychological symptoms were measured by Symptom Check List 90 (SCL-90; Derogatis, Lipman, & Covi, 1973). The patients’ self-image was measured using the Structural Analysis of Social Behavior (SASB), the introject questionnaire (Benjamin, 1974). All therapists were students at the psychology program. In Paper III, 76 therapists participated. The therapists’ mean age was 28 years (SD = 5.55), and 71% of the therapists were women. Therapists’ professional characteristics and work involvement styles were measured by Development of Psychotherapists’ Common Core Questionnaire (DPCCQ; Orlinsky et al., 1999).Four specific objectives have been addressed. The first objective was to investigate the overall effectiveness of treatment. In Papers I and II, the effect sizes implicated that the therapy outcome was moderate. Paper I showed that 67% of the clients were in the dysfunctional domain before therapy compared to 34% after completed therapy. Further in Paper I, it was found that 42% of the clients had recovered or improved at the end of the therapy, but most of the clients remained unchanged (55%) and a few percent had deteriorated (3%). This result is in line with a Norwegian training study (Ryum, Stiles & Vogel, 2007) but less effective than effectiveness studies have shown with professional therapists (e.g. Hunsley & Lee, 2007). Paper II, where we used a subsample of Paper I’s clients, showed a similar result.The second objective was to investigate if clients’ self-image pattern (attachment group, disrupted attachment group, self-control and self-autonomy) predicted change in psychological symptoms (GSI: global severity index) and personality symptoms (PSI: personality symptom index). The disrupted attachment group or the clients’ negative self-image had the strongest relationship to outcome and explained 8% vs. 10% in outcome (PSI vs. GSI). Self-control explained a further 3% (GSI) and 4% (PSI) of the result, and self-autonomy added 1% in both GSI and PSI. The result indicates that clients with an increased negative self-image, higher self-control, and lower level of self-autonomy before therapy improve more in both psychological symptoms and personality symptoms than clients with a less negative self-image, lower self-control, and higher level of self-autonomy.The third objective was to explore if treatment duration (one or two semesters) and training condition (cognitive therapy and psychodynamic therapy) could affect basic psychotherapy outcome. Paper II demonstrated that clients in all training conditions, cognitive therapy two semesters (CT2), psychodynamic therapy one semester (PDT1) and psychodynamic therapy two semesters (PDT2), had significant changes in self-image patterns and symptoms, except for cognitive therapy one semester (CT1). Analyses using clinically significant change demonstrated that fewer clients in CT1 had recovered and reliably improved compared to the other training conditions (in CT1: 20- 23%, in PDT1: 27- 43%, in CT2: 49- 54% and in PDT2: 35- 41%). Two hierarchical multiple regression analyses demonstrated that clients’ pre-tests characteristics self-image pattern (affiliation: AFF) and psychological symptoms (global severity index: GSI) explained 34% of the results. Treatment duration and training condition demonstrated an interaction effect between duration and theoretical approach, explaining about 2%. The regression lines for self-image pattern AFF and psychological symptoms GSI showed that clients in CT2 and PDT1 improved more than clients receiving CT1 and PDT2.The fourth objective was to examine how novice therapists in psychotherapy training develop in professional characteristics and work involvement styles (healing and stressful work involvement styles). The study was longitudinal and therapists were measured at session 2, 8, 16, 22 and endpoint. Mixed model analyses of the Development of Psychotherapists’ Common Core Questionnaire (DPCCQ) (when controlled for therapists’ age and gender) showed that the therapists’ professional characteristics and work involvement styles changed positively over time in training, except for in-session feelings of anxiety and boredom. The therapists increased most in technical expertise and less in basic relational skill. The result also indicated that the students changed linearly over time.Conclusion The present studies draw attention to the moderate outcome for clients in trainee-led psychotherapy. The novices appear to need time to increase in effectiveness possibly due to the high load of technical training in the beginning of the therapy. However, when exploring different training durations and training conditions, the contexts are shown to influence the outcome. In addition, clients with a more negative self-image pattern, with higher levels of self-control and lower levels of self-autonomy had better outcome, a finding with prognostic value. Finally, the training of students improves both a healing and a stressful involvement style, but in-session feelings of anxiety and boredom are more resistant to change.
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| 29. |
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| 30. |
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| 31. |
- Engström, Christer, 1949-
(författare)
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Implementering och utvärdering av Addiction Severity Index (ASI) i socialtjänsten
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this dissertation is to examine the implementation of the Addiction Severity Index (ASI) in social services and how it affects the encounter between the clients and their social workers. As structured interviews are unusual in social service based addiction care there is concern that they will have negative consequences on the relation between the social workers and their clients. The first study therefore investigates the clients’ acceptance of the ASI. The results show that 95 % of the clients accepted the ASI and that 85% viewed it in positive terms. Approximately 8% reported feeling violated by one question without this having any negative effect on the relation to the social workers or confidence in the social services. The results did not give empirical support for negative effects of the ASI. In the second study a comparison was made between a group that had participated in an assessment session using the ASI and a group with which the ASI had not been used. The results show that there is no difference in perception of “the alliance” or “negative experiences” with or without the ASI, but that the clients’ feeling of “own competence” is lower when the ASI is employed. The question of whether the reduced feeling of own competence among the clients is an expression of greater realism and reduced denial or only the negative effect of increased helplessness on the clients’ self-esteem can not be resolved in this study. In the third study, based on the same groups participating in the second study, the social workers were also asked to judge how the clients experienced such assessment sessions. The results show that the social workers’ assessment of the clients’ experiences differed from the clients’ own experiences regarding the “alliance” and “clients’ own feelings of competence”. However, the social workers made a correct assessment of the clients’ “negative experiences” of the sessions. The two different forms of session, with or without the ASI, did not influence the social workers’ assessment of the clients’ perceptions. The fourth study presents the results of a national questionnaire completed by 555 members of staff in social services, the prison service, and addiction services. The results show that supervisors and bosses take an increasingly greater responsibility for ASI training and that opportunities for using the ASI varied according to the place of work. Differences can probably be explained by different services being in different phases of implementation at the time of the study. The ASI has primarily been used in direct client work and only to a minor extent for follow-ups and evaluation. The number of ASI interviews carried out is small especially for those trained prior to 1999.
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| 32. |
- Engström, Christer, 1949-, et al.
(författare)
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Klienters acceptans av strukturerade intervjuer i socialtjänsten.
- 2002
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Ingår i: Nordisk sosialt arbeid. - Köpenhamn : Nordisk Sosionomforbunds Samarbeidskomité. - 0333-1342 .- 1504-3037. ; 22:4, s. 210-216
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Tidskriftsartikel (refereegranskat)abstract
- Uppföljning och utvärdering är nu på agendan även för socialtjänstens vidkommande vilket ökar behovet av enkla användarvänliga och strukturerade dokumentationsmetoder. En viktig fråga i det sammanhanget är klientens acceptans för sådana inslag i det sociala arbetet. I följande studie har ASI-intervjun prövats med avseende på hur den påverkar relationen till socialarbetaren och klienternas förtroende för socialtjänsten.
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| 33. |
- Holmqvist, Rolf, et al.
(författare)
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Sources of psychiatric staff members' feelings towards patients and treatment outcome
- 2006
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Ingår i: Psychology and Psychotherapy. - Leicester, UK : British Psychological Society. - 1476-0835 .- 2044-8341. ; 79:4, s. 571-584
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Tidskriftsartikel (refereegranskat)abstract
- This study had two purposes. The first was to assess to what extent psychiatric staff members' feelings towards patients in small psychiatric units could be attributed to (a) the individual staff member's habitual feeling style, (b) stable and consistent feelings towards individual patients (the patient's evocative style) and (c) the interaction between these two factors. The second purpose was to analyse the associations between the proportions of these factors and the average outcome for the patients in the units. The study was based on a previously presented model for analysing sources of staff counter-transference. The model specifies contributions from the different sources by using two-way ANOVAs. In the present study, data from 21 psychiatric treatment units for patients with psychosis and personality disorder were used. The results indicated that the staff members' individual habitual feeling style and the interaction between this habitual feeling style and the patient's evocative style contributed most to the variance in staff feelings. Patients' individual evocative patterns contributed less. Positive treatment outcome was mainly negatively associated with contributions to the staff counter-transference from these sources, implying that fixed patterns in personal feeling style or fixed reaction styles to individual patients had a negative influence on outcome. © 2006 The British Psychological Society.
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| 34. |
- Höglund, Anna, et al.
(författare)
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Psykosocial arbetsmiljö hos administrativ personal vid den samhällsvetenskapliga fakulteten
- 2003
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under mitten av 90-talet genomfördes en enkätundersökning bland lärareoch forskare vid samhällsvetenskapliga fakulteten, Umeå Universitet, medsyfte att studera hälsotillståndet och den psykosociala arbetsmiljön(Armelius, Eriksson och Höög, 1995; Armelius och Eriksson, 1997). Denadministrativa och tekniska personalen fick emellertid inte möjlighet attdelta i studien, vilket medför att deras upplevda arbetssituation har varit enokänd faktor. Under våren 2001 var det dags för en ny genomlysning avarbetsmiljön bland personalen vid den samhällsvetenskapliga fakulteten, ochnu omfattade enkätundersökningen samtliga personalgrupper. Denadministrativa och tekniska personalen fick besvara en parallellversion avlärar- och forskarenkäten, där frågorna var omarbetade för att passa derasspecifika arbetsuppgifter och förhållanden. Strävan var dock att de bådaenkäterna så långt som möjligt skulle likna varandra. Enkätundersökningenkommer att mynna ut i ett antal rapporter som lyfter fram olika aspekter avhälsa och arbetsmiljö. Syftet med den här studien har varit att undersöka
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| 35. |
- Karlsson, Roger
(författare)
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Reflective-functioning during the process and in relation to outcome in cognitive-behavioral therapy, interpersonal psychotherapy and brief psychodynamic
- 2005
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The objective of this work was to investigate reflective-functioning (RF) as a measure of process in two independent studies that included three types of brief psychotherapy. RF is defined as the ability to recognize the existence and nature of mental processes taking place in the self and in others (e.g., intentions, beliefs, desires, and wishes). Theorists have suggested the ability for RF is crucial for predicting social causality and low RF has been found related to mental disorders. It has recently been suggested in the literature that improved ability for RF might be an important component of successful psychotherapy outcome, especially with respect to achieving structuralchange. RF was in this work investigated during the process through discourse analysis of the patients’ narratives of self-other interactions in the treatment sessions. The Psychotherapy Process Q-set (PQS) was implemented in order to isolate specific components of the process (process correlates) that identified high and low RF and to investigate the links between the process correlates and outcome. The first study investigated 29 cases of cognitive-behavioral therapy(CBT) and 35 cases of interpersonal psychotherapy (IPT) with an average treatment length of 16.2 sessions in a sample from the National Institute of Mental Health (NIMH) randomized clinical trial Treatment of Depression Collaborative Research Program (TDCRP). The sample in the first study consisted of 128 sessions in total, were one session from the early part (on average the 4th session) and one session in the later part of the treatment (on average the 12th session) were rated for RF. The second study investigated a sample of 30 cases of brief psychodynamic psychotherapy (BPDT) with an average treatment length of 15.8 sessions in a naturalistic designand obtained from the Mount Zion Psychotherapy Research Group. In total, the second study included 90 sessions of BPDT, and RF was assessed during the 1st, the 5th, and the 14th session of each treatment. The results from these two studies suggested that the patients’ ability for RF, as measured through the discourse from therapy sessions, is stable (in CBT and BPDT) or decreased(IPT) during the treatments. Furthermore, the process correlates defining high RF had a relation with good outcome, and process correlates defining low RF had a relation with poor outcome.The process correlates identified during the PQS-analysis suggested that both high and low RF was linked with personality characteristics in the patients. For example, high RF was linked to patients’ ability for introspection, expression of negative emotions, and commitment to treatment.Low RF was linked to patients’ expression of passivity, defensiveness, and suspiciousness. This work supported theorists’ suggestions that brief treatments are supportive in their nature and therefore do not promote structural changes (e.g., changes in RF). It is suggested that the abilityfor RF as assessed pre-treatment might be a useful predictor for success in brief psychotherapy and could therefore be used as a patient inclusion criteria for such treatments.
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| 36. |
- Lundgren, Lena, et al.
(författare)
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Association between immigrant status and history of compulsory treatment in a national sample of individuals assessed for drug use disorders through the swedish public welfare system
- 2012
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Ingår i: Substance Use & Misuse. - : Informa UK Limited. - 1082-6084 .- 1532-2491. ; 47:1, s. 67-77
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Tidskriftsartikel (refereegranskat)abstract
- In-person interview data from 13,903 individuals assessed for a drug use disorder in the Swedish welfare system from 2002-2008, were analyzed using logistic regression methods. Second generation immigrants with non-Scandinavian parents were 41% more likely to report a history of compulsory treatment compared to those born in Sweden to Swedish parents after controlling for age, gender, education, mental health treatment homeless status history, and criminal justice history. Implications include the need to study acculturation, stigma, and discrimination-related factors as well as to promote culturally competent outreach to immigrant populations.
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| 37. |
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| 38. |
- Malmgren Olsson, Eva-Britt, et al.
(författare)
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Non-specific musculoskeletal disorders in patients in primary care : subgroups with different outcome patterns
- 2003
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Ingår i: Physiotherapy Theory and Practice. - 0959-3985 .- 1532-5040. ; 19:3, s. 161-173
-
Tidskriftsartikel (refereegranskat)abstract
- Patients with non-specific musculoskeletal disorders are considered to be a heterogeneous group with multifactorial problems. Appropriate and effective treatments for these patients have been hard to find. The purpose of this study was to identify subgroups of patients with different patterns of treatment outcome and to find possible predictors of outcome. A total of 78 patients, 64 females and 14 males, with non-specific musculoskeletal disorders were recruited consecutively to three different treatment approaches, Body Awareness Therapy, Feldenkrais, and conventional, individual physiotherapy in primary care. The outcome variables were calculated as effect-size values and consisted of dynamic balance; pain measurements according to pain drawing and MPI; psychological variables such as psychological distress and self-image; and health related factors with regard to quality of life, self-efficacy and sense of coherence. A cluster analysis revealed three subgroups of patients with significantly different treatment outcomes, which were systematically related to the treatment approach. With Body Awareness Therapy and Feldenkrais, the possibility to achieve positive treatment effects increased significantly in comparison to individual physiotherapy.
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| 39. |
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| 40. |
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| 41. |
- Sundbom, Elisabet, 1946-
(författare)
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Borderline psychopathology and the defense mechanism test
- 1992
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main purpose of the present studies has been to develop the Defense Mechanism Test (DM1) for clinical assessment of severe psychopathology with the focus on the concept of Borderline Personality Organization (BPO) according to Kemberg. By relating the DMT and the Structural Interview to each other, the concurrent validity of the concept of Personality Organization (PO) for psychiatric inpatients has been investigated. Two different assessment approaches have been used for this purpose. One has been to take a theoretical perspective as the starting-point for the classification of PO by means of the DMT. The other has been a purely empirical approach designed to discern natural and discriminating patterns of DMT distortions for different diagnostic groups. A dialogue is also in progress between DMT and current research on the Rorschach test in order to increase understanding of borderline phenomena and pathology.The overall results support Kemberg's idea that borderline patients are characterized by specific intrapsychic constellations different from those of both psychotic and neurotic patients. Both the DMT and the Structural Interview provide reliable and consistent judgements of PO. Patients with the syndrome diagnosis Borderline Personality Disorder exhibit different perceptual distortions from patients suffering from other personality disorders. The classic borderline theory is a one-dimensional developmental model, where BPO constitutes a stable intermediate form between neurosis and psychosis. The present results suggest that a two-dimensional model might be more powerful. Hence, the level of self- and object representations and reality orientation might be considered both from a developmental gad an affective perspective across varying forms of pathology.Kemberg suggests that borderline and psychotic patients share a common defensive constellation, centered around splitting, organizing self- and object representations. This view did not find support. The defensive pattem of the BPO patients is significantly different from the PPO defensive pattern. The BPO patients form their self- and object images affectively and thus the self- and object representations would seem to influence the defensive organization and not the other way around. The results have implications for the procedure and the interpretation of the DMT e.g. one and the same DMT picture can discern different kinds of personality; reactions other than the operationalized defense categories in the DMT manual can be valid predictors of PO; some of the DMT defenses described in the manual have to be reconceptualized such as isolation, repression and to some degree denial. Multivariate models are powerful tools for the integration of reactions to DMT into diagnostic patterns.
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| 42. |
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| 43. |
- Söderberg, Per, et al.
(författare)
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GAF-skalans reliabilitet i kliniskt arbete
- 2004
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Inom psykiatrin finns idag rutiner för att systematiskt följa upppatientarbetet och ett resultatmått som används är skalan GlobalAssessment of Functioning (GAF). I denna studie har vi undersöktskalans reliabilitet och analyserat faktorer som kan påverka skattningen när skalan används rutinmässigt inom kliniskt arbete.81 bedömare från olika psykiatriska öppenvårdsenheter fickbedöma 8 olika patientfall. Huvudresultatet visar att den personalsom ansvarar för diagnostik och bedömningar av nybesöken inomöppenvårdspsykiatrin använder GAF-skalan med tillfredställandereliabilitet, ICC (1,1) = 0.81. Den faktor som tydligast påverkadereliabiliteten var bedömarens subjektiva inställning till att användaGAF-skalan och andra mätinstrument inom psykiatrin. När bedömarna var positivt inställda till att använda mätinstrument var mätfelen färre och vice versa. Studien visar att GAF-skalan kan användas med relativt god tillförlitlighet för att uttala sig om förändringar och resultat på gruppnivå under förutsättning att grupperna är relativt lika.
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| 44. |
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| 45. |
- Söderberg, Per, 1955-, et al.
(författare)
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Outcome in psychiatric outpatient services : reliability, validity and outcome based on routine assessments with the GAF scale
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of the studies presented in this thesis is to investigate the possibility of using clinical data to measure outcomes in psychiatric outpatient services. The specific aims are to investigate whether routine clinical assessments and ratings are reliable and have adequate validity, and then to use these data to calculate treatment outcomes and explore factors that affect these outcomes.The main result shows that ratings of global mental health made by clinicians in routine clinical work can be used to evaluate treatment outcomes in outpatient settings. The clinicians responsible for diagnosing and assessing patients used the GAF scale with satisfactory reliability (ICC1,1 = 0.81) and fair interrater reliability (overall kappa = 0.53) when categorizing main diagnostic groups of the DSM-IV axis I. The GAF scale can thus be used to assess global mental health and to monitor outcomes in clinical settings. However, a GAF culture bias was observed. This bias can probably be corrected with feedback and training.Psychiatric treatment in outpatient settings had a generally positive effect on patients’ global mental heath (ES = 0.65). The overall result when clinical significance methodology was used showed that 28.1% of the patients had recovered and a further 6.6% showed reliable improvement. Patients being treated with psychotherapeutically influenced methods showed a considerably better effect (ES = 1.00). There is a dose of sessions effect that is particularly marked for short treatment episodes. Thirteen sessions are required for 50% of the patients to show reliable improvement. The strongest influence on treatment outcome was whether the termination of a patient’s treatment was planned or unplanned.In conclusion: Clinical databases can be used to study the outcome of psychiatric services provided they a) include a large number of subjects representing an intention-to-treat perspective; b) the instruments used are clinically relevant and reliable; c) the raters contributing to the data base are motivated to decrease attrition; d) the database includes extensive data to allow for control of confounding factors; and e) data are collected at critical occasions in treatment, such as at the start of treatment and at discharge from treatment, making it possible to focus on effects. Psychiatric outpatient treatment has a positive effect, but considerable improvements may be possible with more stringent use of psychotherapeutic methods, sufficient doses of sessions, and planned terminations. However, the progress of treatment is also affected by such factors as pre-treatment severity and diagnoses.
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| 46. |
- Söderberg, Per, 1955-, et al.
(författare)
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Reliability of global assessment of functioning ratings made by clinical psychiatric staff
- 2005
-
Ingår i: Psychiatric Services. - Washington, D.C. : American Psychiatric Association. - 1075-2730 .- 1557-9700. ; 56:4, s. 434-438
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: In the Swedish psychiatric care system, systematic follow-upof clinical work with patients is becoming a part of regular service, anda number of care providers are using the Global Assessment of Functioning(GAF) to measure outcomes. This study investigated the reliabilityof the GAF and analyzed certain factors that affect measurementerrors when the scale is used by regular psychiatric staff. Methods: Eighty-one raters from various psychiatric outpatient clinics ratedeight case vignettes. Interrater reliability was assessed by using intraclasscorrelation coefficients (ICCs), and factors associated with reliabilitywere analyzed by using raters’ unique residual values. Results: The results showed that staff who are responsible for assessing firsttimepatients at outpatient psychiatric clinics and making diagnoses areusing the GAF with satisfactory reliability (ICC1,1=.81). The factors associatedwith reliability were raters’ subjective attitude toward the GAF and motivation to use the scale and other measurement instruments inpsychiatry. Conclusions: GAF ratings made by an individual rater can beused to measure changes and outcomes at the group level. However, themeasurement error is too large for assessment of change for an individualpatient, in which case it might be necessary to use several raters. If raters are positively inclined to use rating instruments, measurementerrors are minimized and reliability is maximized.
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| 47. |
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| 48. |
- Tungström, Stefan, et al.
(författare)
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Relationship between the global assessment of functioning and other DSM axes in routine clinical work
- 2005
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Ingår i: Psychiatric Services. - Washington : American Psychiatric Association. - 1075-2730 .- 1557-9700. ; 56:4, s. 439-443
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to investigate the validity of theGlobal Assessment of Functioning (GAF) when routinely used in clinicalwork by focusing on the relations between the GAF, other axes in theDSM system, and some demographic variables conceptually derived ontheoretical and clinical grounds. Methods: A clinical database containingdata for 5,538 patients assessed by 181 raters as a part of routinepractice in psychiatric outpatient settings in Sweden was used. A hierarchicallinear regression model and a variance component model wereused to analyze the data. Regression models were also used to determinehow the relation between the GAF and axis I depends on the selectionof diagnostic groups in the sample. Results: Seventeen percentof the systematic variance in GAF scores was explained by diagnosticdifferences as defined on DSM-IV axis I, and 5.1 percent was explainedby psychosocial and environmental problems as measured on DSM-IVaxis IV. Unexpectedly, the site of the investigation explained another 3.6percent of the variance. Conclusions: The GAF can be used as a comprehensivemeasure of global mental health in routine clinical work forassessment and for outcome management.
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| 49. |
- Ybrandt, Helene, 1954-, et al.
(författare)
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Measurments instruments scales tests : The Adolescent Drug Abuse Diagnosis composite scores in Swedish normal and antisocial adolescents
- 2008
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Ingår i: Substance Use & Misuse. - : Informa UK Limited. - 1082-6084 .- 1532-2491. ; 43:10, s. 1411-1423
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Tidskriftsartikel (refereegranskat)abstract
- The present study evaluates the utility and issues around the composite scores in Adolescent Drug Abuse Diagnosis (ADAD). Participants were Swedish normal adolescents (121) and adolescents manifesting antisocial problems (1,168), ages 10 to 21. The results show that the interviewer severity ratings seem to be the most appropriate outcome when the objective is to differentiate between normal and antisocial adolescents. The composite scores appear to function as an indicator of current problems in all areas except for Medical and Alcohol sections. The critical items within the Medical and Alcohol composite scores are explored and discussed.
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| 50. |
- Östgård-Ybrandt, Helene, 1954-, et al.
(författare)
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Perception of early mother and father behavior in adolescence. : A study of age and gender differences in groups of normal and antisocial adolescents
- 2003
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This study examined age and gender differences in the perceptions of early mother and father behavior in a group of normal adolescents. Two hundred and seventy-seven boys and girls (aged 12–18 years) completed EMBU (My memories of Upbringing), a questionnaire measuring perceptions of parental rearing behaviors, and questionnaires based on the Structural Analysis of Social behavior (SASB) model. A group of 30antisocial adolescents of similar age was included as a comparison group.The results show that the normal adolescents’ perception of earlyparental behavior is positive with no age or gender differences. The earlybehavior of the mother was perceived more positively than that of thefather. A more negative perception of early parental behaviors was foundin the antisocial adolescent group and especially in the group of antisocial girls. The results of EMBU were consistent with those of SASB with perceptions of more negative parental behavior of rejection and overprotection in the group of antisocial adolescents.
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