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- Boersma, Katja, 1973-, et al.
(författare)
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Exposure-based cognitive behavioral therapy for irritable bowel syndrome : A single-case experimental design across 13 subjects
- 2016
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Ingår i: Cognitive Behaviour Therapy. - Oxon, United Kingdom : Routledge. - 1650-6073 .- 1651-2316. ; 45:6, s. 415-430
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Tidskriftsartikel (refereegranskat)abstract
- Irritable bowel syndrome (IBS) is a highly prevalent disorder with a significant impact on quality of life. The presence of psychological symptoms in IBS patients such as catastrophic worry and behavioral avoidance suggests the possible efficacy of cognitive behavioral interventions. Exposure-based cognitive behavioral therapy (CBT) has proven to be a promising approach but has only been investigated in a few studies and mainly via the Internet. Therefore, the aims of this study were to extend and replicate previous findings and to evaluate whether an individual, face-to-face, exposure-based CBT leads to improvement in gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life in IBS patients. Thirteen patients with IBS according to Rome III criteria participated in a single-case experimental study using a five-week baseline and a subsequent twelve-session intervention phase focusing on psycho-education, mindfulness and in vivo exposure. Standardized measurement of gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life was conducted weekly during baseline as well as intervention phase and at six-month follow-up. Results showed that over 70% of patients improved significantly on gastrointestinal symptoms, pain catastrophizing, and quality of life. Effects on avoidance behavior were modest. These results strengthen and extend earlier findings and provide further support for the efficacy of exposure-based strategies for IBS.
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- Edebol-Carlman, Hanna, 1984-, et al.
(författare)
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Behavior change and pain relief in chronic whiplash associated disorder Grade IV using flotation restricted environmental stimulation technique: A case report
- 2013
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Ingår i: Psychology and Behavioral Sciences. - : Science Publishing Group. - 2328-7837 .- 2328-7845. ; 2, s. 202-216
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Tidskriftsartikel (refereegranskat)abstract
- Pain is a major public health problem and the needs for more differentiated and flexible treatment options are obvious. The purpose of the present study was to examine, for the first time, experiences from long-term flotation Restricted Environmental Stimulation Technique (REST) made by a patient with chronic Whiplash Associated Disorder (WAD), grade IV. The patient of the present study was a middle aged native-born Caucasian male from Sweden who had been diagnosed with chronic WAD IV by a licensed physician. The patient performed regular flotation during one and a half year and wrote about his experiences in a diary. A semi-structured interview was conducted at the end of therapy. Both the diary and the interviews were analyzed with help of the empirical phenomenological psychological method and results describe experiences of relaxation, pain relief, sleep and deep rest, mental coping, increased energy, wellbeing and behavioral changes as a result of flotation. A model describes the rehabilitative circuit of chronic whiplash during flotation and is in line with the potential role of a stress response system for development and management of chronic whiplash. The study provides qualitative insights into the experiences of flotation as a pain- and stress- management system for chronic whiplash. Results are encouraging for future research and even suggest that interested clinics may use flotation-REST in order to relieve chronic pain and enhance the quality of life for a more comprehensive group of patients with whiplash associated disorders.
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- Edebol-Carlman, Hanna, 1984-, et al.
(författare)
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Chronic Whiplash-Associated Disorders and Their Treatment Using Flotation-REST (Restricted Environmental Stimulation Technique).
- 2008
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Ingår i: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; 18:4, s. 480-488
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Tidskriftsartikel (refereegranskat)abstract
- In this study, we investigated for the first time whether flotation-REST might be used for treating chronic whiplash-associated disorders (WAD). Six women and one man, all diagnosed by licensed physicians as having chronic whiplash-associated disorder, participated. Two of the participants were beginners with regard to flotation-REST (2 or 3 treatments), and five of them had experienced between 7 and 15 treatments. The method for data collection was the semistructured qualitative interview. The empirical phenomenological psychological method devised by Karlsson was used for the analyses. Two qualitative models explaining the participants' experiences of flotation-REST emerged. The models describe the participants' experiences of flotation-REST, as well as the short-term effects of the treatment in terms of five phases: (a) intensification, (b) vitalization, (c) transcendation, (d) defocusation, and (e) reorientation. Results indicated that flotation-REST is a meaningful alternative for treating chronic whiplash-associated disorder.
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- Edebol-Carlman, Hanna, 1984-, et al.
(författare)
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Cognitive behavioral therapy for irritable bowel syndrome : the effects on state and trait anxiety and the autonomic nervous system during induced rectal distensions - An uncontrolled trial
- 2018
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter. - 1877-8860 .- 1877-8879. ; 18, s. 81-91
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Irritable bowel syndrome (IBS), is a common multifactorial gastrointestinal disorder linked to disturbances in the microbe gut-brain axis. Cognitive behavioral therapy (CBT), in face-to-face format has showed promising results on IBS and its associated psychological symptoms. The present study explored for the first time if CBT for IBS affects the autonomic nervous system (ANS) during experimentally induced visceral pain and cognitive stress, respectively. The levels of state and trait anxiety, current and perceived stress were also evaluated.Methods: In this uncontrolled trial, individual CBT was performed in face-to-face format for 12 weeks in 18 subjects with IBS. Heart rate variability and skin conductance were measured during experimentally induced visceral pain and during a cognitive task (Stroop color-word test), before and after intervention. The levels of state and trait anxiety as well as self-rated current and perceived stress were also measured before and after the intervention.Results: CBT did not affect ANS activity during experimentally induced visceral pain and cognitive stress. The sympathetic activity was high, typical for IBS and triggered during both visceral pain and cognitive stress. The levels of state and trait anxiety significantly decreased after the intervention. No significant changes in self-rated current or perceived stress were found.Conclusions: Results suggest that face-to-face CBT for IBS improved anxiety- a key psychological mechanism for the IBS pathophysiology, rather than the autonomic stress response to experimentally induced visceral pain and cognitive stress, respectively.
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- Edebol-Carlman, Hanna, 1984-, et al.
(författare)
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Enhanced independence and quality of life through treatment with Flotation-Restricted Environmental Stimulation Technique of a patient with both Attention Deficit Hyperactivity Disorder and Asperger’s Syndrome : A case report
- 2009
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Ingår i: Cases Journal. - : BioMed Central. - 1757-1626. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionThe objective of this qualitative case report was to describe experiences of flotation-Restricted Environmental Stimulation Technique from the perspective of a woman with Attention Deficit Hyperactivity Disorder, Aspergers syndrome and experiences of depression and distress.Case presentationThe respondent is a 36-year-old woman from Sweden, assessed and diagnosed by a neuropsychological multi-professional team in 2006. The 19-session flotation series prolonged during almost one year.ConclusionThe positive development of arousal control, activity regulation, sensory integration and interpretation, cognitive functioning and emotional maturity created experiences of personal independence and quality of life. Flotation-restrictive environmental stimulation technique was experienced as a meaningful treatment. Additional studies of treatment for Attention Deficit Hyperactivity Disorder and comorbid disorders in adults using the flotation-restrictive environmental stimulation technique are strongly encouraged.
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- Edebol-Carlman, Hanna, 1984-, et al.
(författare)
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Face-to-Face Cognitive-Behavioral Therapy for Irritable Bowel Syndrome : The Effects on Gastrointestinal and Psychiatric Symptoms
- 2017
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Ingår i: Gastroenterology Research and Practice. - : Hindawi Publishing Corporation. - 1687-6121 .- 1687-630X.
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Tidskriftsartikel (refereegranskat)abstract
- Irritable bowel syndrome (IBS) is a gastrointestinal disorder linked to disturbances in the gut-brain axis. Visceral hypersensitivity and pain are hallmarks of IBS and linked to the physiological and psychological burden and to the nonadaptive coping with stress. Cognitive-behavioral therapy (CBT) for IBS has proven effective in reducing gastrointestinal and psychiatric symptoms in IBS by means of coping with stress. The present pilot study evaluated for the first time whether CBT for IBS affected visceral sensitivity and pain. Individual CBT was performed for 12 weeks in 18 subjects with IBS and evaluated in terms of visceral sensitivity and pain during rectal distensions using the barostat method and self-rated visceral sensitivity and gastrointestinal and psychiatric symptoms. Visceral discomfort, urge, and pain induced by the barostat were not affected by CBT but were stable across the study. However, the level of self-rated visceral sensitivity and gastrointestinal and psychiatric symptoms decreased after the intervention. Central working mechanisms and increased ability to cope with IBS-symptoms are suggested to play a key role in the alleviation of IBS symptoms produced by CBT.
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| 11. |
- Edebol Carlman, Hanna M. T., et al.
(författare)
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Probiotic Mixture Containing Lactobacillus helveticus, Bifidobacterium longum and Lactiplantibacillus plantarum Affects Brain Responses to an Arithmetic Stress Task in Healthy Subjects : A Randomised Clinical Trial and Proof-of-Concept Study
- 2022
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 14:7
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Tidskriftsartikel (refereegranskat)abstract
- Probiotics are suggested to impact physiological and psychological stress responses by acting on the gut-brain axis. We investigated if a probiotic product containing Bifidobacterium longum R0175, Lactobacillus helveticus R0052 and Lactiplantibacillus plantarum R1012 affected stress processing in a double-blinded, randomised, placebo-controlled, crossover proof-of-concept study (NCT03615651). Twenty-two healthy subjects (24.2 ± 3.4 years, 6 men/16 women) underwent a probiotic and placebo intervention for 4 weeks each, separated by a 4-week washout period. Subjects were examined by functional magnetic resonance imaging while performing the Montreal Imaging Stress Task (MIST) as well as an autonomic nervous system function assessment during the Stroop task. Reduced activation in regions of the lateral orbital and ventral cingulate gyri was observed after probiotic intervention compared to placebo. Significantly increased functional connectivity was found between the upper limbic region and medioventral area. Interestingly, probiotic intervention seemed to predominantly affect the initial stress response. Salivary cortisol secretion during the task was not altered. Probiotic intervention did not affect cognitive performance and autonomic nervous system function during Stroop. The probiotic intervention was able to subtly alter brain activity and functional connectivity in regions known to regulate emotion and stress responses. These findings support the potential of probiotics as a non-pharmaceutical treatment modality for stress-related disorders.
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- Edebol-Carlman, Hanna, 1984-, et al.
(författare)
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Perspektiv på utredning och diagnos vid ADHD
- 2013
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 90:3, s. 328-335
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Attention Deficit Hyperactivity Disorder, ADHD, är en erkänd och väl etablerad klinisk diagnos som används inom psykiatrin för att beteckna en samling beteenden som återfinns hos både barn och vuxna och som orsakar problem i vardagen. Diagnosen har hög klinisk validitet vilket innebär att ADHD hänger ihop rent statistiskt, uppvisas av barn och vuxna som har funktionsnedsättning och behöver hjälp, svarar på behandling samt korrelerar med andra meningsfulla markörer på grupp-nivå t ex olika biologiska och genetiska markörer samt via långtidsuppföljningar. I likhet med de flesta andra psykiatriska diagnoser (förutom vissa typer av mental retardation) har diagnosen inte uppnått etiologisk validitet eftersom vi då skulle behöva förklara orsakerna till ADHD i varje enskilt fall. Mycket forskning är idag inriktad på orsaksmekanismer inom ramen för multifaktoriella teorier.De sociala och medicinska konsekvenserna av ADHD är många och allvarliga och hänger samman med att ADHD hos de flesta, i synnerhet vuxna, idag är en odiagnostiserad funktionsnedsättning. Långsiktig behandling och positiva resultat är ofta avhängig kvaliteten på utredningarna, och här ser vi att vetenskapligt utprovade och tillförlitliga metoder är nödvändiga och utslagsgivande. Vi valde att med utgångspunkt från ett befintligt test (Quantified Behavior Test Plus) utveckla två mått som kan användas vid klinisk utredning av ADHD hos vuxna personer. PADHD är ett kategoriskt mått (ja/nej) som predicerar sannolikheten för ADHD med goda testresultat i avseende på sensitivitet och specificitet. WCS är ett mått på graden av ADHD från 0 till 100 som visat sig i stor utsträckning kunna skilja personer med ADHD från personer utan psykiatriska diagnoser samt skilja ADHD från andra liknande psykiatriska diagnoser. En studie antyder också att WCS kan indikera respons och remission vid behandling med centralstimulerande läkemedel.ADHD diagnosen innebär en rad metodologiska utmaningar samt medför särskilt i obehandlad form allvarliga socialmedicinska konsekvenser för individen och samhället. Diagnosens exakta utformning kommer sannolikt att förändras en del under den närmaste tiden vilket kan påverka utredningsarbetet. Målet är dock detsamma, att på ett systematiskt, empirinära och konstruktivt sätt undersöka, beskriva och göra allt som det enskilda fallet kräver för att uppnå och bibehålla remission samt förmedla att det finns god behandling och hopp att få.
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- Edebol-Carlman, Hanna, 1984-, et al.
(författare)
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Robust mätmetod för ADHD hos vuxna.
- 2013
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Ingår i: Best Practice. - 1329-1874. ; 4:14, s. 18-21
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Tidskriftsartikel (populärvet., debatt m.m.)
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- Rode, Julia, 1992-, et al.
(författare)
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Multi-Strain Probiotic Mixture Affects Brain Morphology and Resting State Brain Function in Healthy Subjects : An RCT
- 2022
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Ingår i: Cells. - : MDPI. - 2073-4409. ; 11:18
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Tidskriftsartikel (refereegranskat)abstract
- Probiotics can alter brain function via the gut-brain axis. We investigated the effect of a probiotic mixture containing Bifidobacterium longum, Lactobacillus helveticus and Lactiplantibacillus plantarum. In a randomized, placebo-controlled, double-blinded crossover design, 22 healthy subjects (6 m/16 f; 24.2 ± 3.4 years) underwent four-week intervention periods with probiotics and placebo, separated by a four-week washout period. Voxel-based morphometry indicated that the probiotic intervention affected the gray matter volume of a cluster covering the left supramarginal gyrus and superior parietal lobule (p < 0.0001), two regions that were also among those with an altered resting state functional connectivity. Probiotic intervention resulted in significant (FDR < 0.05) functional connectivity changes between regions within the default mode, salience, frontoparietal as well as the language network and several regions located outside these networks. Psychological symptoms trended towards improvement after probiotic intervention, i.e., the total score of the Hospital Anxiety and Depression Scale (p = 0.056) and its depression sub-score (p = 0.093), as well as sleep patterns (p = 0.058). The probiotic intervention evoked distinct changes in brain morphology and resting state brain function alongside slight improvements of psycho(bio)logical markers of the gut-brain axis. The combination of those parameters may provide new insights into the modes of action by which gut microbiota can affect gut-brain communication and hence brain function.
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- Rode, Julia, 1992-, et al.
(författare)
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Probiotic Mixture Containing Lactobacillus helveticus, Bifidobacterium longum and Lactiplantibacillus plantarum Affects Brain Responses Toward an Emotional Task in Healthy Subjects : A Randomized Clinical Trial
- 2022
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Ingår i: Frontiers in nutrition. - : Frontiers Media S.A.. - 2296-861X. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence from preclinical studies suggests that probiotics affect brain function via the microbiome-gut-brain axis, but evidence in humans remains limited.Objective: The present proof-of-concept study investigated if a probiotic product containing a mixture of Bifidobacterium longum R0175, Lactobacillus helveticus R0052 and Lactiplantibacillus plantarum R1012 (in total 3 × 109 CFU/day) affected functional brain responses in healthy subjects during an emotional attention task.Design: In this double-blinded, randomized, placebo-controlled crossover study (Clinicaltrials.gov, NCT03615651), 22 healthy subjects (24.2 ± 3.4 years, 6 males/16 females) were exposed to a probiotic intervention and a placebo for 4 weeks each, separated by a 4-week washout period. Subjects underwent functional magnetic resonance imaging while performing an emotional attention task after each intervention period. Differential brain activity and functional connectivity were assessed.Results: Altered brain responses were observed in brain regions implicated in emotional, cognitive and face processing. Increased activation in the orbitofrontal cortex, a region that receives extensive sensory input and in turn projects to regions implicated in emotional processing, was found after probiotic intervention compared to placebo using a cluster-based analysis of functionally defined areas. Significantly reduced task-related functional connectivity was observed after the probiotic intervention compared to placebo. Fecal microbiota composition was not majorly affected by probiotic intervention.Conclusion: The probiotic intervention resulted in subtly altered brain activity and functional connectivity in healthy subjects performing an emotional task without major effects on the fecal microbiota composition. This indicates that the probiotic effects occurred via microbe-host interactions on other levels. Further analysis of signaling molecules could give possible insights into the modes of action of the probiotic intervention on the gut-brain axis in general and brain function specifically. The presented findings further support the growing consensus that probiotic supplementation influences brain function and emotional regulation, even in healthy subjects. Future studies including patients with altered emotional processing, such as anxiety or depression symptoms are of great interest.Clinical Trial Registration: [http://clinicaltrials.gov/], identifier [NCT03615651].
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- Wall, Rebecca, 1979-, et al.
(författare)
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Altered expression of membrane transporters in colonic mucosa of patients with Irritable Bowel Syndrome (IBS) and Post-infectious (PI)-IBS compared to healthy subjects
- 2017
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Ingår i: Neurogastroenterology and Motility. - : John Wiley & Sons. - 1350-1925 .- 1365-2982. ; 29:Suppl. 2, s. 107-108
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Irritable bowel syndrome (IBS) affects 5%- 15% of adults in the general population, and is characterized by chronic recurrent abdominal pain and discomfort and associated with altered bowel habits. The pathophysiology of IBS is complex and not fully under-stood. Hence, treatment is often based on symptomatology rather than underlying physiological aberrancies.Objective: To compare the expression of membrane transporters in mucosal biopsies of healthy subjects, IBS patients and post- infectious (PI)- IBS patients.Methods: Mucosal biopsies were obtained from the unprepared sigmoid colon in 18 IBS patients, 9 PI- IBS patients and 10 healthy subjects. Total RNA was isolated and prepared for gene expression analyses using quantitative reverse- transcription polymerase chain reaction (qRT- PCR). We compared the expression of genes encoding membrane- spanning transporters, using GAPDH as a reference gene, and by using the comparative 2- ΔΔCt method.Results: Colonic expression of SCL7A5 and SLC3A2 (together com-prising the amino acid transporter LAT1+4F2hc) was significantly lower in IBS patients, but not in PI- IBS patients, compared to healthy controls (P<.001). The expression of SLC7A8 (LAT2) tended to be lower in IBS patients compared to controls (P=.06). Mucosal gene ex-pression of the short chain fatty acid transporter SMCT1 (SLC5A8) was lower in both IBS- patients and PI- IBS patients compared to healthy subjects (P<.01).Conclusions: The amino acid transporters LAT1 and LAT2 appeared to be affected in IBS patients, but not in PI- IBS patients, compared to healthy subjects, suggesting a possible alteration in amino acids transport in this patient group. Furthermore, our results suggest a lower uptake of short chain fatty acids in both IBS- and PI- IBS pa-tients. Altered expression of these transporters may be involved in the pathophysiology of IBS as well as being a potential biomarker of this aberration, and therefore deserves further study in IBS.
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