| 1. |
- Soares, Joaquim, et al.
(författare)
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Prevention av smärttillstånd
- 2008. - 2
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Ingår i: Preventiv medicin. - Lund : Studentlitteratur. - 9789144040158 ; , s. 261-272
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Information om boken "Preventiv medicin: Teori och praktik"Är det möjligt att förebygga sjukdom och främja hälsa - och är det lönsamt? Med dagens snabba medicinska landvinningar och ökande vårdbehov hos en åldrande befolkning blir den kurativa medicinen allt dyrare. Samtidigt krymper sjukvårdsekonomin, utrymmet för god och mänsklig vård minskar, individens sociala utsatthet och sårbarhet för kronisk sjukdom tilltar. Den preventiva medicinen har förvånande nog fått liten plats i detta scenario. När vi nu effektivt kan förebygga allt fler sjukdomar, borde vi inte då bättre kunna bespara människor deras lidande och samhället dess sjukvårdskostnader? Preventivt arbete kräver en gränsöverskridande och multidisciplinär ansats, där medicin, epidemiologi, statistik, ekonomi, sociologi, psykologi, och andra vetenskaper samverkar. I denna nya och utvidgade utgåva presenterar 29 expterter sina samlade kunskaper och erfarenheter om hur vi kan begränsa och tygla de stora folksjukdomarna. Boken behandlar skilda områden från tobaksbruk, alkoholanvändning, matvanor, motion och sömn över stressrelaterade livsproblem till en diskussion om våra vanligaste folksjukdomar som hjärt-kärlsjukdomar, cancer och olika tillstånd av psykisk ohälsa med syftet att visa fram var vi kan påverka genom konsekvent prevention - och hur vi kan utvärdera de förebyggande insatserna. Preventiv medicin vänder sig såväl till studerande inom medicin, folkhälso- och vårdvetenskaper som till praktiskt verksamma inom vården, men även till aktörer och organisationer utanför vårdapparaten med förebyggande och hälsofrämjande arbete på sitt program.
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| 2. |
- Ahlborg, Tone, 1950, et al.
(författare)
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Sensual and sexual marital contentment in parents of small children--a follow-up study when the first child is four years old.
- 2008
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Ingår i: Journal of sex research. - : Informa UK Limited. - 0022-4499 .- 1559-8519. ; 45:3, s. 295-304
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Tidskriftsartikel (refereegranskat)abstract
- This follow-up study explored parents' (N=452) intimate relationships when their firstborn child was 6 months old and then 4 years later. The measurement used was a modified version of the Dyadic Adjustment Scale, DAS. The present results show that most parents responding were content sensually at 6 months postpartum in 2002 and 4 years later, in 2006. More parents had changed from being sensually content in 2002 to discontent in 2006, than the contrary, however, and the sexual contentment remained low. The average sexual frequency was low both at 6 months and at 4 years for both parents with and without additional children. Experiencing tiredness as a hindrance to having sex was perceived as a greater problem among those parents without additional children. Prospective regression analyses indicated that sexuality was significantly related to both sensual and sexual contentment 4 years later. Sexuality was also one of the most significant covariates in the cross-sectional regression analysis for sensual contentment. Since sexuality plays a central role in partner well-being, it may be an important target for helping parents with small children.
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| 3. |
- Arnberg, Filip K, 1981-, et al.
(författare)
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Internet-delivered psychological treatments for mood and anxiety disorders : a systematic review of their efficacy, safety, and cost-effectiveness
- 2014
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:5, s. e98118-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Greater access to evidence-based psychological treatments is needed. This review aimed to evaluate whether internet-delivered psychological treatments for mood and anxiety disorders are efficacious, noninferior to established treatments, safe, and cost-effective for children, adolescents and adults.METHODS: We searched the literature for studies published until March 2013. Randomized controlled trials (RCTs) were considered for the assessment of short-term efficacy and safety and were pooled in meta-analyses. Other designs were also considered for long-term effect and cost-effectiveness. Comparisons against established treatments were evaluated for noninferiority. Two reviewers independently assessed the relevant studies for risk of bias. The quality of the evidence was graded using an international grading system.RESULTS: A total of 52 relevant RCTs were identified whereof 12 were excluded due to high risk of bias. Five cost-effectiveness studies were identified and three were excluded due to high risk of bias. The included trials mainly evaluated internet-delivered cognitive behavioral therapy (I-CBT) against a waiting list in adult volunteers and 88% were conducted in Sweden or Australia. One trial involved children. For adults, the quality of evidence was graded as moderate for the short-term efficacy of I-CBT vs. waiting list for mild/moderate depression (d = 0.83; 95% CI 0.59, 1.07) and social phobia (d = 0.85; 95% CI 0.66, 1.05), and moderate for no efficacy of internet-delivered attention bias modification vs. sham treatment for social phobia (d = -0.04; 95% CI -0.24, 0.35). The quality of evidence was graded as low/very low for other disorders, interventions, children/adolescents, noninferiority, adverse events, and cost-effectiveness.CONCLUSIONS: I-CBT is a viable treatment option for adults with depression and some anxiety disorders who request this treatment modality. Important questions remain before broad implementation can be supported. Future research would benefit from prioritizing adapting treatments to children/adolescents and using noninferiority designs with established forms of treatment.
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| 4. |
- Askeland, Kristin Gärtner, et al.
(författare)
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Association of Depressive Symptoms in Late Adolescence and School Dropout
- 2022
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Ingår i: School Mental Health. - : Springer. - 1866-2625 .- 1866-2633. ; 14:4, s. 1044-1056
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Tidskriftsartikel (refereegranskat)abstract
- The present study investigated the association between symptoms of depression in late adolescence and completion of upper secondary school, taking symptoms of ADHD and conduct disorder, and parental education into account. The study is based on the youth@hordaland-survey, conducted in Western Norway in 2012. A total of 9157 adolescents (aged 16-19 years, 53% girls) consented to participation and registry linkage and comprised the sample of the present study. Symptoms of depression, ADHD, and conduct disorder were based on adolescent self-report. Information on parental education, grade point average (GPA), and upper secondary school completion was retrieved from the National Education Database. In the sample, 14.8% had not completed upper secondary education within 5 years. Symptoms of depression were associated with higher odds of failure to graduate within 5 years (adjusted odds ratio (AOR) = 1.50). The association was attenuated but remained significant when adjusting for symptoms of ADHD, conduct disorder, and parental education. Adolescents reporting high levels of both depression and conduct disorder had the highest odds of dropout (AOR = 4.15). GPA partially mediated the association between symptoms of depression and dropout. The results show a consistent, but small association between symptoms of depression in late adolescence and failure to complete upper secondary education within five years. Given the high rate of depressive symptoms in the adolescent population, it is important to identify protective factors that promote school functioning and graduation for adolescents experiencing such symptoms.
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| 5. |
- Bauducco, Serena, 1988-
(författare)
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Adolescents' sleep in a 24/7 society : Epidemiology and prevention
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Sleep undergoes important changes during adolescence and many teenagers experience problems sleeping. These in turn affect adolescents´ academic, physical and psychosocial functioning. Moreover, there are some indications that sleep problems in this age group may be increasing, possibly as a consequence of societal changes, e.g., internet availability. Research on adolescents´ sleep is growing, but more epidemiological studies are needed to clarify the prevalence of poor sleep, long and short-term outcomes associated with it, and potential risk and protective factors to target in preventive interventions. The aim of this dissertation was to contribute to each of these goals; Study I investigated the longitudinal association between sleep problems, defined as symptoms of insomnia, and school absenteeism; Study II explored the prevalence of poor sleep, defined as sleep deficit, in an adolescent population and psychosocial and contextual factors associated with it, including emotional and behavioral problems, stress, sleep hygiene and technology use; finally, Study III evaluated the short-term effects of a novel universal school-based intervention to improve adolescents´ sleep health.The findings show that poor sleep was strongly related to adolescents´ functioning, including emotional and behavioral problems and school attendance, and that sleep deficit was prevalent in adolescents. This supports the need for prevention. Moreover, sleep deficit was associated with stress, technology use and arousal at bedtime, which may represent important barriers to sleep. A preventive intervention targeting these barriers to promote adolescents´ sleep health was successful with the individuals most at risk. However, it remains to be seen whether these changes will be maintained after the intervention and whether incidence of sleep problems will be lower relative to a control group. Implications for theory and practice are discussed.
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| 6. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Making room for sleep : A classroom based prevention program for adolescents
- 2016
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Ingår i: EABCT2016 Abstract Book. ; , s. 546-546
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Sleep patterns go through important changes during adolescence and sleep deprivation is extremely common, with severe consequences for adolescents´ daily functioning (Owens et al., 2014).Previous school-based interventions attempting to prevent sleep problems and their consequences have shown an increase in adolescents´ sleep knowledge but no behavioral changes. These programs usually include sleep education, cognitive and behavioral strategies, and a motivational framework (Cassoff, Knäuper, Michaelsen, & Gruber, 2013). Although the importance of motivation and engagement is unquestionable, previous attempts at enhancing adolescents´ motivation to change sleep behaviors might have been too shallow. We developed a new program that specifically targets barriers adolescents may encounter when trying to change their sleep behaviors, such as use of information and communication technology (ICT) late in the evening, stress due to schoolwork, and extracurricular activities. So, the intervention did not only focus on sleep education but also on improving students’ time management skills and encouraging them to monitor their ICT use. We also developed an interactive app for the intervention to increase engagement and to take advantage of the opportunities of ICT.The aim of this study was to evaluate the effectiveness of this classroom delivered universal sleep intervention. More specifically, we wanted to investigate whether changes in technology usage and perceived stress preceded changes in adolescents´ sleep duration. The intervention consisted of 5x45 min sessions over 6-7 weeks. Students (N = 292) completed weekly questionnaires through the app including a sleep diary for school-week and weekend sleep (bedtime, wake time, sleep onset latency, and wake after sleep onset), mobile usage, and motivation to change. They also completed pre- and post-intervention assessments, including self-reported sleep hygiene, perceived stress, and mood. At the end of the intervention students provided a qualitative evaluation of the sleep program.The intervention is still ongoing and will be completed by the end of the school year (June 2016). So far, the intervention has shown good feasibility in the school context. Preliminary results will be presented on possible changes in sleep duration and sleep hygiene and the role of ICT use and stress.This study will give us important information on adolescents´ sleep and its barriers in our 24/7 society. The discussion will focus on the possibilities of using this kind of preventive school-based interventions, as well as how modern technology (i.e. an interactive app) may be used for promoting engagement in this age group.
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| 7. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Prevalence, Incidence and Risk Factors for Sleep Deprivation in Adolescence : The Role of Technology and Stress
- 2016
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The first aim of this study was to describe the prevalence and incidence of poor sleep duration (<7 hours) over a one year period in a large sample of adolescents. The second aim was to inform prevention about the influence of adolescents´ social context on sleep duration. Therefore, we wanted to describe the longitudinal association between the use of Information and Communication Technology (ICT) at bedtime and daily stressors (e.g. school performance, family and peer issues) and poor sleep duration.Method: Participants were high school students in the 7th and 8th grade (N = 2505; age range: 12-15 years, at baseline) from 17 public schools in three communities in middle Sweden. Students filled out questionnaires in school during the spring, 2014 and one year later (85% retention rate). Sleep measures included bed time (BT), wake up time (WUT), and sleep onset latency (SOL). Total sleep time was calculated as, BT + WUT - SOL.We calculated prevalence, incidence, and chronicity of poor sleep duration. Moreover, the effect of ICT and daily stressors on future sleep duration was estimated with odds ratios, controlling for gender.Results: Prevalence (18.6%), incidence (12.8%) and chronicity (50%) rates indicate that poor sleep duration was persistent and increased one year later. Moreover, adolescents who often used ICT at bedtime (OR = 1.21, p < .001) and reported more school stress (OR = 1.16, p = .02), were more likely to report poor sleep duration one year later.Conclusion: Because poor sleep duration is common and persists over time, it is crucial to intervene early to prevent chronic sleep deprivation. Sleep interventions with younger adolescence, before chronicity occurs, should focus on barriers to change, such as stress and use of technology. The results from this study have been used to develop an early school-based intervention.
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| 8. |
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| 9. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Preventing sleep deficit in adolescents : Long-term effects of a quasi-experimental school-based intervention study
- 2020
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Ingår i: Journal of Sleep Research. - : Wiley-Blackwell. - 0962-1105 .- 1365-2869. ; 29:1
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Tidskriftsartikel (refereegranskat)abstract
- Adolescents are at risk of sleep deficit, which has serious consequences for their daytime functioning. However, school-based interventions to improve sleep have shown limited success. This might be due to the content of the programmes (e.g., not targeting central factors such as daytime stress and technology use) or because changes have not been captured due to a lack of long-term follow-ups. Hence, the aim of this study was to evaluate the long-term effects of a school-based sleep education curriculum including time-management training. The study used a quasi-experimental design. Participants were 3,622 adolescents (mean age 13.7, 48% girls); 286 were in the intervention group and 3,336 were followed as a natural control group. Data were collected before the intervention and at a 1-year follow-up. We divided participants into three groups according to baseline sleep duration (calculated from self-reported bed- and wake times, minus sleep onset latency): insufficient (<7 hr), borderline (7-8 hr) and adequate (>8 hr). Adolescents in the intervention group were ~2 times less likely to report insufficient sleep at follow-up as compared to controls. Sleep knowledge improved significantly in the intervention group but there were no changes in emotional sleep hygiene (e.g., bedtime worry) and perceived stress. Surprisingly, technology use increased and behavioural sleep hygiene worsened in the intervention group. Although the mechanisms of change need further investigation, the results of this study point to potential long-term benefits of school-based sleep programmes.
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| 10. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Sleep duration and patterns in adolescents : Correlates and the role of daily stressors
- 2016
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Ingår i: Sleep Health. - : Elsevier. - 2352-7218 .- 2352-7226. ; 2:3, s. 211-218
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The first aim of this study was to assess the prevalence of sleep deficit in a large sample of adolescents. Second, the study aimed to assess whether short sleep duration in the sample was associated with emotional and behavioral problems. Lastly, the study aimed to investigate the association between daily stressors-bedtime activities and sleep duration.Design: Cross-sectional survey.Setting: The questionnaires were completed during school hours in 17 municipal junior high schools in Sweden.Participants: A total of 2767 adolescents aged 12 to 16 years, 48% girls.Measurements and Results: Sleep measures included total sleep time (TST) for schooldays and weekends, obtained as combined measures of self-reported bed-time, wake-time, and sleep onset latency. We used the new National Sleep Foundation's guidelines to operationalize sleep duration. Overall 12% of younger adolescents (age 12-13 years) and 18% of older adolescents (14-16 years) slept less than recommended (TST < 7 hours). Adolescents reporting nonrecommended TST also reported more behavioral (ie, norm-breaking behaviors) and emotional problems (ie, depression, anxiety, and anger), with effects in the small-medium range. Finally, adolescents reporting bedtime arousal and use of information and communication technology in bed were more likely to report TST < 7 hours. Stress at home (for younger adolescents) and stress of school performance (for older adolescents) were also associated with TST less than 7 hours.Conclusions: The new National Sleep Foundation's recommendations were informative in this context. Future sleep interventions need to target barriers to good sleep practices, such as use of information and communication technology, stress, and worry that may contribute to arousal at bedtime.
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| 11. |
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| 12. |
- Bauducco, Serena V., 1988-, et al.
(författare)
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Too tired for school? : the effects of insomnia on absenteeism in adolescence
- 2015
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Ingår i: Sleep Health. - : Elsevier. - 2352-7218 .- 2352-7226. ; 1:3, s. 205-210
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Sleep has important consequences for a person's daytime functioning. Numerous studies have shown that insomnia predicts work absenteeism and work disability in adults, but only a few studies have examined this association in adolescents. This study aims to explore whether symptoms of insomnia in adolescents predict school absenteeism 1 year later, over and above known psychological risk factors for absenteeism.Design: The study used a longitudinal design with 2 measurement points over 1 year.Setting: The students completed questionnaires during school hours at baseline and again at follow-up.Participants: Students in the 10th to 12th grades in a Swedish upper secondary school were followed prospectively for 1 year (age, 16-20 years; N = 353; 48.1% girls).Measurements and results: We used logistic regression analyses, controlling for the known effects of psychological factors, and arrived at a model elucidating the role of insomnia. That is, besides symptoms of insomnia, the model included previous absenteeism, alcohol intoxication, school-related social phobia, social anxiety, depressive symptoms, somatic symptoms, and bully victimization. Symptoms of insomnia predicted school absenteeism 1 year later, over and above known risk factors for absenteeism. Adolescents reporting severe symptoms of insomnia were almost 3 times more likely than adolescents reporting no or low symptoms to report problematic absenteeism 1 year later. We did not find any gender difference.Conclusions: Our findings underscore the importance of sleep problems on adolescents' daytime functioning as measured by school absenteeism. Therefore, sleep may be an important target for preventive interventions with adolescents.
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| 13. |
- Beales, Darren, et al.
(författare)
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The Predictive Ability of the Full and Short Versions of the Orebro Questionnaire for Absenteeism and Presenteeism Over the Subsequent 12 months, in a Cohort of Young Community-Based Adult Workers
- 2021
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Ingår i: Journal of Occupational and Environmental Medicine. - : Lippincott Williams & Wilkins. - 1076-2752 .- 1536-5948. ; 63:12, s. 1058-1064
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary purpose of this study was to investigate the predictive ability of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) in regard to work productivity (absenteeism and presenteeism) in early adulthood.METHODS: A prospective study was performed using data from the Raine Study Generation 2 (Gen2) 22-year follow-up. The ÖMPSQ was completed at baseline, and absenteeism and presenteeism assessed at 4 intervals over the following 12 months.RESULTS: In early adulthood, the full and short versions of the ÖMPSQ showed some predictive ability for work absenteeism but the Receiver Operator Characteristic demonstrated poor discrimination. There was no evidence of predictive ability for presenteeism.CONCLUSION: Further work is required to increase the fidelity of screening for risk of reduced work productivity at the population level.
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| 14. |
- Beales, Darren, et al.
(författare)
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Work Productivity Loss in Young Workers Is Substantial and Is Associated With Spinal Pain and Mental Ill-health Conditions
- 2017
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Ingår i: Journal of Occupational and Environmental Medicine. - : Lippincott Williams & Wilkins. - 1076-2752 .- 1536-5948. ; 59:3, s. 237-245
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to estimate the effect of spinal pain and mental ill-health conditions on work productivity in 22-year-old workers.Methods: A cross-sectional design using data from the Raine Study cohort (n = 867) including self-reported work productivity and self-report of health practitioner diagnosed medical conditions.Result: Mean (median, 25th-percentile, 75th-percentile) annualized cost of health-related absenteeism was $AUD1899 ($0, $0, $1738) per worker. Annualized cost of presenteeism was $AUD10,674 ($6573, $4003, $13,087) per worker. Spinal pain and mental ill-health conditions were associated with increased health-related absenteeism, but not presenteeism.Conclusion: Work productivity loss in young workers is a substantial problem needing priority attention. Addressing spinal pain and mental ill-health may improve productivity of this important sector of the workforce.
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| 15. |
- Bergbom, Sofia, 1982-, et al.
(författare)
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Both early and late changes in psychological variables relate to treatment outcome for musculoskeletal pain patients at risk for disability
- 2013
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 50:11, s. 726-734
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Tidskriftsartikel (refereegranskat)abstract
- We know little about why some people get better after psychological treatments for pain disability, whereas other people do not. In order to understand differences in treatment response, we need to explore processes of change during treatment. It has been suggested that people with pain complaints who change early in treatment have better outcomes. Therefore, we aimed to investigate whether changes in psychological variables at different time points are related to outcome, and whether early or late changes are better predictors of outcome. We used the fear avoidance model as a theoretical framework. We followed 64 patients weekly over 6–7 weeks and then determined outcome. Our findings indicate that people who decrease in catastrophizing and function early in treatment as well as in depressive symptoms, worry, fear avoidance beliefs and function late in treatment have better outcomes. Early decreases in function, and late decreases in depressive symptoms and worry uniquely predict improvements in disability. While early and late changes covaried concurrently, there were no significant sequential relationships between early and late changes. Changes in the proposed process variables in the fear avoidance model, early as well as late in treatment, thus add valuable information to the explanation of outcome.
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| 16. |
- Bergbom, Sofia, 1982-, et al.
(författare)
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Early psychologically informed interventions for workers at risk for pain-related disability : does matching treatment to profile improve outcome?
- 2014
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Ingår i: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 24:3, s. 446-457
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This randomized controlled trial had two main aims. The first aim was to investigate the effect of early preventive, psychologically informed, interventions for pain-related disability. The second aim was explore whether people who are matched to an intervention specifically targeting their psychological risk profile had better outcomes than people who were not matched to interventions.Methods: A total of 105 participants were recruited from their workplace, screened for psychological risk factors and classified as being at risk for long-term pain-related disability. They were subgrouped into one of three groups based on their psychological profile. Three behaviorally oriented psychological interventions were developed to target each of the three risk profiles. Half of the participants were assigned a matched intervention developed to target their specific profile, and half were assigned an unmatched intervention. After treatment, repeated measure ANOVAs and χ2 tests were used to determine if treatments had an effect on primary and secondary outcomes including perceived disability, sick leave, fear and avoidance, pain catastrophizing and distress, and if matched participants had better outcomes than did unmatched.Results: Treatments had effects on all outcome variables (effect sizes d ranging between 0.23 and 0.66), but matched participants did not have better outcomes than unmatched.Conclusions: Early, preventive interventions have an impact on a number of outcome variables but it is difficult to realize a matching procedure. More in-depth research of the process of matching is needed.
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| 17. |
- Bergbom, Sofia, 1982-, et al.
(författare)
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Psykologer i primärvården - en förbisedd möjlighet
- 2017
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Ingår i: Nerikes Allehanda. - Örebro : Nerikes allehanda AB. - 1103-971X. ; :9 april
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Psykologer har den expertkunskap som krävs för att behandla dagens ohälsa, och regionen riskerar skapa en närsjukvård som tillhör B-laget genom att inte ta vara på psykologers kompetens. Evidensen pekar tydligt ut psykologisk behandling som förstahandsval vid behandling av sömnsvårigheter, depression, ångest och stressproblematik – ändå ignoreras psykologers kunskap i den arbetsgrupp som tillsatts för att tackla nutidens problematik i primärvården.
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| 18. |
- Bergbom, Sofia, 1982-, et al.
(författare)
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Relationship Among Pain Catastrophizing, Depressed Mood, and Outcomes Across Physical Therapy Treatments
- 2011
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Ingår i: Physical Therapy. - : Oxford University Press. - 0031-9023 .- 1538-6724. ; 91:5, s. 754-764
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pain catastrophizing and emotional distress can act as prognosticfactors for pain and disability. Research on how these variables interact withinindividuals and over time is in an early stage. Understanding various patterns ofprognostic factors and how these factors change during treatment is important fordeveloping treatments targeting important factors.Objective: The primary aim of this study was to investigate relationships betweenpain catastrophizing and depressed mood in people seeking primary care for mus-culoskeletal pain. An additional aim was to relate these patterns of prognostic factorsto outcomes during a 6-month period.Design: The design was prospective; data were obtained at baseline and atfollow-up.Methods: Forty-two physical therapists taking part in an educational programrecruited, from their clinical practices in primary care, consecutive patients whowere currently experiencing a pain problem. Patients received various physicaltherapy interventions between baseline and follow-up.Results: On the basis of patterns of scoring for pain catastrophizing and depressedmood, 4 subgroups of participants were found. Belonging to a subgroup withelevated levels of either pain catastrophizing or depressed mood at baseline wasrelated to the absence of improvement and elevated levels of disability after physicaltherapy interventions. Furthermore, elevated levels of both variables were related tothe highest levels of disability.Limitations: The analyses relied on self-report. Neither treatment content norpain-related fear was measured. The sample was a mixture of participants reportingacute pain and subacute pain.Conclusions: The results stress the importance of assessing and targeting prog-nostic factors. Moreover, the results suggest the need to tailor treatments to matchpatterns of prognostic factors and the need to target depressed mood and paincatastrophizing in physical therapy interventions.
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| 19. |
- Bergbom, Sofia, 1982-, et al.
(författare)
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When matching fails : Understanding the process of matching pain-disability treatment to risk profile
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Purpose A previous study [1] showed that matching people at risk for pain-related disability to an intervention aimed at targeting their psychological problem profile did not, as hypothesized, improve the effect of the intervention. Methodological issues were suggested to explain the lack of differential effect. It was questioned whether the profiles used to allocate people to treatment were adequate. The aim of this study was to investigate if the risk profiles used to determine matching were sufficiently stable and valid by comparing the original profiles withprofiles constructed using other methods.Methods Ninety-five people suffering musculoskeletal problems were screened, profiled, and matched to workplace based early interventions according to profiles. We studied stability and validity of their psychological risk profiles by investigating their concordance at different time points. People were originally assigned to profiles at inclusion, using a brief screening questionnaire. Then, they were profiled just before treatment start,using the same items. Finally, they were profiled again at treatment start, using extensive questionnaires. Concordance among the three sets of profiles was investigated.Results Profiles at inclusion were unstable until treatment start. People moved from profiles with more severe elevations in psychological variables, to a profile with moderate elevations. Concordance between the two means of profiling at treatment start was better; the brief screening and the extensive questionnaires assigned people to similar profiles.Conclusions Risk level may be determined with brief instruments at an early stage of problem development. However, profiles and targets for interventions should be determined immediately prior to treatment start, preferably using full questionnaires.
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| 20. |
- Bergbom, Sofia, 1982-, et al.
(författare)
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When matching fails : understanding the process of matching pain-disability treatment to risk profile
- 2015
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Ingår i: Journal of occupational rehabilitation. - : Springer Science and Business Media LLC. - 1053-0487 .- 1573-3688. ; 25:3, s. 518-526
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: A previous study (Bergbom et al. in J Occup Rehabil, 2013) showed that matching people at risk for pain-related disability to an intervention aimed at targeting their psychological problem profile did not, as hypothesized, improve the effect of the intervention. Methodological issues were suggested to explain the lack of differential effect. It was questioned whether the profiles used to allocate people to treatment were adequate. The aim of this study was to investigate if the risk profiles used to determine matching were sufficiently stable and valid by comparing the original profiles with profiles constructed using other methods.Methods: Ninety-five people suffering musculoskeletal problems were screened, profiled, and matched to workplace based early interventions according to profiles. We studied stability and validity of their psychological risk profiles by investigating their concordance at different time points. People were originally assigned to profiles at inclusion, using a brief screening questionnaire. Then, they were profiled just before treatment start, using the same items. Finally, they were profiled again at treatment start, using extensive questionnaires. Concordance among the three sets of profiles was investigated.Results: Profiles at inclusion were unstable until treatment start. People moved from profiles with more severe elevations in psychological variables, to a profile with moderate elevations. Concordance between the two means of profiling at treatment start was better; the brief screening and the extensive questionnaires assigned people to similar profiles.Conclusions: Risk level may be determined with brief instruments at an early stage of problem development. However, profiles and targets for interventions should be determined immediately prior to treatment start, preferably using full questionnaires.
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| 21. |
- Berglund, Per, et al.
(författare)
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Linking Education and Research : A Roadmap for Higher Education Institutions at the Dawn of the Knowledge Society
- 2019
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Ingår i: Linking education and research. - Basel, Switzerland : MDPI. ; , s. 11-33
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- In an era characterized by a move towards a “knowledge society”, universities are central in fostering “knowledgeability”, that is the reflexive understanding of knowledge in knowledge societies. The objective of “knowledgeability” can be met through creating a stronger link between education and research. Furthermore, overall student performance, for example in critical thinking and problem solving, can be improved if research-related activities are incorporated into the curriculum.The aim of this paper is to use international examples to discuss the research- education nexus from four different perspectives, namely context, policy, implementation and quality, with case studies from higher education institutions in Singapore and Sweden.We suggest that different integrative technologies can be used to enhance the links, but it will be essential to consider the inputs of training, service and support in using new technology. Interestingly, the act of evaluating the link between education and research will increase awareness of this linkage by stakeholders involved in both education and research. In turn the link can be strengthened, contributing to increased quality in both education and research.
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| 22. |
- Bergman Nordgren, Lise, et al.
(författare)
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Polariserad debatt om riktlinjer skymmer viktiga frågor
- 2018
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 115:37, s. 1372-1372
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Debatten om Socialstyrelsens nya riktlinjer för ångest och depression har varit polariserad och inte konstruktiv. Diskussionen bör inte handla om PDT eller KBT utan om evidensbaserade metoder och kompetensbrist.
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| 23. |
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| 24. |
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| 25. |
- Besen, Elyssa, et al.
(författare)
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The role of pain catastrophizing as a mediator in the work disability process following acute low back pain
- 2017
-
Ingår i: Journal of applied biobehavioral research. - : John Wiley & Sons. - 1071-2089 .- 1751-9861. ; 22:1
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to assess pain catastrophizing as a mediator in the relationships between pain and recovery expectations with work limitations and functional disability in a working population experiencing acute low back pain (LBP). Workers (n=241) with acute, work-related LBP completed measures of pain and injury at medical intake and then the Pain Catastrophizing Scale (PCS) shortly after the initial intake visit. At 3-months follow-up, measures of work limitations and functional disability were administered. Structural equation modeling was used to assess whether the PCS mediated longitudinal associations between pain and recovery expectations with perceived disability and work limitations. The PCS score completely mediated the relationship between initial pain intensity and 3-month perceptions of disability (40% explained) and work limitations (29% explained). The PCS also completely mediated the longitudinal relationship between pain recovery expectations and 3-month disability (50% explained) and work limitations (40% explained). Effective clinical management during this acute phase of LBP might be improved by incorporating early interventions to reduce catastrophizing in caseswhere pain catastrophizing may be especially problematic.
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| 26. |
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| 27. |
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| 28. |
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| 29. |
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| 30. |
- Boersma, Katja, professor, 1973-, et al.
(författare)
-
Efficacy of a transdiagnostic emotion-focused exposure treatment for chronic pain patients with comorbid anxiety and depression : a randomized controlled trial
- 2019
-
Ingår i: Pain. - : Lippincott Williams & Wilkins. - 0304-3959 .- 1872-6623. ; 160:8, s. 1708-1718
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Tidskriftsartikel (refereegranskat)abstract
- The comorbidity between chronic pain and emotional problems has proven difficult to address with current treatment options. This study addresses the efficacy of a transdiagnostic emotion-focused exposure treatment ("hybrid") for chronic pain patients with comorbid emotional problems. Adults (n = 115) with chronic musculoskeletal pain and functional and emotional problems were included in a 2-centre, parallel randomized controlled, open-label trial comparing this treatment to an active control condition receiving a guided Internet-delivered pain management treatment based on CBT principles (iCBT). The hybrid treatment (n = 58, 10-16 sessions) integrates exposure in vivo for chronic pain based on the fear-avoidance model with an emotion-regulation approach informed by procedures in Dialectical Behavior Therapy. The iCBT (n = 57; 8 treatment modules) addresses topics such as pain education, coping strategies, relaxation, problem solving, stress, and sleep management using standard CBT techniques. Patient-reported outcomes were assessed before and after treatment as well as at a 9-month primary end point. Across conditions, 78% participants completed post-treatment and 81% follow-up assessment. Intent-to-treat analyses showed that the hybrid had a significantly better post-treatment outcome on pain catastrophizing (d = 0.39) and pain interference (d = 0.63) and significantly better follow-up outcomes on depression (d = 0.43) and pain interference (d = 0.51). There were no differences on anxiety and pain intensity. Observed proportions of clinically significant improvement favoured the hybrid on all but one comparison, but no statistically significant differences were observed. We conclude that the hybrid emotion-focused treatment may be considered an acceptable, credible, and efficacious treatment option for chronic pain patients with comorbid emotional problems.
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| 31. |
- Boersma, Katja, professor, 1973-, et al.
(författare)
-
Emotion regulation in chronic pain patients with emotional difficulties : A DBT-inspired exposure treatment
- 2016
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Co-occuring pain and emotional difficulties are strikingly common and a true challenge in the clinic. Nearly all pain patients suffer from some kind of emotional distress. Difficulties with emotion regulation has been pointed out as one core process, which may explain the high co-occurrence of pain and emotional distress. Current treatments have not succeeded in helping pain patients with high levels of emotional distress, and therefore a new treatment approach has been developed, based on emotion regulation theory, DBT and exposure techniques. This presentation will describe the theory behind this new intervention and present preliminary data from a randomized controlled trial in patients with chronic pain and emotional distress. This trial compares the effectiveness of a DBT inspired exposure treatment with internet-based CBT for chronic pain.
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| 32. |
- Boersma, Katja, professor, 1973-, et al.
(författare)
-
Expectancy, fear and pain in the prediction of chronic pain and disability : A prospective analysis
- 2006
-
Ingår i: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 10:6, s. 551-557
-
Tidskriftsartikel (refereegranskat)abstract
- Studies with (sub) acute back pain patients show that negative expectancies predict pain and disability at a one-year follow up. Yet, it is not clear how expectations relate to other factors in the development of chronic disability such as pain and fear. This study investigates the relationship between expectations, pain-related fear and pain and studies how these variables are related to the development of chronic pain and disability. Subjects (N = 141) with back and/or neck pain (duration <1 year) were recruited via primary care. They completed measures on pain, expectancy, pain-related fear (pain-related negative affect and fear avoidance beliefs) and function. A one-year follow up was conducted with regard to pain and function. It was found that pain, expectancy, pain-related fear and function were strongly interrelated. In the cross-sectional analyses negative expectancies were best explained by frequent pain and a belief in an underlying and serious medical problem. Prospectively, negative expectancy, negative affect and a belief that activity may result in (re) injury or increased pain, explained unique variance in both pain and function at one-year follow up. In conclusion, expectancy, negative affect and fear avoidance beliefs are interrelated constructs that have predictive value for future pain and disability. Clinically, it can be helpful to inquire about beliefs, expectancy and distress as an indication of risk as well as to guide intervention. However, the strong interrelations between the variables call for precaution in treating them as if they were separate entities existing in reality.
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| 33. |
- Boersma, Katja, 1973-, et al.
(författare)
-
Exposure-based cognitive behavioral therapy for irritable bowel syndrome : A single-case experimental design across 13 subjects
- 2016
-
Ingår i: Cognitive Behaviour Therapy. - Oxon, United Kingdom : Routledge. - 1650-6073 .- 1651-2316. ; 45:6, s. 415-430
-
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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| 34. |
- Boersma, Katja, 1973-, et al.
(författare)
-
From acute pain to chronic disability : psychosocial processes in the development of chronic musculoskeletal pain and disability
- 2014
-
Ingår i: Handbook of musculoskeletal pain and disability disorders in the workplace. - New York : Springer. - 9781493906116 - 9781493906123 ; , s. 205-217
-
Bokkapitel (refereegranskat)abstract
- In the last decades, there has been a clear recognition of the importance of psychosocial factors in the explanation of chronic musculoskeletal pain. It is generally accepted that chronic musculoskeletal pain and disability has multiple causes, a view that is summarized in the so-called biopsychosocial models (Gatchel, Peng, Peters, Fuchs, & Turk, 2007). However, psychosocial factors have proven to be important predictors of chronic pain and disability already early on in acute and subacute stages of pain. A range of reviews conclude that factors, such as depression, anxiety, pain beliefs, catastrophizing, and coping behaviors, play a primary role in the transition from acute to chronic pain and disability (Linton, 2002; Main, Sullivan, & Watson, 2007; Nicholas, Linton, Watson, & Main, 2011). This supports the notion that psychosocial factors are preferably viewed as an integrated part of musculoskeletal pain, not only in the rehabilitation of chronic problems but also in prevention in the subacute stages.
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| 35. |
- Boersma, Katja, 1973-, et al.
(författare)
-
Lowering fear-avoidance and enhancing function through exposure in vivo : a multiple baseline study across six patients with back pain
- 2004
-
Ingår i: Pain. - : Elsevier. - 0304-3959 .- 1872-6623. ; 108:1-2, s. 8-16
-
Tidskriftsartikel (refereegranskat)abstract
- This study investigated the effects of an exposure in vivo treatment for chronic pain patients with high levels of fear and avoidance. The fear-avoidance model offers an enticing explanation of why some back pain patients develop persistent disability, stressing the role of catastrophic interpretations; largely fueled by beliefs and expectations that activity will cause injury and will worsen the pain problem. Recently, an exposure in vivo treatment was developed that aims to enhance function by directly addressing these fears and expectations. The purpose of this study was to describe the short-term, consequent effect of an exposure in vivo treatment. The study employed a multiple baseline design with six patients who were selected based on their high levels of fear and avoidance. The results demonstrated clear decreases in rated fear and avoidance beliefs while function increased substantially. These improvements were observed even though rated pain intensity actually decreased somewhat. Thus, the results replicate and extend the findings of previous studies to a new setting, with other therapists and a new research design. These results, together with the initial studies, provide a basis for pursuing and further developing the exposure technique and to test it in group designs with larger samples.
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| 36. |
- Breivik, Harald, et al.
(författare)
-
High risk of depression and suicide attempt among chronic pain patients : always explore catastrophizing and suicide thoughts when evaluating chronic pain patients
- 2014
-
Ingår i: Scandinavian Journal of Pain. - : Elsevier. - 1877-8860 .- 1877-8879. ; 5:1, s. 1-3
-
Tidskriftsartikel (refereegranskat)abstract
- A grave but important problem in the treatment of pain, is suicide. While many chronic pain problems are not life threatening, self-harming, e.g. suicide attempts are. Clinicians may ask whether suicide-risk is actually higher in a population of patients with chronic pain. In this issue of the Scandinavian Journal of Pain Elsebeth Stenager and her co-workers publish an important study in which they have combined the WHO research database in Odense on all suicide attempts in Southern Denmark with the database on patients referred to the multidisciplinary university pain clinic in Odense,Denmark. The WHO-database comprises only suicide attempts that resulted in hospitalization, i.e. they were all serious attempts. Suicide attempts of less serious character are not registered, so the research database is probably underestimating the real number of suicide attempts. The unique strength of the Stenager et al. study is that their data are strong, objective data fromc ombining the registry data on suicide attempts with their chronic pain patient-data. This enables the researchers to compare the pain–patient–population with the general population. We are not aware of any similar research on the real risk of suicide-attempts among the many who are burdened by chronic non-cancer pain.
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| 37. |
- Buer, Nina, 1960-, et al.
(författare)
-
Fear-avoidance beliefs and catastrophizing : occurrence and risk factor in back pain and ADL in the general population
- 2002
-
Ingår i: Pain. - 0304-3959 .- 1872-6623. ; 99:3, s. 485-491
-
Tidskriftsartikel (refereegranskat)abstract
- Fear-avoidance beliefs and catastrophizing have been shown to be powerful cognitions in the process of developing chronic pain problems and there is a need for increased knowledge in early stages of pain.The objectives of this study were therefore, firstly, to examine the occurrence of fear-avoidance beliefs and catastrophizing in groups with different degrees of non-chronic spinal pain in a general population, and secondly to assess if fear-avoidance beliefs and catastrophizing were related to current ratings of pain and activities of daily living (ADL).The study was a part of a population based back pain project and the study sample consisted of 917 men and women, 35-45 years old, either pain-free or with non-chronic spinal pain. The results showed that fear-avoidance beliefs as well as catastrophizing occur in this general population of non-patients. The levels were moderate and in catastrophizing a 'dose-response' pattern was seen, such that more the catastrophizing was, the more was pain. The study showed two relationships, which were between fear-avoidance and ADL as well as between catastrophizing and pain intensity. Logistic regression analyses were performed with 95% confidence intervals and the odds ratio for fear-avoidance beliefs and ADL was 2.5 and for catastrophizing and pain 1.8, both with confidence interval above unity. The results suggest that fear-avoidance beliefs and catastrophizing may play an active part in the transition from acute to chronic pain and clinical implications include screening and early intervention. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.
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| 38. |
- Caneiro, J. P., et al.
(författare)
-
From Fear to Safety : A Roadmap to Recovery from Musculoskeletal Pain
- 2022
-
Ingår i: Physical Therapy. - : Oxford University Press. - 0031-9023 .- 1538-6724. ; 102:2
-
Tidskriftsartikel (refereegranskat)abstract
- Contemporary conceptualizations of pain emphasize its protective function. The meaning assigned to pain drives cognitive, emotional, and behavioral responses. When pain is threatening, and a person lacks control over their pain experience, it can become distressing, self-perpetuating, and disabling. Although the pathway to disability is well established, the pathway to recovery is less researched and understood. This Perspective draws on recent data on the lived experience of people with pain-related fear to discuss both fear and safety learning processes and their implications for recovery for people living with pain. Recovery is here defined as achievement of control over pain, as well as improvement in functional capacity and quality of life. Based on the common-sense model, this Perspective proposes a framework utilizing cognitive functional therapy to promote safety learning. A process is described in which experiential learning combined with "sense making" disrupts a person's unhelpful cognitive representation and behavioral and emotional response to pain, leading them on a journey to recovery. This framework incorporates principles of inhibitory processing that are fundamental to pain-related fear and safety learning.
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| 39. |
- Caneiro, J. P., et al.
(författare)
-
How does change unfold? an evaluation of the process of change in four people with chronic low back pain and high pain-related fear managed with Cognitive Functional Therapy : A replicated single-case experimental design study
- 2019
-
Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 117, s. 28-39
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To understand the process of change at an individual level, this study used a single-case experimental design to evaluate how change in potential mediators related to change in disability over time, during an exposure-based behavioural intervention in four people with chronic low back pain and high pain-related fear. A second aim was to evaluate whether the change (sequential or simultaneous) in mediators and disability occurred at the same timepoint for all individuals.RESULTS: For all participants, visual and statistical analyses indicated that changes in disability and proposed mediators were clearly related to the commencement of Cognitive Functional Therapy. This was supported by standard outcome assessments at pre-post timepoints. Cross-lag correlation analysis determined that, for all participants, most of the proposed mediators (pain intensity, pain controllability, and fear) were most strongly associated with disability at lag zero, suggesting that mediators changed concomitantly and not before disability. Importantly, these changes occurred at different rates and patterns for different individuals, highlighting the individual temporal variability of change.CONCLUSION: This study demonstrated the interplay of factors associated with treatment response, highlighting 'how change unfolded' uniquely for each individual. The findings that factors underpinning treatment response and the outcome changed simultaneously, challenge the traditional understanding of therapeutic change.
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| 40. |
- Carstens, Johan K. P., 1979-, et al.
(författare)
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Effects of validating communication on recall during a pain-task in healthy participants
- 2017
-
Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter. - 1877-8860 .- 1877-8879. ; 17, s. 118-125
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Increasing recall of instructions and advice in a pain consultation is important, since it is a prerequisite for adherence to treatment recommendations. However, interference due to pain-related distress may result in poor recall. Whereas there are some indications that recall can be increased by empathic communication that reduces interference, this interesting possibility remains largely untested experimentally. The current experiment aimed at studying effects of empathic communication, and more specifically validation, on recall during a pain test and possible mediators and moderators of this effect.METHOD: Participants received either validating (N=25) or invalidating responses (N=25) from the experimenter during a pain provoking task, followed by self-report measures of interference (affect, situational pain catastrophizing) and recall (accurate and false memories of words).RESULTS: As expected, the validated group exhibited higher accurate recall and less false memories following the pain test as compared to the invalidated group. This was partly due to the effect of interference being counteracted by moderating the relationship between pain catastrophizing and recall.CONCLUSION: These novel results suggest that validating communication can counteract interference due to pain catastrophizing on recall, at least in a controlled experimental setting.IMPLICATIONS: Good communication by health professionals is of utmost importance for adherence to pain management. The current results expand our knowledge on the effects of pain communication by establishing and explaining a clear link between empathic communication and recall, highlighting the role of pain catastrophizing.
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| 41. |
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| 42. |
- Carstens Söderstrand, Johan, 1979-
(författare)
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Communication in the context of acute pain : Persuasion or validation?
- 2018
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Historically, the dominating theoretical framework for communication in the context of acute pain is reassurance. An inherent assumption of this framework is that the person in pain needs to have their fears and doubts removed and be educated, or persuaded, that the pain problem is not dan-gerous. This is then thought to lead to a shift in beliefs that later explain future beneficial outcomesIn later years, another communication technique known as validation has started to gain traction in the pain field. This technique focuses on le-gitimizing the thoughts and emotions of pain patients and is instead thought to influence outcomes through better emotion regulation.The overall aim of this dissertation is to extend current knowledge on effective communication in the context of acute pain. In one observational study a variable supposedly sensitive to shifts in beliefs was observed in a cohort of acute pain patients over the course of the first three months after pain onset. Also, in two controlled experiments we explored the impact of validating communication on pain relevant variables while investigating if this effect was due to improved emotion regulation.Taken together, this dissertation indicates that validating communica-tion shows promise as a form of effective communication in the context of acute pain, in that it influences both pain catastrophizing and recall. The dissertation does not give support to either changes in beliefs nor emotion regulation being the mechanism of change for effective communication. Thus, this dissertation propose a new model of effective communication based both on previous research highlighting the effectiveness of infor-mation and the research presented in this dissertation, more focused on the role of psychological processes such as pain catastrophizing.
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| 43. |
- Coenen, Pieter, et al.
(författare)
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The association of adolescent spinal-pain-related absenteeism with early adulthood work absenteeism : A six-year follow-up data from a population-based cohort
- 2018
-
Ingår i: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health. - 0355-3140 .- 1795-990X. ; 44:5, s. 521-529
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Spinal (ie, back and neck) pain often develops as early as during adolescence and can set a trajectory for later life. However, whether early-life spinal-pain-related behavioral responses of missing school/work are predictive of future work absenteeism is yet unknown. We assessed the association of adolescent spinal-pain-related work or school absenteeism with early adulthood work absenteeism in a prospective population-based cohort.Methods: Six year follow-up data from the Western Australian Pregnancy Cohort (Raine) study were used (N=476; with a 54% response rate). At age 17, participants reported spinal pain (using the Nordic questionnaire) and adolescent spinal-pain-related work/school absenteeism (with a single item question). Annual total and health-related work absenteeism was assessed with the Health and Work Performance questionnaire distributed in four quarterly text messages during the 23rd year of age. We modelled the association of adolescent spinal-pain-related absenteeism with work absenteeism during early adulthood, using negative binomial regression adjusting for sex, occupation and comorbidities.Results: Participants with adolescent low-back or neck pain with work/school absenteeism reported higher total work absenteeism in early adulthood [148.7, standard deviation (SD) 243.4 hours/year], than those without pain [43.7 (SD 95.2) hours/year); incidence rate ratio 3.4 (95% CI 1.2-9.2)]. Comparable findings were found when considering low-back and neck separately, and when considering health-related absenteeism.Conclusions: We found a more than three-fold higher risk of work absenteeism in early adulthood among those with adolescent spinal-pain-related absenteeism, compared to those without. These findings suggest that, to keep a sustainable workforce, pain prevention and management should focus on pain-related behaviors as early as in adolescence.
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| 44. |
- Danielsson, Nanette S., 1967-, et al.
(författare)
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Sleep Disturbance and Depressive Symptoms in Adolescence : The Role of Catastrophic Worry
- 2013
-
Ingår i: Journal of Youth and Adolescence. - : Springer Science and Business Media LLC. - 0047-2891 .- 1573-6601. ; 42:8, s. 1223-1233
-
Tidskriftsartikel (refereegranskat)abstract
- Depression is a common and debilitating disorder in adolescence. Sleep disturbances and depression often co-occur with sleep disturbances frequently preceding depression. The current study investigated whether catastrophic worry, a potential cognitive vulnerability, mediates the relationship between adolescent sleep disturbances and depressive symptoms, as well as whether there are gender differences in this relationship. High school students, ages 16-18, n = 1,760, 49 % girls, completed annual health surveys including reports of sleep disturbance, catastrophic worry, and depressive symptoms. Sleep disturbances predicted depressive symptoms 1-year later. Catastrophic worry partially mediated the relationship. Girls reported more sleep disturbances, depressive symptoms, and catastrophic worry relative to boys. The results, however, were similar regardless of gender. Sleep disturbances and catastrophic worry may provide school nurses, psychologists, teachers, and parents with non-gender specific early indicators of risk for depression. Several potentially important practical implications, including suggestions for intervention and prevention programs, are highlighted.
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| 45. |
- Edebol-Carlman, Hanna, 1984-, et al.
(författare)
-
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
-
Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter. - 1877-8860 .- 1877-8879. ; 18, s. 81-91
-
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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| 46. |
- 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
-
Ingår i: Gastroenterology Research and Practice. - : Hindawi Publishing Corporation. - 1687-6121 .- 1687-630X.
-
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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| 47. |
- Edlund, Sara, 1983-
(författare)
-
Calm down : strategies for emotion regulation in clinical practice
- 2017
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Problems with emotion regulation are common in people who seek help from health care professionals working with problems featuring psychological factors. Two such patient groups, chronic pain patients and patients with severe anxiety, are of interest in this dissertation. Effectively regulating and increasing functional emotion regulation in these patients is often challenging for clinicians, and effective strategies are needed. One treatment that greatly emphasizes the importance of functional emotion regulation is dialectical behavior therapy (DBT). DBT has a strong empirical basis in other patients with severe problems with emotion regulation, raising the question of whether the treatment and its more specific components (e.g., validation, which means communicating understanding and acceptance) could be effec-tive in the groups of patients of interest here.Accordingly, the overall aim of this dissertation was to expand our knowledge of how to use functional emotion-regulation strategies from DBT to regulate emotions in patients with chronic pain or treatment-resistant anxiety disorders. Study I examined whether brief training was enough to increase validation in partners of people with chronic pain, and whether this was associated with better-regulated emotion in the people with chronic pain. Study II explored patient perceptions of validation and invalidation by the physician in a clinical chronic pain context. Lastly, study III investi-gated whether a more extensive treatment intervention inspired by DBT was feasible and effective in patients suffering from treatment-resistant anxiety disorders.The findings indicate that emotion-regulation strategies from DBT can be effective in regulating emotions in these patients. The dissertation also illus-trates some of the difficulties in doing this, providing important information for future work, such as suggestions for modifications that might further increase positive outcomes.
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| 48. |
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| 49. |
- Edlund, Sara M., 1983-, et al.
(författare)
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I see you're in pain : the effects of partner validation on emotions in people with chronic pain
- 2015
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Ingår i: Scandinavian Journal of Pain. - : Elsevier. - 1877-8860 .- 1877-8879. ; 6, s. 16-21
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and aimsChronic pain not only affects the person in pain, but can also have a negative impact on relationships with loved ones. Research shows that chronic pain is associated with difficulties in marital relationships, which in turn is related to a variety of negative outcomes such as psychological distress and conflict within the family. This suggests that couples where chronic physical pain is present also struggle with emotional pain and relationship problems, and thus targeting relationship skills and interpersonal functioning might be helpful for these couples. Although studies in this area are promising, their numbers are few. In the present study, validation as a way of communicating is suggested for handling emotional expression in interpersonal interactions. Validation communicates understanding and acceptance of the other person's experience, and it has been shown to have a down-regulating effect on negative emotions. It has previously been demonstrated to be important for these couples. However, the feasibility and effects of increasing partner validation in these couples are unknown. Therefore, the aim of the present study was to investigate if a brief training session in validation for spouses would result in more validating and fewer invalidating responses towards their partners with pain, and to investigate if changes in these behavioural responses were associated with changes in emotion and pain level in the partner with pain.MethodsParticipants were 20 couples where at least one partner reported chronic pain. The study employed a within-groups design in which spouses of people with pain received validation training (without their partner's knowledge), and their validating and invalidating responses were rated pre- and post-intervention using a reliable observational scale. Also, positive and negative affect and subjective pain level in the persons with pain were rated pre- and post-intervention.ResultsResults showed that the validation training was associated with increased validating and decreased invalidating responses in the partners. Their spouses with chronic pain reported a decrease in negative affect from pre- to post-training.ConclusionsOur results indicate that the partner or closest family member, after brief validation training, increased validating responses and decreased invalidating responses towards the person with pain, which had an immediate positive impact on emotions in the other person.ImplicationsThis study suggests that using validation in interpersonal interactions is a promising tool for couples where chronic pain is present.
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