| 1. |
- Barck-Holst, Peter, et al.
(författare)
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Coping with stressful situations in social work before and after reduced working hours, a mixed-methods study
- 2019
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Ingår i: European Journal of Social Work. - : Informa UK Limited. - 1369-1457 .- 1468-2664.
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about how reduced working hours relate to social work stressors, coping and work-life balance. An exploratory mixed methods study was therefore performed at a Swedish social service agency participating in a quasi-experimental trial of work-time reduction by 25%, with proportionally reduced workload, and retained full-time pay. Social workers that reduced their working hours reported less emotional exhaustion (n = 28, p < 0.05) on the Maslach Burnout Inventory-Human Services Survey, and less reactivity in stressful situations connected to time urgency and irritation (n = 28, p < 0.05) on the Everyday Life Stress Scale. In interviews, the social workers described that despite using effective, problem-focused coping behaviour at work, both before and after work-time reduction, high caseload remained a central stressor, creating time conflicts that exacerbated stressful situations involving emergencies, practical setbacks, client aggression, report deadlines, and managerial stress. In contrast, the work-time reduction was described as fully resolving time conflicts and stress during free-time in situations that involved finding time for friends, household chores, rest, exercise and childcare. Results suggest that reduced working hours lowered emotional exhaustion and situational reactivity by increasing free-time recovery opportunities and decreasing total daily exposure to work stress, but future trials should also compare reduced work-time with reduced caseload.
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| 2. |
- Boström, Adrian Desai E., et al.
(författare)
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Accelerated epigenetic aging in women with emotionally unstable personality disorder and a history of suicide attempts
- 2023
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Ingår i: Translational Psychiatry. - : Nature Publishing Group. - 2158-3188. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Emotional unstable personality disorder (EUPD; previously borderline personality disorder, BPD) is associated with excess natural-cause mortality, comorbid medical conditions, poor health habits and stress related epigenomic alterations. Previous studies demonstrated that GrimAge – a state-of-the-art epigenetic age (EA) estimator – strongly predicts mortality risk and physiological dysregulation. Herein, we utilize the GrimAge algorithm to investigate whether women with EUPD and a history of recent suicide attempts exhibit EA acceleration (EAA) in comparison to healthy controls. Genome-wide methylation patterns were measured using the Illumina Infinum Methylation Epic BeadChip in whole blood from 97 EUPD patients and 32 healthy controls. The control group was significantly older (p < 0.0001) and reported lesser exposure to violent behavior in both youth and adulthood (p < 0.0001). Groups were otherwise comparable regarding gender, BMI, or tobacco usage (p > 0.05). EA estimator DNAmGrimAge exceeded chronological age by 8.8 and 2.3 years in the EUPD and control group, respectively. Similarly, EAA marker AgeAccelGrim was substantially higher in EUPD subjects when compared to controls, in both univariate and multivariate analyzes (p < 0.00001). Tobacco usage conferred substantial within-group effects on the EA-chronological age difference, i.e., 10.74 years (SD = 4.19) compared to 6.00 years (SD = 3.10) in the non-user EUPD group (p < 0.00001). Notably, past alcohol and substance abuse, use of psychotropic medications, global assessment of functioning, self-reported exposure to violent behavior in youth and adulthood, later completed suicide (N = 8) and age at first suicide attempt did not predict EAA in the EUPD group (p > 0.05). These results underscore the importance of addressing medical health conditions along with low-cost preventative interventions aimed at improving somatic health outcomes in EUPD, such as efforts to support cessation of tobacco use. The independency of GrimAge to other EA algorithms in this group of severely impaired EUPD patients, suggest it may have unique characteristics to evaluate risk of adverse health outcomes in context of psychiatric disorders.
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| 3. |
- Hadding, Cecilia, 1976-
(författare)
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”Att nästan inte få existera” : före detta sektmedlemmars erfarenheter – med fokus på psykisk hälsa och mötet med sjukvården
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The controlling culture of a cult can be harmful to its members. Living in and leaving a cult can be challenging, lead to mental illness and experience the need for support.Aims: I - To explore former cult members' perceptions of consultations with healthcare professionals for mental illness that they relate to their cult involvement. The study also aims to identify the needs, obstacles, and facilitating factors related to these consultations. II - To explore the experiences of acculturation into secular Swedish society of former members of cults, with particular focus on mental health, needs and resources. III - To explore exposure to violence and coercive control in cults, and its consequences for mental health.Design: A qualitative approach was used in all studies. Semi structured interviews (I, III) and the cultural formulation interview from DSM -5 (II) were used to collect data. Studies I and II were analyzed using qualitative content analysis with systematic text condensation. Study III was analyzed using reflexive thematic analysis.Participants: Adult former members of ideological or religion-based cults. Studies I and III include nineteen participants who had been in contact with Swedish healthcare professionals due to mental illness related to their cult involvement. Study II include eleven participants.Results: Being a cult member involved constant exposure to threats and violence. The acculturation process after leaving the cult put them in an in-between state and it took time and effort to resettle in mainstream society. They struggled with a persisting coercive bond to the cult's ideals, shame, trauma, and mental health sequalae. In their consultations with healthcare professionals the former cult members remained affected by the cults rules and belief system. This made it harder for them to communicate their needs and accept care.Conclusion: Former cult members face a complex acculturation process while they struggle in several aspects of life with mental health, shame, problems with trust and personal boundaries. To effectively understand and support former cult members, healthcare professionals must consider both the cultural and existential aspects of former cult members' lives, in addition to their mental health and persisting bond to the cult.
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| 4. |
- Jamshidi, Esmail, et al.
(författare)
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Increased methylation of brain-derived neurotrophic factor (BDNF) is related to emotionally unstable personality disorder and severity of suicide attempt in women
- 2023
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Ingår i: Cells. - : MDPI AG. - 2073-4409. ; 12:3
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Tidskriftsartikel (refereegranskat)abstract
- Brain-derived neurotrophic factor (BDNF) has previously been associated with the pathogenesis of both emotionally unstable personality disorder (EUPD) and suicidal behavior. No study has yet investigated BDNF-associated epigenetic alterations in a group of severely impaired EUPD and suicidal patients. The discovery cohort consisted of 97 women with emotionally unstable personality disorder (EUPD) with at least two serious suicide attempts (SAs) and 32 healthy female controls. The genome-wide methylation pattern was measured by the Illumina EPIC BeadChip and analyzed by robust linear regression models to investigate mean BDNF methylation levels in a targeted analysis conditioned upon severity of suicide attempt. The validation cohort encompassed 60 female suicide attempters, stratified into low- (n = 45) and high-risk groups (n = 15) based on degree of intent-to-die and lethality of SA method, and occurrence of death-by-suicide at follow-up. Mean BDNF methylation levels exhibited increased methylation in relation to EUPD (p = 0.0159, percentage mean group difference ~3.8%). Similarly, this locus was confirmed as higher-methylated in an independent cohort of females with severe suicidal behavior (p = 0.0300). Results were independent of age and BMI. This is the first study to reveal emerging evidence of epigenetic dysregulation of BDNF with dependence on features known to confer increased risk of suicide deaths (lethality of suicide-attempt method and presence of EUPD diagnosis with history of recent SAs). Further studies investigating epigenetic and genetic effects of BDNF on severe suicidal behavior and EUPD are needed to further elucidate the role of epigenetic regulatory mechanisms and neurotrophic factors in relation to suicide and EUPD, and hold potential to result in novel treatment methods.
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| 5. |
- Klintbjer, Piroska, et al.
(författare)
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On the development of the child's ability to identify affective state from the prosodic features of adult speech
- 1984
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The ability to judge emotional states (anger, surprise, sadness and happiness) from the non- verbal components of speech was studied in 169 children aged from 4 to 10 years (20- 43 children per group, one group for each year of age except 9) in Uppsala, Sweden . 19 adults were used as a control group. The stimulus material consisted of speech samples, in which a male and a female actor had been instructed to portray the indicated emotional states.In general, the ability to make correct judgements increased with increased age. This was especially the case with the recognition of "surprise", "sadness" and "happiness", for which emotions increasing improvements were seen up to t he age of 8, where the ability was close to that of the adult controls. The ability to recognise an angry voice appeared to be well developed already at the age of 4.The most difficult item was the male voice portraying "happiness", where the children did not show and increase in their scores until the age of 8. Girls were found to have a more developed ability to identify the expressed emotions in all age groups.In most cases where erroneous judgements were made, the male voice was judged to be angry and the female to be sad, irrespective of intended emotion and of the sex of the child.
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| 6. |
- Nilsonne, Åsa, et al.
(författare)
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Measuring the rate of change of voice fundamental frequency in fluent speech during mental depression
- 1988
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Ingår i: The Journal of the Acoustical Society of America. - : American Institute of Physics (AIP). - 0001-4966. ; 83:2, s. 716-728
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Tidskriftsartikel (refereegranskat)abstract
- A method of measuring the rate of change of fundamental frequency has been developed in an effort to find acoustic voice parameters that could be useful in psychiatric research. A minicomputer program was used to extract seven parameters from the fundamental frequency contour of tape‐recorded speech samples: (1) the average rate of change of the fundamental frequency and (2) its standard deviation, (3) the absolute rate of fundamental frequency change, (4) the total reading time, (5) the percent pause time of the total reading time, (6) the mean, and (7) the standard deviation of the fundamental frequency distribution. The method is demonstrated on (a) a material consisting of synthetic speech and (b) voice recordings of depressed patients who were examined during depression and after improvement.
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| 7. |
- Perseius, Kent-Inge, et al.
(författare)
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Does dialectical behavioural therapy reduce treatment cost for patients with borderline personality disorder : A pilot study
- 2004
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Ingår i: Vård i Norden. - : Sykepleiernes Samarbeid i Norden,Northern Nurses Federation. - 0107-4083 .- 1890-4238. ; 24:2, s. 27-30
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Tidskriftsartikel (refereegranskat)abstract
- Objective: In order to assess costs - consequences of dialectal behavioural therapy (DBT) in suicidal women with borderline personality disorder (BPD), the present study takes advantage of pilot data collected during a training phase, in relation to a large scale randomised controlled trail (RCT). Method: Under a 18 month period, 22 suicidal women with BPD were treated with outpatient DBT, with focus on reducing parasuicidal behaviour. Outcome data collected retrospectively 12 months before therapy start, were compared to prospective data collected up to 18 months in therapy. The cost - analysis included direct health care costs only. Results & Conclusions: The results suggest that DBT may have a positive impact on treatment costs, which decreased significantly during the last 12 months in a 18 month therapy period. The reduction of costs is due to decrease in the number of psychiatric inpatient days. The conclusions that can be drawn from the results are, however, limited as the study was not made in RCT conditions and indirect costs to society were not assessed.
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| 8. |
- Sinai, Cave, et al.
(författare)
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Exposure to interpersonal violence and risk of post-traumatic stress disorder among women with borderline personality disorder
- 2018
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Ingår i: Psychiatry Research. - : ELSEVIER IRELAND LTD. - 0165-1781 .- 1872-7123. ; 262, s. 311-315
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study aims to determine the validity of the Karolinska Interpersonal Violence Scale (KIVS), as a screening tool for PTSD, among women with borderline personality disorder (BPD) and severe suicidal behavior. Method: 106 women with BPD and at least two suicide attempts were assessed with the KIVS for exposure to interpersonal violence as a child and as an adult. The screening ability of the KIVS for the diagnosis of PTSD was analyzed using receiver operating characteristic curve analysis. Results: PTSD diagnosis was valid for 61 (58%) women with BPD. The KIVS exposure of lifetime interpersonal violence, displayed fair accuracy of predicting diagnosis of PTSD (area under the curve 0.79, confidence interval [0.71, 0.88]) and performed well (sensitivity 0.90 and specificity 0.62), with a cut-off score of 4 (range 0-10). Poly-traumatization was not significantly related to PTSD diagnosis as compared to single traumatization, whereas sexual victimization was significantly more prevalent in women with PTSD diagnosis, as compared to other types of traumatic events. Conclusion: A score of 4 or more on the KIVS exposure to interpersonal lifetime violence presents well as a screening instrument for risk of PTSD, among women with BPD.
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| 9. |
- Sinai, Cave, et al.
(författare)
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Thyroid hormones and adult interpersonal violence among women with borderline personality disorder
- 2015
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Ingår i: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 227:2-3, s. 253-257
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Tidskriftsartikel (refereegranskat)abstract
- Elevated T3 levels have been reported in men with antisocial behavior. The aim of the present study was to investigate the relationship between thyroid hormones and expressed adult interpersonal violence in female patients with borderline personality disorder (BPD). Furthermore, expressed adult interpersonal violence in female BPD patients was compared to healthy female controls. A total of 92 clinically euthyroid women with BPD and 57 healthy women were assessed with the Karolinska Interpersonal Violence Scales (KIVS). Baseline thyroid function was evaluated by measuring plasma free and bound triiodothyronine (FT3 and T3), thyroxine (FT4 and T4), and thyroid-stimulating hormone (TSH) with immunoassays in patients. Plasma cortisol was also measured. Among females with BPD, expressed interpersonal violence as an adult showed a significant positive correlation with the T3 levels. The mean expression of interpersonal violence as an adult was significantly higher in BPD patients as compared to healthy controls. The multiple regression model indicated that two independent predictors of KIVS expressed interpersonal violence as an adult: T3 and comorbid diagnosis of alcohol abuse. Association between T3 levels and violent/aggressive behavior earlier reported exclusively in male samples may be valid also in females with BPD. (C) 2015 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY-NCND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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| 10. |
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| 11. |
- Werdelin, Lars, et al.
(författare)
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The evolution of the scrotum and testicular descent: a phylogenetic view
- 1999
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Ingår i: Journal of Theoretical Biology. - 0022-5193 .- 1095-8541. ; 196, s. 61-72
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Tidskriftsartikel (refereegranskat)abstract
- The adaptive significance of the scrotum and the evolution of the descent of the testicles and epididymis have been a focus of interest among biologists for a long time. In this paper we use three anatomical character states of the scrotum and descensus: (1) testicles descended and scrotal; (2) testicles descended but ascrotal; (3) testicles not descended (testicondy#). These states are then mapped on an up to date phylogeny of the Mammalia. Three main points arise out of this mapping procedure: (1) the presence of a scrotum is either primitive in extant Mammalia or primitive within eutherian mammals except Insectivora; (2) evolution has generally proceeded from a scrotal condition to progressively more ascrotal; (3) loss of testicular descensus is less common in mammalian evolution than is loss of the scrotum. In the light of these findings we discuss some current hypotheses regarding the origin and evolution of the scrotum. We find that these are all incomplete in so far as it is not the presence of the scrotum in various mammal groups that requires explaining. Instead, it is the reverse process, why the scrotum has been lost in so many groups, that should be explained. We suggest that the scrotum may have evolved before the origin of mammals, in concert with the evolution of endothermy in the mammalian lineage, and that the scrotum has been lost in many groups because descensus in many respects is a costly process that will be lost in mammal lineages as soon as an alternative solution to the problem of the temperature sensitivity of spermatogenesis is available.
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