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| 2. |
- Hildebrand Karlén, Malin, 1984, et al.
(författare)
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Autistic Personality Traits and Treatment Outcome for Alcohol Use Disorders
- 2021
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Ingår i: Journal of Nervous and Mental Disease. - : Ovid Technologies (Wolters Kluwer Health). - 0022-3018 .- 1539-736X. ; 209:9, s. 665-673
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Tidskriftsartikel (refereegranskat)abstract
- The importance of personality traits for the outcome of psychiatric treatment, including treatment for alcohol use disorder (AUD), has been widely acknowledged. Also, research on autism spectrum disorders has evolved in recent years, emphasizing that the behavioral traits within these neuropsychiatric disorders exist on a dimension both within and outside the boundaries of psychopathology. In the present study, the relationship between personality traits associated with autistic functioning and level of alcohol use among patients before and after concluded AUD treatment was investigated. The participants (n = 165, diagnosed with AUD) were part of a longitudinal project on AUD treatment. Data from personality questionnaires (Structured Clinical Interview of Personality Disorders II and Temperament and Character Inventory) were used to assess autistic personality traits (APTs) based on behavior within Wing's triad, which were related to background and treatment outcome. The chosen APT items illustrated a personality functioning with an emphasis on social interaction and rigidity. Only certain included questions were indicative of still having a problematic drinking pattern 2.5 years after treatment entry, which adhered to phobic, obsessive-compulsive, and schizoid personality traits, as well as rigidity/stubbornness. Albeit with modest influence, the degree of APTs was associated with heavier drinking at treatment entry, and symptoms relating to social interaction and rigidity were associated with still having a problematic drinking pattern 2.5 years after treatment entry. A higher degree of such traits may result in having problems taking advice from others and establishing treatment alliance, important parts of treatment efficacy, making assessment of such traits relevant to clinicians.
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| 3. |
- Hildebrand Karlén, Malin, et al.
(författare)
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Autistic Personality Traits and Treatment Outcome for Alcohol Use Disorders
- 2021
-
Ingår i: Journal of Nervous and Mental Disease. - 0022-3018 .- 1539-736X. ; 209:9, s. 665-673
-
Tidskriftsartikel (refereegranskat)abstract
- The importance of personality traits for the outcome of psychiatric treatment, including treatment for alcohol use disorder (AUD), has been widely acknowledged. Also, research on autism spectrum disorders has evolved in recent years, emphasizing that the behavioral traits within these neuropsychiatric disorders exist on a dimension both within and outside the boundaries of psychopathology. In the present study, the relationship between personality traits associated with autistic functioning and level of alcohol use among patients before and after concluded AUD treatment was investigated. The participants (n = 165, diagnosed with AUD) were part of a longitudinal project on AUD treatment. Data from personality questionnaires (Structured Clinical Interview of Personality Disorders II and Temperament and Character Inventory) were used to assess autistic personality traits (APTs) based on behavior within Wing's triad, which were related to background and treatment outcome. The chosen APT items illustrated a personality functioning with an emphasis on social interaction and rigidity. Only certain included questions were indicative of still having a problematic drinking pattern 2.5 years after treatment entry, which adhered to phobic, obsessive-compulsive, and schizoid personality traits, as well as rigidity/stubbornness. Albeit with modest influence, the degree of APTs was associated with heavier drinking at treatment entry, and symptoms relating to social interaction and rigidity were associated with still having a problematic drinking pattern 2.5 years after treatment entry. A higher degree of such traits may result in having problems taking advice from others and establishing treatment alliance, important parts of treatment efficacy, making assessment of such traits relevant to clinicians.
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| 4. |
- Stålheim, Jonas
(författare)
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"Everybody gets a little bit loco”: Interactions between psychotic experiences and substance use as dimensional phenomena
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A large amount of persons with psychosis experience problems related to substance use; and many persons with substance use disorders develop psychiatric symptoms, including psychotic experiences (PEs). The co-existence of PEs and substance use disorders increases the risk for social exclusion, health adversities, violence, and aggravation of symptoms. Besides social exclusion, one of the main factors behind this association is a need for alleviation of distress, or compensatory affect regulation in relative absence of other strategies or protective factors. This may drive a feedback loop between anxiety, increased substance use, lowered self-efficacy, and PEs. There is a need for more research that contributes to the understanding of interactions between substance use, affect regulation and psychopathological processes, not the least since this may have implications for development of psychological treatment. The aim of Study 1 was to examine aspects of substance use patterns in a group of persons with psychosis (n=16), in comparison with a group of persons with other mental health problems (n=22). The results indicate lesser mental state references to substance use and lesser signs of alcohol dependence in the group of persons with psychosis, but no significant differences in overall consumption. The aim of Study 2 was to explore the interactions of substance use and affect regulation within the group of persons with psychosis. Interviews were conducted with twelve participants, and the transcripts were analyzed according to thematic analysis. The material was structured along the lines of two main themes; Approaches to distress and Regulating functions of substances. The results suggest a general tendency to use substances to regulate affect and self-experience in the same time as displaying a great heterogeneity within the group concerning substance use patterns, regulating functions and self-reflection. A possible interpretation is that level of self-reflection and affect regulation style influence pattern and function of substance use on a more primary level than type of psychiatric illness, but that more elaborated levels of self-reflection often are problematic for persons with psychosis. The aim of Study 3 was to investigate the prevalence of PEs in a group of socially stable persons with alcohol use disorders, and possible differences in childhood trauma and alcohol-related self-efficacy between persons in this group with low and high levels of PEs, respectively. The results suggest that a large minority of this group display substantially elevated levels of PEs, and that this is strongly correlated to childhood trauma and perceived difficulties in abstaining from alcohol. One hypothesis generated by the studies, is that capacities of affect consciousness in combination with difficulties in higher order self-reflection, are associated with the highest risk for developing a substance use disorder in persons with psychosis, since it may lead to emotional pain that calls for quick discharge. The integrated result suggests that there is an association between anxiety (often trauma-related), substance use and PEs irrespective of which problem is considered “primary”, and that substance use and PEs should be seen as dimensional and interacting phenomena rather than separate “disorders”.
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| 5. |
- Stålheim, Jonas, et al.
(författare)
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Mentalization and affect regulation reflected in interviews with men diagnosed with psychosis and substance abuse
- 2014
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Ingår i: Mental Health and Substance Use: Dual Diagnosis. - : Informa UK Limited. - 1752-3281 .- 1752-3273. ; 7:4, s. 461-472
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Tidskriftsartikel (refereegranskat)abstract
- © 2014 Taylor & Francis. People with psychosis have a high prevalence of problematic substance use that is generally thought to complicate their treatment. One explanation of the co-occurrence of psychosis and substance-use disorders is that people with psychosis more often than others use substances to ameliorate distress by regulating their affect and self-experience. Affect regulation is related to mentalization, which can be problematic for many people with psychosis. The aim of this study was to investigate the relationship between substance use, mentalization, and affect regulation in psychosis from an experience-based perspective. We interviewed 12 men with diagnoses of psychosis and a concurrent substance-use disorder about their mental health problems, life history, relationships, and substance use. We analysed the semi-structured interviews thematically and deductively, and organized the data into two main themes, each containing related sub-themes. The first theme concerned general ways of handling distress, which we organized hierarchically according to the level of mentalization required. The other theme grouped together different regulating functions of substance use. We discuss, from a theoretical point of view, the systematic interactions among substance use, affect regulation, and mentalization indicated in the data and propose mentalization styles that may indicate especially high risk for substance abuse. These findings may have implications for theoretical understandings of how substance use and mental health problems interact and for verbal therapy for people with both psychosis and substance-use disorders.
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| 6. |
- Stålheim, Jonas, et al.
(författare)
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Psychotic Experiences, Childhood Trauma, and Alcohol-Related Self-Efficacy in a Nonpsychiatric Sample of Individuals in Alcohol Dependence Treatment: A Pilot Study
- 2018
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Ingår i: Alcoholism Treatment Quarterly. - : Informa UK Limited. - 0734-7324 .- 1544-4538. ; 36:3, s. 387-398
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Tidskriftsartikel (refereegranskat)abstract
- There is a substantial co-occurrence between alcohol dependence and psychiatric symptoms. Moreover, research suggests that such symptoms, including psychotic experiences, are continuously distributed in the population. There is a lack of research concerning psychotic symptoms in otherwise non-psychiatric populations with alcohol dependence. The aim of this study was to investigate the prevalence of psychotic symptoms in this population, and to relate this to childhood trauma and management of alcohol dependence. From a population with alcohol dependence two sub-groups were extracted, with low and high levels of psychotic experiences respectively. These were compared concerning childhood trauma and management of dependence using ANOVA, and the resulting model was examined using binary logistic regression. There was a sub-group of 14,3% of the population with elevated levels of psychotic experiences. This group displayed higher degree of self-reported childhood trauma as well as difficulties in managing alcohol dependence, when compared to a sub-group with low levels of psychotic experiences. There may be a substantial sub-group in the otherwise non-psychiatric population with alcohol dependence, with significant difficulties concerning psychotic symptoms, trauma and management of dependence, where anxiety may have a mediating function. If so, this group calls for broader assessment and treatment than standard alcohol interventions.
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| 7. |
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| 8. |
- Stålheim, Jonas, et al.
(författare)
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Substance use patterns in persons with psychosis
- 2013
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Ingår i: Mental Health and Substance Use. - 1752-3281 .- 1752-3273. ; 6:4, s. 351-361
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Tidskriftsartikel (refereegranskat)abstract
- Clinical experience suggests that people with psychosis generally show a diverging substance use pattern compared with other people with ‘dual disorders’. The aim of this study was to describe substance use patterns in individuals with psychosis and relate these to substance use patterns in persons with other kinds of psychiatric disorders in combination with substance abuse. A wider aim was to contribute to a deeper understanding of interactions between mental illness and substance use. Two groups were recruited, one with persons diagnosed with psychotic disorders and one with people with other (mainly anxiety- and affective-) disorders. All participants also had substance-related problems. The participants completed the questionnaires Alcohol Use Disorders Identification Test and Drug Use Disorders Identification Test, and information about socio-demographic and care-related characteristics was collected. Group differences were calculated. The participants with psychosis scored significantly lower on most questions concerning affective/cognitive aspects of drug use, such as longing, guilt and experience of failing in relation to alcohol and drugs. They also showed fewer indications of alcohol dependence. A possible interpretation is that the findings reflect group differences in mentalization and affect-regulation relevant to both substance use and psychiatric illness. This may have implications for theoretical understanding of dual disorders as well as for psychotherapeutic treatment.
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| 9. |
- Stålheim, Jonas, 1970
(författare)
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Substansbruksyndrom och psykos
- 2023
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Ingår i: Handbok i missbruks- och beroendepsykologi. - Stockholm : Liber. - 9789147147762 ; , s. 155-162
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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