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| 3. |
- Andersson, G, et al.
(författare)
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Regional cerebral blood flow during tinnitus : a PET case study with lidocaine and auditory stimulation.
- 2000
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Ingår i: Acta Otolaryngol. - 0001-6489. ; 120:8, s. 967-72
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Tidskriftsartikel (refereegranskat)abstract
- Brain imaging of tinnitus has suggested central correlates of tinnitus perception. This study presents positron emission tomographic (PET) measurements of regional cerebral blood flow (rCBF) in a female tinnitus patient with bilateral left dominant tinnitus. Lidocaine infusion (75 mg during 5 min (0.2 mg/kg/min)) resulted in a 75% reduction of tinnitus and a temporary abolition of the dominant tinnitus in her left ear. Regional CBF was measured in four conditions: i) at rest while concentrating on tinnitus, ii) following maximum effect of lidocaine, iii) during sound stimulation, and iv) the following day at rest while concentrating on tinnitus. Subtraction analyses showed that tinnitus was associated with increased rCBF in the left parieto-temporal auditory cortex, including the primary and secondary auditory cortex with a focus in the parietal cortex (Brodmann areas 39, 41, 42, 21, 22). Activations were also found in right frontal paralimbic areas (Brodmann areas 47, 49 and 15). Sound stimulation resulted in bilateral activation of auditory areas. It is suggested that tinnitus is processed in primary, secondary and integrative auditory cortical areas. Tinnitus perception may involve areas related to auditory attention, while emotional processing relates to temporofrontal paralimbic areas.
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- Fischer, H, et al.
(författare)
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Dispositional pessimism and amygdala activity: a PET study in healthy volunteers
- 2001
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Ingår i: NEUROREPORT. - : LIPPINCOTT WILLIAMS & WILKINS. - 0959-4965. ; 12:8, s. 1635-1638
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Tidskriftsartikel (refereegranskat)abstract
- The present study used scores from Seligman's Attribution Style Questionnaire and [O-15] water positron emission tomographic measurements of regional cerebral blood flow (rCBF) to investigate the relation between individual differences in dispositional pe
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| 16. |
- Furmark, Tomas, et al.
(författare)
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Social phobia subtypes in the general population revealed by cluster analysis
- 2000
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Ingår i: Psychological Medicine. - 0033-2917 .- 1469-8978. ; 30:6, s. 1335-1344
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Tidskriftsartikel (refereegranskat)abstract
- Background. Epidemiological data on subtypes of social phobia are scarce and their defining features are debated. Hence, the present study explored the prevalence and descriptive characteristics of empirically derived social phobia subgroups in the general population. Methods. To reveal subtypes, data on social distress, functional impairment, number of social fears and criteria fulfilled for avoidant personality disorder were extracted from a previously published epidemiological study of 188 social phobics and entered into an hierarchical cluster analysis. Criterion validity was evaluated by comparing clusters on the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). Finally, profile analyses were performed in which clusters were compared on a set of sociodemographic and descriptive characteristics. Results. Three clusters emerged, consisting of phobics scoring either high (generalized subtype), intermediate (non-generalized subtype) or low (discrete subtype) on all variables. Point prevalence rates were 2.0%, 5.9% and 7.7% respectively. All subtypes were distinguished on both SPS and SIAS. Generalized or severe social phobia tended to be over-represented among individuals with low levels of educational attainment and social support. Overall, public-speaking was the most common fear. Conclusions. Although categorical distinctions may be used, the present data suggest that social phobia subtypes in the general population mainly differ dimensionally along a mild-moderate-severe continuum, and that the number of cases declines with increasing severity.
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| 17. |
- Furmark, T, et al.
(författare)
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Social phobia subtypes in the general population revealed by cluster analysis
- 2000
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Ingår i: PSYCHOLOGICAL MEDICINE. - : CAMBRIDGE UNIV PRESS. - 0033-2917. ; 30:6, s. 1335-1344
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Tidskriftsartikel (refereegranskat)abstract
- Background. Epidemiological data on subtypes of social phobia are scarce and their defining features are debated. Hence, the present study explored the prevalence and descriptive characteristics of empirically derived social phobia subgroups in the genera
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| 18. |
- Granrud, MD, et al.
(författare)
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Health Care Personnel's Perspectives on Quality of Palliative Care During the COVID-19 Pandemic : A Cross-Sectional Study
- 2023
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Ingår i: Journal of Multidisciplinary Healthcare. - : Dove Medical Press. - 1178-2390. ; 16, s. 2893-2903
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The provision of high-quality palliative care is challenging, especially during a pandemic like COVID-19. The latter entailed major consequences for health care systems and health care personnel (HCP) in both specialist and community health care services, in Norway and worldwide. The aim of this study was to explore how the HCP perceived the quality of palliative care in nursing homes, medical care units, and intensive care units during the COVID-19 pandemic. Methods: This study had a cross-sectional design. A total of 290 HCP from Norway participated in the study (RR = 25.8%) between October and December 2021. The questionnaire comprised items concerning respondents' demographics and quality of care, the latter measured by the short form of the Quality from the Patient's Perspective-Palliative Care instrument, adapted for HCP. The STROBE checklist was used. Results: This study shows that the HCP scored subjective importance as higher in all dimensions, items and single items than their perception of the actual care received. This could indicate a need for improvement in all areas. Information about medication, opportunity to participate in decisions about medical and nursing care and continuity regarding receiving help from the same physician and nurse are examples of areas for improvement. Conclusion: Study results indicate that HCP from nursing homes, medical care units, and intensive care units perceived that quality of palliative care provided was not in line with what they perceived to be important for the patient. This indicate that it was challenging to provide high-quality palliative care during the COVID-19 pandemic.
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- Marteinsdottir, I., Tillfors, M., Furmark, T., Anderberg, U. M., & Ekselius, L
(författare)
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Personality dimensions measured by the Temperament and Character Inventory (TCI) in subjects with social phobia in relation to personality disorders
- 2003
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Ingår i: Nordic Journal of Psychiatry. ; 57, s. 29-35
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Tidskriftsartikel (refereegranskat)
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| 26. |
- Tillfors, M, et al.
(författare)
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Cerebral blood flow in subjects with social phobia during stressful speaking tasks : a PET study.
- 2001
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Ingår i: Am J Psychiatry. - 0002-953X. ; 158:8, s. 1220-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The central nervous system representation of social phobia (social anxiety disorder) is largely unknown. The aim of this study was to examine brain activity during symptom provocation in social phobics. METHOD: Positron emission tomography with the use of (15)O water was used to measure regional cerebral blood flow (rCBF) in 18 subjects with DSM-IV-defined social phobia and a nonphobic comparison group while they were speaking in front of an audience and in private. Heart rate and subjective anxiety were also recorded. RESULTS: During public versus private speaking, subjective anxiety increased more in the social phobics than in the comparison group. Increased anxiety was accompanied by enhanced rCBF in the amygdaloid complex in the social phobics relative to the comparison subjects. Cortically, brain blood flow decreased in the social phobics and increased in the comparison subjects more during public than private speaking in the orbitofrontal and insular cortices as well as in the temporal pole and increased less in the social phobics than in the comparison group in the parietal and secondary visual cortices. Furthermore, rCBF increased in the comparison group, but not in the social phobics, in the perirhinal and retrosplenial cortices. CONCLUSIONS: An rCBF pattern of relatively increased cortical rather than subcortical perfusion was observed in the nonphobic subjects, indicating that cortical evaluative processes were taxed by public performance. In contrast, the social phobia symptom profile was associated with increased subcortical activity. Thus, the functional neuroanatomy of social phobia involves the activation of a phylogenetically older danger-recognition system.
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| 27. |
- Tillfors, M, et al.
(författare)
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Social phobia and avoidant personality disorder as related to parental history of social anxiety : a general population study.
- 2001
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Ingår i: Behav Res Ther. - 0005-7967. ; 39:3, s. 289-98
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Tidskriftsartikel (refereegranskat)abstract
- Using a validated and DSM-IV compatible questionnaire, the present study related family history of excessive social anxiety to social phobia and avoidant personality disorder (APD) in epidemiologically identified probands in the general population. Probands met diagnostic criteria for social phobia with or without APD and APD with or without social phobia. A two- to three-fold increased relative risk of social anxiety was observed for all diagnostic groups. Increasing severity in probands by varying diagnostic criteria did not affect the relative risk. Because familial aggregation of social anxiety was not modulated by Axis I or II diagnosis or diagnostic cut-off levels, data imply that social phobia and APD may represent a dimension of social anxiety rather than separate disorders. Thus, having an affected family member is associated with a two- to three-fold risk increase for both social phobia and APD.
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| 29. |
- Wallsten, Daniel, et al.
(författare)
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Treating co-morbid insomnia and social anxiety disorder with sequential CBT protocols : a single-case experimental study
- 2021
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Ingår i: Behavioural and Cognitive Psychotherapy. - : Cambridge University Press. - 1352-4658 .- 1469-1833. ; 49:6, s. 641-657
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although insomnia disorder and social anxiety disorder are among the most prevalent psychiatric disorders, no studies have yet evaluated the use of sequential evidence-based treatment protocols in the population with co-morbid social anxiety disorder and insomnia disorder.AIMS: This study aimed to investigate the effects of sequential treatments on co-morbid insomnia disorder and social anxiety disorder. As depression is a common co-morbid syndrome for both insomnia and social anxiety, a secondary aim was to examine depressive symptoms.METHOD: A single-case repeated crossover AB design was used. Ten participants between 18 and 59 years of age with co-morbid DSM-5 diagnoses of insomnia disorder and social anxiety disorder received sequential treatments with cognitive behavioural therapy (CBT). Seven participants completed the treatment course. The primary outcomes were symptoms of insomnia and social anxiety, and the secondary outcome was symptoms of depression.RESULTS: The effects of CBT on people with co-morbid social anxiety disorder and insomnia disorder were mixed. The majority of participants improved their sleep quality and lessened symptoms of social anxiety and depression. However, participants differed in their degree of improvement concerning all three disorders.CONCLUSIONS: Sequential CBT treatments are potentially effective at decreasing symptoms of social anxiety and insomnia for people with co-morbid social anxiety disorder and insomnia disorder. The variation in outcome across participants makes firm conclusions about the treatment efficacy difficult to draw.
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| 30. |
- Costache, Madalina Elena, et al.
(författare)
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Higher- and lower-order personality traits and cluster subtypes in social anxiety disorder
- 2020
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 15:4
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Tidskriftsartikel (refereegranskat)abstract
- Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N = 265) diagnosed with SAD in comparison to healthy controls (N = 164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions. Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables. A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD. Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables. While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.
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| 32. |
- 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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| 38. |
- Holländare, Fredrik, 1972-, et al.
(författare)
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Randomized trial of Internet-based relapse prevention for partially remitted depression
- 2011
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Ingår i: Acta Psychiatrica Scandinavica. - : John Wiley and Sons. - 0001-690X .- 1600-0447. ; 124:4, s. 285-294
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate whether Internet-based cognitive behaviour therapy (CBT) can prevent relapse in persons with partially remitted major depression after previous treatment. less thanbrgreater than less thanbrgreater thanMethod: Seventy-one women and 13 men (N = 84) with partially remitted major depression after treatment were randomly assigned to either 10 weeks of Internet-based CBT or to a control group. Self-help material was used in combination with e-mail contact with a personal therapist. Monthly self-ratings of depressive symptoms were made, and diagnostic interviews were conducted before and after the treatment period, as well as 6 months later. less thanbrgreater than less thanbrgreater thanResults: Significantly fewer participants in the CBT group experienced relapse (4/38 or 10.5%) compared with those in the control group (14/37 or 37.8%). The difference in relapse rates between groups occurred early in the study period and was still apparent after 6 months. A trend towards a larger reduction in depressive symptoms was observed at post-treatment in the participants who received CBT compared with controls. Reduction in depressive symptoms reduced the risk of relapse. A trend towards a higher remission rate was found in the CBT group at the 6 month follow-up. less thanbrgreater than less thanbrgreater thanConclusion: Internet-based CBT seems promising in preventing relapse in persons with partially remitted major depression after previous treatment.
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| 39. |
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| 40. |
- Magson, N. R., et al.
(författare)
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Latent stability and change in subgroups of social anxiety and depressive symptoms in adolescence : A latent profile and transitional analysis
- 2022
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Ingår i: Journal of Anxiety Disorders. - : Elsevier. - 0887-6185 .- 1873-7897. ; 87
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social anxiety and depressive symptoms increase markedly during adolescence. Most research examining the emergence of these symptoms has used a variable-centered approach providing little information about how these symptoms group together in individuals over time. Method: A person-centered approach utilizing latent profile and latent transitional analyses was applied to a large adolescent sample (N = 2742, Mage=13.65; SD=0.63; 47.9% girls). Subgroups differing in their expressions of social anxiety and depressive symptoms at each of four annual time points were identified and then change in membership of these groups was evaluated. Results: Four subgroups were identified: 1. Low Distress, 2. Socially Anxious, 3. Dysphoric, and 4. Comorbid. The low distress group was the largest and most stable, followed by the socially anxious group, who most commonly transitioned into the comorbid group. In contrast, the dysphoric group were most likely to remit and move to the low distress group. The comorbid group was the smallest and least stable, although once in this group, three quarters of adolescents remained in this group over time. Conclusion: Early intervention is particularly imperative for socially anxious adolescents with or without comorbid depressive symptoms as they are the least likely to improve across the adolescent years.
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| 41. |
- Marteinsdottir, Ina, et al.
(författare)
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Personality traits in social phobia.
- 2001
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Ingår i: Eur Psychiatry. - 0924-9338. ; 16:3, s. 143-50
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to assess personality traits in subjects with a DSM-IV diagnosis of social phobia. Thirty-two subjects were administered the Structured Clinical Interview for DSM-IV for Axes I and II disorders (SCID I and II). Personality traits were assessed by means of the Karolinska Scales of Personality (KSP). Current and lifetime axis I co-morbidity was diagnosed in 28% and 53% of the subjects, respectively. In total, 59% had at least one personality disorder and 47% were diagnosed with an avoidant personality disorder. The social phobics scored significantly higher than a Swedish normative sample on the KSP measuring anxiety proneness, irritability, detachment, and indirect aggression but lower on the scales for socialisation and social desirability. The presence as compared to absence of avoidant personality disorder in the social phobics was associated with significantly higher psychic anxiety and inhibition of aggression. In addition, symptom severity was higher in social phobics with an avoidant personality disorder. Generally, the results support the view that social phobia and avoidant personality disorder reflect different aspects of a social anxiety spectrum.
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| 46. |
- Wallsten, Daniel
(författare)
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Shifting the lens on heterogenous psychological suffering : Exploring and evaluating novel psychological treatment approaches to comorbid mental disorders
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This doctoral thesis addresses heterogeneous psychological suffering within a predominantly psychiatric paradigm, emphasizing the high prevalence of comorbid mental disorders. While much of the published empirical research focuses on trials targeting single disorders, this thesis aims to explore and evaluate novel treatment approaches for populations experiencing diverse psychological suffering. It seeks to bridge the gap between traditional disorder-based treatments and the emerging trend of idiographic designs and processes of change. The first clinical trial focused on treating co-morbid insomnia and social anxiety disorder using sequential cognitive behavioral therapy protocols (CBT-I and CBT-S). Findings suggest potential efficacy in reducing symptoms of both disorders, with notable improvements in insomnia symptoms. However, treatment effects still varied among participants, making it difficult to draw clear conclusions regarding efficacy. The second trial investigated group-based Rumination-Focused Cognitive Behavior Therapy (RFCBT) for individuals with depression, anxiety, and insomnia. Results indicate significant improvements in insomnia symptoms post-treatment and at the 2-month follow-up, with potential effectiveness for depression. However, no significant effects were found for anxiety, worry, or rumination. The third trial explored feasibility and preliminary effects of a process-based psychological treatment informed by Relational Frame Theory for individuals with comorbid mental disorders (Process-Based Behavioral Therapy; PBBT). Interpretative Phenomenological analysis revealed participants' varied experiences, emphasizing challenges in emotional engagement and the therapeutic process. Mixed findings from both the qualitative analyses and the suplementary self-rating scales underscored the complexity of treatment outcomes, highlighting the need of more research on treatment approaches based on Relational Frame Theory. Overall, the thesis contributes to addressing and understanding the complexities of heterogeneous psychological suffering and clinical research. Further research should continue to explore idiographic designs and process-based treatments while carefully defining and tracking processes of change. This is particularly important for individuals who do not benefit from current evidence-based treatment approaches.
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