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| 4. |
- Alfonsson, Sven, et al.
(författare)
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Self-Reported Hedonism Predicts 12-Month Weight Loss After Roux-en-Y Gastric Bypass
- 2017
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Ingår i: Obesity Surgery. - : Springer Science and Business Media LLC. - 0960-8923 .- 1708-0428. ; 27:8, s. 2073-2078
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Research regarding psychological risk factors for reduced weight loss after bariatric surgery has yielded mixed results, especially for variables measured prior to surgery. More profound personality factors have shown better promise and one such factor that may be relevant in this context is time perspective, i.e., the tendency to focus on present or future consequences. The aim of this study was to investigate the predictive value of time perspective for 12-month weight loss after Roux-en-Y gastric bypass surgery.Methods A total of 158 patients were included and completed self-report instruments prior to surgery. Weight loss was measured after 12 months by medical staff. Background variables as well as self-reported disordered eating, psychological distress, and time perspective were analyzed with regression analysis to identify significant predictors for 12-month weight loss.Results The mean BMI loss at 12 months was 14 units, from 45 to 30 kg/m(2). Age, sex, and time perspective could significantly predict weight loss but only male sex and self-reported hedonism were independent risk factors for reduced weight loss in the final regression model.Conclusion In this study, self-reported hedonistic time perspective proved to be a better predictor for 12-month weight loss than symptoms of disordered eating and psychological distress. It is possible that a hedonistic tendency of focusing on immediate consequences and rewards is analogous to the impaired delay discounting seen in previous studies of bariatric surgery candidates. Further studies are needed to identify whether these patients may benefit from extended care and support after surgery.
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| 5. |
- Bäckman, Lisa, et al.
(författare)
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Effects of internet-based enhanced acceptance and commitment therapy integrating interoceptive exposure for panic disorder and the association between working alliance and outcome: A randomized controlled trial
- 2024
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Ingår i: Sweesrii 2024.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This study investigated the effectiveness of an improved internet-based Acceptance and Commitment Therapy (iACT) adapted for individuals with Panic Disorder (PD) and concurrent agoraphobia (AF), incorporating interoceptive exposure for better customization. The treatment, spanning eight modules over 10 weeks, demonstrated significant symptom reduction in the primary outcome Panic Disorder Severity Scale (PDSS-SR), with a large effect size (d=0.92) in a randomized controlled trial involving a wait-list control group (n=79). However, no significant impact was observed on the secondary outcome, Brunnsviken Brief Quality of Life Inventory (BBQ). Notably, 43% of of the assessed participants in the treatment group were diagnosed free from panic disorder. Utilizing weekly ratings of therapist-client working alliance (WAI-SR-T/C) and PDSS-SE, we explored their connection throughout the treatment and its association with the final outcome. We found a relation between therapist working alliance and the reduction of panic symptoms during treatment. However, there was no significant relationship observed for client-rated working alliance or with the final treatment outcome. This study suggests that this enhanced iACT can be an effective method for treating panic disorder and shows promise for use, particularly in cases where panic disorder is accompanied by agoraphobia. It is also shedding light on the role of alliance in internet-based treatments, however, here it is important to acknowledge that the sample size was small.
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| 6. |
- Cederberg, J. T., et al.
(författare)
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A preliminary validation of the Swedish version of the Pain Catastrophizing Scale for Children (PCS-C) for children and adolescents with cancer
- 2019
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Ingår i: Journal of Pain Research. - 1178-7090. ; 12, s. 1803-1811
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Pain is reported as one of the most common and difficult symptoms for children and adolescents with cancer to cope with. Pain catastrophizing has been identified as a process clearly related to pain intensity and disability. The Pain Catastrophizing Scale for Children (PCS-C) has been validated in several languages and populations but remains to be validated in pediatric oncology. The aim of the study was to validate a Swedish version of the PCS-C for children and adolescents with cancer. Methods: All children, 7-18 years of age, being treated for cancer in Sweden at the time of the study were invited to participate. Study material was sent out to the registered address. Internal consistency, test-retest reliability and convergent validity were calculated. Factor structure was examined using principal component analysis (PCA). Descriptive statistics were used to investigate background data and norm values. Results: 61 children/adolescents were included in the analyses. The results did not support the original three-factor structure of the PCS-C, but rather suggested that a two-factor structure excluding item 8 best represented the data. The internal consistency of that solution was good (alpha=0.87), the test-rest reliability was excellent (ICC=0.75) and convergent validity was demonstrated (r=0.46). The mean (SD) for the PCS-C in the sample was 19.1 (9.2), without item 8. A statistically significant difference was shown between genders, where girls reported a higher level of pain catastrophizing than boys. No difference was found with regard to age. Discussion: The Swedish version of the PCS-C is now preliminarily validated for children and adolescents with cancer, for whom gender- and age-specific norm values are now available. Questions remain regarding the optimal factor structure of the PCS-C.
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| 7. |
- Cederberg, J. T., et al.
(författare)
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Validation of the Swedish version of the Pain Catastrophizing Scale for Parents (PCS-P) for parents of children with cancer
- 2019
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Ingår i: Journal of Pain Research. - 1178-7090. ; 12, s. 1017-1023
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Pain is reported as one of the most common and burdensome symptoms for children with cancer. Pain catastrophizing is clearly related to pain intensity and disability. Catastrophizing in parents is associated with both child functioning and parent distress. The Pain Catastrophizing Scale for Parents (PCS-P) remains to be validated for parents of children with cancer. The aim of the study was to validate the Swedish version of the PCS-P for parents of children with cancer experiencing pain. Methods: Parents of all children who were being treated for cancer in Sweden at the time of the study were invited to participate. Study material was sent out to the registered address. Internal consistency, test-retest reliability, and convergent validity were calculated, and factor analysis was conducted. Descriptive statistics was used to investigate the background data and norm values. Results: A total of 243 parents participated in the study. The results did not support the original three-factor structure of the PCS-P, but rather suggested that a two-factor structure best represented the data. The results showed excellent internal consistency (alpha=0.93), excellent temporal stability (intraclass correlation coefficient =0.86) and moderate convergent validity (rho=0.57). The mean (SD) for the PCS-P in the sample was 28.3 (10.7). A statistically significant difference was found between mothers and fathers, where mothers reported a higher level of pain catastrophizing than fathers. Conclusion: The psychometric properties of the PCS-P has now been supported in a sample of parents of children with cancer, and norm values are now available. The factor structure does, however, deserve more investigation.
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| 8. |
- Gervind, Elisabet, et al.
(författare)
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The influence of organizational models on the implementation of internet-based cognitive behavior therapy in primary care: A mixed methods study using the RE-AIM framework
- 2024
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Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 35
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Tidskriftsartikel (refereegranskat)abstract
- Background: Internet-Based Cognitive Behavioral Therapy (iCBT) holds great potential in addressing mental health issues, yet its real-world implementation poses significant challenges. While prior research has predominantly focused on centralized care models, this study explores the implementation of iCBT in the context of decentralized organizational structures within the Swedish primary care setting, where all interventions traditionally are delivered at local Primary Care Centers (PCCs).Aim: This study aims to enhance our understanding of iCBT implementation in primary care and assess the impact of organizational models on the implementation's outcome using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework.Method: A mixed-methods research design was employed to identify the factors influencing iCBT implementation across different levels, involving patients, therapists and managers. Data spanning two years was collected and analyzed through thematic analysis and statistical tests. The study encompassed 104 primary care centers, with patient data (n = 1979) sourced from the Swedish National Quality Register for Internet-Based Psychological Treatment (SibeR). Additionally, 53 iCBT therapists and 50 PCC managers completed the Normalization Measure Development Questionnaire, and 15 leaders participated in interviews.Results: Our investigation identified two implementation approaches, one concentrated and one decentralized. Implementation effectiveness was evident through adherence rates suggesting that iCBT is a promising approach for treating mental ill-health in primary care, although challenges were observed concerning patient assessment and therapist drift towards unstructured treatment. Mandatory implementation, along with managerial and organizational support, positively impacted adoption. Results vary in terms of adherence to established protocols, with therapists working in concentrated model showing a significantly higher percentage of registration in the quality register SibeR (X2 (1, N = 2973) = 430.5774, p = 0.001). They also showed significantly higher means in cognitive participation (Z = - 2.179, p = 0.029) and in reflective monitoring (Z = - 2.548, p = 0.011). Discussion: Overall, the study results demonstrate that iCBT, as a complex and qualitatively different intervention from traditional psychological treatment, can be widely implemented in primary care settings. The study's key finding highlights the substantial advantages of the concentrated organizational model. This model has strengths in sustainability, encourages reflective monitoring among therapists, the use of quality registers, and enforces established protocols.Conclusion: In conclusion, this study significantly contributes to the understanding of the practical aspects associated with the implementation of complex internet interventions, particularly in the context of internetbased cognitive-behavioral therapy (iCBT). The study highlights that effective iCBT integration into primary care requires a multifaceted approach, taking into account organizational models, robust support structures, and a commitment to maintaining quality standards. By emphasizing these factors, our research aims to provide actionable insights that can enhance the practicability and real-world applicability of implementing iCBT in primary care settings.
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| 9. |
- Gervind, Elisabet, et al.
(författare)
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The transference of research results to practise: Organization and implementation outcomes of iCBT in primary care – a mixed methods study using the RE-AIM framework
- 2022
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Ingår i: SWESRII 2022.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Healthcare systems all over the world are working in dynamic and resource-constrained contexts. Implementation science plays a critical role in ensuring that costly research results are implemented and improve public health. Implementation of iCBT in regular care has given mixed results and has rarely been documented on the basis of a scientific framework for implementation research. Aim: The overall aim of the present study is to contribute to knowledge about how iCBT can be implemented and organized in primary care. The current study also explores naturalistic variability in two different organizational formats, concentrated and decentralized. Method: A mixed quantitative-qualitative design was used to identify factors that impact the implementation of iCBT across multiple levels, including patient, therapists, leaders and organization. The scientific framework RE-AIM with the dimensions reach (those in the target group participating in the program), effectiveness (effects after completion of the program), adoption (actors who accept the program), implementation (compliance with the program according to protocol), maintenance (sustainability over time) was used to evaluate the implementation. Results: 104 primary care centres participated in the study. Outcomes on patient-data (n=1979) were gathered between 2018 and 2021 from the quality register SibeR. Fifty-four iCBT-therapists, answered the NoMAD-questionnaire and fifteen leaders were interviewed. The materials are currently being analysed.
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| 11. |
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| 12. |
- Larsson, Anna, et al.
(författare)
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IMPACT (Internet-Mediated Psychological treatment - Acceptance and Commitment Therapy) in youths: The role of parental support
- 2022
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Ingår i: SWESRII, 2022.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Internet-delivered cognitive behavioral therapy (iCBT) for youths has not yet been established as an evidence-based method in primary care. Thus, the research project IMPACT (Internet-Mediated Psychological treatment - Acceptance and Commitment Therapy) aims to investigate iCBT for youths between 13-18 years old in primary care compared to treatment as usual (TAU). Method: IMPACT consists of 3 studies: Study 1 is a qualitative thematic analysis of the attitudes and experiences. Study 2 is a mixed-method design investigating the experiences and perceived effects of iCBT and study 3 is a quantitative 1-year follow-up of treatment results of iCBT and TAU. Results: In study 1, the therapists reported positive experiences of using iCBT for youths and considered it a valuable alternative to face-to-face treatment and an appreciated variation in their schedules. Nevertheless, the therapists also reported challenges in selecting, motivating and interacting with the patients and suggested that parental support can increase compliance and improve treatment results. In study 2, the quantitative analysis indicated that iCBT was successful in symptom reduction and underlined that the motivation of the youths was crucial for the treatment outcome. The youths valued independence and freedom in managing the treatment on their own terms whereas the parents expressed uncertainty about their role and how to support their youths. This study further supports the importance of parental involvement in iCBT for youths in supporting and reminding during the course of treatment and collaborating with the therapist. Based on the results in study 1 and 2, a separate parental support programme was developed in the shape of a shorter iCBT programme for the parents to use in parallel with their youths doing iCBT treatment. In study 3, the youths with parental support had significantly higher compliance compared to both TAU and iCBT without parental support. Conclusion: Internet treatment in primary care is accepted by both therapists, youths and their parents in the research project. Furthermore, youth motivation was paramount for treatment outcome and parental support was identified as an important factor.
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| 13. |
- Lilja, Josefine, et al.
(författare)
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Psychometric properties and validation of the Swedish Five Facet Mindfulness Questionnaire in a clinical and non-clinical sample among meditators and non-meditators
- 2020
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Ingår i: Scandinavian Journal of Psychology. - : WILEY. - 0036-5564 .- 1467-9450. ; 61:3, s. 369-379
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Tidskriftsartikel (refereegranskat)abstract
- Over a period of 15 years several attempts to conceptualize mindfulness have been presented and revised, but there is still no clear or agreed-upon definition. The use of mindfulness-based interventions has increased in clinical and research settings the last couple of years, including in Sweden. As a clinician it is crucial to know if a treatment works through the theoretically postulated mechanisms of change. Mindfulness is a concept that is difficult to measure. The overall aim of the current project was to examine the psychometric properties of the Swedish version of the Five Facet Mindfulness Questionnaire (FFMQ_SWE) using three different studies. To test the construct validity of the FFMQ_SWE a hierarchal confirmatory factor analysis was performed in a meditating non-clinical sample, to examine if all the five facets would load on an overall mindfulness construct. Psychometric properties of the instrument were examined in a non-clinical and a clinical sample, and discriminative relationships with other variables were analysed. The convergent validity was examined by analysing the correlations between FFMQ_SWE and Hospital Anxiety and Depression Scale, Sense of Coherence and Difficulties in Emotion Regulation Scale. Test-retest reliability was tested by distributing FFMQ_SWE at two occasions. The hierarchal confirmatory factor analysis showed good fit in a population of meditators. The FFMQ_SWE showed good convergent validity and test-retest reliability in both clinical and non-clinical populations. In sum, the Swedish version of the FFMQ showed good psychometric properties and can be a useful instrument as an evaluation of treatment effects in both health care settings and research settings.
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| 14. |
- Lilja, Josefine, et al.
(författare)
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Youths’ and Parents’ Experiences and Perceived Effects of Internet-Based Cognitive Behavioral Therapy for Anxiety Disorders in Primary Care: Mixed Methods Study
- 2021
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Ingår i: JMIR Pediatrics and Parenting. - : JMIR Publications Inc.. - 2561-6722. ; 4:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anxiety is common among youths in primary care. Face-to-face treatment has been the first choice for clinicians, but during the COVID-19 pandemic, digital psychological interventions have substantially increased. Few studies have examined young people’s interest in internet treatment or the attitudes they and their parents have toward it. Objective: This study aims to investigate adolescents’ and parents’ attitudes toward and experiences of internet-based cognitive behavioral anxiety treatment in primary care and its presumptive effects. Methods: The study used mixed methods, analyzing qualitative data thematically and quantitative data with nonparametric analysis. Participants were 14 adolescents and 14 parents recruited in adolescent primary health care clinics. The adolescents and their parents filled out mental health questionnaires before and after treatment, and were interviewed during ongoing treatment. Results: The quantitative data indicated that the internet-delivered cognitive behavioral therapy program used in this study was successful in reducing symptoms (χ22=8.333; P=.02) and that adolescents’ motivation is essential to the treatment outcome (r=0.58; P=.03). The qualitative results show that youths highly value their independence and freedom to organize treatment work on their own terms. The parents expressed uncertainty about their role and how to support their child in treatment. It was important for parents to respect the youths’ need for autonomy while also engaging with them in the treatment work. Conclusions: Internet treatment in primary care is accepted by both youths and their parents, who need clarification about the difference between their role and the therapist’s role. Patient motivation should be considered before treatment, and therapists need to continue to develop the virtual alliance. Finally, primary care should be clearer in informing adolescents and their parents about the possibility of internet treatment.
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| 15. |
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| 16. |
- Lorén, Helena, 1966, et al.
(författare)
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Facing a new life-The healthy transition to motherhood: What individual and environmental factors are needed? A phenomenological-hermeneutic study
- 2024
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Ingår i: Midwifery. - 0266-6138. ; 130
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the study was to highlight first-time mothers’ experiences of the transition to motherhood uncovering personal and environmental conditions facilitating or preventing the process of a healthy transition in a Swedish context. Design: A qualitative study with interview data analyzed using a phenomenological hermeneutic method. Setting and participants: Ten recent first-time mothers were selected from three primary healthcare centers in western Sweden. Findings: Four themes emerged, and the transition could be divided into several phases, interpreted as facing a new life, while feeling unprepared for identity and existential issues. The experience of becoming a mother was described as oscillation between a loss of former identity from previous life, and on the other hand, the joy and expectations of forming a new family. The mothers had high demands of themselves, often influenced by social media and needed to value the flow of information and `let go of control` to be able to make adequate decisions. The close family of origin was invaluable in this process being able to provide confirmation in the new role, facilitating the development of their own security and self-confidence. Key conclusions: The vulnerability expressed by new mothers shows that support from the family of origin, partners and professionals are indispensable. The desired result after the transition to motherhood is a prosperous, maturity and confident mother. The main promoting factor in this process seems to be having a safe base that can provide required support. Implications for practice: The level of wellbeing after the transition is crucial and the possibility of a warm, responsive and secure parenting needs to be strengthened. The challenge to preventive health care will be to identify a lack of support and ensure that these mothers gain sufficient support to meet today´s demands and still feel that they are good enough mothers for their children.
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| 17. |
- Molander, Peter, et al.
(författare)
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Internet-based acceptance and commitment therapy for psychological distress experienced by people with hearing problems: a pilot randomized controlled trial
- 2018
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Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 47:2, s. 169-184
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 Swedish Association for Behaviour Therapy. Psychological distress is common among people with hearing problems, but treatments that specifically target this aspect have been almost non-existent. In this pilot randomized controlled trial, an eight-week long Internet-based treatment, informed by Acceptance and Commitment Therapy, was administered to explore the feasibility and efficacy of such a treatment. Included participants were randomized to either treatment (n=31) or wait-list control (n=30) condition. All participants were measured prior to randomization and immediately after treatment ended using standardized self-report instruments measuring hearing-related emotional and social adjustment (Hearing Handicap Inventory for the Elderly–S, HHIE-S), quality of life (Quality of Life Inventory, QOLI), and symptoms of depression and anxiety (Patient health Questionnaire, PHQ-9 and Generalized Anxiety Disorder scale, GAD-7). Linear mixed effects regression analysis using the full intention-to-treat sample demonstrated that the treatment had superior outcomes on the main outcome measure as compared with the control group, Cohen’s d=0.93, 95% CI [0.24, 1.63]. The benefits of treatment over control were also evident in scores of depression, Cohen’s d=0.61, 95% CI [0.04, 1.19], and quality of life, Cohen’s d=0.88, 95% CI [0.14, 1.61]. The results provide preliminary support for Internet-delivered acceptance and commitment therapy as a potentially effective treatment of psychological symptoms associated with hearing problems.
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| 18. |
- Molander, Peter, et al.
(författare)
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Internet-Based Acceptance and Commitment Therapy for Psychological Distress Experienced by People With Hearing Problems: Study Protocol for a Randomized Controlled Trial
- 2015
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Ingår i: American Journal of Audiology. - : American Speech-Language-Hearing Association. - 1059-0889 .- 1558-9137. ; 24:3, s. 307-310
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Tidskriftsartikel (refereegranskat)abstract
- © 2015 American Speech-Language-Hearing Association. Purpose: Psychological distress and psychiatric symptoms are prevalent among people with hearing loss or other audiological conditions, but psychological interventions for these groups are rare. This article describes the study protocol for a randomized controlled trial for evaluating the effect of a psychological treatment delivered over the Internet for individuals with hearing problems and concurrent psychological distress. Method: Participants who are significantly distressed will be randomized to either an 8-week Internet-delivered acceptance-based cognitive behavioral therapy (i.e., acceptance and commitment therapy [ACT]), or wait-list control. We aim to include measures of distress associated with hearing difficulties, anxiety, and depression. In addition, we aim to measure acceptance associated with hearing difficulties as well as quality of life. Conclusion: The results of the trial may further our understanding of how to best treat people who present problems with both psychological distress and hearing in using the Internet.
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| 19. |
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| 20. |
- Nissling, Linnea, 1991, et al.
(författare)
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Effectiveness of and processes related to internet-delivered acceptance and commitment therapy for adolescents with anxiety disorders : a randomized controlled trial
- 2023
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Ingår i: RESEARCH IN PSYCHOTHERAPY-PSYCHOPATHOLOGY PROCESS AND OUTCOME. - : PAGEPress Publications. - 2499-7552 .- 2239-8031. ; 26:2
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Tidskriftsartikel (refereegranskat)abstract
- Early access to evidence-based help is crucial for adolescents with anxiety disorders. Internet-delivered acceptance and commitment therapy (iACT) may offer adolescents increased access to care and more flexibility in engaging with treatment when and how they prefer. Process-based therapies, such as ACT, focus on the-oretically derived and empirically tested key mechanisms in treat-ment that enable change. This study aimed to investigate the effectiveness of iACT for adolescents with anxiety disorders. The study also assessed the relationship between psychological flexi-bility and treatment outcomes and the relationship between par-ticipating adolescents' and therapists' perceived alliance and treatment outcomes. This was a randomized controlled trial com-paring a 10-week intervention group with a wait-list control group. The 52 participants, aged 15 to 19, were recruited from all over Sweden. The treatment was effective in increasing quality of life and psychological flexibility, with moderate between-group effect sizes based on observed values. Changes in psychological flexibility was associated with changes in anxiety symptoms. The results further showed a statistically significant between-group difference in post-treatment diagnoses. No significant time per group interaction was found for anxiety symptoms, as both groups improved. Working alliance was rated as high by both participat-ing adolescents and therapists but showed no significant relation-ship with treatment outcomes. Participants found the treatment an acceptable intervention. This study shows promising results for iACT in treating adolescents with anxiety disorders. The results suggest the model of psychological flexibility as an important process of change in treatment outcomes. Future research should validate these findings in larger samples and clinical contexts.
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| 21. |
- Nissling, Linnea, 1991, et al.
(författare)
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Effects of patient-driven iCBT for anxiety in routine primary care and the relation between increased experience of empowerment and outcome : A randomized controlled trial
- 2021
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Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- Background: The World Health Organization has declared that primary care should be organized to empower individuals, families, and communities to optimize health. Internet cognitive behavioral therapy (iCBT) tailored by psychologists' initial assessments to meet patients' specific needs have shown promising effects. However, few studies have evaluated patient involvement in decisions during iCBT. Aim: This study aimed to explore the effect of patient-driven iCBT compared to standard iCBT on perceived control over treatment, adherence, and level of anxiety symptoms. A secondary aim was to assess the relationship between changes in empowerment and changes in anxiety symptoms. Method: Participants were patients recruited form primary care and assessed as meeting the criterion for an anxiety disorder. Participants were randomized to patient-driven iCBT (n = 27) or standard iCBT (n = 28). Patient-driven iCBT was adapted to participants' preferences regarding for example focus of treatment program and order of modules. Participants randomized to the control condition received the standard iCBT program for anxiety disorders at the participating unit. The outcome measures were patients' perceived control over treatment, adherence to treatment, symptoms of anxiety, depression and general disability as well as the experience of empowerment. Results: Participants in patient-driven iCBT had statistically higher perceived control over treatment (t(43) = 2.13, p = .04). Symptoms were significantly reduced in both arms with regards to anxiety, depression, and general disability. A significant time per condition interaction effect for anxiety symptoms was observed (df = 45.0; F = 3.055; p = .038), where the patient-driven condition had a significantly larger reduction in anxiety. For both groups a significant correlation of r = 0.47 was found between changes in empowerment and changes in anxiety. Conclusion: Results indicate that iCBT that is patient-driven, may have a greater effect on anxiety, than standard iCBT. The effect on perceived control over treatment might also be larger in patient-driven treatments than in standard iCBT. Internet-based therapies inherently promote as active agents of their own care and might be well suited for promoting perceived control and empowerment. Findings need to be replicated given the small sample size and the explorative nature of the study.
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| 22. |
- Nissling, Linnea, 1991, et al.
(författare)
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Internet-delivered Acceptance and Commitment Therapy for adolescents with anxiety disorders
- 2023
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Ingår i: SweSRII – The 12th Swedish Congress on Internet Interventions..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background Anxiety disorders are common causes of mental illness in adolescents. Acceptance and Commitment Therapy delivered through internet (iACT) shows promising results for adults with anxiety disorders, but few studies exist on internet-delivered ACT programs for adolescents. Aims investigate the effectiveness of internet-delivered ACT for adolescents with anxiety disorders assess the relationship between psychological flexibility and treatment outcomes assess the relationship between adolescents and therapists perceived alliance and treatment outcomes. Population 52 adolescents aged 15 to 19 and from all over Sweden were recruited through advertisements on social media, in schools, primary health care centers and outpatient psychiatric clinics and were assessed by the diagnostic interview M.I.N.I Kid as meeting criteria for one or several anxiety diagnosis. Intervention An internet-delivered ACT treatment, “Ångesthjälpen UNG”, was developed (Psykologpartners, 2017). Outcomes The treatment increased the adolescents’ self-rated quality of life and psychological flexibillity (moderate between-group effect sizes, d=.65 and d=.51) Post treatment assessment with M.I.N.I Kid showed diminished anxiety diagnoses No significant group difference was found for anxiety symptoms, as both groups improved Changes in psychological flexibility were associated with changes in anxiety symptoms Working alliance was rated as high by both adolescents and therapists but showed no significant relationship with treatment outcomes Take-home message This study shows promising results for internet-delivered ACT in treating adolescents with anxiety disorders. The results suggest the model of psychological flexibility as an important process of change in treatment outcomes. Future research should validate these findings in larger samples and in clinical contexts.
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| 23. |
- Nissling, Linnea, 1991, et al.
(författare)
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Primary Care Peer-Supported Internet-Mediated Psychological Treatment for Adults With Anxiety Disorders: Mixed Methods Study.
- 2020
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Ingår i: JMIR formative research. - : JMIR Publications Inc.. - 2561-326X. ; 4:8
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Tidskriftsartikel (refereegranskat)abstract
- The effect of internet-delivered cognitive behavioral therapy (iCBT) on anxiety in adults is well-known. However, patient dropouts and poor adherence to treatment are common. Feelings of belonging and empowerment from the treatment might be key to the completion of iCBT. Peer support workers are people with a personal experience of mental health problems, trained to provide professional support to people who require mental health care.This study aims to assess patient experiences; the feasibility, safety, and acceptability; and preliminary effectiveness on anxiety and depression, empowerment, and adherence to treatment in an 8-week peer-supported iCBT program for patients with anxiety disorders treated in primary care.This was a single-arm mixed methods feasibility study. Participants were patients referred to a central unit for iCBT in primary care. Quantitative data were collected pre-, post-, and 3 months postintervention. Qualitative data were collected through semistructured interviews.A total of 9 participants completed the quantitative outcome assessment. Statistically significant improvements were observed in perceived empowerment at a 3-month follow-up, and significant decreases in anxiety, depression, and psychological distress at the end of the treatment were maintained at a 3-month follow-up. In total, 8 of the 9 patients showed improvement in the severity of their symptoms of anxiety. Adherence to treatment was good among the participants. No serious adverse events were reported. Eight participants were enrolled in the qualitative analysis. The qualitative results showed 3 main themes: (1) real contact in an online world, (2) empowering experiences, and (3) being behind the wheel. Qualitative results largely emphasized the personal relationship and supported the acceptability of adding peer support to iCBT.Peer support in digital treatment seems to be a safe and acceptable intervention. The preliminary results suggest the effectiveness of peer support on patient empowerment, anxiety, depression, psychological distress, and adherence to treatment. The results indicate the need for future studies to evaluate the effect of adding peer support to iCBT in larger randomized controlled trials.
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| 24. |
- Persson, Marie, et al.
(författare)
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Conceptualising migraine attacks from a biopsychosocial model using qualitative and functional behavioural analysis.
- 2023
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Ingår i: Scandinavian journal of primary health care. - 1502-7724. ; 41:3, s. 257-266
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to explore patients' experiences and management of pain in connection with a migraine attack in episodic migraine.Design, setting and subjects: This qualitative study used a semi-structured interview format based on functional behavioural analysis as commonly used in cognitive behavioural therapy. We interviewed eight participants and analysed their responses using systematic text condensation.Results: Participants' descriptions of their experiences and management of pain from episodic migraine were sorted into three description First physical sensations, Automatic reactions and Acts according to the interpretation.Conclusion: From a biopsychosocial perspective, a migraine attack is much more complex than just an experience of pain. The purely biological pain prompts a number of automatic reactions leading to strategies for pain management.
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| 25. |
- Petersson, E-L, et al.
(författare)
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Examining the description of the concept "treatment as usual" for patients with depression, anxiety and stress-related mental disorders in primary health care research - A systematic review.
- 2023
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Ingår i: Journal of affective disorders. - : Elsevier BV. - 1573-2517 .- 0165-0327. ; 326, s. 1-10
-
Tidskriftsartikel (refereegranskat)abstract
- In randomized controlled trials (RCTs) within medical research, applied interventions are compared to treatment-as-usual (TAU) as the control condition. The aim of the current study was to examine how the concept of TAU is described when used as control condition in RCTs evaluating treatments for depression, anxiety syndromes, and stress-related mental disorders in primary care.A systematic review of RCTs utilizing TAU as control group in the RCT in accordance with PRISMA standards was conducted. We used one multidisciplinary database (Scopus), one database focused on nursing (Cinahl), and one medical database (PubMed). The searches were conducted in November 2021 and May 2022.The included 32 studies comprised of 7803 participants. The content of TAU was classified as follows: 1) Basic descriptions of TAU lacking a detailed account as well as reference to local or national guidelines, 2) Moderate description of TAU including reference to national or local guidelines or a detailed description 3) Advanced description of TAU including references to national guidelines and a detailed description containing five key concepts: early assessment, accessibility, psychological treatment, medication, somatic examination. 18 studies had basic, 11 moderate, and 3 advanced descriptions of TAU.The limitations were that only studies published in English were included.The current study provides an assessment tool with three classification levels for TAU. The description of TAU is still insufficient in RCT studies conducted in primary care, which may affect the interpretation of results. In future research a detailed description of TAU is recommended.
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| 26. |
- Thorsell Cederberg, Jenny, et al.
(författare)
-
A preliminary validation of the Swedish short version of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y8) for children and adolescents with cancer
- 2018
-
Ingår i: Journal of Contextual Behavioral Science. - : Elsevier BV. - 2212-1447. ; 10, s. 103-107
-
Tidskriftsartikel (refereegranskat)abstract
- Psychological inflexibility constitutes a generalized vulnerability for psychopathology. Children and adolescents undergoing cancer treatment are faced with numerous physical and psychological stressors throughout their cancer trajectory. Most of the survivors show resilience but some groups report psychological ill-health and poor quality-of-life long-term. Psychological flexibility has been shown to mediate improvements in psychological health for cancer patients. The Avoidance and Fusion Questionnaire for Youth (AFQ-Y) is the most frequently used measure of psychological inflexibility in children and adolescents. It correlates with a wide range of measures of mental health and long-term functional behavior. The aim of the study was to investigate norm values, psychometric properties and factor structure of the AFQ-Y8 for children and adolescents with cancer. All children and adolescents, aged 7-18 years of age, undergoing cancer treatment in Sweden at the time of the study were invited to participate. Norm values, internal consistency, test-retest reliability and convergent validity were calculated and an exploratory factor analysis was conducted. 62 children participated. The mean of the AFQ-Y8 in the sample was 10.30 (5.75). Internal consistency was acceptable (alpha = 0.76), test-retest reliability was good (ICC = 0.64) and convergent validity was demonstrated (r = 0.42). Norm values are now available, and the psychometric properties supported, for the AFQ-Y8 for children and adolescents with cancer. This provides implications for the prevention and treatment of psychopathology for this population. However, the one-factor structure of the AFQ-Y8 was not unequivocally supported. The results from the PCA rather suggested a two-factor structure. Due to the small sample of the study, the results should be seen as preliminary and further validation is warranted, specifically with regards to factorial validity and sensitivity to change.
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| 27. |
- Thorsell Cederberg, Jenny, et al.
(författare)
-
A preliminary validation of the swedish version of the pain catastrophizing scale for children (PCSC) for children and adolescents with cancer
- 2019
-
Ingår i: Journal of Pain Research. - : DOVE MEDICAL PRESS LTD. - 1178-7090. ; 12, s. 1803-1811
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Tidskriftsartikel (refereegranskat)abstract
- © 2019 Cederberg et al. Objectives: Pain is reported as one of the most common and difficult symptoms for children and adolescents with cancer to cope with. Pain catastrophizing has been identified as a process clearly related to pain intensity and disability. The Pain Catastrophizing Scale for Children (PCS-C) has been validated in several languages and populations but remains to be validated in pediatric oncology. The aim of the study was to validate a Swedish version of the PCS-C for children and adolescents with cancer. Methods: All children, 7–18 years of age, being treated for cancer in Sweden at the time of the study were invited to participate. Study material was sent out to the registered address. Internal consistency, test–retest reliability and convergent validity were calculated. Factor structure was examined using principal component analysis (PCA). Descriptive statistics were used to investigate background data and norm values. Results: 61 children/adolescents were included in the analyses. The results did not support the original three-factor structure of the PCS-C, but rather suggested that a two-factor structure excluding item 8 best represented the data. The internal consistency of that solution was good (α=0.87), the test–rest reliability was excellent (ICC=0.75) and convergent validity was demonstrated (r=0.46). The mean (SD) for the PCS-C in the sample was 19.1 (9.2), without item 8. A statistically significant difference was shown between genders, where girls reported a higher level of pain catastrophizing than boys. No difference was found with regard to age. Discussion: The Swedish version of the PCS-C is now preliminarily validated for children and adolescents with cancer, for whom gender- and age-specific norm values are now available. Questions remain regarding the optimal factor structure of the PCS-C.
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| 28. |
- Thorsell Cederberg, Jenny, et al.
(författare)
-
Children’s and adolescents’ relationship to pain during cancer treatment : a preliminary validation of the Pain Flexibility Scale for Children
- 2017
-
Ingår i: Journal of Pain Research. - : Dove Medical Press. - 1178-7090. ; 10, s. 1171-1178
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Children with cancer often suffer from pain. Pain is associated with psychological distress, which may amplify the pain experience. In chronic pain, it has been shown that psychological acceptance is helpful for both adults and children. For experimentally induced pain, interventions fostering psychological acceptance have been shown to predict increases in pain tolerance and reductions in pain intensity and discomfort of pain. A single subject study aiming to nurture psychological acceptance for children with cancer experiencing pain has shown promising results. No instruments measuring psychological acceptance in acute pain are yet available. The aim of the current study was to develop and preliminarily evaluate an instrument to measure psychological acceptance in children experiencing pain during cancer treatment.Methods: A test version of the Pain Flexibility Scale for Children was sent to all children aged 7–18 years undergoing cancer treatment in Sweden at the time of the study. Exploratory factor analysis was used. Internal consistency, test–retest reliability, and convergent validity were examined.Results: Sixty-one children participated in the study. A two-factor solution with Promax rotation was found to best represent the data. Internal consistency was good to excellent (a =0.87–0.91). The total scale and the subscales demonstrated temporal stability (Intraclass correlation coefficient =0.56–0.61) and satisfactory convergent validity (r=−0.27 to −0.68).Discussion: The Pain Flexibility Scale for Children measuring psychological acceptance in children with cancer experiencing pain is now available for use. This enables the evaluation of acceptance as a mediator for treatment change in the context of acute pain in children with cancer, which in turn is a step forward in the development of psychological treatments to help children cope with the pain during these difficult circumstances. The scale shows good psychometric properties but needs further validation, particularly considering the small sample size.
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| 29. |
- Thorsell Cederberg, Jenny, et al.
(författare)
-
Parents’ relationship to pain during children's cancer treatment – a preliminary validation of the Pain Flexibility Scale for Parents
- 2017
-
Ingår i: Journal of Pain Research. - : Dovepress. - 1178-7090. ; 10, s. 507-514
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Pain is one of the most frequent and burdensome symptoms for children with cancer. Psychological acceptance has been shown to be beneficial in chronic pain. Acceptance-based interventions for experimentally induced pain have been shown to predict increased pain tolerance and decreased pain intensity. An acceptance-based pilot study for children with cancer experiencing pain has shown promising results. Further, parental acceptance has been shown to predict decreased child distress. To date, no instruments measuring acceptance in the context of acute pain in children are available. The aim of this study was to develop and evaluate an instrument to measure acceptance in parents of children experiencing pain during cancer treatment. Methods: A test version of the Pain Flexibility Scale for Parents (PFS-P) was sent to parents of all children undergoing cancer treatment in Sweden at the time of the study. Exploratory factor analysis (n=243) examined numerous solutions. Internal consistency, test-retest reliability and convergent validity were calculated. Results: A three-factor Promax solution best represented the data. The subscales were pain resistance, valued action and pain fusion. Internal consistency was good (alpha=0.81-0.93), and the total scale and the subscales demonstrated temporal stability (r=0.76-0.87) and good convergent validity (-0.40 to -0.84). Discussion: The PFS-P measuring acceptance in parents of children experiencing pain during cancer treatment is now available, enabling evaluation of acceptance in the context of acute pain in children. The scale shows good psychometric properties but needs further validation.
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| 30. |
- Thorsell Cederberg, Jenny, et al.
(författare)
-
Validation of the Swedish Acceptance and Action Questionnaire (SAAQ) for parents of children with cancer
- 2018
-
Ingår i: Journal of Contextual Behavioral Science. - : Elsevier BV. - 2212-1447. ; 10, s. 50-54
-
Tidskriftsartikel (refereegranskat)abstract
- Experiential avoidance (EA) has been shown to constitute a generalized vulnerability for psychopathology. It is described as unwillingness to be in contact with aversive private experiences followed by behavioral responses to avoid those experiences. The Acceptance and Action Questionnaire (AAQ-II) is the most frequently used measure of EA and has been shown to correlate with a wide range of measures of mental health and long-term functional behavior. The Swedish version of the scale has previously been evaluated in a non-clinical sample but remains to be evaluated in a clinical one. A subgroup of parents of children with cancer report psychological ill-health long-term. The aim of the study was to investigate factor structure, norm values and psychometric properties of the Swedish Acceptance and Action Questionnaire (SAAQ) for parents of children with cancer. Parents of all children undergoing cancer treatment in Sweden at the time of the study were invited to participate. Factor structure was investigated and norm values, internal consistency, test-retest reliability and convergent validity were calculated. 243 parents participated. The mean of the SAAQ in the sample was 16.69 (SD 8.68; SE 0.56). Internal consistency (alpha = 0.92) and test-retest reliability (ICC = 0.86) were excellent. The SAAQ correlated moderately with the Pain Catastrophizing Scale for parents (PCS-P). Norm values are now available, and the psychometric properties supported, for the SAAQ for parents of children with cancer. This may facilitate prevention and treatment of psychopathology for this population by providing implications for interventions. First, however, sensitivity to change needs to be assessed.
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| 31. |
- Thorsell Cederberg, Jenny, et al.
(författare)
-
Validation of the Swedish version of the Pain Catastrophizing Scale for Parents (PCS-P) for parents of children with cancer
- 2019
-
Ingår i: Journal of Pain Research. - : DOVE MEDICAL PRESS LTD. - 1178-7090. ; 12, s. 1017-1023
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: Pain is reported as one of the most common and burdensome symptoms for children with cancer. Pain catastrophizing is clearly related to pain intensity and disability. Catastrophizing in parents is associated with both child functioning and parent distress. The Pain Catastrophizing Scale for Parents (PCS-P) remains to be validated for parents of children with cancer. The aim of the study was to validate the Swedish version of the PCS-P for parents of children with cancer experiencing pain.Methods: Parents of all children who were being treated for cancer in Sweden at the time of the study were invited to participate. Study material was sent out to the registered address. Internal consistency, test-retest reliability, and convergent validity were calculated, and factor analysis was conducted. Descriptive statistics was used to investigate the background data and norm values.Results: A total of 243 parents participated in the study. The results did not support the original three-factor structure of the PCS-P, but rather suggested that a two-factor structure best represented the data. The results showed excellent internal consistency (alpha=0.93), excellent temporal stability (intraclass correlation coefficient =0.86) and moderate convergent validity (rho=0.57). The mean (SD) for the PCS-P in the sample was 28.3 (10.7). A statistically significant difference was found between mothers and fathers, where mothers reported a higher level of pain catastrophizing than fathers.Conclusion: The psychometric properties of the PCS-P has now been supported in a sample of parents of children with cancer, and norm values are now available. The factor structure does, however, deserve more investigation.
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| 32. |
- Wallin, Emma, 1981-, et al.
(författare)
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Acceptance and Commitment Therapy to Promote Value Attainment Among Individuals with overweight: A multiple baseline evaluation
- 2018
-
Ingår i: Journal of Contextual Behavioral Science. - : Elsevier BV. - 2212-1447. ; 10:October, s. 41-49
-
Tidskriftsartikel (refereegranskat)abstract
- Although overweight is typically associated with lower quality of life, weight loss in itself does not necessarily improve quality of life. Therefore, there is an increase of studies investigating the effect of Acceptance and Commitment Therapy (ACT) to promote values-based behavior among people with overweight. However, few have evaluated the use of brief self-help interventions with minimal therapist support. The aim of the present study was to evaluate the impact with regard to value attainment related to health and weight related experiential avoidance as well as the acceptability of a self-help intervention based on ACT with therapist support via telephone. A single subject multiple baseline design with temporal staggering and randomization of treatment onset was used. Participants with overweight or obesity (n = 13, 100% women) with a mean age of 42 (SD = 13.79) were recruited through social media. The intervention consisted of a workbook and weekly telephone support during a 3-week treatment period. Primary and secondary outcome measures were collected daily and before, after and at 3-months follow up. Results indicate that the intervention improved daily ratings of value attainment related to health among seven participants and reduced experiential avoidance among five of the participants. Effect sizes for those who improved were medium to large. Remaining participants did not improve with regard to the primary outcomes. Moreover, results indicate that the intervention was associated with acceptable adherence and treatment satisfaction. Future studies are needed in order to understand more about for what types of clients a brief self-help ACT intervention may be helpful to improve values based behavior.
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| 33. |
- Weineland, Sandra, et al.
(författare)
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A conceptual piece: contextualizing obesity struggles
- 2015
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Ingår i: The International Journal of Behavioral Consultation and Therapy. ; 9:4
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Forskningsöversikt (refereegranskat)abstract
- Though research on behavioral processes involved in obesity surgery is needed, few papers have been published from a contextual behavioral perspective. The purpose of this article is to present theoretical frameworks and a tightly-conceptualized analysis, which may be a guide for the researcher and clinician. In a contextual approach behavior is interpreted as inseparable from its current and historical context. Candidates for bariatric surgery often have a history of self-stigma, body dissatisfaction and eating for emotional relief. Despite losing a large amount of weight post surgery, psychological problems may still be present. Though a multidisciplinary team is recommended for post-surgical care, studies evaluating the psychological treatment of patients undergoing bariatric surgery are missing. Efforts to increase knowledge about psychological post surgery issues as well as designing effective behavioral treatment interventions post surgery seem to be needed. This is a conceptual piece of the literature summing up a contextual behavioral approach for obesity surgery patients.
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| 34. |
- Weineland, Sandra
(författare)
-
A Contextual Behavioral Approach for Obesity Surgery Patients
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis investigates a contextual behavioral approach for obesity surgery patients. In a contextual approach a behavior is interpreted as inseparable from its current and historical context. Candidates for bariatric surgery often have a history of self-stigma, body dissatisfaction and eating for emotional relief. Despite losing a large amount of weight post surgery, psychological problems may still be present for some patients. One possible common underlying process observed in body concerns and eating patterns is experiential avoidance. Experiential avoidance is defined as; any attempt to avoid, change, or control unwanted thoughts and feelings when so doing causes harm.Though a multidisciplinary team is recommended for post-surgical care, there are few studies evaluating the psychological treatment of patients undergoing bariatric surgery. In this thesis a protocol based on Acceptance and Commitment Therapy (ACT), was developed and implemented, partly via the Internet, in a clinical setting. In an acceptance-based approach to obesity, psychological well-being is the main outcome. ACT was significantly more effective than ‘treatment as usual’ in terms of body dissatisfaction and quality of life after surgery. Both groups improved in eating disordered attitudes and behaviors. Predictions based on the underlying treatment model were also investigated. Positive treatment outcomes were found to be associated with increased psychological flexibility. Despite some methodological limitations, the results are promising and future studies should further evaluate ACT in the context of bariatric surgery.This thesis also acknowledges the need for clinical assessment tools appropriate for the bariatric surgery context. The Acceptance and Action Questionnaire for Weight (AAQ-W) is a measure of experiential avoidance, and was evaluated in the present thesis. The AAQ-W was found to be a reliable and valid measure for people undergoing bariatric surgery. Another measure, Disordered Eating in Bariatric Surgery (DEBS) was developed and evaluated. The DEBS was found to posses satisfactory psychometric properties in terms of reliability and validity. The AAQ-W and the DEBS may facilitate both systematic clinical evaluation and future research within the area of bariatric surgery.
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| 35. |
- Weineland, Sandra, et al.
(författare)
-
Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT
- 2012
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Ingår i: Obesity Research and Clinical Practice. - : Elsevier BV. - 1871-403X .- 1878-0318. ; 6:1, s. e21-e30
-
Tidskriftsartikel (refereegranskat)abstract
- Bariatric surgery (BS) is rated as the best evidence based treatment for obesity with regard to weight loss and maintenance of weight loss evaluated to date. Although BS interventions are effective, 20-30% of BS patients start to regain weight within 24 months. Emotional eating is a behavior pattern which has been found to predict poor outcome. The aim of this study is to evaluate the effects of acceptance and commitment therapy (ACT) for patients who underwent BS, with regard to emotional eating, body dissatisfaction and quality of life. This study is a randomized controlled trial (n = 39) with two conditions (1) ACT including two face-to-face sessions and support via an Internet application and (2) treatment as usual (TAU) comprising the standard follow-up used by the BS team. Results show that participants in the ACT condition significantly improve on eating disordered behaviors, body dissatisfaction, quality of life and acceptance for weight related thoughts and feelings, as compared to those in the TAU group. This study shows that it is possible to improve effects of BS by specifically targeting emotional eating behavior.
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| 36. |
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| 37. |
- Weineland, Sandra, et al.
(författare)
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Development and validation of a new questionnaire measuring eating disordered behaviours post bariatric surgery
- 2012
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Ingår i: Clinical Obesity. - : International Association for the Study of Obesity. - 1758-8103 .- 1758-8111. ; 2:5-6, s. 160-167
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Tidskriftsartikel (refereegranskat)abstract
- Contextualization of post-surgery circumstances in terms of key behaviours and emotions related to eating is crucial for reliable screening. Disordered eating post surgery is characterized by frequent snacking and a sense of loss of control over food intake. The purpose of this study was to evaluate the psychometric properties of a short self-report questionnaire entitled Disordered Eating after Bariatric Surgery (DEBS). Results indicate that the DEBS possesses satisfactory psychometric properties in terms of reliability, validity, internal consistency and test–retest reliability. The DEBS may facilitate both systematic clinical evaluation and future research within the area of bariatric surgery.
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| 38. |
- Weineland, Sandra, et al.
(författare)
-
Development and validation of a new questionnaire measuring eating disordered behaviours post bariatric surgery.
- 2012
-
Ingår i: Clinical obesity. - : Wiley. - 1758-8103 .- 1758-8111. ; 2:5-6, s. 160-7
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Tidskriftsartikel (refereegranskat)abstract
- Contextualization of post-surgery circumstances in terms of key behaviours and emotions related to eating is crucial for reliable screening. Disordered eating post surgery is characterized by frequent snacking and a sense of loss of control over food intake. The purpose of this study was to evaluate the psychometric properties of a short self-report questionnaire entitled Disordered Eating after Bariatric Surgery (DEBS). Results indicate that the DEBS possesses satisfactory psychometric properties in terms of reliability, validity, internal consistency and test-retest reliability. The DEBS may facilitate both systematic clinical evaluation and future research within the area of bariatric surgery.
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| 39. |
- Weineland, Sandra, et al.
(författare)
-
Do Experiential Avoidance and Emotional Eating Habits Predict Outcomes of Bariatric Surgery at a 2 years follow-up? A short report
- 2015
-
Ingår i: The International Journal of Behavioral Consultation and Therapy. ; 9:4
-
Tidskriftsartikel (refereegranskat)abstract
- Bariatric surgery is associated with weight loss and improvements in co-morbid medical conditions. Although surgery is the best-evidenced method for weight loss, patients still report conditioned behavioral patterns of avoidance and inflexibility. For instance there is substantial proportion of patients reporting loss of control over eating and distress concerning body shape, which seem to effect other outcomes including weight loss and quality of life. The purpose of the current study was to examine how well emotional eating and experiential avoidance perform as predictors of surgical outcomes: satisfaction with life, general well-being and weight loss two years post bariatric surgery. Experiential avoidance refers to when an individual avoids unpleasant internal experiences even in those cases where avoidance interferes with living healthy. Results show that higher levels of experiential avoidance and emotional eating at baseline presurgery and at six months postsurgery, predict outcomes in terms of a lower satisfaction with life and more negative stats of mind at 2 years post-surgery. Results validate experiential avoidance in weight-related problems as an important aspect of life quality following bariatric surgery.
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| 40. |
- Weineland, Sandra, et al.
(författare)
-
Effects of Tailored and ACT-Influenced Internet-Based CBT for Eating Disorders and the Relation Between Knowledge Acquisition and Outcome: A Randomized Controlled Trial
- 2017
-
Ingår i: Behavior Therapy. - : Elsevier BV. - 0005-7894 .- 1878-1888. ; 48:5, s. 624-637
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 This is the first trial to investigate the outcome of tailored and ACT-influenced, cognitive behavioral Internet treatment for eating disorder psychopathology, and the relation between knowledge acquisition and outcome. This study utilized a randomized controlled design, with computer-based allocation to treatment or waiting list control group. Participants were recruited via advertisements in social media and newspapers in Sweden. Participants fulfilling the criteria for bulimia nervosa (BN), or Eating Disorder Not Otherwise Specified (EDNOS), with a BMI above 17.5, were enrolled in the study (N = 92). The treatment group received an Internet-based, ACT-influenced CBT intervention, developed by the authors, for eating disorders. The treatment lasted 8 weeks, and was adapted to the participant's individual needs. A clinician provided support. The main outcome measures were eating disorder symptoms and body shape dissatisfaction. Intent-to-treat analysis showed that the treatment group (n = 46) improved significantly on eating disorder symptoms and body dissatisfaction, compared with the waiting list control group (n = 46), with small to moderate effect sizes (between group effects, d = 0.35–0.64). More than a third of the participants in the treatment group (36.6%), compared to 7.1% in the waiting list control condition, made clinically significant improvements. Results showed a significant increase in knowledge in the treatment group compared to the waiting list control group (between group effect, d = 1.12), but we found no significant correlations between knowledge acquisition and outcome (r = -0.27 to -r = 0.23). The results provide preliminary support for Internet-based, tailored, and ACT-influenced treatment, based on CBT for participants with eating disorder psychopathology.
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| 41. |
- Weineland, Sandra
(författare)
-
Fetma
- 2019
-
Ingår i: Somatisk sjukdom - ett biopsykosocialt perspektiv. - : Studentlitteratur AB. - 9789144119601
-
Bokkapitel (refereegranskat)
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| 42. |
- Weineland, Sandra Mikaela, et al.
(författare)
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Bridging the Gap Between Hearing Screening and Successful Rehabilitation : Research Protocol of a Randomized Controlled Trial of Motivational Interviewing via Internet
- 2015
-
Ingår i: American Journal of Audiology. - : American Speech-Language-Hearing Association. - 1059-0889 .- 1558-9137. ; 24:3, s. 302-306
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Studies point to low help-seeking after a failed hearing screening. This research forum article presents the research protocol for a randomized controlled trial of motivational interviewing via the Internet to promote help-seeking in people who have failed an online hearing screening. Method: Adults who fail a Swedish online hearing screening, including a speech-in-noise recognition test, will be randomized to either an intervention group (participating in motivational interviewing) or an active control group (reading a book on history of hearing aids). Both of the conditions will be delivered via the Internet. The primary outcome is experience with seeking health care and using hearing aids 9 months after the intervention. Secondary outcomes are changes in before and after measures of self-reported hearing difficulties, anxiety, depression, and quality of life. Stages of change and self-efficacy in hearing help-seeking are measured immediately after intervention and at a 9-month follow-up for the purpose of mediation analysis. Results: The results of this randomized controlled trial may help bridge the gap between hearing screening and successful hearing rehabilitation. Conclusion: Although no large instantaneous benefits are expected, a slow change toward healthy behaviors—seeking health care and using hearing aids—would shed light on how to use the Internet to assist people with hearing impairment.
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| 43. |
- Weineland, Sandra, et al.
(författare)
-
Measuring experiential avoidance in a bariatric surgery population--psychometric properties of AAQ-W.
- 2013
-
Ingår i: Obesity research & clinical practice. - : Elsevier BV. - 1871-403X .- 1878-0318. ; 7:6
-
Tidskriftsartikel (refereegranskat)abstract
- Valid measures capturing underlying psychological processes post surgery for obesity are needed to help identify important clinical targets and develop psychosocial interventions in conjunction with surgery. The Acceptance and Action Questionnaire for Weight (AAQ-W) measures experiential avoidance and has never been evaluated in a bariatric surgery population.Participants were recruited at a bariatric surgery clinic during follow-up care. The evaluation of psychometric properties of AAQ-W was done by repeated measurements of reliability (n = 62), convergent validity (n = 75 and n = 178), predictive validity (n = 61), factor analysis and calculation of internal consistency (n = 178).The AAQ-W was found to have satisfactory psychometric properties. Internal consistency was high (α = .86). Results showed good stability over time (r = .77) and validity coefficients ranging from r = .36 to .71. AAQ-W scores measured six months post surgery predicted satisfaction with life, negative emotional states, emotional eating and general eating pathology measured one year post surgery. However AAQ-W measured at six months did not predict percent excess BMI Loss at one year. Factor analysis showed that a five factor solution (Food as Control, Body Acceptance, Self-Stigma, Self-Efficacy and Emotional Avoidance) might be a good fit (n = 178).This study shows that the AAQ-W appears to be a psychometrically sound measure that can be used by researchers and clinicians in the context of bariatric surgery.
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| 44. |
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| 45. |
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| 46. |
- Weineland, Sandra, et al.
(författare)
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Transitioning from face-to-face treatment to iCBT for youths in primary care – therapists’ attitudes and experiences
- 2020
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Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 22
-
Tidskriftsartikel (refereegranskat)abstract
- Background: To address the increasing mental health problems among young people, health care needs to broaden the spectrum of interventions and increase access to care. One particularly promising first-line intervention is cognitive behavioral therapy (CBT) delivered via the Internet (iCBT). The outbreak of the Coronavirus disease -2019 (COVID -19) has made the need for solid digital mental health care systems clear. This is the first published study exploring the transition among therapists of working with face-to-face treatment to using iCBT for youths suffering from anxiety treated in primary care. Methods: Fourteen primary care therapists were included in the study. Semi-structured interviews (n = 26) were conducted on two occasions: before starting to use iCBT for youths, and at a subsequent follow-up after gaining treatment experience. Data was summarized into thematic categories. Results: The overarching themes that were identified were: Attitudes to iCBT before and after implementation; Experiences of treatment delivery; Characteristics of “the right patient;” and The role of the digital therapist. Conclusion: The participants generally had positive attitudes to iCBT for youths and saw it as a valuable alternative to face-to-face treatments. However, they identified challenges related to patient selection, and to motivating patients and maintaining a therapeutic relationship through mainly written communication. The participants appreciated the increase in variety that iCBT brought to their schedules, and also experienced iCBT as a relief from common challenges of therapeutic work, such as emotional stress and high cognitive demands. The participating therapists’ positive experiences support the introduction of iCBT for youths in routine primary care
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| 47. |
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| 48. |
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| 49. |
- Weineland, Sandra, et al.
(författare)
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Values in psychotherapy
- 2009
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Ingår i: Enschede. ACBS World Conference III.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 50. |
- Weineland, Sandra, et al.
(författare)
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Ätstörningar och födorelaterade syndrom
- 2021
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Ingår i: Psykisk ohälsa : ett biopsykosocialt perspektiv. - Lund : Studentlitteratur. - 9789144131160 ; , s. 269-298
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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