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- Bojner Horwitz, Eva, 1965-
(författare)
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Dance/Movement Therapy in Fibromyalgia Patients : Aspects and Consequences of Verbal, Visual and Hormonal Analyses
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis presents hormonal, emotional, physical and visual status changes in female fibromyalgia (FMS) patients after treatment with the Creative Art therapy; dance/movement therapy, compared to controls. FMS is a syndrome of chronic pain involving musculoskeletal aches, stiffness and pain where perturbations in the stress-axis and high scores on somatic anxiety and muscular tension also have been found. The study comprises thirty-six female FMS patients divided in treatment- and control group. Serum concentrations of the hormones prolactin, dehydroepiandrosterone sulphate (DHEA-S), cortisol and neuropeptide Y (NPY) in plasma and cortisol in saliva were analysed. Different verbal self-rating scales concerning well-being, pain, personality and life events among other things have been used. Assessments of the condition of the FMS patients affected by video-viewing were evaluated together with interviews about the self-perception phenomenon of video viewing (a phenomenological hermeneutic method). The results of the study show that six months of dance/movement therapy appears sufficient to improve both psychological and physical function, as indicated by the visual analyses. The video interpretation technique (VIT) and self-figure drawings captured treatment effects that were not evident from verbal scales or reflected in hormone levels. The biological markers probably need a longer treatment period to activate the HPA axis and its inter-related hormones and peptides. The use of different assessment techniques most likely has affected the treatment outcome. Difficulties perceiving information through verbal/cognitive modalities as well as alexithymia are factors discussed. The VIT may be useful for early identification of maladaptive movement patterns and as a mirror of facial and bodily expressions of emotions. In conclusion, this study indicates that both the dance/movement therapy and the VIT have had great influence on the FMS patient’s well-being, self-perception and perception of pain.
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| 12. |
- Bojner Horwitz, Eva, et al.
(författare)
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Dance/movement therapy in fibromyalgia patients : Changes in self-figure drawings and their relation to verbal self-rating scales
- 2006
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Ingår i: The arts in psychotherapy. - : Elsevier BV. - 0197-4556 .- 1873-5878. ; 33:1, s. 11-25
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluates if verbally oriented scales are as effective as the visual instruments of self-figure drawing and video interpretation in detecting treatment responses after 6 months of dance/movement therapy in fibromyalgia patients.The self-figure drawing and video interpretation technique captured treatment effects that were not seen on verbal scales. In the self-figure drawings, significant differences were seen in the variables “amount of body details” and “amount of paper use in percent” between the treatment group and controls after dance/movement therapy. The treatment group showed a significant increase in the “amount of body details” and “amount of paper use in percent” compared to controls. Specific parts of the verbally oriented ratings in CPRS, “bodily discomfort” and “compulsive act,” were positively correlated to “number of different colours.” The variable “pain and ache” in the CPRS indicated a negative correlation to the “amount of paper use in percent,” i.e. the more pain, the less paper used.The use of different assessment techniques may affect the treatment outcome and verbal instrumentation may not be the most appropriate in this patient group. Difficulties perceiving information through verbal/cognitive modalities as well as alexithymia are factors that are discussed.
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| 16. |
- Bojner Horwitz, Eva, 1965-, et al.
(författare)
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Theater for, by and with fibromyalgia patients : evaluation of emotional expression using video interpretation
- 2010
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Ingår i: The arts in psychotherapy. - : Elsevier BV. - 0197-4556 .- 1873-5878. ; 37:1, s. 13-19
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Tidskriftsartikel (refereegranskat)abstract
- The healing function of theatre is reflected in all human cultures. Today, therapists and scientists work with psychodrama and drama therapy, often describing theatre as the art form closest to life itself.In a unique cooperation between professional actors and a dance movement therapist/pain researcher, patients with fibromyalgia have first been trained in body- and voice expression and thereafter acted out a drama onstage together with professional actors. A video interpretation technique was used to help patients interpret their own emotional expressions towards other actors and evaluate their perceived pain and self-rated health.The results of this experimental study show that the variation of emotional expression from video interpretation is dependent upon whether or not the patient acts with an actor. The intensity of emotional expression increases significantly when acting together with a professional actor. The results also show an increase in self-rated health and a decrease in pain after three months of using this theatre-based technique. A correlation between strong emotional expression and decreased pain was also observed. However, when patients did not actively participate in a theatre play, their self-estimated pain was not significantly decreased.In this study, the cross-fertilization of culture/expressive arts and health care is presented as a new resource for pain treatment. In particular there may be a link between intense emotional expressions when acting with professional actors and decreased perceptions of pain. The paper also discusses the potential therapeutic value of working with professional actors in the treatment of other pain patients. Hopefully, this “healing theatre” can contribute to developing collaboration between actors and creative art therapists and stimulate controlled studies of evidence-based science.
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| 19. |
- Hasson, Dan, 1974-
(författare)
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Stress Management Interventions and Predictors of Long-term Health : Prospectively Controlled Studies on Long-term Pain Patients and a Healthy Sample from IT- and Media Companies
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis reports on the effects of stress management on long-term pain patients and on a healthy sample from IT and media companies; two groups that are commonly exposed to high stress levels. Even if there are important differences between these two groups, there are similarities such as the necessity for effective stress management. Stress-related and musculoskeletal disorders are major public health issues in most industrialized countries and are expected to become increasingly common during the coming decades. The pathogenic plastic changes in the CNS and immune system caused by long-term stress pose severe burdens to individuals, organizations as well as society in general. Thus, stress management may be essential to maintain and improve long-term health and wellbeing and to proactively counteract stress-related ill-health.This thesis is based on four papers: Paper I assessed the effects of massage as compared to relaxation tapes in long-term pain patients. Paper II validated some of the Visual Analogue Scale questions that were to be used in paper III and IV. Paper III assessed the effects on mental and physical wellbeing and biological stress markers from a web-based stress management and health promotion tool. Paper IV aimed at mapping out predictors for trends (improvement vs. worsening) in self-rated health (SRH) over a period of one year.The overall results indicate that individually focused stress management interventions in long-term pain patients as well as on a healthy, working population may have short-term beneficial effects on psychological and physiological stress, health and wellbeing. On a long-term basis the beneficial changes seem to revert. In paper four, it is indicated that the stress management intervention is not a significant predictor of long-term changes in SRH. Rather, other factors such as health perception, sleep quality and sense of coherence predicted improvement in SRH over time.
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| 20. |
- Hedborg, Kerstin, 1953-
(författare)
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Migraine and Stress : An Internet administered Multimodal Behavioral Treatment Intervention
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Migraine is a disabling neurological disorder with high prevalence, the clinical manifestations of which are highly dependent on stress. The overall theme of the present thesis was to address aspects of stress in migraine. A multimodal behavioral treatment (MBT) program was developed specifically designed for migraine and focusing on stress as a trigger and an intervention was performed using this Internet-administered program. Migraine symptoms were followed via an Internet administered diary and questionnaires were answered at regular intervals during the 11-month study period. The thesis is based on four papers: In Paper I, life events and current stress, personality traits, and gender were studied cross-sectionally in 106 women and 44 men with migraine, who suffered at least two attacks a month at inclusion. Paper II describes a randomized controlled trial of the MBT program performed on 58 women and 25 men recruited from participants of the study described in Paper I. In the MBT study participants were randomized into one control group and two MBT groups, one of which received hand massage as part of the treatment. In Paper III, complete migraine drug use and changes in use and in drug efficacy during the MBT program were studied. In Paper IV, the salivary cortisol levels of MBT participants were evaluated as a biological stress marker. The MBT program proved effective in decreasing migraine headache; it was feasible and there was low attrition. Moreover, MBT resulted in decreased migraine drug use and increased drug efficacy, but had no discernible effects on salivary cortisol profiles. No effect of hand massage on migraine headache frequency was seen. Personality trait profiling revealed high scores for the neuroticism factor. Stress susceptibility was the single most aberrant personality trait and correlated highly with the reported level of current stress and with experienced negative life events. Gender differences included higher scores for women on trait anxiety, negative life events, depressive mood, anxiety, tension type headache, use of triptans, and efficacy of analgesics, whereas men displayed higher use of analgesics. In conclusion, the efficacy and low attrition associated with the present MBT program appears promising and timely with regard to the development of better and more accessible migraine treatment. Stress susceptibility, gender, negative life events and psychosomatic comorbidity are important factors to consider in relation to the care of persons with migraine.
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