| 1. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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Paradoxical intention for insomnia : A systematic review and meta-analysis
- 2021
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Ingår i: Journal of Sleep Research. - : Wiley-Blackwell Publishing Inc.. - 0962-1105 .- 1365-2869. ; , s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- Paradoxical intention (PI) has been considered an evidence-based treatment for insomnia since the 1990s, but it has not been evaluated with modern review techniques such as meta-analysis. The present study aimed to conduct the first systematic review and meta-analysis of studies that explore the effectiveness of PI for insomnia on insomnia symptomatology and theory-derived processes. A systematic review and meta-analysis was conducted by searching for eligible articles or dissertations in six online bibliographic databases. Randomised controlled trials and experimental studies comparing PI for insomnia to active and passive comparators and assessing insomnia symptoms as outcomes were included. A random effects model was estimated to determine the standardised mean difference Hedge's g at post-treatment. Test for heterogeneity was performed, fail-safe N was calculated, and study quality was assessed. The study was pre-registered at International Prospective Register of Systematic Reviews (PROSPERO, CRD42019137357). A total of 10 trials were identified. Compared to passive comparators, PI led to large improvements in key insomnia symptoms. Relative to active comparators, the improvements were smaller, but still moderate for several central outcomes. Compared to passive comparators, PI resulted in great reductions in sleep-related performance anxiety, one of several proposed mechanisms of change for PI. PI for insomnia resulted in marked clinical improvements, large relative to passive comparators and moderate compared to active comparators. However, methodologically stronger studies are needed before more firm conclusions can be drawn.
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| 2. |
- Andersson, Gerhard, Professor, 1988-, et al.
(författare)
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Individually tailored Internet-delivered cognitive-behavioral therapy for survivors of intimate partner violence : A randomized controlled pilot trial
- 2021
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Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 26
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Tidskriftsartikel (refereegranskat)abstract
- Intimate partner violence (IPV) is a serious public health concern worldwide and defined as behavior performed by spouses or other intimate partners that causes physical, sexual, or psychological harm. Internet-delivered cognitive-behavioral therapy (ICBT) may be particularly useful for survivors of IPV for several reasons, including barriers pertaining to limited community recourses and treatment availability, safety concerns, and issues of stigma, guilt and shame, which may prevent members of this population from seeking help via face-to-face interactions. However, Internet interventions are lacking. The primary aim of the present randomized controlled pilot trial was to explore the feasibility of ICBT as guided self-help individually tailored to the predominant symptomatology of PTSD or depression in survivors of IPV. A second aim was to conduct a preliminary evaluation exploring the short- and long-term effects of the treatment in comparison to a waitlist control condition. Results showed that the treatment was feasible. Attrition rate was low (9.4%), and participants were satisfied with treatment. However, treatment adherence was moderate in terms of completed modules (62.5%). Results of the preliminary evaluation of treatment effects showed large and statistically significant between-group effect sizes (Cohen's d = 0.86–1.08) on some measures of PTSD and depression at post assessment, favoring the treatment condition. However, there were no effects on other measures. At follow-up assessment, when the control condition had received delayed treatment, there were large and statistically significant within-group effect sizes (d = 0.96–1.48) on measures of PTSD, depression and anxiety, and small effects (d = 0.48) on a measure of quality of life. The results of the present pilot study are promising and warrant further research on ICBT for this population.
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| 3. |
- Andersson, Gerhard, Fil dr, Med dr, 1966-, et al.
(författare)
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Use, and perceived usefulness, of cognitive behavioural therapy techniques for self-care among therapists
- 2020
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Ingår i: The Cognitive Behaviour Therapist. - : Cambridge University Press. - 1754-470X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Mental health problems are prevalent among therapists and may have a negative impact on therapist effectiveness. To counteract such problems, therapist self-care (for example, striking a balance between personal and professional demands and seeking personal therapy), has received increased attention. Conceptually, self-care can be considered as part of a personal practice model, focusing on techniques that therapists engage with self-experientially with a focus on their personal and/or professional development. However, studies of the self-application of specific treatment techniques are lacking. We aimed to explore the use, and perceived usefulness, of cognitive behavioural therapy (CBT) techniques for self-care to prevent or treat own mental health problems among practising therapists. Participants were therapists (n= 228) of various professional backgrounds in Sweden. Data were collected using a web-based survey. Descriptive statistics were calculated, and non-parametric analyses conducted to investigate associations of 13 CBT techniques with therapist characteristics. Use of CBT techniques for self-care was highly prevalent among participants, and they perceived the techniques as useful, irrespective of characteristics such as gender, age, profession, years since graduation, clinical experience, level of training in CBT, and previous experience of personal CBT. The high prevalence among therapists of the use of treatment techniques for self-care is very encouraging. Therapist self-care, including the self-application of treatment techniques, may be an important factor for therapist effectiveness, which calls for further development of personal practice models with respect to self-care, and future studies investigating associations between therapist mental health, self-care, effectiveness and patient outcome. Key learning aims Therapist self-care using cognitive behavioural therapy (CBT) techniques to prevent or treat own mental health problems may influence therapist effectiveness. However, studies of self-application of treatment techniques are lacking. In the present survey study, the use of CBT techniques for self-care was highly prevalent among practising therapists, and they perceived the techniques as useful, irrespective of characteristics such as gender, age, profession, years since graduation, clinical experience, level of training in CBT, and previous experience of personal CBT. Almost all therapists believed that it was a good idea to self-apply CBT techniques for their own sake and for the benefit of their patients.
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| 4. |
- Bergvall, Hillevi, et al.
(författare)
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Development of competence in cognitive behavioural therapy and the role of metacognition among clinical psychology and psychotherapy students
- 2023
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Ingår i: Behavioural and Cognitive Psychotherapy. - : CAMBRIDGE UNIV PRESS. - 1352-4658 .- 1469-1833. ; 51:3
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Tidskriftsartikel (refereegranskat)abstract
- Background:There is a paucity of research on therapist competence development following extensive training in cognitive behavioural therapy (CBT). In addition, metacognitive ability (the knowledge and regulation of ones cognitive processes) has been associated with learning in various domains but its role in learning CBT is unknown. Aims:To investigate to what extent psychology and psychotherapy students acquired competence in CBT following extensive training, and the role of metacognition. Method:CBT competence and metacognitive activity were assessed in 73 psychology and psychotherapy students before and after 1.5 years of CBT training, using role-plays with a standardised patient. Results:Using linear mixed modelling, we found large improvements of CBT competence from pre- to post-assessment. At post-assessment, 72% performed above the competence threshold (36 points on the Cognitive Therapy Scale-Revised). Higher competence was correlated with lower accuracy in self-assessment, a measure of metacognitive ability. The more competent therapists tended to under-estimate their performance, while less competent therapists made more accurate self-assessments. Metacognitive activity did not predict CBT competence development. Participant characteristics (e.g. age, clinical experience) did not moderate competence development. Conclusions:Competence improved over time and most students performed over the threshold post-assessment. The more competent therapists tended to under-rate their competence. In contrast to what has been found in other learning domains, metacognitive ability was not associated with competence development in our study. Hence, metacognition and competence may be unrelated in CBT or perhaps other methods are required to measure metacognition.
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| 5. |
- Davies, Benjamin, et al.
(författare)
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Taiwan, Sverige och synen på "ett-Kina-politiken"
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Rapporten redovisar för Taiwans historia och nuvarande utrikespolitiska frågor kopplade till Taiwan. I rapportens andra del beskrivs Sveriges position gentemot Taiwan och hur den har förändrats genom åren.
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| 6. |
- Enö Persson, Johanna, et al.
(författare)
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Experiences of nurses and coordinators in a childhood obesity prevention trial based on motivational interviewing within Swedish child health services
- 2022
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore the experiences of nurses and coordinators in the PRIMROSE childhood obesity prevention trial, and to understand the factors that might help to improve the outcome of future primary prevention of obesity.Methods: Using a qualitative approach, data were obtained by interviewing nine intervention nurses and three regional study coordinators. All participants were female. The interviews were transcribed and analysed using content analysis.Results: Two themes emerged: The nurses experienced that it was rewarding to participate in the trial, but challenging to combine the intervention with regular work; and The study coordinators experienced that they were in a difficult position handling the conflicting needs of the research group and the nurses' commitment to usual child health care services. The importance of support, encouragement, briefer and simpler intervention, and adaptation of the training in motivational interviewing to the setting was emphasized. Stress and lack of time were major barriers to deliver the intervention as intended.Conclusions: Although the PRIMROSE intervention was developed in collaboration with representatives from the child health services, and additional research funding was provided to compensate for time spent working with the trial, nurses experienced stress and time constraints.
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| 7. |
- Gurholt, Tiril P., et al.
(författare)
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Intracranial and subcortical volumes in adolescents with early‐onset psychosis : A multisite mega‐analysis from the ENIGMA consortium
- 2020
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Ingår i: Human Brain Mapping. - Stockholm : Wiley. - 1065-9471 .- 1097-0193. ; 43:1, s. 373-384
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Tidskriftsartikel (refereegranskat)abstract
- Early-onset psychosis disorders are serious mental disorders arising before the age of 18 years. Here, we investigate the largest neuroimaging dataset, to date, of patients with early-onset psychosis and healthy controls for differences in intracranial and subcortical brain volumes. The sample included 263 patients with early-onset psychosis (mean age: 16.4 ± 1.4 years, mean illness duration: 1.5 ± 1.4 years, 39.2% female) and 359 healthy controls (mean age: 15.9 ± 1.7 years, 45.4% female) with magnetic resonance imaging data, pooled from 11 clinical cohorts. Patients were diagnosed with early-onset schizophrenia (n = 183), affective psychosis (n = 39), or other psychotic disorders (n = 41). We used linear mixed-effects models to investigate differences in intracranial and subcortical volumes across the patient sample, diagnostic subgroup and antipsychotic medication, relative to controls. We observed significantly lower intracranial (Cohen's d = −0.39) and hippocampal (d = −0.25) volumes, and higher caudate (d = 0.25) and pallidum (d = 0.24) volumes in patients relative to controls. Intracranial volume was lower in both early-onset schizophrenia (d = −0.34) and affective psychosis (d = −0.42), and early-onset schizophrenia showed lower hippocampal (d = −0.24) and higher pallidum (d = 0.29) volumes. Patients who were currently treated with antipsychotic medication (n = 193) had significantly lower intracranial volume (d = −0.42). The findings demonstrate a similar pattern of brain alterations in early-onset psychosis as previously reported in adult psychosis, but with notably low intracranial volume. The low intracranial volume suggests disrupted neurodevelopment in adolescent early-onset psychosis.
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| 8. |
- Jansson-Frojmark, Markus, et al.
(författare)
-
Paradoxical intention for insomnia : A systematic review and meta-analysis
- 2022
-
Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 31:2
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Tidskriftsartikel (refereegranskat)abstract
- Paradoxical intention (PI) has been considered an evidence-based treatment for insomnia since the 1990s, but it has not been evaluated with modern review techniques such as meta-analysis. The present study aimed to conduct the first systematic review and meta-analysis of studies that explore the effectiveness of PI for insomnia on insomnia symptomatology and theory-derived processes. A systematic review and meta-analysis was conducted by searching for eligible articles or dissertations in six online bibliographic databases. Randomised controlled trials and experimental studies comparing PI for insomnia to active and passive comparators and assessing insomnia symptoms as outcomes were included. A random effects model was estimated to determine the standardised mean difference Hedge's g at post-treatment. Test for heterogeneity was performed, fail-safe N was calculated, and study quality was assessed. The study was pre-registered at International Prospective Register of Systematic Reviews (PROSPERO, CRD42019137357). A total of 10 trials were identified. Compared to passive comparators, PI led to large improvements in key insomnia symptoms. Relative to active comparators, the improvements were smaller, but still moderate for several central outcomes. Compared to passive comparators, PI resulted in great reductions in sleep-related performance anxiety, one of several proposed mechanisms of change for PI. PI for insomnia resulted in marked clinical improvements, large relative to passive comparators and moderate compared to active comparators. However, methodologically stronger studies are needed before more firm conclusions can be drawn.
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| 9. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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Stimulus control for insomnia : A systematic review and meta-analysis
- 2024
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 33:1
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Tidskriftsartikel (refereegranskat)abstract
- Stimulus control (SC) is commonly viewed as an evidence-based treatment for insomnia, but it has not been evaluated comprehensively with modern review and meta-analytic techniques. The aim of the current study was thus to perform a systematic review and meta-analysis of trials that examine the efficacy of stimulus control for insomnia. A systematic search for eligible articles and dissertations was conducted in six online bibliographic databases. The 11 included studies, with the majority published between 1978 and 1998, were randomised controlled and experimental studies in adults, comparing stimulus control for insomnia with passive and active comparators and assessing insomnia symptoms as outcomes. A random effects model was used to determine the standardised mean difference Hedge's g at post-treatment and follow-up for three sleep diary measures: the number of awakenings, sleep onset latency, and total sleep time. A test for heterogeneity was conducted, forest plots were produced, the risk of publication bias was estimated, and the study quality was assessed. In the trials identified, stimulus control resulted in small to large improvements on sleep onset latency and total sleep time, relative to passive comparators (g = 0.38-0.85). Compared with active comparators, the improvements following stimulus control were negligible (g = 0.06-0.30). Although methodological uncertainties were observed in the included trials, stimulus control appears to be an efficacious treatment for insomnia when compared with passive comparators and with similar effects to active comparators. More robust studies are, however, warranted before stronger conclusions are possible to infer.
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| 10. |
- Pahnke, Johan, et al.
(författare)
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Acceptance and commitment therapy for autistic adults : a randomized controlled pilot study in a psychiatric outpatient setting
- 2023
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Ingår i: Autism. - : Sage Publications. - 1362-3613 .- 1461-7005. ; 27:5, s. 1461-1476
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Tidskriftsartikel (refereegranskat)abstract
- Autistic adults are at risk of stress-related psychiatric disorders and reduced life quality due to social, cognitive, and perceptual challenges. Mental health interventions adapted to autistic adults are scarce. Acceptance and commitment therapy has preliminarily indicated health benefits in autistic adults, although it has not been robustly evaluated. Overall, 39 adults (21 males; 21–72 years) with autism spectrum disorder and normal intellectual ability (IQ M = 108.5; SD = 13.5) were randomized to 14 weeks of adapted acceptance and commitment therapy group treatment (NeuroACT) or treatment as usual. The intervention was feasible. Perceived stress and quality of life (primary outcomes), alongside psychological inflexibility, cognitive fusion, cognitive and behavioral avoidance, and autistic mannerism were statistically significantly improved in NeuroACT compared with treatment as usual (d = 0.70–0.90). Clinically significant changes in perceived stress and quality of life were in favor of NeuroACT. Between-group altered depression, anxiety, sleep problems, one quality of life measure, functional impairment, social aspects of autism, and executive difficulties were statistically non-significant. Dropout was slightly higher in NeuroACT. NeuroACT may be a promising treatment for autistic adults with co-existing stress and reduced quality of life. More extensive studies are warranted to evaluate NeuroACT further.
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