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- Alm, Jan, 1947-
(författare)
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Dyslexia: Relevance of Concepts, Validity of Measurements, and Cognitive Functions
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis opens with an exposition of different uses of the term dyslexia. In that context its conceptual relevance is discussed. The empirical studies investigate a) different aspects of validity of cognitive and achievement instruments often used in diagnostic assessment of dyslexia, b) different cognitive profiles for adults with dyslexia, and c) the relationship between cognitive and achievement measures.Study I demonstrated the factor structure of the Swedish WAIS-R to be in close agreement with results of comparable analyses on normal and clinical groups in many countries world-wide, giving strong support for the construct validity of the Swedish WAIS-R for a group of adults diagnosed with dyslexia. The results from the three-factor solution were interpreted in terms of theoretical constructs, notably those posited by Carroll (1993) and Horn (1989).The cognitive profiles of a sample of Swedish adults diagnosed with dyslexia—when using the three factors, the ACID profile, and the four-category Bannatyne profile—all resemble closely the profiles observed for a wide array of U.S. samples of children and adults diagnosed with dyslexia or learning disabilities. Gender differences on Digit Symbol, favoring females, were substantial in magnitude for the present sample, consistent with a bulk of research on gender differences for samples of normal individuals and of those identified with learning problems.In Study II, factor analysis of nine Swedish achievement tests often used for dyslexia assessment yielded five meaningful factors in a group of adults diagnosed with dyslexia. Factors appeared to measure decoding, visual speed, reading comprehension, reading fluency, and phonological ability. The relationship between the five achievement factors and WAIS-R variables was subsequently examined. The Visual Speed and Reading Comprehension factors each correlated significantly with four of six global WAIS-R scores (two of three IQs and two of three factor scores). Visual Speed tended to correlate significantly with nonverbal scores and Reading Comprehension with verbal scores. Although the Phonological Ability factor did not correlate significantly with any verbal or nonverbal global score, it did correlate significantly with the Freedom from Distractibility factor and with all its component subtests—Digit Span, Arithmetic, and Digit Symbol. Decoding (technical reading skill) showed no significant relationship to any WAIS-R variable studied. More surprisingly, the Reading Fluency factor failed to show significant relationships to the WAIS-R.Study III examined the validity of The Word Chain Test, a frequently used instrument in Swedish screening and diagnostic assessments of dyslexia. Different sources of validity evidence were evaluated. In summary, the results failed to support validity both for the WRI-index and the Wordchain subtest, suggesting that the instrument seems to be of questionable value in screening or diagnostic assessment of dyslexia.
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- Marhold, Charlotta, et al.
(författare)
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A cognitive-behavioral return-to-work program : Effects on pain patients with a history of long-term versus short-term sick leave
- 2001
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Ingår i: Pain. - : Elsevier. - 0304-3959 .- 1872-6623. ; 91:1-2, s. 155-163
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Tidskriftsartikel (refereegranskat)abstract
- A cognitive-behavioral return-to-work focused program was evaluated in a randomized controlled design, and the effects were compared between two groups of women with musculoskeletal pain. One group of patients (n=36) had a history of long-term sick leave (>12 months) at the start of the program and the other (n=36) had a history of short-term sick leave (2-6 months). The outpatient treatment program, conducted by a psychologist, included 12 sessions with the primary aim to help the patients return-to-work. The treatment first included teaching of coping strategies such as applied relaxation, stress management, graded activity training and pacing. Thereafter the patients were taught how to manage difficulties at their return-to-work and how to generalize coping strategies to different risk factors at their work places. The control condition received treatment-as-usual. The results showed that the cognitive-behavioral return-to-work program was more effective than the treatment-as-usual control condition in reducing the number of days on sick leave for patients on short-term sick leave, but not for patients on long-term sick leave. The treatment program also helped the patients on short-term sick leave to increase their ability to control and decrease pain and to increase their general activity level compared to the control condition. These results underscore the need for an early return-to-work focused rehabilitation to prevent long-term sick leave and disability.
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- Marhold, Charlotta, et al.
(författare)
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Identification of obstacles for chronic pain patients to return to work : Evaluation of a questionnaire
- 2002
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Ingår i: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 12:2, s. 65-75
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Tidskriftsartikel (refereegranskat)abstract
- The Obstacles to Return-to-Work Questionnaire (ORQ) was developed and evaluated. A total of 154 patients with chronic musculoskeletal pain and prolonged work disability participated in the study. Factor analyses reduced the ORQ to 55 items grouped into 9 subscales. The subscales were named "Depression," "Pain intensity," "Difficulties at work return," "Physical workload and harmfulness," "Social support at work," "Worry due to sick leave," "Work satisfaction," "Family situation and support," and "Perceived prognosis of work return." The subscales showed satisfactory reliability. In order to determine predictive validity a discriminant analysis was conducted with sick leave 9 months after assessment as the outcome. This analysis indicated that the scales "Perceived prognosis of work return," "Social support at work," "Physical workload and harmfulness," "Depression," and "Pain intensity" could significantly predict sick leave and correctly classified 79% of the patients. The Multidimensional Pain Inventory and the Disability Rating Index could also significantly predict sick leave in this sample and correctly classified as many patients as the ORQ. However, these questionnaires do not include any work-oriented items and they had a lower specificity than the ORQ. This study suggests that patients' perceptions and beliefs about work and returning to work may be a significant hindrance for actual recovery.
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