| 1. |
- Thorsell Cederberg, Jenny, et al.
(författare)
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A preliminary validation of the swedish version of the pain catastrophizing scale for children (PCSC) for children and adolescents with cancer
- 2019
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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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| 2. |
- Thorsell Cederberg, Jenny, et al.
(författare)
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Children’s and adolescents’ relationship to pain during cancer treatment : a preliminary validation of the Pain Flexibility Scale for Children
- 2017
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Ingår i: Journal of Pain Research. - : Dove Medical Press. - 1178-7090. ; 10, s. 1171-1178
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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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| 3. |
- Dahl, JoAnne
(författare)
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Valuing in ACT
- 2015
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Ingår i: CURRENT OPINION IN PSYCHOLOGY. - : Elsevier BV. - 2352-250X. ; 2, s. 43-46
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Tidskriftsartikel (refereegranskat)abstract
- Acceptance and Commitment Therapy (ACT) focuses on increasing a person's ability to live a fulfilling, meaningful life together with the discomfort of challenges. Values work in ACT is shown to play an integral part in building and maintaining psychologically flexible behaviour. ACT is rooted in behaviour analysis and defines values in terms of verbally established motivation. ACT empirical research on different levels shows insight into values and its role in psychotherapeutic processes. Research in basic, analogue and applied areas show strong support for valuing as an important process to promote meaning, well-being and improved quality of life across psychological problems but additional research is needed. Valuing is a complex verbal phenomenon and its conceptualization and measurement as a construct are not simple.
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| 4. |
- Finnes, Anna, et al.
(författare)
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Cost-Effectiveness of Acceptance and Commitment Therapy and a Workplace Intervention for Employees on Sickness Absence due to Mental Disorders.
- 2017
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 59:12, s. 1211-1220
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to evaluate cost-effectiveness of Acceptance and Commitment Therapy (ACT) and workplace dialogue intervention (WDI), both as stand-alone interventions and in combination, compared with treatment as usual (TAU), for employees on sickness absence with mental disorders.METHODS: Employees (n = 352, 78.4% females) on sickness absence were randomized to one of four groups. Cost-utility analyses were conducted from a health care perspective and a limited societal perspective.RESULTS: All groups reported significant improvements in health-related quality-of-life (HRQoL) and there were no significant differences in HRQoL or costs between groups. The probability of cost-effectiveness for ACT+WDI was 50% compared with ACT, indicating that both treatment alternatives could be considered equally favorable for decision-makers. TAU and WDI were rejected due to less economic efficiency.CONCLUSION: Adding WDI to ACT cannot be recommended on the basis of our study results.
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| 5. |
- Finnes, Anna, et al.
(författare)
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Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders : a systematic review and meta-analysis of randomized-controlled trials
- 2019
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 92:3, s. 273-293
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Forskningsöversikt (refereegranskat)abstract
- Purpose: Common mental disorders (CMDs) and musculoskeletal disorders are highly prevalent in the population and cause significant distress and disability, and high costs to society. The main objective of this systematic review and meta-analysis was to examine the outcome and comparative effectiveness of psychological interventions in reducing sickness absence (SA) due to CMDs or musculoskeletal disorders, compared to a waitlist control group, usual care or another clinical intervention.Methods: We reviewed 3515 abstracts of randomized controlled trials published from 1998 to 2017. Of these, 30 studies were included in the analysis.Results: The psychological interventions were overall more effective than treatment as usual in reducing SA (small effect sizes), but not compared to other clinical interventions. Results were similar for studies on CMDs and musculoskeletal pain. A few significant moderating effects were found for treatment-specific variables. However, these were difficult to interpret as they pointed in different directions.Conclusion: There was a small but significant effect of psychological treatments in reducing SA. We identified areas of improvement such as methodological problems among the included studies and failure to specifically address RTW in the interventions that were evaluated. Clinical implications of the findings, and ways of improving methodological rigour of future studies are discussed.
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| 6. |
- Finnes, Anna, et al.
(författare)
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Randomized Controlled Trial of Acceptance and Commitment Therapy and a Workplace Intervention for Sickness Absence Due to Mental Disorders.
- 2019
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Ingår i: Journal of Occupational Health Psychology. - : Educational Publishing Foundation. - 1076-8998 .- 1939-1307. ; 24:1, s. 198-212
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Tidskriftsartikel (refereegranskat)abstract
- Mental disorders contribute to high rates of sickness absence (SA) and impaired work functioning. The aim of the present study was to evaluate the efficacy of 3 interventions targeting SA of workers. Participants (n = 352; 78.4% females) of working age with current employment, and SA due to depression, anxiety disorders, or exhaustion disorder, were recruited to the study and randomized to (a) acceptance and commitment therapy (ACT), (b) a workplace dialogue intervention (WDI), (c) a combination of ACT and WDI, or (d) treatment as usual (TAU). For SA days, there was a significant interaction effect for the follow-up period, in which ACT + WDI generated more SA compared with TAU. When diagnostic group was included as a moderator, participants with exhaustion disorder had less SA days in the WDI group compared with TAU. For symptoms of depression, anxiety, and stress-related ill health, there were significant interaction effects for ACT and ACT + WDI, when compared with TAU, from pre- to postmeasurement (small to moderate between-groups effect sizes). Within-group effect sizes pre- to postmeasurement (Cohen’s d) ranged from .55 to 1.17 (ACT), .40 to .94 (WDI), .26 to 1.13 (ACT + WI), and −.06 to .70 (TAU). There were no differences between groups during follow-up for symptoms.
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| 7. |
- Livheim, Fredrik, et al.
(författare)
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Psychometric properties of the Avoidance and Fusion Questionnaire for Youth : A psychological measure of psychological inflexibility in youth
- 2016
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Ingår i: Journal of Contextual Behavioral Science. - : Elsevier BV. - 2212-1447. ; 5:2, s. 103-110
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Tidskriftsartikel (refereegranskat)abstract
- Background: Consistent with the theory underlying Acceptance and Commitment Therapy (ACT), a construct termed psychological inflexibility has been suggested. There are few validated measures of psychological inflexibility for children and adolescents. One such validated instrument is the Avoidance and Fusion Questionnaire for Youth (AFQ-Y). The results from a single study have not so far been replicated for youth.Objective: The aim of this study is to test psychometric characteristics for Swedish versions of the AFQ-Y17 and AFQ-Y8. The participants were recruited from an on-going study within institutional care for young people (12-20 years) with psychosocial problems.Findings: In this study of a sample of 159 Swedish adolescents (15-20 years of age) with psychosocial problems, the full 17-item scale was used, and analyses of the 8 items that constitute the short version (AFQ-Y8) were conducted later. The short version showed better psychometric properties than the full 17-item scale. Confirmatory factor analysis (CFA) was conducted to examine factor solutions. The better fit for AFQ-Y8 was indicated by three of the most common measures of model fit: the comparative fit index (CFI) value exceeded .95 (the recommended cut-off value), the root mean squared error of approximation (RMSEA) was below 08 (the recommended cut-off value), and the value of the standardized root mean squared residual (SRMR) was below the recommended .05 for the AFQ-Y8 scale, which the AFQ-Y17 scale failed to attain.Conclusions: This study supports the reliability, convergent validity and generalizability of both AFQ-Y17 and the shorter version AFQ-Y8. With regards to validity, both versions related in a theoretically consistent way with other psychological constructs. AFQ-Y8 was well represented by a single factor structure, while AFQ-Y17 showed a less good fit to a single factor structure. Overall, the AFQ-Y17 and AFQ-Y8 may be valuable clinical tools in reflecting changes in psychological inflexibility among adolescents. However, since the shorter version, AFQ-Y8, had psychometric properties that were at least as robust as the full 17-item scale, the shorter version is recommended for use among adolescents. (C) 2016 Association for Contextual Behavioral Science.
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| 8. |
- Thorsell Cederberg, Jenny, et al.
(författare)
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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
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Ingår i: Journal of Contextual Behavioral Science. - : Elsevier BV. - 2212-1447. ; 10, s. 103-107
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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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| 9. |
- Thorsell-Cederberg, Jenny, et al.
(författare)
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Acceptance as a Mediator for Change in Acceptance and Commitment Therapy for Persons with Chronic Pain?
- 2016
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 23:1, s. 21-29
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Tidskriftsartikel (refereegranskat)abstract
- Background Cognitive behavior therapy (CBT) is considered effective for chronic pain, but little is known about active treatment components. Although acceptance correlates with better health outcomes in chronic pain patients, no study has examined its mediating effect in an experimental design. Purpose The aim of the present study is to investigate acceptance as a mediator in acceptance and commitment therapy (ACT), a third wave CBT intervention, for chronic pain. Method A bootstrapped cross product of coefficients approach was used on data from a previously published RCT evaluating ACT for chronic pain. To address the specificity of acceptance as a mediator, anxiety and depression were also tested as mediators. Outcome variables were satisfaction with life and physical functioning. Two change scores, preassessment to 6-month follow-up (n=53) and pre-assessment to 12-month follow-up (n=32), were used. Results Acceptance was found to mediate the effect of treatment on change in physical functioning from pre-assessment to follow-up at 6 months. Further, a trend was shown from pre-assessment to follow-up at 12 months. No indirect effect of treatment via acceptance was found for change in satisfaction with life. Conclusion This study adds to a small but growing body of research using mediation analysis to investigate mediating factors in the treatment of chronic pain. In summary, the results suggest that acceptance may have a mediating effect on change in physical functioning in ACT for persons with chronic pain. However, given the small sample size of the study, these findings need to be replicated.
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| 10. |
- Thorsell Cederberg, Jenny
(författare)
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Acceptance for persons suffering from pain : Evaluation of acceptance-based interventions for adults with chronic pain and children with cancer experiencing acute pain
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- It is increasingly clear that pain and emotions are closely interconnected. Pain does not only cause psychological distress, but psychological distress also amplifies pain through neurological mechanisms. Treatment of both chronic and acute pain would benefit from acknowledging the psychological mechanisms of pain neurophysiology. Psychological acceptance predicts increased pain tolerance and decreased pain intensity and discomfort in experimentally induced pain and improved physical and psychosocial functioning for persons with chronic pain.The overall aim of this thesis was to evaluate acceptance-based interventions for persons suffering from pain.In Study I the effect of a manualised ACT-based self-help intervention for adults with chronic pain was evaluated in an RCT (n=90). The results showed improvements in satisfaction with life, physical functioning and pain intensity for the ACT group. Both the ACT and the control group improved regarding depression and anxiety. In Study II the mediating effect of acceptance for treatment change was evaluated, using data from Study I (n=64). The results showed indirect effects of treatment via acceptance for physical functioning but not for satisfaction with life. In Studies III and IV, instruments to measure psychological flexibility in relation to pain were developed for children with cancer, and their parents respectively, using factor analysis. The results showed that a two-factor solution for the child scale (n=61) and a three-factor solution for the parent scale (n=243), best represented the data. In Study V, an acceptance-based intervention was preliminarily evaluated in a single-subject study (n=5) for children reporting pain during cancer treatment. The intervention consisted of an approximately 15-minute long pain exposure exercise. All participants reported reduced discomfort of pain, and three of the participants reported reduced pain intensity.The results suggest that a manualised ACT-based self-help intervention is a valuable addition to the treatment repertoire for persons with chronic pain and that acceptance may mediate the effect of treatment on physical functioning. Furthermore, instruments to measure acceptance in the context of acute pain in children with cancer are now available, although further validation is needed. Lastly, the results indicate that an acceptance-based intervention may help children undergoing cancer treatment to cope with pain.
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