| 1. |
- Tillfors, Maria, 1963-, et al.
(författare)
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Prospective links between social anxiety and adolescent peer relations
- 2012
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Ingår i: Journal of Adolescence. - : Academic Press. - 0140-1971 .- 1095-9254. ; 35:5, s. 1255-1263
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Tidskriftsartikel (refereegranskat)abstract
- This study examines bi-directional links between social anxiety and multiple aspects of peer relations (peer acceptance, peer victimization, and relationship quality) in a longitudinal sample of 1528 adolescents assessed twice with one year between (754 females and 774 males; M = 14.7 years of age). Lower levels of peer acceptance predicted increases in social anxiety. Social anxiety predicted decreases in relationship support for males and increases in peer victimization for females. Collectively our findings suggest that peers seem to play a significant role for adolescent mental health and social anxiety seems to interfere with healthy peer relations. Importantly, developmental pathways for social anxiety seem to differ for adolescent females and males.
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| 2. |
- Edlund, Sara, 1983-, et al.
(författare)
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Facing negative emotions : Evaluating the effects of training in affirmative communication for contact nurses in cancer care
- 2022
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Ingår i: Annals of Oncology. - : Elsevier. - 0923-7534 .- 1569-8041. ; 33:7, s. S1368-S1368
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: In cancer care, contact nurses daily meet people who deal with strong,aversive emotions in relation to that they have or may have cancer where the risk ofdying is constantly present. This places demands on the ability of contact nurses tomaster difficult conversations with strong emotional expressions. One communicationmethod known for its regulating effects on emotions is affirmative communication, socalled validation. The overall aim of the current study was to evaluate effects of atraining in validating communication for contact nurses in cancer care, aimed tostrengthen their ability to work in a person-centered way.Methods: This study had a within-group design with pre-, post- and follow-up mea-surements (2 months). Specifically, the study aimed to evaluate whether the vali-dation training coincided with an increase in validation and a decrease in invalidation.Contact nurses from six regions (n ¼ 17) with a generally long work experience as anurse participated in a digital validation training for six weeks (three training sessionsplus three pre-recorded theoretical lectures). Communicative behaviors wereassessed through video-recordings of interactions between the nurses and fictitiouspatients. The videos were encoded by independent coders and analyzed withdependent MANOVA.Results: The contact nurses showed a significant increase in validation and a signif-icant decrease in invalidation after the training. These effects remained at the 2-month follow-up.Conclusions: Experienced healthcare professionals’ affirmative communication skillscan be improved after a brief training in validation.
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| 3. |
- Edlund, Sara, 1983-, et al.
(författare)
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Facing negative emotions : Evaluation of a brief training in validating communication for contact nurses in cancer care
- 2023
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 66
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Tidskriftsartikel (refereegranskat)abstract
- Background: Contact nurses in cancer care (CNCC) often face challenges when communicating with patients and their families. The overall aim was to evaluate a brief digital validation training for CNCC, to test whether it was associated with increased validation and decreased invalidation. Associations between communication skills in validation and markers of work-related stress were also investigated. Methods: This intervention study investigated associations between the training and validation skills using a within-group design with repeated measures (at pre, post, and eight-week follow-up). Additionally, associations between the training and occupational self-efficacy, self-validation, and exhaustion symptoms were explored. Results: Seventeen CNCCs (all female with relatively long work experience) completed a five-week digital training program. Results indicated a statistically significant increase in validation and a statistically significant decrease in invalidation, showing that the nurses improved their communication skills following the training. No changes were found in markers of work-related stress. Conclusion: The results indicate that digital validation training for CNCCs is potentially beneficial by means of improving communication skills. This study further demonstrates that a brief digital training in validating communication to CNCC is associated with improved person-centered communication regarding strong negative emotions.
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| 4. |
- Edlund, Sara M., 1983-, et al.
(författare)
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I see you're in pain : the effects of partner validation on emotions in people with chronic pain
- 2015
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Ingår i: Scandinavian Journal of Pain. - : Elsevier. - 1877-8860 .- 1877-8879. ; 6, s. 16-21
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and aimsChronic pain not only affects the person in pain, but can also have a negative impact on relationships with loved ones. Research shows that chronic pain is associated with difficulties in marital relationships, which in turn is related to a variety of negative outcomes such as psychological distress and conflict within the family. This suggests that couples where chronic physical pain is present also struggle with emotional pain and relationship problems, and thus targeting relationship skills and interpersonal functioning might be helpful for these couples. Although studies in this area are promising, their numbers are few. In the present study, validation as a way of communicating is suggested for handling emotional expression in interpersonal interactions. Validation communicates understanding and acceptance of the other person's experience, and it has been shown to have a down-regulating effect on negative emotions. It has previously been demonstrated to be important for these couples. However, the feasibility and effects of increasing partner validation in these couples are unknown. Therefore, the aim of the present study was to investigate if a brief training session in validation for spouses would result in more validating and fewer invalidating responses towards their partners with pain, and to investigate if changes in these behavioural responses were associated with changes in emotion and pain level in the partner with pain.MethodsParticipants were 20 couples where at least one partner reported chronic pain. The study employed a within-groups design in which spouses of people with pain received validation training (without their partner's knowledge), and their validating and invalidating responses were rated pre- and post-intervention using a reliable observational scale. Also, positive and negative affect and subjective pain level in the persons with pain were rated pre- and post-intervention.ResultsResults showed that the validation training was associated with increased validating and decreased invalidating responses in the partners. Their spouses with chronic pain reported a decrease in negative affect from pre- to post-training.ConclusionsOur results indicate that the partner or closest family member, after brief validation training, increased validating responses and decreased invalidating responses towards the person with pain, which had an immediate positive impact on emotions in the other person.ImplicationsThis study suggests that using validation in interpersonal interactions is a promising tool for couples where chronic pain is present.
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| 5. |
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| 6. |
- Granrud, Marie Dahlen, et al.
(författare)
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Health Care Personnel's Perspectives on Quality of Palliative Care During the COVID-19 Pandemic - A Cross-Sectional
- 2023
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Ingår i: Journal of Multidisciplinary Healthcare. - : Dove Medical Press. - 1178-2390. ; 16, s. 2893-2903
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The provision of high-quality palliative care is challenging, especially during a pandemic like COVID-19. The latter entailed major consequences for health care systems and health care personnel (HCP) in both specialist and community health care services, in Norway and worldwide. The aim of this study was to explore how the HCP perceived the quality of palliative care in nursing homes, medical care units, and intensive care units during the COVID-19 pandemic. Methods: This study had a cross-sectional design. A total of 290 HCP from Norway participated in the study (RR = 25.8%) between October and December 2021. The questionnaire comprised items concerning respondents' demographics and quality of care, the latter measured by the short form of the Quality from the Patient's Perspective-Palliative Care instrument, adapted for HCP. The STROBE checklist was used. Results: This study shows that the HCP scored subjective importance as higher in all dimensions, items and single items than their perception of the actual care received. This could indicate a need for improvement in all areas. Information about medication, opportunity to participate in decisions about medical and nursing care and continuity regarding receiving help from the same physician and nurse are examples of areas for improvement. Conclusion: Study results indicate that HCP from nursing homes, medical care units, and intensive care units perceived that quality of palliative care provided was not in line with what they perceived to be important for the patient. This indicate that it was challenging to provide high-quality palliative care during the COVID-19 pandemic.
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| 7. |
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| 8. |
- Holländare, Fredrik, 1972-, et al.
(författare)
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Therapist behaviours in internet-based cognitive behaviour therapy (ICBT) for depressive symptoms
- 2016
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Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 3:1, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Internet-based cognitive behaviour therapy (ICBT) is efficacious for treating depression, with therapist guidance identified as important for favourable outcomes. We have limited knowledge, however, about the fundamental components of therapist guidance in ICBT. The purpose of this study was to systematically examine therapist messages sent to patients during the course of ICBT for depressive symptoms in order to identify common “therapist behaviours” and the extent to which these behaviours correlate with completion of modules and improvements in symptoms at post-treatment, one- and two-year follow-up. A total of 664 e-mails from 5 therapists to 42 patients were analysed using qualitative content analysis. The most frequent behaviour was encouraging that accounted for 31.5% of the total number of coded behaviours. This was followed by affirming (25.1%), guiding (22.2%) and urging (9.8%). Less frequently the therapists clarified the internet treatment framework, informed about module content, emphasised the importance of patient responsibility, confronted the patient and made self-disclosures. Six of the nine identified therapist behaviours correlated with module completion. Three behaviours correlated with symptom improvement. Affirmingcorrelated significantly (r = .42, p = .005) with improvement in depressive symptoms at post-treatment and after two years (r = .39, p = .014). Encouraging was associated with outcome directly after treatment (r = .52, p = .001). Self-disclosure was correlated with improvement in depressive symptoms at post-treatment (r = .44, p = .003). The study contributes to a better understanding of therapist behaviours in ICBT for depressive symptoms. Future directions for research are discussed.
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| 9. |
- Olofsson, Viveca, 1963-, et al.
(författare)
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Implementing group based parenting programs : A narrative review
- 2016
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Ingår i: Children and youth services review. - : Elsevier. - 0190-7409 .- 1873-7765. ; 69, s. 67-81
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Forskningsöversikt (refereegranskat)abstract
- Group based preventive parenting programs are efficacious, but seem hard to implement sustainably within regular service. This review aimed to investigate specific challenges related to their implementation. Through a systematic search in several databases, we retrieved 1356 articles for title, abstract, and full-text screening. After screening, we selected 35 articles for quality rating. An established narrative approach allowed us to include 24 studies. We used an ecological approach and a recently suggested implementation construct terminology to report our findings. To date, there are no evaluations of the implementation of group based programs where implementation aspects and effectiveness are compared with other kinds of programs or formats. Hence, important research knowledge is lacking concerning implementation of group based parenting programs. Our finding indicate that certain format specific implementation aspects of group based parenting programs are perceived by practitioners as particularly challenging. For instance, scheduling of group leader workload, provision of additional services (e.g., meals and childcare), and recruitment of participants. Further, practitioners and group leaders influence implementation success and program sustainability as well as parental attitudes and reasons for participation. To highlight the importance of practitioners and parents we suggest adaptations to the ecological model approach. Overall, the theoretical foundation of current implementation research is weak and future implementation research need to be theoretically driven. It is important to fill the existing lack of implementation knowledge because it might be one of the reasons why group based parenting programs have limited impact as preventive interventions on children's mental well-being.
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| 10. |
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| 11. |
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| 12. |
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| 13. |
- Tillfors, Maria, 1963-, et al.
(författare)
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Treating university students with social phobia and public speaking fears : Internet delivered self-help with or without live group exposure sessions
- 2008
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Ingår i: Depression and anxiety (Print). - : Hindawi Limited. - 1091-4269 .- 1520-6394. ; 25:8, s. 708-717
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study investigated the efficacy of an Internet-based self-help program with minimal therapist contact via e-mail for Swedish university students with social phobia and public speaking fears. The main objective was to test if the Internet-based self-help program would be more effective if five live group exposure sessions were added. METHODS: Thirty-eight students meeting the diagnostic and statistical manual of mental disorders, 4th edition criteria for social phobia were randomized into two different treatment groups: Internet delivered cognitive behavior therapy combined with five group exposure sessions (ICBT+ exp) or the Internet program alone (ICBT). RESULTS: Results were analyzed on an intention-to-treat basis. Both treatment groups showed significant improvement from pre- to post-test, and from pre-test to 1-year follow-up, on all measured dimensions (social anxiety, general anxiety, depression levels, and quality of life). For both the groups, the average within-group effect sizes for the primary social anxiety scales, expressed as Cohen's d, were comparable to those seen in traditionally administered cognitive behavioral therapy both at post-test and at 1- year follow-up. CONCLUSIONS: The results suggest that the Internet-based self-help program on its own is efficient in the treatment of university students with social phobia. Adding group exposure sessions did not improve the outcome significantly.
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| 14. |
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| 15. |
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| 16. |
- Anniko, Malin, 1981-, et al.
(författare)
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Development of a Shortened Version of the Adolescent Stress Questionnaire (ASQ-S) : construct validity and sex invariance in a large sample of Swedish adolescents
- 2018
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Ingår i: Scandinavian Journal of Child and Adolescent Psychiatry and Psychology. - New York, NY, USA : Exeley Inc.. - 2245-8875. ; 6:1, s. 4-15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stressor experience is an important topic of research concerning adolescent health and ill-health. For this, valid and reliable measures of adolescent stress are needed. The Adolescent Stress Questionnaire 2 was developed to tap into stressor domains specific for adolescence. Psychometric evaluations in Australian and European samples have indicated adequate psychometric properties. However, the ASQ-2 is quite extensive, which may render its use in large cohort studies, where several aspects of adolescent health are investigated, inconvenient and problematic.Objective: To evaluate the psychometric properties of a short version of the ASQ-2 (ASQ-S) in terms of construct validity and factorial invariance across gender.Method: The ASQ-2 was translated into Swedish and items were retained from nine of the ten scales based on factor loadings. One scale (stress of emerging adult responsibilities) was removed entirely due to low internal consistency and variance explained. The remaining 27 items were piloted and then included in an ongoing 5-year longitudinal study involving the participation of all students in the 7th and 8th grade in public schools from three Swedish municipalities (N = 2768, 47.5 % girls, mean age 13.64 years). For this study data from the first and second wave was used.Results: A nine factor Confirmatory Factor Analysis (CFA) showed a good fit to the data and invariance across sexes was supported. The nine scales correlated positively with depressive symptoms, anxiety and worry and negatively with self-esteem. Girls reported higher stress levels than boys in eight of the nine scales. Stressors related to peer pressure predicted reported levels of anxiety and worry one year later, whereas stressors related to romantic relationships predicted depressive symptoms.Conclusions: Overall this study suggests that the ASQ-S could be a valid measure of adolescent stressor experience and psychometrically equivalent to the full ASQ-2.
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| 17. |
- Anniko, Malin, 1981-, et al.
(författare)
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Investigating the mediating role of cognitive emotion regulation in the development of adolescent emotional problems
- 2018
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Ingår i: Nordic Psychology. - : Routledge. - 1901-2276 .- 1904-0016. ; 70:1, s. 3-16
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Tidskriftsartikel (refereegranskat)abstract
- Previous research has indicated that cognitive emotion regulation strategies contribute to the development and maintenance of emotional problems in adults and adolescents. However, there is a lack of longitudinal research with adolescent samples, hence knowledge of exactly how these strategies influence the development of emotional problems in adolescence is sparse. This study investigated maladaptive cognitive emotion regulation (cognitive avoidance and repetitive negative thinking) as a potential mediator in the development of anxiety and depressed mood over time in adolescence. Self-reported depressed mood, anxiety, and cognitive emotion regulation strategies were assessed during school hours in a sample of Swedish 10th graders (N=149; 53% girls), with follow-up assessments one and two years later. Repetitive negative thinking and cognitive avoidance formed a unidimensional factor of cognitive emotion regulation. Cognitive emotion regulation was found to mediate the development of both anxiety and depressed mood over time, lending support to the previous findings that cognitive emotion regulation strategies such as cognitive avoidance and repetitive negative thinking might act as transdiagnostic mechanisms in the development of emotional symptoms in adolescence. This suggests that maladaptive forms of cognitive emotion regulation could be important targets in prevention and treatment of emotional problems in adolescence.
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| 18. |
- Anniko, Malin, 1981-, et al.
(författare)
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Sources of stress and worry in the development of stress-related mental health problems : A longitudinal investigation from early- to mid-adolescence
- 2018
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Ingår i: Anxiety, Stress, and Coping. - London, United Kingdom : Taylor & Francis. - 1061-5806 .- 1477-2205. ; 32:2, s. 155-167
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives: Stress and stress-related mental health complaints are common and increasing among adolescents, especially girls. Identifying typical sources of stress as well as central intervention targets is an important effort in the development of effective prevention and treatment protocols. This study investigated worry as potential mediator in the development of mental health problems in response to common stressors in adolescence. We also examined to what sources adolescents ascribe their stress over the years from the 7th through the 9th grade. Design: Prospective cohort study. Methods: Self-reported subjective stressor load, worry, anxiety and depressive symptoms were assessed in a sample of Swedish 7th graders (N = 1137; 46% girls, mean age 13.2) with follow-up assessments one and two years later. Results: School was the most common source of stress across all time-points, with girls reporting considerable more stress than boys. Worry mediated the relationship between overall stressor load and depressive symptoms and anxiety over time and was not moderated by gender. Conclusions: Worry may be an important target in stress prevention and efforts to prevent stress-related problems would benefit from focusing on early adolescence as especially school stress is already relatively common in grade 7.
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| 19. |
- Anniko, Malin, 1981-, et al.
(författare)
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Stress and Emotional Distress in Adolescence : The Role of Worry and Rumination
- 2015
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Konferensbidrag (refereegranskat)abstract
- Introduction: Adolescence is a time of profound changes in multiple contexts, giving rise to an increased amount of potential stressors. It is also a developmental period were emotional problems tend to have their onset and are common. We know from previous research that stressors are a risk factor for internalizing problems. However, we know less about how this relationship unfolds. There has been a lack of research into potential mechanisms affecting this relationship such as moderating and mediating variables. Concerning stressors in the form of daily hassles, a potent mechanism is how well adolescents regulate their emotions. Studies have shown that especially cognitive regulatory strategies, such as worry and rumination, tend to increase in early adolescence, an increase that precedes increases in emotional problems. However, with a few exceptions, many studies have been cross-sectional and we do not know exactly how these strategies affects or are affected by stressors and emotional problems. The aim of this study is therefore to investigate how cognitive emotion regulation strategies, more specifically worry and rumination, relate to the development of emotional problems in the face of stressors.Method: This is a prospective study following 3200 Swedish adolescents in 7th and 8th grade across one year. Participants completed questionnaires about amounts of stressors, levels och worry, rumination, anxiety and depressive symptoms during school hours in the spring of 2014 and again in 2015. Half-longitudinal mediational- and moderation analyses will be performed to investigate how worry and rumination relate to the development of emotional problems in the face of stressors.Results: The open paper will give an overview of the above-mentioned analyses and present a discussion of the results with respect to theory and clinical implications.
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| 20. |
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| 21. |
- Anniko, Malin, 1981-
(författare)
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Stuck on repeat : Adolescent stress and the role of repetitive negative thinking and cognitive avoidance
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stress and stress-related mental health problems such as anxiety and depressive symptoms are common in adolescents and seem to be increasing, especially in mid- to late-adolescent girls. Although adolescence, as a period of rapid growth and profound change, is often marked by an increase in normal stressors (e.g. conflicts with parents, fitting in with peers, increased academic demands), most adolescents do not develop more persis-tent problems with stress. To be able to develop effective preventive interventions there is a need to understand both what adolescents are ascribing their stress to, how different stressor domains relate to outcomes, and why some adolescents go on to develop stress-related mental health problems while others do not. This dissertation aimed to answer some of these questions by investigating the role of cognitive avoidance and repetitive negative thinking (RNT) in the development of stress-related mental health problems (Study I & III). It also aimed to develop and validate a shortened version of a questionnaire designed to measure stressor load within different life domains in adolescence (Study II). Findings show that the shortened version of the Adolescents Stress Questionnaire seems to be a valid measure of stressor load within different domains in adolescence. School-related stressors were the most prevalent sources of stress, but social stressors seem to have a stronger link to increases in mental health symptoms. Also, adolescents who report higher levels of distress and stressor load tend to increase their engagement in cognitive avoidance and RNT over time which in turn predicts further increases in mental health symptoms. This suggests that cognitive avoidance and RNT may be important mechanisms in the development of stress-related mental health problems in adoles-cence.
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| 22. |
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| 23. |
- Bauducco, Serena V., 1988-, et al.
(författare)
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Too tired for school? : the effects of insomnia on absenteeism in adolescence
- 2015
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Ingår i: Sleep Health. - : Elsevier. - 2352-7218 .- 2352-7226. ; 1:3, s. 205-210
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Sleep has important consequences for a person's daytime functioning. Numerous studies have shown that insomnia predicts work absenteeism and work disability in adults, but only a few studies have examined this association in adolescents. This study aims to explore whether symptoms of insomnia in adolescents predict school absenteeism 1 year later, over and above known psychological risk factors for absenteeism.Design: The study used a longitudinal design with 2 measurement points over 1 year.Setting: The students completed questionnaires during school hours at baseline and again at follow-up.Participants: Students in the 10th to 12th grades in a Swedish upper secondary school were followed prospectively for 1 year (age, 16-20 years; N = 353; 48.1% girls).Measurements and results: We used logistic regression analyses, controlling for the known effects of psychological factors, and arrived at a model elucidating the role of insomnia. That is, besides symptoms of insomnia, the model included previous absenteeism, alcohol intoxication, school-related social phobia, social anxiety, depressive symptoms, somatic symptoms, and bully victimization. Symptoms of insomnia predicted school absenteeism 1 year later, over and above known risk factors for absenteeism. Adolescents reporting severe symptoms of insomnia were almost 3 times more likely than adolescents reporting no or low symptoms to report problematic absenteeism 1 year later. We did not find any gender difference.Conclusions: Our findings underscore the importance of sleep problems on adolescents' daytime functioning as measured by school absenteeism. Therefore, sleep may be an important target for preventive interventions with adolescents.
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| 24. |
- Buhrman, Monica, et al.
(författare)
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Psychological Treatment Targeting Acceptance and Compassion in Patients With Chronic Pain : A Randomized Controlled, Internet-delivered, Treatment Trial
- 2023
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Ingår i: The Clinical Journal of Pain. - : Wolters Kluwer Health, Inc.. - 0749-8047 .- 1536-5409. ; 39:12, s. 672-685
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Chronic pain is often associated with lower function. Self-criticism is associated with depressive symptoms. The purpose of this study was to explore if fusing Acceptance and Commitment Therapy and compassion-focused therapy could improve psychological well-being and disability in individuals with chronic pain with high levels of self-criticism in comparison to a wait-list control group. METHODS: Individuals with chronic pain (n=71) were randomly assigned to an 8-week internet-based intervention focused on acceptance and compassion or a wait-list condition. Primary treatment outcomes were the Chronic Pain Acceptance Questionnaire, Self-Compassion Scale, and Pain Disability Index. Secondary outcomes were the Montgomery Åsberg Depression Rating Scale, Anxiety Sensitivity Index, Quality of Life Inventory, Multidimensional Pain Inventory, and Perseverative Thinking Questionnaire. RESULTS: Missing data at postintervention were 22.5%. Intention-to-treat analyses were conducted using linear mixed models. The results revealed greater levels of acceptance and self-compassion for the treatment group, which were primary outcomes, with effect sizes ranging from small to large, and these results were maintained at 6-month follow-up. The rates of clinically significant improvements were also greater for the treatment group in comparison to the wait-list control group on acceptance and compassion. The treatment group also improved in the third primary outcome, pain disability. Significant differences were found in several of the secondary outcomes, in favor of the treatment group. DISCUSSION: Internet-based Acceptance and Commitment Therapy with compassion-focused therapy components shows promise as a viable treatment option in the management of chronic pain.
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| 25. |
- Costache, Madalina Elena, et al.
(författare)
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Higher- and lower-order personality traits and cluster subtypes in social anxiety disorder
- 2020
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 15:4
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Tidskriftsartikel (refereegranskat)abstract
- Social anxiety disorder (SAD) can come in different forms, presenting problems for diagnostic classification. Here, we examined personality traits in a large sample of patients (N = 265) diagnosed with SAD in comparison to healthy controls (N = 164) by use of the Revised NEO Personality Inventory (NEO-PI-R) and Karolinska Scales of Personality (KSP). In addition, we identified subtypes of SAD based on cluster analysis of the NEO-PI-R Big Five personality dimensions. Significant group differences in personality traits between patients and controls were noted on all Big Five dimensions except agreeableness. Group differences were further noted on most lower-order facets of NEO-PI-R, and nearly all KSP variables. A logistic regression analysis showed, however, that only neuroticism and extraversion remained significant independent predictors of patient/control group when controlling for the effects of the other Big Five dimensions. Also, only neuroticism and extraversion yielded large effect sizes when SAD patients were compared to Swedish normative data for the NEO-PI-R. A two-step cluster analysis resulted in three separate clusters labelled Prototypical (33%), Introvert-Conscientious (29%), and Instable-Open (38%) SAD. Individuals in the Prototypical cluster deviated most on the Big Five dimensions and they were at the most severe end in profile analyses of social anxiety, self-rated fear during public speaking, trait anxiety, and anxiety-related KSP variables. While additional studies are needed to determine if personality subtypes in SAD differ in etiological and treatment-related factors, the present results demonstrate considerable personality heterogeneity in socially anxious individuals, further underscoring that SAD is a multidimensional disorder.
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