| 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. |
- Norell-Clarke, Annika, 1979-, et al.
(författare)
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Sleep-related cognitive processes and the incidence of insomnia over time : Does anxiety and depression impact the relationship?
- 2021
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Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Aim: According to the Cognitive Model of Insomnia, engaging in sleep-related cognitive processes may lead to sleep problems over time. The aim was to examine associations between five sleep-related cognitive processes and the incidence of insomnia, and to investigate if baseline anxiety and depression influence the associations. Methods: Two thousand three hundred and thirty-three participants completed surveys on nighttime and daytime symptoms, depression, anxiety, and cognitive processes at baseline and 6 months after the first assessment. Only those without insomnia at baseline were studied. Participants were categorized as having or not having incident insomnia at the next time point. Baseline anxiety and depression were tested as moderators. Results: Three cognitive processes predicted incident insomnia later on. Specifically, more safety behaviors and somatic arousal at Time 1 increased the risk of developing insomnia. When investigating changes in the cognitive processes over time, reporting an increase of worry and safety behaviors also predicted incident insomnia. Depressive symptoms moderated the association between changes in worry and incident insomnia. Conclusion: These findings provide partial support for the hypothesis that cognitive processes are associated with incident insomnia. In particular, safety behaviors, somatic arousal, and worry increase the risk for incident insomnia. Preventative interventions and future research are discussed.
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| 3. |
- Lundgren, Tobias, et al.
(författare)
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Acceptance and Commitment Training for Ice Hockey Players : A Randomized Controlled Trial
- 2021
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Recent systematic reviews on the topic of mindfulness- and acceptance-based approaches in sport psychology conclude that there is a need for further trials using a more robust research methodology with direct performance as outcome. Acceptance and Commitment Training (ACT) is a contextual behavioral change method that focuses on facilitating psychological processes such as values, committed action, acceptance and mindfulness. In the present study designed as a randomized controlled trial, 34 junior elite ice hockey players were allocated into either an ACT group intervention or a wait list control group. Results showed significant effects on both objective performance outcomes (goals, assists, and taken shots) and blinded coach ratings of players' performance, focus and commitment to their development in favor of the ACT group. Effects lasted at 3-month follow-up for the coach ratings, but not for the objective performance measures. All ACT trained players recommended ACT to other players and considered the training as important for their development as ice hockey players. The results add to the growing body of evidence on ACT interventions for athletes and its effect on performance. Future studies should investigate the maintenance of effects from the psychological training over time, using robust research methodology and investigate theoretical coherent potential mediating variables.
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| 4. |
- Alfonsson, Sven
(författare)
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Treatment Adherence in Internet-Based CBT : The Effects of Presentation, Support and Motivation
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Homework assignments that patient work with between sessions is a key component in both face-to-face and Internet-based Cognitive Behavior Therapy (CBT). However, adherence to assignments is often low and it is largely unclear what factors predict or affect treatment adherence, and in the end, treatment outcomes. The overall aim of this thesis was to investigate if treatment presentation and therapist support can affect adherence and treatment outcome in internet-based CBT, whether adherence can be predicted by motivation variables and to compare differences in face-to-face and online conditions in this regard.A randomized controlled trial with a brief online relaxation program for people with stress and anxiety symptoms was conducted (n = 162). Participants in the enhanced support conditions completed a larger proportion of the online treatment but adherence was not affected by enhanced treatment presentation (Study I). Participants reported reduced symptoms of stress and anxiety after the relaxation program but there were no significant additional effects of enhanced presentation or support (Study II). Participants who adhered to the prescribed assignments reported lower symptom levels at study end, regardless of treatment conditions. Adherence to the online treatment was predicted by subject factors such as treatment credibility prior to the treatment and intrinsic motivation during the treatment (Study III). To further elucidate how motivation may affect adherence, an experiment with a one-session psychotherapy model was subsequently conducted (n = 100). Participants who were randomized to the face-to-face condition reported higher motivation for the assignment and completed significantly more of the homework compared to participants in the online condition (Study IV). Self-reported intrinsic motivation could predict adherence in both conditions while new motivational variables were identified specifically for the online condition.The results from these studies confirm that adherence to assignments in Internet-based CBT is difficult to affect with treatment features but can be predicted early in treatment by subject factors such as treatment credibility and motivation. How such motivational variables can be affected to improve treatments is still unclear.
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| 5. |
- Arnison, Tor, 1984-, et al.
(författare)
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Longitudinal, bidirectional relationships of insomnia symptoms and musculoskeletal pain across adolescence : the mediating role of mood
- 2022
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Ingår i: Pain. - : Wolters Kluwer. - 0304-3959 .- 1872-6623. ; 163:2, s. 287-298
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have established a bidirectional relationship between sleep and pain, and mood has been proposed as a mediator of this relationship. There are only a limited number of longitudinal studies examining the mediational role of mood, and the directionality of effects between sleep, pain and mood is uncertain. Also, and despite the high prevalence of pain and sleep problems during adolescence, these relationships have rarely been examined in a longitudinal sample of adolescents. Here, longitudinal survey data with five yearly measurements was used to examine the bidirectional relationship between insomnia symptoms and pain across adolescence (Mbaseline age = 13.65 years, Nbaseline = 2766). We also explored if depressed mood, positive affect and anxious mood function as mediators in both directions of the sleep-pain relationship. Utilizing latent variables for insomnia, pain and mood at multiple time-points, the data was analyzed with cross-lagged panel models for longitudinal data with structural equation modeling. Current results confirmed a bidirectional relationship between insomnia symptoms and pain, where the effect of insomnia symptoms on pain was stronger than vice versa. Depressed mood and anxious mood mediated the effect of insomnia symptoms on pain, but not the reverse effect of pain on insomnia symptoms. Positive affect did not serve as a mediator in either direction. These findings add novel insights into the temporal directionality of sleep, pain and mood during adolescence, suggesting a temporal path from sleep to pain, via mood, rather than a reciprocal relationship between the constructs.
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| 6. |
- Arnison, Tor, 1984-, et al.
(författare)
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Sleep phase and pre-sleep arousal predicted co-developmental trajectories of pain and insomnia within adolescence
- 2022
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Ingår i: Scientific Reports. - : Nature Research. - 2045-2322. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- The onset of both chronic pain and insomnia is high during adolescence. Although a bidirectional relationship between pain and insomnia has support, how pain and sleep co-develop throughout adolescence remains unknown. Sleep–wake patterns, pre-sleep behavior and pre-sleep arousal may influence the co-development of pain and insomnia. Four waves of longitudinal self-report data were used (Nbaseline = 2767, Agebaseline M = 13.65 years, SD = 0.65). Multidimensional growth mixture modeling was used to identify four subgroups of adolescents with different concurrent trajectories of pain and insomnia. The trajectories followed each other across time in all classes: one class of consistently low pain and insomnia (68.7%), one class with persistent high symptoms (4.9%), as well as one class of increasing (13.9%), and one of decreasing (12.5%), trajectories. Later sleep–wake patterns and more pre-sleep cognitive-emotional arousal predicted both increasing and decreasing trajectories of concurrent pain and insomnia. The current study showed that developmental trajectories of pain and insomnia follow each other within adolescents and across adolescence. Both sleep-phase focused interventions as well as psychological interventions that focus on pre-sleep cognitive-emotional arousal may prove beneficial for adolescents with comorbid pain and insomnia.
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| 7. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Sleep duration and patterns in adolescents : Correlates and the role of daily stressors
- 2016
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Ingår i: Sleep Health. - : Elsevier. - 2352-7218 .- 2352-7226. ; 2:3, s. 211-218
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The first aim of this study was to assess the prevalence of sleep deficit in a large sample of adolescents. Second, the study aimed to assess whether short sleep duration in the sample was associated with emotional and behavioral problems. Lastly, the study aimed to investigate the association between daily stressors-bedtime activities and sleep duration.Design: Cross-sectional survey.Setting: The questionnaires were completed during school hours in 17 municipal junior high schools in Sweden.Participants: A total of 2767 adolescents aged 12 to 16 years, 48% girls.Measurements and Results: Sleep measures included total sleep time (TST) for schooldays and weekends, obtained as combined measures of self-reported bed-time, wake-time, and sleep onset latency. We used the new National Sleep Foundation's guidelines to operationalize sleep duration. Overall 12% of younger adolescents (age 12-13 years) and 18% of older adolescents (14-16 years) slept less than recommended (TST < 7 hours). Adolescents reporting nonrecommended TST also reported more behavioral (ie, norm-breaking behaviors) and emotional problems (ie, depression, anxiety, and anger), with effects in the small-medium range. Finally, adolescents reporting bedtime arousal and use of information and communication technology in bed were more likely to report TST < 7 hours. Stress at home (for younger adolescents) and stress of school performance (for older adolescents) were also associated with TST less than 7 hours.Conclusions: The new National Sleep Foundation's recommendations were informative in this context. Future sleep interventions need to target barriers to good sleep practices, such as use of information and communication technology, stress, and worry that may contribute to arousal at bedtime.
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| 8. |
- Blanken, Tessa F., et al.
(författare)
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Symptom-Specific Effects of Cognitive Therapy and Behavior Therapy for Insomnia : A Network Intervention Analysis
- 2021
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Ingår i: Journal of Consulting and Clinical Psychology. - : American Psychological Association (APA). - 0022-006X .- 1939-2117. ; 89:4, s. 364-370
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Cognitive therapy (CT) and behavior therapy (BT) are both effective for insomnia but are expected to work via different pathways. Empirically, little is known about their symptom-specific effects. Method: This was a secondary analysis of a randomized controlled trial of online treatment for insomnia disorder (N = 219, 72.9% female, mean age = 52.5 years, SD = 13.9). Participants were randomized to CT (n = 72), BT (n = 73), or wait-list (n = 74). Network Intervention Analysis was used to investigate the symptom-specific treatment effects of CT and BT throughout treatment (wait-list was excluded from the current study). The networks included the Insomnia Severity Index items and the sleep diary-based sleep efficiency and were estimated biweekly from Week 0 until Week 10. Results: Participants in the BT condition showed symptom-specific effects compared to CT on sleep efficiency (Week 4-8, post-test), difficulty maintaining sleep (Week 4), and dissatisfaction with sleep (post-test). Participants in the CT showed symptom-specific effects compared to BT on interference with daily functioning (Week 8, posttest), difficulty initiating sleep, early morning awakenings, and worry about sleep (all post-test). Conclusions: This is the first study that observed specific differential treatment effects for BT and CT throughout the course of their treatment. These effects were more pronounced for BT than for CT and were in line with the theoretical background of these treatments. We think the embedment of the theoretical background of CT and BT in empirical data is of major importance to guide further treatment development.
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| 9. |
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| 10. |
- Choque Olsson, Nora, et al.
(författare)
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Treatment satisfaction with cognitive-behavioral therapy among children and adolescents with anxiety and depression : A systematic review and meta-synthesis
- 2021
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Ingår i: Journal of Behavioral and Cognitive Therapy. - : Elsevier BV. - 2589-9791. ; 31:2, s. 147-191
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Tidskriftsartikel (refereegranskat)abstract
- Recent reviews estimated that the worldwide prevalence of anxiety and depression in children and adolescents is increasing, which has led to rising demands for treatment. Studies on clinical outcomes have shown positive effects of cognitive-behavioral therapy (CBT) in children and adolescents with anxiety and depression. However, there is a limited body of studies on the perspectives and experiences of the treatment participants. The objective of this review was to investigate treatment satisfaction with CBT among children and adolescents with anxiety and depression. We focused on the reporting quality of the treatment satisfaction and experiences of participants in the selected studies. From 1379 identified studies, 35 were selected based on inclusion and exclusion criteria. The results of a meta-synthesis and proportional meta-analysis suggest moderate to high treatment satisfaction with CBT in depressed and anxious children and adolescents. The included studies showed moderate to good reporting quality on treatment satisfaction. The measurements used varied, indicating a risk of different evaluations under the concept of “treatment satisfaction”. The common topics measured for treatment satisfaction were acceptability, treatment usefulness, alliance, barriers, recommendation, and others, leading to uncertainty concerning generalization. A wide variety of measures were used, indicating the need for standardized measures for treatment satisfaction in future research.
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| 11. |
- Danielsson, Katarina, et al.
(författare)
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Cognitive Behavioral Therapy as an Adjunct Treatment to Light Therapy for Delayed Sleep Phase Disorder in Young Adults : A Randomized Controlled Feasibility Study
- 2016
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Ingår i: Behavioral Sleep Medicine. - : Informa UK Limited. - 1540-2002 .- 1540-2010. ; 14:2, s. 212-232
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Tidskriftsartikel (refereegranskat)abstract
- Delayed sleep phase disorder (DSPD) is common among young people, but there is still no evidence-based treatment available. In the present study, the feasibility of cognitive behavioral therapy (CBT) was evaluated as an additive treatment to light therapy (LT) in DSPD. A randomized controlled trial with participants aged 16 to 26 years received LT for two weeks followed by either four weeks of CBT or no treatment (NT). LT advanced sleep-wake rhythm in both groups. Comparing LT+CBT with LT+NT, no significant group differences were observed in the primary endpoints. Although anxiety and depression scores were low at pretreatment, they decreased significantly more in LT+CBT compared to LT+NT. The results are discussed and some suggestions are given for further studies.
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| 12. |
- Danielsson, Katarina, 1983-
(författare)
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Delayed Sleep Phase Disorder : Prevalence, Diagnostic aspects, Associated factors and Treatment concepts
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Delayed sleep phase disorder (DSPD) is the most common circadian rhythm sleep disorder. Persons with DSPD have great difficulties falling asleep and waking up at conventional times. To diagnose DSPD this delayed sleep-wake rhythm should cause social impairment and distress for the individual. Evening melatonin and morning bright light are the recommended treatments. The overall aim of this thesis was to evaluate at-home treatment with Light therapy (LT) and the feasibility of adding cognitive behavior therapy (CBT) to LT in DSPD, furthermore prevalence, diagnostic aspects and associated factors were investigated.Study I included 673 randomly selected individuals aged 16–26 years. The prevalence of DSPD was 4.0%. Unemployment (defined as an absence of educational or work activities) and an elevated level of anxiety were associated with DSPD.In study II, dim light melatonin onset (DLMO) was measured in healthy adults. Time for DLMO DLMO (Mean±SD) was 20:58±55 minutes.Studies III, IV, and V present results from a randomized controlled trial examining the feasibility of CBT as an additive treatment to LT with scheduled rise times, in persons with DSPD. Sleep onset and sleep offset was significantly advanced from baseline (03:00±1:20; 10:22±2:02 respectively) to the end of LT (01:27±1:41; 08:05±1:29, p<0.001 respectively). This advancement was predicted by consistent daily usage of the LT-lamp. At the follow-ups after LT and CBT or LT alone, sleep onset remained stable, sleep offset was delayed, and sleep difficulties were further improved, but there was no significant group interaction over time. There was a significant group interaction over time in the severity of anxiety and depressive symptoms, both in favor of the LT+CBT group.Conclusively, DSPD was common among adolescents and young adults and it was associated with unemployment and elevated levels of anxiety. DLMO appeared in the expected time range in healthy working adults. At-home treatment with LT with scheduled rise times advanced sleep-wake rhythm and improved sleep difficulties in DSPD. Even though sleep-wake rhythm was not further advanced or better preserved in the participants that received LT+CBT compared to LT alone, the addition of CBT to the treatment regimen was feasible and well accepted.
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| 13. |
- Danielsson, Katarina, 1983-, et al.
(författare)
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Delayed sleep phase disorder in a Swedish cohort of adolescents and young adults : Prevalence and associated factors
- 2016
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Ingår i: Chronobiology International. - : Informa UK Limited. - 0742-0528 .- 1525-6073. ; 33:10, s. 1331-1339
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Tidskriftsartikel (refereegranskat)abstract
- A delayed sleep-wake and circadian rhythm often occurs during puberty. While some individuals only develop a delayed sleep phase (DSP), others will fulfill the criteria for the diagnosis of delayed sleep phase disorder (DSPD). All previous studies have however not separated DSP from DSPD, and, as a result, the prevalence and associated factors are largely unknown for the two conditions individually. We estimated the prevalence of DSP and DSPD in a Swedish cohort of adolescents and young adults. We also investigated associated factors in the two conditions relative to each other and individuals with no DSP. A questionnaire regarding sleep patterns, demographics, substance use/abuse and symptoms of depression, anxiety, worry and rumination was sent to 1000 randomly selected participants (16-26 years of age) in Uppsala, Sweden (response rate = 68%). DSP was defined as a late sleep onset and a preferred late wake-up time. The DSPD diagnosis was further operationalized according to the Diagnostic and Statistical Manual of Mental Disorders, Edition 5 (DSM-5) criteria including insomnia or excessive sleepiness, distress or dysfunction caused by the DSP and that the sleep problem had been evident for 3 months. DSP occurred at a frequency of 4.6% and DSPD at a frequency of 4% in the investigated cohort. DSP was more common in males and was associated with not attending educational activity or work, having shift work, nicotine and alcohol use and less rumination. DSPD was equally common in males and females and was associated with not attending educational activity or work and with elevated levels of anxiety. Both DSP and DSPD appear to be common in adolescents and young adults in this Swedish cohort. No educational activity or work was associated with both DSP and DSPD. However, there were also apparent differences between the two groups in shift work, substance use and mental health, relative to persons with no DSP. Thus, it seems reasonable to assess DSP and DSPD as distinct entities in future studies.
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| 14. |
- Danielsson, Katarina, 1983-, et al.
(författare)
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Light Therapy With Scheduled Rise Times in Young Adults With Delayed Sleep Phase Disorder : Therapeutic Outcomes and Possible Predictors
- 2018
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Ingår i: Behavioural Sleep Medicine. - : Informa UK Limited. - 1540-2002 .- 1540-2010. ; 16:4, s. 325-336
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Tidskriftsartikel (refereegranskat)abstract
- Clinical trials with light therapy (LT) for delayed sleep phase disorder (DSPD) are sparse and little is known about factors that are favorable for improvements. In this study, LT with scheduled rise times was conducted at home for 14 days by 44 participants with DSPD aged 16-26 years. Primary outcomes were sleep onset and sleep offset. Potential predictors were demographic characteristics, chronotype, dim light melatonin onset, the number of days the LT lamp was used, the daily duration of LT, daytime sleepiness, anxiety, depression, worry, and rumination. Significant advances were observed in sleep onset and sleep offset from baseline to the end of treatment. The number of days of LT predicted earlier sleep onset and sleep offset.
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| 15. |
- Danielsson, Katarina, 1983-, et al.
(författare)
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The reduced Morningness–Eveningness Questionnaire : Psychometric properties and related factors in a young Swedish population
- 2019
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Ingår i: Chronobiology International. - : Informa UK Limited. - 0742-0528 .- 1525-6073. ; 36:4, s. 530-540
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Tidskriftsartikel (refereegranskat)abstract
- During puberty, there is a delay in sleep patterns and the circadian clock, and the prevalence of sleep difficulties is high among young adults. Thus, it is important to be able to measure chronotype (CT) in this group, both in the clinic and for broader epidemiological studies, to better understand the sleep difficulties observed. The reduced version of one of the most widely used questionnaire to measure CT, the Horne & Östberg Morningness–Eveningness Questionnaire (MEQ), has been developed and validated in many languages. The aim of the present study was to investigate the reliability and validity of the Swedish reduced MEQ (rMEQ) and to investigate factors correlated with rMEQ scores in a random sample of young Swedish participants. We sent the rMEQ, sleep questions, demographic questions, the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale, and the Hospital Anxiety and Depression Scale (HADS-A and HADS-D) to 1000 randomly selected individuals aged 16–26 years in Uppsala, Sweden (response rate = 68%). A parallel analysis of the rMEQ revealed a single factor solution. Inter-item correlations within the questionnaire were between 0.08 and 0.46. One of the rMEQ items displayed weak correlations with the other questions. Cronbach’s alpha of the rMEQ was 0.68. Low rMEQ scores (eveningness) were correlated with more frequent late bedtimes and difficulties getting up in the morning. Lower rMEQ scores were significantly related to male sex, no educational activity or work, nicotine use, younger age, and higher ISI and HADS-D scores. Even though the inter-item correlations of the rMEQ were very low to moderate, the rMEQ had a Cronbach’s alpha not far off from acceptable levels, and the strong correlations of the rMEQ scores with responses to the sleep questions indicated that the rMEQ had an adequate validity. To conclude, the rMEQ can be used to effectively estimate CT when a short questionnaire is required; however, caution should be taken when interpreting the results considering the reliability of the questionnaire.
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| 16. |
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| 17. |
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| 18. |
- Danielsson, Nanette S.
(författare)
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Disturbed sleep and emotion : a developmental perspective
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Sleep disturbances are not only defining features, but also diagnostic criteria for most psychiatric disorders. Recently, researchers have proposed a theoretic role for sleep disturbances in emotion dysregulation, subsequently linking neurobiological processes and psychopathology. Most prior research examining the potential role for sleep disturbance in emotion dysregulation is from a neurophysiological or clinical perspective, or primarily focused on maintaining processes. Less well understood are how sleep disturbances may be involved at the levels of predisposition, precipitation, and perpetuation of emotion dysregulation concurrently and over time.This dissertation presents findings from three studies that were designed to expand on what is known about sleep disturbance in the predisposition, precipitation, and perpetuation of emotion dysregulation. Study 1 examined the long-term relation between sleep-onset problems and neuroticism over twenty-years. Adolescent sleep-onset posed risk (predisposition) for neuroticism in midlife, not vice versa. Study 2 investigated the effects of 3-nights partial sleep deprivation (5-hours total time in bed) on the positive and negative affect and emotions of otherwise healthy adults. Following partial sleep deprivation, people reported significant reductions in positive affect and emotions compared to rested people (precipitation). The only impact on negative emotions was on the discrete level. Sleep deprived peo-ple reported significantly more irritability, loathing, hostility, and shakiness compared to controls. Study 3 measured adolescent sleep disturbances, depressive symptoms, and catastrophic worry. In addition to direct risk, sleep disturbances posed a non-gender specific risk for depressive symptoms one-year later through catastrophic worry (perpetuation). Overall, the results provide support for the role of sleep disturbances in the predis-position, precipitation, and perpetuation of emotion dysregulation. An implication is that sleep disturbances and catastrophic worry are two po-tentially modifiable markers of risk for emotion dysregulation.
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| 19. |
- Danielsson, Nanette S., et al.
(författare)
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Effects of partial sleep deprivation on subjective emotion experience and implicit emotion regulation
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Neurophysiological research implicates sleep deprivation in emotion dysregulation. Less is known about the effects of partial sleep deprivation on the emotions and on emotion regulation of otherwise healthy people. An experimental, randomized pretest-posttest study design was used to examine the differential effects of partial sleep deprivation on emotion experience and implicit emotion regulation following emotion elicitation.Methods: We randomized 81 healthy adults (44 females) into a sleep deprivation or rested condition. Sleep deprivation was defined as 3-nights with 5-hours total time in bed. Scores on positive and negative emotion markers measured emotions. Mixed between-within subjects analyses of variance were used to examine group differences in emotion following the sleep condition and after the emotion elicitation procedures and test.Results: Sleep deprived people reported significantly less positive emotions, and more fatigue, irritability, and hostility compared to people who were rested following the sleep condition. There were negligible differences between groups in implicit emotion regulation following emotion elicitation.Conclusions: These findings suggest that partial sleep deprivation is a potent stressor in emotion dysregulation through reductions in positive emotions. It also appears that implicit emotion regulation works equally well following strong negative emotional events, regardless of sleep condition. From a clinical perspective, sleep deprivation and ensuing reductions in positive affect and emotion may provide clinicians with viable targets in depression treatment. Keywords: Experimental, sleep deprivation, affect, emotions, emotion regulation, emotion elicitation.
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| 20. |
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| 21. |
- Danielsson, Nanette S., et al.
(författare)
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Neuroticism and sleep-onset : What is the long-term connection?
- 2010
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Ingår i: Personality and Individual Differences. - Oxford, United Kingdom : Elsevier BV. - 0191-8869 .- 1873-3549. ; 48:4, s. 463-468
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Tidskriftsartikel (refereegranskat)abstract
- People with sleep-onset problems often experience neuroticism. To what extent the one problem leads to the other is unknown. We used self-reported data from a Swedish longitudinal project to examine developmental links between neuroticism and sleep-onset problems. A sample of 212 people, followed from birth to midlife, was part of a cohort study spanning 37 years. Adolescent neuroticism was measured at age 16 with the High School Personality Questionnaire (HSPQ, Form A) and in midlife at age 37 with the Eysenck Personality Questionnaire (EPQ). Sleep-onset problems were measured at ages 15 to 17, 25, and 37 with items developed for the Solna Project. Adolescent neuroticism failed to predict sleep-onset problems. Instead, sleep-onset problems in adolescence and young adulthood predicted midlife neuroticism. We found that sleep-onset problems during adolescence were a direct risk for midlife neuroticism, as well as, an indirect risk through continuance of sleep-onset problems into adulthood. This study provides longitudinal support for adolescent sleep-onset problems as a potent risk factor for heightened neuroticism in midlife. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(journal abstract)
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| 22. |
- Danielsson, Nanette S., 1967-, et al.
(författare)
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Sleep Disturbance and Depressive Symptoms in Adolescence : The Role of Catastrophic Worry
- 2013
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Ingår i: Journal of Youth and Adolescence. - : Springer Science and Business Media LLC. - 0047-2891 .- 1573-6601. ; 42:8, s. 1223-1233
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Tidskriftsartikel (refereegranskat)abstract
- Depression is a common and debilitating disorder in adolescence. Sleep disturbances and depression often co-occur with sleep disturbances frequently preceding depression. The current study investigated whether catastrophic worry, a potential cognitive vulnerability, mediates the relationship between adolescent sleep disturbances and depressive symptoms, as well as whether there are gender differences in this relationship. High school students, ages 16-18, n = 1,760, 49 % girls, completed annual health surveys including reports of sleep disturbance, catastrophic worry, and depressive symptoms. Sleep disturbances predicted depressive symptoms 1-year later. Catastrophic worry partially mediated the relationship. Girls reported more sleep disturbances, depressive symptoms, and catastrophic worry relative to boys. The results, however, were similar regardless of gender. Sleep disturbances and catastrophic worry may provide school nurses, psychologists, teachers, and parents with non-gender specific early indicators of risk for depression. Several potentially important practical implications, including suggestions for intervention and prevention programs, are highlighted.
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| 23. |
- Flygare, Anna-Lena, et al.
(författare)
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Internet-based CBT for patients with depressive disorders in primary and psychiatric care : Is it effective and does comorbidity affect outcome?
- 2020
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Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Internet-based cognitive behavior therapy (ICBT) has proved effective in reducing mild to moderate depressive symptoms. However, only a few studies have been conducted in a regular healthcare setting which limits the generalizability of the results. The influence of psychiatric comorbidity on outcome is not well understood. In the current study, patients with mild to moderate depressive symptoms in primary and psychiatric care were interviewed using the SCID-I and SCID-II to assess psychiatric diagnoses. Those included were randomly allocated to ICBT (n = 48) or to an active control condition (n = 47). Both groups received therapist support. At post-treatment, ICBT had reduced depressive symptoms on the BDI-II more than the active control intervention (p = .021). However, the difference between groups was no longer significant at the 6-, 12- or 24-month followups. The within-group effect size after ICBT (BDI-II) was large (d = 1.4). A comorbid anxiety disorder didn't moderate the outcome, while the presence of a personality disorder predicted significantly less improvement in depressive symptoms. ICBT had a large effect on depressive symptoms in a sample from regular healthcare. It is possible to obtain a large effect from ICBT despite comorbid anxiety, however, including patients with a comorbid personality disorder in the current form of ICBT seems questionable.
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| 24. |
- Forsström, David, et al.
(författare)
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Experiences of Playscan : Interviews with users of a responsible gambling tool
- 2017
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Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 8, s. 53-62
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Tidskriftsartikel (refereegranskat)abstract
- Online gambling, encompassing a wide variety of activities and around-the-clock access, can be a potential risk factor for gamblers who tend to gamble excessively. Yet, the advent of online gambling has enabled responsible gambling (RG) features that may help individuals to limit their gambling behaviour. One of these features is RG tools that track gamblers' behaviour, performs risk assessments and provides advice to gamblers. This study investigated users' views and experiences of the RG tool Playscan from a qualitative perspective using a semi-structured interview. The tool performs a risk assessment on a three-step scale (low, medium and high risk). Users from every risk category were included. Twenty interviews were carried out and analysed using thematic analysis. Two main themes with associated sub-themes were identified: “Usage of Playscan and the gambling site” and “Experiences of Playscan”. Important experiences in the sub-themes were lack of feedback from the tool and confusion when signing up to use Playscan. These experiences counteracted positive attitudes that should have promoted usage of the tool. Providing more feedback directly to users is a suggested solution to increase usage of the RG tool.
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| 25. |
- Forsström, David, et al.
(författare)
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Further Exploration of the Psychometric Properties of GamTest : A Rasch Analysis
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:9
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Tidskriftsartikel (refereegranskat)abstract
- GamTest is a self-rating scale of negative consequences of gambling, included in the popular responsible gambling tool Playscan as part of an overall risk assessment and feedback feature. Two previous psychometric evaluations of this instrument yielded contradictory results: in an online high-gambling population, a five-factor model was supported and the instrument had overall good psychometric properties, but in a low-gambling population, the same factor structure was not supported. Because GamTest is used with both low- and high-gambling populations, more psychometric research is needed to fully understand how the instrument works. The current study examined, for the first time, psychometric performance among a sample of low-gambling respondents using a Rasch analysis. Results indicated that the instrument could be improved by decreasing the scale-steps and removing several problematic items demonstrating misfit. Furthermore, the findings indicated that some items functioned differently depending on gender, and that a shortened, improved nine-item version could not differentiate between different levels of risk. Our findings suggest that the instrument would arguably benefit from being adapted for use in a low-gambling population.
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| 26. |
- Forsström, David, et al.
(författare)
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GamTest : Psychometric Evaluation in a Low-Gambling General Population
- 2020
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Ingår i: Journal of Gambling Issues. - Toronto : Concurrent Disorders Society Press. - 1910-7595. ; 44, s. 77-102
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Tidskriftsartikel (refereegranskat)abstract
- Instruments that investigate different aspects of gambling activities are needed to distinguish negative consequences. Because gambling is a complex activity that occurs both offline and online, different questionnaires are necessary for screening and risk classification. GamTest, an instrument used by several gambling companies, was designed to cover different aspects of gambling: money and time spent, as well as social, financial, and emotional consequences. This study explores GamTest’s psychometric properties in a general population. A total of 2,234 Swedish respondents completed an online survey containing demographic questions, the questionnaire (GamTest), and the Problem Gambling Severity Index (PGSI). A confirmatory factor analysis was performed and GamTest’s reliability and validity tested. The confirmatory factor analysis yielded an inclusive fit. The internal consistency (omega) for the five factors was high (.79–.91), indicating good reliability, and a high positive correlation with the PGSI supported the validity of the GamTest. The inclusive fit of the confirmatory factor analysis can be explained by the low endorsement of negative consequences of gambling in the sample. However, GamTest seems to have good reliability and validity. The utility of GamTest is discussed in relation to its psychometric properties and its use in the responsible gambling tool Playscan.
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| 27. |
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| 28. |
- Forsström, David, 1981-, et al.
(författare)
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Psychometric properties of the Jonsson-Abbott Scale : Rasch and confirmatory factor analyses
- 2022
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Measuring and assessing the different aspects of gambling behavior and its consequences is crucial for planning prevention, treatment, and understanding the development of at-risk and problem gambling. Studies indicate that instruments measuring problem gambling produce different results based on the characteristics of the population assessed. To accurately measure at-risk and problem gambling behavior, especially in a low-risk population, measures must cover a wider set of dimensions than the negative consequences already manifest. The Jonsson-Abbott Scale (JAS) includes items that cover overconsumption, actions that reinforce gambling behavior, and belief in gambling fallacies, based on a three-factor structure and has previously demonstrated good psychometric properties. However, there is a need to investigate how the instrument also functions in low-risk populations. This study aims to do so using both confirmatory factor and Rasch analysis; this research included 1,413 Swedish participants who endorsed at least one JAS item. The results replicated the previous three-factor solution and indicated that the instrument had good reliability. In addition, the results demonstrated that the three factors are independent, and the overall score per factor needs to be analyzed. In summary, the JAS appears suitable for use in low-risk populations to measure various aspects of gambling behavior.
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| 29. |
- Forsström, David, 1981-
(författare)
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The use and experience of responsible gambling tools : An explorative analysis of user behavior regarding a responsible gambling tool and the consequences of use
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Responsible gambling tools are an intervention that is designed to decrease gambling among individuals with an at-risk gambling behavior. Studies have indicated that responsible gambling tools can decrease gambling behavior, but little is known about how this intervention is used by gamblers. The aim of the present thesis was to explore different facets of the use, experience and functions of these tools. Study I used descriptive statistics and latent class analysis (LCA) combined with multinomial regression to explore the use of the responsible gambling tool Playscan among 9528 gamblers (regular and at-risk gamblers). The participants had volunteered to use the tool. The functions of the tool had a high rate of initial use but a low rate of repeated use. The LCA identified five user classes. Two of the classes (self-testers and multifunctional users) were defined as high users of the tool and had a higher risk of developing gambling problems according to multinomial regression. The multifunctional users were characterized by an extensive use of all the functions while the other high usage class had an extensive use of the self-test. The three other classes were as follows: those who did not use the tool, those who visited the tool but did not engage in any of the functions, and those who only used the tool’s advice on how to decrease their gambling. Participants’ reasons for use and non-use of the tool were attributed to their degree of need of the tool and its functions. The tool’s most widely used function was the self-test that investigated the level of negative consequences faced by a user due to his or her gambling. Study II was a qualitative study investigating participants’ views, experiences and their reasons for using the tool. The study was conducted by interviewing 20 volunteer users of the tool. These semi-structured interviews were analyzed by thematic analysis. The results showed that the users had a positive attitude towards the tool and understood its purpose. The self-test was the most widely used function in this sample as well. However, the participants’ positive attitude toward the tool did not effectively encourage them to use it; they displayed low use of the tool’s functions. This paradox was explained by lack of feedback and the fact that some participants did not understand that they had registered to use the tool. Providing more feedback and tailoring the feedback to individual users were seen as ways of bridging the paradox. Study II also found that participants used the gambling website (which Playscan was linked to) in an analogue way, preparing their bets before placing them online. This limited the time they spent on the site and inhibited their use of Playscan. Study III was motivated by the extensive use of the self-test among users in Study I and Study II. The aim of Study III was to investigate the psychometric properties of the self-test (known as GamTest) to better understand how it could be used with Playscan in the most efficient way. Two thousand two hundred and thirty four respondents answered the questionnaire, along with instruments measuring depression, anxiety and another instrument measuring problems due to gambling. Factor analysis, parallel analysis, Cronbach’s alpha, and correlations were used to establish the tool’s psychometric properties. The results yielded a three-factor model, excellent reliability, and high correlation with the Problem Gambling Severity Index (PGSI), endorsing the validity of the self-test. The results also indicated that the questionnaire could be effectively shortened. Overall, the studies show that the tool has an initial high use, low repeated use and that the self-test is the most used feature. In addition, the self-test had good psychometric properties.
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| 30. |
- Georén, Lisa, et al.
(författare)
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Internet-delivered Cognitive Behavioral Therapy for insomnia in youth with autism spectrum disorder : A pilot study
- 2022
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Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- Adolescents with ASD often suffer from sleep disorders affecting their development and quality of life. Research concerning psychological treatment of insomnia in this population is scarce. The objective of this pilot study was to examine the feasibility of internet-delivered CBT for insomnia (iCBT-I) and the participants' experiences after completing the treatment. Both quantitative and qualitative methods were used. Six adolescents with ASD and insomnia, aged 13 to 17, participated in the study. The results of the qualitative investigation showed general satisfaction with the iCBT-I. The participants experienced both better sleep and insights into their sleep patterns. Thematic analysis revealed five themes: experience of the structure of the treatment, treatment content, experienced outcomes, experienced difficulties, and suggested improvements. The results indicate the need for additional support for some participants and suggest distinct recommendations for further studies. The quantitative investigation showed large reductions in insomnia symptoms indicating the feasibility of the treatment in this population. The findings suggest promising results, but more studies are needed to define the efficacy of iCBT-I for adolescents with ASD.
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| 31. |
- Hertenstein, Elisabeth, et al.
(författare)
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Insomnia as a predictor of mental disorders : A systematic review and meta-analysis
- 2019
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Ingår i: Sleep Medicine Reviews. - : Elsevier BV. - 1087-0792 .- 1532-2955. ; 43, s. 96-105
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Forskningsöversikt (refereegranskat)abstract
- Previous research has identified insomnia as a predictor for the onset of depression. The aim of this meta-analysis is to investigate whether insomnia also predicts the onset of other mental disorders. Longitudinal studies were eligible for inclusion if they investigated insomnia at baseline (including nighttime- and daytime-symptoms) as a predictor of the later onset of psychopathology within a follow-up time-frame of at least 12 mo. Thirteen primary studies were included. The results suggest that insomnia is a significant predictor for the onset of depression (10 studies, OR 2.83, CI 1.55-5.17), anxiety (six studies, OR 3.23, CI 1.52-6.85), alcohol abuse (two studies, OR 1.35, CI 1.08-1.67, and psychosis (one study, OR 1.28, CI 1.03-1.59). The overall risk of bias in the primary studies was moderate. This meta-analysis provides evidence that insomnia increases the risk for psychopathology. A future research agenda should include more prospective studies using established diagnostic criteria, assessing insomnia at baseline and including long-term follow-up intervals evaluating a wider range of mental disorders. In addition, prospective long-term interventional studies investigating the efficacy of insomnia treatment for the prevention of mental disorders are called for.
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| 32. |
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| 33. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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A bidirectional relationship between anxiety and depression, and insomnia? : A prospective study in the general population
- 2008
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Ingår i: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 64:4, s. 443-449
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The purpose of this study was to examine whether there is a bidirectional relationship between on the one hand anxiety and depression and on the other hand insomnia over the course of a year.Methods: A randomly selected sample of 3,000 participants from the general population filled out a baseline (N = 1,812) and 1-year follow-up survey (N = 1,498) on anxiety, depression, and insomnia.Results: In cross-sectional analyses, bivariate correlations showed that anxiety, depression, and insomnia were significantly inter-correlated (φ = .31-.54). In prospective analyses, logistic regression analyses demonstrated that baseline anxiety (OR = 4.27, 8% of the variance) and baseline depression (OR = 2.28, 2% of the variance) were related to new cases of insomnia at follow-up. Further, baseline insomnia was related to new episodes of high anxiety and high depression at follow-up (OR = 2.30, 2% of the variance; OR = 3.51; 4% of the variance).Conclusion: Evidence suggested that there is a bidirectional relationship between on the one hand anxiety and depression and on the other hand insomnia. This suggests that anxiety, depression, and insomnia are intertwined over time, which has implications for theoretical conceptualizations and interventions.
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| 34. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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Are sleep hygiene practices related to the incidence, persistence and remission of insomnia? : Findings from a prospective community study
- 2019
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Ingår i: Journal of behavioral medicine. - : Springer Science and Business Media LLC. - 0160-7715 .- 1573-3521. ; 42:1, s. 128-138
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose was to examine whether sleep hygiene practices are associated with the course of insomnia (incidence, persistence and remission) over 1 year in the general population. This longitudinal study was carried out in the general population. After excluding anyone with other primary sleep disorder than insomnia, 1638 participants returned a baseline and a 1-year follow-up survey. Questions regarding sleep hygiene practices were administered at baseline, and the status of insomnia was assessed at baseline (T1) and at the 1-year follow-up (T2). Age, gender, mental ill-health, and pain were used as covariates in the analyses. Nicotine use, mental ill-health and pain were independently associated with an increased risk for concurrent insomnia at T1, while mental ill-health was the only risk factor for incident insomnia at T2. Relative to not reporting insomnia at the two time-points, nicotine use, light or noise disturbance, mental ill-health, and pain significantly increased the risk for persistent insomnia over 1 year. In comparison with those whose insomnia had remitted at the follow-up, reporting an irregular sleep schedule was a significant risk factor for persistent insomnia. Of the nine sleep hygiene practices examined in this study, only three were independently linked to concurrent and future insomnia, respectively; using nicotine late in the evening, light or noise disturbance, and having an irregular sleep schedule. This may have implications for the conceptualization and management of insomnia as well as for future research.
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| 35. |
- Jansson-Fröjmark, Markus, 1971-, et al.
(författare)
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Associations between psychological factors and night-time/daytime symptomatology in insomnia
- 2012
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Ingår i: Journal of Sleep Research. - : Wiley-Blackwell. - 0962-1105 .- 1365-2869. ; 21:Suppl. 1, s. 168-169
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Cognitive models of insomnia underscore cognitive mechanisms as important in the maintenance of insomnia. The aim of this study was to examine psychological factors in insomnia and the association between psychological mechanisms with night-time and daytime symptoms.Methods: In a cross-sectional examination, participants (n = 2327) from a randomly selected sample of the general population completed a survey on demographic parameters, night-time symptoms, daytime impairment, health outcomes, and psychological factors intended to index five cognitive processes (Harvey, 2002). Excluding those with a sleep disorder other than insomnia, the study sample consisted of 1890 participants. Results: Relative to poor and normal sleepers, the insomnia group scored higher on worry, beliefs, physiologic arousal, monitoring/attentional bias, and safety behaviours relative to the other two groups, and the poor sleepers exhibited a similar pattern relative to the normal sleepers. High total wake time was associated with more worry, physiologic arousal, and safety behaviours (26.3% variance), low sleep restoration with more worry, unhelpful beliefs, and monitoring/attentional bias (28.2% variance), and low sleep quality with higher scores on all the psychological mechanisms (35.8% variance). Elevated daytime symptoms were related to more unhelpful beliefs and monitoring/attentional bias (44.3% variance).Conclusion: The findings show that psychological factors discriminate those with insomnia from those with poor or normal sleep. The results also indicate that psychological factors are linked to insomnia-specific night-time and daytime symptomatology.
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| 36. |
- Jansson-Fröjmark, Markus, et al.
(författare)
-
Associations between psychological factors and nighttime/daytime symptomatology in insomnia
- 2012
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Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 41:4, s. 273-287
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to examine psychological factors in insomnia and the association between psychological mechanisms and nighttime and daytime symptoms.Methods: A cross-sectional examination in the general population was used. The study sample consisted of 1890 participants from the general population. The participants completed a survey on nighttime and daytime symptoms, health outcomes, and psychological factors.Results: Relative to poor and normal sleepers, the insomnia group had higher scores on worry, beliefs, physiologic arousal, monitoring/attentional bias, and safety behaviors than the other two groups, and the poor sleepers exhibited a similar pattern relative to the normal sleepers. High total wake time was associated with more worry, physiologic arousal, and safety behaviors (26.3% variance), low sleep restoration with more worry, unhelpful beliefs, and monitoring/attentional bias (28.2% variance), and low sleep quality with higher scores on all the psychological mechanisms (35.8% variance). Elevated daytime symptoms were related to more unhelpful beliefs and monitoring/attentional bias (44.3% variance).Conclusion: The findings indicate that psychological factors are linked to nighttime and daytime symptomatology in insomnia.
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| 37. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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Attentional bias in insomnia : the dot-probe task with pictorial stimuli depicting daytime fatigue/malaise
- 2013
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Ingår i: Cognitive Therapy and Research. - : Springer Science and Business Media LLC. - 0147-5916 .- 1573-2819. ; 37:3, s. 534-546
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to examine whether individuals with primary insomnia (PI) have an attentional bias towards insomnia-specific stimuli, relative to normal sleepers (NS). Also, the aim was to determine if the attentional bias was characterized by vigilance or disengagement. A between-groups, matched design was employed. Forty-two individuals completed the study (PI = 21; NS = 21). Participants completed a dot-probe task with stimuli comprising insomnia-specific (fatigue/malaise) and neutral pictures. It was hypothesized that individuals with PI would show greater attentional bias to insomnia-specific stimuli compared with NS. An overall bias effect was noted. This effect was however not due to vigilance; taking into account the reaction times on neutral trials, the PI group and the NS group did not display significantly different results in reaction times to insomnia-specific pictures. On the contrary, the results suggest that the overall bias effect was due to disengagement; the PI group had significantly longer reaction times than the NS group when shifting away from the insomnia-specific pictures, relative to neutral-neutral picture presentations. The findings suggest that individuals with insomnia are not more vigilant than normal sleepers to insomnia-specific stimuli, but instead have greater difficulties in shifting away from such stimuli.
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| 38. |
- Jansson-Fröjmark, Markus, 1971-, et al.
(författare)
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Bidirectionality between pain and insomnia symptoms : a prospective study
- 2012
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Ingår i: British Journal of Health Psychology. - : Wiley-Blackwell. - 1359-107X .- 2044-8287. ; 17:2, s. 420-431
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study was to investigate whether there is a bidirectional relationship between pain and insomnia symptoms over the course of a year.Design: A longitudinal design with a 1-year follow-up was used. Methods. From a randomly selected sample of the adult general population (N = 3,000), 1,746 individuals filled out a baseline and 1-year follow-up survey on pain, insomnia symptoms, anxiety symptoms, and depressive symptoms.Results: Pain (OR = 1.64) and anxiety symptoms increased the risk for the incidence of insomnia symptoms (R-2 =.125) and pain (OR = 1.98), anxiety symptoms and depressive symptoms were related to the persistence of insomnia symptoms (R-2 =.212). Gender and anxiety symptoms increased the risk for the incidence of pain (R-2 =. 073); and age, insomnia symptoms (OR= 1.49), anxiety symptoms, and depressive symptoms were associated with the persistence of pain (R-2 =.187).Conclusion: While pain was linked to future insomnia symptoms and insomnia symptoms to the persistence of pain over the course of a year, insomnia symptoms was not associated with the incidence of pain. The results, thus, partly argue against bidirectionality between pain and insomnia symptoms.
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| 39. |
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| 40. |
- Jansson-Fröjmark, Markus, 1971-, et al.
(författare)
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Cognitive-behavioral therapy for insomnia co-morbid with hearing impairment : a randomized controlled trial
- 2012
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Ingår i: Journal of clinical psychology in medical settings. - New York, USA : Springer. - 1068-9583 .- 1573-3572. ; 19:2, s. 224-234
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the current study was to examine the effects of cognitive behavior therapy (CBT-I) for insomnia on patients with insomnia co-morbid with hearing impairment. A randomized controlled design was used with a 3-month follow-up. Thirty-two patients with insomnia co-morbid with hearing impairment were randomized to either CBT-I or a waitlist condition (WLC). The primary outcome was insomnia severity. Secondary outcomes were sleep diary parameters, dysfunction, anxiety, and depression. Compared to WLC, CBT-I resulted in lower insomnia severity at post-treatment and at follow-up (d = 1.18–1.56). Relative to WLC, CBT-I also led, at both assessment points, to reduced total wake time (d = 1.39) and increased sleep restoration (d = 1.03–1.07) and sleep quality (d = 0.91–1.16). Both groups increased their total sleep time, but no significant group difference emerged. Compared to WLC, CBT-I resulted in higher function (d = 0.81–0.96) and lower anxiety (d = 1.29–1.30) at both assessment points. Neither CBT-I nor WLC led to improvement on depression. Based on the Insomnia Severity Index, more CBT-I (53–77%) than WLC participants (0–7%) were treatment responders. Also, more CBT-I (24%) than WLC participants (0%) remitted. In patients with insomnia co-morbid with hearing impairment, CBT-I was effective in decreasing insomnia severity, subjective sleep parameters, dysfunction, and anxiety. These findings are in line with previous results on the effects of CBT-I in other medical conditions.
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| 41. |
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| 42. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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Cognitive Behavioural Therapy for Insomnia in Psychiatric Disorders
- 2016
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Ingår i: Current Sleep Medicine Reports. - : Springer Science and Business Media LLC. - 2198-6401 .- 1805-3742. ; 2:4, s. 233-240
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Tidskriftsartikel (refereegranskat)abstract
- Insomnia means difficulties in initiating or maintaining sleep and is commonly comorbid with psychiatric disorders. From being considered secondary to primary psychiatric disorders, comorbid insomnia is now considered an independent health issue that warrants treatment in its own right. Cognitive behavioural therapy for insomnia (CBT-I) is an evidence-based treatment for insomnia. The effects from CBT-I on comorbid psychiatric conditions have received increasing interest as insomnia comorbid with psychiatric disorders has been associated with more severe psychiatric symptomologies, and there are studies that indicate effects from CBT-I on both insomnia and psychiatric symptomology. During recent years, the literature on CBT-I for comorbid psychiatric groups has expanded and has advanced methodologically. This article reviews recent studies on the effects from CBT-I on sleep, daytime symptoms and function and psychiatric comorbidities for people with anxiety, depression, bipolar disorder, psychotic disorders and post-traumatic stress disorder. Future strategies for research are suggested.
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| 43. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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Developing a cognitive behavioral therapy manual for delayed sleep-wake phase disorder
- 2016
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Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 45:6, s. 518-532
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Tidskriftsartikel (refereegranskat)abstract
- This article reports the development of a treatment protocol, based on cognitive behavioral therapy (CBT) principles, for delayed sleep-wake phase disorder (DSWPD). The protocol consists of psychoeducation, presenting a CBT model for DSWPD, case formulation, motivational interviewing, registering sleep in a diary, strategies to improve the rhythm of sleep and wakefulness, relaxation training, cognitive restructuring, strategies to cope with daytime symptoms, constructing an individualized CBT program, and learning how to deal with relapses. Qualitative data, focusing on how the patients perceived the protocol, were collected within the realm of a trial exploring the efficacy of the protocol. These findings highlighted several advantages but also disadvantages of the therapy. It is our hope that this paper might act as a platform for further clinical work and future research efforts in patients with DSWPD.
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| 44. |
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| 45. |
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| 46. |
- Jansson-Fröjmark, Markus, 1971-, et al.
(författare)
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Don't worry, be constructive : a randomized controlled feasibility study comparing behaviour therapy singly and combined with constructive worry for insomnia
- 2012
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Ingår i: British Journal of Clinical Psychology. - : Wiley-Blackwell. - 0144-6657 .- 2044-8260. ; 51:2, s. 142-157
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Based on the lack of research on interventions targeting intrusive and worrisome thinking for insomnia, the aim was to examine whether a constructive worry (CW) intervention adds to the effects of behaviour therapy (BT).Design: A randomized, controlled design was used. The design included a 2-week baseline, a 4-week intervention phase (sleep restriction and stimulus control [BT] or sleep restriction and stimulus control plus constructive worry [BT + CW]), and a 2-week follow-up.Methods: Twenty-two patients with primary insomnia participated. The primary outcome was the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), and secondary endpoints were subjective sleep estimates, the Insomnia Severity Index (ISI), and the Work and Social Adjustment Scale (WSAS).Results: Although both conditions produced significant improvements in subjective sleep estimates, no significant group differences over time were shown for total wake time (TWT) and total sleep time (TST). Both interventions resulted in reductions over time in insomnia severity, worry, and dysfunction. Compared to BT, BT + CW led to a larger decrease in insomnia severity at all three time points (controlled d= 1.101.68). In comparison with BT, BT + CW resulted in a larger reduction in worry at two of the time points (controlled d= 0.761.64). No significant differences between the two conditions were demonstrated for dysfunction. While more participants responded positively to treatment in the BT + CW (80100%) than in the BT condition (1827%), none of the participants remitted.Conclusions: The findings suggest that, compared to BT alone, CW might result in additional improvements in insomnia severity and worry. Given the small sample size and short follow-up, future studies are warranted.
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| 47. |
- Jansson-Fröjmark, Markus, 1971-, et al.
(författare)
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Exploratory factor analysis of the Modified Somatic Perception Questionnaire on a sample with insomnia symptoms
- 2009
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Ingår i: Psychology, Health & Medicine. - London : Routledge. - 1354-8506 .- 1465-3966. ; 14:1, s. 62-72
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study was to examine the factorial solution of the Modified Somatic Perception Questionnaire (MSPQ) among individuals with insomnia symptoms in the general population.Design: A cross-sectional study with a randomly selected sample from the general population (N = 3,600; 20-60 year old) was used. In total, 251 of the 2,179 respondents fulfilled the criteria for insomnia symptoms and filled out a survey on demographic parameters, the MSPQ, the Hospital Anxiety and Depression Scale, sleep medication use, and health care consumption.Methods: Exploratory factor analysis and correlations were used.Results: The results showed that a two-factor solution, accounting for 47.31% of the variance, was extracted from the 13 items of the MSPQ. While one factor consisting of 10 items determined general symptoms of somatic arousal (a = .83), the other factor with 3 items assessed stomach symptoms and nausea (a = .78). The two factors were significantly inter-correlated (r = .54) and significantly associated with the total MSPQ (r = .96, r = .74). The two factors also showed discriminant validity with anxiety and depression and predictive validity with retrospective reports of sleep medication use and health care consumption. A few significant interactions emerged the two MSPQ factors and degree of sleep complaints.Conclusions: Although it is often assumed that the MSPQ taps a single factor of somatic arousal, this study on individuals with insomnia symptoms suggests that a two-factor solution has the best fit. Further research on the factorial solution of the MSPQ is warranted.
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| 48. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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How is persistent insomnia maintained? : A prospective study on 50-60 years old adults in the general population
- 2008
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Ingår i: British Journal of Health Psychology. - 1359-107X .- 2044-8287. ; 13:1, s. 121-133
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study was to examine whether arousal, distress, and sleep-related beliefs are related to the maintenance of insomnia in old adults.Design: From a randomly selected sample from the general population (N = 3,600; 50-60 year old), 2,239 participants filled out a baseline and 1-year follow-up survey.Methods: Logistic regressions were used to investigate whether psychological mechanisms were related to sleep status (insomnia: n = 230; poor sleep: n = 210; normal sleep: n = 658; good sleep: n = 253) over one year. Cluster analysis was employed to assess whether it was possible to classify the participants based on their profiles of psychological functioning.Results: The results showed that arousal, sleep-related beliefs about future consequences, and anxiety were significantly related to the maintenance of insomnia (14-66% of the variance). Of the individuals with persistent insomnia, 67% belonged to a cluster characterized by high scores on arousal, sleep-related beliefs, and anxiety, 24% to a cluster defined by medium scores on the three mechanisms, and 9% to a cluster characterized by low scores on the three mechanisms.Conclusions: This investigation shows that arousal, sleep-related beliefs, and anxiety are associated with the maintenance of persistent insomnia, but also that these mechanisms often co-occur in individuals with persistent insomnia.
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| 49. |
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| 50. |
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