| 61. |
- Hesser, Hugo, 1982-, et al.
(author)
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A Randomized Controlled Trial of Internet-Delivered Cognitive Behavior Therapy and Acceptance and Commitment Therapy in the Treatment of Tinnitus
- 2012
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In: Journal of Consulting and Clinical Psychology. - Washington, DC, USA : American Psychological Association (APA). - 0022-006X .- 1939-2117. ; 80:4, s. 649-661
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Journal article (peer-reviewed)abstract
- Objective:Our aim in this randomized controlled trial was to investigate the effects on global tinnitus severity of 2 Internet-delivered psychological treatments, acceptance and commitment therapy (ACT) and cognitive behavior therapy (CBT), in guided self-help format.Method: Ninety-nine participants (mean age 48.5 years; 43% female) who were significantly distressed by tinnitus were recruited from the community. Participants were randomly assigned to CBT (n 32), ACT (n 35), or a control condition (monitored Internet discussion forum; n 32), and they were assessed with standardized self-report measures (Tinnitus Handicap Inventory; Hospital Anxiety and Depression Scale; Quality of Life Inventory; Perceived Stress Scale; Tinnitus Acceptance Questionnaire) at pre-, posttreatment (8 weeks), and 1-year follow-up.Results: Mixed-effects linear regression analysis of all randomized participants showed significant effects on the primary outcome (Tinnitus Handicap Inventory) for CBT and for ACT compared with control at posttreatment (95% CI [17.03, 2.94], d 0.70, and 95% CI [16.29, 2.53], d 0.68, respectively). Within-group effects were substantial from pretreatment through 1-year-follow-up for both treatments (95% CI [44.65, 20.45], d 1.34), with no significant difference between treatments (95% CI [14.87, 11.21], d 0.16).Conclusions: Acceptance-based procedures may be a viable alternative to traditional CBT techniques in the management of tinnitus. The Internet can improve access to psychological interventions for tinnitus.
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| 62. |
-
Intensive One-Session Treatment of Specific Phobias
- 2012. - 1
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Editorial collection (other academic/artistic)abstract
- Whether it’s dogs, spiders, blood, heights or some other fear, specific phobias are one of the most prevalent mental health problems, affecting as many as one in eight people. In recent years, cognitive-behavioral therapy (CBT) has emerged as particularly effective in treating young people and adults with specific phobias. And of these methods, one-session treatment stands out as a long-lasting, cost-effective intervention of choice.Intensive One-Session Treatment of Specific Phobias not only provides a summary of the evidence base, it also serves as a practical reference and training guide. This concise volume examines the phenomenology, epidemiology, and etiology of phobias, laying the groundwork for subsequent discussion of assessment strategies, empirically sound one-session treatment methods, and special topics. In addition, expert contributors address challenges common to exposure therapy, offer age-appropriate guidelines for treating young clients, and describe innovative computer-assisted techniques.Organized to be read individually or in sequence, chapters delve into key areas, including:• Evidence-based assessment and treatment of specific phobias in children, adolescents, and adults.• One-session treatment theory and practice with children, adolescents, and adults.• Handling difficult cases of specific phobias in youth.• Interventions for specific phobias in special populations.• Training and assessing therapists in one-session treatment.• Ethical issues in considering exposure.Intensive One-Session Treatment of Specific Phobias is an essential resource for researchers, clinicians, and graduate students in child, school, clinical, and counseling psychology; social work; and general and special education.
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| 63. |
- Johansson, Robert, et al.
(author)
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Depression, anxiety and their comorbidity in the Swedish general population : point prevalence and the effect on health-related quality of life
- 2013
-
In: PeerJ. - : PeerJ. - 2167-8359. ; 1
-
Journal article (peer-reviewed)abstract
- Background. Depression and anxiety disorders are major world-wide problems. There are no or few epidemiological studies investigating the prevalence of depression, generalized anxiety disorder and anxiety disorders in general in the Swedish population.Methods. Data were obtained by means of a postal survey administered to 3001 randomly selected adults. After two reminders response rate was 44.3%. Measures of depression and general anxiety were the 9-item Patient Health Questionnaire Depression Scale (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7). The PHQ-9 identified participants who had experienced clinically significant depression (PHQ-9 >= 10), and who had a diagnosis of major depression (defined by using a PHQ-9 scoring algorithm). Clinically significant anxiety was defined as having a GAD-7 score >= 8. To specifically measure generalized anxiety disorder, the Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV) was used with an established cut-off. Health-related quality of life was measured using the EuroQol (EQ-5D). Experiences of treatments for psychiatric disorders were also assessed.Results. Around 17.2% (95% CI: 15.1-19.4) of the participants were experiencing clinically significant depression (10.8%; 95% CI: 9.1-12.5) and clinically significant anxiety (14.7%; 95% CI: 12.7-16.6). Among participants with either clinically significant depression or anxiety, nearly 50% had comorbid disorders. The point prevalence of major depression was 5.2% (95% CI: 4.0-6.5), and 8.8% (95% CI: 7.3-10.4) had GAD. Among those with either of these disorders, 28.2% had comorbid depression and GAD. There were, generally, significant gender differences, with more women having a disorder compared to men. Among those with depression or anxiety, only between half and two thirds had any treatment experience. Comorbidity was associated with higher symptom severity and lower health-related quality of life.Conclusions. Epidemiological data from the Swedish community collected in this study provide point prevalence rates of depression, anxiety disorders and their comorbidity. These conditions were shown in this study to be undertreated and associated with lower quality of life, that need further efforts regarding preventive and treatment interventions.
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| 64. |
- Kajonius, Petri, 1974-
(author)
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An Inquiry into Satisfaction and Variations in User-Oriented Elderly Care
- 2015
-
Doctoral thesis (other academic/artistic)abstract
- The foundation for this thesis is an ongoing discussion about quality in Swedish elderly care: Which are the most important factors that contribute to elderly care in terms of satisfaction among older persons, and what are the primary reasons for their differences? Aims. The principal aim was to examine what determines satisfaction with elderly care in home care and nursing homes, using the perspective of older persons (Studies I and II). The secondary aim was to analyze why these determinants differ, using the perspective of care workers, managers, and observers (Studies III and IV). Methods. Study I analyzed aggregated statistical data from the level of municipalities and districts (N = 324) based on the Swedish elderly care quality reports “Open Comparisons”, while Study II analyzed individual data based on the original ratings in the annual, nationwide elderly surveys (N = 95,000). Study III describes field observations and interviews with care workers and managers in two municipalities, one with a high rating for user satisfaction and one with an average rating. Study IV describes investigations in these two municipalities concerning their organizing principles and departmental level management climate. Results. The results relating to the principal aim showed that process factors (such as respect, information, and influence) are related considerably more closely than structural factors (such as budget, staffing levels, and training levels) to satisfaction with care. Other process factors (such as treatment, safeness, staff and time availability) were also able to alleviate person factors (such as health, anxiety, and loneliness). Moreover, the results relating to the secondary aim showed that differences in user-oriented elderly care are mainly due to interpersonal factors between the caregiver and the older person. Care workers, however, reported that other factors (such as organizing principles and leadership support) influence the quality of the care process. Overall, older persons who receive home care generally report higher satisfaction with care than those in nursing homes, and feeling less safe. It is possible that differences in the process of aging explain this. Value. This thesis shows that satisfaction with elderly care can be largely explained by psychological quality at the individual level. The sizes of structural resources and organizing principles at the municipal level have minimal effect (< 5%). The thesis also presents a theoretical multiple-level Quality Agents Model to explain the sources of differences in satisfaction with care, and it presents recommendations for elderly care practices. A renewed focus on the psychology of satisfaction may contribute to the development of quality in elderly care.
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| 65. |
- Kapetanovic, Sabina, 1980-, et al.
(author)
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Aspects of the Parent–Adolescent Relationship and Associations With Adolescent Risk Behaviors Over Time
- 2019
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In: Journal of family psychology. - : American Psychological Association (APA). - 0893-3200 .- 1939-1293. ; 33:1, s. 1-11
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Journal article (peer-reviewed)abstract
- Parents' actions and knowledge of adolescents' whereabouts play key roles in preventing risk behaviors in early adolescence, but what enables parents to know about their adolescents' activities and what links there are to adolescent risk behaviors, such as substance use and delinquent behavior, remain unclear. In this study,we investigated whether different aspects of the parent–adolescent relationship predict parental knowledge, and we examined the direct and indirect longitudinal associations between these aspects of the parent–dolescent relationship and adolescents' self-reported delinquent behavior and substance use. The participants were 550 parents and their adolescent children from two small and two midsized municipalities in Sweden. Parental data were collected when the adolescents were 13 years old (mean), and adolescent data on riskbehaviors were collected on two occasions, when they were 13 and 14 years of age (mean). Structural path analyses revealed that adolescent disclosure, parental solicitation, and parental control predicted parental knowledge, with adolescent disclosure being the strongest source of parental knowledge and the strongest negative predictor of adolescent risk behaviors. Parenting competence and adolescents' connectedness to parents were indirectly, through adolescent disclosure and parental solicitation and parental control, associated with substance use and delinquent behavior. Some paths differed for boys and girls. In conclusion, confident parenting and a close parent–adolescent relationship in which adolescent disclosure is promoted, seem protective of adolescent engagement in risk behaviors
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| 66. |
- Kapetanovic, Sabina, 1980-, et al.
(author)
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Validation of the Super-Brief Pathological Narcissism Inventory (SB-PNI) among Swedish adolescents
- 2024
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In: Current Psychology. - : Springer Nature. - 1046-1310 .- 1936-4733. ; 43, s. 19457-19467
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Journal article (peer-reviewed)abstract
- This study examines the psychometric structure and properties of the Swedish version of the Super-Brief Pathological Narcissism Inventory (SB-PNI) among adolescents. In order to ensure the validity and feasibility of the measure, we examined the factor structure, measurement invariance across gender, age and ethnicity, and construct validity in relation to a number of correlates of narcissism in adolescence. Data were drawn from a large cross-sectional survey conducted in 35 schools in southern Sweden. The sample consisted of N = 5313 adolescents (Mage = 16.10 SD = 1.55) with 52.2% girls, 45.9% boys and 1.8% adolescents with unspecified gender, from compulsory and upper secondary schools in southern Sweden. The results showed that the measure holds a two-factor structure, suggesting the use of the subscales grandiosity and vulnerability separately, rather than as a unidimensional measure. The correlated factors grandiosity and vulnerability yielded full configural and metric invariance across gender, age, and ethnicity. Both grandiosity and vulnerability were correlated with externalizing and internalizing symptoms, as well as with low self-esteem. The study provides evidence for the utility of the SB-PNI among Swedish adolescents and indicates that the measure can be used across male and female adolescents of different ages and ethnic groups.
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| 67. |
- Karyotaki, Eirini, et al.
(author)
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Internet-Based Cognitive Behavioral Therapy for Depression : A Systematic Review and Individual Patient Data Network Meta-analysis
- 2021
-
In: JAMA psychiatry. - : American Medical Association. - 2168-6238 .- 2168-622X. ; 78:4, s. 361-371
-
Research review (peer-reviewed)abstract
- IMPORTANCE: Personalized treatment choices would increase the effectiveness of internet-based cognitive behavioral therapy (iCBT) for depression to the extent that patients differ in interventions that better suit them.OBJECTIVE: To provide personalized estimates of short-term and long-term relative efficacy of guided and unguided iCBT for depression using patient-level information.DATA SOURCES: We searched PubMed, Embase, PsycInfo, and Cochrane Library to identify randomized clinical trials (RCTs) published up to January 1, 2019.STUDY SELECTION: Eligible RCTs were those comparing guided or unguided iCBT against each other or against any control intervention in individuals with depression. Available individual patient data (IPD) was collected from all eligible studies. Depression symptom severity was assessed after treatment, 6 months, and 12 months after randomization.DATA EXTRACTION AND SYNTHESIS: We conducted a systematic review and IPD network meta-analysis and estimated relative treatment effect sizes across different patient characteristics through IPD network meta-regression.MAIN OUTCOMES AND MEASURES: Patient Health Questionnaire-9 (PHQ-9) scores.RESULTS: Of 42 eligible RCTs, 39 studies comprising 9751 participants with depression contributed IPD to the IPD network meta-analysis, of which 8107 IPD were synthesized. Overall, both guided and unguided iCBT were associated with more effectiveness as measured by PHQ-9 scores than control treatments over the short term and the long term. Guided iCBT was associated with more effectiveness than unguided iCBT (mean difference [MD] in posttreatment PHQ-9 scores, -0.8; 95% CI, -1.4 to -0.2), but we found no evidence of a difference at 6 or 12 months following randomization. Baseline depression was found to be the most important modifier of the relative association for efficacy of guided vs unguided iCBT. Differences between unguided and guided iCBT in people with baseline symptoms of subthreshold depression (PHQ-9 scores 5-9) were small, while guided iCBT was associated with overall better outcomes in patients with baseline PHQ-9 greater than 9.CONCLUSIONS AND RELEVANCE: In this network meta-analysis with IPD, guided iCBT was associated with more effectiveness than unguided iCBT for individuals with depression, benefits were more substantial in individuals with moderate to severe depression. Unguided iCBT was associated with similar effectiveness among individuals with symptoms of mild/subthreshold depression. Personalized treatment selection is entirely possible and necessary to ensure the best allocation of treatment resources for depression.
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| 68. |
- Lindner, Philip, et al.
(author)
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Validation of the Internet-Administered Quality of Life Inventory (QOLI) in Different Psychiatric Conditions
- 2013
-
In: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 42:4, s. 315-327
-
Journal article (peer-reviewed)abstract
- The Quality of Life Inventory (QOLI) is an established rating scale of self-perceived quality of life across 16 domains. Norms for different psychiatric conditions when rated via the Internet, responsiveness to change following treatment, and the clinical impact of importance-weighting items have yet to be examined. To investigate these unanswered questions, important for the continued and expanded use of the QOLI, we compiled archival screening and post-treatment data from 20 studies featuring Internet-delivered psychological interventions for seven different psychiatric conditions and an undergraduate sample, totalling over 4000 participants. Disorder-specific norms were indicated by between-group analyses and are reported here, item-by-item. The QOLI showed adequate responsiveness to change and construct validity. Discrepancies were found when conducting between-group analyses with and without weighted items (more significant differences when items were not weighted) on both the screening and post-treatment data, suggesting that weighting is a procedure that is likely to have an impact when analysing QOLI results. Limitations and the needs for future research are discussed.
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| 69. |
- Ly, Kien Hoa, et al.
(author)
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Development and initial evaluation of a smartphone application based on acceptance and commitment therapy
- 2012
-
In: SpringerPlus. - : Springer Science and Business Media LLC. - 2193-1801. ; 1
-
Journal article (peer-reviewed)abstract
- Background: An intervention, consisting of an ACT-based smartphone-application and a web-based psychoeducation, has been developed. The smartphone-application, together with the psychoeducation, aims to function as a self-help intervention for living consistently with one's values. The study is an exploratory investigation of this new smartphone-based tool.Case description: Primarily, the study aims at investigating a new field, providing a basis for generating hypotheses for further research. The first aim of this initial, exploratory study was to examine if this intervention had an effect on the variables of: valued actions, psychological flexibility, and life satisfaction as well as the states of depression, anxiety and stress, for a non-clinical sample of 11 Swedish Iphone users. This was made with a quasi-experimental pretest-posttest design without control group. The second aim was to investigate how the participants experienced the intervention, as measured by a qualitative questionnaire.Discussion and evaluation: The group analyses showed that the participants increased their valued action and psychological flexibility significantly during the intervention. Furthermore, value-based actions and psychological flexibility showed small effect sizes when comparing pretest and posttest score. However, the design of the study makes it impossible to draw any certain conclusions. The qualitative questionnaire showed a general positive experience of the intervention.Conclusions: The results from the present study indicated that the intervention should be studied further. The findings also generated a number of hypotheses that could be investigated in further research.
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| 70. |
- Malmberg Gavelin, Hanna, et al.
(author)
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Neural activation in stress-related exhaustion : cross-sectional observations and interventional effects
- 2017
-
In: Psychiatry Research. - Clare : Elsevier. - 0925-4927 .- 1872-7506 .- 0165-1781 .- 1872-7123. ; 269, s. 17-25
-
Journal article (peer-reviewed)abstract
- The primary purpose of this study was to investigate the association between burnout and neural activation during working memory processing in patients with stress-related exhaustion. Additionally, we investigated the neural effects of cognitive training as part of stress rehabilitation. Fifty-five patients with clinical diagnosis of exhaustion disorder were administered the n-back task during fMRI scanning at baseline. Ten patients completed a 12-week cognitive training intervention, as an addition to stress rehabilitation. Eleven patients served as a treatment-as-usual control group. At baseline, burnout level was positively associated with neural activation in the rostral prefrontal cortex, the posterior parietal cortex and the striatum, primarily in the 2-back condition. Following stress rehabilitation, the striatal activity decreased as a function of improved levels of burnout. No significant association between burnout level and working memory performance was found, however, our findings indicate that frontostriatal neural responses related to working memory were modulated by burnout severity. We suggest that patients with high levels of burnout need to recruit additional cognitive resources to uphold task performance. Following cognitive training, increased neural activation was observed during 3-back in working memory-related regions, including the striatum, however, low sample size limits any firm conclusions.
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