| 1. |
- Ahlborg, Tone, 1950, et al.
(författare)
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Sensual and sexual marital contentment in parents of small children--a follow-up study when the first child is four years old.
- 2008
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Ingår i: Journal of sex research. - : Informa UK Limited. - 0022-4499 .- 1559-8519. ; 45:3, s. 295-304
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Tidskriftsartikel (refereegranskat)abstract
- This follow-up study explored parents' (N=452) intimate relationships when their firstborn child was 6 months old and then 4 years later. The measurement used was a modified version of the Dyadic Adjustment Scale, DAS. The present results show that most parents responding were content sensually at 6 months postpartum in 2002 and 4 years later, in 2006. More parents had changed from being sensually content in 2002 to discontent in 2006, than the contrary, however, and the sexual contentment remained low. The average sexual frequency was low both at 6 months and at 4 years for both parents with and without additional children. Experiencing tiredness as a hindrance to having sex was perceived as a greater problem among those parents without additional children. Prospective regression analyses indicated that sexuality was significantly related to both sensual and sexual contentment 4 years later. Sexuality was also one of the most significant covariates in the cross-sectional regression analysis for sensual contentment. Since sexuality plays a central role in partner well-being, it may be an important target for helping parents with small children.
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| 2. |
- Boersma, Katja, 1973-, et al.
(författare)
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Lowering fear-avoidance and enhancing function through exposure in vivo : a multiple baseline study across six patients with back pain
- 2004
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Ingår i: Pain. - : Elsevier. - 0304-3959 .- 1872-6623. ; 108:1-2, s. 8-16
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the effects of an exposure in vivo treatment for chronic pain patients with high levels of fear and avoidance. The fear-avoidance model offers an enticing explanation of why some back pain patients develop persistent disability, stressing the role of catastrophic interpretations; largely fueled by beliefs and expectations that activity will cause injury and will worsen the pain problem. Recently, an exposure in vivo treatment was developed that aims to enhance function by directly addressing these fears and expectations. The purpose of this study was to describe the short-term, consequent effect of an exposure in vivo treatment. The study employed a multiple baseline design with six patients who were selected based on their high levels of fear and avoidance. The results demonstrated clear decreases in rated fear and avoidance beliefs while function increased substantially. These improvements were observed even though rated pain intensity actually decreased somewhat. Thus, the results replicate and extend the findings of previous studies to a new setting, with other therapists and a new research design. These results, together with the initial studies, provide a basis for pursuing and further developing the exposure technique and to test it in group designs with larger samples.
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| 3. |
- 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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| 4. |
- Holm, Sara, et al.
(författare)
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Treating youth in pain : Comparing tailored behavioural medicine treatment provided by physical therapists in primary care with physical exercises
- 2016
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Ingår i: European Journal of Pain. - : Wiley-Blackwell. - 1090-3801 .- 1532-2149. ; 20:4, s. 626-638
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study the efficacy of tailored behavioural medicine treatment within a physical therapy framework.Methods: The study was a randomized controlled study (RCT): tailored behavioural medicine treatment (EXT) delivered by physical therapists (PTs) was compared with exercise-based treatment (CT). Thirty-two adolescents (mean age 14.3 years) with persistent pain participated. Data on pain-related disability and school attendance (primary outcomes), pain intensity, catastrophizing, fear of movement and self-efficacy were collected.Results: The pain-related disability measured by the Functional Disability Inventory (FDI) resulted in mean score change of EXT = -18 and CT = -11, respectively. A significant change within both groups was found (EXT p = 0.003, CT p = 0.001), and a large effect size for FDI between the conditions was demonstrated (AUC of 0.77). For school attendance post-treatment, no difference was found between conditions. For secondary outcomes, a significant improvement in pain intensity and pain catastrophizing was found for the EXT and self-efficacy for the CT groups but no statistically significant difference between the two conditions was detected. Caution should be given to the small sample size, as it may affect the interpretation and generalizability of the results.Conclusion: In this study, differences between tailored behavioural medicine treatment delivered by PTs and exercise-based treatment could not be demonstrated, although the effect size was large. Patients who received either treatment demonstrated significant changes over time in pain-related disability. The low number of participants and suboptimal tailoring of the psychological components may partly explain the failure to demonstrate differences between groups, and future studies are warranted.
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| 5. |
- Jansson-Fröjmark, Markus, 1971-, et al.
(författare)
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The role of emotion dysregulation in insomnia : Longitudinal findings from a large community sample
- 2016
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Ingår i: British Journal of Health Psychology. - : Wiley-Blackwell. - 1359-107X .- 2044-8287. ; 21:1, s. 93-113
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The purpose of this longitudinal investigation was to examine the association between emotion regulation and future insomnia (incidence and persistence).DESIGN: A longitudinal study in the general population.METHODS: A survey was sent out to 5,000 individuals in the community. To those who returned the baseline questionnaire (n = 2,333), two follow-up surveys, 6 and 18 months later, were sent out and then completed by 1,887 and 1,795 individuals, respectively. The survey contained information about demographic factors, insomnia symptomatology, the Difficulties in Emotion Regulation Scale, anxiety, and depression.RESULTS: The findings suggested that emotion regulation at baseline was not associated with the incidence or persistence of insomnia. Overall, the effect sizes were very small to medium. When examining changes in emotion regulation over time, a different pattern emerged. Partial support was established for the notion that decreases in emotion regulation were related to incident and persistent insomnia, as a decrease in emotion regulation was associated with a higher likelihood of future insomnia. Yet, the effect sizes were very small to small.CONCLUSION: This study does partly point towards a longitudinal association between emotion dysregulation and insomnia. This might have implications for the conceptualization and management of insomnia as well as for future research.Statement of contribution: What is already known on this subject?Previous research has indicated that emotion dysregulation might be enhanced in patients with insomnia.A number of limitations have however hindered progress in understanding how emotion dysregulation is related to insomnia, such as limited research on the topic and relying solely on cross-sectional data.What does this study add?The current investigation showed that emotion dysregulation is a risk factor for the development of incident and persistent insomnia.This study also shows that increased emotion dysregulation over time heightens the risk of incident and persistent insomnia.
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| 6. |
- Bergbom, Sofia, 1982-, et al.
(författare)
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When matching fails : understanding the process of matching pain-disability treatment to risk profile
- 2015
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Ingår i: Journal of occupational rehabilitation. - : Springer Science and Business Media LLC. - 1053-0487 .- 1573-3688. ; 25:3, s. 518-526
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: A previous study (Bergbom et al. in J Occup Rehabil, 2013) showed that matching people at risk for pain-related disability to an intervention aimed at targeting their psychological problem profile did not, as hypothesized, improve the effect of the intervention. Methodological issues were suggested to explain the lack of differential effect. It was questioned whether the profiles used to allocate people to treatment were adequate. The aim of this study was to investigate if the risk profiles used to determine matching were sufficiently stable and valid by comparing the original profiles with profiles constructed using other methods.Methods: Ninety-five people suffering musculoskeletal problems were screened, profiled, and matched to workplace based early interventions according to profiles. We studied stability and validity of their psychological risk profiles by investigating their concordance at different time points. People were originally assigned to profiles at inclusion, using a brief screening questionnaire. Then, they were profiled just before treatment start, using the same items. Finally, they were profiled again at treatment start, using extensive questionnaires. Concordance among the three sets of profiles was investigated.Results: Profiles at inclusion were unstable until treatment start. People moved from profiles with more severe elevations in psychological variables, to a profile with moderate elevations. Concordance between the two means of profiling at treatment start was better; the brief screening and the extensive questionnaires assigned people to similar profiles.Conclusions: Risk level may be determined with brief instruments at an early stage of problem development. However, profiles and targets for interventions should be determined immediately prior to treatment start, preferably using full questionnaires.
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| 7. |
- Flink, Ida, 1980-, et al.
(författare)
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Coping with painful sex : Development and initial validation of the CHAMP Sexual Pain Coping Scale
- 2015
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Ingår i: Scandinavian Journal of Pain. - : Elsevier. - 1877-8860 .- 1877-8879. ; 9, s. 74-80
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: Recurrent vulvar pain is a common and debilitating condition which has received remarkably little attention in pain research. For instance, little is known about how these women cope with sexual activities, and there are no structured assessment tools. The purpose of this study was to explore coping strategies in this group, with a view to develop a measure to assess how women with vulvar pain cope with sexual activities.Methods: The current study is based on a subsample from a longitudinal study about vulvar pain in a student sample consisting of women between 18 and 35 years old (N = 964). Only data from the ones reporting recurrent vulvar pain during the last six months (N = 289) were used in the analyses. First, the CHAMP Sexual Pain Coping Scale (CSPCS) was created, with the aim of assessing how women with vulvar pain cope with sexual activities. The scale was inspired by previous research on women with vulvar pain as well as well-known coping strategies in other pain populations. Second, the psychometric properties of the scale were explored by analyzing the factor structure and internal reliability. Third, validity features were examined in terms of criterion validity and construct validity.Results: The analyses supported a three-factor solution, embracing the strategies endurance, avoidance and alternative coping. The internal reliability of the subscales turned out to be good, and the criterion validity was supported for all three subscales. The construct validity was clearly supported for the endurance and the avoidance subscales, but not for the alternative coping subscale.Conclusions: The findings support the CSPCS as an instrument for assessing how women with vulvar pain cope with sexual activities. The strategies endurance, avoidance and alternative coping correspond with findings from earlier research. Endurance reflects a tendency to engage in and continue with sexual activities despite pain, while attempting to minimize or suppress thoughts of pain. Avoidance, on the other hand, involves efforts to stay away from sexual activities, in particular vaginal penetration, because of fear of pain. Alternative coping refers to endeavours to find alternative sexual activities that do not necessarily involve vaginal penetration. Even though this first study indicates that the CSPCS may be psychometrically sound, more studies are needed to confirm the psychometric properties and clinical application of this instrument. In particular, the construct validity of the alternative coping subscale needs to be further evaluated.Implications: A valid instrument for assessing strategies for coping with sexual activities in this population has important clinical implications, since it provides a method that may enhance assessment procedures, be used in research, and stimulate the development of treatment.
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| 8. |
- 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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| 9. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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The role of psychiatric and somatic conditions in incidence and persistence of insomnia : A longitudinal, community study
- 2016
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Ingår i: Sleep Health. - : Elsevier BV. - 2352-7218 .- 2352-7226. ; 2:3, s. 229-238
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The objective was to investigate the role of psychiatric and somatic conditions in incident and persistent insomnia. Design: This was a prospective study with 3 measurement points over 1.5 years. Setting: The participants were sent a survey to their home addresses. Participants: A survey was sent out to 5000 random individuals (18-70 years) in 2 Swedish counties. To those who returned the baseline questionnaire (n = 2333), 2 follow-up surveys (6 and 18 months later) were sent out and completed by 1887 and 1795 individuals, respectively. Measurements: The survey contained questions about sociodemographic factors and insomnia symptomatology, the Hospital Anxiety and Depression Scale, and items assessing 12 forms of somatic conditions (eg, heart disease and headache). Results: Baseline depression, headache, and number of psychiatric and somatic conditions were found to be independent risk factors for incident insomnia. Also, deterioration in depression and heart disease status and increased number of conditions over time increased the risk for insomnia incidence. Anxiety; depression; pain in neck, back, or shoulders; and headache at baseline were found to significantly discriminate between those with persistent insomnia and those with persistent normal sleep. Those with persistent insomnia also reported a higher number of conditions relative to those with persistent normal sleep. None of the psychiatric or somatic conditions were found to be associated with persistence of insomnia relative to remission of insomnia. Conclusion: The current study suggests that both psychiatric and somatic conditions are involved in the incidence but not in the persistence of insomnia. Clinical and theoretical implications of the results are discussed.
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| 10. |
- Linton, Steven J, 1952-, et al.
(författare)
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Are fear-avoidance beliefs related to the inception of an episode of back pain? : a prospective study
- 1999
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Ingår i: Psychology and Health. - : Informa UK Limited. - 0887-0446 .- 1476-8321. ; 14:6, s. 1051-1059
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Tidskriftsartikel (refereegranskat)abstract
- Fear-avoidance beliefs and catastrophizing have been implicated in chronic pain and theoretical models have been developed that feature these factors in che transition from acute to chronic pain. However, little has been done to determine whether these factors occur in the general population or whether they are associated with the inception of an episode of neck or back pain. The aim of this study was to evaluate prospectively the effects of fear-avoidance beliefs and catastrophizing on the development of an episode of self-reported pain and associated physical functioning. To achieve this, we selected a sample of 415 people from the general population who reported no spinal pain during the past year. At the pretest a battery of questionnaires was administered to assess beliefs about pain and activity and it featured the Pain Catastrophizing Scale and a modified version of the Fear-Avoidance Beliefs Questionnaire. One year later outcome was evaluated by self-reports of the occurrence of a pain episode as well as a self-administered physical function test. The results showed that scores on both fear-avoidance and catastrophizing were quite low. During the one year follow-up, 19% of the sample suffered an episode of back pain. Those with scores above the median on fear-avoidance beliefs at the pretest had twice the risk of suffering an episode of back pain and a 1.7 times higher risk of lowered physical function at the follow-up. Catastrophizing was somewhat less salient, increasing the risk of pain or lowered function by 1.5, but with confidence intervals falling below unity. These data indicate that fear-avoidance beliefs may be involved at a very early point in the development of pain and associated activity problems in people with back pain. Theoretically, our results support the idea that fear-avoidance beliefs may develop in an interaction with the experience of pain. Clinically, the results suggest that catastrophizing and particularly fear-avoidance beliefs are important in the development of a pain problem and might be of use in screening procedures.
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