| 41. |
- Malmberg Gavelin, Hanna, et al.
(författare)
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Neural activation in stress-related exhaustion : cross-sectional observations and interventional effects
- 2017
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Ingår i: Psychiatry Research. - Clare : Elsevier. - 0925-4927 .- 1872-7506 .- 0165-1781 .- 1872-7123. ; 269, s. 17-25
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Tidskriftsartikel (refereegranskat)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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| 42. |
- Reuterskiöld, Lena, et al.
(författare)
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Real World Applications of One-Session Treatment
- 2012. - 1
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Ingår i: Intensive One-Session Treatment of Specific Phobias. - New York : Springer. - 9781461432524 ; , s. 127-141
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Randomized Clinical Trials (RCTs) using cognitive-behavioral therapy (CBT) and specifically one-session treatment (OST) for the treatment of a broad spectrum of specific phobias have been conducted in both adult and child samples, and across countries. Furthermore, in clinical practice, OST has been extended to include even more unusual phobias such as fish, mushrooms, knees, and ET (the Extra-Terrestrial movie character) with equally good treatment effects overall. Despite these positive outcomes the dissemination of OST in the real world has not been as evident. There are several explanations for why clinicians might not choose OST for patients presenting with various specific phobias.
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| 43. |
- Schenkman, Bo N., et al.
(författare)
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Human echolocation : Pitch versus loudness information
- 2011
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Ingår i: Perception. - : SAGE Publications. - 0301-0066 .- 1468-4233. ; 40:7, s. 840-852
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Tidskriftsartikel (refereegranskat)abstract
- Blind persons emit sounds to detect objects by echolocation. Both perceived pitch and perceived loudness of the emitted sound change as they fuse with the reflections from nearby objects: Blind persons generally are better than sighted at echolocation, but it is unclear whether this superiority is related to detection of pitch, loudness, or both. We measured the ability of twelve blind and twenty-five sighted listeners to determine which of two sounds, 500 ms noise bursts, that had been recorded in the presence of a reflecting object in a room with reflecting walls using an artificial head. The sound pairs were original recordings differing in both pitch and loudness, or manipulated recordings with either the pitch or the loudness information removed. Observers responded using a 2AFC method with verbal feedback. For both blind and sighted listeners the performance declined more with the pitch information removed than with the loudness information removed. In addition, the blind performed clearly better than the sighted as long as the pitch information was present, but not when it was removed. Taken together, these results show that the ability to detect pitch is a main factor underlying high performance in human echolocation.
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| 44. |
- Shahnavaz, Shervin, et al.
(författare)
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Internet-Based Cognitive Behavioral Therapy for Children and Adolescents With Dental Anxiety : Open Trial
- 2018
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cognitive behavioral therapy (CBT) is an evidence-based method for treating specific phobias, but access to treatment is difficult, especially for children and adolescents with dental anxiety. Psychologist-guided Internet-based CBT (ICBT) may be an effective way of increasing accessibility while maintaining treatment effects.Objective: The aim of this study was to test the hypothesis that psychologist-guided ICBT improves school-aged children’s and adolescents’ ability to manage dental anxiety by (1) decreasing avoidance and affecting the phobia diagnosis and (2) decreasing the dental fear and increasing the target groups’ self-efficacy. The study also aimed to examine the feasibility and acceptability of this novel treatment.Methods: This was an open, uncontrolled trial with assessments at baseline, posttreatment, and the 1-year follow-up. The study enrolled and treated 18 participants. The primary outcome was level of avoidance behaviors, as measured by the picture-guided behavioral avoidance test (PG-BAT). The secondary outcome was a diagnostic evaluation with the parents conducted by a psychologist. The specific phobia section of the structured interview Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime (K-SADS-PL) was used. Other outcome measures included level of dental anxiety and self-efficacy. The ICBT, which employed exposure therapy, comprised 12 modules of texts, animations, dentistry-related video clips, and an exercise package (including dental instruments). Participants accessed the treatment through an Internet-based treatment platform and received Web-based guidance from a psychologist. Treatment also included training at dental clinics. Feasibility and acceptability were assessed by measures of engagement, adherence, compliance, completed measures, patient and parent satisfaction scale, and staff acceptability.Results: The level of avoidance (according to the primary outcome measure PG-BAT) and dental anxiety decreased and self-efficacy increased significantly (P<.001), within-group effect sizes for both the primary outcome (Cohen d=1.5), and other outcomes were large in the range of 0.9 and 1.5. According to K-SADS-PL, 53% (8/15) of the participants were free from diagnosable dental anxiety at the 1-year follow-up. At the 1-year follow-up, improvements were maintained and clinically significant, with 60% (9/15) of participants who had been unable to manage intraoral injection of local anesthetics before ICBT reporting having accomplished this task at a dental clinic. The target group showed improvement in all the outcome measures. High levels of feasibility and acceptability were observed for the treatment.Conclusions: ICBT is a promising and feasible treatment for dental anxiety in children and adolescents. Integrating it into routine pediatric dental care would increase access to an effective psychological treatment. The results of this open trial must be replicated in controlled studies.
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| 45. |
- Sundstrom, C., et al.
(författare)
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High-intensity therapist-guided internet-based cognitive behavior therapy for alcohol use disorder: a pilot study
- 2017
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Ingår i: Bmc Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: A large proportion of individuals with alcohol problems do not seek psychological treatment, but access to such treatment could potentially be increased by delivering it over the Internet. Cognitive behavior therapy (CBT) is widely recognized as one of the psychological treatments for alcohol problems for which evidence is most robust. This study evaluated a new, therapist-guided internet-based CBT program (entitled ePlus) for individuals with alcohol use disorders. Methods: Participants in the study (n = 13) were recruited through an alcohol self-help web site (www.alkoholhjalpen.se) and, after initial internet screening, were diagnostically assessed by telephone. Eligible participants were offered access to the therapist-guided 12-week program. The main outcomes were treatment usage data (module completion, treatment satisfaction) as well as glasses of alcohol consumed the preceding week, measured with the self-rated Timeline Followback (TLFB). Participant data were collected at screening (T0), immediately pre-treatment (T1), post-treatment (T2) and 3 months post-treatment (T3). Results: Most participants were active throughout the treatment and found it highly acceptable. Significant reductions in alcohol consumption with a large within-group effect size were found at the three-month follow-up. Secondary outcome measures of craving and self-efficacy, as well as depression and quality of life, also showed significant improvements with moderate to large within-group effect sizes. Conclusions: Therapist-guided internet-based CBT may be a feasible and effective alternative for people with alcohol use disorders. In view of the high acceptability and the large within-group effect sizes found in this small pilot, a randomized controlled trial investigating treatment efficacy is warranted.
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| 46. |
- Vlaescu, George, et al.
(författare)
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An E-Platform for Rehabilitation of Persons With Hearing Problems
- 2015
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Ingår i: American Journal of Audiology. - : AMER SPEECH-LANGUAGE-HEARING ASSOC. - 1059-0889 .- 1558-9137. ; 24:3, s. 271-275
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this research forum article was to describe a feasible web-based solution for improving the quality of life of persons with hearing problems, such as hearing loss or tinnitus. The online platform was developed at the Department of Behavioural Sciences and Learning at Linköping University, Sweden, and has been running for a number of years and used in numerous studies and treatments. Method: The security aspects of the platform as well as the process flow for running a study or treatment are described, focusing primarily on the technical and practical considerations. Also presented are the design characteristics and the main features and functions available in the platform. Results: We point out the many advantages of running Internet-assisted intervention treatments, the challenges that we have faced, and some intended developments. Many of our research colleagues, both from Sweden and other countries, have already implemented or intend to implement their own studies on this platform. Conclusions: Audiological rehabilitation can be delivered via the Internet using a stable online platform. Security and usability are important factors to have in mind for the design as well as adaptability to the patients. A next development step is to implement and test blended treatments using video conferencing inside the platform.
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| 47. |
- Weineland, Sandra Mikaela, et al.
(författare)
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Bridging the Gap Between Hearing Screening and Successful Rehabilitation : Research Protocol of a Randomized Controlled Trial of Motivational Interviewing via Internet
- 2015
-
Ingår i: American Journal of Audiology. - : American Speech-Language-Hearing Association. - 1059-0889 .- 1558-9137. ; 24:3, s. 302-306
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Studies point to low help-seeking after a failed hearing screening. This research forum article presents the research protocol for a randomized controlled trial of motivational interviewing via the Internet to promote help-seeking in people who have failed an online hearing screening. Method: Adults who fail a Swedish online hearing screening, including a speech-in-noise recognition test, will be randomized to either an intervention group (participating in motivational interviewing) or an active control group (reading a book on history of hearing aids). Both of the conditions will be delivered via the Internet. The primary outcome is experience with seeking health care and using hearing aids 9 months after the intervention. Secondary outcomes are changes in before and after measures of self-reported hearing difficulties, anxiety, depression, and quality of life. Stages of change and self-efficacy in hearing help-seeking are measured immediately after intervention and at a 9-month follow-up for the purpose of mediation analysis. Results: The results of this randomized controlled trial may help bridge the gap between hearing screening and successful hearing rehabilitation. Conclusion: Although no large instantaneous benefits are expected, a slow change toward healthy behaviors—seeking health care and using hearing aids—would shed light on how to use the Internet to assist people with hearing impairment.
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| 48. |
- Wilhelmsson Göstas, Mona, et al.
(författare)
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‘Hard work’ in a new context : clients’ experiences of psychotherapy
- 2013
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Ingår i: Qualitative Social Work. - : Sage Publications. - 1473-3250 .- 1741-3117. ; 12:3, s. 340-357
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe and gain an understanding of clients’ experiences of psychotherapy contracts and processes in cognitive behavioural therapy (CBT) and psychodynamic psychotherapy (PDT). Fourteen participants were interviewed after ending their psychotherapy. To get information richness they were selected with as great a variation as possible in relation to their life context. Qualitative content analysis was used to analyse the descriptions and the significance of the descriptions. Similarities between the two therapy orientations emerged throughout the informants’ experiences. These similarities were expressed in the two themes: The creation of a new context and The working method and the cooperation with the psychotherapist made up a whole. The psychotherapy process was described as ‘hard work’ in a new context, markedly different from the ordinary social context. From the informants’ perspective, the creation of a new context offered a possibility to give full attention, together with the psychotherapist, to oneself and to the problems one was grappling with. A salient feature was the informant’s responsibility for agreements in the psychotherapy contract, especially in relation to the number of sessions and the creation of cooperation with the psychotherapist. Irrespective of therapy orientation the therapeutic techniques were described as inextricably linked to the cooperation with the psychotherapist. An implication for practice and research from these findings is to give more weight to the influence of cooperation in psychotherapy techniques, irrespective of therapy orientation. Another implication is an awareness that the client’s knowledge of her/his difficulties, needs and desire for change, capacity to make an effort and to assume responsibility always have to be highlighted and have an impact on the psychotherapy contract and process.
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| 49. |
- Öst, Lars-Göran
(författare)
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One-Session Treatment : Principles and Procedures with Adults
- 2012. - 1
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Ingår i: Intensive One-Session Treatment of Specific Phobias. - New York, NY : Springer. - 9781461432524 ; , s. 59-95
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- When I started research and clinical work with specific phobics in the mid 1970s, very little differentiation was made in the research literature between agoraphobia, social phobia, and specific phobia regarding the number of therapy sessions. Thus, I used eight 1-hour sessions in my early studies on specific phobias. After having worked with that format for about 5 years I started getting bored seeing the same patients week after week. I also began to question why behavior therapists should follow the same format as devised by psychodynamic short-term therapy (i.e. one session per week for 12–20 weeks).
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| 50. |
- Öst, Lars-Göran
(författare)
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Training Therapists in One-Session Treatment and Assessing Their Competence
- 2012. - 1
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Ingår i: Intensive One-Session Treatment of Specific Phobias. - New York, NY : Springer. - 9781461432524 ; , s. 161-175
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- There is no formalized training for therapists to do one-session treatment (OST), at least not any which has been empirically evaluated. However, a description follows of the way the training for people aspiring to become a protocol therapist in a randomized controlled trial (RCT), or just wanting to work clinically with OST, has been arranged. The major part of this chapter consists of a detailed description of the different items included in the competence rating scale, and explanations of why the respective competencies are important for carrying out OST successfully. This means that the training should focus on providing therapists with adequate skills in the areas covered by the rating scale.
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