| 1. |
- Bråthén Wijana, Moa, et al.
(författare)
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Preliminary evaluation of an intensive integrated individual and family therapy model for self-harming adolescents
- 2018
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To investigate the outcome of an integrated individual and family therapy (Intensive Contextual Treatment: ICT) in terms of reducing suffering and increasing functional adjustment among self-harming and/or suicidal adolescents with high symptom loads and their families. METHODS: Forty-nine self-harming and/or suicidal adolescents, Mage = 14.6, of predominantly Swedish origin and female gender (85.7%) participated with their parents. The study had a within group design with repeated measures at pre- and post-treatment, as well as six- and twelve-months follow-ups. Self-reports were used for the main outcomes; self-harm rates, suicide attempts, parent-reported days of inpatient/institutional care, internalized and externalized symptoms, perceived stress, emotion regulation, school hours and adjustment. Secondary outcomes were levels of reported expressed emotions within family dyads, as well as parental anxiety, depression and stress. RESULTS: From pre- to post-assessment, the adolescents reported significant reductions of self-harm (p = .001, d = 0.54) and suicide attempts (p < .0001, d = 1.38). Parent-reported days of inpatient/institutional care were reduced, as well as parent- and adolescent-reported internalizing and externalizing symptoms. Furthermore, school attendance and adjustment were improved, and the adolescents reported experiencing less criticism while parents reported less emotional over-involvement. The results were maintained at follow-ups. CONCLUSIONS: The adolescents and the parents reported improvements for the main outcomes. This treatment appears promising in keeping the families in treatment and out of hospital, suggesting that an integrative approach may be beneficial and feasible for this group. TRIAL REGISTRATION: This study has been approved 19/12 2011, by the regional review board in Stockholm (Dnr 2011/1593-31/5).
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| 2. |
- Enö Persson, Johanna, et al.
(författare)
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Prevention of Childhood Obesity in Child Health Services : Follow-Up of the PRIMROSE Trial
- 2018
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Ingår i: Childhood Obesity. - : Mary Ann Liebert Inc. - 2153-2168 .- 2153-2176. ; 14:2, s. 99-105
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood obesity is an urgent public health concern, and there's a need for long-term, high-quality, primary prevention trials targeting parents of young children. The aim of the current study was to evaluate the long-term effect of a parental support program based on motivational interviewing (MI). Methods: A cluster randomized controlled trial was carried out in eight Swedish counties. Participating families (N = 1355) were enrolled when the child was 9 months old, and participated in nine sessions during ∼39 months. The aim was to pomote healthy food and physical activity (PA) habits using MI and principles from cognitive behavioral therapy. Nurses in Swedish child health services delivered the intervention, and the control group received usual healthcare. The current study was a 1-year follow-up of effects on children's weight-related measures. Regression analyses were conducted using generalized estimating equations, including analyses to investigate potential parental moderators of the effect. Results: There were no statistically significant intervention effects at follow-up [BMI difference = -0.13, p = 0.29, overweight relative risk (RR) = 0.96, p = 0.78, obesity RR = 0.57, p = 0.20]. Maternal waist circumference and unhealthy eating and paternal PA moderated the effect, but effects were small and failed to reach statistical significance after correction for multiple comparisons. Conclusions: A parent-focused primary prevention intervention based on MI delivered within child health services did not result in effects at 1-year follow-up. The results were in line with those obtained at post-assessment and indicated no late onset of effect. Further studies exploring individual and contextual factors influencing the outcome are called for.
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| 3. |
- Ghaderi, Ata, et al.
(författare)
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Skolbaserade program för att förebygga självskadebeteende inklusive suicidförsök : En systematisk litteraturöversikt
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Slutsatser„ Det finns två skolbaserade program som möjligen kan förebygga suicid- försök. Dessa är dock inte testade på ett vetenskapligt sätt i Sverige.Båda de program som har visat effekt är universella, dvs riktas till alla elever i klasserna.– Good Behavior Game (GBG) ges på lågstadiet under ett till två år. GBG är inte utvecklat för att förebygga självskada utan syftar till att förstärka positiva beteenden och attityder mellan skolelever och lärare.– Youth Aware of Mental Health (YAM) ges på högstadiet och består huvudsakligen av fem timmars interaktiva övningar. YAM är utvecklat specifikt för att förebygga suicid.„För övriga program saknas tillräckligt underlag för att dra slutsatser om effekt på suicidförsök.„Studier av program som förebygger andra former av självskade- beteende har enbart undersökt effekter på attityder eller har saknat uppföljningstid.„Det går inte att dra några slutsatser om eventuella negativa effekter av de skolbaserade programmen eftersom det finns få studier på området.
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| 4. |
- Wiberg, Anne -Charlotte, et al.
(författare)
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Internet-based cognitive behavior therapy for eating disorders : Development and feasibility evaluation
- 2022
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Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 30
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundEating disorders (ED) are severe psychiatric conditions, characterized by decreased quality of life and high mortality. However, only a minority of patients with ED seek care and very few receive treatment. Internet-delivered cognitive behavioral therapy (ICBT) has the potential to increase access to evidence-based treatments.AimsThe aims of the present study were to (1) develop and evaluate the usability of an Internet-delivered guided self-help treatment based on Enhanced Cognitive Behavioral Therapy (ICBT-E) for patients with full or subthreshold bulimia nervosa (BN) or binge eating disorder (BED) with a user centered design process, and (2) to evaluate its feasibility and preliminary outcome in a clinical environment.MethodThe study was undertaken in two stages. In Stage I, a user-centered design approach was applied with iterative phases of prototype development and evaluation. Participants were eight clinicians and 30 individuals with current or previous history of ED. In Stage II, 41 patients with full or subthreshold BN or BED were recruited to a single-group open trial to evaluate the feasibility and preliminary outcome of ICBT-E. Primary outcome variables were diagnostic status and self-rated ED symptoms.ResultsThe user-centered design process was instrumental in the development of the ICBT-E, by contributing to improvements of the program and to the content being adapted to the needs and preferences of end-users. The overall usability of the program was found to be good. ICBT-E targets key maintaining factors in ED by introducing healthy eating patterns and addressing over-evaluation of weight and shape. The results indicate that ICBT-E, delivered in a clinical setting, is a feasible and promising treatment for full or subthreshold BN or BED, with a high level of acceptability observed and treatment completion of 73.2 %. Participation in ICBT-E was associated with significant symptom reductions in core ED symptomology, functional impairment as well as depressive symptoms, and the results were maintained at the 3-month follow-up.ConclusionsICBT-E was developed with end-users' preferences in mind, in accordance with the identified recommendations, and the program was perceived as usable by end-users. The study demonstrated the potential of ICBT-E, which marks a step forward in the effort to make powerful, empirically supported psychological interventions targeting ED more widely available and accessible.
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