| 1. |
- Aardal-Eriksson, Elisabeth
(författare)
-
Salivary cortisol and posttraumatic stress reactions : methodological and applied studies before and after trauma
- 2002
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The field of psychotraumatology has its roots in ancient history. During the past decades, the surveillance of the psychobiological background of reactions to and consequences of traumatic stress has made great progress and the complexity of the human stress response system stands out. The hypothalamic-pituitary-adrenocortical axis activity, modulated by various neuroimmunological substances, seems to play a major role in the stress response. However, there are still inconsistencies in explanations of relationships between biological and psychological changes following traumatic stress. Moreover, the matter of predictive factors for the development of posttraumatic morbidity is still in a speculative phase.The aims of the present thesis were to further develop a commercial serum cortisol radioimmunoassay (RIA) for determination of cortisol in saliva and to test its reliability, specificity and sensitivity as a biochemical assay. The saliva sampling procedures and sample storage stability were also to be tested. Further issues were to investigate determinations of salivary cortisol and serum prolactin in relation to selfratings of posttraumatic psychological distress and general psychological health. Possible predictive and concurrent validity of salivary cortisol as a biochemical marker for posttraumatic psychological distress were to be tested.Cortisol is present in saliva mainly in non-protein form, representing the free, biologically active fraction of the total plasma cortisol concentration. In a first phase of the present thesis, the commercial serum cortisol RIA was modified for determination of cortisol in saliva. The relation between salivary and serum cortisol concentrations was tested. Reference ranges at 8 AM and 10 PM for the salivary cortisol assay were established from 195 healthy subjects. Salivary cortisol concentrations were tested in relation to serum cortisol in estimating adrenocortical function during endocrine dynamic function tests in 37 patients and 13 healthy controls. In testing salivary cortisol as a marker for stress for fieldwork use, a screening study was performed on 66 male rescue workers. Salivary cortisol at 8 AM and 10 PM and serum prolactin were determined and general psychological health and posttraumatic psychological distress were estimated with the self-rating scales General Health Questionnaire, Impact of Event Scale and Posttraumatic Symptom Scale. These scales were used in the second phase of the thesis. Three applied follow-up studies were performed with sampling of salivary cortisol and self-ratings: (a) a study of 31 UN-soldiers five days, two and nine months after a mine accident; (b) a study of 145 UN-soldiers before, at return, and two and six month after a six month mission. (c) a study of 101 UN-soldiers six and twelve months after a six month mission with severe combat exposure.The results from the present thesis indicate that the modified method of salivary cortisol determination possesses sufficient precision, accuracy, sample storage stability and procedural advantages for laboratory, clinical and field application. Moreover, it possesses moderate predictive information and moderate to high concurrent validity as a biochemical marker for posttraumatic psychological distress.
|
|
| 2. |
|
|
| 3. |
- Aardal-Eriksson, Elisabeth, et al.
(författare)
-
Salivary cortisol, posttraumatic stress symptoms, and general health in the acute phase and during 9-month follow-up
- 2001
-
Ingår i: Biological Psychiatry. - 0006-3223 .- 1873-2402. ; 50:12, s. 986-993
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Because traumatic events are unpredictable, there are few studies of psychobiological states immediately following such events. Our study aimed to determine the relation of salivary cortisol to psychologic distress immediately after a traumatic event and then during follow-up.Methods: Measurement of morning and evening salivary cortisol and ratings of psychologic distress (using the Impact of Events Scale [IES], the Post Traumatic Symptom Scale, and the General Health Questionnaire) were performed with 31 United Nations soldiers at three time points—5 days and 2 and 9 months—following a mine accident in Lebanon.Results: Five days after the accident, 15 subjects reported substantial posttraumatic distress according to the IES, as well as significantly lower morning and higher evening cortisol levels compared with the low-impact group. Within 9 months, the posttraumatic distress of the high-impact group was reduced, accompanied by an increase in morning and a decrease in evening cortisol levels. There were significant relationships between evening cortisol and all rating scales at the first and third time points.Conclusions: Subclinical posttraumatic stress following an adverse event can be measured biologically via salivary cortisol levels soon after the event.
|
|
| 4. |
- Dobrov, Eugen, et al.
(författare)
-
"Reasons For Living" - Translation, psychometric evaluation and relationships to suicidal behaviour in a Swedish random sample
- 2004
-
Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 58:4, s. 277-285
-
Tidskriftsartikel (refereegranskat)abstract
- The protective role of positive beliefs and expectations against suicide has been studied using the Reasons For Living inventory (RFL). The RFL has shown to be useful in research and suggested for use in clinical practice. A Swedish translation of the RFL was examined for psychometric properties, reliability, latent structure and convergent validity in a Swedish general population. The RFL was distributed with the Suicide Behaviors Questionnaire (SBQ) to 1366 randomly selected subjects aged 20-65 years in the county of Östergötland. The results were based on 506 complete replies. The Cronbach a of the total RFL was 0.92, ranging from 0.72 to 0.93 in the six scales of RFL. The intercorrelations between the scales were weak and the scale to total RFL score moderate to high. The factor structure and item loadings of the inventory showed great similarities with the American one with exception for the scales Responsibility to Family and Child-related Concerns, which formed one common factor. The convergent validity was supported by significant relationships to the items of the SBQ. It is concluded that the Swedish translation of the RFL inventory in a Swedish general sample possesses great similarities to the American original RFL. Thus, it is suggested as an instrument for research and clinical usage in Sweden. © 2004 Taylor & Francis.
|
|
| 5. |
- Ekbladh, Elin, et al.
(författare)
-
The Worker Role Interview : Preliminary data on the predictive validity of return to work of clients after an insurance medicine investigation
- 2004
-
Ingår i: Journal of Occupational Rehabilitation. - 1053-0487 .- 1573-3688. ; 14:2, s. 131-141
-
Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate the predictive validity of the Worker Role Interview (WRI) for return to work at a 2-year follow-up of clients who attended an insurance medicine investigation center. The WRI identifies psychosocial and environmental factors that influence a person's abilities to return to work. Forty-eight of 202 consecutively selected clients constituted the study group. The Mann–Whitney U test was used to test the statistically significant differences in WRI ratings between those who were working (n=6) and those who were not (n=42) 2 years after their investigations. Five of the 17 items in WRI had a tentative predictive validity of return to work. The content area personal causation in WRI, had the best predictive validity. The results emphasize the importance of considering the unique individual's beliefs and expectations of his/her effectiveness at work when assessing clients' work ability and planning for further rehabilitation.
|
|
| 6. |
- Haglund, Lena, et al.
(författare)
-
Clinical perspective on the Swedish version of the Assessment of Communication and Interaction Skills : Stability of assessments
- 2004
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 18:4, s. 417-423
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of the present study was to investigate whether ratings according to the Assessment of Communication and Interaction Skills, Swedish version (ACIS-S) are related to the settings in which the skills are assessed, and whether the client's comprehension of the setting is related to the ACIS-S rating scores. The ACIS-S is an observation rating scale applied immediately after each of two to six different social sessions that the client takes part in. The selection of settings relies on the client's judgement of them as being meaningful. In total, nine occupational therapists and 16 clients participated in the study. A total of 71 ratings were made in a mean of 4.4 settings per client. The results indicate that the client's rated comprehension of the settings is not significantly related, in general, to the ACIS-S rating scores given by the occupational therapist. However, the clients ACIS-S scores may vary a lot over settings. In the present study, 13- of the 20-items showed ratings of both the existence and the absence of problems in the same skill - but in different settings - in half or more of the client group. This may rise questions for the practitioners how to implement the ACIS-S in clinical practice, for example, how many and which kind of settings and how many times? Further research in the field is recommended. © 2004 Nordic College of Caring Sciences.
|
|
| 7. |
- Haglund, Lena, et al.
(författare)
-
Practice models in Swedish psychiatric occupational therapy
- 2000
-
Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 7:3, s. 107-113
-
Tidskriftsartikel (refereegranskat)abstract
- In clinical settings, occupational therapists need models both from their own field, occupational therapy, and from other fields in order to offer the clients adequate treatment. It is unknown which theoretical approaches and practice models influence Swedish occupational therapists' daily work. In this study a questionnaire (n=334) was used to investigate approaches and models used in Swedish psychiatric care service and in psychiatric occupational therapy service. The results showed that the psychosocial approach influenced both psychiatric care and psychiatric occupational therapy most. The most frequently used practice model was the Model of Human Occupation. However, 75% of the respondents did not identify theoretical thinking based on models from their own field behind their actions. Many practitioners seemed to use knowledge developed by other disciplines more often. Years of clinical experience in the profession or education did not seem to have any impact on the ability to identify the practice models that were used. The results indicate that education in occupational therapy must emphasize knowledge in its own field more than has been done up to now.
|
|
| 8. |
- Spetz, Anna-Clara, 1973-, et al.
(författare)
-
Momentary increase in plasma calcitonin gene-related peptide is involved in hot flashes in men treated with castration for carcinoma of the prostate
- 2001
-
Ingår i: Journal of Urology. - 0022-5347 .- 1527-3792. ; 166:5, s. 1720-1723
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeIn women the vasodilatory neuropeptides calcitonin gene-related peptide and neuropeptide Y seem to be involved in menopausal hot flashes. We assessed whether plasma calcitonin gene-related peptide and neuropeptide Y change during hot flashes in men after castration.Materials and MethodsWe evaluated 10 men 61 to 81 years old who underwent castration due to cancer of the prostate and had frequent hot flashes for changes in plasma calcitonin gene-related peptide and neuropeptide Y during 1 day at the outpatient clinic. At least 5 blood samples were obtained between flashes and 4 were obtained during each flash. The samples were analyzed for calcitonin gene-related peptide and neuropeptide Y using radioimmunoassay technique. Hot flashes were objectively recorded by measuring peripheral skin temperature and skin conductance.ResultsPlasma calcitonin gene-related peptide increased 46% (95% confidence interval 21 to 71) during flashes in the 6 men in whom it was measurable. This change was statistically significant (p = 0.028). The concentration of neuropeptide Y was below the detection limit. Skin conductance and temperature increased significantly during flashes.ConclusionsCalcitonin gene-related peptide is involved in the mechanisms of hot flashes in men who underwent castration due to prostate carcinoma. Thus, there may be a similar mechanism of hot flashes in women and in men deprived of sex steroids.
|
|
