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- 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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- Hesser, Hugo, 1982-, et al.
(author)
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A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress
- 2011
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In: Clinical Psychology Review. - : Elsevier. - 0272-7358 .- 1873-7811. ; 31:4, s. 545-553
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Research review (peer-reviewed)abstract
- Tinnitus is defined as a sound in the ear(s) and/or head without external origin and is a serious health concern for millions worldwide. The aim of the present study was to determine whether Cognitive Behavior Therapy (CBT) is effective in reducing distress associated with tinnitus. Randomized, controlled trials that assessed the efficacy of CBT for tinnitus-related distress in adults were identified by searching electronic databases (PsychINFO, PubMed, the Cochrane Library), and by manual searches. Fifteen studies (total of 1091 participants) were included in the meta-analysis. CBT compared with a passive and active control at post-assessment yielded statistically significant mean effect sizes for tinnitus-specific measures (Hedges's g = 0.70. and Hedges's g = 0.44, respectively). The average weighted pre-to-follow-up effect size for the CBT group suggested that these effects were maintained over time. Smaller but yet statistically significant effects of CBT were found for mood outcome measures. Characteristics of the studies were unrelated to effect sizes. Methodological rigor, publication bias, and a series of sensitivity analyses did not influence the findings. The results suggest that CBT is an effective treatment of tinnitus distress. However, caution is warranted given that few large-scale, well-controlled trials were identified.
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- Hesser, Hugo, 1947-, et al.
(author)
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Acceptance as a Mediator in Internet-delivered Acceptance and Commitment Therapy and Cognitive Behavior Therapy for Tinnitus
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Other publication (other academic/artistic)abstract
- Despite demonstrated efficacy of behavioral and cognitive techniques in treating the impact of tinnitus (constant ringing in the ears), little is known about the mechanisms by which these techniques achieve their effect. The present study examined acceptance of tinnitus as a potential mediator of treatment changes on global tinnitus severity in internet-delivered acceptance and commitment therapy (iACT) and internet-delivered cognitive behavior therapy (iCBT). Data from 67 participants who were distressed by tinnitus and who were randomly assigned to 1 of the 2 treatments were analyzed using a multilevel moderated mediation model. We predicted that acceptance as measured with the two subscales of the tinnitus acceptance questionnaire (i.e., activity engagement and tinnitus suppression) would mediate the outcome in iACT, but not in iCBT. Results provided partial support to the notion that mediation was moderated by treatment: tinnitus suppression mediated changes in tinnitus severity in iACT, but not in iCBT. However, inconsistent with the view that the treatments worked through different processes of change, activity engagement mediated treatment changes across both iACT and iCBT. Acceptance is identified as a key source of therapeutic change in behavioral-based treatments for tinnitus.
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| 6. |
- Hesser, Hugo, et al.
(author)
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Acceptance as a mediator in internet-delivered acceptance and commitment therapy and cognitive behavior therapy for tinnitus
- 2014
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In: Journal of behavioral medicine. - : Springer. - 0160-7715 .- 1573-3521. ; 37:4, s. 756-767
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Journal article (peer-reviewed)abstract
- Despite demonstrated efficacy of behavioral and cognitive techniques in treating the impact of tinnitus (constant ringing in the ears), little is known about the mechanisms by which these techniques achieve their effect. The present study examined acceptance of tinnitus as a potential mediator of treatment changes on global tinnitus severity in internet-delivered acceptance and commitment therapy (iACT) and internet-delivered cognitive behavior therapy (iCBT). Data from 67 participants who were distressed by tinnitus and who were randomly assigned to 1 of the 2 treatments were analyzed using a multilevel moderated mediation model. We predicted that acceptance as measured with the two subscales of the tinnitus acceptance questionnaire (i.e., activity engagement and tinnitus suppression) would mediate the outcome in iACT, but not in iCBT. Results provided partial support to the notion that mediation was moderated by treatment: tinnitus suppression mediated changes in tinnitus severity in iACT, but not in iCBT. However, inconsistent with the view that the treatments worked through different processes of change, activity engagement mediated treatment changes across both iACT and iCBT. Acceptance is identified as a key source of therapeutic change in behavioral-based treatments for tinnitus.
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| 7. |
- Hesser, Hugo, 1982-, et al.
(author)
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Clients' in-session acceptance and cognitive defusion behaviors in acceptance-based treatment of tinnitus distress
- 2009
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In: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 47:6, s. 523-528
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Journal article (peer-reviewed)abstract
- Cognitive-behavioral treatment (CBT) is considered to be an effective treatment of distress associated with tinnitus (perception of internal noises without any Outer auditory stimulation), but the processes by which the therapy works remain Unclear. Mindfulness and acceptance is receiving increased attention in the treatment literature for chronic medical conditions. However, few Studies have examined these and related processes with behavioral or observer measures. In the present Study 57 videotapes (a total of 1710 min) from 19 clients who participated in a Controlled trial of an acceptance-based treatment for tinnitus distress, were coded for frequency and peak level of verbal behaviors expressing either acceptance or cognitive defusion. Frequency of cognitive defusion behaviors and peak level of cognitive defusion as well as peak level of acceptance rated in Session 2, predicted symptom reduction 6 month following treatment. These relationships were not accounted for by the improvement that had occurred prior to the measurement point of the process variables. Moreover, prior symptom changes could not predict process variables rated later in therapy (after most of the improvement in therapy had occurred). Thus, clients' in-session acceptance and cognitive defusion behaviors appear to play an important role in the reduction of negative impact of tinnitus.
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- Knický, Martin, et al.
(author)
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Pelletering av eget kraftfoder för mjölkproduktion– möjligheter för effektiv och hållbar kraftfoderproduktion : Slutrapport
- 2023
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Reports (other academic/artistic)abstract
- En näringsmässig separation av olika grad förekommer vid utfodring av kraftfoder. Dessutom är det malda eller krossad fodret mera mottagligt för mögeltillväxt då det har större angreppsyta och är mer hygroskopiskt och lättare kan ta upp fukt i en fuktig omgivning. Pelletering är ett effektivt sätt att förhindra näringsmässig separation hos en foderblandning. Pelletering ger också bättre möjligheter att hantera faror i foderkedjan med fokus på mikrobiologi och mykotoxiner, förebyggande åtgärder samt uppföljning och övervakning under lagring och hantering.
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