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1.	Almén, Niclas, 1971- (author) Intervening Stress Recovery Behaviors in Everyday Life 2022 Doctoral thesis (other academic/artistic)abstract Background. High levels of perceived stress and stress-related ill health, such as burnout, are common in many countries. Several theories postulate that stress behaviors promote adaption to environmental changes and if sustained they are potentially harmful for the body. In accordance, impaired stress recovery behaviors, i.e., psychophysiological deactivation after periods of stress behaviors, have been suggested to be a critical factor in explaining stress-related ill health. Whereas research shows that interventions targeting stress reactivity can have beneficial effects on stress-related variables, studies on interventions targeting stress recovery are surprisingly few. Also, the number of validated instruments for measuring behaviors important for stress recovery are few, in particular easily used self-rating scales. Aims. The primary aim of the thesis was to evaluate stress and health-related effects of an intervention targeting stress recovery behaviors in everyday life among people perceiving high levels of stress in life. A secondary aim was to validate a self-report scale measuring behaviors important for stress recovery in everyday life. Method. Three empirical studies were conducted to evaluate effects of the behavioral stress recovery intervention “balance in everyday life”, which solely aims at strengthening stress recovery behaviors in everyday life. First, a brief version of the intervention was investigated through a small pilot study in which a single-subject experimental design was used (study 1). After that, the intervention was exploratively tested in a group format in which a quasi-experimental design was used (study 2). Due to the positive results of these two studies, a larger scale study using a randomized controlled design was conducted in order to further investigate the effects of the intervention when delivered in a group format (study 3). To fulfill the secondary aim of the thesis, the Recovery Experience Questionnaire was translated into Swedish and analyzed using exploratory factor analysis and confirmatory factor analysis (study 4). Results. In study 1, data demonstrated immediate reduction of stress symptoms as a function of the intervention. The improvements were maintained at 1-year and 5-year follow-up assessments. In study 2, in comparison with a waiting-list-control group, the intervention yielded statistically significant improvements between pre- and postintervention assessment on eleven out of twelve stress and health-related variables. Medium to large between-groups effect sizes were demonstrated for the primary outcome measures covering (potential) recovery behaviors, perceived stress and rest and experiences of being recovered. In the third study, statistically significant improvements for all outcome measures at postintervention assessment and at the 3-month follow-up were demonstrated. The between-groups effect sizes for the primary measures - perceived stress, tension, and burnout - were medium-to-high at postintervention assessment and at follow-up. In addition, in all studies the intervention was associated with beneficial changes in levels of anxiety and depression. In the last study, support was found for the proposed four-factor structure of the Swedish version of the Recovery Experience Questionnaire. Conclusions. The results clearly indicate that the intervention “balance in everyday life” improves stress and health-related factors in a relatively satisfactory way among people perceiving high levels of stress in life. The empirical support is strongest for the reduction in tension, perceived stress, burnout, anxiety and depression, and to deliver the intervention in a group format. The studies demonstrated results that warrant further investigation of the effects of “balance in everyday life”, for example in different contexts, and to study other behavioral recovery interventions. To test (potential) recovery facilitating behaviors as mediators of intervention effects, such as reduction in burnout, the Swedish version of the Recovery Experience Questionnaire could be used.
2.	Ejeby, Kersti, et al. (author) Randomized controlled trial of transdiagnostic group treatments for primary care patients with common mental disorders 2014 In: Family Practice. - : Oxford University Press (OUP). - 0263-2136 .- 1460-2229. ; 31:3, s. 273-280 Journal article (peer-reviewed)abstract Background. The purpose was to test the effectiveness of two transdiagnostic group interventions compared to care as usual (CAU) for patients with anxiety, depressive or stress-related disorders within a primary health care context. Objectives. To compare the effects of cognitive-based-behavioural therapy (CBT) and multimodal intervention (MMI) on the quality of life and relief of psychological symptoms of patients with common mental disorders or problems attending primary health care centre. Methods. Patients (n = 278), aged 18-65 years, were referred to the study by the GPs and 245 were randomized to CAU or one of two group interventions in addition to CAU: (i) group CBT administered by psychologists and (ii) group MMI administered by assistant nurses. The primary outcome measure was the Mental Component Summary score of short form 36. Secondary outcome measures were Perceived Stress Scale and Self-Rating Scale for Affective Syndromes. The data were analysed using intention-to-treat with a linear mixed model. Results. On the primary outcome measure, the mean improvement based on mixed model analyses across post-and follow-up assessment was significantly larger for the MMI group than for the CBT (4.0; P = 0.020) and CAU (7.5; P = .001) groups. Participants receiving CBT were significantly more improved than those in the CAU group. On four of the secondary outcome measures, the MMI group was significantly more improved than the CBT and CAU groups. The course of improvement did not differ between the CBT group and the CAU group on these measures. Conclusions. Transdiagnostic group treatment can be effective for patients with common mental disorders when delivered in a primary care setting. The group format and transdiagnostic approach fit well with the requirements of primary care.
3.	Ejeby, Kersti, et al. (author) Symptom reduction due to psychosocial interventions is not accompanied by a reduction in sick leave : Results from a randomized controlled trial in primary care 2014 In: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 32:2, s. 67-72 Journal article (peer-reviewed)abstract Objective. To investigate whether interventions that have positive effects on psychological symptoms and quality of life compared with usual care would also reduce days on sick leave. Design. A randomized controlled trial. Setting. A large primary health care centre in Stockholm, Sweden. Intervention. Patients with common mental disorders were recruited by their GPs and randomized into one of two group interventions that took place in addition to usual care. These group interventions were: (a) group cognitive behavioural therapy (CBT), and (b) group multimodal intervention (MMI). Both types of intervention had previously shown significant effects on quality of life, and MMI had also shown significant effects on psychological symptoms. Patients. Of the 245 randomized patients, 164 were employed and had taken sick leave periods of at least two weeks in length during the study period of two years. They comprised the study group. Main outcome measures. The odds, compared with usual care, for being sick-listed at different times relative to the date of randomization. Results. The mean number of days on sick leave increased steadily in the two years before randomization and decreased in the two years afterwards, showing the same pattern for all three groups. The CBT and MMI interventions did not show the expected lower odds for sick-listing compared with usual care during the two-year follow-up. Conclusion. Reduction in psychological symptoms and increased well-being did not seem to be enough to reduce sickness absence for patients with common mental problems in primary care. The possibility of adding workplace-oriented interventions is discussed.
4.	Jansson, Billy, 0063- (author) Does the way in which we perceive the world make us susceptible to anxiety? 2005 Doctoral thesis (other academic/artistic)abstract One major focus of anxiety research in recent years has been the identification of cognitive factors that promote increased vulnerability to anxiety. Cognitive formulations propose that anxiety is characterised by an increased tendency to attend to negatively valenced emotional information, and that this bias may play a causal role in the development and maintenance of clinical anxiety. Evidence suggests that this anxiety-linked processing bias occurs even in conditions in which the stimuli are masked in order to prevent awareness of the content (i.e., preattentive bias). The present thesis focused principally on the preferential processing of threat-related information that occurs outside awareness. Two different outcome measures were used to index preferential preattentive processing of threat-related information in non-clinical populations: The emotional Stroop task was used to index selective attention to masked presentation of threatening word stimuli, whereas skin conductance responses were used to index selective autonomic responses to masked presentation of threatening pictorial stimuli. The empirical studies in the present thesis showed that elevated levels of trait anxiety promote preferential preattentive processing of negatively valenced information, whereas elevated levels of social desirability (interpreted as defensiveness) generally prevent preferential preattentive processing of negatively valenced information, especially among those at higher levels of trait anxiety, irrespective of outcome measure used. Moreover, previous research has demonstrated that a person’s most common emotional reaction when encountering a stressful event is causally influenced by that person’s habitual tendency to selectively encode the most threatening aspects of all available information. Thus, preattentive bias (as measured with the emotional Stroop task) was used to predict the emotional responses (as seen on self-reported emotional distress and autonomic reactivity) following exposure to a laboratory stressor. This study showed that preattentive bias to negative information had significant effects on both self-reported and physiological measures in response to a laboratory stressor, but in diametrically opposite directions. Specifically, whereas preattentive bias was positively associated with self-reported negative emotional response, it was negatively associated with a physiological indicator of emotional response. The results were discussed in terms of an inability to automatically inhibit the processing of threatening cues, which seems to be a vulnerability marker for anxiety. Whether this bias is ultimately sufficient for the development of clinical anxiety remains to be examined in future research. Additionally, more information is needed before it can be established that the emotional Stroop task can be viewed as a reliable diagnostic tool for determining an individual’s anxiety status.
5.	Lundh, Lars-Gunnar, et al. (author) Sömnstörningar 2006 In: Kognitiv beteendeterapi inom psykiatrin. - 912710947X ; , s. 195-210 Book chapter (other academic/artistic)abstract I kapitlet beskrivs kognitiva och beteendeinriktade behandlingsmetoder vid sömnstörningar, i första hand insomni. En översikt ges av diagnos och analys utifrån en KBT-modell. Beteendeanalys med hjälp av intervju, sömndagbok och självskattningsskalor beskrivs. En sammanfattning görs av vanliga behandlingsmetoder som avslappningsmetoder, paradoxal intention, stimuluskontroll, sömnrestriktion och kognitiva metoder. Även andra typer av sömnstörningar (sömnapné, narkolepsi, parasomnier och dygnsrytmstörningar) berörs kort.
6.	Lundh, Lars-Gunnar, et al. (author) Sömnstörningar 2013 In: KBT inom psykiatrin. - 9789127135604 ; 2 rev. & utökade utgåvan, s. 265-282 Book chapter (peer-reviewed)
7.	Saboonchi, Fredrik, et al. (author) Perfectionism and self-consciousness in social phobia and panic disorder with agoraphobia 1999 In: Behaviour Research and Therapy. - 0005-7967 .- 1873-622X. ; 37:9, s. 799-808 Journal article (peer-reviewed)abstract Social phobics were compared to patients with panic disorder with agoraphobia and normal controls on perfectionism and self-consciousness. On concern over mistakes and doubts about action, social phobics scored higher than patients with panic disorder. Social phobics also demonstrated a higher level of public self-consciousness than patients with panic disorder and when this difference was controlled for the significant differences on perfectionism disappeared. Within each patient group, however, perfectionism was more robustly related to social anxiety than was public self-consciousness, which replicates the findings of Saboonchi and Lundh [Saboonchi, F. & Lundh, L. G. (1997). Perfectionism, self-consciousness and anxiety. Personality and Individual Differences, 22, 921–928.] from a non-clinical sample. The results are discussed in terms of public self-consciousness being a differentiating characteristic of the more severe kind of social anxiety which is typical of social phobia.
8.	Santoft, Fredrik, et al. (author) Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout 2019 In: Behavior Therapy. - : Elsevier BV. - 0005-7894 .- 1878-1888. ; 50:3, s. 475-488 Journal article (peer-reviewed)abstract Evidence supporting the effectiveness of cognitive behavior therapy (CBT) for stress-related illness is growing, but little is known about its mechanisms of change. The aim of this study was to investigate potential mediators of CBT for severe stress in form of clinical burnout, using an active psychological treatment as comparator. We used linear mixed models to analyze data from patients (N = 82) with clinical burnout who received either CBT or another psychological treatment in a randomized controlled trial. Potential mediators (i.e., sleep quality, behavioral activation, perceived competence, and therapeutic alliance) and outcome (i.e., symptoms of burnout) were assessed weekly during treatment. The results showed that the positive treatment effects on symptoms of burnout favoring CBT (estimated between-group d = 0.93) were mediated by improvements in sleep quality, ab = -0.017,95% CIasymmetric [-0.037, -0.002], and increase in perceived competence, ab = -0.037, 95% CIasymmetric [-0.070, -0.010]. Behavioral activation, ab = -0.004 [-0.016, 0.007], and therapeutic alliance, ab = 0.002 [-0.006, 0.011], did not significantly mediate the difference in effects between the treatments. Improving sleep quality and increasing perceived competence may thus constitute important process goals in order to attain symptom reduction in CBT for clinical burnout.
9.	Santoft, Fredrik, et al. (author) Processes in cognitive behavior therapy for social anxiety disorder : Predicting subsequent symptom change 2019 In: Journal of Anxiety Disorders. - : Elsevier BV. - 0887-6185 .- 1873-7897. ; 67 Journal article (peer-reviewed)abstract Although cognitive behavior therapy (CBT) is an effective treatment for social anxiety disorder, little is known about the processes during treatment that bring about change. The aim of this study was to investigate whether the proposed processes of change according to the cognitive model of social anxiety disorder predicted subsequent symptom reduction in CBT delivered as therapist-guided bibliotherapy. We analyzed data from patients with social anxiety disorder (N = 61) who participated in an effectiveness trial of CBT in primary care. Seven putative processes and outcome (i.e., social anxiety) were assessed on a weekly basis throughout treatment. We used linear mixed models to analyze within-person relations between processes and outcome. The results showed a unidirectional effect of reduced avoidance on subsequent decrease in social anxiety. Further, we found support for reciprocal influences between four of the proposed processes (i.e., estimated probability and cost of adverse outcome, self-focused attention, and safety behaviors) and social anxiety. The remaining two processes, (i.e., anticipatory and post-event processing) did not predict subsequent social anxiety, but were predicted by prior symptom reduction. The findings support that several of the change processes according to the cognitive model of social anxiety disorder are involved in symptom improvement.
10.	Agdal, Maren Lillehaug, et al. (author) Quality-of-life before and after cognitive behavioral therapy (CBT) in patients with intra-oral injection phobia 2012 In: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 70:6, s. 463-470 Journal article (peer-reviewed)abstract Objective. To evaluate quality-of-life (QoL), before and after cognitive behavioral therapy (CBT) in patients diagnosed with intra-oral injection phobia according to DSM-IV and to compare with the general population. This study also aimed to evaluate if QoL was associated with self-reported injection anxiety, dental anxiety, time since last dental treatment and oral health. Materials and methods. Subjects were 55 patients (mean age 35.5 +/- 12.2, 78.2% women) who participated in a treatment study in which 89% managed an intra-oral injection at 1 year follow-up. The patients completed a set of questionnaires including Quality of Life Inventory (QOLI), Injection Phobia Scale-Anxiety, Dental Anxiety Scale and a single-item question assessing self-perceived oral health. Objective measures of oral health and treatment needs were based on clinical examination. QOLI-scores from a non-clinical sample were used for comparison. Results. Before treatment the general and health specific QoL were lower among intra-oral injection phobics than in the non-clinical sample. At 1 year follow-up the QoL in general had improved significantly and was similar to that of the non-clinical sample. Poor self-reported oral health and long-term avoidance of dental treatment were associated with lower general and health-specific QoL. Self-reported injection anxiety and dental anxiety were not associated with QoL. Conclusions. Patients with intra-oral injection phobia report lower QoL compared with a general population. Phobia treatment seems to increase QoL to normative levels. Self-perceived poor oral health is associated with reduced QoL in these patients.
11.	Almén, Niclas, 1971-, et al. (author) Behavioral Stress Recovery Management Intervention for People With High Levels of Perceived Stress : A Randomized Controlled Trial 2020 In: International Journal of Stress Management. - : American Psychological Association (APA). - 1072-5245 .- 1573-3424. ; 27:2, s. 183-194 Journal article (peer-reviewed)abstract Continuous and prolonged exposure to stressors or unsuccessfully dealing with such exposure has been suggested as precursors for burnout. Current research indicates that such stress problems could be conceptualized as deficiencies in recovery between periods of stress. The purpose of this study was to evaluate the efficacy of a behaviorally oriented stress recovery management intervention for people experiencing high levels of stress. A total of 73 individuals with experiences of stress symptoms and high levels of perceived stress (>= 25 on the Perceived Stress Scale) were randomly allocated to either a 10-week intervention group or a waiting-list control group. Participants were assessed at preintervention, postintervention, and 3-month follow-up. The Perceived Stress Scale, questions about tension, and the Shirom-Melamed Burnout Questionnaire were used as primary outcome measures. and the Hospital Anxiety and Depression Scale was used as a secondary outcome measure. Data were analyzed following the intention-to-treat principle. The analysis demonstrated statistically significant improvements for all measures at posttreatment and at follow-up. The between-groups effect sizes were high at posttreatment and moderate-to-high at follow-up. Intervention focused on stress recovery behavior seems to be an effective way of reducing perceived stress, tension, burnout symptoms, anxiety, and depression in people with stress symptoms and high levels of perceived stress in everyday life. The tested intervention warrants further research. Other stress recovery behavior interventions need to be tested to draw conclusions on the efficacy of stress recovery behavior interventions in general regarding stress and burnout.
12.	Almén, Niclas, 1971-, et al. (author) Bättre arbetsmiljö ger fler psykologer 2018 In: Dagens medicin. - Stockholm. - 1402-1943. ; :27 augusti Journal article (pop. science, debate, etc.)abstract I vårt debattinlägg betonade vi att psykisk ohälsa är ett vida utbrett problem och att patienter inte får effektiv hjälp eftersom det finns ett omfattande underskott på psykologer inom primärvården. Vi var kritiska till Centerpartiets vårdreform som riskerar medföra att problemet förvärras eftersom det inte skulle öka antalet psykologer vilka kan genomföra de behandlingar som Socialstyrelsen rekommenderar.
13.	Almén, Niclas, 1971-, et al. (author) Många är undantagna rätten till effektiv sjukvård 2018 In: Dagens medisin. - Oslo : Dagens medisin. - 1501-4290 .- 1501-4304 .- 1402-1943. ; :16 juli Journal article (pop. science, debate, etc.)
14.	Almén, Niclas, 1971-, et al. (author) Stress-Recovery Management : A Pilot Study Using a Single-Subject Experimental Design 2020 In: Behavior modification. - : SAGE Publications. - 0145-4455 .- 1552-4167. ; 44:3, s. 449-466 Journal article (peer-reviewed)abstract Work-related stress is considered one of the biggest health and safety challenges among the member states of the European Union. A critical factor is recovery between periods of stress. The primary purpose of this study was to investigate whether a brief behaviorally oriented stress-recovery management intervention delivered in an individual setting could reduce stress symptoms among individuals with high levels of perceived stress. A single-subject experimental design with multiple baselines across three individuals was used. The results indicate, with at least moderate experimental control, a temporal relation between the start of the intervention and beneficial changes from baseline in continuous self-recordings of stress symptoms. The changes were maintained at 1-year and 5-year follow-up assessments. Also, self-reporting inventories measuring perceived stress, worry, anxiety, depression, burnout, type A behavior, unwinding and recuperation from work stress, and insomnia showed overall changes in beneficial directions at post-assessment, as well as the two follow-up assessments. The results indicate that a behaviorally oriented stress-recovery management intervention delivered in an individual setting can reduce stress symptoms in individuals with high levels of perceived stress. However, for firm conclusions to be drawn, further research is needed.
15.	Andersson, Gerhard, 1966-, et al. (author) Internet-Based Exposure Treatment Versus One-Session Exposure Treatment of Snake Phobia : A Randomized Controlled Trial 2013 In: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 42:4, s. 284-291 Journal article (peer-reviewed)abstract In this study, the authors compared guided Internet-delivered self-help with one-session exposure treatment (OST) in a sample of snake phobic patients. A total of 30 patients were included following a screening on the Internet and a structured clinical interview. The Internet treatment consisted of four weekly text modules which were presented on a web page, a video in which exposure was modelled, and support provided via Internet. The OST was delivered in a three-hour session following a brief orientation session. The main outcome was the behavioural approach test (BAT), and as secondary measures questionnaires measuring anxiety symptoms and depression were used. Results showed that the groups did not differ at post-treatment or follow-up, with the exception of a significant interaction for the BAT in favour of the OST. At post-treatment, 61.5% of the Internet group and 84.6% of the OST group achieved a clinically significant improvement on the BAT. At follow-up, the corresponding figures were 90% for the Internet group and 100% for the OST group (completer sample). Within-group effect sizes for the Snake Phobia Questionnaire were large (d = 1.63 and d = 2.31 for the Internet and OST groups, respectively, at post-treatment). It is concluded that guided Internet-delivered exposure treatment is a potential treatment option in the treatment of snake phobia, but that OST probably is better.
16.	Andersson, Gerhard, et al. (author) Internet-Based Self-Help Versus One-Session Exposure in the Treatment of Spider Phobia : A Randomized Controlled Trial 2009 In: Cognitive Behaviour Therapy. - : Routledge. - 1650-6073 .- 1651-2316. ; 38:2, s. 114-120 Journal article (peer-reviewed)abstract The authors compared guided Internet-delivered self-help with one session of live-exposure treatment in a sample of spider-phobic patients. A total of 30 patients were included following screening on the Internet and a structured clinical interview. The Internet treatment consisted of five weekly text modules, which were presented on a web page, a video in which exposure was modelled, and support provided via Internet. The live-exposure treatment was delivered in a 3-hr session following a brief orientation session. The main outcome measure was the behavioural approach test (BAT), and as secondary measures the authors used questionnaires measuring anxiety symptoms and depression. Results showed that the groups did not differ at posttreatment or follow-up, with the exception of the proportion showing clinically significant change on the BAT. At posttreatment 46.2% of the Internet group and 85.7% in the live-exposure group achieved this change. At follow-up the corresponding figures were 66.7% for the Internet group and 72.7% for the live treatment. Within-group effect sizes for the spider phobia questionnaire were large (d = 1.84 and 2.58 for the Internet and live-exposure groups, respectively, at posttreatment). The authors conclude that guided Internet-delivered exposure treatment is a promising new approach in the treatment of spider phobia.
17.	Andersson, Gerhard, 1966-, et al. (author) Lovande behandling vid borderlinestörning 2006 In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 103, s. 3188-3190 Journal article (peer-reviewed)abstract Borderline personlighetsstörning (BPD) kännetecknas av ett genomgående mönster av instabilitet i regleringen av känslor, bristande impulskontroll, relationsproblem och låg självkänsla. Självskadande beteenden och självmordsförsök är vanliga. Dialektisk beteendeterapi (DBT) är en form av kognitiv beteendeterapi som utvecklats för självmordsbenägna patienter med BPD. I DBT ingår beteendeförändrande tekniker och metoder för att lära sig acceptera känslor. Behandlingen ges i form av individualterapi med telefonstöd och gruppterapi samt genomförs i flera steg, där självskadande och terapistörande beteenden prioriteras. Enligt SBUs granskning är det vetenskapliga stödet DBT begränsat (Evidensstyrka 3) och främst avgränsat till minskning av självskadande beteende.
18.	Andersson, Gerhard, et al. (author) Paniksyndrom : ond cirkel av feltolkade kroppsliga signaler 2011 In: Läkartidningen. - : Läkartidningen förlag AB. - 0023-7205 .- 1652-7518. ; 108:14, s. 795-797 Journal article (peer-reviewed)abstract Attacker av intensiv rädsla utan tydlig yttre orsak som leder till rädsla för nya attacker – det kännetecknar paniksyndrom. Evidensbaserade behandlingsalternativ finns, och det finns inget skäl att avvakta med behandling.
19.	Andersson, Gerhard, et al. (author) Paniksyndrom - ond cirkel av feltolkade kroppsliga signaler 2011 In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 108:14, s. 795-797 Journal article (peer-reviewed)abstract Paniksyndrom kännetecknas av plötsliga, oväntade panikattacker med rädsla för nya attacker eller konsekvenser av dem. En andel patienter har även agorafobi. Olika förklaringsmodeller har förts fram för att beskriva hur paniksyndrom uppstår och vidmakthålls. Flera behandlingar för paniksyndrom finns, och bland dem är det psykologisk behandling i form av kognitiv beteendeterapi (KBT) eller läkemedelsbehandling (i första hand selektiva serotoninåterupptagshämmare) som rekommenderas och som har stöd i forskningen. I Sverige har Internetbaserad KBT för paniksyndrom utvecklats och prövats med framgång. I valet av behandling bör patientens preferenser vägas in.
20.	Arnberg, Alexandra, et al. (author) CBT for Children with Depressive Symptoms : A Meta-Analysis 2014 In: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1650-6073 .- 1651-2316. ; 43:4, s. 275-288 Journal article (peer-reviewed)abstract Pediatric depression entails a higher risk for psychiatric disorders, somatic complaints, suicide, and functional impairment later in life. Cognitive behavior therapy (CBT) is recommended for the treatment of depression in children, yet research is based primarily on adolescents. The present meta-analysis investigated the efficacy of CBT in children aged 8-12 years with regard to depressive symptoms. We included randomized controlled trials of CBT with participants who had an average age of <= 12 years and were diagnosed with either depression or reported elevated depressive symptoms. The search resulted in 10 randomized controlled trials with 267 participants in intervention and 256 in comparison groups. The mean age of participants was 10.5 years. The weighted between-group effect size for CBT was moderate, Cohen's d=0.66. CBT outperformed both attention placebo and wait-list, although there was a significant heterogeneity among studies with regard to effect sizes. The weighted within-group effect size for CBT was large, d=1.02. Earlier publication year, older participants, and more treatment sessions were associated with a larger effect size. In conclusion, the efficacy of CBT in the treatment of pediatric depression symptoms was supported. Differences in efficacy, methodological shortcomings, and lack of follow-up data limit the present study and indicate areas in need of improvement.
21.	Bergman Nordgren, Lise, et al. (author) Polariserad debatt om riktlinjer skymmer viktiga frågor 2018 In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 115:37, s. 1372-1372 Journal article (pop. science, debate, etc.)abstract Debatten om Socialstyrelsens nya riktlinjer för ångest och depression har varit polariserad och inte konstruktiv. Diskussionen bör inte handla om PDT eller KBT utan om evidensbaserade metoder och kompetensbrist.
22.	Brattmyr, Martin, et al. (author) Clinically representative therapy for Nordic adult outpatients with common mental health problems : A systematic review and meta-analysis 2024 In: Scandinavian Journal of Psychology. - : John Wiley & Sons. - 0036-5564 .- 1467-9450. ; 65:2, s. 311-320 Research review (peer-reviewed)abstract There is a knowledge gap regarding clinically representative therapy given in routine settings, that is treatment as usual (TAU), for patients with common mental health problems (CMHP). This review and meta-analysis aimed to investigate what characterizes clinically representative therapy in Nordic routine clinics and meta-analyze the outcome of such treatment. Databases (PubMed, EMBASE, PsychINFO, and SveMed+) were searched for TAU, CMHP, and Nordic countries, together with backward and forward search in Scopus (7 November 2022). Studies were either randomized controlled trials (RCT) or open trials, using prospective study designs, examining heterogeneous outpatient groups in routine treatment. Within- and between-group effect sizes (ES), using random effects model, and moderator analyses were calculated. Eleven studies (n = 1,413), demonstrated a small to moderate within-group ES with high heterogeneity (g = 0.49, I2 = 90%). ESs in RCTs were significantly smaller than in open trials. TAU had a marginally smaller ES (g = −0.21; adjusted for publication bias g = −0.06) compared to a broad set of clinical interventions. Clinically representative therapy in the Nordic countries demonstrated a wide variety of characteristics and also a marginally lower ES compared to other interventions. The ESs were smaller than other meta-analyses examining evidence-based treatments in routine treatment.
23.	Böckman, Pontus, et al. (author) DN Debatt. ”Pseudovetenskap frodas i vården och på universiteten” 2020 In: Dagens Nyheter. - Stockholm. Journal article (pop. science, debate, etc.)
24.	Carlbring, Per, 1972-, et al. (author) Internet vs. paper and pencil administration of questionnaires commonly used in panic/agoraphobia research 2007 In: Computers in human behavior. - : Elsevier BV. - 0747-5632 .- 1873-7692. ; 23:3, s. 1421-1434 Journal article (peer-reviewed)abstract The aim of this study was to investigate the psychometric properties of Internet administered questionnaires used in panic research. Included were 494 people who had registered for an Internet-based treatment program for panic disorder (PD). Participants were randomly assigned to fill in the questionnaires either on the Internet or the paper-and-pencil versions, and then to fill in the same questionnaires again the next day using the other format. The questionnaires were the body sensations questionnaire [BSQ; Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090-1097], agoraphobic cognitions questionnaire [ACQ; Chambless, D. L., Caputo, G. C., Bright, P., & Gallagher, R. (1984). Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire. Journal of Consulting and Clinical Psychology, 52, 1090-1097], mobility inventory [MI; Chambless, D. L., Caputo, G., Jasin, S., Gracely, E. J., & Williams, C. (1985). The mobility inventory for agoraphobia. Behaviour Research and Therapy, 23, 35-44], beck anxiety inventory [BAI; Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893-897], beck depression inventory 11 [Beck, A. T., & Steer, R. A. (1996). Beck Depression Inventory, Manual, Svensk version (Swedish version). Fagernes, Norway: Psykologiforlaget, AB], quality of life inventory [QOLI; Frisch, M. B., Cornell, J., Villanueva, M., & Retzlaff, P. J. (1992). Clinical validation of the quality of life inventory. A measure of life satisfaction for use in treatment planning and outcome assessment. Psychological Assessment, 4, 92-101], and montgomery angstrom sberg depression rating scale [MADRS; Svanborg, P., & angstrom sberg, M. (1994). A new self-rating scale for depression and anxiety states based on the comprehensive psychopathological rating scale. ACTA Psychiatrica Scandinavica, 89, 21-28]. Results showed largely equivalent psychometric properties for the two administration formats (Cronbach's alpha between 0.79 and 0.95). The results also showed high and significant correlations between the Internet and the paper-and-pencil versions. Analyses of order effects showed an interaction effect for the BSQ and the MI (subscale Accompanied), a main effect was identified for ACQ, MI-Alone, BAI and BDIII. However, in contrast to previous research, the Internet version did not consistently generate higher scores and effect sizes for the differences were generally low. Given the presence of an interaction effect, we recommend that the administration format should be stable in research across measurement points. Finally, the findings suggest that Internet versions of questionnaires used in PD research can be used with confidence.
25.	Cederlund, Rio, et al. (author) Perception of Threat in Children With Social Phobia : Comparison to Nonsocially Anxious Children Before and After Treatment 2011 In: Journal of clinical child and adolescent psychology (Print). - : Informa UK Limited. - 1537-4416 .- 1537-4424. ; 40:6, s. 855-863 Journal article (peer-reviewed)abstract The present study investigated interpretation bias and reduced evidence for danger (RED) bias in 49 children with social phobia and 49 nonsocially anxious children between the ages of 8 and 14 years, using an ambiguous stories task. A posttreatment and follow-up measure was included for 26 of the socially phobic children to examine whether there would be a change in interpretation and RED bias after a 12-week behavior therapy program. Ambiguous scenarios were presented sentence by sentence. Participants gave interpretations and fear ratings after each sentence, and they rated negative emotions after each complete scenario. Compared to the nonsocially anxious children, children with social phobia displayed both a RED bias and an interpretation bias. After the treatment program, the children with social phobia displayed a reduced tendency to make biased interpretations, but there were no significant posttreatment changes in the RED bias. At 1 year follow-up there was a significant reduction in both interpretation and RED bias and clinical children no longer differed from nonsocially anxious controls.

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