| 1. |
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| 2. |
- Nicholas, M. K., et al.
(author)
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Implementation of Early Intervention Protocol in Australia for 'High Risk' Injured Workers is Associated with Fewer Lost Work Days Over 2 Years Than Usual (Stepped) Care
- 2020
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In: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 30:1, s. 93-104
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Journal article (peer-reviewed)abstract
- Purpose: To evaluate whether a protocol for early intervention addressing the psychosocial risk factors for delayed return to work in workers with soft tissue injuries would achieve better long-term outcomes than usual (stepped) care.Methods: The study used a controlled, non-randomised prospective design to compare two case management approaches. For the intervention condition, workers screened within 1-3 weeks of injury as being at high risk of delayed returned to work by the Örebro Musculoskeletal Pain Screening Questionnaire-short version (ÖMPSQ-SF) were offered psychological assessment and a comprehensive protocol to address the identified obstacles for return to work. Similarly identified injured workers in the control condition were managed under usual (stepped) care arrangements.Results: At 2-year follow-up, the mean lost work days for the Intervention group was less than half that of the usual care group, their claim costs were 30% lower, as was the growth trajectory of their costs after 11 months.Conclusions: The findings supported the hypothesis that brief psychological risk factor screening, combined with a protocol for active collaboration between key stakeholders to address identified psychological and workplace factors for delayed return to work, can achieve better return on investment than usual (stepped) care.
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| 3. |
- Nicholas, M. K., et al.
(author)
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Predicting Return to Work in a Heterogeneous Sample of Recently Injured Workers Using the Brief ÖMPSQ-SF
- 2019
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In: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 29:2, s. 295-302
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Journal article (peer-reviewed)abstract
- Purpose: (1) to examine the ability of the Örebro Musculoskeletal Pain Screening Questionnaire-short version (ÖMPSQ-SF) to predict time to return to pre-injury work duties (PID) following a work-related soft tissue injury (regardless of body location); and (2) to examine the appropriateness of 50/100 as a suitable cut-off score for case identification.Methods: Injured workers (IW) from six public hospitals in Sydney, Australia, who had taken medically-sanctioned time off work due to their injury, were recruited by insurance case managers within 5-15 days of their injury. Eligible participants (N = 213 in total) were administered the ÖMPSQ-SF over the telephone by the case manager. For objective (1) Cox proportional hazards regression analysis was used to predict days to return to PID using the ÖMPSQ-SF. For objective (2) receiver operator characteristic (ROC) analysis was used to determine the ÖMPSQ-SF total score that optimises sensitivity and specificity in detecting whether or not participants had returned to PID within 2-7 weeks.Results: The total ÖMPSQ-SF score significantly predicted number of days to return to PID, such that for every 1-point increase in the total ÖMPSQ-SF score the predicted chance of returning to work reduced by 4% (i.e., hazard ratio = 0.96), p < 0.001. Sensitivity and specificity for the ROC analysis comparing ÖMPSQ-SF total score to return to PID within 2-7 weeks suggested 48 as the optimal cut off (sensitivity = 0.65, specificity = 0.79).Conclusion: The results provide strong support for the use of the ÖMPSQ-SF in an applied setting for identifying those IW likely to have delayed RTW when administered within 15 days of the injury. While a score of 48/100 was the optimal cut point for sensitivity and specificity, pragmatically, 50/100 should be acceptable as a cut-off in future studies of this type.
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| 4. |
- Main, Chris J., et al.
(author)
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Implementation Science and Employer Disability Practices : Embedding Implementation Factors in Research Designs
- 2016
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In: Journal of occupational rehabilitation. - : Springer-Verlag New York. - 1053-0487 .- 1573-3688. ; 26:4, s. 448-464
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Journal article (peer-reviewed)abstract
- Purpose: For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant aspects of the workplace. The goal of this article is to summarize recent theoretical and methodological advances in the field of Implementation Science, relate these to research of employer disability management practices, and recommend future research priorities.Methods: The authors participated in a year-long collaboration culminating in an invited 3-day conference, “Improving Research of Employer Practices to Prevent Disability”, held October 14–16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience.Results: A 4-phase implementation model including both outer and inner contexts was adopted as the most appropriate conceptual framework, and aligned well with the set of process evaluation factors described in both the work disability prevention literature and the grey literature. Innovative interventions involving disability risk screening and psychologically-based interventions have been slow to gain traction among employers and insurers. Research recommendations to address this are : (1) to assess organizational culture and readiness for change in addition to individual factors; (2) to conduct process evaluations alongside controlled trials; (3) to analyze decision-making factors among stakeholders; and (4) to solicit input from employers and insurers during early phases of study design.Conclusions: Future research interventions involving workplace support and involvement to prevent disability may be more feasible for implementation if organizational decision-making factors are imbedded in research designs and interventions are developed to take account of these influences.
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| 5. |
- Caneiro, J. P., et al.
(author)
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From Fear to Safety : A Roadmap to Recovery from Musculoskeletal Pain
- 2022
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In: Physical Therapy. - : Oxford University Press. - 0031-9023 .- 1538-6724. ; 102:2
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Journal article (peer-reviewed)abstract
- Contemporary conceptualizations of pain emphasize its protective function. The meaning assigned to pain drives cognitive, emotional, and behavioral responses. When pain is threatening, and a person lacks control over their pain experience, it can become distressing, self-perpetuating, and disabling. Although the pathway to disability is well established, the pathway to recovery is less researched and understood. This Perspective draws on recent data on the lived experience of people with pain-related fear to discuss both fear and safety learning processes and their implications for recovery for people living with pain. Recovery is here defined as achievement of control over pain, as well as improvement in functional capacity and quality of life. Based on the common-sense model, this Perspective proposes a framework utilizing cognitive functional therapy to promote safety learning. A process is described in which experiential learning combined with "sense making" disrupts a person's unhelpful cognitive representation and behavioral and emotional response to pain, leading them on a journey to recovery. This framework incorporates principles of inhibitory processing that are fundamental to pain-related fear and safety learning.
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| 6. |
- Caneiro, J. P., et al.
(author)
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How does change unfold? an evaluation of the process of change in four people with chronic low back pain and high pain-related fear managed with Cognitive Functional Therapy : A replicated single-case experimental design study
- 2019
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In: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 117, s. 28-39
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Journal article (peer-reviewed)abstract
- PURPOSE: To understand the process of change at an individual level, this study used a single-case experimental design to evaluate how change in potential mediators related to change in disability over time, during an exposure-based behavioural intervention in four people with chronic low back pain and high pain-related fear. A second aim was to evaluate whether the change (sequential or simultaneous) in mediators and disability occurred at the same timepoint for all individuals.RESULTS: For all participants, visual and statistical analyses indicated that changes in disability and proposed mediators were clearly related to the commencement of Cognitive Functional Therapy. This was supported by standard outcome assessments at pre-post timepoints. Cross-lag correlation analysis determined that, for all participants, most of the proposed mediators (pain intensity, pain controllability, and fear) were most strongly associated with disability at lag zero, suggesting that mediators changed concomitantly and not before disability. Importantly, these changes occurred at different rates and patterns for different individuals, highlighting the individual temporal variability of change.CONCLUSION: This study demonstrated the interplay of factors associated with treatment response, highlighting 'how change unfolded' uniquely for each individual. The findings that factors underpinning treatment response and the outcome changed simultaneously, challenge the traditional understanding of therapeutic change.
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| 7. |
- Edebol-Carlman, Hanna, 1984-, et al.
(author)
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Face-to-Face Cognitive-Behavioral Therapy for Irritable Bowel Syndrome : The Effects on Gastrointestinal and Psychiatric Symptoms
- 2017
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In: Gastroenterology Research and Practice. - : Hindawi Publishing Corporation. - 1687-6121 .- 1687-630X.
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Journal article (peer-reviewed)abstract
- Irritable bowel syndrome (IBS) is a gastrointestinal disorder linked to disturbances in the gut-brain axis. Visceral hypersensitivity and pain are hallmarks of IBS and linked to the physiological and psychological burden and to the nonadaptive coping with stress. Cognitive-behavioral therapy (CBT) for IBS has proven effective in reducing gastrointestinal and psychiatric symptoms in IBS by means of coping with stress. The present pilot study evaluated for the first time whether CBT for IBS affected visceral sensitivity and pain. Individual CBT was performed for 12 weeks in 18 subjects with IBS and evaluated in terms of visceral sensitivity and pain during rectal distensions using the barostat method and self-rated visceral sensitivity and gastrointestinal and psychiatric symptoms. Visceral discomfort, urge, and pain induced by the barostat were not affected by CBT but were stable across the study. However, the level of self-rated visceral sensitivity and gastrointestinal and psychiatric symptoms decreased after the intervention. Central working mechanisms and increased ability to cope with IBS-symptoms are suggested to play a key role in the alleviation of IBS symptoms produced by CBT.
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| 8. |
- Flink, Ida K., et al.
(author)
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Pain in childbirth and postpartum recovery : the role of catastrophizing
- 2009
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In: European Journal of Pain. - Amsterdam : Elsevier. - 1090-3801 .- 1532-2149. ; 13:3, s. 312-316
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Journal article (peer-reviewed)abstract
- This prospective study investigated how pain catastrophizing was related to labor pain intensity and physical recovery after childbirth. Eighty-eight women giving birth for the first time completed the first questionnaire before delivery. Eighty-two of those returned the second questionnaire after delivery. Participants were classified as catastrophizers (n=38) or non-catastrophizers (n=44) based on their scores on the Pain Catastrophizing Scale. Comparison of the groups showed that catastrophizers anticipated and experienced more intense pain (p<.0125) and had poorer physical recovery (p<.0125), measured as the level of self-reported functioning in activities of daily living, than non-catastrophizers. These results extend the association between catastrophizing and pain, to pain and recovery in childbirth and provide support for the fear-avoidance model. It is concluded that pain catastrophizing plays a role in the experience of pain in childbirth and postpartum recovery. Further research is needed to identify appropriate interventions for catastrophizing women during the latter part of pregnancy.
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| 9. |
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| 10. |
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| 11. |
- Shaw, William S., et al.
(author)
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Effects of workplace, family and cultural influences on low back pain : What opportunities exist to address social factors in general consultations?
- 2013
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In: Baillière's Best Practice & Research. - : Elsevier BV. - 1521-6942 .- 1532-1770. ; 27:5, s. 637-648
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Journal article (peer-reviewed)abstract
- Social factors are widely acknowledged in behavioural models of pain and pain management, but incorporating these factors into general medical consultations for low back pain (LBP) can be challenging. While there is no compelling evidence that social factors contribute to LBP onset, these factors have been shown to influence functional limitation and disability, especially the effects of organisational support in the workplace, spousal support, family conflict and social disadvantage. A number of barriers exist to address such social factors in routine medical encounters for LBP, but there is emerging evidence that improving social and organisational support may be an effective strategy to reduce the negative lifestyle consequences of LBP. For clinicians to address these factors in LBP treatment requires a clearer psychosocial framework in assessment and screening, more individualised problem-solving efforts, more patient-centred interventions involving family, peers and workplace supports and a less biomechanical and diagnostic approach. (C) 2013 Elsevier Ltd. All rights reserved.
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| 12. |
- Shaw, William S., et al.
(author)
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Psychological Distress in Acute Low Back Pain : A Review of Measurement Scales and Levels of Distress Reported in the First 2 Months After Pain Onset
- 2016
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In: Archives of Physical Medicine and Rehabilitation. - Philadelphia, USA : Elsevier. - 0003-9993 .- 1532-821X. ; 97:9, s. 1573-1587
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Research review (peer-reviewed)abstract
- Objective: To characterize the measurement scales and levels of psychological distress reported among published studies of acute low back pain (LBP) in the scientific literature.Data Sources: Peer-reviewed scientific literature found in 8 citation index search engines (CINAHL, Embase, MANTIS, PsycINFO, PubMed, Web of Science, AMED, and Academic Search Premier) for the period from January 1, 1966, to April 30, 2015, in English, Danish, Norwegian, and Swedish languages.Study Selection: Cross-sectional, case-control, cohort, or randomized controlled trials assessing psychological distress and including participants drawn from patients and workers (or an identifiable subset) with acute LBP (<8wk). Three researchers independently screened titles, abstracts, and full-length articles to identify peer-reviewed studies according to established eligibility criteria.Data Extraction: Descriptive data (study populations, definitions of LBP, distress measures) were systematically extracted and reviewed for risk of bias. Distress measures were described, and data were pooled in cases of identical measures. Reported levels of distress were contextualized using available population norms, clinical comparison groups, and established clinical cutoff scores.Data Synthesis: Of 10,876 unique records, 23 articles (17 studies) were included. The most common measures were the Beck Depression Inventory, the modified version of the Zung Self-Rated Depression Scale, the Center for Epidemiologic Studies-Depression Scale, and the Medical Outcomes Study 12-Item Short-Form Health Survey and Medical Outcomes Study 36-Item Short-Form Health Survey. Pooled results for these scales showed consistent elevations in depression, but not anxiety, and reduced mental health status in comparison with the general population.Conclusions: Based on the high consistency across studies using valid measures with a low to moderate risk of bias, there is strong evidence that psychological distress is elevated in acute LBP.
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| 13. |
- Soares, Joaquim, et al.
(author)
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Prevention av smärttillstånd
- 2008. - 2
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In: Preventiv medicin. - Lund : Studentlitteratur. - 9789144040158 ; , s. 261-272
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Book chapter (other academic/artistic)abstract
- Information om boken "Preventiv medicin: Teori och praktik"Är det möjligt att förebygga sjukdom och främja hälsa - och är det lönsamt? Med dagens snabba medicinska landvinningar och ökande vårdbehov hos en åldrande befolkning blir den kurativa medicinen allt dyrare. Samtidigt krymper sjukvårdsekonomin, utrymmet för god och mänsklig vård minskar, individens sociala utsatthet och sårbarhet för kronisk sjukdom tilltar. Den preventiva medicinen har förvånande nog fått liten plats i detta scenario. När vi nu effektivt kan förebygga allt fler sjukdomar, borde vi inte då bättre kunna bespara människor deras lidande och samhället dess sjukvårdskostnader? Preventivt arbete kräver en gränsöverskridande och multidisciplinär ansats, där medicin, epidemiologi, statistik, ekonomi, sociologi, psykologi, och andra vetenskaper samverkar. I denna nya och utvidgade utgåva presenterar 29 expterter sina samlade kunskaper och erfarenheter om hur vi kan begränsa och tygla de stora folksjukdomarna. Boken behandlar skilda områden från tobaksbruk, alkoholanvändning, matvanor, motion och sömn över stressrelaterade livsproblem till en diskussion om våra vanligaste folksjukdomar som hjärt-kärlsjukdomar, cancer och olika tillstånd av psykisk ohälsa med syftet att visa fram var vi kan påverka genom konsekvent prevention - och hur vi kan utvärdera de förebyggande insatserna. Preventiv medicin vänder sig såväl till studerande inom medicin, folkhälso- och vårdvetenskaper som till praktiskt verksamma inom vården, men även till aktörer och organisationer utanför vårdapparaten med förebyggande och hälsofrämjande arbete på sitt program.
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| 14. |
- Ahlborg, Tone, 1950, et al.
(author)
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Sensual and sexual marital contentment in parents of small children--a follow-up study when the first child is four years old.
- 2008
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In: Journal of sex research. - : Informa UK Limited. - 0022-4499 .- 1559-8519. ; 45:3, s. 295-304
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Journal article (peer-reviewed)abstract
- This follow-up study explored parents' (N=452) intimate relationships when their firstborn child was 6 months old and then 4 years later. The measurement used was a modified version of the Dyadic Adjustment Scale, DAS. The present results show that most parents responding were content sensually at 6 months postpartum in 2002 and 4 years later, in 2006. More parents had changed from being sensually content in 2002 to discontent in 2006, than the contrary, however, and the sexual contentment remained low. The average sexual frequency was low both at 6 months and at 4 years for both parents with and without additional children. Experiencing tiredness as a hindrance to having sex was perceived as a greater problem among those parents without additional children. Prospective regression analyses indicated that sexuality was significantly related to both sensual and sexual contentment 4 years later. Sexuality was also one of the most significant covariates in the cross-sectional regression analysis for sensual contentment. Since sexuality plays a central role in partner well-being, it may be an important target for helping parents with small children.
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| 15. |
- Arnberg, Filip K, 1981-, et al.
(author)
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Internet-delivered psychological treatments for mood and anxiety disorders : a systematic review of their efficacy, safety, and cost-effectiveness
- 2014
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:5, s. e98118-
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Journal article (peer-reviewed)abstract
- BACKGROUND: Greater access to evidence-based psychological treatments is needed. This review aimed to evaluate whether internet-delivered psychological treatments for mood and anxiety disorders are efficacious, noninferior to established treatments, safe, and cost-effective for children, adolescents and adults.METHODS: We searched the literature for studies published until March 2013. Randomized controlled trials (RCTs) were considered for the assessment of short-term efficacy and safety and were pooled in meta-analyses. Other designs were also considered for long-term effect and cost-effectiveness. Comparisons against established treatments were evaluated for noninferiority. Two reviewers independently assessed the relevant studies for risk of bias. The quality of the evidence was graded using an international grading system.RESULTS: A total of 52 relevant RCTs were identified whereof 12 were excluded due to high risk of bias. Five cost-effectiveness studies were identified and three were excluded due to high risk of bias. The included trials mainly evaluated internet-delivered cognitive behavioral therapy (I-CBT) against a waiting list in adult volunteers and 88% were conducted in Sweden or Australia. One trial involved children. For adults, the quality of evidence was graded as moderate for the short-term efficacy of I-CBT vs. waiting list for mild/moderate depression (d = 0.83; 95% CI 0.59, 1.07) and social phobia (d = 0.85; 95% CI 0.66, 1.05), and moderate for no efficacy of internet-delivered attention bias modification vs. sham treatment for social phobia (d = -0.04; 95% CI -0.24, 0.35). The quality of evidence was graded as low/very low for other disorders, interventions, children/adolescents, noninferiority, adverse events, and cost-effectiveness.CONCLUSIONS: I-CBT is a viable treatment option for adults with depression and some anxiety disorders who request this treatment modality. Important questions remain before broad implementation can be supported. Future research would benefit from prioritizing adapting treatments to children/adolescents and using noninferiority designs with established forms of treatment.
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| 16. |
- Askeland, Kristin Gärtner, et al.
(author)
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Association of Depressive Symptoms in Late Adolescence and School Dropout
- 2022
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In: School Mental Health. - : Springer. - 1866-2625 .- 1866-2633. ; 14:4, s. 1044-1056
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Journal article (peer-reviewed)abstract
- The present study investigated the association between symptoms of depression in late adolescence and completion of upper secondary school, taking symptoms of ADHD and conduct disorder, and parental education into account. The study is based on the youth@hordaland-survey, conducted in Western Norway in 2012. A total of 9157 adolescents (aged 16-19 years, 53% girls) consented to participation and registry linkage and comprised the sample of the present study. Symptoms of depression, ADHD, and conduct disorder were based on adolescent self-report. Information on parental education, grade point average (GPA), and upper secondary school completion was retrieved from the National Education Database. In the sample, 14.8% had not completed upper secondary education within 5 years. Symptoms of depression were associated with higher odds of failure to graduate within 5 years (adjusted odds ratio (AOR) = 1.50). The association was attenuated but remained significant when adjusting for symptoms of ADHD, conduct disorder, and parental education. Adolescents reporting high levels of both depression and conduct disorder had the highest odds of dropout (AOR = 4.15). GPA partially mediated the association between symptoms of depression and dropout. The results show a consistent, but small association between symptoms of depression in late adolescence and failure to complete upper secondary education within five years. Given the high rate of depressive symptoms in the adolescent population, it is important to identify protective factors that promote school functioning and graduation for adolescents experiencing such symptoms.
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| 17. |
- Bauducco, Serena, 1988-
(author)
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Adolescents' sleep in a 24/7 society : Epidemiology and prevention
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Sleep undergoes important changes during adolescence and many teenagers experience problems sleeping. These in turn affect adolescents´ academic, physical and psychosocial functioning. Moreover, there are some indications that sleep problems in this age group may be increasing, possibly as a consequence of societal changes, e.g., internet availability. Research on adolescents´ sleep is growing, but more epidemiological studies are needed to clarify the prevalence of poor sleep, long and short-term outcomes associated with it, and potential risk and protective factors to target in preventive interventions. The aim of this dissertation was to contribute to each of these goals; Study I investigated the longitudinal association between sleep problems, defined as symptoms of insomnia, and school absenteeism; Study II explored the prevalence of poor sleep, defined as sleep deficit, in an adolescent population and psychosocial and contextual factors associated with it, including emotional and behavioral problems, stress, sleep hygiene and technology use; finally, Study III evaluated the short-term effects of a novel universal school-based intervention to improve adolescents´ sleep health.The findings show that poor sleep was strongly related to adolescents´ functioning, including emotional and behavioral problems and school attendance, and that sleep deficit was prevalent in adolescents. This supports the need for prevention. Moreover, sleep deficit was associated with stress, technology use and arousal at bedtime, which may represent important barriers to sleep. A preventive intervention targeting these barriers to promote adolescents´ sleep health was successful with the individuals most at risk. However, it remains to be seen whether these changes will be maintained after the intervention and whether incidence of sleep problems will be lower relative to a control group. Implications for theory and practice are discussed.
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| 18. |
- Bauducco, Serena, 1988-, et al.
(author)
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Making room for sleep : A classroom based prevention program for adolescents
- 2016
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In: EABCT2016 Abstract Book. ; , s. 546-546
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Conference paper (other academic/artistic)abstract
- Sleep patterns go through important changes during adolescence and sleep deprivation is extremely common, with severe consequences for adolescents´ daily functioning (Owens et al., 2014).Previous school-based interventions attempting to prevent sleep problems and their consequences have shown an increase in adolescents´ sleep knowledge but no behavioral changes. These programs usually include sleep education, cognitive and behavioral strategies, and a motivational framework (Cassoff, Knäuper, Michaelsen, & Gruber, 2013). Although the importance of motivation and engagement is unquestionable, previous attempts at enhancing adolescents´ motivation to change sleep behaviors might have been too shallow. We developed a new program that specifically targets barriers adolescents may encounter when trying to change their sleep behaviors, such as use of information and communication technology (ICT) late in the evening, stress due to schoolwork, and extracurricular activities. So, the intervention did not only focus on sleep education but also on improving students’ time management skills and encouraging them to monitor their ICT use. We also developed an interactive app for the intervention to increase engagement and to take advantage of the opportunities of ICT.The aim of this study was to evaluate the effectiveness of this classroom delivered universal sleep intervention. More specifically, we wanted to investigate whether changes in technology usage and perceived stress preceded changes in adolescents´ sleep duration. The intervention consisted of 5x45 min sessions over 6-7 weeks. Students (N = 292) completed weekly questionnaires through the app including a sleep diary for school-week and weekend sleep (bedtime, wake time, sleep onset latency, and wake after sleep onset), mobile usage, and motivation to change. They also completed pre- and post-intervention assessments, including self-reported sleep hygiene, perceived stress, and mood. At the end of the intervention students provided a qualitative evaluation of the sleep program.The intervention is still ongoing and will be completed by the end of the school year (June 2016). So far, the intervention has shown good feasibility in the school context. Preliminary results will be presented on possible changes in sleep duration and sleep hygiene and the role of ICT use and stress.This study will give us important information on adolescents´ sleep and its barriers in our 24/7 society. The discussion will focus on the possibilities of using this kind of preventive school-based interventions, as well as how modern technology (i.e. an interactive app) may be used for promoting engagement in this age group.
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| 19. |
- Bauducco, Serena, 1988-, et al.
(author)
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Prevalence, Incidence and Risk Factors for Sleep Deprivation in Adolescence : The Role of Technology and Stress
- 2016
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Conference paper (other academic/artistic)abstract
- Aim: The first aim of this study was to describe the prevalence and incidence of poor sleep duration (<7 hours) over a one year period in a large sample of adolescents. The second aim was to inform prevention about the influence of adolescents´ social context on sleep duration. Therefore, we wanted to describe the longitudinal association between the use of Information and Communication Technology (ICT) at bedtime and daily stressors (e.g. school performance, family and peer issues) and poor sleep duration.Method: Participants were high school students in the 7th and 8th grade (N = 2505; age range: 12-15 years, at baseline) from 17 public schools in three communities in middle Sweden. Students filled out questionnaires in school during the spring, 2014 and one year later (85% retention rate). Sleep measures included bed time (BT), wake up time (WUT), and sleep onset latency (SOL). Total sleep time was calculated as, BT + WUT - SOL.We calculated prevalence, incidence, and chronicity of poor sleep duration. Moreover, the effect of ICT and daily stressors on future sleep duration was estimated with odds ratios, controlling for gender.Results: Prevalence (18.6%), incidence (12.8%) and chronicity (50%) rates indicate that poor sleep duration was persistent and increased one year later. Moreover, adolescents who often used ICT at bedtime (OR = 1.21, p < .001) and reported more school stress (OR = 1.16, p = .02), were more likely to report poor sleep duration one year later.Conclusion: Because poor sleep duration is common and persists over time, it is crucial to intervene early to prevent chronic sleep deprivation. Sleep interventions with younger adolescence, before chronicity occurs, should focus on barriers to change, such as stress and use of technology. The results from this study have been used to develop an early school-based intervention.
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| 20. |
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| 21. |
- Bauducco, Serena, 1988-, et al.
(author)
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Preventing sleep deficit in adolescents : Long-term effects of a quasi-experimental school-based intervention study
- 2020
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In: Journal of Sleep Research. - : Wiley-Blackwell. - 0962-1105 .- 1365-2869. ; 29:1
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Journal article (peer-reviewed)abstract
- Adolescents are at risk of sleep deficit, which has serious consequences for their daytime functioning. However, school-based interventions to improve sleep have shown limited success. This might be due to the content of the programmes (e.g., not targeting central factors such as daytime stress and technology use) or because changes have not been captured due to a lack of long-term follow-ups. Hence, the aim of this study was to evaluate the long-term effects of a school-based sleep education curriculum including time-management training. The study used a quasi-experimental design. Participants were 3,622 adolescents (mean age 13.7, 48% girls); 286 were in the intervention group and 3,336 were followed as a natural control group. Data were collected before the intervention and at a 1-year follow-up. We divided participants into three groups according to baseline sleep duration (calculated from self-reported bed- and wake times, minus sleep onset latency): insufficient (<7 hr), borderline (7-8 hr) and adequate (>8 hr). Adolescents in the intervention group were ~2 times less likely to report insufficient sleep at follow-up as compared to controls. Sleep knowledge improved significantly in the intervention group but there were no changes in emotional sleep hygiene (e.g., bedtime worry) and perceived stress. Surprisingly, technology use increased and behavioural sleep hygiene worsened in the intervention group. Although the mechanisms of change need further investigation, the results of this study point to potential long-term benefits of school-based sleep programmes.
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| 22. |
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| 23. |
- Bauducco, Serena V., 1988-, et al.
(author)
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Too tired for school? : the effects of insomnia on absenteeism in adolescence
- 2015
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In: Sleep Health. - : Elsevier. - 2352-7218 .- 2352-7226. ; 1:3, s. 205-210
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Journal article (peer-reviewed)abstract
- Objectives: Sleep has important consequences for a person's daytime functioning. Numerous studies have shown that insomnia predicts work absenteeism and work disability in adults, but only a few studies have examined this association in adolescents. This study aims to explore whether symptoms of insomnia in adolescents predict school absenteeism 1 year later, over and above known psychological risk factors for absenteeism.Design: The study used a longitudinal design with 2 measurement points over 1 year.Setting: The students completed questionnaires during school hours at baseline and again at follow-up.Participants: Students in the 10th to 12th grades in a Swedish upper secondary school were followed prospectively for 1 year (age, 16-20 years; N = 353; 48.1% girls).Measurements and results: We used logistic regression analyses, controlling for the known effects of psychological factors, and arrived at a model elucidating the role of insomnia. That is, besides symptoms of insomnia, the model included previous absenteeism, alcohol intoxication, school-related social phobia, social anxiety, depressive symptoms, somatic symptoms, and bully victimization. Symptoms of insomnia predicted school absenteeism 1 year later, over and above known risk factors for absenteeism. Adolescents reporting severe symptoms of insomnia were almost 3 times more likely than adolescents reporting no or low symptoms to report problematic absenteeism 1 year later. We did not find any gender difference.Conclusions: Our findings underscore the importance of sleep problems on adolescents' daytime functioning as measured by school absenteeism. Therefore, sleep may be an important target for preventive interventions with adolescents.
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| 24. |
- Beales, Darren, et al.
(author)
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The Predictive Ability of the Full and Short Versions of the Orebro Questionnaire for Absenteeism and Presenteeism Over the Subsequent 12 months, in a Cohort of Young Community-Based Adult Workers
- 2021
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In: Journal of Occupational and Environmental Medicine. - : Lippincott Williams & Wilkins. - 1076-2752 .- 1536-5948. ; 63:12, s. 1058-1064
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The primary purpose of this study was to investigate the predictive ability of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) in regard to work productivity (absenteeism and presenteeism) in early adulthood.METHODS: A prospective study was performed using data from the Raine Study Generation 2 (Gen2) 22-year follow-up. The ÖMPSQ was completed at baseline, and absenteeism and presenteeism assessed at 4 intervals over the following 12 months.RESULTS: In early adulthood, the full and short versions of the ÖMPSQ showed some predictive ability for work absenteeism but the Receiver Operator Characteristic demonstrated poor discrimination. There was no evidence of predictive ability for presenteeism.CONCLUSION: Further work is required to increase the fidelity of screening for risk of reduced work productivity at the population level.
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| 25. |
- Bergbom, Sofia, 1982-, et al.
(author)
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Both early and late changes in psychological variables relate to treatment outcome for musculoskeletal pain patients at risk for disability
- 2013
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In: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 50:11, s. 726-734
-
Journal article (peer-reviewed)abstract
- We know little about why some people get better after psychological treatments for pain disability, whereas other people do not. In order to understand differences in treatment response, we need to explore processes of change during treatment. It has been suggested that people with pain complaints who change early in treatment have better outcomes. Therefore, we aimed to investigate whether changes in psychological variables at different time points are related to outcome, and whether early or late changes are better predictors of outcome. We used the fear avoidance model as a theoretical framework. We followed 64 patients weekly over 6–7 weeks and then determined outcome. Our findings indicate that people who decrease in catastrophizing and function early in treatment as well as in depressive symptoms, worry, fear avoidance beliefs and function late in treatment have better outcomes. Early decreases in function, and late decreases in depressive symptoms and worry uniquely predict improvements in disability. While early and late changes covaried concurrently, there were no significant sequential relationships between early and late changes. Changes in the proposed process variables in the fear avoidance model, early as well as late in treatment, thus add valuable information to the explanation of outcome.
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| 26. |
- Bergbom, Sofia, 1982-, et al.
(author)
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Early psychologically informed interventions for workers at risk for pain-related disability : does matching treatment to profile improve outcome?
- 2014
-
In: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 24:3, s. 446-457
-
Journal article (peer-reviewed)abstract
- Purpose: This randomized controlled trial had two main aims. The first aim was to investigate the effect of early preventive, psychologically informed, interventions for pain-related disability. The second aim was explore whether people who are matched to an intervention specifically targeting their psychological risk profile had better outcomes than people who were not matched to interventions.Methods: A total of 105 participants were recruited from their workplace, screened for psychological risk factors and classified as being at risk for long-term pain-related disability. They were subgrouped into one of three groups based on their psychological profile. Three behaviorally oriented psychological interventions were developed to target each of the three risk profiles. Half of the participants were assigned a matched intervention developed to target their specific profile, and half were assigned an unmatched intervention. After treatment, repeated measure ANOVAs and χ2 tests were used to determine if treatments had an effect on primary and secondary outcomes including perceived disability, sick leave, fear and avoidance, pain catastrophizing and distress, and if matched participants had better outcomes than did unmatched.Results: Treatments had effects on all outcome variables (effect sizes d ranging between 0.23 and 0.66), but matched participants did not have better outcomes than unmatched.Conclusions: Early, preventive interventions have an impact on a number of outcome variables but it is difficult to realize a matching procedure. More in-depth research of the process of matching is needed.
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| 27. |
- Bergbom, Sofia, 1982-, et al.
(author)
-
Psykologer i primärvården - en förbisedd möjlighet
- 2017
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In: Nerikes Allehanda. - Örebro : Nerikes allehanda AB. - 1103-971X. ; :9 april
-
Journal article (pop. science, debate, etc.)abstract
- Psykologer har den expertkunskap som krävs för att behandla dagens ohälsa, och regionen riskerar skapa en närsjukvård som tillhör B-laget genom att inte ta vara på psykologers kompetens. Evidensen pekar tydligt ut psykologisk behandling som förstahandsval vid behandling av sömnsvårigheter, depression, ångest och stressproblematik – ändå ignoreras psykologers kunskap i den arbetsgrupp som tillsatts för att tackla nutidens problematik i primärvården.
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| 28. |
- Bergbom, Sofia, 1982-, et al.
(author)
-
Relationship Among Pain Catastrophizing, Depressed Mood, and Outcomes Across Physical Therapy Treatments
- 2011
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In: Physical Therapy. - : Oxford University Press. - 0031-9023 .- 1538-6724. ; 91:5, s. 754-764
-
Journal article (peer-reviewed)abstract
- Background: Pain catastrophizing and emotional distress can act as prognosticfactors for pain and disability. Research on how these variables interact withinindividuals and over time is in an early stage. Understanding various patterns ofprognostic factors and how these factors change during treatment is important fordeveloping treatments targeting important factors.Objective: The primary aim of this study was to investigate relationships betweenpain catastrophizing and depressed mood in people seeking primary care for mus-culoskeletal pain. An additional aim was to relate these patterns of prognostic factorsto outcomes during a 6-month period.Design: The design was prospective; data were obtained at baseline and atfollow-up.Methods: Forty-two physical therapists taking part in an educational programrecruited, from their clinical practices in primary care, consecutive patients whowere currently experiencing a pain problem. Patients received various physicaltherapy interventions between baseline and follow-up.Results: On the basis of patterns of scoring for pain catastrophizing and depressedmood, 4 subgroups of participants were found. Belonging to a subgroup withelevated levels of either pain catastrophizing or depressed mood at baseline wasrelated to the absence of improvement and elevated levels of disability after physicaltherapy interventions. Furthermore, elevated levels of both variables were related tothe highest levels of disability.Limitations: The analyses relied on self-report. Neither treatment content norpain-related fear was measured. The sample was a mixture of participants reportingacute pain and subacute pain.Conclusions: The results stress the importance of assessing and targeting prog-nostic factors. Moreover, the results suggest the need to tailor treatments to matchpatterns of prognostic factors and the need to target depressed mood and paincatastrophizing in physical therapy interventions.
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| 29. |
- Bergbom, Sofia, 1982-, et al.
(author)
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When matching fails : Understanding the process of matching pain-disability treatment to risk profile
-
Other publication (other academic/artistic)abstract
- Purpose A previous study [1] showed that matching people at risk for pain-related disability to an intervention aimed at targeting their psychological problem profile did not, as hypothesized, improve the effect of the intervention. Methodological issues were suggested to explain the lack of differential effect. It was questioned whether the profiles used to allocate people to treatment were adequate. The aim of this study was to investigate if the risk profiles used to determine matching were sufficiently stable and valid by comparing the original profiles withprofiles constructed using other methods.Methods Ninety-five people suffering musculoskeletal problems were screened, profiled, and matched to workplace based early interventions according to profiles. We studied stability and validity of their psychological risk profiles by investigating their concordance at different time points. People were originally assigned to profiles at inclusion, using a brief screening questionnaire. Then, they were profiled just before treatment start,using the same items. Finally, they were profiled again at treatment start, using extensive questionnaires. Concordance among the three sets of profiles was investigated.Results Profiles at inclusion were unstable until treatment start. People moved from profiles with more severe elevations in psychological variables, to a profile with moderate elevations. Concordance between the two means of profiling at treatment start was better; the brief screening and the extensive questionnaires assigned people to similar profiles.Conclusions Risk level may be determined with brief instruments at an early stage of problem development. However, profiles and targets for interventions should be determined immediately prior to treatment start, preferably using full questionnaires.
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| 30. |
- Bergbom, Sofia, 1982-, et al.
(author)
-
When matching fails : understanding the process of matching pain-disability treatment to risk profile
- 2015
-
In: Journal of occupational rehabilitation. - : Springer Science and Business Media LLC. - 1053-0487 .- 1573-3688. ; 25:3, s. 518-526
-
Journal article (peer-reviewed)abstract
- Purpose: A previous study (Bergbom et al. in J Occup Rehabil, 2013) showed that matching people at risk for pain-related disability to an intervention aimed at targeting their psychological problem profile did not, as hypothesized, improve the effect of the intervention. Methodological issues were suggested to explain the lack of differential effect. It was questioned whether the profiles used to allocate people to treatment were adequate. The aim of this study was to investigate if the risk profiles used to determine matching were sufficiently stable and valid by comparing the original profiles with profiles constructed using other methods.Methods: Ninety-five people suffering musculoskeletal problems were screened, profiled, and matched to workplace based early interventions according to profiles. We studied stability and validity of their psychological risk profiles by investigating their concordance at different time points. People were originally assigned to profiles at inclusion, using a brief screening questionnaire. Then, they were profiled just before treatment start, using the same items. Finally, they were profiled again at treatment start, using extensive questionnaires. Concordance among the three sets of profiles was investigated.Results: Profiles at inclusion were unstable until treatment start. People moved from profiles with more severe elevations in psychological variables, to a profile with moderate elevations. Concordance between the two means of profiling at treatment start was better; the brief screening and the extensive questionnaires assigned people to similar profiles.Conclusions: Risk level may be determined with brief instruments at an early stage of problem development. However, profiles and targets for interventions should be determined immediately prior to treatment start, preferably using full questionnaires.
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| 31. |
- Berglund, Per, et al.
(author)
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Linking Education and Research : A Roadmap for Higher Education Institutions at the Dawn of the Knowledge Society
- 2019
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In: Linking education and research. - Basel, Switzerland : MDPI. ; , s. 11-33
-
Book chapter (other academic/artistic)abstract
- In an era characterized by a move towards a “knowledge society”, universities are central in fostering “knowledgeability”, that is the reflexive understanding of knowledge in knowledge societies. The objective of “knowledgeability” can be met through creating a stronger link between education and research. Furthermore, overall student performance, for example in critical thinking and problem solving, can be improved if research-related activities are incorporated into the curriculum.The aim of this paper is to use international examples to discuss the research- education nexus from four different perspectives, namely context, policy, implementation and quality, with case studies from higher education institutions in Singapore and Sweden.We suggest that different integrative technologies can be used to enhance the links, but it will be essential to consider the inputs of training, service and support in using new technology. Interestingly, the act of evaluating the link between education and research will increase awareness of this linkage by stakeholders involved in both education and research. In turn the link can be strengthened, contributing to increased quality in both education and research.
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| 32. |
- Bergman Nordgren, Lise, et al.
(author)
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Polariserad debatt om riktlinjer skymmer viktiga frågor
- 2018
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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.
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| 33. |
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| 34. |
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| 35. |
- Besen, Elyssa, et al.
(author)
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The role of pain catastrophizing as a mediator in the work disability process following acute low back pain
- 2017
-
In: Journal of applied biobehavioral research. - : John Wiley & Sons. - 1071-2089 .- 1751-9861. ; 22:1
-
Journal article (peer-reviewed)abstract
- The purpose of this study was to assess pain catastrophizing as a mediator in the relationships between pain and recovery expectations with work limitations and functional disability in a working population experiencing acute low back pain (LBP). Workers (n=241) with acute, work-related LBP completed measures of pain and injury at medical intake and then the Pain Catastrophizing Scale (PCS) shortly after the initial intake visit. At 3-months follow-up, measures of work limitations and functional disability were administered. Structural equation modeling was used to assess whether the PCS mediated longitudinal associations between pain and recovery expectations with perceived disability and work limitations. The PCS score completely mediated the relationship between initial pain intensity and 3-month perceptions of disability (40% explained) and work limitations (29% explained). The PCS also completely mediated the longitudinal relationship between pain recovery expectations and 3-month disability (50% explained) and work limitations (40% explained). Effective clinical management during this acute phase of LBP might be improved by incorporating early interventions to reduce catastrophizing in caseswhere pain catastrophizing may be especially problematic.
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| 36. |
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| 37. |
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| 38. |
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| 39. |
- Boersma, Katja, professor, 1973-, et al.
(author)
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Efficacy of a transdiagnostic emotion-focused exposure treatment for chronic pain patients with comorbid anxiety and depression : a randomized controlled trial
- 2019
-
In: Pain. - : Lippincott Williams & Wilkins. - 0304-3959 .- 1872-6623. ; 160:8, s. 1708-1718
-
Journal article (peer-reviewed)abstract
- The comorbidity between chronic pain and emotional problems has proven difficult to address with current treatment options. This study addresses the efficacy of a transdiagnostic emotion-focused exposure treatment ("hybrid") for chronic pain patients with comorbid emotional problems. Adults (n = 115) with chronic musculoskeletal pain and functional and emotional problems were included in a 2-centre, parallel randomized controlled, open-label trial comparing this treatment to an active control condition receiving a guided Internet-delivered pain management treatment based on CBT principles (iCBT). The hybrid treatment (n = 58, 10-16 sessions) integrates exposure in vivo for chronic pain based on the fear-avoidance model with an emotion-regulation approach informed by procedures in Dialectical Behavior Therapy. The iCBT (n = 57; 8 treatment modules) addresses topics such as pain education, coping strategies, relaxation, problem solving, stress, and sleep management using standard CBT techniques. Patient-reported outcomes were assessed before and after treatment as well as at a 9-month primary end point. Across conditions, 78% participants completed post-treatment and 81% follow-up assessment. Intent-to-treat analyses showed that the hybrid had a significantly better post-treatment outcome on pain catastrophizing (d = 0.39) and pain interference (d = 0.63) and significantly better follow-up outcomes on depression (d = 0.43) and pain interference (d = 0.51). There were no differences on anxiety and pain intensity. Observed proportions of clinically significant improvement favoured the hybrid on all but one comparison, but no statistically significant differences were observed. We conclude that the hybrid emotion-focused treatment may be considered an acceptable, credible, and efficacious treatment option for chronic pain patients with comorbid emotional problems.
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| 40. |
- Boersma, Katja, professor, 1973-, et al.
(author)
-
Emotion regulation in chronic pain patients with emotional difficulties : A DBT-inspired exposure treatment
- 2016
-
Conference paper (other academic/artistic)abstract
- Co-occuring pain and emotional difficulties are strikingly common and a true challenge in the clinic. Nearly all pain patients suffer from some kind of emotional distress. Difficulties with emotion regulation has been pointed out as one core process, which may explain the high co-occurrence of pain and emotional distress. Current treatments have not succeeded in helping pain patients with high levels of emotional distress, and therefore a new treatment approach has been developed, based on emotion regulation theory, DBT and exposure techniques. This presentation will describe the theory behind this new intervention and present preliminary data from a randomized controlled trial in patients with chronic pain and emotional distress. This trial compares the effectiveness of a DBT inspired exposure treatment with internet-based CBT for chronic pain.
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| 41. |
- Boersma, Katja, professor, 1973-, et al.
(author)
-
Expectancy, fear and pain in the prediction of chronic pain and disability : A prospective analysis
- 2006
-
In: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 10:6, s. 551-557
-
Journal article (peer-reviewed)abstract
- Studies with (sub) acute back pain patients show that negative expectancies predict pain and disability at a one-year follow up. Yet, it is not clear how expectations relate to other factors in the development of chronic disability such as pain and fear. This study investigates the relationship between expectations, pain-related fear and pain and studies how these variables are related to the development of chronic pain and disability. Subjects (N = 141) with back and/or neck pain (duration <1 year) were recruited via primary care. They completed measures on pain, expectancy, pain-related fear (pain-related negative affect and fear avoidance beliefs) and function. A one-year follow up was conducted with regard to pain and function. It was found that pain, expectancy, pain-related fear and function were strongly interrelated. In the cross-sectional analyses negative expectancies were best explained by frequent pain and a belief in an underlying and serious medical problem. Prospectively, negative expectancy, negative affect and a belief that activity may result in (re) injury or increased pain, explained unique variance in both pain and function at one-year follow up. In conclusion, expectancy, negative affect and fear avoidance beliefs are interrelated constructs that have predictive value for future pain and disability. Clinically, it can be helpful to inquire about beliefs, expectancy and distress as an indication of risk as well as to guide intervention. However, the strong interrelations between the variables call for precaution in treating them as if they were separate entities existing in reality.
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| 42. |
- Boersma, Katja, 1973-, et al.
(author)
-
Exposure-based cognitive behavioral therapy for irritable bowel syndrome : A single-case experimental design across 13 subjects
- 2016
-
In: Cognitive Behaviour Therapy. - Oxon, United Kingdom : Routledge. - 1650-6073 .- 1651-2316. ; 45:6, s. 415-430
-
Journal article (peer-reviewed)abstract
- Irritable bowel syndrome (IBS) is a highly prevalent disorder with a significant impact on quality of life. The presence of psychological symptoms in IBS patients such as catastrophic worry and behavioral avoidance suggests the possible efficacy of cognitive behavioral interventions. Exposure-based cognitive behavioral therapy (CBT) has proven to be a promising approach but has only been investigated in a few studies and mainly via the Internet. Therefore, the aims of this study were to extend and replicate previous findings and to evaluate whether an individual, face-to-face, exposure-based CBT leads to improvement in gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life in IBS patients. Thirteen patients with IBS according to Rome III criteria participated in a single-case experimental study using a five-week baseline and a subsequent twelve-session intervention phase focusing on psycho-education, mindfulness and in vivo exposure. Standardized measurement of gastrointestinal symptoms, pain catastrophizing, avoidance behavior and quality of life was conducted weekly during baseline as well as intervention phase and at six-month follow-up. Results showed that over 70% of patients improved significantly on gastrointestinal symptoms, pain catastrophizing, and quality of life. Effects on avoidance behavior were modest. These results strengthen and extend earlier findings and provide further support for the efficacy of exposure-based strategies for IBS.
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| 43. |
- Boersma, Katja, 1973-, et al.
(author)
-
From acute pain to chronic disability : psychosocial processes in the development of chronic musculoskeletal pain and disability
- 2014
-
In: Handbook of musculoskeletal pain and disability disorders in the workplace. - New York : Springer. - 9781493906116 - 9781493906123 ; , s. 205-217
-
Book chapter (peer-reviewed)abstract
- In the last decades, there has been a clear recognition of the importance of psychosocial factors in the explanation of chronic musculoskeletal pain. It is generally accepted that chronic musculoskeletal pain and disability has multiple causes, a view that is summarized in the so-called biopsychosocial models (Gatchel, Peng, Peters, Fuchs, & Turk, 2007). However, psychosocial factors have proven to be important predictors of chronic pain and disability already early on in acute and subacute stages of pain. A range of reviews conclude that factors, such as depression, anxiety, pain beliefs, catastrophizing, and coping behaviors, play a primary role in the transition from acute to chronic pain and disability (Linton, 2002; Main, Sullivan, & Watson, 2007; Nicholas, Linton, Watson, & Main, 2011). This supports the notion that psychosocial factors are preferably viewed as an integrated part of musculoskeletal pain, not only in the rehabilitation of chronic problems but also in prevention in the subacute stages.
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| 44. |
- Boersma, Katja, 1973-, et al.
(author)
-
Lowering fear-avoidance and enhancing function through exposure in vivo : a multiple baseline study across six patients with back pain
- 2004
-
In: Pain. - : Elsevier. - 0304-3959 .- 1872-6623. ; 108:1-2, s. 8-16
-
Journal article (peer-reviewed)abstract
- This study investigated the effects of an exposure in vivo treatment for chronic pain patients with high levels of fear and avoidance. The fear-avoidance model offers an enticing explanation of why some back pain patients develop persistent disability, stressing the role of catastrophic interpretations; largely fueled by beliefs and expectations that activity will cause injury and will worsen the pain problem. Recently, an exposure in vivo treatment was developed that aims to enhance function by directly addressing these fears and expectations. The purpose of this study was to describe the short-term, consequent effect of an exposure in vivo treatment. The study employed a multiple baseline design with six patients who were selected based on their high levels of fear and avoidance. The results demonstrated clear decreases in rated fear and avoidance beliefs while function increased substantially. These improvements were observed even though rated pain intensity actually decreased somewhat. Thus, the results replicate and extend the findings of previous studies to a new setting, with other therapists and a new research design. These results, together with the initial studies, provide a basis for pursuing and further developing the exposure technique and to test it in group designs with larger samples.
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| 45. |
- Breivik, Harald, et al.
(author)
-
High risk of depression and suicide attempt among chronic pain patients : always explore catastrophizing and suicide thoughts when evaluating chronic pain patients
- 2014
-
In: Scandinavian Journal of Pain. - : Elsevier. - 1877-8860 .- 1877-8879. ; 5:1, s. 1-3
-
Journal article (peer-reviewed)abstract
- A grave but important problem in the treatment of pain, is suicide. While many chronic pain problems are not life threatening, self-harming, e.g. suicide attempts are. Clinicians may ask whether suicide-risk is actually higher in a population of patients with chronic pain. In this issue of the Scandinavian Journal of Pain Elsebeth Stenager and her co-workers publish an important study in which they have combined the WHO research database in Odense on all suicide attempts in Southern Denmark with the database on patients referred to the multidisciplinary university pain clinic in Odense,Denmark. The WHO-database comprises only suicide attempts that resulted in hospitalization, i.e. they were all serious attempts. Suicide attempts of less serious character are not registered, so the research database is probably underestimating the real number of suicide attempts. The unique strength of the Stenager et al. study is that their data are strong, objective data fromc ombining the registry data on suicide attempts with their chronic pain patient-data. This enables the researchers to compare the pain–patient–population with the general population. We are not aware of any similar research on the real risk of suicide-attempts among the many who are burdened by chronic non-cancer pain.
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| 46. |
- Buer, Nina, 1960-, et al.
(author)
-
Fear-avoidance beliefs and catastrophizing : occurrence and risk factor in back pain and ADL in the general population
- 2002
-
In: Pain. - 0304-3959 .- 1872-6623. ; 99:3, s. 485-491
-
Journal article (peer-reviewed)abstract
- Fear-avoidance beliefs and catastrophizing have been shown to be powerful cognitions in the process of developing chronic pain problems and there is a need for increased knowledge in early stages of pain.The objectives of this study were therefore, firstly, to examine the occurrence of fear-avoidance beliefs and catastrophizing in groups with different degrees of non-chronic spinal pain in a general population, and secondly to assess if fear-avoidance beliefs and catastrophizing were related to current ratings of pain and activities of daily living (ADL).The study was a part of a population based back pain project and the study sample consisted of 917 men and women, 35-45 years old, either pain-free or with non-chronic spinal pain. The results showed that fear-avoidance beliefs as well as catastrophizing occur in this general population of non-patients. The levels were moderate and in catastrophizing a 'dose-response' pattern was seen, such that more the catastrophizing was, the more was pain. The study showed two relationships, which were between fear-avoidance and ADL as well as between catastrophizing and pain intensity. Logistic regression analyses were performed with 95% confidence intervals and the odds ratio for fear-avoidance beliefs and ADL was 2.5 and for catastrophizing and pain 1.8, both with confidence interval above unity. The results suggest that fear-avoidance beliefs and catastrophizing may play an active part in the transition from acute to chronic pain and clinical implications include screening and early intervention. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.
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| 47. |
- Carstens, Johan K. P., 1979-, et al.
(author)
-
Effects of validating communication on recall during a pain-task in healthy participants
- 2017
-
In: Scandinavian Journal of Pain. - : Walter de Gruyter. - 1877-8860 .- 1877-8879. ; 17, s. 118-125
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Increasing recall of instructions and advice in a pain consultation is important, since it is a prerequisite for adherence to treatment recommendations. However, interference due to pain-related distress may result in poor recall. Whereas there are some indications that recall can be increased by empathic communication that reduces interference, this interesting possibility remains largely untested experimentally. The current experiment aimed at studying effects of empathic communication, and more specifically validation, on recall during a pain test and possible mediators and moderators of this effect.METHOD: Participants received either validating (N=25) or invalidating responses (N=25) from the experimenter during a pain provoking task, followed by self-report measures of interference (affect, situational pain catastrophizing) and recall (accurate and false memories of words).RESULTS: As expected, the validated group exhibited higher accurate recall and less false memories following the pain test as compared to the invalidated group. This was partly due to the effect of interference being counteracted by moderating the relationship between pain catastrophizing and recall.CONCLUSION: These novel results suggest that validating communication can counteract interference due to pain catastrophizing on recall, at least in a controlled experimental setting.IMPLICATIONS: Good communication by health professionals is of utmost importance for adherence to pain management. The current results expand our knowledge on the effects of pain communication by establishing and explaining a clear link between empathic communication and recall, highlighting the role of pain catastrophizing.
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| 48. |
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| 49. |
- Coenen, Pieter, et al.
(author)
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The association of adolescent spinal-pain-related absenteeism with early adulthood work absenteeism : A six-year follow-up data from a population-based cohort
- 2018
-
In: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health. - 0355-3140 .- 1795-990X. ; 44:5, s. 521-529
-
Journal article (peer-reviewed)abstract
- Objectives: Spinal (ie, back and neck) pain often develops as early as during adolescence and can set a trajectory for later life. However, whether early-life spinal-pain-related behavioral responses of missing school/work are predictive of future work absenteeism is yet unknown. We assessed the association of adolescent spinal-pain-related work or school absenteeism with early adulthood work absenteeism in a prospective population-based cohort.Methods: Six year follow-up data from the Western Australian Pregnancy Cohort (Raine) study were used (N=476; with a 54% response rate). At age 17, participants reported spinal pain (using the Nordic questionnaire) and adolescent spinal-pain-related work/school absenteeism (with a single item question). Annual total and health-related work absenteeism was assessed with the Health and Work Performance questionnaire distributed in four quarterly text messages during the 23rd year of age. We modelled the association of adolescent spinal-pain-related absenteeism with work absenteeism during early adulthood, using negative binomial regression adjusting for sex, occupation and comorbidities.Results: Participants with adolescent low-back or neck pain with work/school absenteeism reported higher total work absenteeism in early adulthood [148.7, standard deviation (SD) 243.4 hours/year], than those without pain [43.7 (SD 95.2) hours/year); incidence rate ratio 3.4 (95% CI 1.2-9.2)]. Comparable findings were found when considering low-back and neck separately, and when considering health-related absenteeism.Conclusions: We found a more than three-fold higher risk of work absenteeism in early adulthood among those with adolescent spinal-pain-related absenteeism, compared to those without. These findings suggest that, to keep a sustainable workforce, pain prevention and management should focus on pain-related behaviors as early as in adolescence.
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| 50. |
- Danielsson, Nanette S., 1967-, et al.
(author)
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Sleep Disturbance and Depressive Symptoms in Adolescence : The Role of Catastrophic Worry
- 2013
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In: Journal of Youth and Adolescence. - : Springer Science and Business Media LLC. - 0047-2891 .- 1573-6601. ; 42:8, s. 1223-1233
-
Journal article (peer-reviewed)abstract
- Depression is a common and debilitating disorder in adolescence. Sleep disturbances and depression often co-occur with sleep disturbances frequently preceding depression. The current study investigated whether catastrophic worry, a potential cognitive vulnerability, mediates the relationship between adolescent sleep disturbances and depressive symptoms, as well as whether there are gender differences in this relationship. High school students, ages 16-18, n = 1,760, 49 % girls, completed annual health surveys including reports of sleep disturbance, catastrophic worry, and depressive symptoms. Sleep disturbances predicted depressive symptoms 1-year later. Catastrophic worry partially mediated the relationship. Girls reported more sleep disturbances, depressive symptoms, and catastrophic worry relative to boys. The results, however, were similar regardless of gender. Sleep disturbances and catastrophic worry may provide school nurses, psychologists, teachers, and parents with non-gender specific early indicators of risk for depression. Several potentially important practical implications, including suggestions for intervention and prevention programs, are highlighted.
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