| 1. |
- Bergbom, Sofia, 1982-
(author)
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Matchmaking in pain practice : challenges and possibilities
- 2014
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Doctoral thesis (other academic/artistic)abstract
- All people experience pain and for some people, acute pain may over time develop into long-term disabling problems. Already at an early stage, it is possible to identify people at risk for long-term problems and psychologically oriented interventions have been shown to successfully prevent future disability. However, not all people are helped by treatment and there is room for improvement. Moreover, subgroups of people suffering from pain, with different profiles of psychological factors have been identified, indicating that people with pain problems differ. The first aim of this dissertation was to improve the understanding of how people differ. The second aim was to use these individual differences and to match people to psychological treatment based on their psychological profile. The third aim was to explore what happens during treatment that might be important for treatment outcome.The findings show that people who belonged to subgroups with elevated levels of psychological factors had less favorable outcomes over time, despite treatment, than people with no elevations. Moreover, people with elevations in several psychological factors had even less favorable outcomes. Psychological treatments aimed at preventing future disability performed well, but using profiles to match people to treatment did not improve outcomes further; people who were matched to a treatment and people who were unmatched had similar outcomes. However, the profiles used for matching were unstable over time and there is need to improve the identification of psychological variables used for treatment matching. Finally, a number of psychological factors were shown to be valuable targets for treatment; if the treatments successfully produced change in people’s thoughts and emotions related to pain the treatment outcomes were better. The findings were summarized in a flow chart showing the recommended clinical approach to people seekinghealth care for acute pain problems.
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| 2. |
- Danielsson, Nanette S.
(author)
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Disturbed sleep and emotion : a developmental perspective
- 2013
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Doctoral thesis (other academic/artistic)abstract
- Sleep disturbances are not only defining features, but also diagnostic criteria for most psychiatric disorders. Recently, researchers have proposed a theoretic role for sleep disturbances in emotion dysregulation, subsequently linking neurobiological processes and psychopathology. Most prior research examining the potential role for sleep disturbance in emotion dysregulation is from a neurophysiological or clinical perspective, or primarily focused on maintaining processes. Less well understood are how sleep disturbances may be involved at the levels of predisposition, precipitation, and perpetuation of emotion dysregulation concurrently and over time.This dissertation presents findings from three studies that were designed to expand on what is known about sleep disturbance in the predisposition, precipitation, and perpetuation of emotion dysregulation. Study 1 examined the long-term relation between sleep-onset problems and neuroticism over twenty-years. Adolescent sleep-onset posed risk (predisposition) for neuroticism in midlife, not vice versa. Study 2 investigated the effects of 3-nights partial sleep deprivation (5-hours total time in bed) on the positive and negative affect and emotions of otherwise healthy adults. Following partial sleep deprivation, people reported significant reductions in positive affect and emotions compared to rested people (precipitation). The only impact on negative emotions was on the discrete level. Sleep deprived peo-ple reported significantly more irritability, loathing, hostility, and shakiness compared to controls. Study 3 measured adolescent sleep disturbances, depressive symptoms, and catastrophic worry. In addition to direct risk, sleep disturbances posed a non-gender specific risk for depressive symptoms one-year later through catastrophic worry (perpetuation). Overall, the results provide support for the role of sleep disturbances in the predis-position, precipitation, and perpetuation of emotion dysregulation. An implication is that sleep disturbances and catastrophic worry are two po-tentially modifiable markers of risk for emotion dysregulation.
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| 3. |
- Flink, Ida K., 1980-
(author)
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Stuck in mind : the role of catastrophizing in pain
- 2011
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Doctoral thesis (other academic/artistic)abstract
- Pain catastrophizing emerges in the literature as one of the most important psychological determinants of both pain itself and the negative outcomes commonly associated with it. However, despite decades of research confirming the impact of catastrophizing, there are still areas that remain unexplored or in which the surface has only been scratched. The overall aim of this dissertation was to expand existing knowledge about catastrophizing and to advance the theoretical framework around the concept.The role of catastrophizing was explored in three distinct areas: during pain in childbirth, in exposure treatment for back pain patients, and in a problem solving context. The findings from the three studies confirmed the vital role of catastrophizing in these areas. Firstly, catastrophizing played a critical role in pain in childbirth; women who catastrophized reported labor pain as more intense and the subsequent recovery period as longer than women who did not catastrophize. Secondly, catastrophizing was identified as a moderator of treatment effect in exposure in vivo for back pain patients with pain-related fear; patients who catastrophized were not helped by the exposure. Thirdly, catastrophizing played a role in a problem solving context; although this is in line with contemporary models such as the misdirected problem solving model, the results suggested a somewhat different pathway to this previous model. Taken together, these findings underscore the instrumental role of catastrophizing in diverse areas and imply a need for catastrophzing to be assessed and addressed in clinical contexts. In addition, the findings highlight a need for further development of the theoretical framework around catastrophizing as well as treatment interventions that directly target catastrophizing. Based on these needs, a new model of catastrophizing was proposed – a model of catastrophizing from a process perspective. In this model, the proposed function of catastrophizing is to down-regulate negative affect, as a form of internal avoidance. The model is a complement to existing theoretical models and provides a framework for developing treatment interventions that directly target catastrophizing, for example by problem solving skills training. Successful interventions for people who catastrophize would lead to several gains – for the individual in less suffering and increased ability to handle pain problems, and for society as a whole in reduced costs for health care for these individuals.
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| 4. |
- Glatz, Terese, 1983-
(author)
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Parent's reactions to adolescents' problematic behaviors
- 2011
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Doctoral thesis (other academic/artistic)abstract
- Traditional socialization theories suggest that parents shape their children, and parents’ socialization strategies are decided upon largely independent of the children. These ideas, however, have received criticism. In this dissertation, I focus on how children and adolescents influence their parents’ behaviors. Specifically, I examine parents’ reactions to problematic behaviors in their adolescents. In the three studies, I presented theoretical models that offered explanations why parents react as they do to problematic behaviors in their adolescents. In these models, parents’ cognitions worked as mechanisms to explain their subsequent reactions. The overall pattern in the studies was that parents tended to shift in cognitions about their own role as parents and their adolescents’ behaviors when they were faced with problematic behaviors, which influenced their behaviors toward their adolescents. In Study I, parents became less strictly opposed to adolescent drinking when they encountered their adolescents intoxicated. This reaction was explained by a reduction in dissonance between their attitudes to adolescent drinking and their knowledge of their own adolescents’ drinking. In Study II and Study III, parents of adolescents with hyperactivity, impulsivity, and attention problems (HIA) reported that their adolescents did not respond to their attempts to correct their behaviors. This cognition made them feel powerless and, as a consequence, they increased in negative behaviors and decreased in positive parenting strategies. In these two studies, parents decreased in their thoughts of being able to deal with their adolescents’ misbehaviors. In addition, as was shown in the third study, these cognitions seem to be influenced by parents’ earlier experiences with their first-born children. In sum, the results of this dissertation suggest that adolescents influence their parents’ cognitions and behaviors. Further, the results highlight the importance of focusing on how parents’ ways of thinking influence their parenting strategies.
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| 5. |
- Kakihara, Fumiko, 1974-
(author)
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Incorporating adolescents' interpretations and feelings about parents into models of parental control
- 2010
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Doctoral thesis (other academic/artistic)abstract
- Much of research on parental control has focused on how parents can effectively regulate their adolescents. Barber contributed to this by theorizing that there are two types of control that have import during adolescence: behavioral and psychological control. In his framework, the absence of behavioral control increases adolescents’ externalizing because adolescents’ self-regulation is not promoted, whereas the presence of psychological control increases adolescents’ internalizing problems, through impinging on their psychological and emotional well-being. These conceptualizations, however, focus on parents’ actions, goals, and intentions. Little attention has been given to how adolescents interpret and respond to control in light of their own needs and goals. In this dissertation, a model was tested in which adolescents’ interpretations and responses reflecting their psychological needs are the intermediate processes linking control and adjustment. Using experimental methods, Study I revealed that adolescents interpret parental control. Contrary to Barber’s ideas, adolescents interpreted both high levels of behavioral control and psychological control equally negatively. Compared to moderate levels, adolescents viewed high levels as meaning that parents were being intrusive, and that adolescents were less competent and mattered less to parents. In Study II and III, the full model was tested. The results were consistent with the proposal that when control leads to youths feeling more over-controlled or less connected to their parents, their adjustment suffers. Thus, the effects of control were mediated by adolescents’ responses. In addition, this process depended on adolescents’ age and gender, as well as their acceptance of parental authority. Older adolescents, boys, and those who accept less parental authority tended to view control more negatively than younger adolescents, girls, and those who accept less authority. Across the three studies, the results suggest that when youths’ needs are taken into account, behavioral control acts much like psychological control, impeding adolescents’ adjustment. Discussion focuses on the implications for further research on parental control. It is concluded that it is important to consider adolescents’ perspectives or agency in theoretical accounts of parental control. Parents can only try to control their adolescents, and their success or failure should be viewed as a joint process involving both parents and their adolescents.
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| 6. |
- Koutakis, Nikolaus, 1968-
(author)
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Preventing underage alcohol drinking through working with parents
- 2011
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Doctoral thesis (other academic/artistic)abstract
- An evaluation is reported of an alcohol prevention program that targets parents in order to decrease drinking among 13-16 year-olds. The evaluation was performed in a quasi-experimental study with a matched control group and annual assessments, directed at youths and their parents independently, in a longitudinal intention-to-treat design. The implementation of the program centered around three different schools located in inner city, public housing and small town areas. Participants in the study were 900 students entering junior high school and their parents. The intervention consisted in information and mailings directed at parents, which advised them to maintain restrictive attitudes towards underage alcohol drinking, and to encourage their youths’ involvement in organized leisure activities. The implementation successfully influenced parents’ attitudes to underage drinking, but failed to increase youth participation in organized activities. At post-test at grade 9, youths in the intervention group reported less drunkenness and delinquency. Effect sizes were 0.35 for drunkenness and 0.38 for delinquency. Two subsamples, early starters in drinking and early delinquents, were analyzed separately in addition to full sample. Results from analyses of these subsamples yielded effect sizes of .52 for drunkenness and .32 for delinquency. The findings were similar for boys and girls. The effects of the intervention were not moderated by type of community. The main results were replicated in a latent growth curve analysis, which too the clustered nature of the data into account. It is concluded that working via parents is an effective way of reducing underage drinking and delinquency.
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| 7. |
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| 8. |
- Mousavi-Nasab, S. M. Hossein, 1979-
(author)
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Engaged lifestyle and episodic and semantic memory : longitudinal studies from the betula project
- 2012
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Doctoral thesis (other academic/artistic)abstract
- This dissertation examines whether some aspects of engaged lifestyle, marital status and leisure activity, influence memory performance in adulthood and old age. Direct effects and indirect effects, via health, are investigated. All the studies in the dissertation examine participants in the Betula project, aged 35 to 85 years. Study I investigates whether there are reliable effects of marital status on memory function in a large sample of participants in adulthood and old age. The results demonstrate that marriage has an influence on some specific types of memory functions. They show that there are significant differences between married and single individuals in episodic memory, but not in semantic memory. Also, the extent of decline in episodic memory was found to be significantly larger for singles and widowed individuals than for married people over five years. Study II examines the relationships between different types of social and cognitive activities and episodic and semantic memory. The results show that a unidirectional effect of social activity on episodic memory was detectable on all test occasions. Also, episodic memory predicted change in cognitive activity during all test waves. However, there were no significant effects with regard to semantic memory and leisure activity in either direction. Study III explores longitudinally whetherengaged lifestyle, including marriage and leisure activity, directly affects memory performance, or whether the effect is mediated by health. The overall results demonstrate that marriage predicts episodic memory function directly. Leisure activity can also predict episodic memory performance ten years later, but indirectly via health. An active and engaged lifestyle can protect people against memory decline. The positive impact of engaged lifestyle on memory performance is discussed in terms of cognitive reserve theory, and in relation to the decrease in distress afforded by social support from other people.
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| 9. |
- Norell-Clarke, Annika, 1979-
(author)
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Cogito, ergo insomnis : I think, therefore I am sleepless
- 2014
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Doctoral thesis (other academic/artistic)abstract
- Insomnia is a common health complaint that often becomes a persistent problem. The theoretical frameworks for understanding and treating insomnia have mostly been behavioural, yet the importance of cognitive processes has received greater attention over the years. The overall aim of this dissertation was to expand the knowledge on the processes from the Cognitive Model of Insomnia by investigating them in novel contexts. Study I examined the outcomes from cognitive therapy for insomnia on adolescents. Study II explored the relationship between cognitive processes and the association with remission and persistence of insomnia in the general population. Lastly, Study III investigated if cognitive processes mediated between cognitive behavioural therapy for insomnia (CBT-I) and outcomes of insomnia and depressive severity in a sample of people with insomnia comorbid with depressive problems.The findings show that cognitive therapy for insomnia affected sleep for adolescents, thus this is a promising treatment option for this age group. Further, it was found that cognitive processes distinguished between adults with normal sleep and persistent insomnia. For people with insomnia, elevated sleep-related worry at baseline increased the risk of reporting persistent insomnia later on, whereas a lowering of selective attention and monitoring, and safety behaviours over time increased the likelihood of remission from insomnia. This has clinical implications for insomnia assessment and treatment, as well as theoretical implications, and warrants further research. CBT-I was associated with greater reductions in dysfunctional beliefs and sleep-related safety behaviours compared to control treatment. Dysfunctional beliefs mediated between CBT-I and insomnia severity and depressive severity respectively. This supports the importance of negative thought content in both insomnia and depression.
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| 10. |
- Salihovic, Selma, 1983-
(author)
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A developmental perspective on psychopathic traits in adolescence
- 2013
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Doctoral thesis (other academic/artistic)abstract
- More than half of known crime is committed by 5-6% of the criminal population. Who are these people? Research has shown that it is likely that a majority of these individuals are characterized by having a psychopathic personality. Interestingly, research has shown that psychopathic features are not unique to adults. Youths with high levels of psychopathic traits resemble adult psychopaths in that they are the most frequent, severe and aggressive, delinquent offenders. There is less knowledge, however, about the development of these traits in adolescence, and many fundamental questions have yet to be addressed. The aim of this dissertation is to begin to examine a few of these questions, such as: a) the role of parents andtheir behavior in the development of psychopathic personality in adolescence; b) patterns of stability and change in psychopathic traits during adolescence; and c) whether or not subgroups of adolescents with high levels of psychopathic traits can be identified in a normative community sample. Overall, the results reveal that a psychopathic personality profile characterizes a small group of youths at particular risk of negative development. This group, as well as showing high levels of psychopathic traits throughout adolescence, report high levels of delinquent behavior, and also experience dysfunctional relationships with their parents. Further, the results reveal important subgroups of adolescents with high levels of psychopathic traits, much in accordance with the literature on adult psychopaths. Whereas one group expresses the personality style of primary psychopaths, another is more aggressive, impulsive, and anxious than the other. Taken together, the results of this dissertation suggest that some adolescents are at particular risk of future negative development. Implications for theory and practice, and for the directions of future research, are discussed.
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