| 1. |
- Almén, Niclas, 1971-, et al.
(author)
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Bättre arbetsmiljö ger fler psykologer
- 2018
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In: Dagens medicin. - Stockholm. - 1402-1943. ; :27 augusti
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Journal article (pop. science, debate, etc.)abstract
- I vårt debattinlägg betonade vi att psykisk ohälsa är ett vida utbrett problem och att patienter inte får effektiv hjälp eftersom det finns ett omfattande underskott på psykologer inom primärvården. Vi var kritiska till Centerpartiets vårdreform som riskerar medföra att problemet förvärras eftersom det inte skulle öka antalet psykologer vilka kan genomföra de behandlingar som Socialstyrelsen rekommenderar.
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| 2. |
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| 3. |
- Bjärtå, Anna, 1974-, et al.
(author)
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Assessing Severity of Psychological Distress Among Refugees With the Refugee Health Screener, 13-Item Version
- 2018
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In: Journal of Nervous and Mental Disease. - 0022-3018 .- 1539-736X. ; 206:11, s. 834-839
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Journal article (peer-reviewed)abstract
- The recent inflow of refugees to Sweden has put pressure on health care as well as revealing a need for methods regarding assessment of refugees' mental health status. The present study investigated the use of the Refugee Health Screener (RHS; Hollifield et al., 2013) to distinguish among severity levels of symptoms of psychological distress in refugees. Refugees residing in asylum accommodations (n = 510) were screened with RHS-13, together with screeners for depression, anxiety, and posttraumatic stress disorder (PTSD). Risk for mild, moderate, or severe levels of depression, anxiety, or/and PTSD was used as screening proxy. Receiver operating characteristic analysis rendered cutoff scores of 11, 18, and 25, for mild, moderate, and severe symptoms, respectively. Evaluated against each symptom scale separately, cutoffs performed well. Cutoff 11, previously identified by Hollifield et al. (2016), was also confirmed. However, utilization of additional cutoffs could improve refugee mental health by guiding clinical decision making.
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| 4. |
- Ekdahl, Johanna, 1978-, et al.
(author)
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Vulvovaginal pain from a fear-avoidance perspective : a prospective study among female university students in Sweden
- 2018
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In: International Journal of Sexual Health. - : Routledge. - 1931-7611 .- 1931-762X. ; 30:1, s. 49-59
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Journal article (peer-reviewed)abstract
- Objectives: To examine how fear-avoidance influences vulvovaginal pain and sexual function over time.Method: At baseline and at 10-month follow-up, self-report measures for sexual- and fear avoidance factors were obtained from 483 female university students with and without self-reported vulvovaginal pain.Results: Individuals with pain at both times reported lower sexual function, and higher levels of fear-avoidance compared to the pain-free group. Fear-avoidance beliefs predicted the occurrence of vulvovaginal pain at follow up and the level of pain intensity.Conclusion: The results points to the relevance of the components of the fear-avoidance model in vulvovaginal pain over time.
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| 5. |
- Engman, Linnea, 1987-, et al.
(author)
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Avoiding or enduring painful sex? : A prospective study of coping and psychosexual function in vulvovaginal pain
- 2018
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In: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 22:8, s. 1388-1398
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Journal article (peer-reviewed)abstract
- Background: Recurring vulvovaginal pain is common, with evident effects on affected women's lives. Little is known about how affected women cope with painful sexual activities and how coping relates to pain intensity and psychosexual functioning over time. This prospective study explored the impact of avoidance and endurance on sexual function over time. Additionally, patterns of coping were studied on an individual level to increase knowledge about coping and its relation to psychosexual functioning.Methods: One hundred and seventeen women, 18-35years old, with recurring vulvovaginal pain answered questionnaires at two measurement points, five months apart, assessing avoidance and endurance coping, pain intensity and psychosexual functioning. A multiple regression model explored the predictive value of avoidance and endurance on sexual function over time. Cluster analyses investigated patterns of coping and stability within the clusters. These subgroups were compared on psychosexual outcomes.Results: Avoidance at baseline was the only significant predictor of sexual function five months later. Distinct and stable subgroups with different patterns of coping were identified, where avoidance and endurance coping were used both separately and combined. Women who both avoided and endured had the most unfavourable outcomes in terms of psychosexual functioning.Conclusions: Avoidance of sexual activities was related to reduced sexual function over time, which calls for attention and clinical interventions targeting avoidance. Additionally, women who both avoid and endure sexual activities despite pain possibly need tailored interventions, as women with this coping pattern reported the lowest levels of psychosexual functioning.Significance: In this prospective study, avoidance of sexual activities predicted sexual function over time, when controlling for pain intensity. Subgroups of women using distinct patterns of coping were identified. Those who both avoided and endured had the lowest levels of psychosexual functioning.
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| 6. |
- Leiler, Anna, et al.
(author)
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High levels of psychological distress among asylum seekers and refugees in Sweden
- 2018
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Conference paper (other academic/artistic)abstract
- In 2015 there was an unforeseen increase of refugees worldwide. In order to face the high rates of psychological distress refugees suffer, the AMIR-project created a model for early assessment and intervention of mental health among refugees. Previous research might not be applicable to the groups seeking asylum in Europe from 2015, so as a first step, a study aiming to estimate the prevalence of mental health problems was conducted. Methods. Five hundred and ten refugees participated at open screenings conducted at refugee housing facilities. Of the participants, 367 were asylum seekers and 143 had received a residence permit. Instruments included measures of depressive symptoms, anxiety, risk of having PTSD and quality of life.Preliminary results. A high percentage of individuals (56-58.4%) reported clinically significant levels of depression, anxiety and risk of having PTSD. Prevalence estimates were significantly higher among asylum seekers than among those who had received their residence permit. Quality of life was generally rated below population norms and correlated significantly with mental health outcomes.Conclusions. Individuals residing in refugee housing facilities show high levels of psychological distress. Asylum seekers are worse off than those having received a residence permit. Actions should be taken to improve conditions in housing facilities, to shorten the time awaiting the asylum decision and to provide psychosocial support to help individuals manage their distress during the time of waiting.Key words: Refugee – asylum seeker – mental health – quality of life - prevalence
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| 7. |
- Rondung, Elisabet, 1980-, et al.
(author)
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Comparing Internet-Based Cognitive Behavioral Therapy With Standard Care for Women With Fear of Birth : Randomized Controlled Trial
- 2018
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In: JMIR Mental Health. - : JMIR PUBLICATIONS, INC. - 2368-7959. ; 5:3
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Journal article (peer-reviewed)abstract
- Background: Although many pregnant women report fear related to the approaching birth, no consensus exists on how fear of birth should be handled in clinical care.Objective: This randomized controlled trial aimed to compare the efficacy of a guided internet-based self-help program based on cognitive behavioral therapy (guided ICBT) with standard care on the levels of fear of birth in a sample of pregnant women reporting fear of birth.Methods: This nonblinded, multicenter randomized controlled trial with a parallel design was conducted at three study centers (hospitals) in Sweden. Recruitment commenced at the ultrasound screening examination during gestational weeks 17-20. The therapist-guided ICBT intervention was inspired by the Unified protocol for transdiagnostic treatment of emotional disorders and consisted of 8 treatment modules and 1 module for postpartum follow-up. The aim was to help participants observe and understand their fear of birth and find new ways of coping with difficult thoughts and emotions Standard care was offered in the three different study regions. The primary outcome was self-assessed levels of fear of birth, measured using the Fear of Birth Scale.Results: We included 258 pregnant women reporting clinically significant levels of fear of birth (guided ICBT group, 127; standard care group, 131). Of the 127 women randomized to the guided ICBT group, 103 (81%) commenced treatment, 60 (47%) moved on to the second module, and only 13 (10%) finished >= 4 modules. The levels of fear of birth did not differ between the intervention groups postintervention. At 1-year postpartum follow-up, participants in the guided ICBT group exhibited significantly lower levels of fear of birth (U=3674.00, z=-1.97, P=.049, Cohen d=0.28, 95% CI -0.01 to 0.57). Using the linear mixed models analysis, an overall decrease in the levels of fear of birth over time was found (P <= .001), along with a significant interaction between time and intervention, showing a larger reduction in fear of birth in the guided ICBT group over time (F-1,(192).(538) =4.96, P=.03).Conclusions: Fear of birth decreased over time in both intervention groups; while the decrease was slightly larger in the guided ICBT group, the main effect of time alone, regardless of treatment allocation, was most evident. Poor treatment adherence to guided ICBT implies low feasibility and acceptance of this treatment.
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| 8. |
- Rondung, Elisabet, 1980-, et al.
(author)
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Heterogeneity in childbirth related fear or anxiety
- 2018
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In: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 59:6, s. 634-643
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Journal article (peer-reviewed)abstract
- Many pregnant women experience fear, worry or anxiety relating to the upcoming childbirth. The aim of this cross-sectional study was to investigate possible subgroups in a sample of 206 pregnant women (mean age 29.4 years), reporting fear of birth in mid-pregnancy. Comparisons were made between nulliparous and parous women. In a series of cluster analyses, validated psychological instruments were used to cluster women based on their psychological profiles. A five-cluster solution was suggested, with the clusters characterized by: overall low symptom load, general high symptom load, medium symptom load with high performance-based self-esteem, blood- and injection phobic anxiety, and specific anxiety symptoms. Nulliparous women were more likely to report clinically relevant levels of blood- and injection phobia (OR = 2.57, 95% CI 1.09–6.01), while parous women more often reported previous negative experiences in health care (OR 1.93, 95% CI 1.09–3.39) or previous trauma (OR 2.90, 95% CI 1.58–5.32). The results indicate that women reporting fear of birth are a heterogeneous group. In order to individualize treatment, psychological characteristics may be of greater importance than parity in identifying relevant subgroups.
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| 9. |
- Rondung, Elisabet, 1980-
(author)
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Psychological perspectives on fear of birth : heterogeneity, mechanisms and treatment
- 2018
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Doctoral thesis (other academic/artistic)abstract
- Although it is medically safe to give birth in most western countries, the vast majority of pregnant women experience some kind of anxiety, fear or worry in relation to their pregnancy or the upcoming childbirth. Most pregnant women find ways of coping with these issues but, for many, fear of birth is a significant source of distress during pregnancy, with negative consequences both when giving birth and in the postpartum period.Previous research on fear of birth has for the most part had a medical perspective, investigating risk factors and consequences of this form of fear or anxiety, along with studies evaluating different forms of interventions. The general aim of this thesis was to approach fear of birth from a psychological perspective, by exploring the role of psychological factors in this form of fear, worry or anxiety.Four studies are included in the thesis. The first study is a randomized controlled trial, in which we compared a guided Internet-delivered self-help program, based on cognitive behavior therapy (guided ICBT), with standard care (midwife led fear of birth specific counseling), for the treatment of fear of birth. Despite poor adherence to the guided ICBT, the results showed a similar reduction in fear levels during pregnancy in both groups, with lower levels of fear of birth in the guided ICBT group one year after birth. The second study is a narrative literature review. This study adopted a psychological perspective on the existing literature describing fear of birth, with a special focus on the specificity of this form of fear or anxiety, the pathways of fear acquisition, and the physiological, cognitive and behavioral aspects of fear of birth. Using systematic procedures for the literature search, inclusion and exclusion, 89 original research papers were included and summarized in the study. The aim of the third study was to explore possible heterogeneity among pregnant women reporting high levels of fear of birth. Comparisons between primiparous and multiparous women revealed that these groups were very similar in their levels of fear of birth as well as in the psychological variables investigated. Using a series of hierarchical and non-hierarchical cluster analyses, five possible subgroups based on psychological characteristics were identified, pointing to psychological heterogeneity among women fearing birth. In the fourth study, our aim was to take a first step in trying to identify psychological mechanisms relevant to the understanding of fear of birth. In this study, pain catastrophizing and intolerance of uncertainty were clear predictors of fear of birth, while parity was not.Taken together, the results of the four studies included in this thesis indicate that fear of birth is a concept in need of further investigation, and that psychological perspectives could offer an important contribution to our understanding of this form of fear or anxiety. Women fearing birth seem to be a heterogeneous group, and psychological characteristics (e.g. pain catastrophizing, or catastrophizing in general, and intolerance of uncertainty) might be of greater importance than parity in both describing this diversity and understanding the development and maintenance of fear of birth. Treating fear of birth using guided ICBT can be challenging, and before introducing this form of treatment as an alternative, further refinement and evaluation of the methods are needed.
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