| 1. |
- Alfonsson, Sven, et al.
(författare)
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The Self-Compassion Scale-Short Form : Psychometric evaluation in one non-clinical and two clinical Swedish samples
- 2023
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 30:3, s. 631-642
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Tidskriftsartikel (refereegranskat)abstract
- Background: Self-compassion has been defined as the ability to be with one's feelings of suffering in a warm and caring way. Research has shown a negative association between self-compassion and mental illness, and that low self-compassion can make psychotherapeutic effects less likely. The ability to measure a patient's self-compassion in a fast and reliable way is therefore important in investigating effects of psychotherapies. The aim of the present study was to evaluate the psychometric properties of the Swedish version of the Self-Compassion Scale-Short Form (SCS-SF) in both non-clinical (NC) and clinical samples.Methods: Cross-sectional data were gathered in a NC community sample (n = 1,089), an eating disorder (ED) sample (n = 253) and a borderline personality disorder (BPD) sample (n = 151). All participants were asked to complete a number of questionnaires, including the SCS-SF, and 121 participants in the NC sample repeated the assessment after 2 weeks for test-retest analysis.Results: Confirmatory factor analyses supported the first-order model suggested in previous research. Good internal consistency (Cronbach's alpha = 0.78-0.87) and test-retest reliability (intra-class correlation = 0.84) were demonstrated for the entire scale. Results also showed good convergent validity, demonstrating moderate negative associations between self-compassion and mental illnesses, as expected, and acceptable divergent validity, demonstrating weak positive associations between self-compassion and quality of life and mindfulness.Discussion: The correlations between the SCS-SF and the instruments used for validation were weaker in the clinical samples than the NC sample. This may be due to difficulties measuring these constructs or that the associations differ somewhat between different populations, which could warrant further research. The results added some support to the assumption that self-compassion may overlap with mindfulness yet still represents a distinct construct.Conclusions: Analyses of the SCS-SF provided evidence of adequate to good psychometric properties, supporting use of the scale's total sum score and a first-order factor structure. This is in accordance with previous evaluations of the SCS-SF, suggesting that it is a reliable and time-efficient instrument for measuring a general level of self-compassion. This may be important when evaluating psychotherapy and investigating self-compassion and its influence on psychiatric illness.
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| 2. |
- Andersson, Erik, et al.
(författare)
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Testing the Mediating Effects of Obsessive Beliefs in Internet-Based Cognitive Behaviour Therapy for Obsessive-Compulsive Disorder : Results from a Randomized Controlled Trial
- 2015
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley-Blackwell. - 1063-3995 .- 1099-0879. ; 22:6, s. 722-732
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Tidskriftsartikel (refereegranskat)abstract
- Although cognitive interventions for obsessive-compulsive disorder (OCD) have been tested in randomized trials, there are few trials that have tested the specific mechanisms of cognitive interventions, i.e. how they achieve their effects. In this study, we aimed to investigate the mediating effects of a short cognitive intervention in the treatment of OCD and used data from a recently conducted randomized controlled trial where 101 participants were allocated to either Internet-based CBT (ICBT) or to a control condition. Obsessive beliefs were measured at pre-treatment, at the time they had received the cognitive intervention, and also at post-treatment. Weekly OCD symptoms were measured throughout the 10 weeks of treatment. We hypothesized that (1) the ICBT group would have greater reductions in obsessive beliefs (controlling for change in OCD symptoms) after completing the cognitive intervention, and that (2) this reduction would, in turn, predict greater OCD symptom reduction throughout the rest of the treatment period. Contrary to our expectations, the longitudinal mediation analysis indicated that (1) being randomized to ICBT actually increased the degree of obsessive beliefs after receiving the cognitive intervention at weeks 1-3, and (2) increase in obsessive beliefs predicted better outcome later in treatment. However, when repeating the analysis using cross-sectional data at post-treatment, the results were in line with the initial hypotheses. Results were replicated when the control condition received ICBT. We conclude that, although obsessive beliefs were significantly reduced at post-treatment for the ICBT group, early increase rather than decrease in obsessive beliefs predicted favourable outcome. Copyright (C) 2014 John Wiley & Sons, Ltd.
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| 3. |
- Beckman, Maria, et al.
(författare)
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A behaviour-based coding tool for assessing supervisors' adherence and competence : Findings from a motivational interviewing implementation study
- 2022
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 29:6, s. 1942-1949
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Tidskriftsartikel (refereegranskat)abstract
- Supervision seems to be an essential part of therapist training and thus also of implementing evidence-based practices. However, there is a shortage of valid and reliable instruments for objective assessment of supervision competence that include both global measures and frequency counts of behaviour—two essential aspects of supervisory competence. This study tests the internal consistency and inter-rater reliability of an assessment tool that includes both these measures. Additionally, strategies and techniques used by 10 supervisors in 35 Motivational interviewing supervision sessions are described. Codings were conducted after two separate coding training sessions. The internal consistency across the global measures was acceptable (α = 0.70; 0.71). After the second training, the inter-rater reliabilities for all frequency counts were in the moderate to good range, except for two that were in the poor range; inter-rater reliability for one of the four global measures was in the moderate range, and three were in the poor range. A prerequisite for identifying specific supervisor skills central to the development of therapist skills, teaching these skills to supervisors and performing quality assurance of supervision, is to create instruments that can measure these behaviours. This study is a step in that direction.
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| 4. |
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| 5. |
- Carvalho, S. A., et al.
(författare)
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A pilot randomized controlled trial of online acceptance and commitment therapy versus compassion-focused therapy for chronic illness
- 2022
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Ingår i: Clinical Psychology & Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 29:2, s. 524-541
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Tidskriftsartikel (refereegranskat)abstract
- Literature suggests that acceptance and commitment therapy (ACT) is effective in improving well-being and in reducing psychopathological symptoms commonly experienced by people with chronic illness (CI). Compassion-focused therapy (CFT) reduces psychological distress, especially in individuals with high levels of shame and self-criticism, but few studies have explored CFT in CI. Additionally, studies almost exclusively compared ACT and CFT with inactive controls (wait-list; treatment as usual). Also, there is an interest in developing cost-effective mental health solutions, such as low-intensity online psychological interventions. This randomized controlled trial (RCT) aimed to assess the acceptability and compare the efficacy of four-session online ACT (n = 25) and CFT (n = 24) interventions in a sample of people with CI. Results showed both interventions were acceptable, with attrition rates at post-intervention comparable to those found in similar studies (around 50%). Intention-to-treat analyses showed that participants presented significantly less illness-related shame, less uncompassionate self-responding and more valued living after the intervention, although no difference was found between conditions. Results were sustained at 3- and 6-month follow-up. Results did not find statistical differences between conditions through reliable change index (RCI). Correlation between demographics and RCI showed that, at post-intervention, younger participants presented more behavioural awareness, men presented more valued action, and participants with CI for shorter periods presented less uncompassionate self-responding and less anxiety. Results suggest that low-intensity (four sessions) online ACT and CFT are cost-effective approaches to promote mental health of individuals with CI. Results and limitations are thoroughly discussed.
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| 6. |
- Carvalho, Sérgio A., et al.
(författare)
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Cognitive fusion and depressive symptoms in women with chronic pain : A longitudinal growth curve modelling study over 12 months
- 2019
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 26:5, s. 616-625
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Tidskriftsartikel (refereegranskat)abstract
- This study aims to (a) explore individual differences in women with chronic pain (CP) in regard to pain intensity, functional impairment, cognitive fusion, and depressive symptoms and (b) longitudinally test whether cognitive fusion is a significant predictor of depression symptoms, while controlling for pain intensity and functional impairment, over a 12-month period. This study follows a longitudinal design and was conducted in a sample of 86 women with CP who responded to an online battery of questionnaires in three equally spaced assessment moments. In order to explore the growth trajectory of variables of interest, latent growth curve models were examined. Also, correlation analyses were conducted between demographic and illness-related variables and depressive symptoms, as well as between all variables in all assessment moments. Cognitive fusion and functional impairment (but not pain intensity) were significantly associated with baseline levels of depressive symptoms. Cognitive fusion significantly predicted the growth trajectory of depressive symptoms, whereas pain intensity and functional impairment did not. No demographic (age, marital status, education, socio-economic) nor illness-related variables (number of CP diagnoses, duration of CP, taking medication) were associated with depressive symptoms at any point. These results suggest that the trajectory of depressive symptoms in women with CP is not predicted by the intensity of pain nor pain-related functional impairment, but rather by the tendency to get entangled with internal experiences (e.g., thoughts, emotions, and physical sensations), which may or may not be related to pain-specific contents. Clinical implications are discussed.
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| 7. |
- Chaplin, John, 1955, et al.
(författare)
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DISABKIDS Smiley questionnaire. The TAKE 6 Assisted Health-related Quality of Life measure for 4 to 7 year olds.
- 2008
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1099-0879 .- 1063-3995. ; 15:3, s. 173-180
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Tidskriftsartikel (refereegranskat)abstract
- The DISABKIDS Smiley TAKE 6 was developed to meet the need for a research instrument to measure the health-related quality of life (HrQoL) of children 4–7 years old. TAKE 6 is a European generic assisted-report questionnaire with a proxy version. The items of TAKE 6, scored using a five-point Likert scale, cover a single HrQoL domain. Child and parent focus groups identified the statements which, following a European pilot study, were reduced to six items. A field study of 435 children with a chronic disease in seven European countries revealed that the questionnaire had good reliability (inter-class correlation 0.69), had convergent validity with the KINDL-R (child quality of life questionnaire-revised) (rho 0.60) and satisfactory construct validity showing separation between severity and different medical conditions. The questionnaire was understandable by young children and could be completed within two minutes.
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| 8. |
- Crane, Catherine, et al.
(författare)
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Suicidal imagery in a previously depressed community sample
- 2012
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Ingår i: Clinical Psychology and Psychotherapy. - : WILEY. - 1063-3995 .- 1099-0879. ; 19:1, s. 57-69
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Tidskriftsartikel (refereegranskat)abstract
- This study sought to replicate previous findings of vivid suicide-related imagery in previously suicidal patients in a community sample of adults with a history of depression. Twenty-seven participants were interviewed regarding suicidal imagery. Seventeen participants reported prior suicidal ideation or behaviour in the clinical assessment, and the vast majority of these also reported experiencing suicide-related imagery when at their most depressed and despairing, in many cases in the form of flash-forwards to imagined future suicidal acts. Interestingly, five of the 10 participants who did not report suicidal ideation or behaviour in the clinical interview also described prominent imagery related to themes of death and suicide, but in several cases, these images were associated with meanings that seemed to act to reduce the likelihood of subsequent suicidal acts. Severity of prior suicidality was associated with lower levels of imagery-related distress and higher levels of imagery-related comfort. These findings support the idea that suicide-related imagery is an important component in the phenomenology of depression and despair and hint at potentially important differences in the meaning associated with such imagery between those individuals who report experiencing suicidal ideation or behaviour when depressed and those who do not. The findings are consistent with Joiner's model of acquired capability for suicide through habituation to pain and fear of suicide and suggest that it may be useful to tackle such imagery directly in the treatment of suicidal patients. Copyright (C) 2011 John Wiley & Sons, Ltd.
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| 9. |
- Davies, Charlotte, et al.
(författare)
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Involuntary Memories after a Positive Film Are Dampened by a Visuospatial Task : Unhelpful in Depression but Helpful in Mania?
- 2012
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Ingår i: Clinical Psychology and Psychotherapy. - : WILEY. - 1063-3995 .- 1099-0879. ; 19:4, s. 341-351
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Tidskriftsartikel (refereegranskat)abstract
- Spontaneous negative mental images have been extensively researched due to the crucial role they play in conditions such as post-traumatic stress disorder. However, people can also experience spontaneous positive mental images, and these are little understood. Positive images may play a role in promoting healthy positive mood and may be lacking in conditions such as depression. However, they may also occur in problematic states of elevated mood, such as in bipolar disorder. Can we apply an understanding of spontaneous imagery gained by the study of spontaneous negative images to spontaneous positive images? In an analogue of the trauma film studies, 69 volunteers viewed an explicitly positive (rather than traumatic) film. Participants were randomly allocated post-film either to perform a visuospatial task (the computer game Tetris) or to a no-task control condition. Viewing the film enhanced positive mood and immediately post-film increased goal setting on a questionnaire measure. The film was successful in generating involuntary memories of specific scenes over the following week. As predicted, compared with the control condition, participants in the visuospatial task condition reported significantly fewer involuntary memories from the film in a diary over the subsequent week. Furthermore, scores on a recognition memory test at 1?week indicated an impairment in voluntary recall of the film in the visuospatial task condition. Clinical implications regarding the modulation of positive imagery after a positive emotional experience are discussed. Generally, boosting positive imagery may be a useful strategy for the recovery of depressed mood. Copyright (C) 2012 John Wiley & Sons, Ltd.
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| 10. |
- Elfström, Magnus, et al.
(författare)
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Validation of the Swedish version of the clinical outcomes in routine evaluation outcome measure (CORE-OM)
- 2013
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 20:5, s. 447-455
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to perform an initial validation of a Swedish translation of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM). The CORE-OM is a broad self-report instrument of psychological problems, designed as an outcome measure for evaluating the effects of psychological therapy. Participants included a non-clinical group of 229 university students and a clinical group of 619 persons from four primary care sites. The Swedish CORE-OM showed excellent acceptability, high internal consistency and test-retest reliability, as well as acceptable convergent validity. There was strong differentiation of the clinical and non-clinical samples, with the clinical group scoring significantly more psychological problems than the non-clinical group. Sensitivity to change was demonstrated in psychological treatments in primary care. Overall, the psychometric characteristics of the Swedish CORE-OM were very similar to the original UK data. Nevertheless, the validity of the Swedish version needs to be examined more in detail, in larger and more diverse samples. Our results so far, however, provide support for using the Swedish CORE-OM as a psychological problems measure. To our knowledge, there are few other relatively short measures in Swedish that are free to reprint that meet the demands for psychometric properties and utility in primary care settings in which patients typically present a broad range of psychological problems.
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| 11. |
- Fauskanger Bjaastad, Jon, et al.
(författare)
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Do clinical experience, formal cognitive behavioural therapy training, adherence, and competence predict outcome in cognitive behavioural therapy for anxiety disorders in youth?
- 2018
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 25:6, s. 865-877
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim was to investigate whether clinical experience, formal cognitive behavioural therapy (CBT) training, adherence, and competence predict outcome in CBT for anxiety disorders in youth. Method Videotapes (N = 181) from the sessions in a randomized controlled effectiveness trial (Wergeland et al., 2014, Behaviour Research and Therapy, 57, 1-12) comprising youth (N = 182, M age = 11.5 years) with mixed anxiety disorders were assessed for treatment adherence and competence using the Competence and Adherence Scale for CBT for anxiety disorders in youth (Bjaastad et al., 2016, Psychological Assessment, 28, 908-916). Therapists' (N = 17) clinical experience and educational background were assessed. Participants completed a diagnostic interview (Anxiety Disorders Interview Schedule, child and parent versions) and an anxiety symptom measure (Spence Children's Anxiety Scale, child and parent versions) at pretreatment, posttreatment, and 1-year follow-up. Results Higher therapist adherence was related to better treatment outcomes, whereas number of years of clinical experience and competence was related to worse outcomes. However, these findings were not consistent across informants and the time points for the assessments. Interaction effects suggested that competence among therapists with formal CBT training was related to better patient outcomes. Conclusions Therapist adherence, competence, and clinical experience are associated with outcomes of manualized CBT for youth anxiety disorders, but mixed findings indicate the need for more research in this area.
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| 12. |
- Gold, Stephanie H., et al.
(författare)
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Therapeutic Alliance in the Personal Therapy of Graduate Clinicians : Relationship to the Alliance and Outcomes of Their Patients
- 2015
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 22:4, s. 304-316
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Tidskriftsartikel (refereegranskat)abstract
- This is the first study to explore the relationship between aspects of a therapists' personal therapy and the subsequent psychotherapy process and outcome they perform. The participants were 14 graduate clinicians with various experiences in personal therapy, who treated 54 outpatients engaged in short-term psychodynamic psychotherapy at a university-based community clinic. Results demonstrated non-significant relationships between the duration of personal therapy as well as a graduate clinician's overall alliance in their personal therapy with alliance ratings made by themselves as therapists and their patients, as well as the number of psychotherapy sessions attended by patients. However, the clinician's personal therapy alliance was significant and positively related to their patients' rating of outcome. Additionally, a significant negative correlation was observed between the degree of perceived helpfulness in their personal therapy and how these clinicians rated alliances, as the therapist, with their patients. The current findings suggest a relationship between a clinician's personal therapy alliance and the outcome of treatments they conduct. Implications for clinical training and practice as well as future research are discussed.Key Practitioner MessageWhile graduate clinician's personal therapy alliance was not significantly related to their patients' ratings of alliance, it was related to their patients' ratings of outcome.Trainee satisfaction with or quality of their personal therapy may be a more relevant than the amount or duration of their treatment in regard to the process and outcomes of their patients.The findings from retrospective clinician surveys on the helpfulness of their personal therapy may not be entirely consistent with empirical examination of these issues.The relation of personal therapy and outcome may work through improving the therapist's level of adaptive functioning (i.e., psychological-relational-emotional health) and future research should examine this simpler, more parsimonious, explanation for our findings.
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| 13. |
- Hesser, Hugo, 1982-
(författare)
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Identifying causal mechanisms in psychotherapy : what can we learn from causal mediation analysis?
- 2022
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 29:3, s. 1050-1058
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Tidskriftsartikel (refereegranskat)abstract
- Despite widespread interest in the development of process-based psychotherapies, little is still known about the underlying processes that underpin our most effective therapies. Statistical mediation analysis is a commonly used analytical method to evaluate how, or by which processes, a therapy causes change in an outcome. Causal mediation analysis (CMA) represents a new advancement in mediation analysis that employs causally-defined direct and indirect effects based on potential outcomes. These novel ideas and analytical techniques have been characterized as revolutionary in epidemiology and biostatistics, although they are not (yet) widely known among researchers in clinical psychology. In this paper, I outline the fundamental concepts underlying CMA, clarify the differences between the CMA approach and the traditional approach to mediation, and identify two important data analytical aspects that have been emphasized as a result of these recent advancements. To illustrate the key ideas, assumptions, and mathematical definitions intuitively, an applied clinical example from a previously published randomized controlled trial is used. CMA's main contributions are discussed, as well as some of the key challenges. Finally, it is argued that the most significant contribution of CMA is the formalization of mediation in a unified causal framework with clear assumptions.
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| 14. |
- Hesser, Hugo, 1982-, et al.
(författare)
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Preventing intimate partner violence via the Internet : A randomized controlled trial of emotion-regulation and conflict-management training for individuals with aggression problems
- 2017
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 24:5, s. 1163-1177
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this randomized controlled trial was to investigate the effect of an Internet-delivered cognitive behaviour therapy (iCBT), which incorporated emotion-regulation and conflict-resolution techniques, on intimate partner violence (IPV). Another aim was to test the theoretical underpinnings of the treatment model using mediation analysis.Method: Sixty-five participants with aggression problems in intimate adult relationships were recruited from the community and were randomly assigned to iCBT or to a monitored waitlist control. Participants were assessed with standardized self-report measures of IPV or aggression (Multidimensional Measure of Emotional Abuse, Revised Conflict Tactics Scale, and Aggression Questionnaire), relationship quality (Dyadic Adjustment Scale), anxiety or depression symptomatology (Patient Health Questionnaire; Generalized Anxiety Disorder Screener), at pretreatment, posttreatment (8weeks), and 1-year follow-up. Process variables (subscales of Dysfunctional and Emotional Regulation Scale and Anger Rumination Scale) were assessed weekly over the active treatment phase.Results: Robust linear regression analysis of all randomized participants showed significant treatment effects on emotional abuse relative to control at postassessment. Mediation analysis using growth curve modeling revealed that the treatment effect was partially mediated by changes in emotion-regulation ability. Controlled effects on secondary outcomes were also observed. Analyses of uncontrolled effects indicted that gains on IPV were maintained at 1-year follow-up.Conclusions: iCBT focusing on enhancing conflict-resolution skills and emotion-regulation ability has the potential to reduce IPV among self-recruited individuals with mild forms of abusive behaviour in intimate relationships. Emotion-regulation ability is potentially a key therapeutic process of change.Key Practitioner Message:Internet-delivered clinician-guided cognitive behaviour therapy is a viable treatment option for reducing intimate partner violence among self-recruited individuals with mild forms of abusive behaviour.For persons who display patterns of frequent and severe violence, other treatments are most likely needed.Emotion-regulation training is potentially a key therapeutic component that ought to be incorporated in interventions targeting IPV.
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| 15. |
- Hesser, Hugo, et al.
(författare)
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Therapeutic Alliance in Internet-Delivered Cognitive Behaviour Therapy for Depression or Generalized Anxiety
- 2017
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 24:2, s. 451-461
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Tidskriftsartikel (refereegranskat)abstract
- There has been limited research on therapeutic alliance in the context of therapist-assisted Internet-delivered cognitive behaviour therapy (ICBT) when delivered in clinical practice. The present study investigated therapeutic alliance in ICBT delivered to patients seeking treatment for symptoms of depression (n=83) or generalized anxiety (n=112) as part of an open dissemination trial. ICBT was provided by 27 registered therapists or 28 graduate students working in six geographically dispersed clinics; therapist-assistance was delivered primarily through secure messages and occasionally telephone calls. The Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 were collected pre-, mid- and post-treatment, and the Therapeutic Alliance Questionnaire was assessed mid- and post-treatment. Therapeutic alliance ratings were high both at mid-treatment and post-treatment (above 80%). There was no relationship between therapeutic alliance ratings and improvement on primary outcomes. Among patients treated for depression, lower ratings of mid-treatment alliance were associated with concurrent treatment by a psychiatrist and fewer phone calls and emails from their therapist. Among patients treated for generalized anxiety, ratings of mid-treatment alliance were higher among registered providers as compared to graduate students. Multiple directions for future research on therapeutic alliance in ICBT are offered, including suggestions for developing a new measure of therapeutic alliance specific to ICBT and measuring therapeutic alliance throughout the treatment process.
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| 16. |
- Kanstrup, Marie, et al.
(författare)
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A single case series using visuospatial task interference to reduce the number of visual intrusive memories of trauma with refugees
- 2021
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 28:1, s. 109-123
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Tidskriftsartikel (refereegranskat)abstract
- The current worldwide so-called "refugee crisis" has led to an unprecedented increase in migration globally. Because of stigma and language barriers, mental health care for refugees is limited. There is a need for novel, scalable psychological interventions. We investigated whether a brief behavioural intervention involving a memory reminder cue and Tetris gameplay on a smartphone reduces intrusive memories in refugees using a single case (N= 4) ABAB withdrawal design. The baseline phase (A) included a no-intervention week; the intervention phase (B) included an in-person session with the researchers, comprised of the behavioural intervention followed by self-guided use in daily life the following week. All participants reported a decrease in intrusive memories after the intervention, as well as functional improvements (e.g., in concentration). Importantly, participants rated the intervention as feasible and acceptable. As one in-person session was effective in persistent intrusion reduction, ABAB proved not to be the optimal design as intrusions did not rebound in the withdrawal phase. Findings are promising and highlight the need for further evaluation of novel interventions for mental health problems in refugees.
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| 17. |
- Khan, Sammyh, 1979-, et al.
(författare)
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Making connections : Social identification with new treatment groups for lifestyle management of severe obesity
- 2020
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 27:5, s. 686-696
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Tidskriftsartikel (refereegranskat)abstract
- Groups are regularly used to deliver healthcare services, including the management of obesity, and there is growing evidence that patients' experiences of such groups fundamentally shape treatment effects. This study investigated factors related to patients' shared social identity formed within the context of a treatment group for the management of severe obesity. A cross-sectional survey was administered to patients registered with a UK medical obesity service and enrolled on a group-based education and support programme. Patients (N = 78; M-BMI = 48 on entry to the service) completed measures of group demographics (e.g., group membership continuity) and psychosocial variables (e.g., past experiences of weight discrimination) and reported their social identification with the treatment group. The results showed that patients identified with the treatment group to the extent that there was continuity in membership across the programme and they perceived themselves more centrally in terms of their weight status. Weight centrality was negatively associated with external social support and positively associated with experiences of weight discrimination. Group continuity was positively correlated with session attendance frequency. Patients presenting to clinical treatment services with severe obesity often do so after sustained weight loss failure and exposure to negative societal experiences. This study highlights that providing a treatment environment wherein these experiences can be shared with other patients may provide common ground for development of a new, positive social identity that can structure programme engagement and progression.
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| 18. |
- Knutsson, Jens, et al.
(författare)
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Adolescent and Family-Focused Cognitive-Behavioural Therapy for Paediatric Bipolar Disorders: A Case Series
- 2017
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Ingår i: Clinical Psychology & Psychotherapy. - : Wiley. - 1099-0879 .- 1063-3995. ; 24:3, s. 589-617
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Tidskriftsartikel (refereegranskat)abstract
- Although pharmacological treatments can help alleviate mood symptoms in youth with paediatric bipolar disorder (PBD), residual symptoms still commonly persist. In many cases, these symptoms seriously affect the social and psychological development of children and adolescents suffering from PBD. Complementary interventions, such as psychosocial and psychoeducational treatments, can help children and their families manage mood regulation and other challenges throughout childhood and adolescence. However, most research on such interventions has focused on children, single-family psychoeducation, and individual cognitive behavioural therapy. The present study, conducted in Sweden, used a case-series design to explore whether child- and family-focused cognitive behavioural therapy (CFF-CBT) for PBD, adapted from children (8-12 years) to adolescents (13-18 years) and applied in a multi-family format, could help reduce symptoms, improve psychosocial functioning, increase parents' knowledge of and skills for coping with the disorder, and improve family expressed emotion for adolescents with PBD. Furthermore, we aimed to assess whether the effects of such CFF-CBT are maintained at a one-year follow-up. Seven adolescents and 11 parents in two multi-family groups received twelve sessions of CFF-CBT. Self-rating questionnaires and clinical observations were used to evaluate clinically significant changes for individual cases. The results suggest that CFF-CBT is feasible to deliver in an outpatient psychiatric setting and may be effective for developing parents' skills and knowledge for coping with PBD, increasing adolescents' psychosocial functioning, and improving family climate. The results are in line with previous findings on CFF-CBT for children with PBD, suggesting that CFF-CBT is a valuable adjunctive treatment for adolescents with PBD. Key Practitioner Message: Preliminary evidence indicates that CFF-CBT (RAINBOW) is both acceptable and an important complement to pharmacological treatment for adolescents suffering from paediatric bipolar disorder (PBD). Adolescent PBD populations show a high degree of comorbidity and individual clinical presentations that influence treatment results. Families show a large variation in ability to participate and benefit from RAINBOW treatment. Assessing and addressing pre-treatment environmental stressors and family climate during treatment is important for optimizing treatment effect. Symptoms of PBD fluctuate and new episodes can occur spontaneously. It is therefore important to follow PBD symptoms over time to draw more precise conclusions on treatment effects. When assessing treatment effects on psychiatric symptoms, social functioning, and family climate, it is important to use multiple rating sources, as ratings can vary considerably between adolescents, parents, and clinicians.
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| 19. |
- Kraepelien, Martin, et al.
(författare)
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The effects of component-specific treatment compliance in individually tailored internet-based treatment
- 2019
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 26:3, s. 298-308
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to explore the effects of treatment compliance in a guided individually tailored internet-based treatment (TAIL) in relation to depression and co-morbid symptoms. Compliance with the homework in the different treatment components in TAIL, each aimed at a specific condition, was rated for 207 participants by independent assessors. Six subgroups (n = 34-131) were constructed consisting of participants with co-occurring symptoms of worry, panic, social anxiety, stress, insomnia, or pain. For each group, hierarchical regression was used to investigate whether the total sum of compliance points, Overall Compliance, predicted reductions in depression and in condition-specific symptoms. Also, in each subgroup, it was tested whether working with specific treatment components, Specific Compliance, predicted reduction of the targeted symptoms. Overall Compliance predicted 15% of the reduction in depression symptoms. For participants with worry, panic, social anxiety, stress, or insomnia, Overall Compliance also predicted symptom reductions in that specific condition. Specific Compliance predicted reduction in the targeted symptoms for participants with social anxiety, stress, and insomnia. Specific Compliance with stress and insomnia components also predicted reductions in depression. Our results strengthen the importance of compliance in internet-based treatments. Because compliance with stress and insomnia components was particularly important for broad symptom reductions, these conditions should not be ignored when treating patients with co-morbid symptoms.
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| 20. |
- Kuutmann, Klara, et al.
(författare)
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Exploring In-Session Focus on the Patient-Therapist Relationship : Patient Characteristics, Process and Outcome
- 2012
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 19:3, s. 187-202
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Forskningsöversikt (refereegranskat)abstract
- This study explored the amount of in-session focus on the patienttherapist relationship during early treatment with patient pre-treatment interpersonal style, personality pathology, patient ratings of session process and outcome. The sample consisted of 76 outpatients engaged in short-term psychodynamic psychotherapy. Results showed that higher levels of pre-treatment personality pathology and interpersonal problems were positively related to a greater focus on the patienttherapist relationship early in treatment. This was especially true for patients with a cold/distant interpersonal style and low self-esteem. Moreover, these two patient pre-treatment characteristics demonstrated a significant change over the course of therapy. These post-treatment changes also demonstrated a significant relationship with greater early treatment focus on the patienttherapist relationship. In addition, we found an interaction effect between quality of object relations (i.e., higher levels of object relations) and greater early treatment focus on the patienttherapist relationship with subsequent changes in patient cold/distant interpersonal problems. Greater in-session focus on the therapeutic relationship was not significantly related to patient ratings of session process. Implications for clinical practice and future research are discussed.
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| 21. |
- Larsson, Johannes, 1993-, et al.
(författare)
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Anger profiles among individuals seeking treatment for maladaptive anger : Associations with emotion regulation
- 2023
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 30:3, s. 599-610
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Tidskriftsartikel (refereegranskat)abstract
- Individuals who experience problems with anger represent a heterogeneous group. Identifying clinically relevant subtypes of anger may advance treatment research. In the current study, latent profile analysis (LPA) was conducted to explore if distinct subtypes of anger could be identified within a sample of individuals seeking treatment for maladaptive anger (N = 538; 55.4% females; mean age = 39.78, SD = 12.28). Furthermore, the utility of the empirical classification was examined based on differences in usage of emotion regulation strategies (cognitive reappraisal, expressive suppression, mindful emotion awareness and relaxation) across subtypes. Four anger profiles were identified in the best-fitted LPA model: Low Anger (n = 153, 28.4%), Anger In (n = 91, 16.9%), Moderate Anger (n = 193, 35.9%) and High Anger (n = 101, 35.5%). Results from the multinominal regression revealed that the use of emotion regulation differed across all profiles. Participants from the High Anger and Anger In profiles exhibited distinct patterns of dysfunctional emotion regulation. The results add to the increasing amount of evidence demonstrating a link between emotion regulation strategies and maladaptive anger. Clinical implications on how to tailor treatments for individuals with maladaptive anger are discussed.
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| 22. |
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| 23. |
- Lilliengren, Peter, 1972-, et al.
(författare)
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Intensive Short-Term Dynamic Psychotherapy for generalized anxiety disorder : A pilot effectiveness and process-outcome study
- 2017
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 24:6, s. 1313-1321
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to evaluate the clinical- and cost-effectiveness of Intensive Short-Term Dynamic Psychotherapy (ISTDP) for generalized anxiety disorder (GAD). We further aimed to examine if a key clinical process within the ISTDP framework, termed the level of mobilization of unprocessed complex emotions (MUCE), was related to outcome. The sample consisted of 215 adult patients (60.9% female) with GAD and comorbid conditions treated in a tertiary mental health outpatient setting. The patients were provided an average of 8.3 sessions of ISTDP delivered by 38 therapists. The level of MUCE in treatment was assessed from videotaped sessions by a rater blind to treatment outcome. Year-by-year healthcare costs were derived independently from government databases. Multilevel growth models indicated significant decreases in psychiatric symptoms and interpersonal problems during treatment. These gains were corroborated by reductions in healthcare costs that continued for 4years post-treatment reaching normal population means. Further, we found that the in-treatment level of MUCE was associated with larger treatment effects, underlining the significance of emotional experiencing and processing in the treatment of GAD. We conclude that ISTDP appears to reduce symptoms and costs associated with GAD and that the ISTDP framework may be useful for understanding key therapeutic processes in this challenging clinical population. Controlled studies of ISTDP for GAD are warranted.
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| 24. |
- Nilsson, Magnus, et al.
(författare)
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Childhood maltreatment and self-hatred as distinguishing characteristics of psychiatric patients with self-harm: A comparison with clinical and healthy controls
- 2022
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Ingår i: Clinical Psychology & Psychotherapy. - : Wiley. - 1099-0879 .- 1063-3995. ; 29:5, s. 1778-1789
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Deliberate self-harm (DSH) is common in clinical populations. Childhood maltreatment (CM) and attitudes both towards oneself and towards DSH may be of importance for the development of DSH. This study aimed to test whether patients with DSH report more CM, more negative attitudes towards oneself and more positive attitudes towards DSH than a clinical and a healthy comparison group, and whether the effects of CM are mediated by negative attitudes towards oneself.Method: Females with DSH and psychiatric disorders (n = 34), females without DSH but with psychiatric disorders (n = 31) and healthy female individuals (n = 29) were compared regarding DSH, CM, attitudes towards the self and attitudes towards self-harm.Results: Females with DSH reported more emotional abuse and more self-hatred as compared to both comparison groups. The effect of emotional abuse was mediated by self-hatred. The DSH-group had significantly more positive attitudes towards DSH than the healthy comparison group.Conclusion: Self-hatred and CM in the form of emotional abuse may be distinguishing characteristics of female patients with DSH in psychiatric settings. The present results are compatible with the hypothesis that emotional abuse leads to DSH via self-hatred, but the cross-sectional nature of the study precludes any causal conclusions. The clinical utility of the results is discussed.
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| 25. |
- Raune, D, et al.
(författare)
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The simulation heuristic and visual imagery in pessimism for future negative events in anxiety
- 2005
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Ingår i: Clinical Psychology and Psychotherapy. - : JOHN WILEY & SONS LTD. - 1063-3995 .- 1099-0879. ; 12:4, s. 313-325
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Tidskriftsartikel (refereegranskat)abstract
- A salient feature of clinical anxiety and its disorders is an elevated subjective probability judgement that future negative events will happen to the individual. A neglected area of research is the cognitive mechanisms that might underlie this judgement in patient populations. First, we investigated the ease of being able to simulate imaginary negative events happening to the individual ('the simulation heuristic'). Second, we conducted the first investigation to our knowledge into the possible role of visual imagery characteristics on subjective probability for negative events. Twenty-six patients who had a clinical level of anxiety and 26 low-anxiety control participants simulated mentally and also formed visual images of future negative events. They then rated the likelihood of the events happening to them. As predicted, with anxious patients the simulation heuristic was correlated with subjective probability, and they reported increased access to their simulations compared to control participants. The visual image results were more complex: anxious patients' ease of image formation was correlated with subjective probability but did not differ from that of the control participants, and vividness and dismissibility were enhanced in anxious patients but did not correlate with subjective probability. Clinically, helping anxious patients to improve their access to simulations of why events will not happen may help lower their subjective probability. Future research could seek to confirm this experimentally in a clinical intervention study, as well as isolate further the different roles particular visual image characteristics may play in specific aspects of clinical anxiety. Copyright (c) 2005 John Wiley & Sons, Ltd.
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| 26. |
- Swanson, Linda, et al.
(författare)
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Metacognitive training for negative symptoms : support for the cognitive model
- 2023
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 30:2, s. 486-490
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Tidskriftsartikel (refereegranskat)abstract
- Developing effective treatment options for negative symptoms of psychotic disorders remains a major unmet treatment need and area for further research. In a recent uncontrolled study by the main author, Metacognition Training (MCT) for negative symptoms was found to lead to fewer negative symptoms, less stigma and increased self-rated reflective ability. As the analysis examined negative symptoms as a whole, we here performed an additional analysis on individual negative symptom items as recent research has suggested that negative symptoms are best conceptualized through a five-factor model. It was found that the intervention led to changes specifically on sociality and blunted affect (with large effect sizes), which might reflect changes in both intrapersonal and interpersonal (meta)cognitive processes.
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| 27. |
- Swanson, Linda, et al.
(författare)
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Metacognitive training modified for negative symptoms : A feasibility study
- 2022
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 29:3, s. 1068-1079
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Although patients often prioritize the treatment of negative symptoms, few psychological interventions targeting negative symptoms exist. This study attempts to fill this gap by piloting a modified metacognitive training programme, specifically targeted at negative symptoms (MCT-N), with a group of patients with prominent negative symptoms.METHOD: We adopted a mixed methods case series design, providing detailed quantitative data on changes over time, to focus on potential mechanisms underlying the intervention, in combination with qualitative interviews.RESULTS: The intervention showed good feasibility as demonstrated by the attendance rate, the positive feedback from participants and the multidisciplinary team, and the improvements on negative symptoms observed following the intervention. Multilevel modelling showed that depression, internalized stigma and reflective functioning explained the variance in negative symptoms.DISCUSSION: The pilot study indicated that the intervention has high feasibility and that improvements in negative symptoms can be partially explained by improvements on depression, stigma and reflective functioning.
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| 28. |
- Trindade, Inês A., 1990-, et al.
(författare)
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Chronic illness-related cognitive fusion explains the impact of body dissatisfaction and shame on depression symptoms in breast cancer patients
- 2018
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 25:6, s. 886-893
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Tidskriftsartikel (refereegranskat)abstract
- Breast cancer is linked to psychological distress and mood disorders that are in turn associated with higher psychological dysfunction and decreased breast cancer survival. It is considered that psychological health in breast cancer is considerably affected by body image impairment, which in turn seems to be highly associated with shame. However, the impact of these variables on mental health may not be direct. The current study aimed to explore a comprehensive model regarding the role of chronic illness-related cognitive fusion in the relationship of body image dissatisfaction and chronic illness-related shame with depression symptoms. The sample was composed of 75 women with nonmetastatic breast cancer, recruited in a Radiotherapy Service in central Portugal. The conducted path model presented an excellent fit and accounted for 59% of the variance of depressive symptomatology. Further, it demonstrated that body image dissatisfaction's impact on depressed mood is significantly explained by the mechanisms of chronic illness-related shame and chronic illness-related cognitive fusion. It was also revealed that chronic illness-related cognitive fusion additionally mediated the impact of chronic illness-related shame on depression. These findings are suggestive of the importance of body image and chronic illness shame in the determination of breast cancer patients' depression symptoms and also the central role of chronic illness-related cognitive fusion in these relationships. Therefore, the implementation of acceptance and defusion-based psychotherapeutic interventions to improve mental health in cancer patients seems to be of great importance.
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| 29. |
- Trindade, Inês A., 1990-, et al.
(författare)
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Chronic Illness-Related Shame : Development of a New Scale and Novel Approach for IBD Patients' Depressive Symptomatology
- 2017
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 24:1, s. 255-263
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to develop and validate a scale specifically focused on shame feelings derived from chronic illness-related experiences, the Chronic Illness-related Shame Scale (CISS) and to fill a gap in literature and analyse the role of this construct in the association between inflammatory bowel disease (IBD) symptomatology and depressed mood. This study comprised two samples: a sample of 161 IBD patients and a mixed sample of 65 chronic patients that reported medical data and completed self-report measures. The CISS's unidimensional seven-item structure was evaluated through confirmatory factor analyses. These analyses revealed good to excellent global and local adjustments in both samples. Results also showed that the CISS presents excellent internal consistencies and convergent, concurrent and divergent validity, being a valid, short and robust scale. Furthermore, the present study explored through path analyses, the role of CISS and self-judgement in the relationship between IBD symptomatology and depressed mood. Results showed that, although the level of IBD symptomatology directly predicted patients' depressive symptoms, the majority of this effect was mediated by CISS and self-judgement. Possible explanations for these findings are discussed in more detail in the succeeding text. The present study seems to highlight the pertinence of developing IBD patients' self-compassionate abilities to adaptively deal with symptomatology and related shame feelings. It thus may represent an avenue for the development of compassionate-based interventions for IBD patients and for the conduction of future studies exploring the shame phenomenon in other chronic illnesses.
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| 30. |
- Trindade, Inês A., 1990-, et al.
(författare)
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Developments on committed action : Validity of the CAQ-8 and analysis of committed action's role in depressive symptomatology in breast cancer patients and healthy individuals
- 2018
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 25:1, s. e42-e50
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Tidskriftsartikel (refereegranskat)abstract
- Committed action, a process of acceptance and commitment therapy's psychological flexibility model, is considered an understudied construct that currently can only be measured by one instrument, the Committed Action Questionnaire (CAQ-8). This study aims at analysing the psychometric properties of the CAQ-8 in healthy individuals and breast cancer patients. This study also aims to explore the specific meditational role of committed action in the well-established relationship between experiential avoidance and depression symptoms. The healthy sample comprised 294 adults from the general population, and the breast cancer samples comprised 82 participants. Both groups completed the validated self-report measures. CAQ-8's robustness was examined through validity analyses, confirmatory factor analyses, and multigroup analysis. The meditational model was conducted using structural equation modelling. The CAQ-8 presented good internal consistency and construct, convergent, concurrent, and divergent validity in both samples. Further, the CAQ-8 showed incremental validity over a measure of engaged living. Findings also demonstrated measurement invariance between healthy individuals and breast cancer patients. Regarding the conducted meditational model that was also invariant between the two analysed groups, it was demonstrated that part of the effect that experiential avoidance holds on depressive symptomatology is explained by committed action. This study suggests that the CAQ-8 is adequate for use in healthy and cancer populations. Moreover, it provides novel, empirical support regarding the links between committed action, experiential avoidance, and depressed mood, being also the first investigation to particularly study committed action in a cancer population. Implications for theory and practice are discussed.
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| 31. |
- Trindade, Inês A., 1990-, et al.
(författare)
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The impact of illness-related shame on psychological health and social relationships : Testing a mediational model in students with chronic illness
- 2018
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 25:3, s. 408-414
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the impact of illness-related shame on the quality of social relationships and psychological health in chronic patients. We aimed to examine the roles of fear of receiving compassion from others and experiential avoidance as potential mediators of this relationship. Although some studies have demonstrated the negative impact of chronic illness-related shame on psychological functioning, the mechanisms that may underlie this link remain understudied. The sample was comprised by 115 college students, which had been diagnosed with at least 1 chronic illness. Participants completed self-report measures on an online platform. This study's design was cross-sectional. A path analysis was conducted using structural equation modelling. Results showed that the impact of illness-related shame on both psychological health (R-2=.45) and the quality of social relationships (R-2=.33) was fully accounted by fear of compassion from others and experiential avoidance. This model revealed an excellent fit. Fear of receiving compassion from others was the main mediator of the illness-related shame link with the quality of social relationships (=-.22). The main mediator of the association between shame-related chronic illness and psychological health was experiential avoidance (=-.21).This study shed light on possible psychological mechanisms linking feelings of shame associated with having a chronic condition and impaired social relationships and mental health. On one hand, resisting feelings of compassion and care from others and, on the other hand, avoiding difficult internal experiences and situations that might trigger them seem to underlie the impact of shame on psychological and social functioning in chronic patients.
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| 32. |
- Trindade, Inês A., 1990-, et al.
(författare)
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The influence of self-criticism on depression symptoms among ambulatory patients with inflammatory bowel disease
- 2019
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 26:6, s. 743-750
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Tidskriftsartikel (refereegranskat)abstract
- Considering that self-criticism is an important process in the development and maintenance of depression, and taking into account the stigma associated with inflammatory bowel disease (IBD), the present study aimed to analyse whether self-criticism exacerbates the relationships of depression symptoms with IBD symptomatology and chronic illness-related shame. The sample included 53 ambulatory IBD patients (66% females) with ages from 18 to 65. Moderation analyses were conducted using structural equation modelling. Self-criticism exacerbated the associations of depression with IBD symptoms (b = 0.01; standard error [SE] = 0.00; Z = 3.73; P < .001) and illness shame (b = 0.02; SE = 0.01; Z = 2.40; P = .016). For the same level of IBD symptomatology or chronic illness-related shame, those individuals who present more feelings of inadequacy towards the self, experience more symptoms of depression. This exacerbation effect is stronger when IBD symptomatology and chronic illness-related shame are more intense. A high self-critical IBD patient may view the illness and/or symptomatology as a flaw or error that should be self-corrected. Physicians and other health professionals should be attentive to these pathological mechanisms and should attempt to alleviate them. It may be beneficial to refer high self-critical patients to psychological care.
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| 33. |
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| 34. |
- Zar, M, et al.
(författare)
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Relations between anxiety disorders and fear of childbirth during late pregnancy
- 2002
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995 .- 1099-0879. ; 9:2, s. 122-130
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Tidskriftsartikel (refereegranskat)abstract
- In a group of late pregnant women we investigated the prevalence of extreme fear of childbirth and anxiety disorders, both assessed by means of diagnostic interviews. We also explored the relation between anxiety disorders and extreme fear of childbirth on the one hand and fear of childbirth, as measured by means of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), on the other hand. A subgroup of women (2.4%) fulfilled the criteria for a phobia-like fear of childbirth. Anxiety disorders were related to fear of childbirth, as measured by the W-DEQ. The group of women with extreme fear of childbirth (with or without anxiety disorders) had obviously the highest W-DEQ scores. But also in the group of women with anxiety disorders only the W-DEQ scores were high. Clinical assessment of anxiety disorders among pregnant women should be considered, above all in women who report fear of the anticipated delivery. Copyright ⌐ 2002 John Wiley & Sons, Ltd.
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| 35. |
- Åström, Elisabeth, et al.
(författare)
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Examining the psychometric properties of the Swedish version of Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) in a clinical sample using classical test theory and item response theory
- 2023
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Ingår i: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 30:2, s. 398-409
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine the psychometric properties of the Swedish version of the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) using classical test theory and item response theory (IRT). The CORE-OM is a commonly used 34-item self-report instrument measuring psychological problems/distress covering four domains: subjective well-being, problems/symptoms, functioning and risk. Despite its broad application, only a few studies have used IRT to examine the psychometric properties, and the properties of the Swedish version have only been examined in one initial study. The present study included 1,011 clients with mild to moderate symptoms of distress, applying for psychotherapy at an outpatient training clinic in Sweden. Clients' responses were subjected to classical item analyses as well as IRT (Rasch) analysis using the partial credit model. The classical analyses demonstrated high levels of internal consistency and acceptable levels of item discrimination for the majority of the items, although lower for some items, particularly in the Risk domain. IRT analyses showed that there was a rather good match between item and respondent locations and the measurement precision was high. Disordered step and average measures for some of the items in the Risk domain indicate that these items were problematic from a psychometric point of view and only applicable for a minority of the participants. Differential item functioning for gender in some of the items suggests that they might need to be revised to minimise potential gender bias.
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| 36. |
- Andersson, Gerhard, et al.
(författare)
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Contributions of clinical psychology in audiology: Hearing impairment and tinnitus
- 1997
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Ingår i: CLINICAL PSYCHOLOGY & PSYCHOTHERAPY. - : JOHN WILEY & SONS LTD. - 1063-3995. ; 4:1, s. 42-50
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Tidskriftsartikel (refereegranskat)abstract
- In audiological medicine, the problems of hearing loss and tinnitus (ringing or buzzing in the ear) sometimes lead to psychological problems for the patients, This paper describes these conditions and the contribution of clinical psychology to their mana
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| 37. |
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| 38. |
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| 39. |
- Sommer, R., et al.
(författare)
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Experiencing health-related quality of life in paediatric short stature - a cross-cultural analysis of statements from patients and parents
- 2017
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Ingår i: Clinical Psychology and Psychotherapy. - : Wiley. - 1063-3995. ; 24:6, s. 1370-1376
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Direct assessment of the patient perspective is necessary to thoroughly understand patients' experiences of disease. We aimed to examine information from children with short stature on their perceived HrQoL within 5 European countries. METHODS: Patients, identified through clinical databases, were approached by their clinicians according to the inclusion criteria regarding a diagnosis of growth hormone deficiency or idiopathic short stature and age requirements. A focus group methodology was applied in 84 children and 112 parents. Based on a category system, individual statements were allocated to domains. To evaluate the emerging topics, qualitative content analysis was conducted. Domains and respective coding frequencies per category were compared across countries and respondents. RESULTS: The highest number of statements produced by the children and parents were related to social (29%) and emotional needs and concerns (28%). In particular, children stressed their experience of social exclusion but also their perception of social support. Regarding emotional needs, they stated mainly the desire to be taller in order to be less teased by peers. National differences were identified, for example, Swedish (22%) and British (16%) children and their parents (Sweden 26%; Britain 23%) stressed physical HrQoL aspects, whereas German children (21%) strongly focused on treatment aspects, mainly the benefit of treatment. CONCLUSION: Comprehensive knowledge of the impact of a chronic condition such as short stature on wellbeing is an important precondition of effective treatment. Because socioemotional topics were rated in all the countries to be most important, interventions aimed at improving HrQoL should target social and emotional responses to short stature. Key Practitioner Messages Focus group discussions have been shown to be a useful method for children with short stature and their parents to describe, communicate, prioritize and present aspects of health-related quality of life to health care professionals. Social and emotional aspects of living with short stature are the most frequently discussed topics by children as well as by parents across countries; these topics provide important objectives for tailoring appropriate psychosocial interventions. Clinicians should consider both child and parent concerns, include psychosocial screening tools and propose appropriate referral options for patients and family members.
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| 40. |
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| 41. |
- Olsson, O., et al.
(författare)
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Epidemiology of intra- and peri-articular structural injuries in traumatic knee joint hemarthrosis – data from 1145 consecutive knees with subacute MRI
- 2016
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Ingår i: Osteoarthritis and Cartilage. - : Elsevier BV. - 1063-4584. ; 24:11, s. 1890-1897
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Tidskriftsartikel (refereegranskat)abstract
- Objective In patients with traumatic knee distorsion and hemarthrosis, to investigate the panorama of structural injury, as visualized on magnetic resonance imaging (MRI). Design Cohort study of 1145 consecutive patients with traumatic knee distorsion who underwent MRI within median 8 days after injury. We present structural injury as visualized on MRI in relation to age, sex and activity at injury. Population based gender specific annual incidences of common structural injuries were calculated. Results The majority of injuries (72%) occurred during sports. Overall, anterior cruciate ligament (ACL) rupture was the most common structural injury (52%), followed by meniscal tear (41%) and lateral patella dislocation (LPD, 17%). Only 12% of ACL tears were isolated with meniscal tear being the most common associated injury (55%). The annual incidence of ACL injury was 77 (70–85, 95% CI) per 100,000 inhabitants with significant differences between men (91, 80–103) and women (63, 53–73). In those aged 16 years and younger, LPD was the most frequent structural injury, both in boys (39%) and girls (43%). In this age group, the annual incidence of LPD was 88 (68–113) and higher in boys (113, 81–154) than in girls (62, 39–95). Conclusions ACL injury occurs in one out of two knees with traumatic hemarthrosis but only 12% are without concomitant structural injury. The overall rate of traumatic knee hemarthrosis and ACL injury is higher in men. In those aged 10–19 years, ACL rupture is more common among girls than boys whereas in those 16 years and younger, LPD is more common among boys than girls.
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