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Mazzer, K., Boersma, K. & Linton, S. J. (2019). A longitudinal view of rumination, poor sleep and psychological distress in adolescents. Journal of Affective Disorders, 245, 686-696
Open this publication in new window or tab >>A longitudinal view of rumination, poor sleep and psychological distress in adolescents
2019 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 245, p. 686-696Article in journal (Refereed) Published
Abstract [en]

Background: Given the high prevalence and negative impact of psychological problems during adolescence, examining transdiagnostic factors that may have scope to positively influence a variety of psychological problems is imperative. The main purpose of this study was to investigate the longitudinal relationship between rumination and psychological distress and whether sleep mediated this relationship over a 2 year period.

Methods: Participants were 1620 high school students in the 7th and 8th grade at baseline from 17 public schools in three middle Sweden communities. Students completed questionnaires at school during the spring of 2014, 2015 and 2016. Rumination and psychological distress were self-reported, and sleep duration was calculated from reported bed-times, wake-times and sleep onset latencies.

Results: Sleep duration declined with age, whereas rumination and psychological distress increased. Rumination was predictive of future psychological distress and distress at a given time was predictive of concurrent rumination. Sleep duration did not consistently mediate the reciprocal relationships between rumination and psychological distress over time.

Limitations: Stronger longitudinal associations may have been obtained by using smaller measurement intervals or further delineation of outcome constructs.

Conclusions: Reducing rumination, rather than targeting sleep patterns, may work towards preventing the development of a number of psychological problems and is a strategy anticipated to function across disorders to improve young people's mental wellbeing.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Rumination, Adolescence, Sleep, Distress, Longitudinal
National Category
Neurology Psychiatry
Identifiers
urn:nbn:se:oru:diva-72423 (URN)10.1016/j.jad.2018.11.053 (DOI)000456697100084 ()30447567 (PubMedID)2-s2.0-85056473453 (Scopus ID)
Funder
Swedish Research Council Formas
Available from: 2019-02-14 Created: 2019-02-14 Last updated: 2019-02-14Bibliographically approved
Engman, L., Flink, I., Ekdahl, J., Boersma, K. & Linton, S. J. (2018). Avoiding or enduring painful sex?: A prospective study of coping and psychosexual function in vulvovaginal pain. European Journal of Pain, 22(8), 1388-1398
Open this publication in new window or tab >>Avoiding or enduring painful sex?: A prospective study of coping and psychosexual function in vulvovaginal pain
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2018 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 22, no 8, p. 1388-1398Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Psychology Anesthesiology and Intensive Care Neurology
Identifiers
urn:nbn:se:oru:diva-66612 (URN)10.1002/ejp.1227 (DOI)000441435800002 ()29635880 (PubMedID)2-s2.0-85045933115 (Scopus ID)
Available from: 2018-04-17 Created: 2018-04-17 Last updated: 2018-08-27Bibliographically approved
Engman, L., Flink, I., Ter Kuile, M. & Linton, S. J. (2018). CBT group treatment for vulvovaginal pain with partner involvement: a single case experimental design pilot. In: : . Paper presented at IASR (International Academy of Sex Research) 44th annual meeting, Madrid, Spain, 2018.
Open this publication in new window or tab >>CBT group treatment for vulvovaginal pain with partner involvement: a single case experimental design pilot
2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: Recurring pain in the vulvovaginal regional induced by touch or pressure is thought to be the most frequent cause of superficial dyspareunia in premenopausal women. Its prevalence is 7-15% in community samples and has a serious impact on couples sexual function, sexual satisfaction, general psychological well-being and overall quality of life.

The last decade of research suggests that psychological factors, such as fear of pain, catastrophizing, and avoidance behavior may contribute to the maintenance and exacerbation of dyspareunia. Conventional cognitive behavioral therapy (CBT) interventions aim at reducing pain, restoring sexual function and improving the romantic relationship by targeting the thoughts, emotions, behaviors and couple interactions associated with the experience of dyspareunia. Furthermore, given the interpersonal sexual context in which dyspareunia is most often triggered, relationship factors is an important area to address.

Research Questions: The primary purpose is to evaluate whether a CBT group program with partner involvement improves pain during penetration in women with superficial dyspareunia. Secondary objectives are to evaluate women’s (and their partner’s) sexuality (sexual function & satisfaction), psychological adjustment (negative and positive penetration beliefs, pain coping behaviour) and relationship factors (relationship satisfaction). 

Methods: The current study consists of a CBT group treatment program of 10 group sessions and 3 individual couple sessions distributed over a period of 6 months. The study will employ a single case experimental design with multiple baselines (N=6) where each individual represents a case and is randomized to a specific length of baseline. The primary and secondary outcomes will be measured weekly through both baseline and treatment phase to enable investigation of changes in outcome between the two phases. Additionally, secondary outcomes for both women and their partners are measured pre- and post-treatment. Single case experimental designs are recommended as a first step to investigate individual responses to psychological interventions as well as testing interventions as a pilot before implementing treatments in extensive RCT studies (Morley, 2017).

Results: Data collection is in progress and will be completed early June 2018. The results of the study will be presented at the conference.

Keywords
Vulvovaginal pain, CBT group treatment, Partner participation, Single case experimental design
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-70480 (URN)
Conference
IASR (International Academy of Sex Research) 44th annual meeting, Madrid, Spain, 2018
Available from: 2018-12-04 Created: 2018-12-04 Last updated: 2018-12-04Bibliographically approved
Edebol-Carlman, H., Schrooten, M. G. S., Ljóttson, B., Boersma, K., Linton, S. J. & Brummer, R. J. (2018). Cognitive behavioral therapy for irritable bowel syndrome: the effects on state and trait anxiety and the autonomic nervous system during induced rectal distensions - An uncontrolled trial. Scandinavian Journal of Pain, 18, 81-91
Open this publication in new window or tab >>Cognitive behavioral therapy for irritable bowel syndrome: the effects on state and trait anxiety and the autonomic nervous system during induced rectal distensions - An uncontrolled trial
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2018 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 18, p. 81-91Article in journal (Refereed) Published
Abstract [en]

Background and aims: Irritable bowel syndrome (IBS), is a common multifactorial gastrointestinal disorder linked to disturbances in the microbe gut-brain axis. Cognitive behavioral therapy (CBT), in face-to-face format has showed promising results on IBS and its associated psychological symptoms. The present study explored for the first time if CBT for IBS affects the autonomic nervous system (ANS) during experimentally induced visceral pain and cognitive stress, respectively. The levels of state and trait anxiety, current and perceived stress were also evaluated.

Methods: In this uncontrolled trial, individual CBT was performed in face-to-face format for 12 weeks in 18 subjects with IBS. Heart rate variability and skin conductance were measured during experimentally induced visceral pain and during a cognitive task (Stroop color-word test), before and after intervention. The levels of state and trait anxiety as well as self-rated current and perceived stress were also measured before and after the intervention.

Results: CBT did not affect ANS activity during experimentally induced visceral pain and cognitive stress. The sympathetic activity was high, typical for IBS and triggered during both visceral pain and cognitive stress. The levels of state and trait anxiety significantly decreased after the intervention. No significant changes in self-rated current or perceived stress were found.

Conclusions: Results suggest that face-to-face CBT for IBS improved anxiety- a key psychological mechanism for the IBS pathophysiology, rather than the autonomic stress response to experimentally induced visceral pain and cognitive stress, respectively.

Place, publisher, year, edition, pages
Walter de Gruyter, 2018
Keywords
irritable bowel syndrome; cognitive behavioral therapy; state anxiety; trait anxiety; stress; autonomic nervous system; visceral hypersensitivity
National Category
Neurology
Identifiers
urn:nbn:se:oru:diva-64294 (URN)10.1515/sjpain-2017-0153 (DOI)000426817200009 ()2-s2.0-85043578532 (Scopus ID)
Available from: 2018-01-16 Created: 2018-01-16 Last updated: 2018-03-27Bibliographically approved
Wiklund, T., Linton, S. J., Alföldi, P. & Gerdle, B. (2018). Is sleep disturbance in patients with chronic pain affected by physical exercise or ACT-based stress management?: A randomized controlled study. BMC Musculoskeletal Disorders, 19(1), Article ID 111.
Open this publication in new window or tab >>Is sleep disturbance in patients with chronic pain affected by physical exercise or ACT-based stress management?: A randomized controlled study
2018 (English)In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 19, no 1, article id 111Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Most people suffering chronic pain are plagued by sleeping difficulties. Cognitive behaviour therapy has produced promising results for insomnia comorbid with chronic pain, but the access to such treatment is often limited. Over the last ten years, interventions aiming to increase cognitive flexibility and physical activity have been assumed to be effective treatments for a variety of conditions, including insomnia and chronic pain. If proven effective, these treatments could constitute the first steps in a stepped care model for chronic pain and insomnia.

METHODS: Two hundred ninety-nine chronic pain subjects were randomized to Exercise, ACT-based stress management (ACT-bsm), or an active control group. Two hundred thirty-two participants (78%) received their allocated intervention at least to some extent. These participants were evaluated using mixed model analyses for changes in sleep (Insomnia Severity Index, ISI), pain intensity, depression, and anxiety immediately after treatment, six months and twelve months after treatment.

RESULTS: The mixed model analyses revealed that Exercise had a positive effect on insomnia compared with the control group and the effect remained after 12 months. No clear effect (i.e., both for completers and for completers together with treatment non-completers) upon ISI was found for the ACT-bsm. Pain intensity decreased significantly both in the exercise group and in the control group. For the two psychological variables (i.e., symptoms of anxiety and depression) were found significant improvements over time but no group differences. The treatment effects for ISI and pain intensity did not reach clinical significance per definitions presented in other relevant studies.

CONCLUSIONS: Beneficial significant effects on insomnia was confirmed in the exercise condition. However, these changes were probably not clinically important. For pain intensity a general decrease was found in the Exercise condition and in the control condition, while no change occurred in ACT-bsm. No group differences were found for the two psychological variables.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Sleep, Insomnia, Rehabilitation, Chronic pain, Exercise, Acceptance and commitment therapy, Randomized controlled trial
National Category
Applied Psychology
Identifiers
urn:nbn:se:oru:diva-66613 (URN)10.1186/s12891-018-2020-z (DOI)000429815900002 ()29631567 (PubMedID)2-s2.0-85045212758 (Scopus ID)
Note

Funding Agencies:

Vårdal Foundation (Rehsam)

County Council of Östergötland

Available from: 2018-04-17 Created: 2018-04-17 Last updated: 2018-09-20Bibliographically approved
Mazzer, K., Bauducco, S., Linton, S. J. & Boersma, K. (2018). Longitudinal associations between time spent using technology and sleep duration among adolescents. Journal of Adolescence, 66, 112-119
Open this publication in new window or tab >>Longitudinal associations between time spent using technology and sleep duration among adolescents
2018 (English)In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 66, p. 112-119Article in journal (Refereed) Published
Abstract [en]

Technology use has been the focus of much concern for adolescents' sleep health. However, few studies have investigated the bidirectional association between sleep duration and time spent using technology. The aim of this study was to test whether time spent using technology predicted shorter sleep duration, and/or vice versa using cross-lagged analyses over one year. Participants were 1620 high school students in the 8th and 9th grade at baseline from 17 public schools in three middle Sweden communities. Students completed questionnaires at school during the spring of 2015 and 2016. Time spent using technology was self-reported and sleep duration was calculated from reported bed-times, wake-times and sleep onset latency. Time spent using technology significantly predicted shorter subsequent sleep duration and vice versa. Public health advocates educating others about the negative impacts of technology on sleep must also be mindful of the opposite, that many young people may turn to technological devices when experiencing difficulty sleeping.

Place, publisher, year, edition, pages
Academic Press, 2018
Keywords
Total sleep time, Technology, Adolescence, Bidirectional associations, Longitudinal
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-68140 (URN)10.1016/j.adolescence.2018.05.004 (DOI)000437074100012 ()29842997 (PubMedID)2-s2.0-85047450715 (Scopus ID)
Funder
Swedish Research Council Formas
Available from: 2018-07-26 Created: 2018-07-26 Last updated: 2018-07-26Bibliographically approved
Vlaeyen, J. W. S., Maher, C. G., Wiech, K., Van Zundert, J., Meloto, C. B., Diatchenko, L., . . . Linton, S. J. (2018). Low back pain. Nature reviews. Disease primers, 4(1), Article ID 52.
Open this publication in new window or tab >>Low back pain
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2018 (English)In: Nature reviews. Disease primers, E-ISSN 2056-676X, Vol. 4, no 1, article id 52Article in journal (Refereed) Published
Abstract [en]

Low back pain affects individuals of all ages and is a leading contributor to disease burden worldwide. Despite advancements in assessment and treatment methods, the management of low back pain remains a challenge for researchers and clinicians alike. One reason for the limited success in identifying effective treatments is the large variation in the manifestations, possible causes, precipitating and maintaining factors, course, prognosis and consequences in terms of activity interference and quality of life. However, despite these challenges, steady progress has been achieved in the understanding of back pain, and important steps in the understanding of the psychological and social risk factors, genetics and brain mechanisms of low back pain have been made. These new findings have given impetus to the development of new diagnostic procedures, evidence-based screening methods and more targeted interventions, which underscore the need for a multidisciplinary approach to the management of low back pain that integrates biological, psychological and social aspects.

Place, publisher, year, edition, pages
Nature Publishing Group, 2018
National Category
Physiotherapy Psychology
Identifiers
urn:nbn:se:oru:diva-70802 (URN)10.1038/s41572-018-0052-1 (DOI)000453579000001 ()30546064 (PubMedID)2-s2.0-85058594468 (Scopus ID)
Note

Funding Agencies:

Research Foundation Flanders, Belgium (FWO Vlaanderen)  G001818N  G071118N 

'Asthenes' long-term structural funding-Methusalem grant by the Flemish Government, Belgium  METH/15/011 

National Institute for Health and Disability Insurance (NIHDI)  2018-00047 

National Health and Medical Research Council of Australia  APP1103022  APP1113532  APP1134856 

Louise and Alan Edwards Foundation  

Canadian Excellence Research Chair fund  CERC 09 

Available from: 2018-12-18 Created: 2018-12-18 Last updated: 2019-01-08Bibliographically approved
Linton, S. J. & Flink, I. (2018). Sömn, dröm, mardröm: kunskap och verktyg för god sömn. Stockholm: Natur och kultur
Open this publication in new window or tab >>Sömn, dröm, mardröm: kunskap och verktyg för god sömn
2018 (Swedish)Book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Stockholm: Natur och kultur, 2018. p. 170
National Category
Psychology
Identifiers
urn:nbn:se:oru:diva-71831 (URN)9789127818095 (ISBN)
Available from: 2019-01-25 Created: 2019-01-25 Last updated: 2019-01-25Bibliographically approved
Coenen, P., Smith, A., Kent, P., Harris, M., Linton, S. J., Pransky, G., . . . Straker, L. (2018). The association of adolescent spinal-pain-related absenteeism with early adulthood work absenteeism: A six-year follow-up data from a population-based cohort. Scandinavian Journal of Work, Environment and Health, 44(5), 521-529
Open this publication in new window or tab >>The association of adolescent spinal-pain-related absenteeism with early adulthood work absenteeism: A six-year follow-up data from a population-based cohort
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2018 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 5, p. 521-529Article in journal (Refereed) Published
Abstract [en]

Objectives: Spinal (ie, back and neck) pain often develops as early as during adolescence and can set a trajectory for later life. However, whether early-life spinal-pain-related behavioral responses of missing school/work are predictive of future work absenteeism is yet unknown. We assessed the association of adolescent spinal-pain-related work or school absenteeism with early adulthood work absenteeism in a prospective population-based cohort.

Methods: Six year follow-up data from the Western Australian Pregnancy Cohort (Raine) study were used (N=476; with a 54% response rate). At age 17, participants reported spinal pain (using the Nordic questionnaire) and adolescent spinal-pain-related work/school absenteeism (with a single item question). Annual total and health-related work absenteeism was assessed with the Health and Work Performance questionnaire distributed in four quarterly text messages during the 23rd year of age. We modelled the association of adolescent spinal-pain-related absenteeism with work absenteeism during early adulthood, using negative binomial regression adjusting for sex, occupation and comorbidities.

Results: Participants with adolescent low-back or neck pain with work/school absenteeism reported higher total work absenteeism in early adulthood [148.7, standard deviation (SD) 243.4 hours/year], than those without pain [43.7 (SD 95.2) hours/year); incidence rate ratio 3.4 (95% CI 1.2-9.2)]. Comparable findings were found when considering low-back and neck separately, and when considering health-related absenteeism.

Conclusions: We found a more than three-fold higher risk of work absenteeism in early adulthood among those with adolescent spinal-pain-related absenteeism, compared to those without. These findings suggest that, to keep a sustainable workforce, pain prevention and management should focus on pain-related behaviors as early as in adolescence.

Place, publisher, year, edition, pages
Nordic Association of Occupational Safety and Health, 2018
Keywords
adolescence, back pain, neck pain, Raine Study
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:oru:diva-70226 (URN)10.5271/sjweh.3744 (DOI)000449167400009 ()29893981 (PubMedID)2-s2.0-85052923773 (Scopus ID)
Note

Funding Agencies:

National Health and Medical Research Council  

University of Western Australia  

Raine Medical Research Foundation  

Telethon Kids Institute  

University of Western Australia Faculty of Medicine, Dentistry, and Health Sciences  

Women and Infants Research Foundation  

Curtin University  

Edith Cowan University  

National Health and Medical Research Council  1021858  1027449  1044840 

National Health and Medical Research Council Senior Research Fellowship 

Available from: 2018-11-20 Created: 2018-11-20 Last updated: 2018-11-20Bibliographically approved
Linton, S. J., Flink, I. & Vlaeyen, J. W. S. (2018). Understanding the Etiology of Chronic Pain From a Psychological Perspective. Physical Therapy, 98(5), 315-324
Open this publication in new window or tab >>Understanding the Etiology of Chronic Pain From a Psychological Perspective
2018 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 98, no 5, p. 315-324Article in journal (Refereed) Published
Abstract [en]

The etiology of chronic pain-related disability is not fully understood, particularly from a clinical perspective. Investigations to date have identified risk factors and elucidated some important processes driving the development of persistent pain problems. Yet this knowledge and its application are not always accessible to practicing physical therapists or other clinicians. This article aims to summarize the main psychological processes involved in the development of chronic pain disability and to derive some guidelines for treatment and future research. To this end, the focus is on the paradox of why coping strategies that are helpful in the short term continue to be used even when-ironically-they maintain the problem in the long term. To aid in summarizing current knowledge, 4 tenets that elucidate the etiology of chronic pain are described. These tenets emphasize that chronic pain disability is a developmental process over time, contextual factors set the stage for this development, underlying transdiagnostic psychological factors fuel this development, and the principles of learning steer the development of pain behaviors. With these tenets, an explanation of how a chronic problem develops for one person but not another is provided. Finally, hypotheses that can be empirically tested to guide clinical application as well as basic research are generated. In conclusion, understanding the psychological processes underlying the etiology of chronic pain provides testable ideas and a path forward for improving treatment interventions.

Place, publisher, year, edition, pages
American Physical Therapy Association, 2018
National Category
Applied Psychology
Identifiers
urn:nbn:se:oru:diva-67030 (URN)10.1093/ptj/pzy027 (DOI)000434093900004 ()29669087 (PubMedID)
Funder
Swedish Research Council
Note

Funding Agencies:

Riksbanken  

Örebro University  

"Asthenes" long-term structural funding Methusalem grant from the Flemish Government, Belgium 

Available from: 2018-05-18 Created: 2018-05-18 Last updated: 2018-06-20Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-5359-0452

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