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Wurm, M., Anniko, M., Tillfors, M., Flink, I. & Boersma, K. (2018). Musculoskeletal pain in early adolescence: A longitudinal examination of pain prevalence and the role of peer-related stress, worry, and gender. Journal of Psychosomatic Research, 111, 76-82
Open this publication in new window or tab >>Musculoskeletal pain in early adolescence: A longitudinal examination of pain prevalence and the role of peer-related stress, worry, and gender
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2018 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 111, p. 76-82Article in journal (Refereed) Published
Abstract [en]

Objective: Adolescence is a time of change during which several health problems, such as pain problems, increase. Psychosocial mechanisms involved in this development, such as interpersonal stressors and worry, are still understudied, especially longitudinally. The first aim of this study was to investigate the prevalence of musculoskeletal pain in Swedish adolescents between the ages 13 and 15 using pain grades. The second aim was to study the role of peer-related stress, worry, and gender in the development of musculoskeletal pain problems over time.

Methods: Adolescents in 18 public schools were followed from 7th to 9th grade (N=1181) and answered selfreport questionnaires at three time points. Prevalence was assessed at all three time points and a moderated mediation analysis investigated if peer-related stress in 7th grade predicted musculoskeletal pain two years later and if this relationship was mediated by worry in 8th grade. Gender was entered as a moderator.

Results: In 7th grade, 8.4% of adolescents reported musculoskeletal pain with some functional impairment. In 8th and 9th grade around 10% of adolescents reported musculoskeletal pain problems, with girls reporting a higher prevalence than boys. Peer-related stress in 7th grade predicted musculoskeletal pain problems in 9th grade, mediated by worry in 8th grade. The mediation was moderated by gender: peer-related stress predicted worry for girls, but not for boys.

Conclusion: Peer-related stress and worry seem to be involved in the development of pain over time. These factors should therefore be targeted in preventative interventions and during treatment.

Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Psychology (excluding Applied Psychology) Psychiatry
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-67289 (URN)10.1016/j.jpsychores.2018.05.016 (DOI)000437386600012 ()29935758 (PubMedID)2-s2.0-85048472319 (Scopus ID)
Funder
Swedish Research Council FormasSwedish Research CouncilVINNOVA, 2012-65Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2018-06-17 Created: 2018-06-17 Last updated: 2018-07-25Bibliographically approved
Malmquist, A. & Wurm, M. (2018). Regnbågsfamiljer: Familjer där föräldrarna är homo, bi, trans eller queer. Fokus på familien: Tidsskrift for familiebehandling, 46(2), 113-132
Open this publication in new window or tab >>Regnbågsfamiljer: Familjer där föräldrarna är homo, bi, trans eller queer
2018 (Swedish)In: Fokus på familien: Tidsskrift for familiebehandling, ISSN 0332-5415, E-ISSN 0807-7487, Vol. 46, no 2, p. 113-132Article in journal (Refereed) Published
Abstract [sv]

Familjer uppvisar idag en stor mångfald och hbtq-personers föräldraskap – regnbågsfamiljerna– blir allt vanligare. Samtidigt kvarstår en normativ idealbild av familjen som bestående av ett heterosexuellt par med gemensamma biologiska barn. En grundläggande kännedom om hbtq-personers familjeliv och vägar till föräldraskap är centralt för ett professionellt bemötande av regnbågsfamiljer. I denna artikel ges en introduktion till ämnesområdet och fyra former av regnbågsfamiljer tas upp: samkönade kvinnliga par med barn, samkönade manliga par med barn, familjer med fler än två föräldrar och familjer där en förälder är transperson. Artikeln belyser även möten mellan regnbågsfamiljer och professionella i psykologisk behandling.

Abstract [en]

Families today exhibit a great deal of diversity, and LGBTQ parents are becoming more common. At the same time a normative idealised picture of the family prevails, consisting of a heterosexual couple with their biological children. Basic knowledge of LGBTQ peoples’ family life and paths to parenthood is central to a professional engagement with LGBTQ families. This article introduces the subject area and describes four types of families: same-sex female couples with children, same-sex male couples with children, families with more than two parents and families where a parent is transgender. The article also highlights encounters between LGBTQ families and professionals in psychological treatment.

Place, publisher, year, edition, pages
Universitetsforlaget, 2018
Keywords
familj, hbtq, regnbågsfamiljer, professionellt bemötande
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-67299 (URN)10.18261/issn.0807-7487-2018-01-04 (DOI)
Available from: 2018-06-18 Created: 2018-06-18 Last updated: 2018-06-18Bibliographically approved
Wurm, M. (2018). Understanding Comorbid Pain and Emotions: A transdiagnostic approach. (Doctoral dissertation). Örebro: Örebro University
Open this publication in new window or tab >>Understanding Comorbid Pain and Emotions: A transdiagnostic approach
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Experiencing pain, including an emotional reaction, is part of being hu­man. Emotional comorbidity is common in pain patients, and corre­lated to higher symptomatology and worse treatment outcome. The shared vulnerability model suggests that many vulnerability and main­taining factors may be involved in both pain and emotional problems. Hence, they may be transdiagnostic. Since our knowledge about these shared factors is lacking, potential targets for risk assessment, preven­tion, and treatment are likely underutilized. The overarching aim of this dissertation was to further our understanding of comorbid musculo­skeletal pain and emotional problems by investigating the role of trans­diagnostic factors. Specifically, it was studied if levels of shared vulner­abilities (negative affect and anxiety sensitivity) and symptomatology covary in pain patients depending on the occurrence of comorbid social anxiety symptoms (Study I); if peer-related stress predicts musculoskel­etal pain problems over time in adolescents, and if this is mediated by worry and moderated by gender (Study II); and if symptomatology can be decreased in pain patients with comorbid emotional problems by using an internet delivered unified protocol for emotional disorders (Study III). Results show that vulnerabilities covaried with comorbid pain and social anxiety. Also, peer-related stress predicted musculoskel­etal pain problems in adolescents and was mediated by worry for girls. However, the internet-delivered unified protocol did not unequivocally decrease symptomatology. In sum, the studies in this dissertation pro­vide partial support for the role of transdiagnostic factors in comorbid musculoskeletal pain and emotional problems. A transdiagnostic ap­proach may offer a parsimonious understanding of the  development and maintenance of this comorbid symptomatology.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2018. p. 98
Series
Örebro Studies in Psychology, ISSN 1651-1328 ; 40
Keywords
Transdiagnostic approach, musculoskeletal pain, emotions, comorbidity, shared vulnerability model, social factors, gender
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-66696 (URN)978-91-7529-250-2 (ISBN)
Public defence
2018-06-08, Örebro universitet, Långhuset, Hörsal L2, Fakultetsgatan 1, Örebro, 09:15 (English)
Opponent
Supervisors
Available from: 2018-04-23 Created: 2018-04-23 Last updated: 2018-06-08Bibliographically approved
Wurm, M. & Hanner, H. (2017). Att möta samhället som hbtq+. In: Lundren, Tove; Malmquist, Anna; Wurm, Matilda (Ed.), HBTQ+: Psykologiska perspektiv och bemötande (pp. 153-168). Stockholm: Natur & Kultur
Open this publication in new window or tab >>Att möta samhället som hbtq+
2017 (Swedish)In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundren, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur & Kultur , 2017, p. 153-168Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Stockholm: Natur & Kultur, 2017
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-67225 (URN)978-91-27-14743-0 (ISBN)
Available from: 2018-06-12 Created: 2018-06-12 Last updated: 2019-02-28Bibliographically approved
Wurm, M., Flink, I., Tillfors, M. & Boersma, K. (2017). External and internal social factors as risk factors for the development of back/neck pain in Swedish adolescents. In: : Pain in Europe. Paper presented at 10th Congress of the European Pain Federation (EFIC 2017), Pain in Europe, Copenhagen, Denmark, September 6-9, 2017.
Open this publication in new window or tab >>External and internal social factors as risk factors for the development of back/neck pain in Swedish adolescents
2017 (English)In: : Pain in Europe, 2017Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background and aim: Back/neck pain is common in adolescents. Studies show correlations with social factors, such as bully victimization and individual social functioning (social anxiety). In adult pain populations, comorbid social anxiety has been correlated with higher symptomatology and worse treatment outcome. The aim of this study was to describe the prevalence of back/neck pain and to analyze the influence of bullying and social anxiety on back/neck pain over time in a general population sample of Swedish adolescents.

Method: Data consisted at baseline of all pupils in 7’th grade attending public schools in three Swedish municipalities (N= 1453, Mage= 13.19, sd= .43, 52.6 % boys), followed up yearly. Pupils were categorized as having a pain-problem based on self-reported pain frequency, pain intensity, and functional limitation. A multivariate logistic regression was conducted with bullying victimization, social anxiety, back/neck pain and gender at time 1 as predictors for back/neck pain at time 3.

Results: The prevalence of problematic back/neck pain was 8.4% (N= 122) at time 1, 10.5% (N=144) at time 2 and 9.9% (N=117) at time 3. The regression model was statistically significant (X² (4, N= 1181) = 84.46, p=.000). Gender, back/neck pain and bully victimization at time 1, but not social anxiety, significantly predicted pain problem at time 3.

Conclusions: External social factors rather than individual social function predicted back/neck pain. Since studies have found correlations between bully victimization and social anxiety and social anxiety may be prevalent and influence treatment outcomes in adult pain populations, this relationship should be studied further.

Keywords
epidemiology, back/neck pain, adolescents, bully victimization, social anxiety
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-62936 (URN)
Conference
10th Congress of the European Pain Federation (EFIC 2017), Pain in Europe, Copenhagen, Denmark, September 6-9, 2017
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareVINNOVASwedish Research CouncilSwedish Research Council Formas
Available from: 2017-12-04 Created: 2017-12-04 Last updated: 2017-12-06Bibliographically approved
Anna, M. & Wurm, M. (2017). Föräldraskap. In: Lundren, Tove; Malmquist, Anna; Wurm, Matilda (Ed.), HBTQ+: Psykologiska perspektiv och bemötande (pp. 227-244). Stockholm: Natur och kultur
Open this publication in new window or tab >>Föräldraskap
2017 (Swedish)In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundren, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur och kultur, 2017, p. 227-244Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Stockholm: Natur och kultur, 2017
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-67223 (URN)978-91-27-14743-0 (ISBN)
Available from: 2018-06-11 Created: 2018-06-11 Last updated: 2018-06-12Bibliographically approved
Wurm, M., Klein Strandberg, E., Lorenz, C., Tillfors, M., Buhrman, M., Holländare, F. & Boersma, K. (2017). Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study. Internet Interventions, 10, 54-64
Open this publication in new window or tab >>Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study
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2017 (English)In: Internet Interventions, ISSN 2214-7829, Vol. 10, p. 54-64Article in journal (Refereed) Published
Abstract [en]

In pain patients, comorbid emotional problems have been linked to negative outcomes, including suboptimaltreatment gains. Developing parsimonious and accessible treatment options is therefore important. The overarchingaim of this study was to test an internet delivered therapist guided transdiagnostic treatment withtelephone support. An adapted version of the Unified Protocol for Transdiagnostic Treatments of EmotionalDisorders was used as an intervention for pain patients with residual pain problems and comorbid emotionalproblems after having received a multimodal pain rehabilitation. The study used a replicated AB single caseexperimental design (N =5; 3 females). Outcome measures were depressive and general anxiety symptoms, painintensity, pain coping problems, and diagnostic status. Feasibility measures (completion and compliance) andpatient satisfaction were also assessed. Scores on Nonoverlap of All Pairs (NAP) indicate a decrease of anxiety forthree participants and a decrease of depression for four participants. Decreases were small and did not alwaysreach statistical significance. Also, Tau-U scores could only confirm a reliable trend for one participant. Two outof four patients who were diagnosed with psychiatric disorders before treatment did no longer fulfill diagnosticcriteria posttreatment. No improvements could be seen on pain problems. The treatment was feasible and patientsatisfaction was high. Hence, while an internet delivered transdiagnostic treatment with telephone support maybe a feasible and accepted secondary intervention for pain patients with comorbid emotional problems, theeffects are unclear. The gap between high patient satisfaction and small changes in symptomatology should beexplored further.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Internet delivered treatment; pain; transdiagnostic; emotional comorbidity; single case
National Category
Other Medical Sciences not elsewhere specified
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-62356 (URN)10.1016/j.invent.2017.10.004 (DOI)000457134100008 ()2-s2.0-85032807121 (Scopus ID)
Projects
SÅS
Available from: 2017-11-14 Created: 2017-11-14 Last updated: 2019-02-13Bibliographically approved
Edlund, S., Wurm, M., Holländare, F., Linton, S. J., Fruzzetti, A. E. & Tillfors, M. (2017). Pain patients´ experiences of validation and invalidation from physicians before and after multimodal pain rehabilitation: Associations with pain, negative affectivity and treatment outcome. Scandinavian Journal of Pain, 17, 77-86
Open this publication in new window or tab >>Pain patients´ experiences of validation and invalidation from physicians before and after multimodal pain rehabilitation: Associations with pain, negative affectivity and treatment outcome
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2017 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 17, p. 77-86Article in journal (Refereed) Published
Abstract [en]

Background and aims: Validating and invalidating responses play an important role in communication with pain patients, for example regarding emotion regulation and adherence to treatment. However, it is unclear how patients’ perceptions of validation and invalidation relate to patient characteristics and treatment outcome. The aim of this study was to investigate the occurrence of subgroups based on pain patients’ perceptions of validation and invalidation from their physicians. The stability of these perceptions and differences between subgroups regarding pain, pain interference, negative affectivity and treatment outcome were also explored.

Methods: A total of 108 pain patients answered questionnaires regarding perceived validation and invalidation, pain severity, pain interference, and negative affectivity before and after pain rehabilitation treatment. Two cluster analyses using perceived validation and invalidation were performed, one on pre-scores and one on post-scores. The stability of patient perceptions from pre- to post-treatment was investigated, and clusters were compared on pain severity, pain interference, and negative affectivity. Finally, the connection between perceived validation and invalidation and treatment outcome was explored.

Results: Three clusters emerged both before and after treatment: (1) low validation and heightened invalidation, (2) moderate validation and invalidation, and (3) high validation and low invalidation. Perceptions of validation and invalidation were generally stable over time, although there were individuals whose perceptions changed. When compared to the other two clusters, the low validation/heightened invalidation cluster displayed significantly higher levels of pain interference and negative affectivity post-treatment but not pre-treatment. The whole sample significantly improved on pain interference and depression, but treatment outcome was independent of cluster. Unexpectedly, differences between clusters on pain interference and negative affectivity were only found post-treatment. This appeared to be due to the pre- and post-heightened invalidation clusters not containing the same individuals. Therefore, additional analyses were conducted to investigate the individuals who changed clusters. Results showed that patients scoring high on negative affectivity ended up in the heightened invalidation cluster post-treatment.

Conclusions: Taken together, most patients felt understood when communicating with their rehabilitation physician. However, a smaller group of patients experienced the opposite: low levels of validation and heightened levels of invalidation. This group stood out as more problematic, reporting greater pain interference and negative affectivity when compared to the other groups after treatment. Patient perceptions were typically stable over time, but some individuals changed cluster, and these movements seemed to be related to negative affectivity and pain interference. These results do not support a connection between perceived validation and invalidation from physicians (meeting the patients pre- and post-treatment) and treatment outcome. Overall, our results suggest that there is a connection between negative affectivity and pain interference in the patients, and perceived validation and invalidation from the physicians. Implications In clinical practice, it is important to pay attention to comorbid psychological problems and level of pain interference, since these factors may negatively influence effective communication. A focus on decreasing invalidating responses and/or increasing validating responses might be particularly important for patients with high levels of psychological problems and pain interference.

Place, publisher, year, edition, pages
Walter de Gruyter, 2017
Keywords
Chronic pain; Communication; Validation; Invalidation; Treatment outcome
National Category
Psychology Neurology
Research subject
Psychology
Identifiers
urn:nbn:se:oru:diva-59104 (URN)10.1016/j.sjpain.2017.07.007 (DOI)000419851500012 ()28850377 (PubMedID)2-s2.0-85026788123 (Scopus ID)
Note

Funding Agency:

Regional Research Council (Regionala Forskningsradet, RFR) 

Available from: 2017-08-15 Created: 2017-08-15 Last updated: 2018-08-01Bibliographically approved
Wurm, M. & Traczyk, M. (2017). Riktlinjer. In: Lundren, Tove; Malmquist, Anna; Wurm, Matilda (Ed.), HBTQ+: Psykologiska perspektiv och bemötande (pp. 333-338). Stockholm: Natur & Kultur
Open this publication in new window or tab >>Riktlinjer
2017 (Swedish)In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundren, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur & Kultur , 2017, p. 333-338Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Stockholm: Natur & Kultur, 2017
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-67222 (URN)978-91-27-14743-0 (ISBN)
Available from: 2018-06-11 Created: 2018-06-11 Last updated: 2018-06-12Bibliographically approved
Wurm, M. (2017). Trans (1ed.). In: Lundberg, Tove; Malmquist, Anna; Wurm, Matilda (Ed.), HBTQ+: Psykologiska perspektiv och bemötande (pp. 137-152). Stockholm: Natur och kultur
Open this publication in new window or tab >>Trans
2017 (Swedish)In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundberg, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur och kultur, 2017, 1, p. 137-152Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Stockholm: Natur och kultur, 2017 Edition: 1
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-62357 (URN)9789127147430 (ISBN)
Available from: 2017-11-14 Created: 2017-11-14 Last updated: 2017-11-28Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3887-6281

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