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Gustafsson, Sanna Aila
Alternative names
Publications (10 of 24) Show all publications
Fogelkvist, M., Gustafsson, S. A., Kjellin, L. & Parling, T. (2020). Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms: A randomized controlled trial. Body image, 32, 155-166
Open this publication in new window or tab >>Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms: A randomized controlled trial
2020 (English)In: Body image, ISSN 1740-1445, E-ISSN 1873-6807, Vol. 32, p. 155-166Article in journal (Refereed) Epub ahead of print
Abstract [en]

Body image problems are central aspects of eating disorders (ED), and risk factors both for the development of and relapse into an ED. Acceptance and commitment therapy (ACT) aims at helping patients accept uncomfortable internal experiences while committing to behaviors in accordance with life values. The aim of the present study was to compare the effectiveness of a group intervention, consisting of 12 sessions, based on ACT to treatment as usual (TAU) for patients with residual ED symptoms and body image problems. The study was a randomized controlled superiority trial. Patients with residual ED symptoms and body image problems were recruited from a specialized ED clinic in Sweden. The final sample consisted of 99 women, randomized to ACT or TAU. At the two-year follow-up, patients who received ACT showed a significant greater reduction in ED symptoms and body image problems and received less specialized ED care than patients in TAU. In conclusion, ACT was superior in reducing ED symptoms and body image problems.

Place, publisher, year, edition, pages
Saunders Elsevier, 2020
Keywords
Acceptance and commitment therapy, Body dissatisfaction, Body image, Eating disorder, Psychotherapy, Randomized controlled trial
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-79954 (URN)10.1016/j.bodyim.2020.01.002 (DOI)32000093 (PubMedID)
Available from: 2020-02-19 Created: 2020-02-19 Last updated: 2020-02-19Bibliographically approved
Nyman-Carlsson, E., Norring, C., Engström, I., Gustafsson, S. A., Lindberg, K., Paulson-Karlsson, G. & Nevonen, L. (2019). Individual cognitive behavioral therapy and combined family/individual therapy for young adults with Anorexia nervosa: A randomized controlled trial. Psychotherapy Research
Open this publication in new window or tab >>Individual cognitive behavioral therapy and combined family/individual therapy for young adults with Anorexia nervosa: A randomized controlled trial
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2019 (English)In: Psychotherapy Research, ISSN 1050-3307, E-ISSN 1468-4381Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: In this study, we evaluate the efficacy of outpatient individual cognitive behavioral therapy for young adults (CBT-YA) and combined family/individual therapy for young adults (FT-YA) for anorexia nervosa (AN).

METHOD: Participants (aged 17-24 years) with AN in Sweden were recruited and assigned to 18 months of CBT-YA or FT-YA. Treatment efficacy was assessed primarily using BMI, presence of diagnosis, and degree of eating-related psychopathology at post-treatment and follow-up. Secondary outcomes included depression and general psychological psychopathology. The trial was registered at http://www.isrctn.com/, ISRCTN (25181390).

RESULTS: Seventy-eight participants were randomized, and seventy-four of them received allocated treatment and provided complete data. Clinical outcomes from within groups resulted in significant improvements for both groups. BMI increased from baseline (CBT-YA 16.49; FT-YA 16.54) to post-treatment (CBT-YA 19.61; FT-YA 19.33) with high effect sizes. The rate of weight restoration was 64.9% in the CBT-YA group and 83.8% in the FT-YA group. The rate of recovery was 76% in both groups at post-treatment, and at follow-up, 89% and 81% had recovered in the CBT-YA and FT-YA groups respectively.

CONCLUSIONS: Outpatient CBT-YA and FT-YA appear to be of benefit to young adults with AN in terms of weight restoration and reduced eating disorder and general psychopathology.

Place, publisher, year, edition, pages
Routledge, 2019
Keywords
Anorexia nervosa, cognitive behavioral therapy, family therapy, outpatient treatment, randomized controlled trial
National Category
Applied Psychology
Identifiers
urn:nbn:se:oru:diva-77871 (URN)10.1080/10503307.2019.1686190 (DOI)000495523000001 ()31709920 (PubMedID)
Note

Funding Agencies:

Vardal Foundation, Sweden  

Krica Foundation, Sweden  

Örebro University, Sweden 

Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-27Bibliographically approved
Nyman-Carlsson, E., Birgegård, A., Engström, I., Gustafsson, S. A. & Nevonen, L. (2019). Predictors of outcome among young adult patients with anorexia nervosa in a randomised controlled trial. European eating disorders review, 27(1), 76-85
Open this publication in new window or tab >>Predictors of outcome among young adult patients with anorexia nervosa in a randomised controlled trial
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2019 (English)In: European eating disorders review, ISSN 1072-4133, E-ISSN 1099-0968, Vol. 27, no 1, p. 76-85Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The prognosis in cases of anorexia nervosa (AN) is unsatisfactory, and it is therefore important to examine pretreatment predictors of outcome.

METHODS: Female AN patients (N = 74) included in a randomised controlled trial receiving individual cognitive behavioural therapy (CBT) or family-based treatment (FBT) were included. Predictors of the outcome were explored using pretreatment eating disorder psychopathology.

RESULTS: In the CBT group, lower levels of emotional dysregulation and greater deficits in identifying and coping with inner states were predictors of weight increase, explaining 37.7% of the variance. In the FBT group, lower interoceptive deficits predicted an increase in weight (explaining 17.7% of the variance), whereas bulimic behaviour (32.4%) and problems with emotional regulation (23.3%) were predictors of increased diagnostic symptoms.

CONCLUSIONS: Bulimic symptoms and the ability to identify and cope with emotional states appear to be important aspects that should be addressed in the treatment of young adult patients with AN.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
BMI, anorexia nervosa, outcome, prediction, young adults
National Category
Psychiatry Psychology
Identifiers
urn:nbn:se:oru:diva-68439 (URN)10.1002/erv.2630 (DOI)000453012700008 ()30094893 (PubMedID)2-s2.0-85052807835 (Scopus ID)
Funder
Vårdal Foundation
Available from: 2018-08-13 Created: 2018-08-13 Last updated: 2019-01-08Bibliographically approved
Lindstedt, K., Neander, K., Kjellin, L. & Gustafsson, S. A. (2018). A life put on hold: adolescents' experiences of having an eating disorder in relation to social contexts outside the family. Journal of Multidisciplinary Healthcare, 11, 425-437
Open this publication in new window or tab >>A life put on hold: adolescents' experiences of having an eating disorder in relation to social contexts outside the family
2018 (English)In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 11, p. 425-437Article in journal (Refereed) Published
Abstract [en]

Background: As suffering from an eating disorder often entails restrictions on a person's everyday life, one can imagine that it is an important aspect of recovery to help young people learn to balance stressful demands and expectations in areas like the school environment and spare-time activities that include different forms of interpersonal relationships.

Purpose: The aim of the present study was to investigate how adolescents with experience from a restrictive eating disorder describe their illness and their time in treatment in relation to social contexts outside the family.

Patients and methods: This qualitative study is based on narratives of 15 adolescents with experience from outpatient treatment for eating disorders with a predominately restrictive symptomatology, recruited in collaboration with four specialized eating-disorder units. Data were explored through inductive thematic analysis.

Results: The adolescents' descriptions of their illness in relation to their social contexts outside the family follow a clear timeline that includes narratives about when and how the problem arose, time in treatment, and the process that led to recovery. Three main themes were found: 1) the problems emerging in everyday life (outside the family); 2) a life put on hold and 3) creating a new life context.

Conclusion: Young people with eating disorders need to learn how to balance demands and stressful situations in life, and to grasp the confusion that often preceded their illness. How recovery progresses, and how the young people experience their life contexts after recovery, depends largely on the magnitude and quality of peer support and on how school and sports activities affect and are affected by the eating disorder.

Place, publisher, year, edition, pages
DOVE Medical Press Ltd., 2018
Keywords
restrictive eating disorder, patients' perspectives, qualitative research, thematic analysis, recovery
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-68969 (URN)10.2147/JMDH.S168133 (DOI)000443480600001 ()
Note

Funding Agencies:

Region Örebro County  

Örebro University 

Available from: 2018-09-19 Created: 2018-09-19 Last updated: 2019-01-23Bibliographically approved
Lindberg, K., Nevonen, L., Gustafsson, S. A., Nyman-Carlsson, E. & Norring, C. (2018). Validation of the Inventory of Interpersonal Problems (IIP-64): a comparison of Swedish female outpatients with anorexia nervosa or bulimia nervosa and controls. Nordic Journal of Psychiatry, 72(5), 347-353
Open this publication in new window or tab >>Validation of the Inventory of Interpersonal Problems (IIP-64): a comparison of Swedish female outpatients with anorexia nervosa or bulimia nervosa and controls
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2018 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 72, no 5, p. 347-353Article in journal (Refereed) Published
Abstract [en]

AIM: The aim of the study was to explore the psychometric properties of the Inventory of Interpersonal Problems (IIP-64) and to compare levels of interpersonal distress in Swedish female outpatients with anorexia nervosa or bulimia nervosa with age- and gender-matched controls.

METHODS: Totally, 401 participants were included; anorexia nervosa (n = 74), bulimia nervosa (n = 85) and controls (n = 242). All participants completed the IIP-64. The eating disorder (ED) patients also filled out the Eating Disorder Inventory-2/3 (EDI).

RESULTS: Internal consistency of IIP-64 was acceptable to high. Principal component analyses with varimax rotation of the IIP-64 subscales confirmed the circumplex structure with two underlying orthogonal dimensions; affiliation and dominance. Significant correlations between EDI-3 composite scales ineffectiveness and interpersonal problems and IIP-64 were found. ED patients reported higher levels of interpersonal distress than controls on all but one subscale (intrusive/needy).

CONCLUSIONS: IIP-64 can be considered to have acceptable to good reliability and validity in a Swedish ED sample. IIP-64 can be a useful complement in assessment of interpersonal problems in ED.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Anorexia nervosa, IIP-64, bulimia nervosa, inventory of interpersonal problems, psychometrics
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-66873 (URN)10.1080/08039488.2018.1465589 (DOI)000440750600005 ()29703121 (PubMedID)2-s2.0-85046027153 (Scopus ID)
Note

Funding Agency:

Stockholm County Council  20150170  20160063

Available from: 2018-05-23 Created: 2018-05-23 Last updated: 2018-08-22Bibliographically approved
Lindstedt, K., Kjellin, L. & Gustafsson, S. A. (2017). Adolescents with full or subthreshold anorexia nervosa in a naturalistic sample: characteristics and treatment outcome. Journal of Eating Disorders, 5(1), Article ID 4.
Open this publication in new window or tab >>Adolescents with full or subthreshold anorexia nervosa in a naturalistic sample: characteristics and treatment outcome
2017 (English)In: Journal of Eating Disorders, E-ISSN 2050-2974, Vol. 5, no 1, article id 4Article in journal (Refereed) Published
Abstract [en]

Background: Anorexia Nervosa (AN) destroys developmentally important early years of many young people and knowledge is insufficient regarding course, treatment outcome and prognosis. Only a few naturalistic studies have been conducted within the field of eating disorder (ED) research. In this naturalistic study we included adolescents with AN or subthreshold AN treated in outpatient care, and the overall aim was to examine sample characteristics and treatment outcome. Additional aims were to examine potential factors associated with remission as an outcome variable, and possible differences between three time periods for treatment onset.

Methods: Participants were identified through the Swedish national quality register for eating disorder treatment (SwEat), in which patients are registered at treatment onset and followed up once a year until end of treatment (EOT). Inclusion criteria were: medical or self-referral to one of the participating treatment units between 1999 and 2014, 13-19 years of age at initial entry into SwEat and diagnosed with AN or subthreshold AN. The total sample consisted of 3997 patient from 83 different treatment units.

Results: The results show that 55% of the participants were in remission and approximately 85% were within a healthy weight range at EOT. Of those who ended treatment according to plan, 70% were in remission and 90% within a healthy weight range. The average treatment duration was approximately 15 months. About one third of the patients terminated treatment prematurely, which was associated with a decreased chance of achieving remission. Remission rates and weight recovery increased over time, while treatment duration decreased. Considering treatment outcome, the results did not show any differences between patients with AN or subthreshold AN.

Conclusions: The present study shows a relatively good prognosis for adolescent patients with AN or subthreshold AN in routine care and the results indicate that treatment for adolescents with ED in Sweden has become more effective over the past 15 years. The results of the present study contribute to the scope of treatment research and the large-scale naturalistic setting secures the generalizability to a clinical environment. However, more research is needed into different forms of evidence, new research strategies and diversity of treatment approaches.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Adolescents, Anorexia nervosa, Eating disorders, Naturalistic sample, Treatment
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:oru:diva-57066 (URN)10.1186/s40337-017-0135-5 (DOI)000395733900001 ()28265410 (PubMedID)2-s2.0-85014399551 (Scopus ID)
Note

Funding Agencies:

Region Örebro County

Örebro University

Available from: 2017-04-18 Created: 2017-04-18 Last updated: 2019-01-23Bibliographically approved
Bäck, M., Gustafsson, S. A. & Holmqvist, R. (2017). Interpersonal psychotherapy for eating disorders with co-morbid depression: A pilot study. European Journal of Psychotherapy, 19(4), 378-395
Open this publication in new window or tab >>Interpersonal psychotherapy for eating disorders with co-morbid depression: A pilot study
2017 (English)In: European Journal of Psychotherapy, ISSN 1364-2537, E-ISSN 1469-5901, Vol. 19, no 4, p. 378-395Article in journal (Refereed) Published
Abstract [en]

Objective: Patients with eating disorders (ED) often suffer from co-morbid depression, which may complicate the ED treatment. Previous studies have found that ED interventions seem to have limited capacity to reduce depressive symptoms. Several studies of interpersonal psychotherapy (IPT), have found that when patients have been treated for depression, co-morbid symptoms have diminished. As depression and EDs are commonly co-occurring conditions, this pilot study aimed to examine the effect of an IPT treatment for these conditions, with the focus on the depressive symptoms.

Method: In this multi-centre study, 16 patients with EDs and co-occurring major depression received 16 weeks of depression-focused IPT.

Results: Significant improvements with substantial effect sizes were found for both depression (d = 1.48) and ED (d =.93). Symptom reduction in the two syndromes were strongly correlated (r = .625, p = .004). Patients with a restrictive ED did not improve on either depression or ED symptoms.

Conclusion: These findings point to the usefulness of IPT for concurrent depression and ED with a bingeing/purging symptomatology. Working with negative affect and problem-solving related to current interpersonal problems may alleviate general psychological distress among these patients.

Place, publisher, year, edition, pages
Routledge, 2017
Keywords
IPT, interpersonal psychotherapy, depression, eating disorder, co-morbidity
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:oru:diva-64421 (URN)10.1080/13642537.2017.1386226 (DOI)000419521300004 ()2-s2.0-85034612398 (Scopus ID)
Note

Funding Agency:

SwEat - Swedish Eating Disorder Register

Available from: 2018-01-19 Created: 2018-01-19 Last updated: 2018-09-14Bibliographically approved
Sandberg, J., Gustafsson, S. A. & Holmqvist, R. (2017). Interpersonally traumatised patients' view of significant and corrective experiences in the psychotherapeutic relationship. European Journal of Psychotherapy, 19(2), 175-199
Open this publication in new window or tab >>Interpersonally traumatised patients' view of significant and corrective experiences in the psychotherapeutic relationship
2017 (English)In: European Journal of Psychotherapy, ISSN 1364-2537, E-ISSN 1469-5901, Vol. 19, no 2, p. 175-199Article in journal (Refereed) Published
Abstract [en]

Background: Clinical experience points to the importance of significant experiences in the therapy relationship for patients who have been interpersonally traumatised but the empirical research is limited.

Aim: The aim was to gain increased knowledge about how significant and potentially corrective experiences within the therapeutic relationship were described by patients in trauma-focused therapy and how the participants thought such experiences might have affected the therapeutic work.

Method: Five patients who were, or recently had been, in trauma-focused therapy were interviewed about their experiences of the therapy relationship. Thematic analysis was used to analyse the interviews.

Results: Four themes were identified: 'Human contact', 'Validation', 'To face the painful' and 'Development of trust'. Positive experiences in the therapeutic relationship were sometimes seen as crucial for the therapeutic work and for patients' improvement.

Conclusions: Previous findings about the significance of corrective experiences in psychotherapy were confirmed, particularly experiences of the therapist's accepting stance, personal and human contact and encouragement. The therapist's ability to evoke trust in the patient and her capacity to help patients to face painful material may be particularly important for traumatised patients.

Place, publisher, year, edition, pages
Routledge, 2017
Keywords
PTS D, trauma, psychotherapy relationship, corrective emotional experience, corrective relational experience, significant events, attachment
National Category
Psychology
Identifiers
urn:nbn:se:oru:diva-61159 (URN)10.1080/13642537.2017.1313881 (DOI)000410790000005 ()2-s2.0-85019063482 (Scopus ID)
Available from: 2017-09-27 Created: 2017-09-27 Last updated: 2017-09-27Bibliographically approved
Strand, M., Bulik, C. M., von Hausswolff-Juhlin, Y. & Gustafsson, S. A. (2017). Self-admission to inpatient treatment for patients with anorexia nervosa: The patient's perspective. International Journal of Eating Disorders, 50(4), 398-405
Open this publication in new window or tab >>Self-admission to inpatient treatment for patients with anorexia nervosa: The patient's perspective
2017 (English)In: International Journal of Eating Disorders, ISSN 0276-3478, E-ISSN 1098-108X, Vol. 50, no 4, p. 398-405Article in journal (Refereed) Published
Abstract [en]

The aim of the present study was to explore patients' experiences of participating in a self-admission program at a specialist eating disorders clinic. Sixteen adult program participants with a diagnosis of anorexia nervosa were interviewed at 6 months about their experiences in the self-admission program. A qualitative content analysis approach was applied to identify recurring themes. Four themes were identified: Agency and Flexibility, Functions, Barriers, and Applicability. Participants used self-admission to boost healthy behaviors, to prevent deterioration, to forestall the need for longer periods of hospitalizations, and to get a break from overwhelming demands. Quick access to brief admissions provides a safety net that can increase feelings of security in everyday life, even for patients who do not actually make use of the opportunity to self-admit. It also provided relief to participants' relatives. Furthermore, participants experienced that self-admission may foster agency and motivation. However, the model also requires a certain level of maturity and an encouraging environment to overcome barriers that could otherwise hinder optimal use, such as ambivalence in asking for help. Informants experienced that self-admission could allow them to gain greater insight into their disease process, take greater responsibility for their recovery, and transform their health care from crisis-driven to proactive. By offering a shift in perspective on help-seeking and participation, self-admission may potentially strengthen participants' internal responsibility for their treatment and promote partnership in treatment.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
anorexia nervosa, eating disorders, inpatients, patient admissions, patient participation, patient-centered care, voluntary admissions
National Category
Nutrition and Dietetics Psychology Psychiatry
Research subject
Nutrition
Identifiers
urn:nbn:se:oru:diva-57403 (URN)10.1002/eat.22659 (DOI)000398841500009 ()28106920 (PubMedID)2-s2.0-85010410345 (Scopus ID)
Available from: 2017-05-02 Created: 2017-05-02 Last updated: 2018-09-12Bibliographically approved
Strand, M., Gustafsson, S. A., Bulik, C. M. & von Hausswolff-Juhlin, Y. (2017). Self-admission to inpatient treatment in psychiatry: lessons on implementation. BMC Psychiatry, 17, Article ID 343.
Open this publication in new window or tab >>Self-admission to inpatient treatment in psychiatry: lessons on implementation
2017 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 17, article id 343Article in journal (Refereed) Published
Abstract [en]

Background: Interest has increased in programs offering self-admission to inpatient treatment for patients with severe psychiatric illness, whereby patients who are well-known to a service are afforded the opportunity to admit themselves at will for a brief period of time. The aim of the present study was to examine patient experiences of practical considerations during the start-up phase of a self-admission program in an eating disorder service.

Methods: Sixteen adult participants in a self-admission program at a specialist eating disorders service were interviewed at 6 months about their experiences during the implementation phase. A qualitative content analysis approach was applied in order to identify recurring themes.

Results: Six subcategories regarding implementation and logistics of self-admission were identified: "Start-up problems", "Problems associated with reserving a bed", "Lack of staff continuity", "Not enough emphasis on long-term goals", "Too demanding in terms of freedom and responsibility", and "Suggestions for alternative models".

Conclusions: Practical recommendations can be offered for the implementation of future self-admission programs, such as thoroughly informing all participants about the rationale behind self-admission with particular emphasis on patient accountability, establishing a waiting list procedure for occasions when all designated beds are occupied, and assigning an individual contact staff member responsible for each self-admitted patient.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Psychiatry, Inpatients, Patient admissions, Patient participation, Voluntary admissions
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-61927 (URN)10.1186/s12888-017-1505-x (DOI)000412678000004 ()29017471 (PubMedID)2-s2.0-85030836611 (Scopus ID)
Note

Funding Agencies:

Värkstadsstiftelsen  

Psykiatrifonden  

Available from: 2017-10-24 Created: 2017-10-24 Last updated: 2018-09-04Bibliographically approved
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