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  • 1.
    Andersson, E.
    et al.
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
    Ljótsson, B.
    Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
    Hedman, E.
    Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden; Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Hesser, Hugo
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Enander, J.
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Kaldo, V.
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Andersson, G.
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Lindefors, N.
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Rück, C.
    Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Testing the Mediating Effects of Obsessive Beliefs in Internet-Based Cognitive Behaviour Therapy for Obsessive-Compulsive Disorder: Results from a Randomized Controlled Trial2015In: Clinical Psychology and Psychotherapy, ISSN 1063-3995, E-ISSN 1099-0879, Vol. 22, no 6, p. 722-732Article in journal (Refereed)
    Abstract [en]

    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.

  • 2.
    Andersson, G.
    et al.
    Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institute, Stockholm, Sweden.
    Hesser, Hugo
    Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Cima, R. F. F.
    Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
    Weise, C.
    Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany.
    Autobiographical Memory Specificity in Patients with Tinnitus Versus Patients with Depression and Normal Controls2013In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 42, no 2, p. 116-126Article in journal (Refereed)
    Abstract [en]

    Several studies show that patients with depression and post-traumatic stress disorder respond with fewer specific autobiographical memories in a cued memory task (i.e. the autobiographical memory test; AMT) compared to healthy controls. One previous study found this phenomenon among tinnitus patients as well (Andersson, Ingerholt, & Jansson, 2003). The aim of this study was to replicate the previous study with an additional control group of depressed patients and memory errors as measured with the AMT as an additional outcome. We included 20 normal hearing tinnitus patients, 20 healthy controls and 20 persons diagnosed with clinical depression. The AMT was administered together with self-report measures of depression, anxiety and tinnitus distress. Both the tinnitus and depression groups differed from the healthy control group in that they reported fewer specific autobiographical memories. There were, however, differences between the tinnitus and depression groups in terms of the errors made on the AMT. The depression group had more overgeneral memories than the normal control group, whereas the tinnitus group did not differ from the control group on this memory error. The tinnitus group had more semantic associations and non-memories than the other two groups, suggesting that executive functioning may play a role for the tinnitus group when completing the AMT. Clinical and theoretical implications of the findings are discussed.

  • 3.
    Andersson, G.
    et al.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden.
    Hesser, Hugo
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Hummerdal, D.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Bergman-Nordgren, L.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Carlbring, P.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; Department of Psychology, Umeå University, Umeå, Sweden.
    A 3.5-year follow-up of Internet-delivered cognitive behavior therapy for major depression2013In: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 22, no 2, p. 155-164Article in journal (Refereed)
    Abstract [en]

    Background: Internet-delivered cognitive behavior therapy (ICBT) for major depression has been tested in several trials, but only with follow-ups up to 1.5 years.

    Aim: The aim of this study was to evaluate the outcome of ICBT 3.5 years after treatment completion.

    Methods: A total of 88 people with major depression were randomized to either guided self-help or e-mail therapy in the original trial. One-third was initially on a waiting-list. Treatment was provided for eight weeks and in this report long-term follow-up data were collected. Also included were data from post-treatment and six-month follow-up. A total of 58% (51/88) completed the 3.5-year follow-up. Analyses were performed using a random effects repeated measures piecewise growth model to estimate trajectory shape over time and account for missing data.

    Results: Results showed continued lowered scores on the Beck Depression Inventory (BDI). No differences were found between the treatment conditions. A large proportion of participants (55%) had sought and received additional treatments in the follow-up period. A majority (56.9%) of participants had a BDI score lower than 10 at the 3.5-year follow-up.

    Conclusions: People with mild to moderate major depression may benefit from ICBT 3.5-years after treatment completion.

  • 4.
    Andersson, G.
    et al.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden.
    Hesser, Hugo
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Veilord, A.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Svedling, L.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Andersson, F.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Sleman, O.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Mauritzson, L.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Sarkohi, A.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Claesson, E.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Zetterqvist, V.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Lamminen, M.
    Redakliniken, Linköping, Sweden.
    Eriksson, T.
    Redakliniken, Linköping, Sweden.
    Carlbring, P.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Randomised controlled non-inferiority trial with 3-year follow-up of internet-delivered versus face-to-face group cognitive behavioural therapy for depression2013In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 151, no 3, p. 986-994Article in journal (Refereed)
    Abstract [en]

    Background: Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in the treatment of mild to moderate depression, but there have been no direct comparisons with the more established group-based CBT with a long-term follow-up.

    Method: Participants with mild to moderate depression were recruited from the general population and randomized to either guided ICBT (n =33) or to live group treatment (n=36). Measures were completed before and after the intervention to assess depression, anxiety, and quality of life. Follow-ups were conducted at one-year and three-year after the treatment had ended.

    Results: Data were analysed on an intention-to-treat basis using linear mixed-effects regression analysis. Results on the self-rated version of the Montgomery-Asberg Depression Scale showed significant improvements in both groups across time indicating non-inferiority of guided ICBT, and there was even a tendency for the guided ICBT group to be superior to group-based CBT at three year follow-up. Within-group effect sizes for the ICBT condition at post treatment showed a Cohen's d=1.46, with a similar large effect at 3-year follow-up, d=1.78. For the group CBT the corresponding within group effects were d =0.99 and d=1.34, respectively.

    Limitations: The study was small with two active treatments and there was no placebo or credible control condition.

    Conclusions: Guided ICBT is at least as effective as group based CBT and long-term effects can be sustained up to 3 years after treatment.

  • 5.
    Andersson, G.
    et al.
    Department of Behavioural Sciences and Learning, SwedishInstitute for Disability Research, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Section of Psychiatry, Karolinska Institute, Stockholm, Sweden.
    Sarkohi, A.
    Department of Behavioural Sciences and Learning, SwedishInstitute for Disability Research, Linköping University, Linköping, Sweden; Department of Psychiatry, Linköping University Hospital, Linköping, Sweden.
    Karlsson, J.
    Department of Behavioural Sciences and Learning, SwedishInstitute for Disability Research, Linköping University, Linköping, Sweden.
    Bjärehed, J.
    Department of Psychology, Lund University, Lund, Sweden.
    Hesser, Hugo
    Department of Behavioural Sciences and Learning, SwedishInstitute for Disability Research, Linköping University, Linköping, Sweden.
    Effects of two forms of internet-delivered cognitive behaviour therapy for depression on future thinking2013In: Cognitive Therapy and Research, ISSN 0147-5916, E-ISSN 1573-2819, Vol. 37, no 1, p. 29-34Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate if future thinking would change following two forms of Internet-delivered cognitive behavior therapy (ICBT) for major depression. A second aim was to study the association between pre-post changes in future thinking and pre-post changes in depressive symptoms. Effects of psychological treatments are most often tested with self-report inventories and seldom with tests of cognitive function. We included data from 47 persons diagnosed with major depression who received either e-mail therapy or guided self-help during 8 weeks. Participants completed a future thinking task (FTT), in which they were asked to generate positive and negative events that they thought were going to happen in the future and rated the events in terms of emotion and likelihood. The FTT was completed before and after treatment. Data on depressive symptoms were also collected. FTT index scores for negative events were reduced after treatment. There was no increase for the positive events. Change scores for the FTT negative events and depression symptoms were significantly correlated. We conclude that ICBT may lead to decreased negative future thinking and that changes in depression symptoms correlate to some extent with reductions in negative future thinking.

  • 6.
    Andersson, Gerhard
    et al.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Hesser, Hugo
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Hummerdal, Daniel
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Bergman Nordgren, Lise
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Carlbring, Per
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; Department of psychology, Umeå University, Umeå, Sweden.
    A 3.5-year follow-up of Internet-delivered cognitive behavior therapy for major depression2013In: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 22, no 2, p. 155-164Article in journal (Refereed)
    Abstract [en]

    Background: Internet-delivered cognitive behavior therapy (ICBT) for major depression has been tested in several trials, but only with follow-ups up to 1.5 years.

    Aim: The aim of this study was to evaluate the outcome of ICBT 3.5 years after treatment completion.

    Methods: A total of 88 people with major depression were randomized to either guided self-help or e-mail therapy in the original trial. One-third was initially on a waiting-list. Treatment was provided for eight weeks and in this report long-term follow-up data were collected. Also included were data from post-treatment and six-month follow-up. A total of 58% (51/88) completed the 3.5-year follow-up. Analyses were performed using a random effects repeated measures piecewise growth model to estimate trajectory shape over time and account for missing data. Results Results showed continued lowered scores on the Beck Depression Inventory (BDI). No differences were found between the treatment conditions. A large proportion of participants (55%) had sought and received additional treatments in the follow-up period. A majority (56.9%) of participants had a BDI score lower than 10 at the 3.5-year follow-up.

    Conclusions: People with mild to moderate major depression may benefit from ICBT 3.5-years after treatment completion.

  • 7.
    Andersson, Jonas
    Örebro University, School of Law, Psychology and Social Work.
    Preventiva interventioner för barn i familjehem. En översikt.2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna översikt är att beskriva den teoretiska grunden för preventiva interventioner till barn i familjehemsvård som undergått vetenskaplig utvärdering samt att dokumentera de interventioner som används i Sverige. 20 interventioner och deras teoretiska grund beskrivs varav en används i Sverige. Majoriteten av interventionerna är selektiva eller indikerade. En tredjedel är universella. En majoritet av interventionerna är kognitivt-beteendeinriktade med social inlärningsteori som grund. Flest interventioner riktar sig till familjehemsföräldrar. Flera av interventionerna och andra interventioner med samma teoretiska grund används i Sverige, men kommer sannolikt inte familjehemsplacerade barn och ungdomar till del. I översikten konkluderas att det finns förutsättningar för att introducera fler interventioner i Sverige och utvärdera deras effekter i svensk kontext.

  • 8.
    Andersson, Ulrika
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Persson, Jerry
    Örebro University, School of Law, Psychology and Social Work.
    Kognitiv träning vid depression2009Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Depression is a widely spread disorder. Cognitive training could be a

    cost effective and easily accessible intervention to treat the disorder in

    an early stage. Previous research indicates that cognitive training is

    effective in alleviating depression and cognitive deficits. The aim of

    this study was to investigate whether cognitive training at home would

    lead to improvements in depression, and whether improvements were

    due to the training per se. Four subjects with depression participated

    in training with the Paced Audity Serial Addition Task (PASAT). The

    study had an n=1-design with pre- and post-measures, and control by

    a pseudo-intervention. Daily and weekly measures showed effects

    only for one participant. Thus the training was not shown to be

    effective. Three participants experienced benefits from the

    intervention. That could be a reason for further studies of cognitive

    interventions of depression.

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    FULLTEXT01
  • 9.
    Anniko, Malin
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Bodland Fielding, Lisa
    Örebro University, School of Law, Psychology and Social Work.
    Stressing emotions: A single subject design study testing an emotion-focused transdiagnostic treatment for stress-related ill health2011Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

     Abstract 

    Individual psychological factors have been recognized to play an important role in the development of stress-related symptomatology. Despite extensive comorbidity between stress-related ill health and mood disorders, the advances in research on emotion regulation and transdiagnostics, have not been recognized in stress research to any considerable degree. In the current study, using a single subject design with multiple baselines across individuals (n=6), a transdiagnostic treatment intervention targeting maladaptive emotional regulation strategies was implemented on patients suffering from stress-related symptomatology. Results show that symptoms of exhaustion decreased in five of six participants on post-measures, with considerable convergence between measures of depression, anxiety and stress. Further investigation of treatment effects, alongside the processes linking emotion regulation and stress-related symptomatology are needed. 

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    Stressing Emotions- DIVA
  • 10.
    Aramo-Immonen, Heli
    et al.
    Tampere University of Technology, Pori, Finland.
    Jussila, Jari
    Tampere University of Technology, Tampere, Finland.
    Huhtamaki, Jukka
    Tampere University of Technology, Tampere, Finland.
    Exploring co-learning behavior of conference participants with visual network analysis of Twitter data2015In: Computers in human behavior, ISSN 0747-5632, E-ISSN 1873-7692, Vol. 51, no B, p. 1154-1162Article in journal (Refereed)
    Abstract [en]

    Knowledge management has acknowledged organizational learning as a key factor for creating competitive advantage for companies already from early 1990. However, the studies of co-learning in this connection are in their infancy. This article contributes to an emerging field of 'smart data' research on Twitter by presenting a case study of how community managers in Finland used this social media platform to construct a co-learning environment around an annually organized conference. In this empirical study we explore the co-learning behavior in project contexts especially by analyzing and visualizing co-learning behavior from conference participants Twitter data.

  • 11.
    Arnison, Tor
    Örebro University, School of Medical Sciences. Örebro University Hospital. Clinical Epidemiology and Biostatistics.
    Prevention is better than cure: why early interventions for insomnia and chronic pain during adolescence should be a priority2023In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14, article id 1206977Article in journal (Refereed)
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    Publisher´s fulltext
  • 12.
    Arnison, Tor
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Schrooten, Martien G. S.
    Örebro University, School of Law, Psychology and Social Work.
    Bauducco, Serena
    Örebro University, School of Law, Psychology and Social Work.
    Jansson-Fröjmark, Markus
    Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
    Persson, Jonas
    Örebro University, School of Law, Psychology and Social Work. Aging Research Center (ARC), Karolinska Institute and Stockholm University, Stockholm, Sweden.
    Sleep phase and pre-sleep arousal predicted co-developmental trajectories of pain and insomnia within adolescence2022In: Scientific Reports, E-ISSN 2045-2322, Vol. 12, no 1, article id 4480Article in journal (Refereed)
    Abstract [en]

    The onset of both chronic pain and insomnia is high during adolescence. Although a bidirectional relationship between pain and insomnia has support, how pain and sleep co-develop throughout adolescence remains unknown. Sleep–wake patterns, pre-sleep behavior and pre-sleep arousal may influence the co-development of pain and insomnia. Four waves of longitudinal self-report data were used (Nbaseline = 2767, Agebaseline M = 13.65 years, SD = 0.65). Multidimensional growth mixture modeling was used to identify four subgroups of adolescents with different concurrent trajectories of pain and insomnia. The trajectories followed each other across time in all classes: one class of consistently low pain and insomnia (68.7%), one class with persistent high symptoms (4.9%), as well as one class of increasing (13.9%), and one of decreasing (12.5%), trajectories. Later sleep–wake patterns and more pre-sleep cognitive-emotional arousal predicted both increasing and decreasing trajectories of concurrent pain and insomnia. The current study showed that developmental trajectories of pain and insomnia follow each other within adolescents and across adolescence. Both sleep-phase focused interventions as well as psychological interventions that focus on pre-sleep cognitive-emotional arousal may prove beneficial for adolescents with comorbid pain and insomnia.

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    Sleep phase and pre-sleep arousal predicted co-developmental trajectories of pain and insomnia within adolescence
  • 13.
    Aronsson, Gunnar
    et al.
    Faculty of Social Sciences, Department of Psychology, Stockholm University, Stockholm, Sweden.
    Bejerot, Eva
    Faculty of Social Sciences, Department of Psychology,Stockholm University, Stockholm, Sweden.
    Brist på kollegialt inflytande urholkar lojalitet med chef och organisation… men inte med patienterna2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 12-13, p. 553-556Article in journal (Refereed)
    Abstract [en]

    The aim of the investigation was to examine relations between physicians’ experiences of opportunities to exert their competence, and have arenas for collegially influence on the organization’s activities and loyalty, protest and exit. In total, 1 400 physicians participated in a questionnaire study. Strong feelings of loyalty with the organization, workplace and immediate supervisor were 2–3 times more common among those with arenas, than those without the experience of an arena. Loyalty with their profession and patients was high, and independent of access to such arenas. Of those with high access to arenas, 87% reported that their viewpoints on work conditions were taken into consideration, compared to 21% of those with low access. Considerations for changes in profession, employer or workplace were twice as common among those with low access to arenas. In conclusion, employers who want to attract physicians must have arenas where the physicians’ competence can influence the organisational activities.

  • 14.
    Badinlou, Farzaneh
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Kormi-Nouri, Reza
    Örebro University, School of Law, Psychology and Social Work.
    Enactment Effect In Development: Comparing Action Memory In School-Aged Children2015Conference paper (Other academic)
    Abstract [en]

    Memory works better when we have hands on experience with learning materials. In a same way, children remember action phrases better if they are instructed to enact it rather than when they only read it or watch someone else do it. We investigated this enactment effect in different grades´ children in order to find out the developmental pattern of differences.  In this study, we first tried to replicate typical enactment effect in children. Then, we compared memory in subject-performed tasks, experimenter-performed tasks and verbal tasks using three memory tests (free recall, cued recall, and recognition) in children. Four hundred and ten pupils from four grades (2nd, 4th, 6th, and 8th) participated in the study. The results showed that first, there is an enactment effect in school-aged children as well as in adults. Second, the encoding conditions and memory tests determine memory performance in children. And most important, the findings indicated that there were significant differencesfrom grade 2 to grade 8 in free recall and cued recall, but not recognition of all three learning conditions. These findings indicate that action memory develops through school ages. In another word, age has an important role in memory and especially enactment effect; older children had better recall performance in all kind of encoding conditions. These findings can be explained through development of memory strategies, item-specific information processing, and relational information processing.

  • 15.
    Badinlou, Farzaneh
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Kormi-Nouri, Reza
    Örebro University, School of Law, Psychology and Social Work.
    Mousavi Nasab, Hossein
    Department of Psychology, Shahid Bahonar University of Kerman, Kerman, Iran.
    Knopf, Monika
    Department of Psychology, Johann Wolfgang Goethe-University, Frankfurt, Germany.
    Developmental differences in episodic memory across school ages: Evidence from enacted events performed by self and others2017In: Memory, ISSN 0965-8211, E-ISSN 1464-0686, Vol. 25, no 1, p. 84-94Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine action memory as a form of episodic memory among school-aged subjects. Most research on action memory has focused on memory changes in adult populations. This study explored the action memory of children over time. A total of 410 school-aged child participants, comprising 201 girls and 208 boys in four age groups (8, 10, 12, 14), were included in this study. We studied two forms of action encoding, subject-performed tasks (SPTs) and experimenter-performed tasks (EPTs), which were compared with one verbal encoding task as a control condition. At retrieval, we used three memory tests (free recall, cued recall, and recognition). We observed significant differences in memory performance in children aged 8-14 years with respect to free recall and cued recall but not recognition. The largest memory enhancement was observed for the SPTs in the 8-14-year-old participants under all test conditions. Participants performed equally well on the free recall of SPTs and EPTs, whereas they displayed better performances on the cued recall and recognition of SPTs compared to EPTs. The strategic nature of SPTs and the distinction between item-specific information and relational information are discussed.

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    Fulltext
  • 16.
    Bartels, Sara Laureen
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Johnsson, Sophie I.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Flink, Ida
    Örebro University, School of Law, Psychology and Social Work.
    McCracken, Lance M.
    Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden.
    Petersson, Suzanne
    Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden.
    Christie, Hannah L.
    Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, Netherlands.
    Feldman, Inna
    Department of Public Health and Caring Science, Uppsala Universitet, Uppsala, Sweden.
    Simons, Laura E.
    Department of Anaesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
    Onghena, Patrick
    Research Group on Methods, Individual and Cultural Differences, Affect and Social Behavior, KU Leuven, Leuven, Belgium.
    Vlaeyen, Johan W. S.
    Research Group Health Psychology, KU Leuven, Leuven, Belgium; Research Group Experimental Health Psychology, Maastricht University, Maastricht, The Netherlands.
    Wicksell, Rikard K.
    Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Pain Clinic, Capio St. Göran Hospital, Stockholm, Sweden.
    Development, evaluation and implementation of a digital behavioural health treatment for chronic pain: study protocol of the multiphase DAHLIA project2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 4, article id e059152Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Chronic pain affects about 20%-40% of the population and is linked to mental health outcomes and impaired daily functioning. Pharmacological interventions are commonly insufficient for producing relief and recovery of functioning. Behavioural health treatment is key to generate lasting benefits across outcome domains. However, most people with chronic pain cannot easily access evidence-based behavioural interventions. The overall aim of the DAHLIA project is to develop, evaluate and implement a widely accessible digital behavioural health treatment to improve well-being in individuals with chronic pain.

    METHODS AND ANALYSIS: The project follows the four phases of the mHealth Agile Development and Evaluation Lifecycle: (1) development and pre-implementation surveillance using focus groups, stakeholder interviews and a business model; (2) iterative optimisation studies applying single case experimental design (SCED) method in 4-6 iterations with n=10 patients and their healthcare professionals per iteration; (3) a two-armed clinical randomised controlled trial enhanced with SCED (n=180 patients per arm) and (4) interview-based post-market surveillance. Data analyses include multilevel modelling, cost-utility and indicative analyses.In October 2021, inter-sectorial partners are engaged and funding is secured for four years. The treatment content is compiled and the first treatment prototype is in preparation. Clinical sites in three Swedish regions are informed and recruitment for phase 1 will start in autumn 2021. To facilitate long-term impact and accessibility, the treatment will be integrated into a Swedish health platform (www.1177.se), which is used on a national level as a hub for advice, information, guidance and e-services for health and healthcare.

    ETHICS AND DISSEMINATION: The study plan has been reviewed and approved by Swedish ethical review authorities. Findings will be actively disseminated through peer-reviewed journals, conference presentations, social media and outreach activities for the wider public.

    TRIAL REGISTRATION NUMBER: NCT05066087.

  • 17.
    Bartels, Sara Laureen
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Taygar, Afra S.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Institute of Social Sciences, Uskudar University, Istanbul, Turkey.
    Johnsson, Sophie I.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Petersson, Suzanne
    Department of Medicine and Optometry, Linnaeus University, Kalmar, Region Kalmar County, Sweden.
    Flink, Ida
    Örebro University, School of Behavioural, Social and Legal Sciences.
    Boersma, Katja
    Örebro University, School of Behavioural, Social and Legal Sciences.
    McCracken, Lance M.
    Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden.
    Wicksell, Rikard K.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Pain clinic, Capio St. Göran Hospital, Stockholm, Sweden.
    Using Personas in the development of eHealth interventions for chronic pain: A scoping review and narrative synthesis2023In: Internet Interventions, ISSN 2214-7829, Vol. 32, article id 100619Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVES: Behavioral eHealth interventions can enhance self-management and improve well-being in people with chronic pain. The development of these interventions calls for a user-centered approach to ensure that patient needs are appreciated. However, it may be challenging to involve patients; particularly during the early stages of the process. Fictional user profiles, known as Personas, can represent needs and guide designing eHealth interventions. This article provides a comprehensive overview of the use of Personas in the development of behavioral eHealth interventions for people with chronic pain with the aim to identify benefits and challenges.

    METHODS: Bibliographic databases (Medline, Web of Science Core Collection, PsycInfo, CINAHL) and registries (PubMed Central, medaRxiv) were systematically searched. In a double-reviewing process, n = 6830 hits and n = 351 full-texts were screened and read. Ten peer-reviewed studies published between 2017 and 2022 were included in the narrative synthesis.

    FINDINGS: Ten studies reported using "Pain Personas" in the development of eHealth interventions for such purposes as to gain a shared understanding of the user and to discuss solutions in team meetings, or for patients to identify with (if Personas are included in the intervention). Personas were based on qualitative and/or quantitative data. However, the procedure for creating Personas was only described in half of the included studies (n = 5). These five studies provided descriptive details of the Personas (i.e., picture, name, narrative of their pain behavior, technological skills, and motivation).

    CONCLUSIONS: Although Personas have been used by pain researchers in recent projects and were highlighted as an important ingredient in the development process, available design guidelines for the creation and use of Personas are not followed or communicated transparently. Benefits and challenges when using Personas in the development of eHealth interventions for people with chronic pain are discussed to support future eHealth efforts and to improve the quality of eHealth innovation in the field of pain.

  • 18.
    Bauducco, Serena
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Flink, Ida
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Preventing sleep deficit in adolescents: Long-term effects of a quasi-experimental school-based intervention study2020In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 29, no 1, article id e12940Article in journal (Refereed)
    Abstract [en]

    Adolescents are at risk of sleep deficit, which has serious consequences for their daytime functioning. However, school-based interventions to improve sleep have shown limited success. This might be due to the content of the programmes (e.g., not targeting central factors such as daytime stress and technology use) or because changes have not been captured due to a lack of long-term follow-ups. Hence, the aim of this study was to evaluate the long-term effects of a school-based sleep education curriculum including time-management training. The study used a quasi-experimental design. Participants were 3,622 adolescents (mean age 13.7, 48% girls); 286 were in the intervention group and 3,336 were followed as a natural control group. Data were collected before the intervention and at a 1-year follow-up. We divided participants into three groups according to baseline sleep duration (calculated from self-reported bed- and wake times, minus sleep onset latency): insufficient (<7 hr), borderline (7-8 hr) and adequate (>8 hr). Adolescents in the intervention group were ~2 times less likely to report insufficient sleep at follow-up as compared to controls. Sleep knowledge improved significantly in the intervention group but there were no changes in emotional sleep hygiene (e.g., bedtime worry) and perceived stress. Surprisingly, technology use increased and behavioural sleep hygiene worsened in the intervention group. Although the mechanisms of change need further investigation, the results of this study point to potential long-term benefits of school-based sleep programmes.

  • 19.
    Bauducco, Serena
    et al.
    Örebro University, School of Behavioural, Social and Legal Sciences. College of Education, Psychology & Social Work, Flinders University, Adelaide, South Australia, Australia.
    Gardner, L. A.
    The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia.
    Champion, K.
    The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia.
    Newton, N.
    The Matilda Centre for Research Excellence in Mental Health and Substance Use, The University of Sydney, Sydney, New South Wales, Australia.
    Gradisar, M.
    Sleep Cycle, Gothenburg, Sweden; WINK Sleep, Adelaide, South Australia, Australia.
    It's past your bedtime, but does it matter anymore? How longitudinal changes in bedtime rules relate to adolescents' sleep2023In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, article id e13940Article in journal (Refereed)
    Abstract [en]

    This study investigated how changing or maintaining parent-set bedtimes over time relates to adolescents' sleep timing, latency, and duration. Adolescents (n = 2509; Mage  = 12.6 [0.5] years; 47% m) self-reported their sleep patterns, and whether they had parent-set bedtimes on two separate occasions in 2019 (T1; 12.6 years) and 2020 (T2; 13.7 years). We identified four groups based on parent-set bedtimes: (1) bedtime rules at both T1 and T2 (46%, n = 1155), (2) no bedtime rules at T1 nor T2 (26%, n = 656), (3) bedtime rules at T1 but not T2 (19%, n = 472), (4) no bedtime rules at T1 but a parent-set bedtime at T2 (9%, n = 226). As expected, the entire sample showed that bedtimes generally became later and sleep duration shorter across adolescence, but the change differed among the groups. Adolescents whose parents introduced bedtime rules at T2 reported earlier bedtimes and longer sleep duration (~20 min) compared with adolescents with no bedtime rules at T2. Importantly, they no longer differed from adolescents who consistently had bedtimes across T1 and T2. There was no significant interaction for sleep latency, which declined at a similar rate for all groups. These results are the first to suggest that maintaining or re-introducing a parent-set bedtime may be possible and beneficial for adolescents' sleep.

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    It's past your bedtime, but does it matter anymore? How longitudinal changes in bedtime rules relate to adolescents' sleep
  • 20.
    Bendelin, N.
    et al.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Hesser, Hugo
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Dahl, J.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Carlbring, P.
    Department of Psychology, Umeå University, Umeå, Sweden.
    Nelson, K. Z.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Andersson, G.
    Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden; Department of ClinicalNeuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden.
    Experiences of guided Internet-based cognitive-behavioural treatment for depression: A qualitative study2011In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 11, article id 107Article in journal (Refereed)
    Abstract [en]

    Background: Internet-based self-help treatment with minimal therapist contact has been shown to have an effect in treating various conditions. The objective of this study was to explore participants' views of Internet administrated guided self-help treatment for depression.

    Methods: In-depth interviews were conducted with 12 strategically selected participants and qualitative methods with components of both thematic analysis and grounded theory were used in the analyses.

    Results: Three distinct change processes relating to how participants worked with the treatment material emerged which were categorized as (a) Readers, (b) Strivers, and (c) Doers. These processes dealt with attitudes towards treatment, views on motivational aspects of the treatment, and perceptions of consequences of the treatment.

    Conclusions: We conclude that the findings correspond with existing theoretical models of face-to-face psychotherapy within qualitative process research. Persons who take responsibility for the treatment and also attribute success to themselves appear to benefit more. Motivation is a crucial aspect of guided self-help in the treatment of depression.

  • 21.
    Berg, Iren
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Bergquist, Rose-Marie
    Örebro University, School of Law, Psychology and Social Work.
    Edvardsson, Bo
    Örebro University, School of Law, Psychology and Social Work.
    BUP-utredningar: En kritisk granskning2002Report (Other academic)
    Abstract [en]

    Fifteen child psychiatric investigations are critically examined. Serious deficits and lack of objectivity and ethics are pointed out. 

    Download full text (pdf)
    BUPdiva.pdf
  • 22.
    Bergman Nordgren, Lise
    et al.
    Linköping University, Linköping, Sweden.
    Andersson, Gerhard
    Karolinska Institutet, Stockholm, Sweden; Linköping University, Linköping, Sweden.
    Kadowaki, Åsa
    County council of Östergötland, Linköping, Sweden.
    Carlbring, Per
    Umeå University, Umeå, Sweden.
    Tailored internet-administered treatment of anxiety disorders for primary care patients: Study protocol for a randomised controlled trial2012In: Trials, E-ISSN 1745-6215, Vol. 13, no 1, article id 16Article in journal (Refereed)
    Abstract [en]

    Internet-administered cognitive behavioural therapy (ICBT) has been found to be effective for a range of anxiety disorders. However, most studies have focused on one specific primary diagnosis and co-morbidity has not been considered. In primary care settings, patients with anxiety often suffer from more than one psychiatric condition, making it difficult to disseminate ICBT for specific conditions. The aim of this study will be to investigate if ICBT tailored according to symptom profile can be a feasible treatment for primary care patients with anxiety disorders. It is a randomised controlled trial aimed to evaluate the treatment against an active control group. Participants with anxiety disorders and co-morbid conditions (N = 128), will be recruited from a primary care population. The Clinical Outcome in Routine Evaluation (CORE-OM) will serve as the primary outcome measure. Secondary measures include self-reported depression, anxiety, quality of life and loss of production and the use of health care. All assessments will be collected via the Internet and measure points will be baseline, post treatment and 12 months post treatment. This trial will add to the body of knowledge on the effectiveness of ICBT for anxiety disorders in primary care. The trial will also add knowledge on the long term effects of ICBT when delivered for regular clinic patients ClinicalTrials.gov: NCT01390168.

  • 23.
    Bergman Nordgren, Lise
    et al.
    Linköping University, Linköping, Sweden.
    Carlbring, Per
    Stockholm University, Stockholm, Sweden.
    Linna, Emma
    Cereb, Stockholm, Sweden.
    Andersson, Gerhard
    Linköping University, Linköping, Sweden.
    Role of the Working Alliance on Treatment Outcome in Tailored Internet-Based Cognitive Behavioural Therapy for Anxiety Disorders: Randomized Controlled Pilot Trial2013In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 2, no 1, article id e4Article in journal (Refereed)
    Abstract [en]

    Background: Internet-based cognitive behavioral therapy (ICBT) is a form of guided self-help that has been found to be effective for addressing several problems. The target for this type of therapy is usually restricted to one specific disorder. Tailoring the treatment widens the scope of ICBT in that it can address comorbid conditions directly.

    Objectives: The working, or therapeutic, alliance has been found to predict outcome in studies of face-to-face therapy. The extent to which these findings apply to ICBT is largely unknown. We therefore decided to find out whether the working alliance could predict outcome in tailored ICBT for anxiety disorders.

    Methods: Data were obtained from the treatment group (n=27) in a randomized controlled trial aiming to test the effects of tailored ICBT for anxiety disorders. The forthcoming study was designed to test the hypothesis that the working alliance measured both pre-treatment and early in treatment (week 3) can predict treatment outcome as measured by the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) in a heterogeneous group of patients with anxiety disorders (n=27).

    Results: Working alliance measured at week 3 into the treatment correlated significantly with the residual gain scores on the primary outcome measure (r=-.47, P=.019, n=25), while expected working alliance pre-treatment did not (r=-.17, P=.42, n=27).

    Conclusions: These results raise questions about the importance of working alliance in ICBT treatments, and suggest that the working alliance could be important in ICBT.

  • 24.
    Björk, Lisa
    et al.
    Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.
    Bejerot, Eva
    Department of Psychology, University of Stockholm, Stockholm, Sweden.
    Jacobshagen, Nicola
    Institut für Psychologie, Universität Bern, Bern, Switzerland.
    Härenstam, Annika
    Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.
    I shouldn't have to do this: Illegitimate tasks as a stressor in relation to organizational control and resource deficits2013In: Work & Stress, ISSN 0267-8373, E-ISSN 1464-5335, Vol. 27, no 3, p. 262-277Article in journal (Refereed)
    Abstract [en]

    The performance of tasks that are perceived as unnecessary or unreasonable - illegitimate tasks - represents a new stressor concept that refers to assignments that violate the norms associated with the role requirements of professional work. Research has shown that illegitimate tasks are associated with stress and counterproductive work behaviour. The purpose of this study was to provide insight into the contribution of characteristics of the organization on the prevalence of illegitimate tasks in the work of frontline and middle managers. Using the Bern Illegitimate Task Scale (BITS) in a sample of 440 local government operations managers in 28 different organizations in Sweden, this study supports the theoretical assumptions that illegitimate tasks are positively related to stress and negatively related to satisfaction with work performance. Results further show that 10% of the variance in illegitimate tasks can be attributed to the organization where the managers work. Multilevel referential analysis showed that the more the organization was characterized by competition for resources between units, unfair and arbitrary resource allocation and obscure decisional structure, the more illegitimate tasks managers reported. These results should be valuable for strategic-level management since they indicate that illegitimate tasks can be counteracted by means of the organization of work.

  • 25.
    Blom, K.
    et al.
    Karolinska Institutet, Department of Clinical Neuroscience, Division of Psychiatry, Stockholm, Sweden.
    Tarkian Tillgren, H.
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Wiklund, T.
    Department of Pain and Rehabilitation Center, Linköping, Sweden; Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Danlycke, E.
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Forssén, M.
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Söderström, A.
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Johansson, R.
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Hesser, Hugo
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Jernelöv, S.
    Karolinska Institutet, Department of Clinical Neuroscience, Section of Psychology, Stockholm, Sweden.
    Lindefors, N.
    Karolinska Institutet, Department of Clinical Neuroscience, Division of Psychiatry, Stockholm, Sweden.
    Andersson, G.
    Karolinska Institutet, Department of Clinical Neuroscience, Division of Psychiatry, Stockholm, Sweden; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Kaldo, V.
    Karolinska Institutet, Department of Clinical Neuroscience, Division of Psychiatry, Stockholm, Sweden.
    Internet-vs. group-delivered cognitive behavior therapy for insomnia: A randomized controlled non-inferiority trial2015In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 70, p. 47-55Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare guided Internet-delivered to group-delivered cognitive behavioral therapy (CBT) for insomnia. We conducted an 8-week randomized controlled non-inferiority trial with 6-months follow-up. Participants were forty-eight adults with insomnia, recruited via media. Interventions were guided Internet-delivered CBT (ICBT) and group-delivered CBT (GCBT) for insomnia. Primary outcome measure was the Insomnia Severity Index (ISI), secondary outcome measures were sleep diary data, depressive symptoms, response- and remission rates. Both treatment groups showed significant improvements and large effect sizes for ISI (Within Cohen's d: ICBT post = 1.8, 6-months follow-up = 2.1; GCBT post = 2.1, 6-months follow-up = 2.2). Confidence interval of the difference between groups posttreatment and at FU6 indicated non-inferiority of ICBT compared to GCBT. At post-treatment, two thirds of patients in both groups were considered responders (ISI-reduction > 7p). Using diagnostic criteria, 63% (ICBT) and 75% (GCBT) were in remission. Sleep diary data showed moderate to large effect sizes. We conclude that both guided Internet-CBT and group-CBT in this study were efficacious with regard to insomnia severity, sleep parameters and depressive symptoms. The results are in line with previous research, and strengthen the evidence for guided Internet-CBT for insomnia.

    Trial registration: The study protocol was approved by, and registered with, the regional ethics review board in Linkoping, Sweden, registration number 2010/385-31.

  • 26.
    Blom, Victoria
    et al.
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Bodin, Lennart
    Division of Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Bergström, Gunnar
    Division of Intervention and Implementation Research, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Svedberg, Pia
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    Applying the demand-control-support model on burnout in managers and non-managers2016In: International Journal of Workplace Health Management, ISSN 1753-8351, E-ISSN 1753-836X, Vol. 9, no 1, p. 110-122Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper is to study the demand-control-support (DCS) model on burnout in male and female managers and non-managers, taking into account genetic and shared family environmental factors, contributing to the understanding of mechanisms of how and when work stress is related to burnout.

    Design/methodology/approach: A total of 5,510 individuals in complete same-sex twin pairs from the Swedish Twin Registry were included in the analyses. Co-twin control analyses were performed using linear mixed modeling, comparing between-pairs and within-pair effects, stratified by zygosity and sex.

    Findings: Managers scored higher on demands and control in their work than non-managers, and female managers seem to be particularly at risk for burnout facing more demands which are not reduced by a higher control as in their male counterparts. Co-twin analyses showed that associations between control and burnout as well as between demands and burnout seem to be affected by shared family environmental factors in male non-managers but not in male managers in which instead the associations between social support and burnout seem to be influenced by shared family environment.

    Practical implications: Taken together, the study offers knowledge that shared environment as well as sex and managerial status are important factors to consider in how DCS is associated to exhaustion.

    Originality/value: Using twin data with possibilities to control for genetics, shared environment, sex and age, this study offers unique insight into the DCS research, which focusses primarily on the workplace environment rather than individual factors.

  • 27.
    Boersma, Katja
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Editorial comment on Nina Kreddig's and Monika Hasenbring's study on pain anxiety and fear of (re) injury in patients with chronic back pain: Sex as a moderator2017In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 16, p. 89-90, article id S1877-8860(17)30050-2Article in journal (Refereed)
  • 28.
    Boersma, Katja
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Expectancy, fear and pain in the prediction of chronic pain and disability: A prospective analysis2006In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 10, no 6, p. 551-557Article in journal (Refereed)
    Abstract [en]

    Studies with (sub) acute back pain patients show that negative expectancies predict pain and disability at a one-year follow up. Yet, it is not clear how expectations relate to other factors in the development of chronic disability such as pain and fear. This study investigates the relationship between expectations, pain-related fear and pain and studies how these variables are related to the development of chronic pain and disability. Subjects (N = 141) with back and/or neck pain (duration <1 year) were recruited via primary care. They completed measures on pain, expectancy, pain-related fear (pain-related negative affect and fear avoidance beliefs) and function. A one-year follow up was conducted with regard to pain and function. It was found that pain, expectancy, pain-related fear and function were strongly interrelated. In the cross-sectional analyses negative expectancies were best explained by frequent pain and a belief in an underlying and serious medical problem. Prospectively, negative expectancy, negative affect and a belief that activity may result in (re) injury or increased pain, explained unique variance in both pain and function at one-year follow up. In conclusion, expectancy, negative affect and fear avoidance beliefs are interrelated constructs that have predictive value for future pain and disability. Clinically, it can be helpful to inquire about beliefs, expectancy and distress as an indication of risk as well as to guide intervention. However, the strong interrelations between the variables call for precaution in treating them as if they were separate entities existing in reality. 

  • 29.
    Boersma, Katja
    et al.
    Örebro University, School of Law, Psychology and Social Work. Center for Health and Medical Psychology.
    Södermark, Martin
    Department of Medical and Health Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden.
    Hesser, Hugo
    Department of Behavioural Sciences and Learning, Division of Psychology, Linköping University, Linköping, Sweden.
    Flink, Ida
    Örebro University, School of Law, Psychology and Social Work.
    Gerdle, Björn
    Department of Medical and Health Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work. Center for Health and Medical Psychology.
    Efficacy of a transdiagnostic emotion-focused exposure treatment for chronic pain patients with comorbid anxiety and depression: a randomized controlled trial2019In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 160, no 8, p. 1708-1718Article in journal (Refereed)
    Abstract [en]

    The comorbidity between chronic pain and emotional problems has proven difficult to address with current treatment options. This study addresses the efficacy of a transdiagnostic emotion-focused exposure treatment ("hybrid") for chronic pain patients with comorbid emotional problems. Adults (n = 115) with chronic musculoskeletal pain and functional and emotional problems were included in a 2-centre, parallel randomized controlled, open-label trial comparing this treatment to an active control condition receiving a guided Internet-delivered pain management treatment based on CBT principles (iCBT). The hybrid treatment (n = 58, 10-16 sessions) integrates exposure in vivo for chronic pain based on the fear-avoidance model with an emotion-regulation approach informed by procedures in Dialectical Behavior Therapy. The iCBT (n = 57; 8 treatment modules) addresses topics such as pain education, coping strategies, relaxation, problem solving, stress, and sleep management using standard CBT techniques. Patient-reported outcomes were assessed before and after treatment as well as at a 9-month primary end point. Across conditions, 78% participants completed post-treatment and 81% follow-up assessment. Intent-to-treat analyses showed that the hybrid had a significantly better post-treatment outcome on pain catastrophizing (d = 0.39) and pain interference (d = 0.63) and significantly better follow-up outcomes on depression (d = 0.43) and pain interference (d = 0.51). There were no differences on anxiety and pain intensity. Observed proportions of clinically significant improvement favoured the hybrid on all but one comparison, but no statistically significant differences were observed. We conclude that the hybrid emotion-focused treatment may be considered an acceptable, credible, and efficacious treatment option for chronic pain patients with comorbid emotional problems.

  • 30.
    Borbely, Danielle
    Örebro University, School of Law, Psychology and Social Work.
    Abusive Parenting Behavior and its Relation to Adolescent Violence and Violence Victimization.2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
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    fulltext
  • 31.
    Borbely, Danielle
    Örebro University, School of Law, Psychology and Social Work.
    Are all Children affected by Abusive Parenting in the same Way? The Role of Shyness and Coping in Understanding the Effects of Abusive Home Context.2012Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
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    fulltext
  • 32.
    Brinkborg, H.
    et al.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Michanek, J.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Hesser, Hugo
    Örebro University, School of Law, Psychology and Social Work. Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden.
    Berglund, G.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Acceptance and commitment therapy for the treatment of stress among social workers: A randomized controlled trial2011In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 49, no 6-7, p. 389-398Article in journal (Refereed)
    Abstract [en]

    Chronic stress increases the risk of health problems and absenteeism, with negative consequences for individuals, organizations and society. The aim of the present study was to examine the effect of a brief stress management intervention based on the principles of Acceptance and Commitment Therapy (ACT) on stress and general mental health for Swedish social workers (n = 106) in a randomized, controlled trial. Participants were stratified according to stress level at baseline in order to examine whether initial stress level moderated the effect of the intervention. Two thirds of the participants had high stress levels at baseline (Perceived Stress Scale; score of >= 25). The results showed that the intervention significantly decreased levels of stress and burnout, and increased general mental health compared to a waiting list control. No statistically significant effects were, however, found for those with low levels of stress at baseline. Among participants with high stress, a substantial proportion (42%) reached criteria for clinically significant change. We concluded that the intervention successfully decreased stress and symptoms of burnout, and increased general mental health. Evidence is, thus, provided supporting ACT as brief, stress management intervention for social workers.

  • 33.
    Buhrman, Monica
    et al.
    Uppsala universitet, Uppsala, Sweden.
    Tillfors, Maria
    Department of Social and Psychological Studies, Section of Psychology, Karlstad University, Karlstad.
    Holländare, Fredrik
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Lekström, Emily
    Uppsala universitet, Uppsala, Sweden.
    Håkansson, Alexander
    Örebro University, School of Behavioural, Social and Legal Sciences.
    Boersma, Katja
    Örebro University, School of Behavioural, Social and Legal Sciences.
    Psychological treatment targeting acceptance and compassion in chronic pain patients: a randomized controlled, internet delivered, treatment trial2023In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 39, no 12, p. 672-685Article in journal (Other academic)
    Abstract [en]

    Objectives: Chronic pain is often associated with suffering. Self-criticism is associated with depressive symptoms. The purpose of this study was to explore if fusing acceptance and commitment therapy (ACT) and compassion focused therapy (CFT), could improve psychological wellbeing and disability in chronic pain patients with high levels of self-criticism in comparison to a wait-list control group. 

    Methods: Individuals with chronic pain (n=71) were randomly assigned to an 8-week internet-based intervention focused on acceptance and compassion or a wait-list condition. Primary treatments outcomes were Chronic Pain Acceptance Questionnaire, Self-Compassion Scale, and Pain Disability index. Secondary outcomes were Montgomery Åsberg Depression Rating Scale, Anxiety sensitivity index, Quality of Life Inventor, Multidimensional Pain Inventory and Perseverative Thinking Questionnaire. 

    Results: Missing data at post-intervention was 22.5%. ITT-analyses were conducted using linear mixed-models. Results revealed significantly greater levels of acceptance and self-compassion for the treatment group, which were primary outcomes, with effect sizes ranging from small to large and these results were maintained at six-month follow-up. Rates of clinical significant improvements were also greater for the treatment group in comparison to the wait-list control group on acceptance and compassion. Results in the third primary outcome showed also improvements in disability levels. Significant differences were also found in several of the secondary outcomes, in favour for the treatment group.

    Discussion: Internet-based ACT with CFT components shows promise as a viable treatment option in the management of chronic pain.

  • 34.
    Caneiro, J. P.
    et al.
    Curtin University, School of Allied Health, Faculty of Health Sciences, Perth, Western Australia, Australia.
    Smith, Anne
    Curtin University, School of Allied Health, Faculty of Health Sciences, Perth, Western Australia, Australia.
    Bunzli, Samantha
    University of Melbourne Department Surgery, St. Vincent's Hospital, Melbourne, Australia.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Moseley, G Lorimer
    IIMPACT in Health, University of South Australia, Adelaide, Australia.
    O'Sullivan, Peter
    Curtin University, School of Allied Health, Faculty of Health Sciences, Perth, Western Australia, Australia.
    From Fear to Safety: A Roadmap to Recovery from Musculoskeletal Pain2022In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 102, no 2, article id pzab271Article in journal (Refereed)
    Abstract [en]

    Contemporary conceptualizations of pain emphasize its protective function. The meaning assigned to pain drives cognitive, emotional, and behavioral responses. When pain is threatening, and a person lacks control over their pain experience, it can become distressing, self-perpetuating, and disabling. Although the pathway to disability is well established, the pathway to recovery is less researched and understood. This Perspective draws on recent data on the lived experience of people with pain-related fear to discuss both fear and safety learning processes and their implications for recovery for people living with pain. Recovery is here defined as achievement of control over pain, as well as improvement in functional capacity and quality of life. Based on the common-sense model, this Perspective proposes a framework utilizing cognitive functional therapy to promote safety learning. A process is described in which experiential learning combined with "sense making" disrupts a person's unhelpful cognitive representation and behavioral and emotional response to pain, leading them on a journey to recovery. This framework incorporates principles of inhibitory processing that are fundamental to pain-related fear and safety learning.

  • 35.
    Carstens, Johan K. P.
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Schrooten, Martien G. S.
    Örebro University, School of Law, Psychology and Social Work.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Effects of validating communication on recall during a pain-task in healthy participants2017In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 17, p. 118-125, article id S1877-8860(17)30143-XArticle in journal (Refereed)
    Abstract [en]

    BACKGROUND: Increasing recall of instructions and advice in a pain consultation is important, since it is a prerequisite for adherence to treatment recommendations. However, interference due to pain-related distress may result in poor recall. Whereas there are some indications that recall can be increased by empathic communication that reduces interference, this interesting possibility remains largely untested experimentally. The current experiment aimed at studying effects of empathic communication, and more specifically validation, on recall during a pain test and possible mediators and moderators of this effect.

    METHOD: Participants received either validating (N=25) or invalidating responses (N=25) from the experimenter during a pain provoking task, followed by self-report measures of interference (affect, situational pain catastrophizing) and recall (accurate and false memories of words).

    RESULTS: As expected, the validated group exhibited higher accurate recall and less false memories following the pain test as compared to the invalidated group. This was partly due to the effect of interference being counteracted by moderating the relationship between pain catastrophizing and recall.

    CONCLUSION: These novel results suggest that validating communication can counteract interference due to pain catastrophizing on recall, at least in a controlled experimental setting.

    IMPLICATIONS: Good communication by health professionals is of utmost importance for adherence to pain management. The current results expand our knowledge on the effects of pain communication by establishing and explaining a clear link between empathic communication and recall, highlighting the role of pain catastrophizing.

  • 36.
    Carvalho, Sérgio A.
    et al.
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal; HEI-Lab, Digital Human-Environment Interaction Lab, School of Psychology and Life Sciences, Lusófona University, Lisbon, Portugal.
    Gillanders, David
    School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK.
    Forte, Teresa
    Department of Social, Political and Territorial Sciences, University of Aveiro, Aveiro, Portugal.
    Trindade, Inês A.
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Pinto-Gouveia, José
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.
    Lapa, Teresa
    Anaesthesiology Service, Coimbra Hospital and University Centre, Coimbra, Portugal; Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.
    Valentim, Ana
    Anaesthesiology Service, Coimbra Hospital and University Centre, Coimbra, Portugal.
    Santos, Elsa
    Anaesthesiology Service, Coimbra Hospital and University Centre, Coimbra, Portugal.
    Paciência, Juliana
    Anaesthesiology Service, Coimbra Hospital and University Centre, Coimbra, Portugal.
    Guiomar, Raquel
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.
    Castilho, Paula
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.
    Self-compassion in Acceptance and Commitment Therapy for chronic pain: A pilot study2022In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 22, no 3, p. 631-638Article in journal (Refereed)
    Abstract [en]

    Objectives: Evidence shows that Acceptance and Commitment Therapy (ACT) is an empirically supported psychological approach for chronic pain (CP) management. Although self-compassion is not explicitly a target of ACT, it seems to be one mechanism of change in ACT for CP. However, research is lacking on the benefits of including explicit self-compassionate exercises in ACT for CP. The current study pilot tested a Compassionate ACT 8-session group program (COMP.ACT; n=9), as well as an ACT-only 8-session group program (ACT; n=7), in a sample of women with CP.

    Methods: The current study follows a quasi-experimental design, and conducts Reliable and Significant Change analyses comparing pre- to post-intervention scores of self-report measures.

    Results: No differences were found between conditions at baseline, nor between completers and drop-outs. Although preliminary, results showed COMP.ACT led to greater clinical improvements in depression and anxiety, while ACT led to greater improvements in stress and uncompassionate self-responding. Reliable and Significant Change analysis showed that some participants improved significantly (in psychopathological symptoms, valued living and uncompassionate self-responding) in both conditions, while the majority did not change significantly.

    Conclusions: More research is needed to conclude whether explicit self-compassion exercises are useful in ACT for CP. Limitations and implications are further discussed.

  • 37.
    Carvalho, Sérgio A.
    et al.
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal; CINEICC, Faculdade de Psicologia e de Ciências da Educação da Universidade de Coimbra, Coimbra, Portugal.
    Palmeira, Lara
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal; Oporto Global University, Porto, Portugal.
    Coutinho, Mariana
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    Barbosa, Rosa
    Portuguese League Against Cancer, Porto, Portugal.
    Trindade, Inês
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    Self-as-context and depressive symptoms in the general population: A further analysis of the self experiences questionnaire2022In: Current Psychology, ISSN 1046-1310, E-ISSN 1936-4733, Vol. 41, no 12, p. 8897-8907Article in journal (Refereed)
    Abstract [en]

    The current study aims to contribute to the psychometric validation of the Self Experiences Questionnaire (SEQ), a measure of self-as-context as conceptualized by Acceptance and Commitment Therapy, and to contribute to a better understanding of the relationship between self-as-context, other psychological flexibility processes, and depressive symptoms. The sample (N = 266; 72.6% women) was obtained through paper-pencil and online collection methods in the general Portuguese population. Confirmatory factor analysis, reliability analyses, and convergent and divergent analyses were conducted. A mediation analysis of the effects of self-as-distinction and self-as-observer on depression symptoms through openness to experience, behavioral awareness, and valued action (while controlling for brooding) was performed using PROCESS. Items 8, 12 and 15 were removed to achieve the best model fit, which resulted in a 12-item final version of the SEQ. This version appears to be a psychometrically valid two-dimensional measure of self-as-distinction and self-as-observer, as well as a one global measure of self-as-context. Results from mediation analyses suggested that the relationship of self-as-observer and self-as-distinction with depressive symptoms is mediated by the ability to be behaviorally aware and to act according to personal values, but not by the ability to be open to experience. The behaviorally-oriented aspects of psychological flexibility seem to have particular importance on the presentation of depressive symptoms. More studies are nonetheless needed to analyze SEQ's structure and validity in order to attain a consensual version of the questionnaire.

  • 38.
    Carvalho, Sérgio A.
    et al.
    Universidade Lusófona de Humanidades e Tecnologias, Escola de Psicologia e Ciências da Vida, HEI–Lab, Lisboa, Portugal; Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal.
    Skvarc, David
    School of Psychology, Deakin University, Geelong, Victoria, Australia.
    Barbosa, Rosa
    Unidade de Psico-Oncologia, Núcleo Regional do Centro da Liga Portuguesa Contra o Cancro (Portuguese League Against Cancer), Coimbra, Portugal.
    Tavares, Tito
    Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal.
    Santos, Diana
    Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal.
    Trindade, Inês A.
    Universidade de Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Coimbra, Portugal; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    A pilot randomized controlled trial of online acceptance and commitment therapy versus compassion-focused therapy for chronic illness2022In: Clinical Psychology and Psychotherapy, ISSN 1063-3995, E-ISSN 1099-0879, Vol. 29, no 2, p. 524-541Article in journal (Refereed)
    Abstract [en]

    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.

  • 39.
    Carvalho, Sérgio A.
    et al.
    University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Coimbra, Portugal.
    Trindade, Inês A.
    University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Coimbra, Portugal.
    Duarte, Joana
    Lund University, Department of Psychology, Lund, Sweden.
    Menezes, Paulo
    University of Coimbra, Department of Electrical and Computer Engineering, Coimbra, Portugal; Institute of Systems and Robotics, Coimbra, Portugal.
    Patrão, Bruno
    University of Coimbra, Department of Electrical and Computer Engineering, Coimbra, Portugal; Institute of Systems and Robotics, Coimbra, Portugal.
    Nogueira, Maria Rita
    Institute of Systems and Robotics, Coimbra, Portugal; University of Coimbra, College of Arts, Coimbra, Portugal.
    Guiomar, Raquel
    University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Coimbra, Portugal.
    Lapa, Teresa
    Coimbra Hospital and University Center, Pain Unit, Coimbra, Portugal; Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal.
    Pinto-Gouveia, José
    University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Coimbra, Portugal.
    Castilho, Paula
    University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Coimbra, Portugal.
    Efficacy of an ACT and Compassion-Based eHealth Program for Self-Management of Chronic Pain (iACTwithPain): Study Protocol for a Randomized Controlled Trial2021In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 12, article id 630766Article in journal (Refereed)
    Abstract [en]

    Background: Chronic pain (CP) has serious medical and social consequences and leads to economic burden that threatens the sustainability of healthcare services. Thus, optimized management of pain tools to support CP patients in adjusting to their condition and improving their quality of life is timely. Although acceptance and commitment therapy (ACT) is considered an evidence-based psychological approach for CP, evidence for the efficacy of online-delivered ACT for CP is still scarce. At the same time, studies suggest that self-compassion mediates the change in disability and psychopathological symptoms in ACT interventions for CP, although self-compassion is not a specific target in ACT. Thus, an explicit focus on self-compassion might increase the efficacy of ACT interventions for CP, although this hypothesis has not been tested. This study aims to develop an eHealth ACT and compassion-based self-management intervention for CP, the iACTwithPain, and to compare its efficacy in improving health outcomes to a similar ACT-only intervention and a medical TAU group.

    Methods: The eHealth platform that will host the interventions will be developed using a flat design identity and will be interactive. The iACTwithPain intervention will comprise eight weekly self-management sessions and will be developed taking into consideration the psychological flexibility model applied to CP, with the addition of explicit compassion-based components. To analyze whether the iACTwithPain intervention will present superiority in improving CP's impact and related health markers over the two other conditions, this study will follow an RCT design with three arms. CP patients will be recruited through direct contact with patient associations and healthcare services and a national press release in Portugal. Outcome measurement will be conducted at baseline, post-intervention and at 3- and 6-month follow-ups. The interventions' acceptability will also be assessed.

    Discussion: The iACTwithPain intervention is expected to improve CP patients' psychosocial functioning, quality of life, and empowerment, by promoting adaptive disease management and regulation of pain-related internal experiences. Results will contribute to a better understanding on the pertinence of adding compassion elements to ACT for CP and to reach an optimized intervention for CP.

  • 40.
    Carvalho, Sérgio A.
    et al.
    Cognitive‐Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    Trindade, Inês A.
    Cognitive‐Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    Gillanders, David
    School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK.
    Pinto-Gouveia, José
    Cognitive‐Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    Castilho, Paula
    Cognitive‐Behavioural Research Centre (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    Cognitive fusion and depressive symptoms in women with chronic pain: A longitudinal growth curve modelling study over 12 months2019In: Clinical Psychology and Psychotherapy, ISSN 1063-3995, E-ISSN 1099-0879, Vol. 26, no 5, p. 616-625Article in journal (Refereed)
    Abstract [en]

    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.

  • 41.
    Carvalho, Sérgio A.
    et al.
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal.
    Trindade, Inês A.
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal.
    Gillanders, David
    School of Health in Social Sciences, University of Edinburgh, Edinburgh, Scotland.
    Pinto-Gouveia, José
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal.
    Castilho, Paula
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal.
    Self-Compassion and Depressive Symptoms in Chronic Pain (CP): A 1-Year Longitudinal Study2020In: Mindfulness, ISSN 1868-8527, E-ISSN 1868-8535, Vol. 11, no 3, p. 709-719Article in journal (Refereed)
    Abstract [en]

    Objectives: Self-compassion is associated with less depressive symptoms, better mental health outcomes, and less disability in chronic pain (CP). However, it remains longitudinally unexplored the role of self-compassion in CP. Also, although it acknowledged the conceptual overlapping between mindfulness and self-compassion, few studies have explored the role of self-compassion in CP while controlling for mindfulness in a longitudinal design.

    Methods: The current study conducts correlational and hierarchical linear regression analyses in a sample of 86 women with CP who completed an online battery of questionnaires that assess pain intensity, functional impairment, depressive symptoms, mindfulness, and self-compassion in three time points: baseline (T0), 6 months (T1), and 12 months (T2).

    Results: Results show that self-compassion (but not mindfulness) significantly predicts depressive symptoms at T1 and at T2 above and beyond depressive symptoms and functional impairment. Also, the interaction between functional impairment and self-compassion at T0 significantly predicts depressive symptoms at T1, but not at T2.

    Conclusions: These findings expand the current knowledge on the role of self-compassion in CP in showing that self-compassion is a significant predictor of later depressive symptoms in CP and suggesting its potential role in buffering the impact of functional impairment in future levels of depressive symptoms.

  • 42.
    Coelho, Helena L.
    et al.
    Centre for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    Trindade, Inês A.
    Centre for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    Mendes, Ana Laura
    Centre for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    Ferreira, Cláudia
    Centre for Research in Neuropsychology and Cognitive and Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal.
    The mediating role of shame and fear of compassion on the relationship between major life events and depressive symptoms2021In: Current Psychology, ISSN 1046-1310, E-ISSN 1936-4733, Vol. 40, no 9, p. 4553-4562Article in journal (Refereed)
    Abstract [en]

    An extensive body of research has showed the impact of major life events on depressive symptoms. However, the underlying psychological processes that contribute to this association are still unclear. The present study aims to explore the mediating role of external shame and fears of receiving compassion on the associations of the number of major life events and their appraisals by the individual with depressive symptoms. Participants were 400 Portuguese-speaking adults from the general population (121 men and 279 women) with ages between 18 and 65 years, that completed self-report measures. Correlation analysis showed significant and positive associations between the number of major life events that occurred in the previous year and the positive and negative appraisal of such events, external shame, fears of receiving compassion, and depressive symptoms. Path analysis revealed that external shame and fears of receiving compassion fully mediated the effects of number of life events on depressive symptoms. Furthermore, results showed a direct effect of negative appraisal of major life events on depressive symptoms. This study sheds light on the psychological processes that may underlie the relationship between the cumulative number of major life events and depressive symptoms. Specifically, it suggests that the occurrence of major life events can impact on depressive symptoms when associated with feelings of shame and fears of receiving compassion from others.

  • 43.
    Coutinho, Mariana
    et al.
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Portugal.
    Trindade, Inês A.
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Portugal.
    Ferreira, Cláudia
    Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), University of Coimbra, Portugal.
    Experiential avoidance, committed action and quality of life: Differences between college students with and without chronic illness2021In: Journal of Health Psychology, ISSN 1359-1053, E-ISSN 1461-7277, Vol. 26, no 7, p. 1035-1045Article in journal (Refereed)
    Abstract [en]

    This study aimed to explore, through structural equation modelling, experiential avoidance and committed action's effects on the association between anxiety and psychological quality of life and whether this relationship presents significant differences across a sample of 115 college students with chronic illness and a sample of 232 students without illness. Students with chronic illness presented higher levels of anxiety and experiential avoidance and lower levels of quality of life. The association between anxiety and psychological quality of life was partially explained by experiential avoidance and committed action. This path model was shown to be invariant between the two groups of students.

  • 44.
    Dias, Bernardo Santos
    et al.
    CINEICC, Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal.
    Ferreira, Cláudia
    CINEICC, Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal.
    Trindade, Inês A.
    CINEICC, Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal.
    Influence of fears of compassion on body image shame and disordered eating2020In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 25, no 1, p. 99-106Article in journal (Refereed)
    Abstract [en]

    Purpose: The current study tested a path model examining the impact of fears of compassion in the adoption of disordered eating and whether social safeness and body shame would mediate this relationship.

    Methods: Participants were 645 women (aged between 18 and 55) from the general community, who completed an online survey.

    Results: Results indicated that fears of compassion were negatively associated with one's ability to feel secure and safe within close relationships, and positively linked with higher levels of body shame and disordered eating. The tested model accounted for 62% of the variance of disordered eating. Path analyses results revealed that the three dimensions of fears of compassion impacted on disordered eating. Particularly, fear of expressing compassion for others presented a direct impact on disordered eating. Moreover, fears of self-compassion and fears of receiving compassion from others partially impacted on disordered eating attitudes and behaviours, through the mechanisms of social safeness and body image-focused shame. These findings suggested that women who present higher levels of fear of self-compassion and of receiving signs of affection and compassion from others tend to feel more insecure in their social group, which seem explain body shame and the engagement in disordered eating behaviours.

    Conclusions: This study highlights the pathogenic impact of fears of compassion on body image and eating attitudes and behaviours. The current data seem to offer relevant insights for research and clinical practice, by supporting the relevance of developing compassionate abilities and attitudes to target body image and eating-related difficulties.

  • 45.
    Dirkse, D.
    et al.
    Department of Psychology, University of Regina, Regina SK, Canada.
    Hadjistavropoulos, H. D.
    Department of Psychology, University of Regina, Regina SK, Canada.
    Hesser, Hugo
    Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.
    Barak, A.
    Department of Counseling Psychology, University of Haifa, Haifa, Israel.
    Linguistic Analysis of Communication in Therapist-Assisted Internet-Delivered Cognitive Behavior Therapy for Generalized Anxiety Disorder2015In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 44, no 1, p. 21-32Article in journal (Refereed)
    Abstract [en]

    Therapist-assisted Internet-delivered cognitive behavior therapy (ICBT) involves elements of expressive writing through secure messaging with a therapist. Expressive writing has been associated with psychological and physical health benefits in past research; furthermore, certain linguistic dimensions in expressive writing have been identified as particularly beneficial to health, such as less frequent use of negative emotion words and greater use of positive emotion words. No research, to date, has analyzed linguistic dimensions in client communication over the course of therapist-assisted ICBT for individuals with symptoms of generalized anxiety. This naturalistic study examined messages sent to therapists during the course of ICBT using linguistic analysis, and explored covariation of word use with symptom improvement. Data were obtained from patients with symptoms of generalized anxiety (N=59) who completed 12 modules of therapist-assisted ICBT and rated symptoms of anxiety, depression, and panic at the beginning of each module. Linguistic analysis categorized text submitted to therapists into different word categories. Results found that patients' use of negative emotion, anxiety, causation, and insight words reduced over the course of treatment, while past tense words increased. Furthermore, negative emotion words significantly covaried with symptom ratings over the course of treatment. While causal statements cannot be made, findings improve our understanding of patient communication in ICBT and suggest that the further study of linguistic dimensions as psychological indicators and the potential utility of expressive writing strategies in therapist-assisted ICBT may be worthwhile.

  • 46.
    Duarte, Cristiana
    et al.
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
    Ferreira, Cláudia
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
    Pinto-Gouveia, José
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
    Trindade, I. A.
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
    Martinho, A.
    Faculty of Psychology and Educational Sciences, University of Coimbra, University of Coimbra, Portugal.
    What makes dietary restraint problematic? Development and validation of the Inflexible Eating Questionnaire2017In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 114, p. 146-154Article in journal (Refereed)
    Abstract [en]

    This study presents the Inflexible Eating Questionnaire (IEQ), which measures the inflexible adherence to subjective eating rules.

    The scale's structure and psychometric properties were examined in distinct samples from the general population comprising both men and women.

    IEQ presented an 11-item one-dimensional structure, revealed high internal consistency, construct and temporal stability, and discriminated eating psychopathology cases from non-cases. The IEQ presented significant associations with dietary restraint, eating psychopathology, body image inflexibility, general psychopathology symptoms, and decreased intuitive eating. IEQ was a significant moderator on the association between dietary restraint and eating psychopathology symptoms.

    Findings suggested that the IEQ is a valid and useful instrument with potential implications for research on psychological inflexibility in disordered eating.

  • 47.
    Duarte, Cristiana
    et al.
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), University of Coimbra, Portugal.
    Ferreira, Cláudia
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), University of Coimbra, Portugal.
    Trindade, Inês A.
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), University of Coimbra, Portugal.
    Pinto-Gouveia, José
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), University of Coimbra, Portugal.
    Body image and college women's quality of life: The importance of being self-compassionate2015In: Journal of Health Psychology, ISSN 1359-1053, E-ISSN 1461-7277, Vol. 20, no 6, p. 754-764Article in journal (Refereed)
    Abstract [en]

    This study explored self-compassion as a mediator between body dissatisfaction, social comparison based on body image and quality of life in 662 female college students. Path analysis revealed that while controlling for body mass index, self-compassion mediated the impact of body dissatisfaction and unfavourable social comparisons on psychological quality of life. The path model accounted for 33per cent of psychological quality of life variance. Findings highlight the importance of self-compassion as a mechanism that may operate on the association between negative body image evaluations and young women's quality of life.

  • 48.
    Duarte, Cristiana
    et al.
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal.
    Ferreira, Cláudia
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal.
    Trindade, Inês A.
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal.
    Pinto-Gouveia, José
    Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculdade de Psicologia e Ciências da Educação, Universidade de Coimbra, Coimbra, Portugal.
    Normative body dissatisfaction and eating psychopathology in teenage girls: the impact of inflexible eating rules2016In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 21, no 1, p. 41-48Article in journal (Refereed)
    Abstract [en]

    Adolescence has been considered a critical time for the development of body image-related difficulties and disordered eating behaviours, especially in females. Although adherence to eating rules has been linked to disordered eating, literature has not yet explored how the inflexible subscription to those rules impacts on eating psychopathology. Therefore, the aim of the current study was to explore whether inflexible eating impacts on the relationships between weight and body image-related variables, and disordered eating.

    Participated in this study are 497 female adolescents from the community, aged between 14 and 18 years old, who completed self-report measures.

    Results revealed that the majority of the participants were dissatisfied with their weight and body shape. Moreover, 6.64 % of the participants demonstrated severe eating psychopathology. A path analysis revealed that BMI, body dissatisfaction and social comparisons based on physical appearance impact on disordered eating behaviours, through the mechanism of inflexible adherence to eating rules. This model explained 52 % of eating psychopathology's variance.

    Findings highlight the relevance of body image-related difficulties in adolescence and additionally they emphasise the importance of promoting more flexible attitudes towards eating in prevention and intervention programmes with female adolescents.

  • 49.
    Edlund, Sara M.
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Carlsson, Maria L.
    Örebro University, School of Law, Psychology and Social Work.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Fruzzetti, Alan E.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    I see you're in pain: the effects of partner validation on emotions in people with chronic pain2013Conference paper (Other academic)
  • 50.
    Edlund, Sara M.
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Carlsson, Maria L.
    School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Fruzzetti, Alan E.
    Department of Psychology 298, University of Nevada, Reno, USA.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    I see you're in pain: the effects of partner validation on emotions in people with chronic pain2015In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 6, p. 16-21Article in journal (Other academic)
    Abstract [en]

    Background and aims

    Chronic pain not only affects the person in pain, but can also have a negative impact on relationships with loved ones. Research shows that chronic pain is associated with difficulties in marital relationships, which in turn is related to a variety of negative outcomes such as psychological distress and conflict within the family. This suggests that couples where chronic physical pain is present also struggle with emotional pain and relationship problems, and thus targeting relationship skills and interpersonal functioning might be helpful for these couples. Although studies in this area are promising, their numbers are few. In the present study, validation as a way of communicating is suggested for handling emotional expression in interpersonal interactions. Validation communicates understanding and acceptance of the other person's experience, and it has been shown to have a down-regulating effect on negative emotions. It has previously been demonstrated to be important for these couples. However, the feasibility and effects of increasing partner validation in these couples are unknown. Therefore, the aim of the present study was to investigate if a brief training session in validation for spouses would result in more validating and fewer invalidating responses towards their partners with pain, and to investigate if changes in these behavioural responses were associated with changes in emotion and pain level in the partner with pain.

    Methods

    Participants were 20 couples where at least one partner reported chronic pain. The study employed a within-groups design in which spouses of people with pain received validation training (without their partner's knowledge), and their validating and invalidating responses were rated pre- and post-intervention using a reliable observational scale. Also, positive and negative affect and subjective pain level in the persons with pain were rated pre- and post-intervention.

    Results

    Results showed that the validation training was associated with increased validating and decreased invalidating responses in the partners. Their spouses with chronic pain reported a decrease in negative affect from pre- to post-training.

    Conclusions

    Our results indicate that the partner or closest family member, after brief validation training, increased validating responses and decreased invalidating responses towards the person with pain, which had an immediate positive impact on emotions in the other person.

    Implications

    This study suggests that using validation in interpersonal interactions is a promising tool for couples where chronic pain is present.

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