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  • 1. Anna, Malmquist
    et al.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Föräldraskap2017In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundren, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur och kultur, 2017, p. 227-244Chapter in book (Other (popular science, discussion, etc.))
  • 2.
    Anniko, Malin
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Stressing Emotions: Emotion Focused Transdiagnostic Treatment for Work Stress2014Conference paper (Refereed)
    Abstract [en]

    Background: Work related stress usually involves a variety of difficulties within the realm of emotional disorders, while CBT treatments are often disorder specific. To effectively address work stress, more versatile and parsimonious interventions are needed. Transdiagnostic treatments, targeting common psychological processes in emotion related disorders are now available. One such treatment, the Unified Protocol (Barlow et al., 2011), has shown promising results. It focuses on inflexible and maladaptive use of emotion regulation strategies. Research implies that maladaptive strategies such as excessive worrying and avoidance may also be important for stress prolongation. Thus, the implementation of a transdiagnostic treatment protocol for work stress needs to be evaluated.

    Aim: To study whether treatment using the Unified Protocol, targeting generic emotional regulation, is feasible for patients who present with work stress. Furthermore, the aim is to investigate whether this treatment affects levels of stress as well as symptoms of anxiety and depression.

    Method: Using a single case experimental design, we recruited six patients seeking treatment for work stress at an occupational health care center. After baseline assessments, they took part in an eight-session treatment using the Unified Protocol. Levels of perceived stress, emotional symptoms and use of regulatory strategies were daily monitored. A six month follow-up was also completed. Results: All participants completed and reported that they were satisfied with treatment. Four out of six participants also improved on reported stress-levels and emotional symptoms. Improvements were sustained at follow-up.

    Discussion: Results showed that it is feasible to use a unified approach for emotional problems in patients with work stress. Treatment was also associated with symptom changes for most participants. Employing a unified CBT approach for stress would provide flexibility and parsimony for clinicians while retaining a strong theoretical framework and guiding principles. Although initial results were promising randomized controlled trials are needed. 

  • 3.
    Edlund, Sara
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Holländare, Fredrik
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Psychiatry, Örebro University Hospital, Örebro, Sweden.
    Linton, Steven J.
    Örebro University, School of Law, Psychology and Social Work.
    Fruzzetti, Alan E.
    McLean Hospital & Department of Psychiatry, Harvard Medical School, Boston, USA.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Pain patients´ experiences of validation and invalidation from physicians before and after multimodal pain rehabilitation: Associations with pain, negative affectivity and treatment outcome2017In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 17, p. 77-86Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 4.
    Klein Strandberg, Ester
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    When standard pain rehabilitation is not enough: A transdiagnostic internet-delivered guided CBT intervention as a secondary intervention for individuals with chronic pain and co-morbid emotional problems2016Conference paper (Other academic)
  • 5.
    Lundberg, Tove
    et al.
    University of Oslo, Oslo, Norway.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    The formation of an LGBTQ network for psychologists in Sweden: A work in progress2016In: Psychology of Sexualities Review, ISSN 2047-1467, Vol. 7, no 1, p. 29-40Article in journal (Refereed)
    Abstract [en]

    The mobilisation of psychologists in Sweden working for lesbian, gay, bisexual, trans* and queer (LGBTQ) wellbeing and rights has so far not succeeded in creating continuity despite several attempts to establish some kind of organisation since the mid 1990s. A new attempt was made in 2013 when the Swedish LGBTQ network for psychologists was formed following a formal decision at the congress of the Swedish Psychological Association. Even though the establishment of the network is still a work in progress, the network consists of approximately 100 members and seems to be growing. This paper describes some historical highlights from Swedish LGBTQ psychology, as well as how the network came about, underpinning perspectives and what the network aims to achieve.

  • 6.
    Malmquist, Anna
    et al.
    Linköping University, Linköping, Sweden.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Regnbågsfamiljer: Familjer där föräldrarna är homo, bi, trans eller queer2018In: Fokus på familien: Tidsskrift for familiebehandling, ISSN 0332-5415, E-ISSN 0807-7487, Vol. 46, no 2, p. 113-132Article in journal (Refereed)
    Abstract [en]

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

  • 7.
    Olofsson, Malin Elisabeth
    et al.
    Modum Bad, Vikersund, Norway.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Engh, Johannes
    School of Law, Psychology and Social Work, Örebro University, Sweden.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    A psychometric evaluation of the Swedish version of the Responses to Positive Affect questionnaire2014In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 68, no 8, p. 588-593Article in journal (Refereed)
    Abstract [en]

    Background: Previous research mainly focused on responses to negative affect in relation to depression, and less on responses to positive affect. Cognitive responses to positive affect are interesting in the context of emotion regulation and emotion disorders: positive rumination is associated to hypomania risk and bipolar disorder. There is to date no questionnaire in Swedish that captures the phenomena of cognitive response styles.

    Aims: The aim of this study was to investigate the replicability of the Responses to Positive Affect questionnaire (RPA) in a newly translated Swedish versionand to test its psychometric properties.

    Methods: Swedish undergraduates (n 111) completed a set of self-report questionnaires in a fixed order.

    Results: The hypothesized three-factor model was largely replicated in the subscales Self-focused positive rumination, Emotion-focused positive rumination and Dampening. The two positive rumination subscales were strongly associated with each other and current positive affect. The subscales showed acceptable convergent and incremental validity with concurrent measures of depression, hypomania, anxiety, repetitive negative thinking, and positive and negative affect. The model explained 25% of the variance in hypomania, but fell short in the explanation of depression.

    Conclusions: The Swedish version of the RPA shows satisfactory reliability and initial fi ndings from a student sample indicate that it is a valid measure comparable with the original RPA questionnaire. Results give emphasis to the importance of further exploration of cognitive response styles in relation to psychopathology.

  • 8.
    Olofsson, Malin Elisabeth
    et al.
    Department of Psychology, Oslo University, Oslo, Norway; Modum Bad Psychiatric Center, Vikersund, Norway.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Do responses to positive affect influence mood reactivity?: exploring cognitive response styles through a mood induction procedure2016In: Nordic Psychology, ISSN 1901-2276, E-ISSN 1904-0016, Vol. 68, no 4, p. 220-232Article in journal (Refereed)
    Abstract [en]

    Cognitive responses to positive affect (PA) are interesting in the context of emotion dysregulation and emotion disorders. Previous research mainly focused on ruminative responses to negative affect in relation to psychopathology. The aim of this study was to explore the interaction between cognitive response styles as measured with the Responses to Positive Affect questionnaire (RPA) and changes in emotional state during an experimental manipulation in a non-clinical sample. Using a pre-test post-test design, Swedish undergraduate students (n = 60) were randomized into either a mood induction procedure designed to evoke positive mood or a control condition. Results revealed that the two positive rumination subscales of the RPA were associated with each other and with PA. However, none of the RPA subscales interacted with participants’ mood reactivity, thus meaning that cognitive response styles did not predict changes in mood as the participants were exposed to a mood induction procedure. The results postulate new questions on the conceptualization and functioning of cognitive response styles, as their role concerning reactivity to elevated mood states remain unclear.

  • 9.
    Traczyk, Michal
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Ahonen, Lia
    Örebro University, School of Law, Psychology and Social Work.
    "Det är ju inget vi frågar efter som psykologer": psykologers upplevelse av klienter med könsöverskridande beteende2013In: Lambda Nordica: Tidskrift om homosexualitet, ISSN 1100-2573, Vol. 3-4, p. 77-99Article in journal (Refereed)
    Abstract [en]

    People with gender-incongruent behaviors have a higher risk for psychiatric problems compared to others. A professional approach is an important part of the treatment process and will influence the therapeutic outcome. Earlier research shows deficits in the contact between care personnel and people with gender-incongruent behaviours. There are no studies focusing on psychologists and their work with this client group. The aim of this study is to research psychologists’ subjective experience of clients with gender-incongruent behaviours. The study uses a qualitative method. The research data was collected with semi-structured interviews with five psychologists that had some experience with clients with gender-incongruent behaviours. The results point to gender-incongruent behaviors being a topic that evokes both interest and commitment, but also some insecurity in psychologists. Psychologists’ preconceptions and personal beliefs play a big role during the work with these clients when education and access to information on the topic is limited. A non-pathologizing outlook on gender-incongruent behaviours dominates, but the opposite also exists. More research is needed to map out in which way psychologist-related factors influence treatment of people with gender-incongruent behaviours. Another important aspect is how existing knowledge can be implemented in psychologists’ basic training and how it can be spread effectively amongst professionals.

  • 10.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Trans2017In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundberg, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur och kultur, 2017, 1, p. 137-152Chapter in book (Other (popular science, discussion, etc.))
  • 11.
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Understanding Comorbid Pain and Emotions: A transdiagnostic approach2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

    List of papers
    1. Characteristics and consequences of the co-occurence between social anxiety and pain-related fear in chronic pain patients receiving multimodal pain rehabilitation treatment
    Open this publication in new window or tab >>Characteristics and consequences of the co-occurence between social anxiety and pain-related fear in chronic pain patients receiving multimodal pain rehabilitation treatment
    2016 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 12, p. 45-52Article in journal (Refereed) Published
    Abstract [en]

    Background and aims: Chronic pain problems are related to specific pain related fears and maladaptive pain-coping but also commonly co-occur with other anxiety problems. Shared emotional vulnerabil-ity factors may explain this comorbidity and may influence treatment outcome. Indeed, pain patients going through multimodal pain treatment are a heterogeneous group and treatment results vary. One understudied anxiety disorder co-occurring with pain is social anxiety. This may be relevant as many pain-related challenges are situated in social contexts. The aim of this study is to investigate the occur-rence of subgroups with differential patterns of social anxiety and pain related fear in a sample of chronic pain patients who receive multimodal pain treatment. The aim is also to study the characteristics of these potential subgroups and the consequences of different patterns of social anxiety and pain related fear.

    Methods: 180 patients with chronic musculoskeletal pain answered questionnaires before and after a multimodal pain treatment in a hospital rehabilitation setting in middle Sweden. A cluster analysis using pre-treatment scores on the Social Phobia Screening Questionnaire and the Tampa Scale of Kinesiophobia was performed. Subgroups were thereafter validated and compared on impairment due to social anxi-ety, pain catastrophizing, anxiety, and depression. Moreover, subgroups were described and compared on vulnerability factors (anxiety sensitivity, negative affect) and outcome factors (pain intensity, pain interference, and return to work self-efficacy).

    Results: Four distinct clusters emerged: (1) low scores, (2) pain-related fear only, (3) social concern only, and (4) high social anxiety and pain-related fear. Patients high on social anxiety and pain-related fear had significantly higher levels of anxiety sensitivity, negative affect, and higher general emotional symptomatology. They also had remaining problems posttreatment.

    Conclusions: A subgroup of patients with clinical levels of social anxiety has suboptimal rehabilitation results, with residual emotional problems and high levels of emotional vulnerability.

    Implications: These patients may be in need of additional treatment efforts that are not being met today. To prevent insufficient treatment results and prolonged work disability, these patients need to be detected during screening and may benefit from pain treatment that takes their emotional problems into account.

    Place, publisher, year, edition, pages
    Amsterdam: Elsevier, 2016
    Keywords
    Social anxiety, pain related fear, chronic pain, comorbidity, treatment outcome, vulnerability factors
    National Category
    Psychology Neurology
    Research subject
    Psychology; Neurology
    Identifiers
    urn:nbn:se:oru:diva-51689 (URN)10.1016/j.sjpain.2016.03.006 (DOI)000383375000009 ()2-s2.0-84962840819 (Scopus ID)
    Note

    Funding Agency:

    Regional Research Council (Regionala Forskningsrådet, RFR)

    Available from: 2016-08-17 Created: 2016-08-17 Last updated: 2018-05-16Bibliographically approved
    2. Musculoskeletal pain in adolescents: Prevalence, and the role of peer-related stress, worry, and gender in the development of pain problems over time
    Open this publication in new window or tab >>Musculoskeletal pain in adolescents: Prevalence, and the role of peer-related stress, worry, and gender in the development of pain problems over time
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Psychology (excluding Applied Psychology)
    Identifiers
    urn:nbn:se:oru:diva-66950 (URN)
    Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2018-06-18Bibliographically approved
    3. Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study
    Open this publication in new window or tab >>Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study
    Show others...
    2017 (English)In: Internet Interventions, ISSN 2214-7829, Vol. 10, p. 54-64Article in journal (Refereed) Published
    Abstract [en]

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

    Place, publisher, year, edition, pages
    Elsevier, 2017
    Keywords
    Internet delivered treatment; pain; transdiagnostic; emotional comorbidity; single case
    National Category
    Other Medical Sciences not elsewhere specified
    Research subject
    Psychology
    Identifiers
    urn:nbn:se:oru:diva-62356 (URN)10.1016/j.invent.2017.10.004 (DOI)000457134100008 ()2-s2.0-85032807121 (Scopus ID)
    Projects
    SÅS
    Available from: 2017-11-14 Created: 2017-11-14 Last updated: 2019-02-13Bibliographically approved
  • 12.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Anniko, Malin
    Örebro University, School of Law, Psychology and Social Work.
    Tillfors, Maria
    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.
    Musculoskeletal pain in early adolescence: A longitudinal examination of pain prevalence and the role of peer-related stress, worry, and gender2018In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 111, p. 76-82Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 13.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Det senaste inom psykoterapi och smärta: Aktuellt från CHAMP: Unified Protocol online och Compassion Focused Therapy för smärtpatienter2016Conference paper (Other academic)
  • 14.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Edlund, Sara
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Comorbi social anxiety and pain: Relationship with transdiagnostic psychological processes2013Conference paper (Other academic)
  • 15.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Edlund, Sara
    Örebro University, School of Law, Psychology and Social Work.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Characteristics and consequences of the co-occurence between social anxiety and pain-related fear in chronic pain patients receiving multimodal pain rehabilitation treatment2016In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 12, p. 45-52Article in journal (Refereed)
    Abstract [en]

    Background and aims: Chronic pain problems are related to specific pain related fears and maladaptive pain-coping but also commonly co-occur with other anxiety problems. Shared emotional vulnerabil-ity factors may explain this comorbidity and may influence treatment outcome. Indeed, pain patients going through multimodal pain treatment are a heterogeneous group and treatment results vary. One understudied anxiety disorder co-occurring with pain is social anxiety. This may be relevant as many pain-related challenges are situated in social contexts. The aim of this study is to investigate the occur-rence of subgroups with differential patterns of social anxiety and pain related fear in a sample of chronic pain patients who receive multimodal pain treatment. The aim is also to study the characteristics of these potential subgroups and the consequences of different patterns of social anxiety and pain related fear.

    Methods: 180 patients with chronic musculoskeletal pain answered questionnaires before and after a multimodal pain treatment in a hospital rehabilitation setting in middle Sweden. A cluster analysis using pre-treatment scores on the Social Phobia Screening Questionnaire and the Tampa Scale of Kinesiophobia was performed. Subgroups were thereafter validated and compared on impairment due to social anxi-ety, pain catastrophizing, anxiety, and depression. Moreover, subgroups were described and compared on vulnerability factors (anxiety sensitivity, negative affect) and outcome factors (pain intensity, pain interference, and return to work self-efficacy).

    Results: Four distinct clusters emerged: (1) low scores, (2) pain-related fear only, (3) social concern only, and (4) high social anxiety and pain-related fear. Patients high on social anxiety and pain-related fear had significantly higher levels of anxiety sensitivity, negative affect, and higher general emotional symptomatology. They also had remaining problems posttreatment.

    Conclusions: A subgroup of patients with clinical levels of social anxiety has suboptimal rehabilitation results, with residual emotional problems and high levels of emotional vulnerability.

    Implications: These patients may be in need of additional treatment efforts that are not being met today. To prevent insufficient treatment results and prolonged work disability, these patients need to be detected during screening and may benefit from pain treatment that takes their emotional problems into account.

  • 16.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Flink, Ida
    Örebro University, School of Law, Psychology and Social Work.
    Anniko, Malin
    Örebro University, School of Law, Psychology and Social Work.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Musculoskeletal pain in adolescents: Prevalence, and the role of peer-related stress, worry, and gender in the development of pain problems over timeManuscript (preprint) (Other academic)
  • 17.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Flink, Ida
    Örebro University, School of Law, Psychology and Social Work.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    External and internal social factors as risk factors for the development of back/neck pain in Swedish adolescents2017In: : Pain in Europe, 2017Conference paper (Other academic)
    Abstract [en]

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

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

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

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

  • 18.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Hanner, Hans
    Att möta samhället som hbtq+2017In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundren, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur & Kultur , 2017, p. 153-168Chapter in book (Other (popular science, discussion, etc.))
  • 19.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Klein Strandberg, Ester
    Örebro University, School of Law, Psychology and Social Work.
    Lorenz, Caroline
    Buhrman, Monica
    Uppsala University, Uppsala, Sweden.
    Holländare, Fredrik
    Örebro University, School of Medical Sciences.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Chronic pain and emotional problems: A replicated single case study of an internet based therapist guided treatment based on CBT principles and the Unified Protocol of transdiagnostic treatments2016Conference paper (Other academic)
  • 20.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Klein Strandberg, Ester
    Örebro University, School of Law, Psychology and Social Work.
    Lorenz, Caroline
    Private person.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social Work.
    Buhrman, Monica
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Holländare, Fredrik
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Centre, Region Örebro County, Örebro, Sweden.
    Boersma, Katja
    Örebro University, School of Law, Psychology and Social Work.
    Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study2017In: Internet Interventions, ISSN 2214-7829, Vol. 10, p. 54-64Article in journal (Refereed)
    Abstract [en]

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

  • 21.
    Wurm, Matilda
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Traczyk, Michal
    Riktlinjer2017In: HBTQ+: Psykologiska perspektiv och bemötande / [ed] Lundren, Tove; Malmquist, Anna; Wurm, Matilda, Stockholm: Natur & Kultur , 2017, p. 333-338Chapter in book (Other (popular science, discussion, etc.))
1 - 21 of 21
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