Till Örebro universitet

Introduction: Adolescents with neurodevelopmental disorders, such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD), often experience significant sleep disturbances, including difficulties with sleep initiation and sleep maintenance (i.e., insomnia). These sleep issues may exacerbate existing challenges related to emotional regulation, stress, and daily functioning. Despite the high prevalence of sleep disorders in this population, few studies directly address both neurodevelopmental challenges and sleep-related problems. This study evaluates the feasibility and preliminary effects of NeuroACT, a skills training program based on Acceptance and Commitment Therapy (ACT) principles, among adolescents with neurodevelopmental disorders and symptoms of insomnia.

Materials and methods: The study employs a within-group design and is conducted at child and adolescent psychiatry services in Karlstad, Sweden. Participants (current: n=4; target: N=34) are adolescents aged 13-19 diagnosed with autism and/or ADHD, and symptoms of insomnia, recruited through clinical services. Inclusion criteria include fluency in Swedish, stable medication regimen (if applicable), and informed consent from both participants and guardians for those under 15 years. Exclusion criteria comprise ongoing substance abuse, suicidality, psychosis, intellectual disability, or severe mood disorders. The NeuroACT intervention consists of 12 weekly sessions, each lasting 120 minutes, involving groups of 4–8 participants. Two licensed psychologists, with at least one having formal NeuroACT training, lead the sessions. The training covers key themes such as stress management, emotional regulation, mindfulness, social interactions, and goal setting. Quantitative data are collected using validated measures of insomnia (Insomnia Severity Index), stress (Perceived Stress Scale), psychological distress (Hospital Anxiety and Depression Scale), mindfulness (Five Facet Mindfulness Questionnaire), and overall functioning (Strengths and Difficulties Questionnaire) at pre-, mid-, and post-intervention. Additionally, qualitative feedback is gathered through semi-structured interviews to capture participants’ subjective experiences of the skills training.

Results: The initial results indicate that the intervention is feasible and promising for this patient group in terms of perceived stress (pre M=38.00, SD=14.00; post M=27.25, SD=6.45), and mindfulness (pre M=66.00, SD=33.96; post M=80.25, SD=22.59). Measures of insomnia (pre M=9.75, SD=4.27; post M=10.50, SD=3.42), psychological distress (pre M=16.75, SD=10.97; post M=22.33, SD=6.03), and overall functioning (pre M=21.67, SD=5.03; post M=20.00, SD=8.19) have not shown improvements at this stage, highlighting areas for further investigation. Attendance rates are relatively high, and no significant adverse effects have been reported thus far. Preliminary themes from the interviews: (1) Overcoming initial hesitation and vulnerability; (2) Group support and tailored treatment as enablers of change; and (3) Improvements within a complex reality.

Conclusions: Early findings suggest that NeuroACT is a feasible and potentially beneficial intervention for adolescents with neurodevelopmental disorders, particularly in reducing stress and enhancing mindfulness. These results support continued evaluation of Acceptance and Commitment Therapy-based approaches addressing the complex interplay between neurodevelopmental symptoms and sleep problems in youth.

BACKGROUND: The study objective was to explore children and adolescents' views on coping with stress and aversive feelings.

METHODS: Swedish children and adolescents from Värmland county, aged 10-14 (N = 44, girls = 26), participated in group interviews on health and coping. In total, eight group interviews were conducted at four different schools.

RESULTS: Data was analyzed with reflexive thematic analysis and resulted in three themes: Accepting and expressing feelings, Doing things that make you feel good, and Searching for help.

CONCLUSIONS: Encouraging healthy emotional expression, support-seeking, and challenging societal norms can, according to the analysis of children and adolescents' testimonies, foster resilience. Family, peers, student health services, professionals, teachers, and animals contribute to their coping resources, with trust and relatability playing significant roles. The implications of the study can inform and improve future child health interventions and educational programs for nurturing effective coping skills from an early age.

Background: Breast cancer, the most prevalent cancer among women in Portugal, significantly affects both physical and psychological well-being. Recent research has emphasized the beneficial effects of self-compassion and the consequences that fear of receiving compassion has on mental health. This study examined fear of receiving compassion from others as a moderator of the relationships of self-compassion with symptoms of depression, anxiety, and stress.

Methods: Portuguese women (N = 78) with nonmetastatic breast cancer completed self-report measures of interest (depression, anxiety, stress, and self-compassion). Data were analyzed using the PROCESS macro for moderation analysis.

Results: The relationship between self-compassion and depressive symptoms was influenced by fear of receiving compassion from others. This relationship was statistically significant when the fear was moderate or high, but it was not statistically significant when the fear was low. The relationships between self-compassion and both anxiety and stress were not affected by fear of receiving compassion from others.

Conclusions: This is the first study to explore fear of receiving compassion from others as a moderating factor of the relationship between self-compassion and psychological distress in women with breast cancer. More longitudinal, compassion-based intervention studies targeting fear of receiving compassion, as well as qualitative studies of patients' experiences of self-compassion, fear of compassion, and compassion-based interventions, should be conducted. 

OBJECTIVES: Insomnia is the most common sleep disorder in adults. About 10% of adults meet the diagnostic criteria, and about 30% suffer from subclinical symptoms. Seeking advice online is common when having health issues. There are no previous studies on Swedish Internet forums regarding types of advice and the logic behind the recommendations given for how to handle troubled sleep. The purpose of the study was to examine which treatment methods for insomnia symptoms were recommended by forum users on the Swedish Internet forum Flashback.

METHODS: A thematic analysis was conducted on 1174 posts.

RESULTS: The analysis resulted in four themes: (1) Advice on healthcare, (2) Bedtime and sleep environment strategies, (3) Implement long-term lifestyle changes, and (4) Advice on nonprescribed, legal, or illegal drugs. Notably, a large portion of the recommendations provided emphasized the utilization of pharmacological interventions, including prescription drugs, over-the-counter medications, supplements, illegal substances, or combinations of these. This despite the fact that many advice givers attributed insomnia to psychological causes such as stress.

CONCLUSIONS: Insight into recommendations given on Internet forums is important for healthcare personnel; advice might shape patients' sleep habits as well as expectations on insomnia treatments.

Hope is defined as the capability to pursue a desired goal by leveraging one's abilities and potential pathways to goal attainment. This study aims to (1) chart and integrate conceptualizations and operationalizations of hope in travel and well-being research, and (2) investigate the relationship between hope and travel behaviour, as well as its associations with well-being concepts relevant to travel behaviour research, as a base for developing a Travel-Hope Framework. A scoping review was conducted with the following inclusion criteria: (i) adult participants, (ii) validated hope scales, (iii) relevance to travel behaviour and well-being research, (iv) written in English, and (v) peer-reviewed. A systematic search identified 13 studies on hopes conceptualizations and measurement. While none explicitly explored its link to travel behaviour, hope was associated with cognitive, emotional, and social well-being components relevant to travel behaviour research. Building on these insights, we introduce the Travel-Hope Framework, which posits that hope - particularly in the form of travel autonomy and perceived accessibility, and experience and anticipation - is essential for behaviour change and well-being. By illuminating the role of hope in travel decision-making, this framework provides a novel perspective for travel research and policy. Understanding the dynamic interplay between hope, travel and well-being can inform targeted interventions to improve commuting experiences, foster equitable accessibility, and promote sustainable travel choices.

BACKGROUND: Definitions and perceptions of health and mental health have not remained static over time. This is also true for statistics over Swedish children's and adolescents' health and mental health status. The majority of Swedish school-aged children and adolescents report good physical health and good life satisfaction. However, there are some warning signs when it comes to children's and adolescents' health and mental health status, for instance, an increased overweight or obesity in children and adolescents, as well as a higher proportion reporting psychological problems and stress. There is also a need for knowing more about the younger population's voices in this matter. The aim was therefore to explore children's and adolescent's conceptualizations and perceptions of health in general, and mental health in particular.

METHODS: Open semistructured group interviews with 44 Swedish children and adolescents (10-14 years old) recruited from four schools were conducted. The interviews were conducted between April 2022 and January 2023. Data were analyzed with qualitative content analysis. RESULTS: Children's and adolescents' conceptualizations of health included aspects of both the body and the mind, with a focus on the latter. Mental health was expressed as a state of being, illustrated by various lived experiences of emotions, moods, and thoughts. The social world was ever present in their understanding of health, e.g., through the lenses of social and gender norms.

CONCLUSIONS: This study revealed children's and adolescents' recognition of health terms and their ability to observe nuances between mental health problems and everyday struggles. The participants discussed mental health problems to a greater extent than positive mental health. An implication of this study is the highlighted need to focus more on mental health promotion in future preventive programs. These findings might potentially influence how school staff and student health teams communicate with children and adolescents about these concepts.

The study objective was to assess the effects of a five-week compassionate mind training for university students regarding symptoms of depression, anxiety and stress, and self-compassion compared with an active control group. Swedish university students were randomized to a compassionate mind training group or to an active control group. The outcome measures were. the Hospital Anxiety and Depression scale, the Perceived Stress Scale 14, and the Self-Compassion Scale - Short Form. All outcomes were measured pre- and post-intervention. Data were analyzed with linear mixed-effects models. The only statistically significant difference between the groups were depression symptoms (p = 0.02, d = -0.40) corresponding to a slight clinically relevant improvement. The study's results are consistent with prior research suggesting that compassionate mind training may be beneficial for alleviating depression symptoms. However, the low baseline depression levels in this sample and the short duration of the intervention may limit the generalizability and the magnitude of the findings. The small sample size and relatively homogenous group, also point to the need for larger and more diverse samples.

Individuals with chronic illnesses and those infected with SARS-CoV-2 often face stigma, shame, and psychological distress related to their conditions. Higher psychological flexibility and self-compassion are often associated with less stigma and shame. Examining and comparing these experiences between people with chronic illness and people who have recovered from SARS-CoV-2 can provide valuable insights into the shared and unique challenges they encounter. This study aimed to compare these two groups, and used structural equation modelling to investigate the links between stigma, shame, and psychological distress, with a focus on the mediating roles of psychological flexibility and self-compassion in these associations. The study included 270 Portuguese participants (chronic illness: n = 104; SARS-CoV-2: n = 166), with an average age of 36.73 years and 86.6% of the sample being women. Results showed that the chronic illness subgroup reported higher levels of illness stigma, anxiety, and depression, compared to the SARS-CoV-2 subgroup. Findings from the mediation analysis, revealed that the model fit exceptionally well, accounting for 48% of the variance in anxiety and 45% in depression symptoms across the entire sample. Most parameters were consistent between the two subgroups, except for the association between self-compassion and depression symptoms, which was only statistically significant in the chronic illness subgroup. In this group, both psychological flexibility and self-compassion mediated the association between stigma and shame with symptoms of anxiety and depression. In the SARS-CoV-2 subgroup, these processes mediated the association with anxiety, whereas psychological flexibility only mediated depression symptoms. The findings from this study provide directions for future research on the possible development or refinement of personalized psychological interventions targeting emotional distress in adults with chronic illnesses and viral disease recovery cohorts.