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  • 1.
    Alaie, Iman
    et al.
    Uppsala universitet.
    Frick, Andreas
    Uppsala universitet.
    Marteinsdottir, Ina
    Linköping University.
    Hartvig, Per
    Copenhagen University.
    Tillfors, Maria
    Örebro universitet.
    Eriksson, Elias
    Gothenburg University.
    Fredrikson, Mats
    Uppsala universitet.
    Furmark, Tomas
    Uppsala universitet.
    Serotonin Synthesis Rate and the Tryptophan Hydroxylase-2 G-703T Polymorphism in Social Anxiety Disorder2014In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 75, no 9, p. 357S-357SArticle in journal (Refereed)
  • 2.
    Anniko, Malin K.
    et al.
    Örebro University.
    Boersma, Katja
    Örebro University.
    van Wijk, Nikil Ph. L.
    Aquarius Analyses & Training, Willemstad, Curacao.
    Byrne, Don
    Australian National University, Australia.
    Tillfors, Maria
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Development of a Shortened Version of the Adolescent Stress Questionnaire (ASQ-S): Construct validity and sex invariance in a large sample of Swedish adolescents2018In: Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, E-ISSN 2245-8875, Vol. 6, no 1, p. 4-15Article in journal (Refereed)
    Abstract [en]

    Background: Stressor experience is an important topic of research concerning adolescent health and ill-health. For this, valid and reliable measures of adolescent stress are needed. The Adolescent Stress Questionnaire 2 was developed to tap into stressor domains specific for adolescence. Psychometric evaluations in Australian and European samples have indicated adequate psychometric properties. However, the ASQ-2 is quite extensive, which may render its use in large cohort studies, where several aspects of adolescent health are investigated, inconvenient and problematic. Objective: To evaluate the psychometric properties of a short version of the ASQ-2 (ASQ-S) in terms of construct validity and factorial invariance across gender. Method: The ASQ-2 was translated into Swedish and items were retained from nine of the ten scales based on factor loadings. One scale (stress of emerging adult responsibilities) was removed entirely due to low internal consistency and variance explained. The remaining 27 items were piloted and then included in an ongoing 5-year longitudinal study involving the participation of all students in the 7th and 8th grade in public schools from three Swedish municipalities (N = 2768, 47.5 % girls, mean age 13.64 years). For this study data from the first and second wave was used. Results: A nine factor Confirmatory Factor Analysis (CFA) showed a good fit to the data and invariance across sexes was supported. The nine scales correlated positively with depressive symptoms, anxiety and worry and negatively with self-esteem. Girls reported higher stress levels than boys in eight of the nine scales. Stressors related to peer pressure predicted reported levels of anxiety and worry one year later, whereas stressors related to romantic relationships predicted depressive symptoms. Conclusions: Overall this study suggests that the ASQ-S could be a valid measure of adolescent stressor experience and psychometrically equivalent to the full ASQ-2.

  • 3.
    Bauer, A. Z.
    et al.
    University of Massachusetts, 1 University Avenue, Lowell, MA, 01854, USA.
    Kriebel, D.
    University of Massachusetts, 1 University Avenue, Lowell, MA, 01854, USA.
    Herbert, M. R.
    Harvard Medical School, Charlestown USA.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Swan, S. H.
    Icahn School of Medicine at Mount Sinai, New York City, NY 10029, USA.
    Prenatal paracetamol exposure and child neurodevelopment: A review2018In: Hormones and Behavior, ISSN 0018-506X, E-ISSN 1095-6867Article in journal (Refereed)
    Abstract [en]

    Background: The non-prescription medication paracetamol (acetaminophen, APAP) is currently recommended as a safe pain and fever treatment during pregnancy. However, recent studies suggest a possible association between APAP use in pregnancy and offspring neurodevelopment. Objectives: To conduct a review of publications reporting associations between prenatal APAP use and offspring neurodevelopmental outcomes. Methods: Relevant sources were identified through a key word search of multiple databases (Medline, CINAHL, OVID and TOXNET) in September 2016. All English language observational studies of pregnancy APAP and three classes of neurodevelopmental outcomes (autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and intelligence quotient (IQ)) were included. One reviewer (AZB) independently screened all titles and abstracts, extracted and analyzed the data. Results: 64 studies were retrieved and 55 were ineligible. Nine prospective cohort studies fulfilled all inclusion criteria. Data pooling was not appropriate due to heterogeneity in outcomes. All included studies suggested an association between prenatal APAP exposure and the neurodevelopmental outcomes; ADHD, ASD, or lower IQ. Longer duration of APAP use was associated with increased risk. Associations were strongest for hyperactivity and attention-related outcomes. Little modification of associations by indication for use was reported. Conclusions: Together, these nine studies suggest an increased risk of adverse neurodevelopmental outcomes following prenatal APAP exposure. Further studies are urgently needed with; precise indication of use and exposure assessment of use both in utero and in early life. Given the current findings, pregnant women should be cautioned against indiscriminate use of APAP. These results have substantial public health implications.

  • 4.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013). Karlstad Univ, Dept Publ Hlth, Univ Gatan 2, S-65188 Karlstad, Sweden..
    von Kobyletzki, Laura B.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karlstad Univ, Dept Publ Hlth, Univ Gatan 2, S-65188 Karlstad, Sweden.;Lund Univ, Skane Univ Hosp, Dept Dermatol, Jan Waldenstroms Gatan 16, S-21428 Malmo, Sweden..
    Svensson, Mikael
    Sahlgrenska Univ, Hlth Metr Unit, Box 414, S-40530 Gothenburg, Sweden..
    Determinants of Antidepressants Use and Economic Costs: A Population Based Study2017In: Journal of Mental Health Policy and Economics, Vol. 20, no Suppl.1, p. S2-S2Article in journal (Other academic)
  • 5.
    Draxler, Helena
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Hiltunen, Arto
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    A modification of enhanced cognitive behavioral therapy for Anorexia Nervosa – a case study2012In: Clinical Case Studies, ISSN 1534-6501, E-ISSN 1552-3802, Vol. 11, no 3, p. 201-217Article in journal (Refereed)
    Abstract [en]

    This case study illustrates the treatment of an adult woman who was diagnosed with anorexia nervosa (AN). For approximately 10 years, the client had suffered from various forms of eating disorders and had had several unsuccessful encounters with the health care services. In this study, she was treated with a modification of enhanced cognitive behavioral therapy (CBT-E). CBT-E is a relatively new treatment guide with a transdiagnostic perspective on eating disorders. In all, the treatment consisted of 14 sessions where most sessions were held on a weekly basis. Thereafter, a maintenance and follow-up was conducted via email and with the aid of self-help literature. Treatment time lasted for 8 months followed by a follow-up of 4 months. In this study, the content of each session is described, as are the modifications that were made. The modifications were made to increase motivation and self-esteem, as well as perceived control of eating, which, in itself, is a contribution to increased efficiency and a clarification of important treatment components. Apart from a description of treatment interventions, the study shows the weight gain and other clinically significant components regarding eating disorders that concern, among other things, self-esteem and general mental health. The results of this study demonstrate that this treatment, with the proposed modifications, has been highly effective for this client and hence provides a positive anticipation that this might be a more effective treatment in general for people with AN.

  • 6.
    Edebol, Hanna
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Global Assessment of Attention Deficit Hyperactivity Disorder: Examining Objective Measures of Hyperactivity, Impulsivity and Inattention in Adults2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis is to examine objective laboratory measures of Attention Deficit Hyperactivity Disorder (ADHD) in adult persons and to develop measures for diagnosis and treatment using a psychometric instrument called the Quantified Behavior Test Plus. The instrument objectively quantifies cardinal symptom manifestations in adult ADHD using motion tracking devices and continuous performance testing. Paper I-IV suggest that ADHD predisposes adult persons to perform poorer on continuous performance tasks and to have higher levels of motor activity while performing these tasks as compared to other clinical as well as non-clinical groups. Performance by adults with ADHD is normalized following stimulant treatment which implicates therapeutic effects and measures of response to treatment and remission for ADHD is suggested.

    Paper I concludes that the psychometric instrument needs to be calibrated with regard to adult ADHD and emphasizes the importance of a composite measure for the disorder. Paper II generates two new measures, the Weighed Core Symptom scale (WCS) - a composite measure of adult ADHD ranging from 0 to 100, and Prediction of ADHD (PADHD) - a categorical variable of the diagnostic status with good predictive power. A majority of participants with ADHD has low points on WCS (indicating high levels of symptoms) and a majority of non-ADHD normative participants has high points on WCS (indicating low levels of symptoms). Paper III examines WCS and PADHD among complex clinical groups with shared symptoms vis-à-vis ADHD. Here, findings from Paper II are replicated since participants with ADHD present the highest level of global symptoms, followed by participants with bipolar II disorder and borderline personality disorder, participant with diconfirmed ADHD and finally, non-clinical participants has the lowest level of global symptoms. In Paper IV, the measures are proposed as indications of response to treatment and remission after titration with stimulant treatment and WCS indicates response to small changes in dose level.

    The major findings of the present thesis may be summarized as the construction of two new objective measures for ADHD in adult persons with practical implications for diagnosis and treatment. Hyperactivity is the most specific marker of ADHD in both men and women, followed by the cognitive markers of inattention and impulsivity. The composite measure, WCS, quantifies the global amount of ADHD symptoms and provides the most sensitive measure for the disorder. PADHD and WCS may not replace a thorough neuropsychiatric assessment and further studies promoting diagnostic subtype stratification is suggested. Future studies may want to consider these measures in outcome-based investigations of treatment efficacy as well as in the study of neuropsychological endophenotypes. Practical implications include clinical strategies to enhance objectivity during assessment as well as optimizing beneficial effects of treatment and attaining remission.

     

     

  • 7.
    Edebol, Hanna
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Helldin, Lars
    The NU-Health Care, Trollhättan, Sweden.
    Norlander, Torsten
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology. Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden.
    Objective measures of behavior manifestations in adult ADHD and differentiation from participants with Bipolar II disorder, Borderline personality disorder, participants with disconfirmed ADHD as well as Normative participants2012In: Clinical Practice and Epidemiology in Mental Health, ISSN 1745-0179, E-ISSN 1745-0179, Vol. 8, p. 134-143Article in journal (Refereed)
    Abstract [en]

    Background: The present study evaluated two psychometric instruments derived from the objective measurement of adult ADHD using the Quantified Behavior Test Plus. The instruments were examined in ADHD versus a clinical group with overlapping symptoms including borderline personality disorder and bipolar II disorder, and another clinical group with participants assessed for but disconfirmed a diagnosis of ADHD as well as adult normative participants.

    Methods: The Quantified Behavior Test Plus includes Continuous Performance Testing and a Motion Tracking System with parameters related to attention and activity operationalized as the cardinal symptoms of ADHD and then summarized into a Weighed Core Symptoms scale with ten cut-points ranging from 0 to 100. A categorical predictor variable called Prediction of ADHD was used to examine the levels of sensitivity and specificity for the Quantified Behavior Test Plus with regard to ADHD.

    Results: The Weighed Core Symptoms scale separated ADHD and normative participants from each other as well as from the two clinical reference groups. The scale reported highest levels of core symptoms in the ADHD group and the lowest level of core symptoms in the normative group. Analyses with Prediction of ADHD yielded 85 % specificity for the normative group, 87 % sensitivity for the ADHD group, 36 % sensitivity for the bipolar II and borderline group and 41 % sensitivity for the group with a disconfirmed diagnosis of ADHD.

    Conclusions: The Weighed Core Symptoms scale facilitated objective assessment of adult ADHD insofar that the ADHD group presented more core symptoms than the other two clinical groups and the normative group. Sensitivity for the Quantified Behavior Test Plus was lower in complex clinical groups with Bipolar II disorder, Borderline disorder and in patients with a disconfirmed diagnosis of ADHD. The psychometric instruments may be further evaluated with regard to well-documented and effective treatment programs for ADHD core symptoms.

  • 8. Ellonen, Noora
    et al.
    Peltonen, Kirsi
    Poso, Tarja
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    A multifaceted risk analysis of fathers' self-reported physical violence toward their children2017In: Aggressive Behavior, ISSN 0096-140X, E-ISSN 1098-2337, Vol. 43, no 4, p. 317-328Article in journal (Refereed)
    Abstract [en]

    Existing research has shown that child maltreatment is carried out by both mothers and fathers. There is also an extensive body of literature analyzing reasons for mothers' violent behavior. Among fathers, reasons are less well studied, resulting in the lack of a comprehensive picture of paternal child abuse. In this study, 20 child-, parent-, and family-related factors have been included in a combined analysis to assess which of these may pose a risk for fathers' severe violent behavior toward their children. The study is based on merged data from Finland and Sweden, in which an anonymous survey was answered by parents, based on representative samples of parents with 0-12-year-old children. The merged data set included 679 fathers and analyses were carried out using logistic regression models. Six percent of the fathers had committed severe violent acts, that is, slapped, hit, punched, kicked, bit, hit/tried to hit their child with an object or shook (under 2-year-old) their child at least once during the 12 months preceding the survey. Corporal punishment experienced by the fathers when they were children, or used by the father as a method of discipline, strongly increased the likelihood of severe violent acts. The findings emphasize the importance of preventing all forms of corporal punishment in seeking to minimize the occurrence of severe physical violence by fathers toward their children. Aggr. Behav. 43:317-328, 2017. (c) 2016 Wiley Periodicals, Inc.

  • 9.
    Eskilsson, Therese
    et al.
    Umeå universitet.
    Jarvholm, Lisbeth Slunga
    Umeå universitet.
    Gavelin, Hanna Malmberg
    Umeå universitet.
    Stigsdotter Neely, Anna
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Boraxbekk, Carl-Johan
    Copenhagen university hospital, Denmark.
    Aerobic training for improved memory in patients with stress-related exhaustion: a randomized controlled trial2017In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 17, article id 322Article in journal (Refereed)
    Abstract [en]

    Background: Patients with stress-related exhaustion suffer from cognitive impairments, which often remain after psychological treatment or work place interventions. It is important to find effective treatments that can address this problem. Therefore, the aim of this study was to investigate the effects on cognitive performance and psychological variables of a 12-week aerobic training program performed at a moderate-vigorous intensity for patients with exhaustion disorder who participated in a multimodal rehabilitation program. Methods: In this open-label, parallel, randomized and controlled trial, 88 patients diagnosed with exhaustion disorder participated in a 24-week multimodal rehabilitation program. After 12 weeks in the program the patients were randomized to either a 12-week aerobic training intervention or to a control group with no additional training. Primary outcome measure was cognitive function, and secondary outcome measures were psychological health variables and aerobic capacity. Results: In total, 51% patients in the aerobic training group and 78% patients in the control group completed the intervention period. The aerobic training group significantly improved in maximal oxygen uptake and episodic memory performance. No additional improvement in burnout, depression or anxiety was observed in the aerobic group compared with controls. Conclusion: Aerobic training at a moderate-vigorous intensity within a multimodal rehabilitation program for patients with exhaustion disorder facilitated episodic memory. A future challenge would be the clinical implementation of aerobic training and methods to increase feasibility in this patient group.

  • 10.
    Granerud, Arild
    et al.
    Avdeling for folkhelsefag, Högskolen i Hedmark.
    Eriksson, Bengt G
    Högskolen i Hedmark, Avdeling for folkhelsefag.
    The Core of Green Care - from the User's Perspective2012Conference paper (Refereed)
  • 11.
    Grönberg Eskel, Marit
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Från slutna institutioner till institutionaliserat omhändertagande2012Doctoral thesis, monograph (Other academic)
    Abstract [en]

    In recent years, a number of reforms have been made regarding the provision of care to people experiencing psychiatric disabilities. The aim of these reforms was to enable these people to participate in society and to ”live as others”. This political ambition, as well as research on recovery, stands to a certain extent in contrast to the message conveyed in the media, where the mentally ill/disabled to a great extent are represented as dangerous and incurable. The aim of the thesis is to analyse if, and how a group of people experiencing psychiatric disabilities create a sense of being like others, and to relate the analysis to the historical emergence of the contemporary conception of mental illness/psychiatric disability. This thesis employs the method of interviews.

    I highlight the informants encounter with the historically based stereotype that defines the persons as unreasonable, irrational and incapable of taking care of themselves. When the informants face the stereotype, they act to reduce the negative consequences. The informants’ actions can be interpreted in terms of approaches and in this perspective the informants appear as strong actors, who, contrary to the stereotype, are capable of take care of themselves. Three approaches are described: expertise, adaptation, and distancing. In situations where the stereotype is not present, the informants can create a feeling of being like anyone else. Their stories show that the feeling of being like others is individual. The development taking place in the field is “path-dependent”, meaning that the initial activity, the differentiation of persons with mental illness and the subsequent events is a development following a pattern which could explain the failure of the good political intentions. It has progressed from closed institutions to an institutionalized care service.

     

  • 12.
    Helldin, L.
    et al.
    NU Hlth Care, Psychiat, Trollhattan, Sweden.;Karlstad Univ, Psychol, Karlstad, Sweden..
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. Department of Psychiatry, NU Health Care, Trollhättan, Sweden.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. Department of Psychiatry, NU-Hospital Organisation, Trollhättan, Sweden; Department of Psychology, Karlstad University, Karlstad, Sweden .
    Average lifespan among schizophrenia patients is more closely linked to cognitive ability than to symptom activity2015In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 41, p. S140-S141Article in journal (Refereed)
  • 13.
    Helldin, Lars
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. Department of Psychiatry, NU Health Care, Trollhättan, Sweden.
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies. Department of Psychiatry, NU Health Care, Trollhättan, Sweden.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Schizophrenia and Short Lifetime Expectancy: The Importance of Identifying Risk Factors Early in the Illness.2016Conference paper (Refereed)
  • 14.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology.
    Screening Family Burden in Clinical Practice: The development of a new instrument and investigation of its correlates to psychotic disorders2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The primary purpose of this thesis is to develop a short and user-friendly instrument for the assessment of family burden caused by psychotic disorders. A secondary purpose is to further investigate variables that might be linked to an increased burden. Of these variables, patients’ reduced functioning will be addressed in more detail. As a final purpose, ratings of disorder-related variables carried out by staff will be compared to similar ratings carried out by relatives. These different purposes are investigated in five studies.

    In the first study (Paper I) the instrument Burden Inventory for Relatives to persons with Psychotic disturbances (BIRP) is created. This new screening instrument contains ten statements and shows good psychometrical properties for those dimensions that are investigated. In the second study (Paper II) results show that increased family burden can be tied to patients’ impaired functioning as well as to patients’ higher self ratings regarding distress. In the third study (Paper III) different parts of patients’ observable behavioral functioning are investigated and results show that most functional dimensions correlate with family burden. Also staff ratings of function are compared with relatives’ ratings and despite similar patterns in ratings there are differences. In the fourth study (Paper IV) demographic variables are studied and results show that only higher age and fewer contact hours correlate significantly with lower burden.  Also, the BIRP instrument shows good stability. In the fifth study (Paper V) correlations with family burden are generally stronger for relatives’ own ratings of illness activity as compared to symptom ratings made by staff. Relatives’ ratings of illness activity do not correlate significantly with staff symptom ratings on all instruments used.

    The conclusions of this thesis are that the new screening instrument BIRP can be considered a good instrument to use in regular clinical practice in order to measure relatives’ burden in connection to psychotic disorders. Also, the thesis contributes with knowledge about what in the psychotic disorder and which demographic factors might be linked to an increase of family burden. Findings also indicate that it matters who does the rating of a disorder-related variable. Furthermore, in this thesis a theoretical framework for family burden is presented.

     

  • 15.
    Ingvarsdotter, K
    et al.
    Malmö University.
    Persson, K.
    Malmö University.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Östman, M.a
    Malmö University.
    How Professionals View Multifamily Psychoeducation: A Qualitative Study2016In: Psychiatric quarterly, ISSN 0033-2720, E-ISSN 1573-6709, Vol. 87, no 2, p. 1-13Article in journal (Refereed)
    Abstract [en]

    Severe mental illness causes suffering for the patient as well as the patient’s immediate family. The Swedish National Board of Health and Welfare has recommended the implementation of multifamily psychoeducation in order to assist patient and family in the recovery process. The aim of this study was to determine how introducing multifamily psychoeducation in Sweden has been viewed by professionals. Semi-structured interviews were conducted with 11 service providers, who were involved in evaluating multifamily psychoeducation. Our main findings fell under the headings of defensive culture and unsuitable model. Resistance to introducing the new intervention was found on multiple levels. The model proposed was considered too rigid for both the target group and the organizations because it could not be adjusted to the needs of patients, families, or facilitators. Despite good evidence for the effectiveness of the intervention, there were difficulties introducing the multifamily psychoeducation model in clinical practice. The feasibility of an intervention needs to be evaluated before adopting it as a national guideline.

  • 16.
    Ivarsson, Bo
    et al.
    Psychiatric services in West Gotaland, Psykiatriska kliniken, SÄS-Borås lasarett.
    Malm, Ulf
    Department of Clinical Neuropsychiatry, Sahlgrenska Academy, University of Gothenburg.
    Self-reported consumer satisfaction in mental health services: Validation of a self-rating version of the UKU-Consumer Satisfaction Rating Scale2007In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 61, no 3, p. 194-200Article in journal (Refereed)
  • 17. Johansson, Madeleine
    et al.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Psychology. Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    What could be learned from a decade with standardized remission criteria in schizophrenia spectrum disorders: An exploratory follow-up study2018In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 195, no May, p. 103-109Article in journal (Refereed)
    Abstract [en]

    A decade has passed since the standardized remission criteria of schizophrenia spectrum disorders-the Andreasen Criteria-were defined. Over 2000 studies have been published, but only a few describe symptomatic remission over time. In this prospective study we followed patients for 3 and 5 years, respectively. The aim was to investigate how different symptoms affect the occurrence of remission and how the remission cut-off level affects remission sustainability. The participants were patients diagnosed with schizophrenia spectrum disorders (DSM-IV). First, the importance of each core symptom for remission was examined using the Positive and Negative Syndrome Scale (n = 274). Second, we investigated which items affect patients to either go in and out of remission or never achieve remission (n = 154). Third, we investigated how the sustainability of remission is affected by a cut-off set to 2 (minimal) and 3 (mild) points, respectively (n = 154). All core symptoms affected the occurence of remission, to a higher or lesser extent. Delusions and Hallucinatory behavior contributed the strongest to fluctuation between remission and non-remission, while the contribution of Mannerism and posturing was very marginal. Negative symptoms were enhanced when remission was never achieved. Moreover, the study found that remission duration was significantly longer for the cut-off score 2 rather than 3. The study shows that, over time, remission criteria discriminate between being stable, unstable, or never in remission. Patients with only a minimal occurrence of symptom intensity exhibit a significantly longer remission duration compared to patients with mild symptom intensity, indicating that the treatment goal should be minimal symptom intensity.

  • 18.
    Karlsson, Lis Bodil
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Malmqvist, Annika
    Stockholm.
    "Poetry in yarn": Making sense of life experiences in the shadow of schizophrenia2013In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 39, no 4, p. 732-736Article in journal (Refereed)
  • 19.
    Lindqvist, Mona
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Olsson, Eva
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Everyday resistance in psychiatry through harbouring strategies2017In: Journal of Political Power, ISSN 2158-379X, E-ISSN 2158-3803, Vol. 10, no 2, p. 200-218Article in journal (Refereed)
    Abstract [en]

    The purpose of this article is to study emotion management by focusing on emotion labour in relation to organisational resistance in psychiatry. Drawing on focus group interviews and individual interviews with 11 therapists in psychiatry, and on theories of emotion management and harbouring work (i.e. managing emotion work and renewing energy in a team), we argue that individual workers in psychiatry have to create strategies on their own. The main findings show that emotions are harboured alone and resistance strategies created in solitude can be characterised as everyday resistance and organisational misbehaviour, performed in deep backstage spaces such as the bathroom.

  • 20.
    Lindwall, Lillemor
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Boussaid, Lena
    School of Health, Care and Social Welfare, Mälardalen University.
    Kulzer, Sonja
    School of Health, Care and Social Welfare, Mälardalen University, Västerås.
    Wigerblad, Åse
    School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna.
    Patient dignity in psychiatric nursing practice2012In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 19, no 7, p. 569-576Article in journal (Refereed)
    Abstract [en]

    Professional nurses have an ethical responsibility to protect and preserve the patients' dignity. The aim of this study was to describe how nurses experienced incidents relating to patients' dignity in a psychiatric nursing practice. A hermeneutic approach was used and data were collected using the critical incident technique. Data included 77 written critical incidents, which were interpreted by using a hermeneutic text interpretation. The findings show preserved dignity – caregivers have the courage to be present, and offended dignity – caregivers create powerlessness taken away by the patient. These findings show that patients' dignity in a psychiatric nursing practice can be preserved when caregivers act on their ethical responsibility. When patients' dignity is offended, the caregiver has become an inner value conflict, something they have been a part of against their own will.

  • 21.
    Mateos-Moreno, Daniel
    et al.
    University of Malaga, Spain.
    Atencia-Doña, Lidia
    Universidad de Malaga, Malaga, Spain.
    Effect of a combined dance/movement and music therapy on young adults diagnosed with severe autism2013In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 40, no 5, p. 465-472Article in journal (Refereed)
    Abstract [en]

    Current literature is scarce on the potential effects of combined dance/movement and music therapy on adults diagnosed with severe autism, particularly in distinguishing these effects on different areas of psychopathological disorders. We set two goals: first, to assess the effectiveness based on the score the participants obtained from the Revised Clinical Scale for the Evaluation of Autistic Behavior (ECA-R) after a series of dance/movement and music therapeutic procedures on adults with severe autism; second, to contrast the differences in effectiveness in concrete areas defined by subscales of the ECA-R, especially in its defined 2 factors and 12 functions. An overall of 36 one-hour sessions were carried out during 17 weeks on a sample of 8 participants with severe autism (approximately 2 sessions per week). During the treatment 8 measurements were taken (1 every 3 weeks) from this sample and from a control sample, which was also comprised of 8 subjects who were equally monitored at the same care center by two independent psychologists. Our experimental study seems to suggest that combined dance/movement and music therapy could be effective if used regularly for the improvement of autistic symptoms in adults diagnosed with severe autism. © 2013 Elsevier Ltd.

  • 22.
    Moradi, Hawar
    et al.
    Department of Psychiatry, NU Health Care Hospital, Trollhättan, Sweden & Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Harvey, Philip D.
    Department of Psychiatry, University of Miami Miller School of Medicine, United States & Research Service, Bruce W. Carter VA Medical Center, Miami, FL, United States.
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). Department of Psychiatry, NU Health Care Hospital, Trollhättan, Sweden.
    Correlates of risk factors for reduced life expectancy in schizophrenia: Is it possible to develop a predictor profile?2018In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 201, p. 388-392Article in journal (Refereed)
    Abstract [en]

    Patients with schizophrenia have significantly greater mortality rates than the general population, with an estimated reduced lifespan of 10–20 years. We previously reported on a link between impairment in cognition and premature death in a prospective 20-year study. Patients who had died prematurely showed neurocognitive impairment in nine different cognitive tests compared to those who did not. Based on those findings, in this study the surviving patients in the cohort were divided into three different groups based on neurocognitive impairment and compared on symptom severity including remission status, RAND-36, weight and BMI at onset of illness and baseline of the study, and medical/physical symptomatology (i.e., blood pressure, symptom awareness, vertigo and orthostatic symptoms). Differences were most prominent between the cognitively unimpaired and severely cognitively impaired (SCI) groups, with remission, negative symptoms, general symptoms and PANSS total scores differing. For SF-36 (RAND) Physical functioning and Role limitations due to physical health subscales the SCI were worst. The findings indicate that greater impairments in cognitive ability during the illness are associated with several potential indicators of risk for early mortality. Together these factors may be of guidance for establishing an algorithm to detect patients at risk of premature death early in their illness.

  • 23. Moradi, Hawar
    et al.
    Olsson, Anna-Karin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Harvey, Philip
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    SU42. Physical Fitness in Association With Cognitive Performance—Possible Marker of Short Lifetime Expectancy for Patients With Schizophrenia2017In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 43, no Suppl 1, p. S176-S176Article in journal (Other academic)
    Abstract [en]

    Background: Patients with schizophrenia have about 20 years shorter lifetime expectancy compared to healthy population. Among these patients, cognitive performance is a predictor of early death while illness severity, as expressed in both symptom activity and remission status, has no relation with length of life. Vital signs, such as blood pressure and heart rate, weight including BMI, and spontaneously reported symptoms did neither indicate an increased risk for early death. This work focus on whether self-rated physical condition and activities, in contrast to vital signs and perceived symptoms, could be related to cognitive performance and length of life.Methods: From the Clinical Long-term Investigation of Psychosis in Sweden (CLIPS) study, 310 participants were categorized into 4 groups from their cognitive performance at baseline: good cognitive function (GCF), n = 114, impaired cognitive function (ICF), n = 90, and severely impaired cognitive function (SICF), n = 45. The fourth group was patients who had passed away during the study time, n = 61. Patients’ perceived physical condition was assessed at baseline using the SF-36, which included 10 questions about everyday physical activities. The 4 groups were compared using ANOVAs and post hoc analyzes.Results: Patients who had deceased reported, on average 9.5 years before their death, a significantly (P < .001) more impaired physical condition compared to the GCF group and the ICF group (P = .028) but did not show any difference compared with the SICF group (P = .424). An item analysis showed that especially physical activities, such as walking a distance or climbing the stairs, were impaired. When only alive patients’ physical status vs cognitive performance were analyzed, the GCP were more physical fit than the ICF (P = .018) and SICF (P = .011), but there were no difference between ICF and SICF.Conclusion: In contrast to vital signs and perceived symptoms of illness, patient reported differences in physical fitness corresponded to differences in their cognitive ability. It has earlier been argued that physical performance is an underappreciated variable for improving ADLs. This study indicates that patents’ physical performance may, several years in advance, offer important information about increased risk of an early death.

  • 24.
    Olsson, Anna-Karin
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). Department of Psychiatry, NU-Hospital Group, Trollhättan, Sweden.
    Hjärthag, Fredrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Helldin, Lars
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). Department of Psychiatry, NU-Hospital Group, Trollhättan, Sweden.
    Overestimated function in patients with schizophrenia: A possible risk factor for inadequate support?2019In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 206, p. 194-199Article in journal (Refereed)
    Abstract [en]

    People with schizophrenia often demonstrate an impaired ability to assess and report aspects of their everyday functioning, and the aim of this study is to investigate how patients' self-rating ability regarding functional performance relates to neurocognitive performance and real-world functional performance. A total of 222 outpatients with a schizophrenia spectrum disorder participated in this study. They were divided into groups based on their self-rating ability (determined using self-rating questions) and their observed functional capacity (the UCSD Performance-Based Skills Assessment-Brief, UPSA-B). The results showed that patients with impaired functional capacity perform at a similar cognitive level, regardless of their self-rating ability. When comparing patients with unimpaired function to those with impaired function, we found differences in two cognitive domains; premorbid functioning and executive functioning. The results also reveal that clinicians seem to have greater difficulty assessing patients who over-estimate their functioning. Consequently, when clinicians assessed the patients with the Specific Levels of Functioning Scale (SLOF) no significant differences were found between the group with unimpaired function and the group of overestimators. Patients who overestimate their functioning risk receiving inadequate treatment and support.

  • 25.
    Pernebo, K.
    et al.
    Linnaeus University, Växjö, Sweden.
    Fridell, M.
    Lunds universitet.
    Almqvist, Kjerstin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Reduced psychiatric symptoms at 6 and 12 months’ follow-up of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence2019In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 93, p. 228-238Article in journal (Refereed)
    Abstract [en]

    Background: Long-term follow-up studies of interventions for children exposed to intimate partner violence are few, and the sustainability of their outcomes often remains unexplored and uncertain. Current research including follow-up assessment suggests that treatment gains may be maintained or continue post termination. In addition some children may show increased levels of symptoms. Objective: The present effectiveness study investigated the long-term outcomes of two established group interventions for children exposed to intimate partner violence and their non-offending parent. Participants and Setting: The study included 50 children, 24 girls and 26 boys, aged 4 to 13 years attending a psychotherapeutic child and adolescent mental health service intervention and a psychoeducative community-based intervention. Methods: Background information, child and parental mental health problems, trauma symptoms, and exposure to violence were assessed pre- and post treatment and at 6 and 12 months’ follow-up. Results: Sustained treatment gains and late improvements in children's internalizing and externalizing symptoms and in symptoms of traumatic stress were recorded from post treatment to the follow-up assessments (p =.004–.044; d = 0.29–0.67). No significant increase in symptoms was reported. Additionally, very little continued or renewed child exposure to violence was reported. Conclusions: The results of the study indicate that the children did benefit from the two interventions studied and that the outcomes of reduced child symptoms and protection from exposure to violence were sustainable. Children with severe trauma symptoms benefited the most, though maternal psychological problems may for some have hindered recovery. Clinical implications are discussed.

  • 26.
    Ranjbar, Vanja
    et al.
    Angered Hospital; SwedenDepartment of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Näslund, Monica S
    Crisis and Disaster Psychology Unit, Academic Primary Health Care Centre, Stockholm County Council, Stockholm.
    Vingare, Emme-Li
    Department of Social Work, Linnaeus University, Växjö, Sweden.
    Hagelthorn, Christina
    Swedish Psychotrauma Society, Sweden.
    Englund, Liselotte
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Karlsson, Ingvar
    Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden.
    The Swedish Psychotrauma Society: Joining forces for a national psychotrauma platform from a multidisciplinary and holistic approach2015In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 6, no 1, article id 28546Article in journal (Refereed)
    Abstract [en]

    Events such as the discotheque fire in Gothenburg, Sweden, in 1998 and the 2004 tsunami in Thailand, in which many Swedish citizens’ lives were lost, exemplify events of traumatic character with implications for different professions in Sweden (Arnberg, Hultman, Michel, & Lundin, 2013; Wahlström, Michélsen, Schulman, Backheden, & Keskinen-Rosenqvist, 2013). Such events highlight the need for Swedish research on psychotraumatology to meet needs arising in connection with such traumas. Also events in Sweden's immediate vicinity, such as the terrorist attacks in Oslo and in Utøya in 2011, can be considered to have impact on Swedish society and its emergency preparedness. The Swedish Psychotrauma Society was formed in 2013. Its objectives are to increase and disseminate knowledge on psychotraumatology by creating a network of professionals and individuals who are active and/or interested in the subject, promote research and training in the field, and collaborate nationally and internationally on issues relating to psychotraumatology. The society is open to researchers, students, practitioners, and others alike with an interest in psychotraumatology, thereby encouraging multidisciplinary and holistic work and collaboration as well as being one of its kind in Sweden within this field. Not least, the society strives to be a link between research and practice. To this effect, the society organised its first scientific conference in May 2015, with a grant from The Swedish Foundation for Humanities and Social Science. The conference aimed to offer internationally renowned psychotrauma researchers as keynote speakers (Litz, 2015; Newman & Drevo, 2015; Olff, Van Zuiden, & Bakker, 2015) and gather a nationwide audience consisting of professionals and researchers from various disciplines. By establishing a Swedish psychotrauma society and inspire and strengthen the field of psychotraumatology in Sweden, it is hoped that the Swedish Psychotrauma Society during the coming year can become affiliated to the ESTSS and commence collaborations with its European counterparts.

  • 27.
    Skogsberg, Anna-karin
    et al.
    Karlstad University, Faculty of Social and Life Sciences.
    Högnelid, Riitta
    Karlstad University, Faculty of Social and Life Sciences.
    Hur bemöts patienter vid psykiatrisk tvångsvård?: En litteraturstudie ur patientperspektiv2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Enligt Hälso- och sjukvårdslagen har patienten rätt att bli bemött med respekt för sitt självbestämmande och sin integritet. Många patienter blir dåligt bemötta i vården, de känner sig kränkta, utelämnade och maktlösa. Psykiatrisk tvångsvård kan innebära en konflikt mellan att bedriva god vård och utöva tvång. Det är därför av största vikt att undersöka hur tvångsvårdade patienter upplever att de blivit bemötta och vad bra bemötande är vid psykiatrisk tvångsvård. Syftet med denna studie är att undersöka hur patienter upplever att de blivit bemötta vid psykiatrisk tvångsvård. Studien genomfördes som en litteraturstudie med kvalitativ innehållsanalys som metod. Manifest och latent ansats användes. Resultatet baserades på 12 vetenskapliga artiklar och en avhandling. Resultatet i studien presenteras i två huvudteman: Dåligt bemötande vid tvångsvård och bra bemötande vid tvångsvård. Sex underteman framkom: att inte vara delaktig i vården, att bli bemött med makt, att förlora sitt människovärde, att känna sig delaktig i vården, att få god omvårdnad och att känna sig som en människa. Genom att ta reda på patienters upplevelse och behov, kan vården bli individuellt anpassad. Bra bemötande leder till att patienten känner sig respekterad och bekräftad som människa.

  • 28.
    Van Geelen, Stefan
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Rydelius, Per-Anders
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Somatic symptoms and psychological concerns in a general adolescent population: Exploring the relevance of DSM-5 Somatic Symptom Disorder2015In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 79, no 4, p. 251-258Article in journal (Refereed)
    Abstract [en]

    Objective: DSM-5 somatic symptom disorder (SSD) constitutes a major change for psychosomaticmedicine and psychiatry, as well as for epidemiological research in these fields. This studyinvestigates somatic symptoms and psychological concerns among adolescents in order tosystematically explore the relevance of SSD for general adolescent populations.

    Methods: A crosssectionalpopulation-based design, with a symptoms-based strategy and a symptom-andpsychological-concerns-based strategy, was used to estimate the prevalence of somatic symptomsand psychological concerns in a general adolescent population (n=2476, mean age=16 years, 49%boys, 51% girls). Somatic symptoms and psychological concerns in relation to gender, and selfreportedmedical and psychiatric conditions were investigated. The association between somaticsymptoms, psychological concerns, and functional impairment in school-, family-, peer- and physicalactivities was studied.

    Results: Reporting 3+ persistent distressing somatic symptoms wassignificantly more common than reporting one or more persistent distressing somatic symptom(s)combined with serious psychological concern. The prevalence of such complaints was significantlyhigher in girls. The proportion of medical and psychiatric conditions was highest in the groupreporting 3+ persistent distressing somatic symptoms combined with serious psychological concern.Belonging to this group most significantly increased odds ratios for functional impairment.

    Conclusion: For large-scale studies on SSD, results suggest the use of measures based on multiplesomatic items in combination with psychological concerns, and a methodologically soundstandardized measure of functional impairment. To further enhance clinical decision-making, therelation of symptoms to functional impairment, and the substantial overlap of SSD with medical andpsychiatric conditions during adolescence should be addressed.

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