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  • 1. Hedman-Lagerlöf, Erik
    et al.
    Axelsson, Erland
    Andersson, Erik
    Ljotsson, Brjann
    Andreasson, Anna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Macquarie University, Australia.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    The impact of exposure-based cognitive behavior therapy for severe health anxiety on self-rated health: Results from a randomized trial2017In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 103, p. 9-14Article in journal (Refereed)
    Abstract [en]

    Objective: Self-rated health (SRH) has been shown to be a stable predictor of illness and mortality. Improvement in SRH, even in the absence of change in objective health, predicts better health and reduced mortality. Severe health anxiety (SHA) is characterized by fear of illness and distorted health perception. The objective of the present study was to investigate if exposure-based cognitive behavior therapy (CBT) for SHA can lead to improvement in SRH and whether this improvement is mediated by reduced health anxiety. Methods: Data were collected from a randomized controlled trial where participants with SHA were allocated to 12 weeks of exposure-based CBT (n = 99) for SHA or to a no treatment control condition (n = 33). The mediation analysis was based on SRH- and health anxiety data collected weekly during the treatment phase. Results: Linear mixed effects models analysis showed a significant interaction effect of group and time indicating superior improvements in SRH in exposure-based CBT compared to the control condition (Z = 2.69, p = 0.007). The controlled effect size was moderately large (d = 0.64) and improvements were stable at 1-year follow-up. Reduced health anxiety was a significant mediator of improvement in SRH. Conclusions: 12 weeks of exposure-based CBT for SHA can lead to significant improvements in SRH. Considering the previously established importance of SRH as a predictor for disease and mortality, exposure-based CBT for severe health anxiety may lead to improvements on several important health parameters, possibly even increasing the likelihood of longevity.

  • 2.
    Riva, Roberto
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Mork, Paul Jarle
    Norwegian University of Science and Technology, Human Movement Science Programme.
    Westgaard, Rolf Harald
    Norwegian University of Science and Technology, Department of Industrial Economics and Technology.
    Okkenhaug Johansen, Tonje
    Norwegian University of Science and Technology, Department of Neuroscience.
    Lundberg, Ulf
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Catecholamines and heart rate in female fibromyalgia patients2012In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 72, no 1, p. 51-57Article in journal (Refereed)
    Abstract [en]

    Background: Fibromyalgia syndrome is a disease of unknown pathogenesis characterised by widespread chronic musculoskeletal pain. Fibromyalgia has been associated with dysregulation of the stress systems, but results are inconsistent.

    Purpose: To investigate autonomic nervous system activity (urinary noradrenaline, adrenaline, dopamine, and heart rate) of fibromyalgia patients and healthy controls.

    Methods: Urinary catecholamines and heart rate were assessed for a 24-hour period in a controlled hospital setting (including relaxation, a test with prolonged mental stress, and sleep), and during daily activity in 29 female fibromyalgia patients and 29 age-matched female healthy controls.

    Results: With repeated measures ANOVAs, catecholamine levels were lower in patients than controls (P = .035 for noradrenaline; P = .005 for adrenaline; P = .001 for dopamine). One-way ANOVAs for the single periods showed that patients compared to controls had significantly lower adrenaline levels during the night (P = .010) and the second day (P = .010), significantly lower dopamine levels during the first day (P = .008), the night (P = .001), and the second day (P = .004). However, single time point noradrenaline levels were not significantly different between the groups. Overall, heart rate was significantly higher in patients than controls (P = .014). Specifically, significant differences emerged during relaxation (P = .016) and sleep (P = .011), but not during stress provocation or daily activities.

    Conclusions: The results indicate an altered regulation of the autonomic nervous system in fibromyalgia patients, with attenuated activity of both the sympathetic (adrenal medulla component) and the parasympathetic branch.

  • 3.
    Stenfors, Cecilia U. D.
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). University of Chicago, USA.
    Jonsdottir, I. H.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Associations between systemic pro-inflammatory markers, cognitive function and cognitive complaints in a population-based sample of working adults2017In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 96, p. 49-59Article in journal (Refereed)
    Abstract [en]

    Background: The knowledge is limited regarding the relation between systemic inflammatory biomarkers and subjective and objective cognitive functioning in population-based samples of healthy adults across the adult age-span. Thus, the aim of this study was to study a selection of four pro-inflammatory biomarkers (IL-6, MCP-1, TNF-alpha, CRP) in relation to executive cognitive functioning, episodic memory and subjective cognitive complaints (SCC) in a population-based sample of 215 working adults (age 25-67).

    Results: Higher levels of MCP-1 were associated with poorer executive cognitive functioning, even after adjustments for demographical factors, health status/conditions, SCC and depressive symptoms. IL-6 and CRP were associated with poorer executive cognitive functioning, but these associations covaried with age especially and were not present after adjustment for demographical factors. MCP-1 was associated with poorer episodic memory, but this association also covaried with age especially and was not present after adjustment for demographical factors, and CRP was associated with episodic memory only among participants without reported health conditions. Higher MCP-1 levels were also associated with more SCC and this association covaried with depressive symptoms, while higher levels of TNF-alpha were associated with less SCC.

    Conclusion: Low grade inflammatory processes in terms of higher systemic levels of pro-inflammatory biomarkers (MCP-1, IL-6 & CRP) were associated with poorer executive functioning in this sample of working adults, and MCP-1 was so after extensive adjustments. Support for associations between these biomarkers and episodic memory and SCC were more limited. Future research should address the causality of associations between low grade inflammatory processes and cognitive functioning.

  • 4. Van Laethem, Michelle
    et al.
    Beckers, Debby G. J.
    Kompier, Michiel A. J.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    van den Bossche, Seth N. J.
    Geurts, Sabine A. E.
    Bidirectional relations between work-related stress, sleep quality and perseverative cognition2015In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 79, no 5, p. 391-398Article in journal (Refereed)
    Abstract [en]

    Objective

    In this longitudinal two-wave study, bidirectional relations between work-related stress and sleep quality were examined. Moreover, it was investigated whether perseverative cognition is a potential underlying mechanism in this association, related to both work-related stress and sleep quality.

    Methods

    A randomly selected sample of Dutch employees received an online survey in 2012 and 2013. Of all invited employees, 877 participated in both waves. Structural equation modeling was performed to analyze the data.

    Results

    We found evidence for reversed relations between work-related stress and sleep quality. Specifically, when controlling for perseverative cognition, work-related stress was not directly related to subsequent sleep quality, but low sleep quality was associated with an increase in work-related stress over time. Moreover, negative bidirectional associations over time were found between perseverative cognition and sleep quality, and positive bidirectional associations were found between work-related stress and perseverative cognition. Lastly, a mediation analysis showed that perseverative cognition fully mediated the relationship between work-related stress and sleep quality.

    Conclusion

    The study findings suggest that perseverative cognition could be an important underlying mechanism in the association between work-related stress and sleep quality. The bidirectionality of the studied relationships could be an indication of a vicious cycle, in which work-related stress, perseverative cognition, and sleep quality mutually influence each other over time.

  • 5.
    Åkerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Axelsson, John
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Orsini, Nicola
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Do sleep, stress, and illness explain daily variations in fatigue?: A prospective study2014In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 76, no 4, p. 280-285Article in journal (Refereed)
    Abstract [en]

    Objective: Fatigue is related to a number of serious diseases, as well as to general well-being. It is also a major cause of sickness absence and use of health facilities. Still, the determinants of variations in fatigue are little investigated. The purpose of present study was to investigate the relationships between the daily variations of fatigue with sleep during the previous night, stress or disease symptoms during the same day - across 42 consecutive days of normal life. Methods: 50 individuals participated and gave diary reports and used an actigraph across the 42 days. The data was analyzed using a multilevel approach with mixed model regression. Results: The analyses showed that the day-to-day variation in fatigue was related to (poor) sleep quality (p < .001) and (reduced) sleep duration (p < .01) the previous night, as well as to higher stress (p < .05), and to the occurrence of a cold or fever (p < .001) during the same day as the fatigue rating. Fatigue was also strongly related to poorer subjective health (p < .001) and sleepiness (p < .001) during the same day. Conclusion: The results indicate that prior sleep (and sleepiness) as well as stress and illness are consistently connected to how fatigue is experienced during normal living conditions.

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