Children with language impairment (LI) and children with typical development (TD) were assessed by their respective parents using The MacArthur Communicative Development Inventories (Swedish version SECDI) and Greenspan Socio Emotional Growth Chart (GSEGC). The aim was to investigate socio-emotional and language development in children with LI and TD with respect to possible differential patterns and relations between the groups. The results highlight a clear association between language and socio-emotional development. Children with LI were rated similar to young language-matched children with TD, but significantly lower relative to age-matched TD children, particularly concerning symbolic stages of development: the use of linguistic symbols as well as related areas such as symbol play and symbolic mental ability. The results are discussed in light of presumable background factors and possible consequences for children or sub-groups of children with LI.

With the aim of describing variability in the long-term outcome of quality of life after neurosurgically treated pediatric traumatic brain injury, mostly self-reports of 21 individuals with mild or moderate/severe injury were gathered using Mayo-Portland Adaptability Inventory in telephone interviews 13 years aftyer injury. A majority of the participants reported brain injury-related problems. The median outcome on Mayo-Portland Adaptability Inventory was mild to moderate limitations. The variation within the moderate/severe group varied between relatively good outcome and moderate/severe limitations. Concentration, irritability, fatigue, and transportation were reported as the most problematic areas, whereas self-care was reported as well functioning. Societal participation appeared to be the best functional domain in this Swedish study. Examples of individual reports of the life-situation at various outcome levels were provided. Variability in outcome is large within severity groups, and research may gain by addressing both outcomes of the individuals and groups. Objective questions of outcome should be accompanied by questions of actual functioning in everyday life. To ensure long-term support for quality of life for those with remaining dysfunction after pediatric traumatic brain injury, healthcare systems should implement systematic routines for referral to rehabilitation and support.

Scientific research on how people perceive, experience or understand the acoustic environment as a whole (i.e., soundscape) is still in development, both with regards to acoustic properties, as well as personality and individual differences. In order to predict how people would perceive an acoustic environment, it is central to identify the underlying acoustic properties of soundscapes. In this study these properties were approached by investigating the visual similarity of colour prints of 50 audio spectrograms (time vs. frequency), representing audio recordings of a variety of acoustic environments. In total, 15 female and 15 male students from the University of Sheffield were recruited to assess the 50 spectrograms by sorting them into groups based on how similar they were perceived to be. A distance matrix, derived from the sorting data, was subjected to a Multidimensional Scaling analysis to map the underlying dimensions of similarity among the spectrograms, which are proposed to represent the underlying acoustic properties of the corresponding acoustic environments. Three dimensions were identified. The first dimension relates to Distinguishable–Indistinguishable sound sources, the second dimension to Background–Foreground sounds, and the third dimension to Intrusive–Smooth sound sources. The results also show that established acoustic parameters are inappropriate as indicators of acoustic environments and that further research is needed in this field.

Previous research is scarce on the problems and needs of the “triply troubled” – among offenders with mental health problems and problematic substance use. Classifying this population into clusters based on problem profiles may provide information about individual needs for treatment. In a previous study, we identified four clusters of triply troubled: less troubled, severely triply troubled, triply troubled with medical problems, and working triply troubled. The present study explored the stability and predictive validity of these clusters in a naturalistic design. In total, 125 triply troubled individuals included in any of the four clusters were followed for approximately three years with regard to their inpatient and outpatient treatment participation. They were also interviewed with the 6th version of the Addiction Severity Index, the Psychopathy Checklist–Revised, and the World Health Organization Quality of Life–Bref. The main finding of the study was that on average the participants of all four clusters exhibited substantial improvements over the course of time but that improvements were cluster-specific rather than sample-specific. Implications of the study are discussed.

Studies of effects on speech intelligibility from aircraft noise in outdoor places are currently lacking. To explore these effects, first-order ambisonic recordings of aircraft noise were reproduced outdoors in a pergola. The average background level was 47 dB L-Aeq. Lists of phonetically balanced words (L-ASmax,L- word = 54 dB) were reproduced simultaneously with aircraft passage noise (L-ASmax,L- noise = 72-84 dB). Twenty individually tested listeners wrote down each presented word while seated in the pergola. The main results were (i) aircraft noise negatively affects speech intelligibility at sound pressure levels that exceed those of the speech sound (signal-to-noise ratio, S/N < 0), and (ii) the simple A-weighted S/N ratio was nearly as good an indicator of speech intelligibility as were two more advanced models, the Speech Intelligibility Index and Glasberg and Moore's [J. Audio Eng. Soc. 53, 906-918 (2005)] partial loudness model. This suggests that any of these indicators is applicable for predicting effects of aircraft noise on speech intelligibility outdoors.

Att arbeta med par ställer psykoterapeuten inför helt nya utmaningar. Den här boken ger teoretisk kunskap och praktiska instruktioner för att hjälpa par med relationssvårigheter. Metoden som presenteras utgår från den så kallade tredje vågens beteendeterapi och betonar vikten av acceptans. Boken visar hur bedömningen går till och hur behandlingen genomförs. Den ger också fylliga beskrivningar av acceptans- och förändringsstrategier och arbetets olika faser illustreras med hjälp av fallbeskrivningar och dialoger. Par i beteendeterapi är den första boken som presenterar metoden IBCT (Integrative Behavioural Couples Therapy) på svenska. Den vänder sig till KBT-behandlare som vill börja arbeta med par och till behandlare som redan arbetar med parterapi och vill öka sin kunskap om hur man kan göra det ur ett inlärningsteoretiskt perspektiv. Boken är även lämplig som kurslitteratur under utbildning.

In this chapter we review the literature on internet-delivered treatment for social anxiety disorder (SAD). There are several different treatment programs that have been tested in randomized controlled trials and evidence now suggests that guided internet-based cognitive behavior therapy (ICBT) can be as effective as face-to-face therapy, that therapists may need less training than in face-to-face treatment, and that ICBT works in representative clinical settings, thereby supporting effectiveness. Moreover, there are studies to suggest that ICBT has enduring effects up to five years after treatment and that it is cost-effective. Since there are advantages with internet treatments, this treatment option should be considered as a complement or alternative to face-to-face treatments for SAD. Treatment mechanisms, including moderators and mediators of outcome, remain to be investigated.

Internet-delivered cognitive behaviour therapy (ICBT) has been tested in many research trials but to a lesser extent been directly compared against face-to-face delivered cognitive behaviour therapy (CBT). We conducted a systematic review and meta-analysis on trials in which guided ICBT was directly compared against face-to-face CBT within the same trial. Studies on psychiatric and somatic conditions were included. Systematic searches resulted in 13 studies (total N=1053) that met all review criteria and were included in the review. There were 3 studies on social anxiety disorder, 3 on panic disorder, 2 on depressive symptoms, 2 on body dissatisfaction, 1 on tinnitus, 1 on male sexual dysfunction, and 1 on spider phobia. Face-to-face CBT was either in the individual format (n=6 ) or in the group format (n=7). We also assessed quality and risk of bias. Results showed a pooled effect size at post-treatment across of Hedges g = -0.01 (95% CI, -0.13 to 0.12), indicating that ICBT and face-to-face treatment produce equivalent overall effects. Study quality did not affect outcomes. While the overall results indicate equivalence, there are still few studies for each psychiatric and somatic condition and many for which guided ICBT has not been compared against face-to-face treatment. Thus, more research is needed to establish equivalence of the two treatment formats.

Internet-delivered cognitive behavior therapy (ICBT) has been tested in many research trials, but to a lesser extent directly compared to face-to-face delivered cognitive behavior therapy (CBT). We conducted a systematic review and meta-analysis of trials in which guided ICBT was directly compared to face-to-face CBT. Studies on psychiatric and somatic conditions were included. Systematic searches resulted in 13 studies (total N=1053) that met all criteria and were included in the review. There were three studies on social anxiety disorder, three on panic disorder, two on depressive symptoms, two on body dissatisfaction, one on tinnitus, one on male sexual dysfunction, and one on spider phobia. Face-to-face CBT was either in the individual format (n=6) or in the group format (n=7). We also assessed quality and risk of bias. Results showed a pooled effect size (Hedges' g) at post-treatment of −0.01 (95% CI: −0.13 to 0.12), indicating that guided ICBT and face-to-face treatment produce equivalent overall effects. Study quality did not affect outcomes. While the overall results indicate equivalence, there are still few studies for each psychiatric and somatic condition and many conditions for which guided ICBT has not been compared to face-to-face treatment. Thus, more research is needed to establish equivalence of the two treatment formats.

Guided internet-delivered cognitive behaviour therapy (ICBT) has been tested in many trials since the early studies dating back to the late 1990’s. The aim of this review was to investigate the most recent literature on guided ICBT for depression. We identified 11 controlled studies published between January 2013 and September 2014. Overall, large treatment effects were observed with a few exceptions. A majority (7 studies) provided some information regarding unwanted effects such as deterioration. Three studies directly compared guided ICBT against face-to-face CBT. We added an earlier study and calculated meta-analytic summary statistics for the four studies involving a total of 336 participants. The average effect size difference was Hedges g = 0.12 (95% CI: -0.08~0.32) in the direction of favouring guided ICBT, but with no practical importance. We conclude that guided ICBT is a promising treatment for depression and mood disorders and that the research is rapidly expanding.

Earlier studies have indicated the importance of IQ, educational aspirations, school grades, and task persistence during childhood and adolescence for later educational and vocational attainment. In this study, these characteristics were studied from a person-oriented perspective, identifying typical competence profiles using cluster analysis. The aim was to investigate a potential career bonus for adolescents with a highly positive competence profile for later educational and occupational success. Data were analyzed from the longitudinal Swedish Individual Development and Adaptation (IDA) study (N = 1326) with career outcomes measured in midlife (age 43-47). Results showed that having a highly positive competence profile predicted higher income and increased the probability of having a high occupational level, controlling for the separate competence components. The effects were only significant for males. Taken together, our findings support the idea that adolescent boys with a highly positive competence profile are optimized for career success to a larger extent than could be expected from the competence components considered separately.

Single scores from limited and unbalanced test batteries of cognitive ability can be ambiguous to interpret theoretically. In this study, a limited verbally and knowledge-loaded cognitive test battery, from applicants to the Swedish police academies (N=1,344), was examined to provide foundations for the use and interpretation of test scores. Three measurement models were compared: one single factor model and two bifactor models, which decomposed the variance of the battery into orthogonal components. The models were evaluated by fit indices and omega coefficients, and then applied to the prediction of academic performance. The overall prediction of all models was similar, although specific abilities also were found to provide substantial predictive validity over and above general intelligence (g). The findings provide support for the use of single scores in applied settings (selection), but suggest that it may be more appropriate to interpret such scores as composites of substantive components, and not just as measures of g.

Pediatric depression entails a higher risk for psychiatric disorders, somatic complaints, suicide, and functional impairment later in life. Cognitive behavior therapy (CBT) is recommended for the treatment of depression in children, yet research is based primarily on adolescents. The present meta-analysis investigated the efficacy of CBT in children aged 8-12 years with regard to depressive symptoms. We included randomized controlled trials of CBT with participants who had an average age of <= 12 years and were diagnosed with either depression or reported elevated depressive symptoms. The search resulted in 10 randomized controlled trials with 267 participants in intervention and 256 in comparison groups. The mean age of participants was 10.5 years. The weighted between-group effect size for CBT was moderate, Cohen's d=0.66. CBT outperformed both attention placebo and wait-list, although there was a significant heterogeneity among studies with regard to effect sizes. The weighted within-group effect size for CBT was large, d=1.02. Earlier publication year, older participants, and more treatment sessions were associated with a larger effect size. In conclusion, the efficacy of CBT in the treatment of pediatric depression symptoms was supported. Differences in efficacy, methodological shortcomings, and lack of follow-up data limit the present study and indicate areas in need of improvement.

The study investigated the working conditions associated with the accumulation of stress and lack of recovery and how recovery is related to health. The study group was employed in pre-school, home care and social work (n = 193). Recovery was assumed to be an explanatory variable for the relations between work and health. The response rate on a survey was 79 per cent. Cluster analysis identified three groups: the ‘Recovered’ (36 per cent of the total group) and ‘Not Recovered’ (25 per cent) and the ‘In-between’ (39 per cent). The Not Recovered displayed the whole chain of risk factors, involving difficult working conditions to which they responded with increased compensatory strategies. Despite this group having significantly greater reports of ill health, work absenteeism was not greater, which is likely related to their substituting sickness absence with sickness presence. As many as 43 per cent of the social workers were found to belong to the Not Recovered group. Multiple regression analyses controlling for background variables revealed that the Not Recovered group had a significantly higher relative risk for poor self-rated health than those in the Recovered group. Even sharper increases in relative risk existed for the other five symptoms that were analysed. Practical implications and new research questions are discussed.

I en enkätstudie undersöktes relationen mellan läkares uppfattning om kollegialt inflytande och lojalitet, protest och sorti.

Stark lojalitet med organisation och chef är 2–3 gånger vanligare bland dem som har stor tillgång till arenor för kollegialt inflytande. Lojaliteten med profession och patienter är stark och oberoende av tillgång till arenor.

Bland dem som har stor tillgång till arenor anser 87 procent att de får gehör för synpunkter jämfört med 21 procent bland dem med liten tillgång. 

Överväganden om att byta yrke, arbetsgivare eller arbetsplats är dubbelt så vanliga vid liten tillgång till arenor.

Arbetsgivare som vill attrahera läkare måste ha arenor där läkarna får inflytande över verksamheten.

In the present work we present an overview of experimental findings corroborating olfactory imagery observations with the visual and auditory modalities. Overall, the results indicate that imagery of olfactory information share many features with those observed in the primary senses although some major differences are evident. One such difference pertains to the considerable individual differences observed, with the majority being unable to reproduce olfactory information in their mind. Here, we highlight factors that are positively related to an olfactory imagery capacity, such as semantic knowledge, perceptual experience, and olfactory interest that may serve as potential moderators of the large individual variation.

The restructuring of human service organisations into more lean organisations has brought increased work demands for many human service professions. Social work stands out as a particularly exposed occupational group, in which high work demands are paired with a large individual responsibility to carry out the job. The objectives of the study were to identify what kind of coping strategies social workers employ to handle the imbalance between demands and resources in work and to investigate how different strategies affect outcomes regarding health, service quality and professional development. 16 individual interviews and four group interviews with another 16 social workers were conducted. The analysis identified five different main types of strategies: Compensatory, Demand-reducing, Disengagement, Voice and Exit. An extensive use of compensatory strategies was connected with negative outcomes in health. Often these compensatory strategies were replaced or combined with different means of reducing the work demands, which in turn influence performance and service quality in a negative way. The results highlight dilemmas the social workers are facing when the responsibility to deal with this imbalance are “decentralised” to the individual social worker. When resources do not match the organisational goals or quality standards, the social workers are forced into strategies that either endanger their own health or threaten the quality of service.

A field experiment was conducted to explore whether water sounds from a fountain had a positive impact on soundscape quality in a downtown park. In total, 405 visitors were recruited to answer a questionnaire on how they perceived the park, including its acoustic environment. Meanwhile the fountain was turned on or off, at irregular hours. Water sounds from the fountain were not directly associated with ratings of soundscape quality. Rather, the predictors of soundscape quality were the variables Road-traffic noise and Other natural sounds. The former had a negative and the latter a positive impact. However, water sounds may have had an indirect impact on soundscape quality by affecting the audibility of road-traffic and natural sounds. The present results, obtained in situ, agree with previous results in soundscape research that the sounds perceived particularly roadtraffic and natural sounds explain soundscape quality. They also agree with the results from laboratory studies that water sounds may mask roadtraffic sounds, but that this is not simple and straight forward. Thus sound should be brought into the design scheme when introducing water features in urban open spaces, and their environmental impact must be thoroughly assessed empirically.

For both legal and clinical purposes, it is of importance to study children's memories and reports of stressful events. The present study investigated the reporting patterns of 83 children who had witnessed homicidal violence, which is considered to be a highly stressful experience. More specifically, we explored the possible effects of prior violence exposure and of repeated questioning on the amount of details reported. Results showed that the majority of children provided detailed reports about the homicidal violence they had witnessed, including details concerning what happened before, during, and after the violent act. The children provided detailed and vivid testimonies from their experiences, whether they witnessed the event for the first time or had prior experience of witnessing severe violence against the victim by the perpetrator. Children with no prior experience of repeated violence who underwent repeated interviews provided more details than those interviewed once. The present data indicate that children are competent witnesses when questioned in legal contexts after having been exposed to extremely stressful events. These findings have implications for research related to children's memories and reporting of traumatic experiences, as well as practical implications for future treatment and evaluation of children's testimonies.

Die deutsche S3-Leitline zur Behandlung von Angststörungen (Panikstörung/Agoraphobie, generalisierte Angststörung, soziale Phobie, spezifische Phobie) bei Erwachsenen wurde unter Beratung und Moderation durch die Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) von einem Gremium erstellt, das 20 Fachverbände und andere Organisationen aus den Bereichen Psychotherapie, Psychologie, psychosomatische Medizin, Psychiatrie und Allgemeinmedizin sowie Patientenvertreter und Selbsthilfeorganisationen umfasst. Die Empfehlungen dieser Leitlinie basieren auf einer Sichtung der Evidenz der verfügbaren randomisierten klinischen Studien zu Angststörungen nach ICD/DSM und einer Synthese der Empfehlungen anderer Leitlinien.