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  • 101. Cernvall, Martin
    et al.
    Skogseid, Ellen
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Ljungman, Lisa
    Ljungman, Gustaf
    von Essen, Louise
    Experiential avoidance and rumination in parents of children on cancer treatment: relationships with posttraumatic stress symptoms and symptoms of depression2016Inngår i: Journal of clinical psychology in medical settings, ISSN 1068-9583, E-ISSN 1573-3572, Vol. 23, nr 1, s. 67-76Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We conducted a cross-sectional survey study to investigate whether there is a relationship between experiential avoidance (EA), rumination, post-traumatic stress symptoms (PTSS), and symptoms of depression, in parents of children on cancer treatment. Data from 79 parents (55 mothers) of 79 children with a median of three months since their cancer diagnosis were included in cross-sectional analyses. EA and rumination were positively correlated with PTSS and symptoms of depression. EA and rumination did not provide incremental explained variance in PTSS over and above that explained by symptoms of depression, while controlling for symptoms of anxiety and demographic characteristics. However, EA and rumination provided incremental explained variance in symptoms of depression over and above that explained by PTSS, while controlling for symptoms of anxiety and demographic characteristics. Rumination and EA are important constructs in the understanding of PTSS and symptoms of depression in parents of children on cancer treatment. Future research should delineate the temporal relationships between these constructs.

  • 102.
    Christianson, Sven Å.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    A cat-and-mouse game: Media Manipulation2016Inngår i: Shrunk: Crime and disorders of the mind / [ed] J Thomas Dalby, Lisa Ramshaw, Calgary: Durvile Publications , 2016, s. 22-39Kapittel i bok, del av antologi (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    SHRUNK is a collection of true cases by eminent Canadian and international forensic psychologists and psychiatrists facing the tough topic of mental illness in the criminal justice system.

  • 103.
    Christianson, Sven Å.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Förhör och utredande intervjumetodik2008Inngår i: Handbok i rättspsykologi, Liber, Stockholm , 2008Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [sv]

    This chapter gives an overview of a number of principles and central aspects in interviewing practices regarding victims and bystander witnesses: for example, planning and preparation, empathy, documentation, ground rules, context reinstatement and various techniques for guided retrieval, conclusion and evaluation.

  • 104.
    Christianson, Sven Å.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Äkta och simulerad minnesförlust hos gärningsmän2008Inngår i: Handbok i rättspsykologi, Liber, Stockholm , 2008Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [sv]

    There is a need for a more comprehensive insight into forensic issues pertaining to trauma, memory and amnesia among offenders, both on a theoretical and applied level, in order to further our understanding of how to elicit and evaluate their recall of violent crime events. This chapter discusses different explanations for memory loss for criminal offences and the motivation to simulate amnesia among offenders.

  • 105.
    Christianson, Sven Å.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Granhag, Pär Anders
    Rättspsykologi - en introduktion2008Inngår i: Handbok i rättspsykologi, Liber, Stockholm , 2008Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [sv]

    This chapter presents definitions and a historical overview of forensic psychology and the development and trends in this field during the last decades. The chapter also review the most common research topics in current international and domestic forensic psychology.

  • 106.
    Christianson, Sven Å.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Rogland, Ulrika
    Vad är grooming?2016Bok (Annet (populærvitenskap, debatt, mm))
  • 107. Clefberg Liberman, Lisa
    et al.
    Larsson, Karolina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Paz Altuzarra, Maria
    Öst, Lars-Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Ollendick, Thomas
    Self-reported Life Satisfaction and Response Style Differences Among Children in Chile and Sweden2015Inngår i: Journal of Child and Family Studies, ISSN 1062-1024, E-ISSN 1573-2843, Vol. 24, nr 1, s. 66-75Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of the current study was to assess self-perceived life satisfaction in Chilean and Swedish children. The total sample consisted of a non-clinical sample of 1,352 school children between 8 and 14 years of age. Analyses were carried out to compare the children's subjective quality of life and life satisfaction. In addition, possible response style differences across the two countries were explored. Based on our findings, no difference was found between the two countries for the total life satisfaction score, and the only area on which the Swedish children had a significantly higher rating than the Chilean children was on their satisfaction with their friends. However, the Chilean children reported a higher satisfaction with their siblings, school and health than the Swedish children. Moreover, an interaction effect was found between country and age group on the school variable, with the three age groups in the Swedish sample being significantly different, whereas no significant difference was found between the age groups on this variable among the Chilean children. Overall, the satisfaction with the children's different life areas decreased, as they grew older, whereas gender differences were only found on three variables. Small significant response style differences were found between the Chilean and Swedish children. As the effect sizes of these differences were quite small, they should be viewed with caution, and are not likely to explain the few differences found between the children. How I Feel about Things seems fully adequate for use across normal non-clinical boys and girls belonging to different age groups and living in different countries in order to assess their self-reported life satisfaction.

  • 108.
    Cortes, Diana
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Laukka, Petri
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi.
    Asperholm, Martin
    Fredborg, William
    Döllinger, Lillian
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Xiao, Shanshan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Högman, Lennart
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Dang, Junhua
    Fischer, Håkan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Intranasal Oxytocin and Response Inhibition in Young and Older Adults2017Konferansepaper (Fagfellevurdert)
    Abstract [en]

    In normal aging, people are confronted with impairment in both socioemotional and cognitive abilities. Specifically, there are age-related declines in inhibitory processes that regulate attention towards irrelevant material. In last years, the intranasal administration of the neuropeptide oxytocin has mainly been related to improvements in several domains such as emotion recognition and memory, but to date the effects of oxytocin in aging remain largely unknown. In a randomized, double blind, placebo controlled, within-subjects study design, we investigated whether oxytocin facilitates inhibitory processing in older adults compared to younger adults. In total, 41 older adults (51% women; age range 65-75 years) and 37 younger adults (49% women; age range 20-30 years) participated in this study two times, receiving a single intranasal dose of 40 IU of placebo and oxytocin in randomized order 45 minutes before engaging in the task. Participants were tested approximately a month apart and mostly at the same hour during both occasions. Inhibition was measured with a Go/NoGo task which included happy and neutral faces as targets (Go stimuli) and distractors (NoGo stimuli) shown on a computer screen. Participants were instructed to press a button any time they saw a target and remain passive when encountering a distractor. Preliminary results indicate effects for happy and neutral faces, but only in the distractor condition. For happy distractors, women rejected correctly happy faces more accurately than men did, both in the placebo and oxytocin conditions. A main effect of age was observed for the neutral distractors, where older adults were more successful in inhibiting responses than younger adults during oxytocin and placebo treatments. We did not observe effects of oxytocin in the different tasks. The role of oxytocin was not clear distinguished in the tasks. In sum, our findings showed that age and gender can influence inhibition but their effects depend on the displayed emotions. This suggests that the ability to inhibit interfering distractors may remain intact despite of age and that deficits in inhibition may be selective. The role of oxytocin in inhibition needs to be further investigated since it is possible that it is context dependent.

  • 109.
    Cortes, Diana S.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Månsson, Kristoffer
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Fischer, Håkan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Laukka, Petri
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi.
    Oxytocin Induces Brain Activity Reductions to Negative Emotional Stimuli in Younger and Older Adults2018Konferansepaper (Fagfellevurdert)
    Abstract [en]

    In recent years, the intranasal administration of the neuropeptide oxytocin has mainly been related to improvements in domains such as emotion recognition and memory, but to date the effects of oxytocin in aging remain largely unknown. A major caveat in oxytocin research is that it is almost exclusively based on young men which may reflect an inadequate picture of the potential benefits of oxytocin administration. In a randomized, double blind, placebo controlled, within-subjects study design, we investigated whether oxytocin affects the recognition of positive and negative stimuli differently in younger and older adults. Forty-four older adults (50% women; M= 69.82) and 44 younger adults (50% women; M= 24.75) participated in this study two times, receiving a single intranasal dose of 40 IUs of placebo and oxytocin in randomized order 40 minutes before engaging in the task. Participants watched short videoclips where actors displayed nine emotions: neutrality, happiness, pride, interest, relief, anger, despair, sadness, and disgust. Preliminary results indicate that oxytocin-induced reductions to negative emotions were found in bilateral fusiform gyrus (Z > 4.16, Family wise error corrected, pFWE < 0.009), hippocampus (Z > 4.53, pFWE < 0.002), insula (Z > 3.69, pFWE < 0.045), and superior temporal gyrus (Z > 4.34, pFWE < 0.008), as well as, right-lateralized reductions in the amygdala (Z = 3.73, pFWE = 0.005). These findings are in line with previous studies showing decreased brain activity to negative stimuli and suggest that this mechanism in not only present in younger adults but it can also be extended to an older population. Future studies should investigate how oxytocin impacts socioemotional and cognitive processes in elderly.

  • 110.
    Cortes, Diana S.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Skragge, Michael
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Döllinger, Lillian
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Laukka, Petri
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi.
    Fischer, Håkan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Nilsson, Mats E.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Perception och psykofysik.
    Hovey, Daniel
    Westberg, Lars
    Larsson, Marcus
    Granqvist, Pehr
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Personlighets-, social- och utvecklingspsykologi.
    Mixed support for a causal link between single dose intranasal oxytocin and spiritual experiences: opposing effects depending on individual proclivities for absorption2018Inngår i: Social Cognitive & Affective Neuroscience, ISSN 1749-5016, E-ISSN 1749-5024, Vol. 13, nr 9, s. 921-932Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Intranasal oxytocin (OT) has previously been found to increase spirituality, an effect moderated by OT-related genotypes. This pre-registered study sought to conceptually replicate and extend those findings. Using a single dose of intranasal OT vs placebo (PL), we investigated experimental treatment effects, and moderation by OT-related genotypes on spirituality, mystical experiences, and the sensed presence of a sentient being. A more exploratory aim was to test for interactions between treatment and the personality disposition absorption on these spirituality-related outcomes. A priming plus sensory deprivation procedure that has facilitated spiritual experiences in previous studies was used. The sample (N = 116) contained both sexes and was drawn from a relatively secular context. Results failed to conceptually replicate both the main effects of treatment and the treatment by genotype interactions on spirituality. Similarly, there were no such effects on mystical experiences or sensed presence. However, the data suggested an interaction between treatment and absorption. Relative to PL, OT seemed to enhance spiritual experiences in participants scoring low in absorption and dampen spirituality in participants scoring high in absorption.

  • 111. Dahlin, Mats
    et al.
    Andersson, Gerhard
    Magnusson, Kristoffer
    Johansson, Tomas
    Sjögren, Johan
    Håkansson, Andreas
    Pettersson, Magnus
    Kadowaki, Åsa
    Cuijpers, Pim
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: A randomized controlled trial2016Inngår i: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 77, s. 86-95Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Generalized anxiety disorder (GAD) is a disabling condition which can be treated with cognitive behaviour therapy (CBT). The present study tested the effects of therapist-guided internet-delivered acceptance-based behaviour therapy on symptoms of GAD and quality of life. An audio CD with acceptance and mindfulness exercises and a separate workbook were also included in the treatment. Participants diagnosed with GAD (N = 103) were randomly allocated to immediate therapist-guided internet-delivered acceptance-based behaviour therapy or to a waiting-list control condition. A six month follow-up was also included. Results using hierarchical linear modelling showed moderate to large effects on symptoms of GAD (Cohen's d = 0.70 to 0.98), moderate effects on depressive symptoms (Cohen's d = 0.51 to 0.56), and no effect on quality of life. Follow-up data showed maintained effects. While there was a 20% dropout rate, sensitivity analyses showed that dropouts did not differ in their degree of change during treatment. To conclude, our study suggests that internet-delivered acceptance-based behaviour therapy can be effective in reducing the symptoms of GAD.

  • 112. Dahlin, Mats
    et al.
    Ryberg, Marielle
    Vernmark, Kristofer
    Annas, Nina
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Andersson, Gerhard
    Internet-delivered acceptance-based behavior therapy for generalized anxiety disorder: A pilot study2016Inngår i: Internet Interventions, ISSN 2214-7829, Vol. 6, s. 16-21Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Internet-delivered cognitive behavior therapy (ICBT) has been developed and tested for treating persons with generalized anxiety disorder (GAD). A new form of CBT focuses on acceptance (of internal experiences or difficult psychological content), mindfulness and valued actions. To date this form of CBT has not been delivered via the internet for persons with GAD. The aim of this study was to describe the functionality of a new internet-delivered acceptance-based behavior therapy for GAD, and to test the effect of the intervention in an open pilot trial. Methods: Following exclusion of two patients we included 14 patients diagnosed with GAD from two primary care clinics. At 2–3 months follow-up after treatment 10 patients completed the outcome measures. The treatment lasted for an average of 15 weeks and consisted of acceptance-based techniques, behavior therapy components and homework assignments. Results: A majority of participants completed all modules during the treatment. Findings on the Penn State Worry Questionnaire showed a within-group improvement of Cohen's d = 2.14 at posttreatment. At the follow-up results were maintained. Client satisfaction ratings were high. Conclusions: We conclude that internet-delivered acceptance-based behavior therapy potentially can be a promising new treatment for GAD. A controlled trial of the program has already been completed.

  • 113. Danielsson, Katarina
    et al.
    Jansson Fröjmark, Markus
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Broman, Jan-Erik
    Markström, Agneta
    Cognitive Behavioral Therapy as an Adjunct Treatment to Light Therapy for Delayed Sleep Phase Disorder in Young Adults: A Randomized Controlled Feasibility Study2016Inngår i: Behavioral Sleep Medicine, ISSN 1540-2002, Vol. 14, nr 2, s. 212-232Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Delayed sleep phase disorder (DSPD) is common among young people, but there is still no evidence-based treatment available. In the present study, the feasibility of cognitive behavioral therapy (CBT) was evaluated as an additive treatment to light therapy (LT) in DSPD. A randomized controlled trial with participants aged 16 to 26 years received LT for two weeks followed by either four weeks of CBT or no treatment (NT). LT advanced sleep-wake rhythm in both groups. Comparing LT+CBT with LT+NT, no significant group differences were observed in the primary endpoints. Although anxiety and depression scores were low at pretreatment, they decreased significantly more in LT+CBT compared to LT+NT. The results are discussed and some suggestions are given for further studies.

  • 114. Danielsson, Katarina
    et al.
    Jansson-Fröjmark, Markus
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Broman, Jan-Erik
    Markström, Agneta
    Light Therapy With Scheduled Rise Times in Young Adults With Delayed Sleep Phase Disorder: Therapeutic Outcomes and Possible Predictors2018Inngår i: Behavioural Sleep Medicine, ISSN 1540-2002, E-ISSN 1540-2010, Vol. 16, nr 4, s. 325-336Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Clinical trials with light therapy (LT) for delayed sleep phase disorder (DSPD) are sparse and little is known about factors that are favorable for improvements. In this study, LT with scheduled rise times was conducted at home for 14 days by 44 participants with DSPD aged 16-26 years. Primary outcomes were sleep onset and sleep offset. Potential predictors were demographic characteristics, chronotype, dim light melatonin onset, the number of days the LT lamp was used, the daily duration of LT, daytime sleepiness, anxiety, depression, worry, and rumination. Significant advances were observed in sleep onset and sleep offset from baseline to the end of treatment. The number of days of LT predicted earlier sleep onset and sleep offset.

  • 115. Danielsson, Katarina
    et al.
    Markström, Agneta
    Broman, Jan-Erik
    von Knorring, Lars
    Jansson-Fröjmark, Markus
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Delayed sleep phase disorder in a Swedish cohort of adolescents and young adults: Prevalence and associated factors2016Inngår i: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 33, nr 10, s. 1331-1339Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A delayed sleep-wake and circadian rhythm often occurs during puberty. While some individuals only develop a delayed sleep phase (DSP), others will fulfill the criteria for the diagnosis of delayed sleep phase disorder (DSPD). All previous studies have however not separated DSP from DSPD, and, as a result, the prevalence and associated factors are largely unknown for the two conditions individually. We estimated the prevalence of DSP and DSPD in a Swedish cohort of adolescents and young adults. We also investigated associated factors in the two conditions relative to each other and individuals with no DSP. A questionnaire regarding sleep patterns, demographics, substance use/abuse and symptoms of depression, anxiety, worry and rumination was sent to 1000 randomly selected participants (16-26 years of age) in Uppsala, Sweden (response rate = 68%). DSP was defined as a late sleep onset and a preferred late wake-up time. The DSPD diagnosis was further operationalized according to the Diagnostic and Statistical Manual of Mental Disorders, Edition 5 (DSM-5) criteria including insomnia or excessive sleepiness, distress or dysfunction caused by the DSP and that the sleep problem had been evident for 3 months. DSP occurred at a frequency of 4.6% and DSPD at a frequency of 4% in the investigated cohort. DSP was more common in males and was associated with not attending educational activity or work, having shift work, nicotine and alcohol use and less rumination. DSPD was equally common in males and females and was associated with not attending educational activity or work and with elevated levels of anxiety. Both DSP and DSPD appear to be common in adolescents and young adults in this Swedish cohort. No educational activity or work was associated with both DSP and DSPD. However, there were also apparent differences between the two groups in shift work, substance use and mental health, relative to persons with no DSP. Thus, it seems reasonable to assess DSP and DSPD as distinct entities in future studies.

  • 116. Davis, Thompson E.
    et al.
    Ollendick, Thomas H.
    Öst, Lars-Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    One-Session Treatment of Specific Phobias in Children: Recent Developments and a Systematic Review2019Inngår i: Annual Review of Clinical Psychology, ISSN 1548-5943, E-ISSN 1548-5951, Vol. 15, s. 233-256Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    One-Session Treatment is a well-established evidence-based treatment for specific phobias in youths that incorporates reinforcement, cognitive challenges, participant modeling, psychoeducation, and skills training into a single, massed session of graduated exposure. This review begins by briefly examining the phenomenology, etiology, epidemiology, and assessment of specific phobias and then pivots to a description of One-Session Treatment. We examine the use of One-Session Treatment with children and adolescents, briefly discussing its components and application, and subsequently review almost two decades of research supporting its efficacy. Finally, we propose future directions for research and practice.

  • 117. Delahunty, Fionn
    et al.
    Johansson, Robert
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. Linköping University, Sweden.
    Arcan, Mihael
    Passive Diagnosis incorporating the PHQ-4 for Depression and Anxiety2019Inngår i: Proceedings of the 4th Social Media Mining for Health Applications (#SMM4H): Workshop & Shared Task / [ed] Davy Weissenbacher, Graciela Gonzalez-Hernandez, Association for Computational Linguistics , 2019, s. 40-46Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Depression and anxiety are the two most prevalent mental health disorders worldwide, impacting the lives of millions of people each year. In this work, we develop and evaluate a multilabel, multidimensional deep neural network designed to predict PHQ-4 scores based on individuals written text. Our system outperforms random baseline metrics and provides a novel approach to how we can predict psychometric scores from written text. Additionally, we explore how this architecture can be applied to analyse social media data.

  • 118. Deserno, Heinrich
    et al.
    Hau, Stephan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Psychoanalyse2018Inngår i: Traum und Schlaf: Ein interdisziplinäres Handbuch / [ed] Alfred Krovoza, Christine Walde, Stuttgart: Verlag J. B. Metzler, 2018, s. 258-274Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [de]

    Traum und Schlaf lassen sich von zwei gegensätzlichen Auffassungen her darstellen: zum einen sinnverstehend- hermeneutisch, zum anderen erklärendexperimentell.. In diesem Beitrag geht es darum, die beiden Auffassung nicht als sich gegenseitig ausschließend zu sehen, sondern da, wo es plausibel ist, auch eine Zusammenschau zu versuchen. Insgesamt soll die psychoanalytische Theorie von Traum und Schlaf im Vordergrund stehen.

  • 119. Donker, Tara
    et al.
    Cornelisz, Ilja
    van Klaveren, Chris
    van Straten, Annemieke
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. University of Southern Denmark, Denmark.
    Cuijpers, Pim
    van Gelder, Jean-Louis
    Effectiveness of Self-guided App-Based Virtual Reality Cognitive Behavior Therapy for Acrophobia: A Randomized Clinical Trial2019Inngår i: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 76, nr 7, s. 682-690Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Importance Globally, access to evidence-based psychological treatment is limited. Innovative self-help methods using smartphone applications and low-cost virtual reality have the potential to significantly improve the accessibility and scalability of psychological treatments.

    Objective To examine the effectiveness of ZeroPhobia, a fully self-guided app-based virtual reality cognitive behavior therapy (VR CBT) using low-cost (cardboard) virtual reality goggles compared with a wait-list control group and to determine its user friendliness.

    Design, Setting, and Participants In a single-blind randomized clinical trial, participants were enrolled between March 24 and September 28, 2017, and randomly assigned (1:1) by an independent researcher to either VR CBT app or a wait-list control group. A total of 193 individuals aged 18 to 65 years from the Dutch general population with acrophobia symptoms and access to an Android smartphone participated. The 6 animated modules of the VR-CBT app and gamified virtual reality environments were delivered over a 3-week period in participants’ natural environment. Assessments were completed at baseline, immediately after treatment, and at 3-month follow-up. Analysis began April 6, 2018, and was intention to treat.

    Intervention Self-guided app-based VR CBT.

    Main Outcomes and Measures The primary outcome measure was the Acrophobia Questionnaire. The hypothesis was formulated prior to data collection.

    Results In total, 193 participants (129 women [66.84%]; mean [SD] age, 41.33 [13.64] years) were randomly assigned to intervention (n = 96) or a wait-list control group (n = 97). An intent-to-treat analysis showed a significant reduction of acrophobia symptoms at posttest at 3 months for the VR-CBT app compared with the controls (b = –26.73 [95% CI, −32.12 to −21.34]; P < .001; d = 1.14 [95% CI, 0.84 to 1.44]). The number needed to treat was 1.7. Sensitivity and robustness analysis confirmed these findings. Pretreatment attrition was 22 of 96 (23%) because of smartphone incompatibility. Of the 74 participants who started using the VR-CBT app, 57 (77%) completed the intervention fully.

    Conclusions and Relevance A low-cost fully self-guided app-based virtual reality cognitive behavioral therapy with rudimentary virtual reality goggles can produce large acrophobia symptom reductions. To our knowledge, this study is the first to show that virtual reality acrophobia treatment can be done at home without the intervention of a therapist.

    Trial Registration Trialregister.nl identifier: NTR6442

  • 120.
    Döllinger, Lillian
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Högman, Lennart
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Bänziger, Tanja
    Laukka, Petri
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi.
    Makower, Irena
    Fischer, Håkan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Hau, Stephan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    The effectiveness of a dynamic multimodal emotion recognition accuracy training program2019Inngår i: Program: ISRE 2019 Amsterdam, 2019, s. 165-165, artikkel-id 77Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Background: Computerized trainings for emotion recognition accuracy (ERA) have shown to be successful, however, are often lacking external validity. The use of still pictures, the focus on the face, and limited response sets limit generalizability of findings. Further, trainings often use between-subjectsdesigns and short time intervals between, or same items for ERA training and outcome measure. In response, we developed and evaluated a multi-modal ERA training in a randomized controlled trial.

    Method: Seventy-two undergraduate students (M=24.7, SD=7.69, 75% women) signed up for the study; 68 completed all measurements. They were randomly assigned to the multimodal ERA training or one of two control conditions. The ERA outcome measure (ERAM; Laukka et al., 2015) assesses 12 emotions separately in three modalities (audio, video, audio-video) using 72 dynamic stimuli. The multimodal training consisted and immediate and extensive feedback using different items. The last training session and the ERA outcome measurement lay approximately one week apart.

    Results and Conclusions: A repeated-measures ANOVA with baseline as covariate showed a main effect of training on the ERAM, F(2/63) = 8.04, p < .001, ηp2 = .20. Bonferroni-corrected posthoc tests revealed the change for the multimodal training was significantly superior to the control conditions (p=.001; p=.003). Detailed results per modality and descriptive statistics will be presented. Due to its multimodal and dynamic nature, delay between training and outcome measure and use of different items, the multimodal training is a promising tool for training ERA in different contexts, like clinical settings, assessment procedures or law enforcement training.

  • 121.
    Döllinger, Lillian
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Högman, Lennart
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Bänziger, Tanja
    Laukka, Petri
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Perception och psykofysik.
    Makower, Irena
    Magnusson, Tova
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Spejare, Amanda
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Cortes, Diana S.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Månsson, Kristoffer N.T.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Manzouri, Amirhossein
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Fischer, Håkan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Hau, Stephan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Effectively training emotion recognition accuracy: The evaluation of two systematic training programs2019Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    This study presents findings about the effectiveness of two computerized training-programs for emotion recognition accuracy that were evaluated in a double-blind randomized controlled study with repeated measures design. Both trainings are effective in training emotion recognition accuracy. The trainings and results are presented in detail and practical implications are discussed.

  • 122. Ebert, D. D.
    et al.
    Donkin, L.
    Andersson, G.
    Andrews, G.
    Berger, T.
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Rozental, Alexander
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Choi, I.
    Laferton, J. A. C.
    Johansson, R.
    Kleiboer, A.
    Lange, A.
    Lehr, D.
    Reins, J. A.
    Funk, B.
    Newby, J.
    Perini, S.
    Riper, H.
    Ruwaard, J.
    Sheeber, L.
    Snoek, F. J.
    Titov, N.
    Ünlü Ince, B.
    van Bastelaar, K.
    Vernmark, K.
    van Straten, A.
    Warmerdam, L.
    Salsman, N.
    Cuijpers, P.
    Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials2016Inngår i: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 46, nr 13, s. 2679-2693Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Almost nothing is known about the potential negative effects of Internet-based psychological treatments for depression. This study aims at investigating deterioration and its moderators within randomized trials on Internet-based guided self-help for adult depression, using an individual patient data meta-analyses (IPDMA) approach.

    Studies were identified through systematic searches (PubMed, PsycINFO, EMBASE, Cochrane Library). Deterioration in participants was defined as a significant symptom increase according to the reliable change index (i.e. 7.68 points in the CES-D; 7.63 points in the BDI). Two-step IPDMA procedures, with a random-effects model were used to pool data.

    A total of 18 studies (21 comparisons, 2079 participants) contributed data to the analysis. The risk for a reliable deterioration from baseline to post-treatment was significantly lower in the intervention v. control conditions (3.36 v. 7.60; relative risk 0.47, 95% confidence interval 0.29–0.75). Education moderated effects on deterioration, with patients with low education displaying a higher risk for deterioration than patients with higher education. Deterioration rates for patients with low education did not differ statistically significantly between intervention and control groups. The benefit–risk ratio for patients with low education indicated that 9.38 patients achieve a treatment response for each patient experiencing a symptom deterioration.

    Internet-based guided self-help is associated with a mean reduced risk for a symptom deterioration compared to controls. Treatment and symptom progress of patients with low education should be closely monitored, as some patients might face an increased risk for symptom deterioration. Future studies should examine predictors of deterioration in patients with low education.

  • 123.
    Engblom Rosengren, Cecilia
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Strömbäck, Erik
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Relationen mellan måluppfyllelse och besvär i psykoterapi2019Independent thesis Advanced level (professional degree), 60 poäng / 90 hpOppgave
    Abstract [sv]

    Psykoterapeutisk behandling har traditionellt utvärderats med diagnosspecifika skattningsskalor. Syftet med psykoterapi ses alltså som besvärsminskning. Denna metod kan vara problematisk eftersom items i skalorna inte alltid är relevanta för patienten, och denna syn på psykoterapi inte är kompatibel med KBT som metod. Ett alternativ till att mäta besvär är att istället se till patientens mål och utvärdera terapin utifrån dessa. Ett sådant sätt att mäta kan ha flera fördelar; vara mer relevant för den enskilda patienten, ha en terapeutisk effekt i sig självt, ge en riktning åt terapin, ge kriterier för utvärdering samt vara mer kompatibelt med KBT. Dock saknas kunskap om relationen mellan minskning av besvär och uppfyllelse av terapimål under psykoterapi. I denna studie undersöks relationen mellan besvärsminskning och måluppfyllelse under behandling session för session. Data samlades in från nio behandlingar, och resultaten visade som förväntat en negativ korrelation mellan besvärsminskning och måluppfyllnad. Ingen tydlig trend kunde ses i vilket mått som förbättrades först. Ett starkare samband fanns mellan livskvalitet och måluppfyllelse än mellan livskvalitet och besvärsminskning.

  • 124.
    Eninger, Lilianne
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Personlighets-, social- och utvecklingspsykologi.
    Ferrer-Wreder, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Personlighets-, social- och utvecklingspsykologi.
    Eichas, Kyle
    Allodi Westling, Mara
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Smedler, Ann-Charlotte
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Olsson, Tina
    Sedem, Mina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Ginnner Hau, Hanna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Herkner, Birgitta
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Domitrovic, Celene
    Culture and Young Children’s Social Emotional Competence: Findings and Implications for the Cultural Adaptation of Interventions2017Konferansepaper (Annet vitenskapelig)
  • 125. Eriksson, Malin C.
    et al.
    Christianson, Sven Å.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Professionals' Experiences With and Perceptions of Children Exposed to Severe and Homicidal Violence in Sweden2017Inngår i: Victims & Offenders, ISSN 1556-4886, E-ISSN 1556-4991, Vol. 12, nr 4, s. 523-548Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The present study aimed to examine professionals' experiences, perceptions, and knowledge regarding violence-exposed children in order to clarify the status and opportunities these children have in the Swedish legal system. A questionnaire was distributed to 63 professionals, representing police, prosecutors, social personnel, and treatment personnel. Findings revealed several problems that hindered effective work. Routines and guidelines were lacking and knowledge gaps regarding these children were found among all professions. Perceptions that children remember and tell were widely held, although conditions enabling sufficient reports are seldom met. Results can be used to guide necessary changes in national routines and guidelines to ensure recovery and maintaining of societal rights of this group of psychologically abused victims.

  • 126. Fagernäs, Simon
    et al.
    Lindner, Philip
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Miloff, Alexander
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Andersen, Joel
    Sigeman, Martin
    Furmark, Tomas
    Andersson, Gerhard
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Moderating effects of presence and adherence in internetbased CBT with virtual reality exposure therapy for public speaking anxiety2017Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Introduction: Previous research has revealed that Virtual Reality Exposure Therapy (VRET) is an effective method for reducing symptoms of public speaking anxiety (PSA). Research about presence in the virtual environment indicates a moderating effect on physiological arousal, but more ambiguous effect on treatment effects where some research indicates a small effect while other indicate no effect. Furthermore, previous research has found adherence to home work assignments to moderate treatment outcome. In this treatment study which aimed for treating public speaking anxiety with VRET and a internetbased CBT-program, we investigated whether presence in the virtual environment and adherence to home work moderated treatment effects.

    Methods: N=25 adult participants from the general public with clinically significant PSA were recruited to a wait-list to another study. After five weeks on waitlist, they started the treatment with a self-guided in virtuo exposure session followed by a four week online maintenance promoting in-vivo exposure. Participants got a simple VR headset by post. The three-hour exposure session included psychoeducation in text, and the participants conducted speech exercises, framed as behavioral experiments targeting idiosyncratic catastrophic beliefs, in front of virtual audiences, and listening to audio recording afterwards. Primary outcome measure was self-reported PSA. To measure moderating effects of presence on the primary outcome measure a self-reported validated scale with subscales for presence (iGroup Presence Questionnaire, IPQ) were used, and for adherence a score were manually calculated based on the number of completed home-work assignments in both a linear model and a binary model dividing participants in two groups: one with at least one completed home work assignment and one with no completed home work assignment. The analysis on presence included both the effects of the VRET-session alone and in combination with the internetbased CBT-program. Data were analyzed using mixed effects modeling.

    Results: No significant results were found in moderating effects of presence with its subscales on the primary outcome measure for either the VRET-session (p = .375-.616) nor in combination with the internetbased CBT-program (p = .454 - .877). Moderating effects of adherence on primary outcome measure neither revealed no significant results in the linear model (p = .368) nor the binary model (p = .113).

    Conclusions: The findings of this study indicate, in line with some previous research, that presence in the virtual environment has no significant moderating effect on treatment outcome. Furthermore, in contrast to previous research, this study found no significant moderating effect on adherence to home work assignments on primary treatment outcome. Internal- and external validity and other potential explanations are discussed in detail in the poster.

  • 127. Faria, Vanda
    et al.
    Gingnell, Malin
    Hoppe, Johanna M.
    Hjort, Olof
    Alaie, Iman
    Frick, Andreas
    Hultberg, Sara
    Wahlstedt, Kurt
    Engman, Jonas
    Månsson, Kristoffer N. T.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. Uppsala University, Sweden; Karolinska Institutet, Sweden.
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Andersson, Gerhard
    Reis, Margareta
    Larsson, Elna-Marie
    Fredrikson, Mats
    Furmark, Tomas
    Do You Believe It? Verbal Suggestions Influence the Clinical and Neural Effects of Escitalopram in Social Anxiety Disorder: A Randomized Trial2017Inngår i: EBioMedicine, ISSN 0360-0637, E-ISSN 2352-3964, Vol. 24, s. 179-188Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for depression and anxiety, but their efficacy relative to placebo has been questioned. We aimed to test how manipulation of verbally induced expectancies, central for placebo, influences SSRI treatment outcome and brain activity in patients with social anxiety disorder (SAD).

    Methods: We did a randomized clinical trial, within an academic medical center (Uppsala, Sweden), of individuals fulfilling the DSM-IV criteria for SAD, recruited through media advertising. Participants were 18 years or older and randomized in blocks, through a computer-generated sequence by an independent party, to nine weeks of overt or covert treatment with escitalopram(20 mg daily). The overt group received correct treatment information whereas the covert group was treated deceptively with the SSRI described, by the psychiatrist, as active placebo. The treating psychiatrist was necessarily unmasked while the research staff was masked from intervention assignment. Treatment efficacy was assessed primarily with the self-rated Liebowitz Social Anxiety Scale (LSAS-SR), administered at week 0, 1, 3, 6 and 9, also yielding a dichotomous estimate of responder status (clinically significant improvement). Before and at the last week of treatment, brain activity during an emotional face-matching task was assessed with functional magnetic resonance imaging (fMRI) and during fMRI sessions, anticipatory speech anxiety was also assessed with the Spielberger State-Trait Anxiety Inventory - State version (STAI-S). Analyses included all randomized patients with outcome data at posttreatment. This study is registered at ISRCTN, number 98890605.

    Findings: Between March 17th 2014 and May 22nd 2015, 47 patients were recruited. One patient in the covert group dropped out after a few days of treatment and did not provide fMRI data, leaving 46 patients with complete outcome data. After nine weeks of treatment, overt (n = 24) as compared to covert (n = 22) SSRI administration yielded significantly better outcome on the LSAS-SR (adjusted difference 21.17, 95% CI 10.69–31.65, p < 0.0001) with more than three times higher response rate (50% vs. 14%; χ2(1) = 6.91, p = 0.009) and twice the effect size (d = 2.24 vs. d = 1.13) from pre-to posttreatment. There was no significant between-group difference on anticipatory speech anxiety (STAI-S), both groups improving with treatment. No serious adverse reactions were recorded. On fMRI outcomes, there was suggestive evidence for a differential neural response to treatment between groups in the posterior cingulate, superior temporal and inferior frontal gyri (all z thresholds exceeding 3.68, p ≤ 0.001). Reduced social anxiety with treatment correlated significantly with enhanced posterior cingulate (z threshold 3.24, p = 0.0006) and attenuated amygdala (z threshold 2.70, p = 0.003) activity.

    Interpretation: The clinical and neural effects of escitalopram were markedly influenced by verbal suggestions. This points to a pronounced placebo component in SSRI-treatment of SAD and favors a biopsychosocial over a biomedical explanatory model for SSRI efficacy.

  • 128. Fauskanger Bjaastad, Jon
    et al.
    Henningsen Wergeland, Gro Janne
    Storm Mowatt Haugland, Bente
    Gjestad, Rolf
    Havik, Odd E.
    Heiervang, Einar R.
    Öst, Lars-Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. Karolinska Institute, Sweden; Haukeland University Hospital, Norway.
    Do clinical experience, formal cognitive behavioural therapy training, adherence, and competence predict outcome in cognitive behavioural therapy for anxiety disorders in youth?2018Inngår i: Clinical Psychology and Psychotherapy, ISSN 1063-3995, E-ISSN 1099-0879, Vol. 25, nr 6, s. 865-877Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective The aim was to investigate whether clinical experience, formal cognitive behavioural therapy (CBT) training, adherence, and competence predict outcome in CBT for anxiety disorders in youth. Method Videotapes (N = 181) from the sessions in a randomized controlled effectiveness trial (Wergeland et al., 2014, Behaviour Research and Therapy, 57, 1-12) comprising youth (N = 182, M age = 11.5 years) with mixed anxiety disorders were assessed for treatment adherence and competence using the Competence and Adherence Scale for CBT for anxiety disorders in youth (Bjaastad et al., 2016, Psychological Assessment, 28, 908-916). Therapists' (N = 17) clinical experience and educational background were assessed. Participants completed a diagnostic interview (Anxiety Disorders Interview Schedule, child and parent versions) and an anxiety symptom measure (Spence Children's Anxiety Scale, child and parent versions) at pretreatment, posttreatment, and 1-year follow-up. Results Higher therapist adherence was related to better treatment outcomes, whereas number of years of clinical experience and competence was related to worse outcomes. However, these findings were not consistent across informants and the time points for the assessments. Interaction effects suggested that competence among therapists with formal CBT training was related to better patient outcomes. Conclusions Therapist adherence, competence, and clinical experience are associated with outcomes of manualized CBT for youth anxiety disorders, but mixed findings indicate the need for more research in this area.

  • 129. Fernández-Alvarez, J.
    et al.
    Rozental, Alexander
    Karolinska Institutet, Sweden; University College London, United Kingdom.
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Botella, Cristina
    Deterioration rates in virtual reality therapy: An individual patient data meta-analysis and implications for research and practice2018Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Ample evidence supports the use of Virtual Reality for anxiety disorders. Throughout 20 years of research there have continuous advancements, not only in the quality of studies but also in the diversity of populations included as well as the technological progresses developed. All those steps forwards are accurately compiled in several meta-analysis, reviews and chapters. Nonetheless, there is no evidence yet on the potential negative effects and its moderators that Virtual Reality treatment strategies can provoke.

    From the diversity of negative effects’ operationalizations, this study uses the deterioration rates concept defined as the worsening of the clinical symptomatology from the pre-test scores to the post-test scores using the Reliable Change Index (RCI). An individual patient data meta-analyses (IPDMA) approach that systematically reviewed all the randomized control trials in Virtual Reality and gathered 16 datasets from the total 35 studies conducted within the field of research. A total of 846 patients constitutes the sample of the study. RCI’s for each primary outcome measure is performed as well as moderator analyses for demographic variables. In this talk the results will be discussed in terms of their clinical and research implications regarding the current status and future challenges of Virtual Reality therapy in the clinical psychology realm.

  • 130. Fernández-Álvarez, Javier
    et al.
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Botella, Cristina
    Deterioration rates in Virtual Reality Therapy: An individual patient data level meta-analysis2019Inngår i: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 61, s. 3-17Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets. The current study sample was composed of 810 patients. Randomized control trials (RCTs) for each primary outcome measure were performed, in addition to moderator analyses of the socio-demographic variables. Deterioration rates were 14 patients (4.0%) in VR, 8 (2.8%) in active control conditions, and 27 (15%) in the WL condition. With regard to receiving treatment, patients in a waiting list control condition had greater odds of deteriorating than in the two active conditions, odds ratios (ORs) 4.87, 95% confidence interval (CI) [0.05, 0.67]. In the case of the socio-demographic variables, none of them were associated with higher or lower odds of deterioration, with the exception of marital status in the WL condition; married people presented a significantly lower probability of deterioration, OR 0.19, 95% CI [0.05, 0.67]. Finally, when comparing pooled effects of VR versus all control conditions, the OR was 0.61 (95% CI 0.31–1.23) in favor of VR, although this result was not statistically significant. This study provides evidence about the deterioration rates of a therapeutic VR approach, showing that the number of deteriorated patients coincides with other therapeutic approaches, and that deterioration is less likely to occur, compared to patients in WL control groups.

  • 131.
    Ferrer-Wreder, Laura
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Personlighets-, social- och utvecklingspsykologi.
    Eninger, Lilianne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Personlighets-, social- och utvecklingspsykologi.
    Eichas, Kyle
    Allodi Westling, Mara
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Ginnner Hau, Hanna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Olsson, T.M.
    Sedem, Mina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Clausén Gull, Ingela
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Personlighets-, social- och utvecklingspsykologi.
    Smedler, Ann-Charlotte
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Herkner, Birgitta
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Specialpedagogiska institutionen.
    Implementation of a Swedish effectiveness trial of preschool PATHS2019Konferansepaper (Annet (populærvitenskap, debatt, mm))
  • 132. Finnes, Anna
    et al.
    Enebrink, Pia
    Ghaderi, Ata
    Dahl, JoAnne
    Nager, Anna
    Öst, Lars-Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders: a systematic review and meta-analysis of randomized-controlled trials2019Inngår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 92, nr 3, s. 273-293Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: Common mental disorders (CMDs) and musculoskeletal disorders are highly prevalent in the population and cause significant distress and disability, and high costs to society. The main objective of this systematic review and meta-analysis was to examine the outcome and comparative effectiveness of psychological interventions in reducing sickness absence (SA) due to CMDs or musculoskeletal disorders, compared to a waitlist control group, usual care or another clinical intervention.

    Methods: We reviewed 3515 abstracts of randomized controlled trials published from 1998 to 2017. Of these, 30 studies were included in the analysis.

    Results: The psychological interventions were overall more effective than treatment as usual in reducing SA (small effect sizes), but not compared to other clinical interventions. Results were similar for studies on CMDs and musculoskeletal pain. A few significant moderating effects were found for treatment-specific variables. However, these were  difficult to interpret as they pointed in different directions.

    Conclusion: There was a small but significant effect of psychological treatments in reducing SA. We identified areas of improvement such as methodological problems among the included studies and failure to specifically address RTW in the interventions that were evaluated. Clinical implications of the findings, and ways of improving methodological rigour of future studies are discussed.

  • 133. Fjermestad, K. W.
    et al.
    Lerner, M. D.
    McLeod, B. D.
    Wergeland, G. J. H.
    Haugland, B. S. M.
    Havik, O. E.
    Öst, Lars-Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Silverman, W. K.
    Motivation and treatment credibility predict alliance in cognitive behavioral treatment for youth with anxiety disorders in community clinics2018Inngår i: Journal of Clinical Psychology, ISSN 0021-9762, E-ISSN 1097-4679, Vol. 74, nr 6, s. 793-805Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective We examined whether motivation and treatment credibility predicted alliance in a 10-session cognitive behavioral treatment delivered in community clinics for youth anxiety disorders.

    Method Ninety-one clinic-referred youths (mean(age)=11.4 years, standard deviation=2.1, range 8-15 years, 49.5% boys) with anxiety disorders-rated treatment motivation at pretreatment and perceived treatment credibility after session 1. Youths and therapists (YT) rated alliance after session 3 (early) and session 7 (late). Hierarchical linear models were applied to examine whether motivation and treatment credibility predicted YT early alliance, YT alliance change, and YT alliance agreement.

    Results Motivation predicted high early YT alliance, but not YT alliance change or alliance agreement. Youth-rated treatment credibility predicted high early youth alliance and high YT positive alliance change, but not early therapist alliance or alliance agreement.

    Conclusion Efforts to enhance youth motivation and treatment credibility early in treatment could facilitate the formation of a strong YT alliance.

  • 134. Fjermestad, Krister W.
    et al.
    Lerner, Matthew D.
    McLeod, Bryce D.
    Wergeland, Gro Janne H.
    Heiervang, Einar R.
    Silverman, Wendy K.
    Öst, Lars-Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    De Los Reyes, Andres
    Havik, Odd E.
    Haugland, Bente S. M.
    Therapist-youth agreement on alliance change predicts long-term outcome in CBT for anxiety disorders2016Inngår i: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 57, nr 5, s. 625-632Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: In individual cognitive behavioral therapy (ICBT) for youth anxiety disorders, it is unclear whether, and from whose perspective, the alliance predicts outcome. We examined whether youth- and therapist-rated alliance, including level of youth-therapist alliance agreement, predicted outcome in a randomized controlled trial.

    Methods: Youth (N = 91, M age = 11.4 years (SD = 2.1), 49.5% boys, 86.8% Caucasian) diagnosed with separation anxiety disorder, social phobia, or generalized anxiety disorder drawn from the ICBT condition of an effectiveness trial were treated with an ICBT program. Youth- and therapist-rated alliance ratings, assessed with the Therapeutic Alliance Scale for Children (TASC-C/T), were collected following session 3 (early) and 7 (late). Early alliance, change in alliance from early to late, and level of youth-therapist agreement on early alliance and alliance change were examined, in relation to outcomes collected at posttreatment and 1-year follow-up. Outcome was defined as primary diagnosis loss and reduction in clinicians' severity ratings (CSR; Anxiety Disorders Interview Schedule; ADIS-C/P) based on youth- and parent-report at posttreatment and follow-up, and youth treatment satisfaction collected at posttreatment (Client Satisfaction Scale; CSS).

    Results: Early TASC-C scores positively predicted treatment satisfaction at posttreatment. Higher levels of agreement on change in TASC-C and TASC-T scores early to late in treatment predicted diagnosis loss and CSR reduction at follow-up.

    Conclusions: Only the level of agreement in alliance change predicted follow-up outcomes in ICBT for youth anxiety disorders. The findings support further examination of the role that youth-therapist alliance discrepancies may play in promoting positive outcomes in ICBT for youth anxiety disorders. Clinical trial number NCT00586586, clinicaltrials.gov.

  • 135. Forsell, E.
    et al.
    Rozental, Alexander
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Svensson, A.
    Andersson, G.
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Overcoming procrastination: One-year follow-up and predictors of change in a randomized controlled trial of Internet-based cognitive behavior therapy2016Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Procrastination; the purposeful delay of an intended course of action is, for many, a persistent behavior associated with reduced mood, increased stress, and poorer performance. 20 % of adults and 50 % of students experience significant difficulties with procrastination. Internet- based cognitive behavior therapy (ICBT) shows promise for several conditions, but has never been applied to procrastination. The current study examined the efficacy of ICBT for procrastination at post treatment and one-year follow-up, and investigated predictors of change.

    Method: Participants (N = 150) were randomized to 10 weeks of either guided self-help, unguided self-help, or wait-list control (receiving unguided self-help after the first treatment period). Outcome measures were the Pure Procrastination Scale (PPS), the Irrational Procrastination Scale (IPS), the Susceptibility to Temptation Scale, the Montgomery Åsberg Depression Rating Scale, the Generalized Anxiety Disorder Assessment, and the Quality of Life Inventory. Intention-to-treat was used for all statistical analyses, with mixed-effects models to assess the effect of time and group.

    Results: Moderate to large effect sizes were obtained post treatment comparing guided and unguided self-help with wait-list control, the PPS, Cohen’s d = 0.70, 95% confidence interval (CI) [0.29, 1.10], and d = 0.50, 95% CI [0.10, 0.90], and the IPS, d = 0.81 95% CI [0.40, 1.22], and d = 0.69 95% CI [0.29, 1.09]. Clinically significant change was achieved among 31.3–40.0% for guided self-help and 24.0–36.0% for unguided self-help. Neither treatment condition was superior on any outcome measure, Fs (98, 65.17-72.55) < 1.70, p > .19. One-year follow-up data has been collected and the results will be available at the time of the conference, including predictors of change.

    Conclusion: ICBT could be useful for self-reported problems of procrastination, with results at one-year follow-up and predictors of change revealing the long-term benefit and variables associated with successful treatment outcome.

  • 136.
    Forsström, David
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Hesser, Hugo
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Usage of a Responsible Gambling Tool: A Descriptive Analysis and Latent Class Analysis of User Behavior2016Inngår i: Journal of Gambling Studies, ISSN 1050-5350, E-ISSN 1573-3602, Vol. 32, nr 3, s. 889-904Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Gambling is a common pastime around the world. Most gamblers can engage in gambling activities without negative consequences, but some run the risk of developing an excessive gambling pattern. Excessive gambling has severe negative economic and psychological consequences, which makes the development of responsible gambling strategies vital to protecting individuals from these risks. One such strategy is responsible gambling (RG) tools. These tools track an individual’s gambling history and supplies personalized feedback and might be one way to decrease excessive gambling behavior. However, research is lacking in this area and little is known about the usage of these tools. The aim of this article is to describe user behavior and to investigate if there are different subclasses of users by conducting a latent class analysis. The user behaviour of 9528 online gamblers who voluntarily used a RG tool was analysed. Number of visits to the site, self-tests made, and advice used were the observed variables included in the latent class analysis. Descriptive statistics show that overall the functions of the tool had a high initial usage and a low repeated usage. Latent class analysis yielded five distinct classes of users: self-testers, multi-function users, advice users, site visitors, and non-users. Multinomial regression revealed that classes were associated with different risk levels of excessive gambling. The self-testers and multi-function users used the tool to a higher extent and were found to have a greater risk of excessive gambling than the other classes.

  • 137.
    Forsström, David
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Jansson-Fröjmark, Markus
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. Centre for Psychiatry Research, Sweden.
    Hesser, Hugo
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Experiences of Playscan: Interviews with users of a responsible gambling tool2017Inngår i: Internet Interventions, ISSN 2214-7829, Vol. 8, s. 53-62Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Online gambling, encompassing a wide variety of activities and around-the-clock access, can be a potential risk factor for gamblers who tend to gamble excessively. Yet, the advent of online gambling has enabled responsible gambling (RG) features that may help individuals to limit their gambling behaviour. One of these features is RG tools that track gamblers' behaviour, performs risk assessments and provides advice to gamblers. This study investigated users' views and experiences of the RG tool Playscan from a qualitative perspective using a semi-structured interview. The tool performs a risk assessment on a three-step scale (low, medium and high risk). Users from every risk category were included. Twenty interviews were carried out and analysed using thematic analysis. Two main themes with associated sub-themes were identified: “Usage of Playscan and the gambling site” and “Experiences of Playscan”. Important experiences in the sub-themes were lack of feedback from the tool and confusion when signing up to use Playscan. These experiences counteracted positive attitudes that should have promoted usage of the tool. Providing more feedback directly to users is a suggested solution to increase usage of the RG tool.

  • 138.
    Frick, Andreas
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Uppsala University, Sweden.
    Månsson, Kristoffer N.T.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. Karolinska Institutet, Sweden; Uppsala University, Sweden.
    Brain changes in social anxiety disorder run in the family2018Inngår i: EBioMedicine, ISSN 0360-0637, E-ISSN 2352-3964, Vol. 36, s. 5-6Artikkel i tidsskrift (Fagfellevurdert)
  • 139. Furmark, Tomas
    et al.
    Holmström, Annelie
    Sparthan, Elisabeth
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Andersson, Gerhard
    Social fobi - social ångest: effektiv hjälp med KBT2019 (oppl. 3)Bok (Annet vitenskapelig)
    Abstract [sv]

    Social fobi (social ångest) är en stark rädsla för situationer där man känner sig värderad eller granskad av andra. Bokens självhjälpsprogram baseras på KBT och är vetenskapligt utprövat med mycket goda resultat. Programmet omfattar nio steg med både teoretisk kunskap och praktiska övningar.

    Den tredje omarbetade upplagan innehåller flera nyheter: Ett kunskapstest - Testa dig själv - har lagts till efter varje kapitel (med facit på Libers webbplats). Flera avsnitt har utvidgats och uppdaterats, bland annat med ett nytt avsnitt om forskningsläget kring självhjälpsbehandling där hjärnavbildningsstudier styrker behandlingens effekt.

    Boken vänder sig till personer som lider av social fobi och deras anhöriga. Den vänder sig också till psykologer, psykiater, psykoterapeuter och andra professionella som arbetar med problematiken, samt till studerande på psykolog- och psykoterapiutbildningar.

  • 140. Gale, Catherine M.
    et al.
    Eikeseth, Svein
    Klintwall, Lars
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Children with Autism show Atypical Preference for Non-social Stimuli2019Inngår i: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, artikkel-id 10355Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The present investigation describes three studies testing the hypothesis that children with Autism Spectrum Disorder (ASD) show an atypical preference for non-social stimuli. Preference for non-social and social stimuli was assessed using applications on a portable tablet computer. Twenty-eight children with ASD were matched on developmental age with the chronological age of 41 typically developing (TD) children. The non-social stimuli consisted of six different films of abstract moving geometric patterns. Social stimuli were six different films of the face of young adults (Study 1 and 3) or six films of different dogs' faces (Study 2). When given a choice between the non-social and social stimuli, children with ASD preferred the non-social stimuli. When the human faces were replaced with dogs' faces the participants with ASD continued to prefer the non-social stimuli. A high reinforcement value of non-social stimuli was also demonstrated when the non-social stimuli were presented alone, suggesting the preference for the non-social stimuli was not simply an avoidance of social stimuli. Whenever an infant prefers non-social stimuli over social stimuli, non-typical development in social communication and social interests may result, together with the development of high levels and frequently occurring stereotyped and repetitive behavior. These behaviors define Autism.

  • 141. Geraghty, A.
    et al.
    Essery, R.
    Kirby, S.
    Stuart, B.
    Turner, D.
    Little, P.
    Bronstein, A.
    Andersson, Gerhard
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Yardley, L.
    Internet-based vestibular rehabilitation for older adults with chronic dizziness: A randomised controlled trial in primary care2017Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Introduction: Vestibular dysfunction occurs in 50% of those over age 60, and with an ageing population the health burden will increase. Vestibular Rehabilitation (VR) has been shown to be effective for dizziness caused by vestibular dysfunction, but it is seldom provided in primary care. The rapid growth in internet access provides a promising vehicle for VR to achieve widespread health impact. We aimed to determine the effectiveness of internet-based VR on chronic dizziness in older adults in primary care.

    Method: We conducted a single centre randomised controlled trial comparing an internet-based VR intervention with usual primary care. 296 primary care patients aged 50 years and over with current dizziness exacerbated by head movements were recruited from 54 primary care practices from southern England. Patients in the intervention arm accessed an automated internet-based intervention that taught VR exercises and suggested cognitive behavioural management strategies. Dizziness was measured by the Vertigo Symptom Short-Form (VSS-SF) at baseline, 3 and 6 months. The primary outcome was VSS-SF score at 6 months (ISRCTN: 86912968).

    Results: The VSS-SF was completed by 250 (84%) at 3 months and 230 (78%) at 6 months. Dizziness symptoms were significantly lower in the internet-based VR group compared to usual care at 3 (2.75, 95% CI:1.39, 4.12; p<0.001 and 6 months (2.26, 95% CI: 0.39, 4.12; p=0.018). Dizziness-related disability was also significantly lower in the internet-based VR condition, at 3 (5.33, 95% CI: 1.41, 9.26; p=0.008) and 6 month (5.58 95% CI: 1.19, 10.0; p=0.013).

    Discussion: Internet-based VR improves dizziness and reduces dizziness-based disability in older primary care patients without requiring structured guidance. The effectiveness without the need for health professional support indicates that this intervention could be made rapidly available to GPs for provision to their patients and wider dissemination in the community.

  • 142. Geraghty, Adam W. A.
    et al.
    Essery, Rosie
    Kirby, Sarah
    Stuart, Beth
    Turner, David
    Little, Paul
    Bronstein, Adolfo
    Andersson, Gerhard
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Yardley, Lucy
    Internet-Based Vestibular Rehabilitation for Older Adults With Chronic Dizziness: A Randomized Controlled Trial in Primary Care2017Inngår i: Annals of Family Medicine, ISSN 1544-1709, E-ISSN 1544-1717, Vol. 15, nr 3, s. 209-216Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: Vestibular rehabilitation is an effective intervention for dizziness due to vestibular dysfunction, but is seldom provided. We aimed to determine the effectiveness of an Internet-based vestibular rehabilitation program for older adults experiencing dizziness in primary care.

    METHODS: We undertook a single-center, single-blind randomized controlled trial comparing an Internet-based vestibular rehabilitation intervention (Balance Retraining, freely available from https://balance.lifeguidehealth.org) with usual primary care in patients from 54 primary care practices in southern England. Patients aged 50 years and older with current dizziness exacerbated by head movements were enrolled. Those in the intervention group accessed an automated Internet-based program that taught vestibular rehabilitation exercises and suggested cognitive behavioral management strategies. Dizziness was measured by the Vertigo Symptom Scale–Short Form (VSS-SF) at baseline, 3 months, and 6 months. The primary outcome was VSS-SF score at 6 months.

    RESULTS: A total of 296 patients were randomized in the trial; 66% were female, and the median age was 67 years. The VSS-SF was completed by 250 patients (84%) at 3 months and 230 patients (78%) at 6 months. Compared with the usual care group, the Internet-based vestibular rehabilitation group had less dizziness on the VSS-SF at 3 months (difference, 2.75 points; 95% CI, 1.39–4.12; P <.001) and at 6 months (difference, 2.26 points; 95% CI, 0.39–4.12; P = .02, respectively). Dizziness-related disability was also lower in the Internet-based vestibular rehabilitation group at 3 months (difference, 6.15 points; 95% CI, 2.81–9.49; P <.001) and 6 months (difference, 5.58 points; 95% CI, 1.19–10.0; P = .01).

    CONCLUSIONS: Internet-based vestibular rehabilitation reduces dizziness and dizziness-related disability in older primary care patients without requiring clinical support. This intervention has potential for wide application in community settings.

  • 143. Gerlach, Alf
    et al.
    Hau, Stephan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Forschung und psychoanalytische Psychotherapie2019Inngår i: Analytische und tiefenpsychologisch fundierte Psychotherapie: Theorie und Praxis der psychoanalytisch begründeten Verfahren / [ed] Matthias Elzer, Alf Gerlach, Psychosozial Verlag , 2019, s. 353-360Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 144. Gidhagen, Ylva
    et al.
    Holmqvist, Rolf
    Philips, Björn
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. Linköping University, Sweden.
    Attachment style among outpatients with substance use disorders in psychological treatment2018Inngår i: Psychology and Psychotherapy: Theory, Research and Practice, ISSN 1476-0835, E-ISSN 2044-8341, Vol. 91, nr 4, s. 490-508Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives To explore the associations between self-rated attachment style, psychological distress and substance use among substance use disorder (SUD) outpatients in psychological treatment.

    Design and Methods In this practice-based study, 108 outpatients were asked to fill in the Experiences in Close Relationships - Short form, the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), the Alcohol Use Disorders Identification Test (AUDIT), and the Drug Use Disorders Identification Test (DUDIT) at treatment start and end. Patients were given psychological treatments with a directive, reflective or supportive orientation.

    Results An insecure attachment style was more common among the SUD outpatients, compared to non-clinical groups. Patients with a fearful attachment style scored higher on psychological distress than patients with a secure attachment style. The associations between the attachment dimensions and psychological distress were stronger than those between attachment and SUD. Significantly more patients had a secure attachment style at treatment end.

    Conclusions This study shows significant relations between patients' attachment style and their initial psychological distress. The causal relationship between attachment style and psychological distress is, however, not clear and can likely go in both directions. The psychological treatment of patients with SUD contributed significantly to changes from insecure to secure attachment style.

  • 145. Gingnell, Malin
    et al.
    Frick, Andreas
    Engman, Jonas
    Alaie, Iman
    Björkstrand, Johannes
    Faria, Vanda
    Carlbring, Per
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Andersson, Gerhard
    Reis, Margareta
    Larsson, Elna-Marie
    Wahlstedt, Kurt
    Fredrikson, Mats
    Furmark, Tomas
    Combining escitalopram and cognitive–behavioural therapy for social anxiety disorder: randomised controlled fMRI trial2016Inngår i: British Journal of Psychiatry, ISSN 0007-1250, E-ISSN 1472-1465, Vol. 209, nr 3, s. 229-235Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Selective serotonin reuptake inhibitors (SSRIs) and cognitive–behavioural therapy (CBT) are often used concomitantly to treat social anxiety disorder (SAD), but few studies have examined the effect of this combination.

    Aims

    To evaluate whether adding escitalopram to internet-delivered CBT (ICBT) improves clinical outcome and alters brain reactivity and connectivity in SAD.

    Method

    Double-blind, randomised, placebo-controlled neuroimaging trial of ICBT combined either with escitalopram (n = 24) or placebo (n = 24), including a 15-month clinical follow-up (trial registration: ISRCTN24929928).

    Results

    Escitalopram+ICBT, relative to placebo+ICBT, resulted in significantly more clinical responders, larger reductions in anticipatory speech state anxiety at post-treatment and larger reductions in social anxiety symptom severity at 15-month follow-up and at a trend-level (P = 0.09) at post-treatment. Right amygdala reactivity to emotional faces also decreased more in the escitalopram+ICBT combination relative to placebo+ICBT, and in treatment responders relative to non-responders.

    Conclusions

    Adding escitalopram improves the outcome of ICBT for SAD and decreased amygdala reactivity is important for anxiolytic treatment response.

  • 146. Goodwin, Guy M.
    et al.
    Holmes, Emily A.
    Andersson, Erik
    Browning, Michael
    Jones, Andrew
    Lass-Hennemann, Johanna
    Månsson, Kristoffer N. T.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. Karolinska Institutet, Sweden; Uppsala University, Sweden.
    Moessnang, Carolin
    Salemink, Elske
    Sanchez, Alvaro
    van Zutphen, Linda
    Visser, Renée M.
    From neuroscience to evidence based psychological treatments - The promise and the challenge, ECNP March 2016, Nice, France2018Inngår i: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 28, nr 2, s. 317-333Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This ECNP meeting was designed to build bridges between different constituencies of mental illness treatment researchers from a range of backgrounds with a specific focus on enhancing the development of novel, evidence based, psychological treatments. In particular we wished to explore the potential for basic neuroscience to support the development of more effective psychological treatments, just as this approach is starting to illuminate the actions of drugs. To fulfil this aim, a selection of clinical psychologists, psychiatrists and neuroscientists were invited to sit at the same table. The starting point of the meeting was the proposition that we know certain psychological treatments work, but we have only an approximate understanding of why they work. The first task in developing a coherent mental health science would therefore be to uncover the mechanisms (at all levels of analysis) of effective psychological treatments. Delineating these mechanisms, a task that will require input from both the clinic and the laboratory, will provide a key foundation for the rational optimisation of psychological treatments. As reviewed in this paper, the speakers at the meeting reviewed recent advances in the understanding of clinical and cognitive psychology, neuroscience, experimental psychopathology, and treatment delivery technology focussed primarily on anxiety disorders and depression. We started by asking three rhetorical questions: What has psychology done for treatment? What has technology done for psychology? What has neuroscience done for psychology? We then addressed how research in five broad research areas could inform the future development of better treatments: Attention, Conditioning, Compulsions and addiction, Emotional Memory, and Reward and emotional bias. Research in all these areas (and more) can be harnessed to neuroscience since psychological therapies are a learning process with a biological basis in the brain. Because current treatment approaches are not fully satisfactory, there is an imperative to understand why not. And when psychological therapies do work we need to understand why this is the case, and how we can improve them. We may be able to improve accessibility to treatment without understanding mechanisms. But for treatment innovation and improvement, mechanistic insights may actually help. Applying neuroscience in this way will become an additional mission for ECNP. (C) 2018 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

  • 147. Graham, Bronwyn M.
    et al.
    Li, Sophie H.
    Black, Melissa J.
    Öst, Lars-Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. Karolinska Institutet, Sweden; Haukeland University Hospital, Norway.
    The association between estradiol levels, hormonal contraceptive use, an responsiveness to one-session-treatment for spider phobia in women2018Inngår i: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 90, s. 134-140Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Preclinical studies have demonstrated that conditioned fear extinction is impaired in females with low endogenous levels of the sex hormone estradiol, due to menstrual fluctuations or hormonal contraceptive use. As fear extinction is a laboratory model of exposure therapy for anxiety and trauma disorders, here we assessed the hypothesis that treatment outcomes may be diminished when exposure therapy occurs during periods of low estradiol. 90 women with spider phobia (60 cycling and 30 using hormonal contraceptives) underwent a one session exposure treatment for spider phobia, following which, serum estradiol levels were assessed. A median split in estradiol level was used to divide cycling participants into two groups; lower and higher estradiol. Behavioral avoidance and self-reported fear of spiders were measured pre-treatment, post-treatment, and at a 12 week follow-up assessment. Women using hormonal contraceptives exhibited a significantly slower rate of improvement across treatment, greater behavioral avoidance at post-treatment and follow-up, and fewer self initiated post-treatment exposure tasks, relative to both groups of cycling women, who did not differ. No group differences in self-reported fear were evident. Correlational analyses revealed that across the whole sample, lower estradiol levels were associated with slower rates of improvement across treatment, and greater self reported fear and behavioral avoidance at post-treatment, but not follow-up. These results provide the first evidence of an association between endogenous estradiol, hormonal contraceptive use, and exposure therapy outcomes in spider phobic women. Hormonal profile may partly account for variability in responsiveness to psychological treatments for anxiety and trauma disorders in women.

  • 148.
    Granqvist, Pehr
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Personlighets-, social- och utvecklingspsykologi.
    Vestbrant, Karolina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen.
    Döllinger, Lillian
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Liuzza, Marco Tullio
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi. University of Catanzaro, Italy.
    Olsson, Mats J.
    Blomkvist, Anna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Personlighets-, social- och utvecklingspsykologi.
    Lundström, Johan N.
    Stockholms universitet, Humanistiska fakulteten, Institutionen för lingvistik. Karolinska Institutet, Sweden; Monell Chemical Senses Center, USA; University of Pennsylvania, USA.
    The scent of security: Odor of romantic partner alters subjective discomfort and autonomic stress responses in an adult attachment-dependent manner2019Inngår i: Physiology and Behavior, ISSN 0031-9384, E-ISSN 1873-507X, Vol. 198, s. 144-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    When in a stressful situation, access to adult attachment figures (e.g., romantic partners) is an important means by which adults regulate stress responses. The practice of smelling a partner's worn garment is reported as a self-treatment against stress. Here, we experimentally determined whether exposure to a partner's body odor attenuates adults' subjective discomfort and psychophysiological responses, and whether such effects are qualified by adult attachment security. In a blocked design, participants (N = 34) were presented with their partner's body odor, their own body odor, the odor of a clean t-shirt and rose odor, while exposed to weak electric shocks to induce discomfort and stress responses. Results showed that partner body odor reduces subjective discomfort during a stressful event, as compared with the odor of oneself. Also, highly secure participants had attenuated skin conductance when exposed to partner odor. We conclude that partner odor is a scent of security, especially for attachment-secure adults.

  • 149. Granström, Kjell
    et al.
    Guvå, Gunilla
    Hau, Stephan
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi.
    Hylander, Ingrid
    Näslund, Johan
    Rosander, Michael
    Demonstrationer och sporthändelser: en bok om poliser, demonstranter, idrottssupportrar, kravaller och folkfest2016 (oppl. 2 uppl.)Bok (Annet vitenskapelig)
  • 150. Hansen, Bjarne
    et al.
    Hagen, Kristen
    Öst, Lars-Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Klinisk psykologi. Haukeland University Hospital, Norway.
    Solem, Stian
    Kvale, Gerd
    The Bergen 4-Day OCD Treatment Delivered in a Group Setting: 12-Month Follow-Up2018Inngår i: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 9, artikkel-id 639Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The Bergen 4-day concentrated exposure treatment (cET) for obsessive-compulsive disorder (OCD) has proven highly acceptable; with practically no drop-out and a 6 month remission rate of nearly 70%. The aim of the present study was to evaluate long term gains of the approach, and to compare the results to findings from our recent meta-analysis. Sixty-nine of 95 patients consecutively referred to an outpatient clinic in the specialist health care, were offered the Bergen 4-day treatment. Among the 65 who initiated treatment, 60.0% were classified with severe to extreme OCD. None of the patients dropped-out during treatment. Independent Yale-Brown Obsessive-Compulsive Scale interviews were conducted post-treatment, and at 3- and 12-month follow-up. Using the international consensus criteria, 83.1% responded to treatment at 12-month follow-up, and 67.7% of patients were classified as recovered. Significant changes were also seen in depression, as measured by Patient Health Questionnaire-9, and in generalized anxiety, as measured by Generalized Anxiety Disorder-7 scale. A total of 89% of the patients rated the treatment as very good and 100% would recommend the treatment to a friend. Compared to results in a recent meta-analysis, the Bergen 4-day treatment is favorable in respect to attrition, response and 12-month recovery. In sum the Bergen 4-day treatment is a feasible way to deliver treatment for OCD, and the effects are stable at 12-month follow-up. Implications for dissemination are discussed.

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