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Rousseau, Andreas
Alternative names
Publications (10 of 18) Show all publications
Johansson, R., Björklund, M., Hornborg, C., Karlsson, S., Hesser, H., Ljótsson, B., . . . Andersson, G. (2013). Affect-focused psychodynamic psychotherapy for depression and anxiety through the Internet: a randomized controlled trial. PeerJ, 1, e102
Open this publication in new window or tab >>Affect-focused psychodynamic psychotherapy for depression and anxiety through the Internet: a randomized controlled trial
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2013 (English)In: PeerJ, ISSN 2167-8359, Vol. 1, p. e102-Article in journal (Refereed) Published
Abstract [en]

Background. Psychodynamic psychotherapy is a psychological treatment approach that has a growing empirical base. Research has indicated an association between therapist-facilitated affective experience and outcome in psychodynamic therapy. Affect-phobia therapy (APT), as outlined by McCullough et al., is a psychodynamic treatment that emphasizes a strong focus on expression and experience of affect. This model has neither been evaluated for depression nor anxiety disorders in a randomized controlled trial. While Internet-delivered psychodynamic treatments for depression and generalized anxiety disorder exist, they have not been based on APT. The aim of this randomized controlled trial was to investigate the efficacy of an Internet-based, psychodynamic, guided self-help treatment based on APT for depression and anxiety disorders.

Methods. One hundred participants with diagnoses of mood and anxiety disorders participated in a randomized (1:1 ratio) controlled trial of an active group versus a control condition. The treatment group received a 10-week, psychodynamic, guided self-help treatment based on APT that was delivered through the Internet. The treatment consisted of eight text-based treatment modules and included therapist contact (9.5 min per client and week, on average) in a secure online environment. Participants in the control group also received online therapist support and clinical monitoring of symptoms, but received no treatment modules. Outcome measures were the 9-item Patient Health Questionnaire Depression Scale (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7). Process measures were also included. All measures were administered weekly during the treatment period and at a 7-month follow-up.

Results. Mixed models analyses using the full intention-to-treat sample revealed significant interaction effects of group and time on all outcome measures, when comparing treatment to the control group. A large between-group effect size of Cohen’s d = 0.77 (95% CI: 0.37–1.18) was found on the PHQ-9 and a moderately large between-group effect size d = 0.48 (95% CI: 0.08–0.87) was found on the GAD-7. The number of patients who recovered (had no diagnoses of depression and anxiety, and had less than 10 on both the PHQ-9 and the GAD-7) were at post-treatment 52% in the treatment group and 24% in the control group. This difference was significant, χ2(N = 100, df = 1) = 8.3, p < .01. From post-treatment to follow-up, treatment gains were maintained on the PHQ-9, and significant improvements were seen on the GAD-7.

Conclusion. This study provides initial support for the efficacy of Internet-delivered psychodynamic therapy based on the affect-phobia model in the treatment of depression and anxiety disorders. The results support the conclusion that psychodynamic treatment approaches may be transferred to the guided self-help format and delivered via the Internet.

Keywords
Depression, Anxiety, Psychotherapy, Psychodynamic therapy, Internet, Affect, Emotion, Internet-delivered treatments, e-health
National Category
Applied Psychology
Identifiers
urn:nbn:se:liu:diva-96838 (URN)10.7717/peerj.102 (DOI)23862104 (PubMedID)
Available from: 2013-08-27 Created: 2013-08-27 Last updated: 2018-12-12
Johansson, R., Ekbladh, S., Hebert, A., Lindström, M., Möller, S., Petitt, E., . . . Andersson, G. (2012). Psychodynamic Guided Self-Help for Adult Depression through the Internet: A Randomised Controlled Trial. PLoS ONE, 7(5), e38021
Open this publication in new window or tab >>Psychodynamic Guided Self-Help for Adult Depression through the Internet: A Randomised Controlled Trial
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2012 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 5, p. e38021-Article in journal (Refereed) Published
Abstract [en]

Background and aims

Psychodynamic psychotherapy (PDT) is an effective treatment for major depressive disorder (MDD), but not all clients with MDD can receive psychotherapy. Using the Internet to provide psychodynamic treatments is one way of improving access to psychological treatments for MDD. The aim of this randomised controlled trial was to investigate the efficacy of an Internet-based psychodynamic guided self-help treatment for MDD.

Methods

Ninety-two participants who were diagnosed with MDD according to the Mini-International Neuropsychiatric Interview were randomised to treatment or an active control. The treatment consisted of nine treatment modules based on psychodynamic principles with online therapist contact. The active control condition was a structured support intervention and contained psychoeducation and scheduled weekly contacts online. Both interventions lasted for 10 weeks. The primary outcome measure was the Beck Depression Inventory-II (BDI-II).

Results

Mixed-effects model analyses of all randomised participants showed that participants receiving Internet-based PDT made large and superior improvements compared with the active control group on the BDI-II (between-group Cohen's d = 1.11). Treatment effects were maintained at a 10-month follow-up.

Conclusions

Internet-based psychodynamic guided self-help is an efficacious treatment for MDD that has the potential to increase accessibility and availability of PDT for MDD.

National Category
Psychology Psychiatry
Identifiers
urn:nbn:se:liu:diva-77847 (URN)10.1371/journal.pone.0038021 (DOI)000305349600055 ()
Note

http://dx.plos.org/10.1371/journal.pone.0038021

Available from: 2012-05-31 Created: 2012-05-31 Last updated: 2019-06-27
Johansson, R., Sjöberg, E., Sjögren, M., Johnsson, E., Carlbring, P., Andersson, T., . . . Andersson, G. (2012). Tailored vs. Standardized Internet-Based Cognitive Behavior Therapy for Depression and Comorbid Symptoms: A Randomized Controlled Trial. PLoS ONE, 7(5)
Open this publication in new window or tab >>Tailored vs. Standardized Internet-Based Cognitive Behavior Therapy for Depression and Comorbid Symptoms: A Randomized Controlled Trial
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2012 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 5Article in journal (Refereed) Published
Abstract [en]

Background and Aims: Major depression can be treated by means of cognitive behavior therapy, delivered via the Internet as guided self-help. Individually tailored guided self-help treatments have shown promising results in the treatment of anxiety disorders. This randomized controlled trial tested the efficacy of an Internet-based individually tailored guided self-help treatment which specifically targeted depression with comorbid symptoms. The treatment was compared both to standardized (non-tailored) Internet-based treatment and to an active control group in the form of a monitored online discussion group. Both guided self-help treatments were based on cognitive behavior therapy and lasted for 10 weeks. The discussion group consisted of weekly discussion themes related to depression and the treatment of depression. Methods: A total of 121 participants with diagnosed major depressive disorder and with a range of comorbid symptoms were randomized to three groups. The tailored treatment consisted of a prescribed set of modules targeting depression as well as comorbid problems. The standardized treatment was a previously tested guided self-help program for depression. Results: From pre-treatment to post-treatment, both treatment groups improved on measures of depression, anxiety and quality of life. The results were maintained at a 6-month follow-up. Subgroup analyses showed that the tailored treatment was more effective than the standardized treatment among participants with higher levels of depression at baseline and more comorbidity, both in terms of reduction of depressive symptoms and on recovery rates. In the subgroup with lower baseline scores of depression, few differences were seen between treatments and the discussion group. Conclusions: This study shows that tailored Internet-based treatment for depression is effective and that addressing comorbidity by tailoring may be one way of making guided self-help treatments more effective than standardized approaches in the treatment of more severe depression.

Place, publisher, year, edition, pages
Public Library of Science, 2012
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-79824 (URN)10.1371/journal.pone.0036905 (DOI)000305336300049 ()
Available from: 2012-08-14 Created: 2012-08-14 Last updated: 2017-12-07
Johansson, R., Holmdahl, J., Rydell, M., Rousseau, A. & Andersson, G. (2011). An open study of the effectiveness of a tailored Internet-delivered cognitive behaviour therapy treatment for symptoms of depression and anxiety in a primary care setting. Paper presented at 41th annual conference of the European Association for Behavioural and Cognitive Psychotherapies (EABCT 2011), 31 August - 3 September 2011, Reykjavik, Iceland.
Open this publication in new window or tab >>An open study of the effectiveness of a tailored Internet-delivered cognitive behaviour therapy treatment for symptoms of depression and anxiety in a primary care setting
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2011 (English)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Psychiatry Applied Psychology
Identifiers
urn:nbn:se:liu:diva-91688 (URN)
Conference
41th annual conference of the European Association for Behavioural and Cognitive Psychotherapies (EABCT 2011), 31 August - 3 September 2011, Reykjavik, Iceland
Funder
Swedish Research Council
Available from: 2013-04-29 Created: 2013-04-29 Last updated: 2014-11-28
Sjöberg, F., Iredahl, F., Larsen, R., Samuelsson, A., Thorfinn, J., Bak, Z., . . . Rousseau, A. (2011). Data visar att hyperbar syrgasbehandling kan vara skadlig. Läkartidningen, 108(32-33), 1506-1506
Open this publication in new window or tab >>Data visar att hyperbar syrgasbehandling kan vara skadlig
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2011 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 32-33, p. 1506-1506Article, review/survey (Other (popular science, discussion, etc.)) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-75951 (URN)
Available from: 2012-03-19 Created: 2012-03-19 Last updated: 2017-12-07
Sjöberg, F., Larsen, R., Bak, Z., Samuelsson, A., Iredahl, F., Thorfinn, J., . . . Rousseau, A. (2011). Hyperbar syrgasbehandling kan vara skadlig vid kolmonoxidförgiftning. Läkartidningen, 108(32-33), 1506
Open this publication in new window or tab >>Hyperbar syrgasbehandling kan vara skadlig vid kolmonoxidförgiftning
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2011 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 32-33, p. 1506-Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-75561 (URN)21922948 (PubMedID)
Available from: 2012-03-07 Created: 2012-03-07 Last updated: 2017-12-07
Rousseau, A., Tesselaar, E., Henricson, J. & Sjöberg, F. (2010). Prostaglandins and Radical Oxygen Species Are Involved in Microvascular Effects of Hyperoxia. JOURNAL OF VASCULAR RESEARCH, 47(5), 441-450
Open this publication in new window or tab >>Prostaglandins and Radical Oxygen Species Are Involved in Microvascular Effects of Hyperoxia
2010 (English)In: JOURNAL OF VASCULAR RESEARCH, ISSN 1018-1172, Vol. 47, no 5, p. 441-450Article in journal (Refereed) Published
Abstract [en]

Hyperoxia causes vasoconstriction in most tissues, by mechanisms that are not fully understood. We investigated microvascular effects of breathing 100% oxygen in healthy volunteers, using iontophoresis to deliver acetylcholine (ACh) and sodium nitroprusside (SNP). Aspirin and vitamin C were used to test for involvement of prostaglandins and radical oxygen species. Forearm skin perfusion was measured using laser Doppler perfusion imaging. Results were analysed using dose-response modelling. The response to ACh was reduced by 30% during oxygen breathing compared to air breathing [0.98 (0.81-1.15) PU vs. 1.45 (1.30-1.60) PU, p andlt; 0.001]. ED50 values were unchanged [2.25 (1.84-2.75) vs. 2.21 (1.79-2.74), not significant]. Aspirin pre-treatment abolished the difference in response between oxygen breathing and air breathing [maximum: 1.03 (0.90-1.16) vs. 0.89 (0.77-1.01), not significant; ED50: 1.83 (1.46-2.30) vs. 1.95 (1.65-2.30), not significant]. ACh-mediated vasodilatation during 100% oxygen breathing was partially restored after pre-treatment with vitamin C. Breathing 100% oxygen did not change the microvascular response to SNP [1.45 (1.28-1.62) vs. 1.40 (1.26-1.53), not significant]. These results favour the hypothesis that hyperoxic vasoconstriction is mediated by inhibition of prostaglandin synthesis. Radical oxygen species may be involved as vitamin C, independently of aspirin, partially restored ACh-mediated vasodilatation during hyperoxia.

Place, publisher, year, edition, pages
S. Karger AG, 2010
Keywords
Acetylcholine, Perfusion, Hyperoxia, Iontophoresis, Prostaglandins, Radical oxygen species, Sodium nitroprusside
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-59256 (URN)10.1159/000282667 (DOI)000281228100007 ()
Note
Original Publication: Andreas Rousseau, Erik Tesselaar, Joakim Henricson and Folke Sjöberg, Prostaglandins and Radical Oxygen Species Are Involved in Microvascular Effects of Hyperoxia, 2010, JOURNAL OF VASCULAR RESEARCH, (47), 5, 441-450. http://dx.doi.org/10.1159/000282667 Copyright: S. Karger AG http://www.karger.com/ Available from: 2010-09-10 Created: 2010-09-10 Last updated: 2012-03-20
Bak, Z., Sjöberg, F., Rousseau, A., Janerot Sjöberg, B. & Steinvall, I. (2007). Human cardiovascular dose-response to supplemental oxygen. Acta Physiologica, 191(1), 15-24
Open this publication in new window or tab >>Human cardiovascular dose-response to supplemental oxygen
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2007 (English)In: Acta Physiologica, ISSN 1748-1708, E-ISSN 1748-1716, Vol. 191, no 1, p. 15-24Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of the study was to examine the central and peripheral cardiovascular adaptation and its coupling during increasing levels of hyperoxaemia. We hypothesized a dose-related effect of hyperoxaemia on left ventricular performance and the vascular properties of the arterial tree.

Methods: Oscillometrically calibrated arterial subclavian pulse trace data were combined with echocardiographic recordings to obtain non-invasive estimates of left ventricular volumes, aortic root pressure and flow data. For complementary vascular parameters and control purposes whole-body impedance cardiography was applied. In nine (seven males) supine, resting healthy volunteers, aged 23–48 years, data was collected after 15 min of air breathing and at increasing transcutaneous oxygen tensions (20, 40 and 60 kPa), accomplished by a two group, random order and blinded hyperoxemic protocol.

Results: Left ventricular stroke volume [86 ± 13 to 75 ± 9 mL (mean ± SD)] and end-diastolic area (19.3 ± 4.4 to 16.8 ± 4.3 cm2) declined (P < 0.05), and showed a linear, negative dose–response relationship to increasing arterial oxygen levels in a regression model. Peripheral resistance and characteristic impedance increased in a similar manner. Heart rate, left ventricular fractional area change, end-systolic area, mean arterial pressure, arterial compliance or carbon dioxide levels did not change.

Conclusion: There is a linear dose–response relationship between arterial oxygen and cardiovascular parameters when the systemic oxygen tension increases above normal. A direct effect of supplemental oxygen on the vessels may therefore not be excluded. Proximal aortic and peripheral resistance increases from hyperoxaemia, but a decrease of venous return implies extra cardiac blood-pooling and compensatory relaxation of the capacitance vessels.

Keywords
arterial compliance, end-diastolic area, hyperoxaemia, hyperoxia, normocapnia, stroke volume, vascular resistance
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-12899 (URN)10.1111/j.1748-1716.2007.01710.x (DOI)
Available from: 2008-01-28 Created: 2008-01-28 Last updated: 2017-12-13
Rousseau, A., Steinwall, I., Woodson, R. & Sjöberg, F. (2007). Hyperoxia decreases cutaneous blood flow in high-perfusion areas. Microvascular Research, 74(1), 15-22
Open this publication in new window or tab >>Hyperoxia decreases cutaneous blood flow in high-perfusion areas
2007 (English)In: Microvascular Research, ISSN 0026-2862, E-ISSN 1095-9319, Vol. 74, no 1, p. 15-22Article in journal (Refereed) Published
Abstract [en]

The mechanism by which hyperoxia decreases blood flow is still not understood. Hyperoxemia-induced vasoconstriction is known to occur in many organs, including brain and retina, skeletal muscle, and myocardium. Whether this also occurs in skin is unknown.

This study was conducted in healthy volunteers exposed intermittently to 100% oxygen (FIO2 1.0). Perfusion of forearm skin was measured by laser Doppler imaging (LDI). In series 1, it was measured in 7 subjects before, during, and after 15 min of oxygen breathing. In series 2, flow was measured, also during air and O2 breathing, after perfusion was raised by (a) sympathetic blockade (induced by a topically applied local anesthetic) (n = 9) and by (b) current-induced vasodilation (n = 8).

In normal unperturbed skin, there was no significant change with hyperoxia. When basal perfusion was raised by topical anesthesia or by current, there was also no change in mean perfusion overall with hyperoxia. However, areas with the highest perfusion (upper decile) showed a significant perfusion decrement with hyperoxia (− 30% and − 20%, respectively; p < 0.001).

Vasoconstriction with hyperoxia has been demonstrated in human skin. The fact that it is observed only when flow is increased above basal levels and then only in high-flow vessels suggests that cutaneous blood flow control is primarily regulated by variables other than oxygen.

National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-39470 (URN)10.1016/j.mvr.2007.02.001 (DOI)48745 (Local ID)48745 (Archive number)48745 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13Bibliographically approved
Rousseau, A. & Sjöberg, F. (2006). Den okritiska syrgasbehandlingens tid är förbi. Läkartidningen, 103(14), 1100-1104
Open this publication in new window or tab >>Den okritiska syrgasbehandlingens tid är förbi
2006 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, no 14, p. 1100-1104Article in journal (Other academic) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-36966 (URN)33167 (Local ID)33167 (Archive number)33167 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2017-12-13
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