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  • 1.
    Adnan, Ali
    et al.
    Univ Gothenburg, Sweden.
    Hogmo, Anders
    Karolinska Hosp, Sweden.
    Sjodin, Helena
    Karolinska Hosp, Sweden.
    Gebre-Medhin, Maria
    Lund Univ, Sweden.
    Laurell, Goran
    Uppsala Univ, Sweden.
    Reizenstein, Johan
    Orebro Univ Hosp, Sweden; Orebro Univ, Sweden.
    Farnebo, Lovisa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Norberg, Lena S.
    Umea Univ, Sweden.
    Notstam, Isak
    Umea Univ, Sweden.
    Holmberg, Erik
    Sahlgrens Univ Hosp, Sweden.
    Cange, Hedda H.
    Univ Gothenburg, Sweden.
    Hammerlid, Eva
    Univ Gothenburg, Sweden.
    Health-related quality of life among tonsillar carcinoma patients in Sweden in relation to treatment and comparison with quality of life among the population2020In: Head and Neck, ISSN 1043-3074, E-ISSN 1097-0347, Vol. 42, no 5, p. 860-872Article in journal (Refereed)
    Abstract [en]

    Background The health-related quality of life (HRQOL) of tonsillar carcinoma survivors was explored to investigate any HRQOL differences associated with tumor stage and treatment. The survivors HRQOL was also compared to reference scores from the population. Methods In this exploratory cross-sectional study patients were invited 15 months after their diagnosis and asked to answer two quality of life questionnaires (EORTC QLQ- C30, EORTC QLQ- HN35), 405 participated. Results HRQOL was associated with gender, with males scoring better than females on a few scales. Patients HRQOL was more associated with treatment than tumor stage. Patients HRQOL was worse than that in an age- and sex-matched reference group from the normal population, the largest differences were found for problems with dry mouth followed by problems with sticky saliva, senses, swallowing and appetite loss. Conclusions The tonsillar carcinoma patients had a worse HRQOL compared to the general population one year after treatment.

  • 2.
    Alexander, Lind
    et al.
    Lund Univ CRC, Sweden.
    Yang, Cao
    Orebro Univ, Sweden; Karolinska Inst, Sweden.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Orebro Univ, Sweden.
    Maria, Hardstedt
    Orebro Univ, Sweden; Uppsala Univ, Sweden; Vansbro Primary Hlth Care Ctr, Sweden.
    Stefan, Jansson
    Orebro Univ, Sweden; Uppsala Univ, Sweden.
    Ake, Lernmark
    Lund Univ, Sweden.
    Martin, Sundqvist
    Orebro Univ, Sweden.
    Staffan, Tevell
    Orebro Univ, Sweden; Karlstad Hosp, Sweden; Reg Varmland, Sweden.
    Cheng-ting, Tsai
    Enable Biosci Inc, CA USA.
    Jeanette, Wahlberg
    Orebro Univ, Sweden.
    Johan, Jendle
    Orebro Univ, Sweden.
    Anxiety, depression and quality of life in relation to SARS-CoV-2 antibodies in individuals living with diabetes during the second wave of COVID-192024In: DIABETES EPIDEMIOLOGY AND MANAGEMENT, ISSN 2666-9706, Vol. 13, article id 100194Article in journal (Refereed)
    Abstract [en]

    Aims: The objective was to compare anxiety, depression, and quality of life (QoL) in individuals living with type 1 (T1D) and type 2 (T2D) diabetes with matched controls during the second wave of the COVID-19 pandemic. Methods: Via randomization, individuals living with diabetes T1D (n = 203) and T2D (n = 413), were identified during February-July 2021 through health-care registers. Population controls (n = 282) were matched for age, gender, and residential area. Questionnaires included self-assessment of anxiety, depression, QoL, and demographics in relation to SARS-CoV-2 exposure. Blood was collected through home-capillary sampling, and SARS-CoV-2 Nucleocapsid (NCP) and Spike antibodies (SC2_S1) were determined by multiplex Antibody Detection by Agglutination-PCR (ADAP) assays. Results: Younger age and health issues were related to anxiety, depression, and QoL, with no differences between the study groups. Female gender was associated with anxiety, while obesity was associated with lower QoL. The SARS-CoV-2 NCP seroprevalence was higher in T1D (8.9 %) compared to T2D (3.9 %) and controls (4.0 %), while the SARS-CoV-2 SC2_S1 seroprevalence was higher for controls (25.5 %) compared to T1D (16.8 %) and T2D (14.0 %). Conclusions: A higher SARS-CoV-2 infection rate in T1D may be explained by younger age and higher employment rate, and the associated increased risk for viral exposure. (c) 2023 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC

  • 3.
    Aminoff, Victoria
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Bobeck, Johan
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences.
    Hjort, Sofia
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Sorliden, Elise
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Ludvigsson, Mikael
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Linköping. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Berg, Matilda
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Tailored internet-based psychological treatment for psychological problems during the COVID-19 pandemic: A randomized controlled trial2023In: Internet Interventions, ISSN 2214-7829, Vol. 34, article id 100662Article in journal (Refereed)
    Abstract [en]

    The COVID-19 pandemic influence mental health in both infected and non-infected populations. In this study we examined if individually tailored internet-based cognitive behavioral therapy (ICBT) could be an effective treatment for psychological symptoms related to the pandemic. Following recruitment we included 76 participants who were randomized to either a treatment group (n = 37) or a waitlist control group (n = 39). The treatment group received 8 modules (out of 16 possible) during 8 weeks with weekly therapist support. We collected data on symptoms of depression, experienced quality of life, anxiety, stress, anger, insomnia, PTSD, and alcohol use before, after the treatment and at one year follow-up. Using multiple regression analysis, group condition was found to be a statistically significant predictor for a decrease, favoring the treatment group, in symptoms of depression, insomnia, and anger with small to moderate effect sizes. The improvements remained at one year follow-up. Group condition did not significantly predict changing symptoms regarding experienced quality of life, anxiety, stress, PTSD and alcohol use. Findings indicate that ICBT is an effective intervention for some psychological symptoms associated with the COVID-19 pandemic. There is a need for further studies on mechanisms of change and on tailored ICBT for problems associated with crises like the pandemic.

  • 4.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Forskningsmetoder och consilience2021In: Psykisk ohälsa: ett biopsykosocialt perspektiv / [ed] Ali Sarkohi, Gerhard Andersson, Lund: Studentlitteratur AB, 2021, Vol. Sidorna 23-50, p. 23-50Chapter in book (Other academic)
    Abstract [sv]

    I denna bok omnämns flera olika psykiska ohälsotillstånd och mekanismerna bakom dem. I detta kapitel vill jag ge en översikt med några exempel på metoder för de olika nivåerna i den biopsykosociala modellen. Begreppet consilience, myntat av Edward O. Wilson, introducerades som ett ramverk för hur olika vetenskapstraditioner kan samverka och berika varandra. Jag går igenom olika metoder inom olika forskningstraditioner och avslutar med en diskussion om utmaningar med att förena olika angreppssätt i förståelsen av psykisk sjukdom.

  • 5.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Innovating CBT and Answering New Questions: the Role of Internet-Delivered CBT2023In: International Journal of Cognitive Therapy, ISSN 1937-1209, E-ISSN 1937-1217Article in journal (Refereed)
    Abstract [en]

    Internet-delivered cognitive behavior therapy (ICBT) was developed in the late 1990s, and since then, a large number of studies have been conducted. Many programs have been developed and sometimes implemented, and ICBT has become a major way to investigate and innovate CBT including important questions regarding mechanisms and moderating factors. The aim of this narrative review was to comment on the treatment format, the evidence behind ICBT, innovations, and finally challenges. ICBT has been developed and tested for a range of conditions including both psychiatric and somatic health problems and also transdiagnostic problems like loneliness and poor self-esteem. Meta-analytic reviews suggest that guided ICBT can be as effective as face-to-face CBT and by using individual patient data meta-analytic methods (IPDMA), it is now possible have better power for the search of moderators. There are also several reports of how well ICBT works in regular clinical settings, mostly replicating the results reported in efficacy studies. Cost-effectiveness has also been documented as well as studies using qualitative methodology to document client and clinician experiences. In terms of innovation, there are now studies on problems for which there is limited previous face-to-face research, and one major advancement is the use of factorial design trials in which more than one independent variable is tested. Finally, ICBT has the potential to be useful in times of crisis, with the COVID-19 pandemic being one recent example. Future challenges include use of artificial intelligence in both treatment development and possibly treatment delivery. Another urgent priority is to reach less favored parts of the world as most studies and programs have been tested and implemented in Western countries. In conclusion, ICBT is now an established as a way to develop, test, and deliver CBT.

  • 6.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Internet-Delivered Psychological Treatments for Tinnitus: A Brief Historical Review2022In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 31, no 3, p. 1013-1018Article, review/survey (Refereed)
    Abstract [en]

    Objectives: Internet-delivered psychological treatments were developed more than 20 years ago, and tinnitus was among the first target conditions. The aim of this review article is to describe the history of Internet treatments for tinnitus and to comment on the evidence base. Challenges for future research and implementations will be mentioned. Method: A narrative historical review was conducted. Findings: There are now several studies including controlled trials on Internet interventions based on cognitive behavior therapy (ICBT) for tinnitus. Effects in controlled trials are moderate to large with regard to tinnitus annoyance. While the treatment format now exists in four languages, there is a large treatment versus demand gap as very few clients with tinnitus receive ICBT. There is a lack of research on related conditions with the exception of hearing loss. However, there is substantial support for Internet interventions for comorbid conditions such as insomnia and depression but not specifically in association with tinnitus. Conclusions: ICBT is a promising treatment approach for tinnitus and will hopefully increase access to evidence-based treatment to reduce tinnitus distress. More research is needed for related conditions such as hyperacusis and larger trials on tinnitus.

  • 7.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    The latest developments with internet-based psychological treatments for depression2024In: Expert Review of Neurotherapeutics, ISSN 1473-7175, E-ISSN 1744-8360, Vol. 24, no 2, p. 171-176Article, review/survey (Refereed)
    Abstract [en]

    IntroductionInternet-based psychological treatments for depression have been around for more than 20 years. There has been a continuous line of research with new research questions being asked and studies conducted.Areas coveredIn this paper, the author reviews studies with a focus on papers published from 2020 and onwards based on a Medline and Scopus search. Internet-based cognitive behavior therapy (ICBT) programs have been developed and tested for adolescents, older adults, immigrant groups and to handle a societal crisis (e.g. COVID-19). ICBT works in regular clinical settings and long-term effects can be obtained. Studies on different treatment orientations and approaches such as acceptance commitment therapy, unified protocol, and tailored treatments have been conducted. Effects on quality-of-life measures, knowledge acquisition and ecological momentary assessment as a research tool have been reported. Factorial design trials and individual patient data meta-analysis are increasingly used in association with internet intervention research. Finally, prediction studies and recent advances in artificial intelligence are mentioned.Expert opinionInternet-delivered treatments are effective, in particular if therapist guidance is provided. More target groups have been covered but there are many remaining challenges including how new tools like artificial intelligence will be used when treating depression.

  • 8.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Tinnitus in 2021. Time to consider evidence-based digital interventions2022In: The Lancet Regional Health: Europe, E-ISSN 2666-7762, Vol. 12, article id 100263Article in journal (Other academic)
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  • 9.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Yrsel och balansproblem2019In: Somatisk sjukdom: ett biopsykosocialt perspektiv / [ed] Ali Sarkohi, Gerhard Andersson, Lund: Studentlitteratur AB, 2019, 1, Vol. Sidorna 245-259, p. 245-259Chapter in book (Other academic)
  • 10.
    Andersson, Gerhard
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Käll, Anton
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Juhlin, Simon
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Wahlstrom, Carl
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Licht, Edvard de Fine
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Färdeman, Simon
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Franck, Anna
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Tholcke, Anna
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Nachtweij, Karin
    Linnaeus Univ, Sweden.
    Fransson, Emma
    Linnaeus Univ, Sweden.
    Vernmark, Kristofer
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Ludvigsson, Mikael
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Linköping. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Berg, Matilda
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Free choice of treatment content, support on demand and supervision in internet-delivered CBT for adults with depression: A randomized factorial design trial2023In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 162, article id 104265Article in journal (Refereed)
    Abstract [en]

    Even if much is known regarding the effects of internet-delivered cognitive behaviour therapy (ICBT) for depression there are several topics that have not been studied. In this factorial design trial with 197 participants we investigated if clients in ICBT could select treatment modules themselves based on a selection of 15 tailored treatment modules developed for use in ICBT for depression. We contrasted this against clinician-tailored module selection. We also investigated if support on demand (initiated by the client) could work as well as scheduled support. Finally, we tested if clients that were mentioned in supervision would improve more than clients not mentioned (with the exception of acute cases). The treatment period lasted for 10 weeks, and we measured effects at post-treatment and two-year follow-up. Measures of depression and secondary outcomes were collected at pre-treatment, post-treatment and two-year follow-up. Overall, within-group effects were large across con-ditions (e.g., d = 1.73 on the BDI-II). We also found a small but significant difference in favour of self-tailored treatment over clinician-tailored (d = 0.26). Within-group effects for the secondary measures were all moderate to large including a test of knowledge about CBT. The other two contrasts "support on demand" and "supervision" yielded mostly non-significant differences, with the exception of a larger dropout rate in the support on demand condition. There were few negative effects (2.2%). Effects were largely maintained at a two-year follow-up. We conclude that clients can choose treatment modules and that support on demand may work. The role of su-pervision is not yet clear as advice can be transferred across clients.

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  • 11.
    Andersson, Gerhard
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Institutionen för klinisk neurovetenskap, Karolinska Instituttet, Stockholm.
    Sarkohi, Ali
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Avslutande ord2019In: Somatisk sjukdom: ett biopsykosocialt perspektiv, Lund: Studentlitteratur , 2019, 1, , p. 495p. 261-263Chapter in book (Other academic)
  • 12.
    Andersson, Gerhard
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Institutionen för klinisk neurovetenskap, Karolinska Instituttet, Stockholm.
    Sarkohi, Ali
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Introduktion till ett biopsykosocialt perspektiv2021In: Psykisk ohälsa: ett biopsykosocialt perspektiv, Lund: Studentlitteratur , 2021, 1, , p. 495p. 15-21Chapter in book (Other academic)
  • 13.
    Asbrand, Julia
    et al.
    Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
    Gerdes, Samantha
    NHS Veterans’ Mental Health and Wellbeing Service, Camden and Islington NHS Trust, London, United Kingdom.
    Breedvelt, Josefien
    NatCen Social Research, London, United Kingdom; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands.
    Guidi, Jenny
    Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy.
    Hirsch, Colette
    Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, United Kingdom; National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, United Kingdom; South London and Maudsley NHS Foundation Trust, Denmark Hill, Camberwell, London, United Kingdom.
    Maercker, Andreas
    Department of Psychology, Division of Psychopathology and Clinical Intervention, University of Zurich, Zurich, Switzerland; Wissenschaftskolleg Berlin–Institute of Advanced Study, Berlin, Germany.
    Douilliez, Céline
    Université catholique de Louvain, Psychological Sciences Research Institute, Louvain-La-Neuve, Belgium.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Stockholm, Sweden.
    Debbané, Martin
    Psychoanalysis Unit, Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom; Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
    Cieslak, Roman
    Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.
    Rief, Winfried
    Department of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany.
    Bockting, Claudi
    Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands; Department of Psychiatry, Amsterdam University Medical Centers (location AMC), Amsterdam, The Netherlands.
    Clinical Psychology and the COVID-19 Pandemic: A Mixed Methods Survey Among Members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT).2023In: Clinical Psychology in Europe, E-ISSN 2625-3410, Vol. 5, no 1, article id e8109Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The COVID-19 pandemic has affected people globally both physically and psychologically. The increased demands for mental health interventions provided by clinical psychologists, psychotherapists and mental health care professionals, as well as the rapid change in work setting (e.g., from face-to-face to video therapy) has proven challenging. The current study investigates European clinical psychologists and psychotherapists' views on the changes and impact on mental health care that occurred due to the COVID-19 pandemic. It further aims to explore individual and organizational processes that assist clinical psychologists' and psychotherapists' in their new working conditions, and understand their needs and priorities.

    METHOD: Members of the European Association of Clinical Psychology and Psychological Treatment (EACLIPT) were invited (N = 698) to participate in a survey with closed and open questions covering their experiences during the first wave of the pandemic from June to September 2020. Participants (n = 92) from 19 European countries, mostly employed in universities or hospitals, completed the online survey.

    RESULTS: Results of qualitative and quantitative analyses showed that clinical psychologists and psychotherapists throughout the first wave of the COVID-19 pandemic managed to continue to provide treatments for patients who were experiencing emotional distress. The challenges (e.g., maintaining a working relationship through video treatment) and opportunities (e.g., more flexible working hours) of working through this time were identified.

    CONCLUSIONS: Recommendations for mental health policies and professional organizations are identified, such as clear guidelines regarding data security and workshops on conducting video therapy.

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  • 14.
    Atzor, Marie-Christin
    et al.
    Philipps Univ Marburg, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    von Lersner, Ulrike
    Humboldt Univ, Germany.
    Weise, Cornelia
    Philipps Univ Marburg, Germany.
    Effectiveness of Internet-Based Training on Psychotherapists' Transcultural Competence: A Randomized Controlled Trial2024In: Journal of Cross-Cultural Psychology, ISSN 0022-0221, E-ISSN 1552-5422Article in journal (Refereed)
    Abstract [en]

    Treating culturally diverse patients (CDPs) presents considerable challenges for psychotherapists, including language barriers, differing beliefs, and insecurities. Improving their transcultural competence requires training, but empirical evidence is lacking. This 6-week randomized controlled trial evaluated the impact of standardized internet-based training on psychotherapists' transcultural competence (i.e., awareness, engagement, and handling challenges). Demographic data were collected before training. Transcultural competence was measured at pre-training, post-training, and 3-month follow-up. Training satisfaction was assessed at post-training and follow-up visits. In the guided training group (GTG; n = 83), psychotherapists received hands-on training with practical exercises, weekly knowledge assessments, and online feedback. The second condition comprised a non-guided control group (CG; n = 90) that received only text-based training. Primary analyses on both intent-to-treat (n = 173) and completer analyses (n = 95) indicated significant improvements in transcultural awareness and engagement after 6 weeks of training for both groups. Significant within-group improvements were noted, as evidenced by large Cohen's d effect sizes for both groups. No between-group differences were observed. Qualitative assessments revealed that GTG participants evaluated the training's concept and content significantly more positively than CG participants and felt significantly less insecure about treating CDPs. Such training could pave the way for the long-term development of innovative, culturally sensitive mental health care services that more effectively meet the needs of CDPs.

  • 15.
    Axelsson, Erland
    et al.
    Karolinska Inst, Sweden; Reg Stockholm, Sweden; Reg Stockholm, Sweden.
    Kern, Dorian
    Karolinska Inst, Sweden; Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Hedman-Lagerlof, Erik
    Karolinska Inst, Sweden.
    Lindfors, Perjohan
    Karolinska Inst, Sweden.
    Palmgren, Josefin
    Karolinska Inst, Sweden.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Orebro Univ, Sweden.
    Andersson, Erik
    Karolinska Inst, Sweden.
    Johansson, Robert
    Stockholm Univ, Sweden.
    Olen, Ola
    Karolinska Inst, Sweden; Karolinska Inst, Sweden; Sachs Childrens Hosp, Sweden.
    Bonnert, Marianne
    Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Lalouni, Maria
    Karolinska Inst, Sweden.
    Ljotsson, Brjann
    Karolinska Inst, Sweden.
    Psychological treatments for irritable bowel syndrome: a comprehensive systematic review and meta-analysis2023In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 52, no 6, p. 565-584Article, review/survey (Refereed)
    Abstract [en]

    A wide range of psychological treatments have been found to reduce the symptoms of irritable bowel syndrome (IBS) but their relative effects are unclear. In this systematic review and meta-analysis, we determined the effects of psychological treatments for IBS, including subtypes of cognitive behavior therapy, versus attention controls. We searched 11 databases (March 2022) for studies of psychological treatments for IBS, reported in journal articles, books, dissertations, and conference abstracts. The resulting database comprised 9 outcome domains from 118 studies published in 1983-2022. Using data from 62 studies and 6496 participants, we estimated the effect of treatment type on improvement in composite IBS severity using random-effects meta-regression. In comparison with the attention controls, there was a significant added effect of exposure therapy (g = 0.52, 95% CI = 0.17-0.88) and hypnotherapy (g = 0.36, 95% CI = 0.06-0.67) when controlling for the pre- to post-assessment duration. When additional potential confounders were included, exposure therapy but not hypnotherapy retained a significant added effect. Effects were also larger with a longer duration, individual treatment, questionnaire (non-diary) outcomes, and recruitment outside of routine care. Heterogeneity was substantial. Tentatively, exposure therapy appears to be a particularly promising treatment for IBS. More direct comparisons in randomized controlled trials are needed. OSF.io identifier: 5yh9a.

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  • 16.
    Axelsson, Lars
    et al.
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Holmberg, Erik
    Reg Canc Ctr Western Sweden, Sweden; Univ Gothenburg, Sweden.
    Nyman, Jan
    Univ Gothenburg, Sweden.
    Hogmo, Anders
    Karolinska Univ Hosp, Sweden.
    Sjodin, Helena
    Karolinska Univ Hosp, Sweden.
    Gebre-Medhin, Maria
    Lund Univ Hosp, Sweden.
    von Beckerath, Mathias
    Orebro Univ Hosp, Sweden.
    Ekberg, Tomas
    Uppsala Univ Hosp, Sweden.
    Farnebo, Lovisa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Talani, Charbél
    Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Spak, Lena Norberg
    Norrlands Univ Hosp, Sweden.
    Notstam, Isak
    Cty Hosp Sundsvall Harnosand, Sweden.
    Hammerlid, Eva
    Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden.
    Swedish National Multicenter Study on Head and Neck Cancer of Unknown Primary: Prognostic Factors and Impact of Treatment on Survival2021In: International Archives of Otorhinolaryngology, ISSN 1809-9777, E-ISSN 1809-4864, Vol. 25, no 03, p. e433-e442Article in journal (Refereed)
    Abstract [en]

    Introduction Head and neck cancer of unknown primary (HNCUP) is a rare condition whose prognostic factors that are significant for survival vary between studies. No randomized treatment study has been performed thus far, and the optimal treatment is not established. Objective The present study aimed to explore various prognostic factors and compare the two main treatments for HNCUP: neck dissection and (chemo) radiation vs primary (chemo) radiation. Methods A national multicenter study was performed with data from the Swedish Head and Neck Cancer Register (SweHNCR) and from the patients medical records from 2008 to 2012. Results Two-hundred and sixty HNCUP patients were included. The tumors were HPVpositive in 80%. The overall 5-year survival rate of patients treated with curative intent was 71%. Age (p < 0.001), performance status (p = 0.036), and N stage (p = 0.046) were significant factors for overall survival according to the multivariable analysis. Treatment with neck dissection and (chemo) radiation (122 patients) gave an overall 5-year survival of 73%, and treatment with primary (chemo) radiation (87 patients) gave an overall 5-year survival of 71%, with no significant difference in overall or disease-free survival between the 2 groups. Conclusions Age, performance status, and N stage were significant prognostic factors. Treatment with neck dissection and ( chemo) radiation and primary (chemo)

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  • 17.
    Azharuddin, Mohammad
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Chemistry. Linköping University, Faculty of Medicine and Health Sciences.
    Roberg, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Dhara, Ashis Kumar
    Natl Inst Technol Durgapur, India.
    Jain, Mayur Vilas
    Lund Univ, Sweden.
    D´arcy, Padraig
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences.
    Hinkula, Jorma
    Linköping University, Department of Clinical and Experimental Medicine, Division of Hematopoiesis and Developmental Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Slater, Nigel K. H.
    Univ Cambridge, England.
    Patra, Hirak Kumar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Univ Cambridge, England.
    Dissecting multi drug resistance in head and neck cancer cells using multicellular tumor spheroids2019In: Scientific Reports, E-ISSN 2045-2322, Vol. 9, article id 20066Article in journal (Refereed)
    Abstract [en]

    One of the hallmarks of cancers is their ability to develop resistance against therapeutic agents. Therefore, developing effective in vitro strategies to identify drug resistance remains of paramount importance for successful treatment. One of the ways cancer cells achieve drug resistance is through the expression of efflux pumps that actively pump drugs out of the cells. To date, several studies have investigated the potential of using 3-dimensional (3D) multicellular tumor spheroids (MCSs) to assess drug resistance; however, a unified system that uses MCSs to differentiate between multi drug resistance (MDR) and non-MDR cells does not yet exist. In the present report we describe MCSs obtained from post-diagnosed, pre-treated patient-derived (PTPD) cell lines from head and neck squamous cancer cells (HNSCC) that often develop resistance to therapy. We employed an integrated approach combining response to clinical drugs and screening cytotoxicity, monitoring real-time drug uptake, and assessing transporter activity using flow cytometry in the presence and absence of their respective specific inhibitors. The report shows a comparative response to MDR, drug efflux capability and reactive oxygen species (ROS) activity to assess the resistance profile of PTPD MCSs and two-imensional (2D) monolayer cultures of the same set of cell lines. We show that MCSs provide a robust and reliable in vitro model to evaluate clinical relevance. Our proposed strategy can also be clinically applicable for profiling drug resistance in cancers with unknown resistance profiles, which consequently can indicate benefit from downstream therapy.

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  • 18.
    Bendelin, Nina
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Hurdles and potentials when implementing internet-delivered Acceptance and commitment therapy for chronic pain: a retrospective appraisal using the Quality implementation framework2023In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 24, no 1, article id 20220139Article in journal (Refereed)
    Abstract [en]

    Objectives: Internet-delivered psychological interventions can be regarded as evidence-based practices and have been implemented in psychiatric and somatic care at primary and specialist levels. However, challenges as low adherence and poor routinization, have arisen during attempts to implement internet-delivered interventions in chronic pain settings. Internet-delivered Acceptance and Commitment Therapy (IACT) has been found to be helpful for chronic pain patients and might aid in developing pain rehabilitation services. However, the integration of IACT into standard health care has not yet been described from an implementation science perspective. The aim of this hybrid 1 effectiveness-implementation study was to evaluate the process of implementing IACT in a pain rehabilitation setting, to guide future implementation initiatives.Methods: In this retrospective study we described actions taken during an implementation initiative, in which IACT was delivered as part of an interdisciplinary pain rehabilitation program (IPRP) at a specialist level clinic. All documents relevant to the study were reviewed and coded using the Quality Improvement Framework (QIF), focusing on adoption, appropriateness and sustainability.Results: The QIF-analysis of implementation actions resulted in two categories: facilitators and challenges for implementation. Sustainability may be facilitated by sensitivity to the changing needs of a clinical setting and challenged by unfitting capacity building. Appropriateness might be challenged by an insufficient needs assessment and facilitated by aligning routines for communication with the clinics existing infrastructure. Adoption may be facilitated by staff key champions and an ability to adapt to occurring hurdles. Possible influential factors, hypotheses and key process challenges are presented in a logic model to guide future initiatives.Conclusions: Sustainable implementation may depend on both the continuity of facilitating implementation actions and flexibility to the changing needs and interests of patients, caregivers and organization. We conclude that the use of theories, models and frameworks (TMF) as well as a logic model may ease design, planning and evaluation of an implementation process. Lastly, we suggest that IACT may be appropriate for IPRP when given before or after IPRP, focusing on psychiatric comorbidities.

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  • 19.
    Berg, Malin
    et al.
    Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Adnan, Ali
    Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Högmo, Anders
    Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Sjödin, Helena
    Theme Cancer, HHLH, Karolinska University Hospital, Stockholm, Sweden.
    Gebre-Medhin, Maria
    Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden.
    Laurell, Göran
    Department of Surgical Sciences, Section of Otorhinolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden.
    Reizenstein, Johan
    Department of Oncology, Örebro University Hospital and Örebro University, Örebro, Sweden.
    Farnebo, Lovisa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Norberg, Lena Spaak
    Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden.
    Notstam, Isak
    Department of Clinical Sciences/ENT, Umeå University, Umeå, Sweden.
    Holmberg, Erik
    Regional Cancer Center Western Sweden, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Cange, Hedda Haugen
    Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Hammerlid, Eva
    Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
    A national study of health-related quality of life in patients with cancer of the base of the tongue compared to the general population and to patients with tonsillar carcinoma2021In: Head and Neck, ISSN 1043-3074, E-ISSN 1097-0347, Vol. 43, no 12, p. 3843-3856Article in journal (Refereed)
    Abstract [en]

    Background: This exploratory, registry-based, cross-sectional study aimed to evaluate patients' health-related quality of life (HRQOL) in a subsite of oropharyngeal cancer: cancer of the base of the tongue (CBT). Methods: CBT patients, treated with curative intent, completed the EORTC QLQ-C30 and QLQ-H&N35 questionnaires 15 months after diagnosis. The HRQOL of CBT patients was compared to reference scores from the general population and to that of tonsillar carcinoma patients. Results: The 190 CBT patients scored significantly worse than members of the general population on most scales. CBT patients with human papilloma virus (HPV)-positive tumors had significantly better HRQOL on 8 of 28 scales than HPV-negative patients. Compared to 405 tonsillar carcinoma patients, CBT patients had significantly worse HRQOL on 8 of the 28 scales, the majority local head and neck related problems. Conclusion: One year after treatment, CBT patients' HRQOL was significantly worse in many areas compared to that of the general population and slightly worse than that of tonsillar carcinoma patients. © 2021 Wiley Periodicals LLC.

  • 20.
    Berg, Matilda
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Klemetz, Helena
    Psykologpartners, Linkoping, Sweden.
    Lindegaard, Tomas
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Self-esteem in new light: a qualitative study of experiences of internet-based cognitive behaviour therapy for low self-esteem in adolescents2023In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 23, no 1, article id 810Article in journal (Refereed)
    Abstract [en]

    BackgroundLow self-esteem is common and can be impairing for adolescents. Treatments that primarily target low-esteem are lacking. Internet-delivered cognitive behaviour therapy (ICBT) is a treatment that can be used for adolescents but ICBT is yet to be evaluated for low self-esteem using qualitative methods. The aim of this study was to investigate experiences of participating in a novel ICBT treatment for adolescents suffering from low self-esteem.MethodFifteen adolescent girls who had received ICBT consented to participate in a semi-structured qualitative telephone interview at post-treatment. Data were analysed and categorised using inductive Thematic Analysis.ResultsFour overarching themes were identified; (1) Increased awareness and agency in difficult situations, (2) Enhanced self-image, (3) Unique but not alone, and (4) Widened understanding and new perspectives. Participants reported positive changes in their thinking and behaviour, as well as helpful learning experiences in relation to themselves and their self-esteem. For instance, participants described a more self-accepting attitude, learned how to manage negative thoughts, and experienced an increased sense of connection to others.ConclusionThe results suggest that ICBT is experienced as helpful and will inform further use and development of ICBT for low self-esteem. Future studies should validate and further evaluate experiences of ICBT for low self-esteem in other settings and in particular for boys as the study only include female participants.

  • 21.
    Bergman, Pia
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Jonkoping Cty Hosp, Sweden.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Univ Oslo, Norway.
    Harder, Henrik
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Mäki-Torkko, Elina
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Orebro Univ, Sweden.
    The Outcome of Unilateral Cochlear Implantation in Adults: Speech Recognition, Health-Related Quality of Life and Level of Anxiety and Depression: a One- and Three-Year Follow-Up Study2020In: International Archives of Otorhinolaryngology, ISSN 1809-9777, E-ISSN 1809-4864, Vol. 24, no 03, p. 338-346Article in journal (Refereed)
    Abstract [en]

    Introduction Hearing impairment is a common disease worldwide, with a comprehensive impact, and cochlear implantation (CI) is an intervention for profound hearing impairment. Objective To study the outcome one and three years after unilateral CI on hearing, health-related quality of life and level of depression and anxiety, and the correlation between the outcomes. Second, to study whether age, gender, etiology, operated side, residual hearing or cognitive performance can predict the outcome. Methods A prospective longitudinal study including adults with profound postlingual hearing impairment, with respect to hearing (speech recognition), health-related quality of life (Health Utilities Index 3) and level of depression and anxiety (Hospital Anxiety and Depression scale), pre-CI, and one and three years post-CI. The total sample was composed of 40 participants (40% of men), with a mean age of 71 years. Results Speech recognition and the overall health-related quality of life improved one year post-CI (p = 0.000), without correlation (rho= 0.27), and with no difference three years post-CI. The hearing attribute (in the health-related quality of life instrument) improved one and three years post-CI (p = 0.000). The level of anxiety did not change one and three years post-CI. The level of depression improved one year post-CI (p = 0.036), and deteriorated three years post-CI (p = 0.031). Age, etiology, operated side, residual hearing and cognitive performance did not predict the outcome, but the female gender did significantly improve speech recognition compared with men (p = 0.009). Conclusion The CI significantly improved speech recognition, health-related quality of life and level of depression one year post-CI without mutual correlation, and women performed significantly better than men. There were no further improvements three years post-CI, apart from the hearing attribute.

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  • 22.
    Bergvall, Hillevi
    et al.
    Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Ghaderi, Ata
    Karolinska Inst, Sweden.
    Andersson, Joakim
    Karolinska Inst, Sweden.
    Lundgren, Tobias
    Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Bohman, Benjamin
    Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Development of competence in cognitive behavioural therapy and the role of metacognition among clinical psychology and psychotherapy students2023In: Behavioural and Cognitive Psychotherapy, ISSN 1352-4658, E-ISSN 1469-1833, article id PII S1352465822000686Article in journal (Refereed)
    Abstract [en]

    Background:There is a paucity of research on therapist competence development following extensive training in cognitive behavioural therapy (CBT). In addition, metacognitive ability (the knowledge and regulation of ones cognitive processes) has been associated with learning in various domains but its role in learning CBT is unknown. Aims:To investigate to what extent psychology and psychotherapy students acquired competence in CBT following extensive training, and the role of metacognition. Method:CBT competence and metacognitive activity were assessed in 73 psychology and psychotherapy students before and after 1.5 years of CBT training, using role-plays with a standardised patient. Results:Using linear mixed modelling, we found large improvements of CBT competence from pre- to post-assessment. At post-assessment, 72% performed above the competence threshold (36 points on the Cognitive Therapy Scale-Revised). Higher competence was correlated with lower accuracy in self-assessment, a measure of metacognitive ability. The more competent therapists tended to under-estimate their performance, while less competent therapists made more accurate self-assessments. Metacognitive activity did not predict CBT competence development. Participant characteristics (e.g. age, clinical experience) did not moderate competence development. Conclusions:Competence improved over time and most students performed over the threshold post-assessment. The more competent therapists tended to under-rate their competence. In contrast to what has been found in other learning domains, metacognitive ability was not associated with competence development in our study. Hence, metacognition and competence may be unrelated in CBT or perhaps other methods are required to measure metacognition.

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  • 23.
    Beukes, Eldre W.
    et al.
    Lamar Univ, TX 77710 USA; Anglia Ruskin Univ, England.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Fagelson, Marc A.
    East Tennessee State Univ, TN USA; Vet Affairs Med Ctr, TN USA.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Manipal Univ, India.
    Dismantling internet-based cognitive behavioral therapy for tinnitus: The contribution of applied relaxation: A randomized controlled trial2021In: Internet Interventions, ISSN 2214-7829, Vol. 25, article id 100402Article in journal (Refereed)
    Abstract [en]

    Background: Internet-based cognitive behavioral therapy (ICBT) for tinnitus is an evidence-based intervention. The components of ICBT for tinnitus have, however, not been dismantled and thus the effectiveness of the different therapeutic components is unknown. It is, furthermore, not known if heterogeneous tinnitus subgroups respond differently to ICBT. Aims: This dismantling study aimed to explore the contribution of applied relaxation within ICBT for reducing tinnitus distress and comorbidities associated with tinnitus. A secondary aim was to assess whether outcomes varied for three tinnitus subgroups, namely those with significant tinnitus severity, those with low tinnitus severity, and those with significant depression. Methods: A parallel randomized controlled trial design (n = 126) was used to compare audiologist-guided applied relaxation with the full ICBT intervention. Recruitment was online and via the intervention platform. Assessments were completed at four-time points including a 2-month follow-up period. The primary outcome was tinnitus severity as measured by the Tinnitus Functional Index. Secondary outcomes were included for anxiety, depression, insomnia, negative tinnitus cognitions, health-related quality of life, hearing disability, and hyperacusis. Treatment engagement variables including the number of logins, number of modules opened, and the number of messages sent. Both an intention-to-treat analysis and completers only analysis were undertaken. Results: Engagement was low which compromised results as the full intervention was undertaken by few participants. Both the ICBT and applied relaxation resulted in large reduction of tinnitus severity (within-group effect sizes d = 0.87 and 0.68, respectively for completers only analysis), which were maintained, or further improved at follow-up. These reductions in tinnitus distress were greater for the ICBT group, with a small effect size differences (between-group d = 0.15 in favor of ICBT for completers only analysis). Tinnitus distress decreased the most at post-intervention for those with significant depression at baseline. Both ICBT and applied relaxation contributed to significant reductions on most secondary outcome measures, with no group differences, except for a greater reduction of hyperacusis in the ICBT group. Conclusion: Due to poor compliance partly attributed to the COVID-19 pandemic results were compromised. Further studies employing strategies to improve compliance and engagement are required. The interventions effectiveness increased with initial level of tinnitus distress; those with the highest scores at intake experienced

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  • 24.
    Beukes, Eldre W.
    et al.
    Lamar Univ, TX 77710 USA; Anglia Ruskin Univ, England.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Fagelson, Marc
    East Tennessee State Univ, TN USA; Vet Affairs Med Ctr, TN USA.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Manipal Univ, India.
    Audiologist-Supported Internet-Based Cognitive Behavioral Therapy for Tinnitus in the United States: A Pilot Trial2021In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 30, no 3, p. 717-729Article in journal (Refereed)
    Abstract [en]

    Background: Patients often report that living with a condition such as tinnitus can be debilitating, worrying, and frustrating. Efficient ways to foster management strategies for individuals with tinnitus and promoting tinnitus self-efficacy are needed. Internet-based cognitive behavioral therapy (ICBT) for tinnitus shows promise as an evidence-based intervention in Europe, but is not available in the United States. The aim of this pilot study was to evaluate the feasibility of an ICBT intervention for tinnitus in the United States. Method: This study reports the Phase 1 trial intended to support implementation of a larger randomized clinical trial (RCT) comparing ICBT to a weekly monitoring group. As a pilot study, a single-group pretest-posttest design was used to determine outcome potential, recruitment strategy, retention, and adherence rates of ICBT for tinnitus. The primary outcome was a change in tinnitus distress. Secondary outcome measures included measures of anxiety, depression, insomnia, tinnitus cognitions, hearing-related difficulties, and quality of life. Results: Of the 42 screened participants, nine did not meet the inclusion criteria and six withdrew. There were 27 participants who completed the intervention, with a mean age of 55.48 (+/- 9.9) years. Feasibility was established, as a large pretest-posttest effect size of d = 1.6 was found for tinnitus severity. Large pretest-posttest effect sizes were also found for tinnitus cognitions and hearing-related effects, and a medium effect was found for insomnia and quality of life. Treatment adherence varied with a retention rate of 85% (n = 23) at post-intervention assessment and 67% (n = 18) for the follow-up assessment. Conclusions: This pilot study supported the feasibility of ICBT for tinnitus in the United States. Ways of improving intervention retention and recruitment rates need to be explored in future ICBT studies. Protocol refinements that were identified will be implemented prior to further RCTs to investigate the efficacy of ICBT for tinnitus in the United States.

  • 25.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin Univ, England; Virtual Hearing Lab, CO USA.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Fagelson, Marc
    East Tennessee State Univ, TN USA; Vet Affairs Med Ctr, TN USA.
    Manchaiah, Vinaya
    Virtual Hearing Lab, CO USA; Univ Pretoria, South Africa; Univ Colorado, CO USA; Univ Colorado Hosp, CO USA; Manipal Acad Higher Educ, India.
    Internet-Based Audiologist-Guided Cognitive Behavioral Therapy for Tinnitus: Randomized Controlled Trial2022In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 24, no 2, article id e27584Article in journal (Refereed)
    Abstract [en]

    Background: Tinnitus is a symptom that can be very distressing owing to hearing sounds not related to any external sound source. Managing tinnitus is notoriously difficult, and access to evidence-based care is limited. Cognitive behavioral therapy (CBT) is a tinnitus management strategy with the most evidence of effectiveness but is rarely offered to those distressed by tinnitus. The provision of internet-based CBT for tinnitus overcomes accessibility barriers; however, it is not currently readily available in the United States. Objective: The aim of this study is to investigate the efficacy of internet-based CBT compared with that of weekly monitoring for the management of tinnitus in reducing tinnitus distress; reducing tinnitus-related comorbidities, including tinnitus cognitions, insomnia, anxiety, and depression; and assessing the stability of the intervention effects 2 months after the intervention. Methods: A 2-arm randomized clinical trial comparing audiologist-guided internet-based CBT (n=79) to a weekly monitoring group (n=79) with a 2-month follow-up assessed the efficacy of internet-based CBT. Eligible participants included adults seeking help for tinnitus. Recruitment was conducted on the web using an open-access website. Participants were randomized via 1:1 allocation, but blinding was not possible. The study was undertaken by English or Spanish speakers on the web. The primary outcome was a change in tinnitus distress as measured using the Tinnitus Functional Index. Secondary outcome measures included anxiety, depression, insomnia, tinnitus cognition, hearing-related difficulties, and quality of life. Results: Internet-based CBT led to a greater reduction in tinnitus distress (mean 36.57, SD 22) compared with that in weekly monitoring (mean 46.31, SD 20.63; effect size: Cohen d=0.46, 95% CI 0.14-0.77) using an intention-to-treat analysis. For the secondary outcomes, there was a greater reduction in negative tinnitus cognition and insomnia. The results remained stable over the 2-month follow-up period. No important adverse events were observed. Further, 16% (10/158) of participants withdrew, with low overall compliance rates for questionnaire completion of 72.3% (107/148) at T1, 61% (91/148) at T2, and 42% (62/148) at T3. Conclusions: This study is the first to evaluate and indicate the efficacy of audiologist-delivered internet-based CBT in reducing tinnitus distress in a US population. It was also the first study to offer internet-based CBT in Spanish to accommodate the large Hispanic population in the United States. The results have been encouraging, and further work is indicated in view of making such an intervention applicable to a wider population. Further work is required to improve compliance and attract more Spanish speakers.

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  • 26.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin Univ, England; Univ Colorado, CO USA; Univ Pretoria, CO USA; Anglia Ruskin Univ, England.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Manchaiah, Vinaya
    Univ Colorado, CO USA; Univ Colorado Hosp, CO USA; Univ Pretoria, South Africa; Manipal Acad Higher Educ, India.
    Long-term efficacy of audiologist-guided Internet-based cognitive behaviour therapy for tinnitus in the United States: A repeated-measures design2022In: Internet Interventions, ISSN 2214-7829, Vol. 30, article id 100583Article in journal (Refereed)
    Abstract [en]

    Objectives: This study investigated the long-term outcomes 1-year after undertaking an Internet-based cognitive behavioural therapy (ICBT) for tinnitus distress in a US population. Secondary aims were to identify the effects on additional difficulties associate with tinnitus and any unwanted events related to ICBT for tinnitus. Methods: A repeated-measures design with 4 time points was used. Participants previously undertaking two randomized ICBT efficacy trials for tinnitus in the US were invited to participate. Of the 200 invited, 132 (66 %) completed the 1-year follow-up questionnaire. The primary outcome was a change in tinnitus distress from baseline at one year post-intervention, as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for anxiety, depression, insomnia, hearing disability, hyperacusis, tinnitus cognitions and health-related quality of life. Results: Undertaking ICBT for tinnitus led to significant improvements 1-year post-intervention for tinnitus severity, with a large effect size (d = 1.06; CI: 0.80 to 1.32). Medium effects were found for anxiety (d = 0.54; CI: 0.29 to 0.79), depression (d = 0.46; CI: 0.21 to 0.70), insomnia (d = 0.47; CI: 0.22 to 0.72), and tinnitus cognitions (d = 0.43, CI: 0.18 to 0.68). Small effect sizes were found for hearing disability, hyperacusis and healthrelated quality of life. Adverse events related to the intervention were only reported by 1 participant. Conclusions: The benefits of audiologist-guided ICBT for tinnitus and tinnitus-related difficulties were maintained 1-year post-intervention with very few adverse events reported. Ways of disseminate evidence-based easily accessible interventions to the general population with bothersome tinnitus should be sought.

  • 27.
    Beukes, Eldre W.
    et al.
    Lamar Univ, TX 77710 USA; Anglia Ruskin Univ, England; Virtual Hearing Lab, IL 60123 USA.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Virtual Hearing Lab, IL 60123 USA; Univ Pretoria, South Africa; Manipal Acad Higher Educ, India.
    Patient Uptake, Experiences, and Process Evaluation of a Randomized Controlled Trial of Internet-Based Cognitive Behavioral Therapy for Tinnitus in the United States2021In: Frontiers in Medicine, E-ISSN 2296-858X, Vol. 8, article id 771646Article in journal (Refereed)
    Abstract [en]

    Introduction: An internet-based cognitive behavioral therapy (ICBT) offers a way to increase access to evidence-based tinnitus care. To increase the accessibility of this intervention, the materials were translated into Spanish to reach Spanish as well as English speakers. A clinical trial indicated favorable outcomes of ICBT for tinnitus for the population of the United States. In view of later dissemination, a way to increase the applicability of this intervention is required. Such understanding is best obtained by considering the perspectives and experiences of participants of an intervention. This study aimed to identify the processes that could facilitate or hinder the clinical implementation of ICBT in the United States.Methods: This study evaluated the processes regarding enrolment, allocation, intervention delivery, the outcomes obtained, and the trial implementation. The study sample consisted of 158 participants who were randomly assigned to the experimental and control group.Results: Although the recruitment was sufficient for English speakers, recruiting the Spanish participants and participants belonging to ethnic minority groups was difficult despite using a wide range of recruitment strategies. The allocation processes were effective in successfully randomizing the groups. The intervention was delivered as planned, but not all the participants chose to engage with the materials provided. Compliance for completing the outcome measures was low. The personal and intervention factors were identified as barriers for the implementation whereas the facilitators included the support received, being empowering, the accessibility of the intervention, and its structure.Conclusion: An understanding regarding the factors contributing to the outcomes obtained, the barriers and facilitators of the results, engagement, and compliance were obtained. These insights will be helpful in preparing for the future dissemination of such interventions.

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  • 28.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin Univ, England; Univ Colorado, CO 80045 USA; Univ Pretoria, CO 80045 USA.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Manchaiah, Vinaya
    Univ Colorado, CO 80045 USA; Univ Pretoria, CO 80045 USA; Univ Colorado, CO 80045 USA; Univ Colorado Hosp, CO 80045 USA; Univ Pretoria, South Africa; Manipal Acad Higher Educ, India.
    Third-Party Disability for Significant Others of Individuals with Tinnitus: A Cross-Sectional Survey Design2023In: Audiology Research, ISSN 2039-4330, E-ISSN 2039-4349, Vol. 13, no 3, p. 378-388Article in journal (Refereed)
    Abstract [en]

    There is currently increasing awareness of third-party disability, defined as the disability and functioning of a significant other (SO) due to a health condition of one of their family members. The effects of third-party disability on the SOs of individuals with tinnitus has received little attention. To address this knowledge gap, this study investigated third-party disability in the significant others (SOs) of individuals with tinnitus. A cross-sectional survey design included 194 pairs of individuals from the USA with tinnitus and their significant others. The SO sample completed the Consequences of Tinnitus on Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. The CTSOQ showed that 34 (18%) of the SOs were mildly impacted, 59 (30%) were significantly impacted, and 101 (52%) were severely impact. The clinical variables of tinnitus severity, anxiety, and hyperacusis in individuals with tinnitus were the best predictors of the impact of tinnitus on SOs. These results show that the SOs of individuals with tinnitus may experience third-party disability. The effect of the individuals tinnitus on their SO may be greater when the individual with tinnitus has a higher level of tinnitus severity, anxiety, and hyperacusis.

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  • 29.
    Beukes, Eldre W.
    et al.
    Lamar Univ, TX 77710 USA; Anglia Ruskin Univ, England.
    Baguley, David M.
    Nottingham Biomed Res Ctr, England; Univ Nottingham, England; Univ Nottingham Hosp, England.
    Jacquemin, Laure
    Antwerp Univ Hosp, Belgium; Univ Antwerp, Belgium.
    Lourenco, Matheus P. C. G.
    Maastricht Univ, Netherlands; KU Leuven Univ, Belgium.
    Allen, Peter M.
    Anglia Ruskin Univ, England.
    Onozuka, Joy
    Amer Tinnitus Assoc, DC USA.
    Stockdale, David
    British Tinnitus Assoc, England.
    Kaldo, Viktor
    Linnaeus Univ, Sweden; Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Manipal Univ, India.
    Changes in Tinnitus Experiences During the COVID-19 Pandemic2020In: Frontiers In Public Health, ISSN 2296-2565, Vol. 8, article id 592878Article in journal (Refereed)
    Abstract [en]

    Introduction: The COVID-19 pandemic has disrupted delivery of healthcare, economic activity, and affected social interactions. Identifying and supporting those most affected by the pandemic is required. The purpose of this study was to determine the impact of the pandemic on individuals with tinnitus and to identify mediating factors. Methods: This is a mixed-methods exploratory cross-sectional study, using data collected via an online survey from 3,103 individuals with tinnitus from 48 countries. The greatest representation was from North America (49%) and Europe (47%) and other countries were only marginally represented. Results: Although the study was aimed at those with pre-existing tinnitus, 7 individuals reported having COVID-19 initiated tinnitus. Having COVID-19 symptoms exacerbated tinnitus in 40% of respondents, made no change in 54%, and improved tinnitus in 6%. Other mediating factors such as the social and emotional consequences of the pandemic made pre-existing tinnitus more bothersome for 32% of the respondents, particularly for females and younger adults, better for 1%, and caused no change to tinnitus for 67%. Pre-existing tinnitus was significantly exacerbated for those self-isolating, experiencing loneliness, sleeping poorly, and with reduced levels of exercise. Increased depression, anxiety, irritability, and financial worries further significantly contributed to tinnitus being more bothersome during the pandemic period. Conclusions: These findings have implications for tinnitus management, because they highlight the diverse response both internal and external factors have on tinnitus levels. Clinical services should be mindful that tinnitus may be caused by contracting COVID-19 and pre-existing tinnitus may be exacerbated, although in the majority of respondents there was no change. Additional support should be offered where tinnitus severity has increased due to the health, social, and/or emotional effects of the COVID-19 pandemic. Tinnitus may be more bothersome for those experiencing loneliness, having fewer social interactions, and who are more anxious or worried.

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  • 30.
    Beukes, Eldre W.
    et al.
    Lamar Univ, TX 77710 USA; Anglia Ruskin Univ, England.
    Baguley, David M.
    Nottingham Biomed Res Ctr, England; Univ Nottingham, England; Nottingham Univ Hosp, England.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Manipal Univ, India.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Allen, Peter M.
    Anglia Ruskin Univ, England.
    Kaldo, Viktor
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Linnaeus Univ, Sweden.
    Jacquemin, Laure
    Antwerp Univ Hosp, Belgium; Univ Antwerp, Belgium.
    Lourenco, Matheus P. C. G.
    Maastricht Univ, Netherlands; KU Leuven Univ, Belgium.
    Onozuka, Joy
    Amer Tinnitus Assoc, DC USA.
    Stockdale, David
    British Tinnitus Assoc, England.
    Maidment, David W.
    Loughborough Univ, England.
    Investigating tinnitus subgroups based on hearing-related difficulties2021In: International journal of clinical practice (Esher), ISSN 1368-5031, E-ISSN 1742-1241, Vol. 75, no 10, article id e14684Article in journal (Refereed)
    Abstract [en]

    Purpose Meaningfully grouping individuals with tinnitus who share a common characteristics (ie, subgrouping, phenotyping) may help tailor interventions to certain tinnitus subgroups and hence reduce outcome variability. The purpose of this study was to test if the presence of tinnitus subgroups are discernible based on hearing-related comorbidities, and to identify predictors of tinnitus severity for each subgroup identified. Methods An exploratory cross-sectional study was used. The study was nested within an online survey distributed worldwide to investigate tinnitus experiences during the COVID-19 pandemic. The main outcome measure was the tinnitus Handicap Inventory- Screening Version. Results From the 3400 respondents, 2980 were eligible adults with tinnitus with an average age of 58 years (SD = 14.7) and 49% (n = 1457) being female. A three-cluster solution identified distinct subgroups, namely, those with tinnitus-only (n = 1306; 44%), those presenting with tinnitus, hyperacusis, hearing loss and/or misophonia (n = 795; 27%), and those with tinnitus and hearing loss (n = 879; 29%). Those with tinnitus and hyperacusis reported the highest tinnitus severity (M = 20.3; SD = 10.5) and those with tinnitus and no hearing loss had the lowest tinnitus severity (M = 15.7; SD = 10.4). Younger age and the presence of mental health problems predicted greater tinnitus severity for all groups (beta <= -0.1, P <= .016). Conclusion Further exploration of these potential subtypes are needed in both further research and clinical practice by initially triaging tinnitus patients prior to their clinical appointments based on the presence of hearing-related comorbidities. Unique management pathways and interventions could be tailored for each tinnitus subgroup.

  • 31.
    Beukes, Eldre W.
    et al.
    Lamar Univ, TX 77710 USA; Anglia Ruskin Univ, TX USA.
    Fagelson, Marc
    East Tennessee State Univ, TN USA; Vet Affairs Med Ctr, TN USA.
    Aronson, Elizabeth Parks
    Lamar Univ, TX 77710 USA.
    Munoz, Maria F.
    Lamar Univ, TX 77710 USA.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Manipal Univ, India; Audiol India, India.
    Readability Following Cultural and Linguistic Adaptations of an Internet-Based Intervention for Tinnitus for Use in the United States2020In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 29, no 2, p. 97-109Article in journal (Refereed)
    Abstract [en]

    Purpose: An Internet-based tinnitus intervention for use in the United States could improve the provision of tinnitusrelated services. Although clinical trials of such interventions were completed in Europe, the United Kingdom, and Australia, their suitability for adults with tinnitus in the United States is yet to be established. The aim of this study was to improve the cultural and linguistic suitability, and lower the readability level, of an existing program for tinnitus to ensure its suitability for U.S. English- and Spanish-speaking populations. Method: Guidelines for adaptation were followed and involved four phases: (a) cultural adaptations, as interventions targeted at specific cultures have been shown to improve outcomes; (b) creating Spanish materials to improve access of the materials to the large Spanish-speaking population in the United States; (c) professional review of the materials for acceptability as an intervention tool for a U.S. population; and (d) literacy-level adjustments to make the content accessible to those with lower levels of health literacy skills. Results: Cultural adaptations were made by using word substitutions, changing examples, and modifying the spelling of certain words. The materials were then translated into Spanish and cross-checked. Professional review ensured suitability of the chapters. Literacy-level adjustments ensured all chapters were within the guidelines for readability grade levels below the sixth-grade level. Conclusions: The previously developed tinnitus materials were revised to adhere to best practice guidelines and ensure cultural suitability for adults with tinnitus in the United States. As it is also available in Spanish, members of the large Hispanic community also have access to the intervention in their first language. Further studies should determine whether these changes improve patients self-efficacy, engagement, and motivation to complete the intervention.

  • 32.
    Beukes, Eldre W.
    et al.
    Lamar Univ, TX 77710 USA; Anglia Ruskin Univ, England.
    Lourenco, Matheus P. C. G.
    Maastricht Univ, Netherlands; KU Leuven Univ, Belgium.
    Biot, Lana
    Univ Antwerp, Belgium.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Kaldo, Viktor
    Karolinska Inst, Sweden; Linnaeus Univ, Sweden.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Manipal Univ, India.
    Jacquemin, Laure
    Univ Antwerp, Belgium; Antwerp Univ Hosp, Belgium.
    Suggestions for shaping tinnitus service provision in Western Europe: Lessons from the COVID-19 pandemic2021In: International journal of clinical practice (Esher), ISSN 1368-5031, E-ISSN 1742-1241, Vol. 75, no 7, article id e14196Article in journal (Refereed)
    Abstract [en]

    Background Tinnitus severity has been exacerbated because of the COVID-19 pandemic and those with tinnitus require additional support. Such support should be informed by patient preferences and needs. The objective of this study was to gather information from individuals with tinnitus living in Europe to inform stakeholders of the (a) support they needed in relation to changes associated with the COVID-19 pandemic and (b) suggestions regarding tinnitus care for the future. Methods A cross-sectional mixed method study design was used using closed and open-ended questions via an online survey. Data were gathered from 710 adults experiencing tinnitus in Western Europe, with the majority living in The Netherlands, Belgium and Sweden. Data were analysed using qualitative content analysis and descriptive statistics. Results Those with tinnitus indicated the following support needs during the pandemic (a) support for tinnitus, (b) support for hearing-related difficulties, (c) social support and (d) pandemic-related support. Five directions for future tinnitus care were provided, namely, (a) need for understanding professional support and access to multidisciplinary experts, (b) greater range of therapies and resources, (c) access to more information about tinnitus, (d) prioritising tinnitus research and (e) more support for hearing protection and hearing loss prevention. Conclusions The findings point to the need for accessible (remote), patient-centred, suitable and evidence-based tinnitus care. Insights from the current study can be used by various stakeholders including clinical practitioners and tinnitus support services to ensure those with tinnitus have access to the help and support required in order to reduce service provision insufficiencies.

  • 33.
    Beukes, Eldre W.
    et al.
    Lamar Univ, TX 77710 USA; Anglia Ruskin Univ, England; Univ Pretoria, South Africa.
    Maidment, David W.
    Loughborough Univ, England.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Fagleson, Marc A.
    East Tennessee State Univ, TN USA; Vet Affairs Med Ctr, TN USA.
    Heffernan, Eithne
    Natl Univ Ireland, Ireland.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Manipal Univ, India; Univ Pretoria, South Africa; Univ Pretoria, South Africa.
    Development and psychometric validation of a questionnaire assessing the impact of tinnitus on significant others2022In: Journal of Communication Disorders, ISSN 0021-9924, E-ISSN 1873-7994, Vol. 95, article id 106159Article in journal (Refereed)
    Abstract [en]

    Introduction: Despite evidence showing that tinnitus can have a detrimental impact on significant others (SOs), no standardized self-reported measure is currently available that specifically as-sesses the presence of third-party disability for tinnitus. The aim of this study was to develop and assess the psychometric properties of a newly developed self-reported measure for SOs of tinnitus and assess how scores could be meaningfully interpreted. Methods: The research consisted of two phases. During Phase I, the Consequences of Tinnitus on Significant Others Questionnaire (CTSOQ) was developed using the The COnsensus-based Stan-dards for the selection of health Measurement INstruments (COSMIN) guidance. Phase II included the assessment of psychometric properties of the CTSOQ including the construct validity, internal consistency, interpretability, and responsiveness. Pairs of 194 individuals with tinnitus and their SOs completed a series of online questionnaires. SOs completed the CTSOQ measure while in-dividuals with tinnitus completed measures related to tinnitus distress, anxiety, depression, insomnia, and quality of life. Results: A 25 item CTSOQ was developed using a formative model. The questionnaire validation process indicated good psychometric properties with an internal consistency of 0.93 and inter-item correlation of 0.60. Support was found for the construct and discriminative validity of the measure. Floor and ceiling effects were negligible. Scores can be meaningfully interpreted to indicate mild, significant, or severe effect of tinnitus on SOs. The questionnaire was also found to be responsive to treatment-related changes. Conclusions: The CTSOQ was found to have sufficient measurement properties suggesting that it is a suitable measure of third-party disability for SOs of individuals with tinnitus. Further research should be initiated to measure face validity and what scores reflect clinically meaningful change.

  • 34.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin Univ, England; Collaborat Initiat Univ Colorado Sch Med & Univ P, CO 80045 USA.
    Manchaiah, Vinaya
    Collaborat Initiat Univ Colorado Sch Med & Univ P, CO 80045 USA; Univ Colorado, CO USA; Univ Colorado Hosp, CO USA; Univ Pretoria, South Africa; Manipal Acad Higher Educ, India.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Maidment, David W.
    Loughborough Univ, England.
    Application of the Behavior Change Wheel Within the Context of Internet-Based Cognitive Behavioral Therapy for Tinnitus Management2022In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 31, no 2, p. 433-444Article in journal (Refereed)
    Abstract [en]

    Purpose: Although experiencing tinnitus can lead to many difficulties, these can be reduced by using techniques derived from cognitive behavioral therapy. Internet-based cognitive behavioral therapy (ICBT) has been developed to provide an accessible intervention. The aim of this study was to describe how ICBT can facilitate tinnitus management by identifying the active ingredients of the intervention from the perspective of health behavior change. Method: The ICBT intervention was evaluated using the Behavior Change Wheel in eight steps across the following three stages: (1) understanding the behavior, (2) identifying intervention options, and (3) identifying content and implementation options. Results: Target behaviors identified to reduce tinnitus distress, as well as additional problems associated with tinnitus, included goal setting, an increased understanding of tinnitus, encouraging deep breathing and progressive muscle relaxation, identifying and restructuring unhelpful thoughts, engaging in positive imagery, and reducing avoidance behaviors. ICBT provided the required components for individuals to be physically and psychologically capable of adapting to tinnitus, providing social and environmental opportunities to manage hearing loss through practice and training, and facilitated automatic and reflective motivation. Conclusion: Understanding ICBT in the context of the Behavior Change Wheel has helped identify how its effectiveness can be improved and can be used for future tinnitus intervention planning.

  • 35.
    Beukes, Eldre W.
    et al.
    Lamar Univ, TX 77710 USA; Anglia Ruskin Univ, England.
    Munzo, Maria F.
    Lamar Univ, TX 77710 USA.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Manipal Acad Higher Educ, India.
    Internet-based cognitive behavioural therapy for tinnitus in Spanish: a global feasibility trial2022In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 61, no 8, p. 632-641Article in journal (Refereed)
    Abstract [en]

    Objective Internet-based cognitive behavioural therapy (ICBT) for tinnitus is an evidence-based intervention, but only available in a few languages. To increase accessibility, ICBT was translated into Spanish. This studys objective was to determine the feasibility of ICBT for Spanish speakers. Design A single-group pre-test post-test design was used. Compliance, engagement, acceptance and outcome feasibility were measured. Study Sample Forty-six Spanish speakers with tinnitus were screened. There were 32 participants meeting the eligibility criteria, with a mean age of 47 (+/- 11) years. Of these 91% were Hispanic or Latino with 66% living in Spain and 34% living in South America. Results Outcome feasibility was established, as a large pre- and post-test within-group effect size of d = 0.90 was found for tinnitus severity. Large pre- and post-test effect sizes were also present for the secondary outcomes of anxiety and depression with a medium effect for insomnia, health-related quality of life, and tinnitus cognitions. Intervention engagement and compliance were not optimal although no participants withdrew. Intervention acceptance rates indicated scope for improvement. Conclusions ICBT for Spanish communities appears to be feasible. A randomised controlled trial is required to further investigate the effects and identify ways of improving engagement and attracting Spanish speakers from different countries.

  • 36.
    Beukes, Eldre Wiida
    et al.
    Anglia Ruskin Univ, England; Univ Colorado, CO 80045 USA; Univ Pretoria, CO 80045 USA.
    Ulep, Alyssa Jade
    Lamar Univ, TX 77705 USA.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Manchaiah, Vinaya
    Univ Colorado, CO 80045 USA; Univ Pretoria, CO 80045 USA; Univ Colorado, CO 80045 USA; Univ Pretoria, South Africa; Acad Higher Educ, India.
    The Effects of Tinnitus on Significant Others2022In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, no 5, article id 1393Article in journal (Refereed)
    Abstract [en]

    Although chronic conditions could cause third-party disability for significant others (SOs), little is known regarding the impact of tinnitus on SO. This study aimed to identify the effects of tinnitus on SOs. SOs of individuals with tinnitus were invited to participate in this study. SOs completed three open-ended questions focusing on the effects of tinnitus. Individuals with tinnitus completed the Tinnitus Functional Index as a self-reported measure of tinnitus severity. A mixed-methods analysis approach was undertaken. Of the 156 SOs responding, 127 (85%) reported that tinnitus impacted them. The impact surrounded sound adjustments, activity limitations, additional demands, emotional toll, and helplessness. Tinnitus negatively affected the relationship for 92 (58%) due to communication frustrations and growing apart. When asked if tinnitus had any positive effects, 64 (47%) SOs reported positive lifestyle adaptions, personal development, health awareness, and a changed outlook. There was no association between the level of tinnitus severity and SOs reporting that tinnitus had an impact on them individually, their relationships, or those reporting positive experiences. The study highlighted the third-party disability many SOs of individuals with tinnitus experience. The results indicate that SOs may benefit from a shared intervention to help mitigate the negative effects through a better understanding of tinnitus.

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  • 37.
    Beukes, Eldré W
    et al.
    Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States; Vision and Hearing Sciences Research Centre, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom.
    Manchaiah, Vinaya
    Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States; Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India.
    Allen, Peter M.
    Vision and Hearing Sciences Research Centre, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom; Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Institute, Stockholm, Sweden.
    Baguley, David M.
    National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Ropewalk House, Nottingham, United Kingdom; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Nottingham Audiology Services, Nottingham University Hospitals, Nottingham, United Kingdom.
    Exploring tinnitus heterogeneity2021In: Tinnitus - an interdisciplinary approach towards individualized treatment: from heterogeneity to personalized medicine / [ed] Winfried Schlee, Berthold Langguth, Tobias Kleinjung, Sven Vanneste, Dirk De Ridder, Amsterdam: Elsevier , 2021, Vol. 260, p. 79-99Chapter in book (Refereed)
    Abstract [en]

    Tinnitus experiences differ widely. A greater understanding of the core processes underlying these variations is needed. Moreover, meaningful definitions for different subgroups are required to better manage this heterogeneous population. The objective of the present research was to contribute toward the understanding of tinnitus heterogeneity by identifying factors that can predict tinnitus severity and to ascertain if distinct subgroups of tinnitus presentation can be identified.

  • 38.
    Bjureberg, Johan
    et al.
    Stanford Univ, CA 94305 USA; Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Ojala, Olivia
    Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Berg, Anton
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Edvardsson, Elin
    Karolinska Inst, Sweden.
    Kolbeinsson, Örn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Molander, Olof
    Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Morin, Evelina
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Nordgren, Line
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Region Östergötland, Psykiatricentrum, Department of Child and Adolescent Psychiatry in Linköping. Linköping University, Faculty of Arts and Sciences.
    Palme, Kristin
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Sarnholm, Josefin
    Karolinska Inst, Sweden.
    Wedin, Leif
    Karolinska Inst, Sweden.
    Ruck, Christian
    Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Gross, James J. J.
    Stanford Univ, CA 94305 USA.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Orebro Univ, Sweden.
    Targeting Maladaptive Anger With Brief Therapist-Supported Internet-Delivered Emotion Regulation Treatments: A Randomized Controlled Trial2023In: Journal of Consulting and Clinical Psychology, ISSN 0022-006X, E-ISSN 1939-2117, Vol. 91, no 5, p. 254-266Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the relative impact of three brief therapist-supported internet-delivered emotion regulation treatments for maladaptive anger (mindful emotion awareness [MEA], cognitive reappraisal [CR], and mindful emotion awareness + cognitive reappraisal [MEA + CR]) and to test whether baseline levels of anger pathology moderate treatment outcome. Method: Treatments were evaluated in a randomized controlled trial. In total, 234 participants (59% female; mean age = 41.1, SD = 11.6) with maladaptive anger were randomized to MEA (n = 78), CR (n = 77), or MEA + CR (n = 79). Self-reported primary and secondary outcomes were followed up at primary endpoint, 3 months after treatment termination (88% retention). Primary outcomes were also assessed weekly during a prolonged baseline phase (4 weeks) and an active treatment phase (4 weeks). Results: At the primary endpoint, the MEA + CR was superior in terms of anger expression (d = 0.27 95% confidence interval, CI [0.03, 0.51]), aggression (d = 0.43 [0.18, 0.68]), and anger rumination (d = 0.41 [0.18, 0.63]). MEA + CR was particularly effective in reducing anger expression (d = 0.66 [0.21, 1.11]), aggression (d = 0.90 [0.42, 1.39]), and anger rumination (d = 0.80 [0.40, 1.20]) for individuals who reported high values (+1SD) of the outcomes at baseline. Conclusions: Brief therapist-supported internet-delivered MEA and CR treatments are effective interventions for maladaptive anger. Combining MEA and CR is especially effective in reducing anger expression and aggression, particularly, in individuals who report higher levels of initial anger pathology. The present study highlights the importance of emotion regulation as an important treatment target for reducing maladaptive anger.

  • 39.
    Boersma, Katja
    et al.
    Orebro Univ, Sweden.
    Södermark, Martin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Flink, Ida K.
    Orebro Univ, Sweden.
    Gerdle, Björn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Linton, Steven J.
    Orebro Univ, Sweden.
    Efficacy of a transdiagnostic emotion-focused exposure treatment for chronic pain patients with comorbid anxiety and depression: a randomized controlled trial2019In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 160, no 8, p. 1708-1718Article in journal (Refereed)
    Abstract [en]

    The comorbidity between chronic pain and emotional problems has proven difficult to address with current treatment options. This study addresses the efficacy of a transdiagnostic emotion-focused exposure treatment ("hybrid") for chronic pain patients with comorbid emotional problems. Adults (n = 115) with chronic musculoskeletal pain and functional and emotional problems were included in a 2-centre, parallel randomized controlled, open-label trial comparing this treatment to an active control condition receiving a guided Internet-delivered pain management treatment based on CBT principles (iCBT). The hybrid treatment (n = 58, 10-16 sessions) integrates exposure in vivo for chronic pain based on the fear-avoidance model with an emotion-regulation approach informed by procedures in Dialectical Behavior Therapy. The iCBT (n = 57; 8 treatment modules) addresses topics such as pain education, coping strategies, relaxation, problem solving, stress, and sleep management using standard CBT techniques. Patient-reported outcomes were assessed before and after treatment as well as at a 9-month primary end point. Across conditions, 78% participants completed post-treatment and 81% follow-up assessment. Intent-to-treat analyses showed that the hybrid had a significantly better post-treatment outcome on pain catastrophizing (d = 0.39) and pain interference (d = 0.63) and significantly better follow-up outcomes on depression (d = 0.43) and pain interference (d = 0.51). There were no differences on anxiety and pain intensity. Observed proportions of clinically significant improvement favoured the hybrid on all but one comparison, but no statistically significant differences were observed. We conclude that the hybrid emotion-focused treatment may be considered an acceptable, credible, and efficacious treatment option for chronic pain patients with comorbid emotional problems.

  • 40.
    Boéthius, Helena
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Saarto, Tiina
    Helsinki Univ Hosp, Finland; Univ Helsinki, Finland.
    Laurell, Goran
    Uppsala Univ, Sweden.
    Farnebo, Lovisa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Makitie, Antti A.
    Univ Helsinki, Finland; Helsinki Univ Hosp, Finland; Univ Helsinki, Finland; Karolinska Inst, Sweden; Karolinska Hosp, Sweden.
    A Nordic survey of the management of palliative care in patients with head and neck cancer2021In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 278, p. 2027-2032Article in journal (Refereed)
    Abstract [en]

    Background The five Nordic countries with a population of 27M people form a rather homogenous region in terms of health care. The management of Head and Neck Cancer (HNC) is centralized to the 21 university hospitals in these countries. Our aim was to survey the current status of organization of palliative care for patients with HNC in the Nordic countries as the field is rapidly developing. Materials and methods A structured web-based questionnaire was sent to all the Departments of Otorhinolaryngology-Head and Neck Surgery and Oncology managing HNC in the Nordic countries. Results All 21 (100%) Nordic university hospitals responded to the survey. A majority (over 90%) of the patients are discussed at diagnosis in a multidisciplinary tumor board (MDT), but the presence of a palliative care specialist is lacking in 95% of these MDTs. The patients have access to specialized palliative care units (n = 14, 67%), teams (n = 10, 48%), and consultants (n = 4, 19%) in the majority of the hospitals. Conclusion The present results show that specialized palliative care services are available at the Nordic university hospitals. A major finding was that the collaboration between head and neck surgeons, oncologists and palliative care specialists is not well structured and the palliative care pathway of patients with HNC is not systematically organized. We suggest that early integrated palliative care needs to be included as an addition to the already existing HNC care pathways in the Nordic countries.

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  • 41.
    Bruneau, Jonas
    et al.
    Kristianstad Hosp, Sweden.
    Talani, Charbél
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Nilsson, Johan S.
    Skane Univ Hosp, Sweden; Lund Univ, Sweden.
    Exstirpation of symptomatic lingual thyroid with transoral robotic surgery (TORS): A promising novel treatment option2022In: ACTA OTO-LARYNGOLOGICA CASE REPORTS, ISSN 2377-2484, Vol. 7, no 1, p. 48-51Article in journal (Refereed)
    Abstract [en]

    Ectopic thyroid is a rare condition most often found at the base of the tongue, lingual thyroid (LT). The majority of patients are asymptomatic. Recently, transoral robotic surgery (TORS) has emerged as an option for definitive treatment. Here, we present a 20-year-old patient with symptomatic LT, treated with TORS-assisted surgery without adverse events and with depletion of symptoms. We advocate TORS as a very promising means to be considered when encountering the rare condition of symptomatic LT.

  • 42.
    Budimir, Sanja
    et al.
    Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria.
    Kuska, Martin
    Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria.
    Spiliopoulou, Myra
    Knowledge Management & Discovery Lab, Faculty of Computer Science, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
    Schlee, Winfried
    Department of Psychiatry and Psychotherapy, Regensburg University, Regensburg, Germany.
    Pryss, Rüdiger
    Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Department of Clinical Neuroscience, Karolinska Institute , Stockholm , Sweden.
    Goedhart, Hazel
    Tinnitus Hub, London, United Kingdom.
    Harrison, Stephen
    Tinnitus Hub, London, United Kingdom.
    Vesala, Markku
    Tinnitus Hub, London, United Kingdom.
    Hegde, Gourish
    Knowledge Management & Discovery Lab, Faculty of Computer Science, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
    Langguth, Berthold
    Department of Psychiatry and Psychotherapy, Regensburg University, Regensburg, Germany.
    Pieh, Christoph
    Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria.
    Probst, Thomas
    Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria.
    Reasons for Discontinuing Active Participation on the Internet Forum Tinnitus Talk: Mixed Methods Citizen Science Study2021In: JMIR Formative Research, E-ISSN 2561-326X, Vol. 5, no 4, article id e21444Article in journal (Refereed)
    Abstract [en]

    Background: Tinnitus Talk is a nonprofit online self-help forum. Asking inactive users about their reasons for discontinued usage of health-related online platforms such as Tinnitus Talk is important for quality assurance. Objective: The aim of this study was to explore reasons for discontinued use of Tinnitus Talk, and their associations to the perceptions of Tinnitus Talk and the age of users who ceased logging on to the platform. Methods: Initially, 13,745 users that did not use Tinnitus Talk within the previous 2 months were contacted and the response rate was 20.47% (n=2814). After dataset filtering, a total of 2172 past members of Tinnitus Talk were included in the analyses. Nine predefined reasons for discontinued usage of Tinnitus Talk were included in the survey as well as one open question. Moreover, there were 14 predefined questions focusing on perception of Tinnitus Talk (usefulness, content, community, and quality of members' posts). Mixed methods analyses were performed. Frequencies and correlation coefficients were calculated for quantitative data, and grounded theory methodology was utilized for exploration of the qualitative data. Results: Quantitative analysis revealed reasons for discontinued use of Tinnitus Talk as well as associations of these reasons with perceptions of Tinnitus Talk and age. Among the eight predefined reasons for discontinued use of Tinnitus Talk, the most frequently reported was not finding the information they were looking for (451/2695, 16.7%). Overall, the highest rated perception of Tinnitus Talk was content-related ease of understanding (mean 3.9, SD 0.64). A high number (nearly 40%) of participants provided additional free text explaining why they discontinued use. Qualitative analyses identified a total of 1654 specific reasons, more than 93% of which (n=1544) could be inductively coded. The coding system consisted of 33 thematically labeled codes clustered into 10 categories. The most frequent additional reason for discontinuing use was thinking that there is no cure or help for tinnitus symptoms (375/1544, 24.3%). Significant correlations (P<.001) were observed between reasons for discontinued usage and perception of Tinnitus Talk. Several reasons for discontinued usage were associated with the examined dimensions of perception of Tinnitus Talk (usefulness, content, community, as well as quality of members' posts). Moreover, significant correlations (P<.001) between age and reasons for discontinued use were found. Older age was associated with no longer using Tinnitus Talk because of not finding what they were looking for. In addition, older participants had a generally less positive perception of Tinnitus Talk than younger participants (P<.001). Conclusions: This study contributes to understanding the reasons for discontinued usage of online self-help platforms, which are typically only reported according to the dropout rates. Furthermore, specific groups of users who did not benefit from Tinnitus Talk were identified, and several practical implications for improvement of the structure, content, and goals of Tinnitus Talk were suggested. 

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  • 43.
    Carlbring, Per
    et al.
    Stockholm Univ, Sweden.
    Hadjistavropoulos, Heather
    Univ Regina, Canada.
    Kleiboer, Annet
    Vrije Univ Amsterdam, Netherlands.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    A new era in Internet interventions: The advent of Chat-GPT and AI-assisted therapist guidance2023In: Internet Interventions, ISSN 2214-7829, Vol. 32, article id 100621Article in journal (Other academic)
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  • 44.
    Cawthorne, Tom
    et al.
    Royal Holloway Univ London, England; Camden & Islington NHS Fdn Trust, England.
    Käll, Anton
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Bennett, Sophie
    UCL Great Ormond St Inst Child Hlth, England.
    Baker, Elena
    Kent & Medway NHS & Social Care Partnership Trust, England.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Shafran, Roz
    UCL Great Ormond St Inst Child Hlth, England.
    The development and preliminary evaluation of Cognitive Behavioural Therapy (CBT) for Chronic Loneliness in Young People.2023In: Behavioural and Cognitive Psychotherapy, ISSN 1352-4658, E-ISSN 1469-1833, Vol. 51, no 5, p. 414-431, article id PII S1352465823000231Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Approximately 10% of young people 'often' feel lonely, with loneliness being predictive of multiple physical and mental health problems. Research has found CBT to be effective for reducing loneliness in adults, but interventions for young people who report loneliness as their primary difficulty are lacking.

    METHOD: CBT for Chronic Loneliness in Young People was developed as a modular intervention. This was evaluated in a single-case experimental design (SCED) with seven participants aged 11-18 years. The primary outcome was self-reported loneliness on the Three-Item Loneliness Scale. Secondary outcomes were self-reported loneliness on the UCLA-LS-3, and self- and parent-reported RCADS and SDQ impact scores. Feasibility and participant satisfaction were also assessed.

    RESULTS: At post-intervention, there was a 66.41% reduction in loneliness, with all seven participants reporting a significant reduction on the primary outcome measure (p < .001). There was also a reduction on the UCLA-LS-3 of a large effect (d = 1.53). Reductions of a large effect size were also found for parent-reported total RCADS (d = 2.19) and SDQ impact scores (d = 2.15) and self-reported total RCADS scores (d = 1.81), with a small reduction in self-reported SDQ impact scores (d = 0.41). Participants reported high levels of satisfaction, with the protocol being feasible and acceptable.

    CONCLUSIONS: We conclude that CBT for Chronic Loneliness in Young People may be an effective intervention for reducing loneliness and co-occurring mental health difficulties in young people. The intervention should now be evaluated further through a randomised controlled trial (RCT).

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  • 45.
    De Ridder, Dirk
    et al.
    Univ Otago, New Zealand.
    Schlee, Winfried
    Univ Regensburg, Germany.
    Vanneste, Sven
    Trinity Coll Dublin, Ireland.
    Londero, Alain
    Hop Europeen Georges Pompidou, France.
    Weisz, Nathan
    Salzburg Univ, Austria.
    Kleinjung, Tobias
    Univ Zurich, Switzerland.
    Shekhawat, Giriraj Singh
    Flinders Univ S Australia, Australia; UCL, England; Tinnitus Res Initiat, Germany.
    Elgoyhen, Ana Belen
    Inst Invest Ingn Genet & Biol Mol Dr Hector N Tor, Argentina.
    Song, Jae-Jin
    Seoul Natl Univ, South Korea.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Adhia, Divya
    Univ Otago, New Zealand.
    de Azevedo, Andreia Aparecida
    OTOSUL, Brazil.
    Baguley, David M.
    Univ Nottingham, England; Nottingham Univ Hosp NHS Trust, England.
    Biesinger, Eberhard
    Ctr Otorhinolaryngol, Germany.
    Carolina Binetti, Ana
    Buenos Aires British Hosp, Argentina.
    Del Bo, Luca
    Del Bo Tecnol Ascolto Srl, Italy.
    Cederroth, Christopher R.
    Nottingham Univ Hosp NHS Trust, England; Univ Nottingham, England; Karolinska Inst, Sweden.
    Cima, Rilana
    Maastricht Univ, Netherlands; Katholieke Univ Leuven, Belgium; Adelante, Netherlands.
    Eggermont, Jos J.
    Univ Calgary, Canada.
    Figueiredo, Ricardo
    Ctr Univ Valenca, Brazil; OTOSUL, Brazil.
    Fuller, Thomas E.
    Maastricht Univ, Netherlands; Medtronic, Netherlands.
    Gallus, Silvano
    Ist Ric Farmacol Mario Negri IRCCS, Italy.
    Gilles, Annick
    Antwerp Univ Hosp, Belgium; Antwerp Univ, Belgium.
    Hall, Deborah A.
    Univ Nottingham, England; Univ Nottingham, England; Nottingham Univ Hosp NHS Trust, England; Univ Nottingham Malaysia, Malaysia.
    Van de Heyning, Paul
    Univ Antwerp, Belgium.
    Hoare, Derek J.
    Univ Nottingham, England.
    Khedr, Eman M.
    Assiut Univ Hosp, Egypt.
    Kikidis, Dimitris
    Natl & Kapodistrian Univ Athens, Greece.
    Kleinstaeuber, Maria
    Univ Otago, New Zealand.
    Kreuzer, Peter M.
    Univ Regensburg, Germany.
    Lai, Jen-Tsung
    Kuang Tien Gen Hosp, Taiwan.
    Lainez, Jose Miguel
    Catholic Univ Valencia, Spain.
    Landgrebe, Michael
    Kbo Lech Mangfall Kliniken Agatharied, Germany.
    Li, Lieber Po-Hung
    Cheng Hsin Gen Hosp, Taiwan.
    Lim, Hubert H.
    Univ Minnesota, MN 55455 USA.
    Liu, Tien-Chen
    Natl Taiwan Univ, Taiwan.
    Lopez-Escamez, Jose Antonio
    Univ Granada, Spain; Hosp Univ Virgen de la as Nieves, Spain; Univ Granada, Spain.
    Mazurek, Birgit
    Charite Univ Med Berlin, Germany.
    Moller, Aage R.
    Univ Texas Dallas, TX USA.
    Neff, Patrick
    Univ Zurich, Switzerland.
    Pantev, Christo
    Univ Munster, Germany.
    Park, Shi Nae
    Catholic Univ Korea, South Korea.
    Piccirillo, Jay F.
    Washington Univ, MO USA.
    Poeppl, Timm B.
    Rhein Westfal TH Aachen, Germany.
    Rauschecker, Josef P.
    Georgetown Univ, DC USA; TUM, Germany; TUM, Germany.
    Salvi, Richard
    SUNY Buffalo, NY USA.
    Sanchez, Tanit Ganz
    Univ Sao Paulo, Brazil; Inst Ganz Sanchez, Brazil.
    Schecklmann, Martin
    Univ Regensburg, Germany.
    Schiller, Axel
    Univ Regensburg, Germany.
    Searchfield, Grant D.
    Univ Auckland, New Zealand; Univ Auckland, New Zealand; Univ Auckland, New Zealand.
    Tyler, Richard
    Dept Otolaryngol Head & Neck Surg, IA USA.
    Vielsmeier, Veronika
    Univ Regensburg, Germany.
    Vlaeyen, Johan W. S.
    Katholieke Univ Leuven, Belgium; Maastricht Univ, Netherlands.
    Zhang, Jinsheng
    Wayne State Univ, MI 48201 USA.
    Zheng, Yiwen
    Univ Otago, New Zealand.
    de Nora, Matteo
    Tinnitus Res Initiat, Germany.
    Langguth, Berthold
    Univ Regensburg, Germany.
    Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal)2021In: TINNITUS - AN INTERDISCIPLINARY APPROACH TOWARDS INDIVIDUALIZED TREATMENT: FROM HETEROGENEITY TO PERSONALIZED MEDICINE, Vol. 260Article, review/survey (Refereed)
    Abstract [en]

    As for hypertension, chronic pain, epilepsy and other disorders with particular symptoms, a commonly accepted and unambiguous definition provides a common ground for researchers and clinicians to study and treat the problem. The WHOs ICD11 definition only mentions tinnitus as a nonspecific symptom of a hearing disorder, but not as a clinical entity in its own right, and the American Psychiatric Associations DSM-V doesnt mention tinnitus at all. Here we propose that the tinnitus without and with associated suffering should be differentiated by distinct terms: "Tinnitus" for the former and "Tinnitus Disorder" for the latter. The proposed definition then becomes "Tinnitus is the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source, which becomes Tinnitus Disorder "when associated with emotional distress, cognitive dysfunction, and/or autonomic arousal, leading to behavioural changes and functional disability.". In other words "Tinnitus" describes the auditory or sensory component, whereas "Tinnitus Disorder" reflects the auditory component and the associated suffering. Whereas acute tinnitus may be a symptom secondary to a trauma or disease, chronic tinnitus may be considered a primary disorder in its own right. If adopted, this will advance the recognition of tinnitus disorder as a primary health condition in its own right. The capacity to measure the incidence, prevalence, and impact will help in identification of human, financial, and educational needs required to address acute tinnitus as a symptom but chronic tinnitus as a disorder.

  • 46.
    Demetry, Youstina
    et al.
    Karolinska Inst, Sweden; Karolinska Inst, Sweden.
    Wasteson, Elisabet
    Mid Sweden Univ, Sweden.
    Lindegaard, Tomas
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Abuleil, Amjad
    Competence Team migrat Hlth, Sweden.
    Geranmayeh, Anahita
    Karolinska Inst, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Shahnavaz, Shervin
    Karolinska Inst, Sweden.
    Individually Tailored and Culturally Adapted Internet-Based Cognitive Behavioral Therapy for Arabic-Speaking Youths With Mental Health Problems in Sweden: Qualitative Feasibility Study2023In: JMIR Formative Research, E-ISSN 2561-326X, Vol. 7, article id e46253Article in journal (Refereed)
    Abstract [en]

    Background: Most forcibly displaced refugees in Sweden originate from the Arab Republic of Syria and Iraq. Approximately half of all refugees are aged between 15 and 26 years. This particular group of youths is at a higher risk for developing various mental disorders. However, low use of mental health services across Europe has been reported. Previous research indicates that culturally adapted psychological interventions may be suitable for refugee youths. However, little is known about the feasibility, acceptability, and efficacy of such psychological interventions. Objective: This study aimed to explore the feasibility, acceptability, and preliminary efficacy of an individually tailored and culturally adapted internet-based cognitive behavioral therapy for Arabic-speaking refugees and immigrant youths in Sweden. Methods: A total of 17 participants were included to participate in an open trial study of an individually tailored and culturally adapted internet-based cognitive behavioral therapy targeting common mental health problems. To assess the intervention outcome, the Hopkins Symptom Checklist was used. To explore the acceptability of the intervention, in-depth interviews were conducted with 12 participants using thematic analysis. Feasibility was assessed by measuring treatment adherence and by calculating recruitment and retention rates. Results: The intervention had a high dropout rate and low feasibility. Quantitative analyses of the treatment efficacy were not possible because of the high dropout rate. The qualitative analysis resulted in 3 overarching categories: experiences with SahaUng (the treatment), attitudes toward psychological interventions, and personal factors important for adherence. Conclusions: The findings from this study indicate that the feasibility and acceptability of the current intervention were low and, based on the qualitative analysis, could be increased by a refinement of recruitment strategies, further simplification of the treatment content, and modifications to the cultural adaptation.

  • 47.
    Drakskog, Cecilia
    et al.
    The Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm.
    de Klerk, Nele
    The Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm.
    Westerberg, Johanna
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Mäki-Torkko, Elina
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Faculty of Medicine and Health, Örebro University.
    Georén, Susanna Kumlien
    The Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm.
    Cardell, Lars Olaf
    The Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm; Department of ENT Diseases, Karolinska University Hospital, Stockholm.
    Extensive qPCR analysis reveals altered gene expression in middle ear mucosa from cholesteatoma patients2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 9, article id e0239161Article in journal (Refereed)
    Abstract [en]

    The middle ear is a small and hard to reach compartment, limiting the amount of tissue that can be extracted and the possibilities for studying the molecular mechanisms behind diseases like cholesteatoma. In this paper 14 reference gene candidates were evaluated in the middle ear mucosa of cholesteatoma patients and two different control tissues. ACTB and GAPDH were shown to be the optimal genes for the normalisation of target gene expression when investigating middle ear mucosa in multiplex qPCR analysis. Validation of reference genes using c-MYC expression confirmed the suitability of ACTB and GAPDH as reference genes and showed an upregulation of c-MYC in middle ear mucosa during cholesteatoma. The occurrence of participants of the innate immunity, TLR2 and TLR4, were analysed in order to compare healthy middle ear mucosa to cholesteatoma. Analysis of TLR2 and TLR4 showed variable results depending on control tissue used, highlighting the importance of selecting relevant control tissue when investigating causes for disease. It is our belief that a consensus regarding reference genes and control tissue will contribute to the comparability and reproducibility of studies within the field.

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  • 48.
    Dumarkaite, Austeja
    et al.
    Vilnius Univ, Lithuania; Vilnius Univ, Lithuania.
    Truskauskaite, Inga
    Vilnius Univ, Lithuania.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Jovarauskaite, Lina
    Vilnius Univ, Lithuania.
    Jovaisiene, Ieva
    Vilnius Univ, Lithuania.
    Nomeikaite, Auguste
    Vilnius Univ, Lithuania.
    Kazlauskas, Evaldas
    Vilnius Univ, Lithuania.
    The efficacy of the internet-based stress recovery intervention FOREST for nurses amid the COVID-19 pandemic: A randomized controlled trial2023In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 138, article id 104408Article in journal (Refereed)
    Abstract [en]

    Background: The COVID-19 pandemic demanded exceptional physical and mental effort from healthcare workers worldwide. Since healthcare workers often refrain from seeking professional psychological support, internet-delivered interventions could serve as a viable alternative option.Objective: We aimed to investigate the effects of a therapist-guided six-week CBT-based internet-delivered stress recovery intervention among medical nurses using a randomized controlled trial design. We also aimed to assess program usability.Methods: 168 nurses working in a healthcare setting (Mage = 42.12, SDage = 11.38; 97 % female) were included in the study. The intervention group included 77 participants, and the waiting list control group had 91 participants. Self-report data were collected online at three timepoints: pre-test, post-test, and three-month follow-up. The primary outcome was stress recovery. Secondary outcomes included measures of perceived stress, anxiety and depression symptoms, psychological well-being, posttraumatic stress and complex posttraumatic stress symp-toms, and moral injury.Results: We found that the stress recovery intervention FOREST improved stress recovery, including psychologi-cal detachment (d = 0.83 [0.52; 1.15]), relaxation (d = 0.93 [0.61, 1.25]), mastery (d = 0.64 [0.33; 0.95]), and control (d = 0.46 [0.15; 0.76]). The effects on psychological detachment, relaxation, and mastery remained stable at the three month follow-up. The intervention was also effective in reducing its users stress (d = -0.49 [-0.80;-0.18]), anxiety symptoms (d = -0.31 [-0.62;-0.01]), depression symptoms (d = -0.49 [-0.80;-0.18]) and increasing psychological well-being (d = 0.53 [0.23; 0.84]) with the effects on perceived stress, depression symptoms, and well-being remaining stable at the three-month follow-up. High user satisfac-tion and good usability of the intervention were also reported.Conclusions: The present study demonstrated that an internet-bas ed intervention for healthcare staff could increase stress recovery skills, promote psychological well-being, and reduce stress, anxiety, and depression symptoms, with most of the effects being stable over three months.Trial registration: NCT04817995 (https://clinicaltrials.gov/ct2/show/NCT04817995). Registration date: March 30, 2021. Date of first recruitment: April 1, 2021.(c) 2022 Elsevier Ltd. All rights reserved.

  • 49.
    Eimontas, Jonas
    et al.
    Vilnius Univ, Lithuania.
    Gegieckaite, Goda
    Vilnius Univ, Lithuania.
    Asaciova, Irena
    Vilnius Univ, Lithuania.
    Sticinskaite, Nikol
    Vilnius Univ, Lithuania.
    Arcimaviciute, Livija
    Vilnius Univ, Lithuania.
    Savickaite, Dovile
    Vilnius Univ, Lithuania.
    Vaitiekunaite-Zubriakoviene, Donata
    Vilnius Univ, Lithuania; Vilnius Univ Hosp Santaros Klin, Lithuania.
    Polianskis, Marius
    Vilnius Univ, Lithuania.
    Gans, Jennifer
    Mindfulness Based Tinnitus Stress Reduct MBTSR, CA USA.
    Beukes, Eldre
    Anglia Ruskin Univ, England; Collaborat Initiat Univ Colorado Sch Med & Univ Pr, CO USA.
    Manchaiah, Vinaya
    Collaborat Initiat Univ Colorado Sch Med & Univ Pr, CO USA; Univ Colorado, CO USA; Univ Colorado Hosp, CO USA; Univ Pretoria, South Africa; Univ Pretoria, South Africa; Manipal Acad Higher Educ, India.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Lesinskas, Eugenijus
    Vilnius Univ, Lithuania.
    Internet-delivered cognitive behavioral therapy for tinnitus compared to Internet-delivered mindfulness for tinnitus: a study protocol of a randomized controlled trial2023In: Trials, E-ISSN 1745-6215, Vol. 24, no 1, article id 269Article in journal (Refereed)
    Abstract [en]

    BackgroundTinnitus affects around 15% of the population and can be a debilitating condition for a sizeable part of them. However, effective evidence-based treatments are scarce. One recommended treatment for tinnitus is cognitive behavioral therapy which has been found to be effective when delivered online. However, more treatments including mindfulness-based interventions have been studied recently in an attempt to facilitate the availability of effective treatments. There are promising findings showing great effects in reducing tinnitus-induced distress and some evidence about the efficacy of such intervention delivered online. However, there is a lack of evidence on how these two treatments compare against one another. Therefore, the aim of this study will be to compare Internet-delivered cognitive behavioral therapy for tinnitus against an Internet-delivered mindfulness-based tinnitus stress reduction intervention in a three-armed randomized controlled trial with a waiting list control condition.MethodsThis study will be a randomized controlled trial seeking to recruit Lithuanian-speaking individuals suffering from chronic tinnitus. The self-report measure Tinnitus Handicap Inventory will be used. Self-referred participants will be randomized into one of three study arms: Internet-delivered cognitive behavioral therapy, Internet-delivered mindfulness-based tinnitus stress reduction intervention, or a waiting-list control group. Post-treatment measures will be taken at the end of the 8-week-long intervention (or waiting). Long-term efficacy will be measured 3 and 12 months post-treatment.DiscussionInternet-delivered interventions offer a range of benefits for delivering evidence-based treatments. This is the first randomized controlled trial to directly compare Internet-delivered CBT and MBTSR for tinnitus in a non-inferiority trial.

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  • 50.
    Fischer, Vinicius Jobim
    et al.
    Univ Luxembourg, Luxembourg.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Billieux, Joel
    Univ Lausanne, Switzerland.
    Infanti, Alexandre
    Univ Luxembourg, Luxembourg.
    Vogele, Claus
    Univ Luxembourg, Luxembourg.
    The Role of Emotion Regulation Strategies for Sexual Function and Mental Health: A Cluster Analytical Approach2023In: Journal of sex & marital therapy, ISSN 0092-623X, E-ISSN 1521-0715Article in journal (Refereed)
    Abstract [en]

    We investigated distinct profiles in emotion regulation strategies (reappraisal and suppression) and their associations with sexual function and mental health. The online survey sample consisted of 5436 adult participants. The gender stratified cluster analysis resulted in a four-cluster solution for both men and women. Better sexual function and mental health scores were found for participants with high cognitive reappraisal and low expressive suppression. High expressive suppression was associated with higher anxiety and depression and worse sexual function. Sexological care should take into account the assessment of emotion regulation abilities and emotion regulation training interventions to support reappraisal strategies.

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