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  • 1.
    Aspeqvist, Erik
    et al.
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten.
    Andersson, Hedvig
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten.
    Korhonen, Laura
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för barnafrid.
    Dahlström, Örjan
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Measurement and stratification of nonsuicidal self-injury in adolescents2024Ingår i: BMC Psychiatry, E-ISSN 1471-244X, Vol. 24, nr 1, artikel-id 107Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundNonsuicidal self-injury (NSSI) is highly prevalent in adolescents. In survey and interview studies assessing NSSI, methods of assessment have been shown to influence prevalence estimates. However, knowledge of which groups of adolescents that are identified with different measurement methods is lacking, and the characteristics of identified groups are yet to be investigated. Further, only a handful of studies have been carried out using exploratory methods to identify subgroups among adolescents with NSSI.MethodsThe performance of two prevalence measures (single-item vs. behavioral checklist) in the same cross-sectional community sample (n = 266, age M = 14.21, 58.3% female) of adolescents was compared regarding prevalence estimates and also characterization of the identified groups with lifetime NSSI prevalence. A cluster analysis was carried out in the same sample. Identified clusters were compared to the two groups defined using the prevalence measures.ResultsA total of 118 (44.4%) participants acknowledged having engaged in NSSI at least once. Of these, a group of 55 (20.7%) adolescents confirmed NSSI on a single item and 63 (23.7%) adolescents confirmed NSSI only on a behavioral checklist, while denying NSSI on the single item. Groups differed significantly, with the single-item group being more severely affected and having higher mean scores on difficulties in emotion regulation, self-criticism, number of methods, higher frequency of NSSI, higher rates of suicidal ideation and suicidal behavior and lower mean score on health-related quality of life. All cases with higher severity were not identified by the single-item question. Cluster analysis identified three clusters, two of which fit well with the groups identified by single-item and behavioral checklist measures.ConclusionsWhen investigating NSSI prevalence in adolescents, findings are influenced by the researchers' choice of measures. The present study provides some directions toward what kind of influence to expect given the type of measure used, both with regards to the size of the identified group and its composition. Implications for future research as well as clinical and preventive work are discussed.

  • 2.
    Berg, Matilda
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Rozental, Alexander
    Karolinska Inst, Sweden; UCL, England.
    de Brun Mangs, Josefine
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Näsman, Maja
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Strömberg, Karin
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Viberg, Linn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Wallner, Erik
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Åhman, Hanna
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Silfvernagel, Kristin
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Topooco, Naira
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Ctr M2Hlth, CA USA.
    Johansson Capusan, Andrea
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Linköping.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. UCL, England.
    The Role of Learning Support and Chat-Sessions in Guided Internet-Based Cognitive Behavioral Therapy for Adolescents With Anxiety: A Factorial Design Study2020Ingår i: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 11, artikel-id 503Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Increased awareness of anxiety in adolescents emphasises the need for effective interventions. Internet-based cognitive behavioural therapy (ICBT) could be a resource-effective and evidence-based treatment option, but little is known about how to optimize ICBT or which factors boost outcomes. Recently, the role of knowledge in psychotherapy has received increased focus. Further, chat-sessions are of interest when trying to optimize ICBT for youths. This study aimed to evaluate the role of learning support and chat-sessions during ICBT for adolescent anxiety, using a factorial design. Method A total of 120 adolescents were randomised to one of four treatment groups, in a 2x2 design with two factors: with or without learning support and/or chat-sessions. Results Anxiety and depressive symptoms were reduced (Beck Anxiety Inventory- BAI; Cohensd=0.72; Beck Depression Inventory- BDI;d=0.97). There was a main effect of learning support on BAI (d=0.38), and learning support increased knowledge gain (d =0.42). There were no main effects or interactions related to the chat-sessions. Treatment effects were maintained at 6-months, but the added effect of learning support had by then vanished. Conclusion ICBT can be an effective alternative when treating adolescents with anxiety. Learning support could be of importance to enhance short-term treatment effects, and should be investigated further.

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  • 3.
    Dahlström, Örjan
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Filosofiska fakulteten.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Lundh, Lars-Gunnar
    Department of Psychology, Lund University, Lund, Sweden..
    Svedin, Carl Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Functions of Nonsuicidal Self-Injury: Exploratory and Confirmatory Factor Analyses in a Large Community Sample of Adolescents2015Ingår i: Psychological Assessment, ISSN 1040-3590, E-ISSN 1939-134X, Vol. 27, nr 1, s. 302-313Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Given that nonsuicidal self-injury (NSSI) is prevalent in adolescents, structured assessment is an essential tool to guide treatment interventions. The Functional Assessment of Self-Mutilation (FASM) is a self-report scale that assesses frequency, methods, and functions of NSSI. FASM was administered to 3,097 Swedish adolescents in a community sample. With the aim of examining the underlying factor structure of the functions of FASM in this sample, the adolescents with NSSI who completed all function items (n = 836) were randomly divided into 2 subsamples for cross-validation purposes. An exploratory factor analysis (EFA) was followed by a confirmatory factor analysis (CFA) using the mean and variance adjusted weighted least squares (WLSMV) estimator in the Mplus statistical modeling program. The results of the EFA suggested a 3-factor model (social influence, automatic functions, and nonconformist peer identification), which was supported by a good fit in the CFA. Factors differentiated between social/interpersonal and automatic/intrapersonal functions. Based on learning theory and the specific concepts of negative and positive reinforcement, the nonconformist peer identification factor was then split into 2 factors (peer identification and avoiding demands). The resulting 4-factor model showed an excellent fit. Dividing social functions into separate factors (social influence, peer identification, and avoiding demands) can be helpful in clinical practice, where the assessment of NSSI functions is an important tool with direct implications for treatment.

  • 4.
    Holmqvist Larsson, Kristina
    et al.
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Inst, Sweden.
    Stern, Helene
    Psykologhalsan, Linkoping, Sweden.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Emotion regulation group skills training for adolescents and parents: A pilot study of an add-on treatment in a clinical setting2020Ingår i: Clinical Child Psychology and Psychiatry, ISSN 1359-1045, E-ISSN 1461-7021, Vol. 25, nr 1, s. 141-155Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Difficulties with emotion regulation have been identified as an underlying mechanism in mental health. This pilot study aimed at examining whether group skills training in emotion regulation for adolescents and parents as an add-on intervention was feasible in an outpatient child and adolescent psychiatric clinic. We also investigated if the treatment increased knowledge and awareness of emotions and their functions, increased emotion regulation skills and decreased self-reported symptoms of anxiety and depression. Six skills training groups were piloted with a total of 20 adolescents and 21 adults. The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired-samples t test was used to compare differences between before-and-after measures for adolescents and parents separately. The primary outcome measure, Difficulties in Emotion Regulation Scale, showed significant improvement after treatment for both adolescents and parents. For adolescents, measures of alexithymia were significantly reduced. Also, emotional awareness was significantly increased. Measures of depression and anxiety did not change. In conclusion, group skills training as an add-on treatment can be feasible and effective but further studies are needed.

  • 5.
    Holmqvist Larsson, Kristina
    et al.
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Lowen, Anna
    Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Hellerstedt, Linda
    Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Bergcrona, Linn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Salerud, Mimmi
    Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Emotion regulation group skills training: a pilot study of an add-on treatment for eating disorders in a clinical setting2020Ingår i: Journal of Eating Disorders, E-ISSN 2050-2974, Vol. 8, nr 1, artikel-id 12Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Emotion regulation difficulties appear to play a role in the development and maintenance of several eating disorders. This pilot study aimed at examining whether a short add-on group skills training in emotion regulation for young adults with different eating disorders was feasible in a psychiatric clinical setting. We also investigated if the treatment increased knowledge of emotions, and decreased self-reported difficulties with emotion regulation, alexithymia, symptoms of eating disorder, anxiety and depression, as well as clinical impairment. Methods Six skills training groups were piloted with a total of 29 participants (M = 21.41 years, SD = 1.92). The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired samples t-test was used to compare differences between before-and-after measures. Results The primary outcomes measures difficulties in emotion regulation (p < 0.001) and alexithymia (p < 0.001) showed significant improvement after treatment. The total eating disorder score (p = 0.009) was also significantly reduced, as was clinical impairment (p < 0.001). Acceptance/valued direction, identifying primary emotions and learning about secondary emotions was rated as especially helpful. Conclusions This preliminary pilot study showed that group training targeting emotion regulation skills was feasible and appreciated by participants, as well as being potentially promising as an adjunctive treatment for different eating disorders. Further controlled studies are needed.

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  • 6.
    Jonsson, Linda
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Barnafrid. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Svedin, Carl Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Barnafrid. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Pribe, Gisela
    Department of Psychology, IKV, Lund University, Lund, Sweden.
    Fredlund, Cecilia
    Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten.
    Wadsby, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Similarities and differences in the functions of nonsuicidal self-injury (NSSI) and sex as self-injury (SASI)2019Ingår i: Journal of Suicide and Life-threatening Behaviour, ISSN 0363-0234, E-ISSN 1943-278X, nr 1, s. 120-136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Differences and similarities were studied in the functions of two different self-injurious behaviors (SIB): nonsuicidal self-injury (NSSI) and sex as self-injury (SASI). Based on type of SIB reported, adolescents were classified in one of three groups: NSSI only (n = 910), SASI only (n = 41), and both NSSI and SASI (n = 76). There was support for functional equivalence in the two forms of SIB, with automatic functions being most commonly endorsed in all three groups. There were also functional differences, with adolescents in the SASI only group reporting more social influence functions than those with NSSI only. Adolescents reporting both NSSI and SASI endorsed the highest number of functions for both behaviors. Clinical implications are discussed, emphasizing the need for emotion regulation skills.

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  • 7.
    Lundgren, Charlotte
    et al.
    Linköpings universitet, Institutionen för kultur och kommunikation, Avdelningen för svenska och litteratur. Linköpings universitet, Filosofiska fakulteten.
    Zetterqvist Carlsson, Mari
    MZ Equitation, Sweden.
    “And now the ancle a bit further back”: Interaction analyses of trainers and riders work with horse-rider communication in dressage training2014Ingår i: CONFERENCE PROCEEDINGS 10TH INTERNATIONAL EQUITATION SCIENCE CONFERENCE, DCA - Danish Centre for Food and Agriculture , 2014Konferensbidrag (Refereegranskat)
    Abstract [en]

    In the equestrian sports we agree that the communication between horse and rider forms the core of good riding. This communication is therefore often the main focus of for instance a dressage training session. However, in-depth analyses of how the communication between horse and rider is used as an educational resource in training are scarce. Here, theories and methods from communication and learning science are brought together to show how trainers and riders together address this communication during intermediate level dressage training. The results presented are based on a qualitative, mixed methods study, combining interactional analyses of 15 hrs of video recordings of dressage trainings and phenomenographic analysis of interviews with the participants. Analyses of the interviews show the complexity of these learning situations: the foci of the training sessions vary depending on the riders’ and the horses’ condition and the goals set up by the human participants as well as on the experience of the horse and the rider. Regardless of the didactical focus (on training the rider, training the rider to train the horse or training the horse) and the scope of the training session, the analyses of the video recordings show how all trainers orient towards the horse-rider interaction in essentially the same three ways. The trainers give verbal instructions aimed at modifying the horse-rider communication, they use their own bodies as models and they intervene physically by for instance altering the posture of the rider, the position of parts of the rider’s body or showing the correct degree of pressure to be applied in a certain situation (and combinations of the above). However, trainers do not always set the agenda for the discussions. When given the opportunity, many riders participate actively the discussions. During the presentation, extracts from the video material will be used as illustrations of these findings. By enlightening the complex interaction between the participants as well as the interaction’s intrinsic connections to the goals of the training, it becomes possible to discuss (and further develop) the communication in the horse-rider-trainer triad within both the equestrian and the scientific communities.

  • 8.
    Perini, Irene
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten.
    Gustafsson, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Hamilton, Paul
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten.
    Kämpe, Robin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Heilig, Markus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Psykiatriska kliniken.
    The salience of self, not social pain, is encoded by dorsal anterior cingulate and insula2018Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 8, artikel-id 6165Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The human neural correlates of social rejection have attracted significant research interest, but remain subject to vigorous debate. Specifically, it has been proposed that a matrix of brain regions overlapping with the classical pain matrix, and including the dorsal anterior cingulate cortex (dACC) and the anterior insular cortex (AI) is critical for processing of social rejection. The present study expands on this conceptualization, by showing that these areas are involved in processing of self-relevant social evaluation, irrespective of valence. Forty healthy adolescents (N = 20 females) were tested in a magnetic resonance imaging (MRI) scanner. We used a novel paradigm that balanced participants experience of rejection and acceptance. In addition, the paradigm also controlled for whether the social judgment was towards the participants or towards other fictitious players. By creating a "self" and "other" distinction, we show that right AI and dACC are involved in processing the salience of being judged by others, irrespective of the quality of this judgment. This finding supports the idea that these regions are not specific to social rejection or even to pain or metaphorically painful experiences, but activate to self-relevant, highly salient information.

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  • 9.
    Topooco, Naira
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Berg, Matilda
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Johansson, Sofie
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Liljethörn, Lina
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Radvogin, Ella
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Vlaescu, George
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Bergman Nordgren, Lise
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Chat- and internet-based cognitive-behavioural therapy in treatment of adolescent depression: randomised controlled trial2018Ingår i: Bjpsych Open, ISSN 2056-4724, Vol. 4, nr 4, s. 199-207Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Depression is a major contributor to the burden of disease in the adolescent population. Internet-based interventions can increase access to treatment.

    Aims

    To evaluate the efficacy of internet-based cognitive–behavioural therapy (iCBT), including therapist chat communication, in treatment of adolescent depression.

    Method

    Seventy adolescents, 15–19 years of age and presenting with depressive symptoms, were randomised to iCBT or attention control. The primary outcome was the Beck Depression Inventory II (BDI-II).

    Results

    Significant reductions in depressive symptoms were found, favouring iCBT over the control condition (F(1,67) = 6.18, P < 0.05). The between-group effect size was Cohen's d = 0.71 (95% CI 0.22–1.19). A significantly higher proportion of iCBT participants (42.4%) than controls (13.5%) showed a 50% decrease in BDI-II score post-treatment (P < 0.01). The improvement for the iCBT group was maintained at 6 months.

    Conclusions

    The intervention appears to effectively reduce symptoms of depression in adolescents and may be helpful in overcoming barriers to care among young people.

    Declaration of interest

    N.T. and G.A. designed the programme. N.T. authored the treatment material. The web platform used for treatment is owned by Linköping University and run on a non-for-profit basis. None of the authors receives any income from the programme.

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  • 10.
    Zetterqvist Carlsson, Mari
    et al.
    MZ Equitation, Sweden.
    Lundgren, Charlotte
    Linköpings universitet, Institutionen för kultur och kommunikation, Avdelningen för svenska och litteratur. Linköpings universitet, Filosofiska fakulteten.
    Riders´ perception of their communication with the horse2014Ingår i: CONFERENCE PROCEEDINGS 10TH INTERNATIONAL EQUITATION SCIENCE CONFERENCE: ISES 2014 10TH INTERNATIONAL EQUITATION SCIENCE CONFERENCE, DCA- Danish Centre for Food and Agriculture , 2014Konferensbidrag (Refereegranskat)
    Abstract [en]

    This study is part of a project with the overall aim to improve riding education through a better understanding of the interplay between rider, riding instructor and horse. The rider influences the horse through a combination of weight, leg and rein aids together with the voice. The horse responds to these and the rider receives and interprets these responses. The current study aimed to describe and analyse the riders´ perceptions and views on this communication. Fifteen experienced riders (all female) of intermediate level in dressage were recruited to participate in the study, most of them riding their own horses. The riders received private training from five experienced riding instructors/trainers. One training of each rider was video and audio recorded. Directly after the training, the riders watched 10 minutes from the video recording (stimulated recall) followed by a semi-structured in-depth interview. The riders were asked to give a general description of how they communicated with their horses. They were also asked to describe how they interpreted the horse’s responses to the rider’s signals and how they acted when the horse responded/or did not respond to their signals. The results showed that all riders were well aware of the importance of giving clear and precise signals to the horse and to remove a given signal (aid) as soon as the horse responds. Most riders (12 of 15) agreed that it is essential to check that the horse responds to the rider’s basic signals in the beginning of each training session. The riders also pointed out that it is important to adjust the aids to the character of the horse and to the current physical and mental status of their horse. When the horses responded correctly on the rider’s aids, the riders praised the horse either by using their voice or by petting the horse. When the horse did not respond as the rider wished, the riders generally repeated or strengthened their signals until they received a desired response. Interestingly, a major part of the riders (13 of 15) blamed themselves when the communication with the horse failed. In conclusion, the riders seemed to be aware of the practical application of the basic principles of learning theory, even if they were not familiar with the terminology. However, the riders also reported that in practice they perceived difficulties to control their own bodies and to adequately give and release their signals.

  • 11.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Nonsuicidal Self-Injury in Adolescents: Characterization of the Disorder and the Issue of Distress and Impairment.2017Ingår i: Journal of Suicide and Life-threatening Behaviour, ISSN 0363-0234, E-ISSN 1943-278X, Vol. 47, nr 3, s. 321-335Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Nonsuicidal self-injury disorder (NSSID) is a condition in need of further study to assess the validity of the potential diagnosis and its suggested criteria. This study examined the NSSID diagnosis and investigated the distress/impairment criterion by comparing community adolescents who met all criteria for NSSID (n = 186) to adolescents with five or more nonsuicidal self-injury (NSSI) episodes (n = 314), and to a group of adolescents who met all criteria but negated that their NSSI caused them any distress or impairment, thus failing to meet criterion E (n = 29). The NSSID group delimited from the ≥ 5 NSSI group by reporting significantly more frequent and severe self-injurious thoughts and behaviors, as well as having more experiences of negative life events and higher levels of trauma symptoms. There were also some differences between the NSSID group and adolescents without distress/impairment, which together contribute valuable information on the potential NSSID diagnosis, as well as the discussion of criterion E.

  • 12. Beställ onlineKöp publikationen >>
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    Non-Suicidal Self-Injury in Swedish Adolescents: Prevalence, Characteristics, Functions and Associations With Childhood Adversities2014Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Självskadebeteende, t ex att avsiktligt skära, bränna eller slå sig själv är potentiellt skadliga beteenden. Empiriska studier är viktiga för att kunna förebygga självskadebeteende hos ungdomar. Föreliggande avhandling syftar till att undersöka självskadebeteendets förekomst, funktion, karaktäristik och metoder hos svenska ungdomar, samt att undersöka relationen till negativa livshändelser och traumasymptom. Samtliga fyra empiriska studier hade en tvärsnittsdesign och baserades på 3,097 ungdomar i Östergötland, 15-17 år, i gymnasieskolans årskurs 1, vars skolklasser valts ut slumpmässigt och som besvarat självskattningsformulär.

    I studie I (n = 3,060) angav 17.2%, som svar på en allmän självskadefråga, att de avsiktligt skadat sig under sin livstid. När ungdomarna däremot svarade på en checklista med olika självskadebeteenden, angav 35.6% att de hade ägnat sig åt någon typ av självskadebeteende under det senaste året. De vanligaste metoderna var att avsiktligt bita eller slå sig själv, sudda på huden och att skära sig. De föreslagna diagnoskriterierna för icke-suicidal självskada i DSM-5 resulterade i en förekomst av 6.7%. Studie II (n = 2,964) visade att ungdomar utan självskadebeteende rapporterade de lägsta antalet negativa livshändelser och traumasymptom, medan de med erfarenhet av både självskadebeteende och självmordsförsök (5.7%) rapporterade de högsta antalen jämfört med de med endast självskadebeteende eller självmordsförsök. Ungdomar med fler självskadetillfällen rapporterade fler negativa livshändelser och traumasymptom än de med färre tillfällen. Automatiska/intrapersonella funktioner, såsom att generera och reglera känslor samt att straffa sig själv var de vanligaste funktionerna som rapporterades. Försök att konfirmera Nock och Prinsteins (2004) fyrfaktormodell av underliggande funktionsfaktorer i studie I resulterade i en modell med nära acceptabel passform. Ett försök att förbättra faktoranalysen på den aktuella urvalsgruppen gjordes med Mplus i studie III (n = 836). En exploratorisk analys resulterade i en trefaktormodell (interpersonell påverkan, automatisk/intrapersonell funktion samt ”icke-konformistisk” kamratidentifikation), vilken även validerades i den konfirmatoriska analysen. Med utgångspunkt i inlärningsteori och begreppen negativ och positiv förstärkning delades därefter den tredje faktorn upp i två faktorer. Det resulterade i en fyrfaktormodell (interpersonell påverkan, automatisk/intrapersonell funktion, kamratidentifikation samt undvikande av krav). Fyrfaktormodellen visade utmärkt passform i den konfirmatoriska analysen. Studie IV (n = 816) visade att självskadebeteendets frekvens, kön (flicka), självrapporterade erfarenheter av psykisk och fysisk misshandel, självmordsförsök, kronisk sjukdom eller handikapp under uppväxten, liksom symptom på depression och dissociation predicerade automatiska självskadefunktioner. De variablerna är potentiellt viktiga för förståelsen av de mekanismer som är involverade när ungdomar skadar sig själva för att generera och reglera känslor, få kontroll, liksom att straffa sig själva. Relationen mellan psykisk och fysisk misshandel och de automatiska funktionerna medierades av symptom på depression och dissociation. Självskadefrekvens, kön, psykisk misshandel, sjukdom/handikapp och symptom på depression predicerade enbart automatiska men inte sociala funktioner. Självrapporterad fysisk misshandel, självmordsförsök, symptom på ångest och dissociation var signifikanta prediktorer för de sociala funktionerna (att påverka/kommunicera med andra, undvika krav eller identifiera sig med kamrater). Ångestsymptom var unikt associerade med sociala funktioner. Symptom på ångest och dissociation medierade vidare relationen mellan fysisk misshandel och sociala självskadefunktioner.

    Sammanfattningsvis visade resultaten att självskadebeteende är vanligt förekommande hos ungdomar. Avhandlingen bidrar med empiri till diskussionen gällande icke suicidal självskada i DSM-5. Det är viktigt att beakta olika negativa livserfarenheter och traumasymptom i relation till självskadebeteende hos ungdomar. Att undersöka självskadebeteendets funktioner kan vara kliniskt hjälpsamt för att utveckla och utvärdera individuellt anpassade behandlingsstrategier.

    Delarbeten
    1. Prevalence and Function of Non-Suicidal Self-Injury (NSSI) in a Community Sample of Adolescents, Using Suggested DSM-5 Criteria for a Potential NSSI Disorder
    Öppna denna publikation i ny flik eller fönster >>Prevalence and Function of Non-Suicidal Self-Injury (NSSI) in a Community Sample of Adolescents, Using Suggested DSM-5 Criteria for a Potential NSSI Disorder
    2013 (Engelska)Ingår i: Journal of Abnormal Child Psychology, ISSN 0091-0627, E-ISSN 1573-2835, Vol. 41, nr 5, s. 759-773Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Previous prevalence rates of non-suicidal self-injury (NSSI) in adolescents have varied considerably. In the present cross-sectional study, prevalence rates, characteristics and functions of NSSI were assessed in a large randomized community sample consisting of 3,060 (50.5 % female) Swedish adolescents aged 15-17 years. The suggested criteria for NSSI disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, (DSM-5) were used to assess prevalence rates with the aim of arriving at a more precise estimate. Out of the whole sample, 1,088 (35.6 %) adolescents (56.2 % female) reported at least one episode of NSSI during the last year, of which 205 (6.7 %) met suggested DSM-5 criteria for a potential NSSI disorder diagnosis. The NSSI disorder diagnosis was significantly more common in girls (11.1 % vs. 2.3 %, χ (2) (1, N = 3046) = 94.08, p < 0.001, cOR = 5.43, 95 % CI [3.73, 7.90]). The NSSI disorder group consisted of significantly more smokers and drug users compared to adolescents with NSSI that did not meet DSM-5 criteria for NSSI disorder, and also differed concerning demographic variables. A confirmatory factor analysis (CFA) was conducted on reported functions of NSSI, with the aim of validating Nock and Prinstein's (Journal of Consulting and Clinical Psychology 72:885-890, 2004, Journal of Abnormal Psychology 114:140-146, 2005) four-factor model on a Swedish community sample, resulting in a close to acceptable fit. A two-factor model (social and automatic reinforcement) resulted in a slightly better fit. The most frequently reported factors were positive and negative automatic reinforcement. A majority of functions were significantly more often reported by girls than boys. The implications of the suggested DSM-5 criteria and reported functions are discussed.

    Ort, förlag, år, upplaga, sidor
    Springer, 2013
    Nyckelord
    Non-suicidal self-injury disorder, DSM-5, Prevalence, Function, Adolescents
    Nationell ämneskategori
    Psykiatri
    Identifikatorer
    urn:nbn:se:liu:diva-91375 (URN)10.1007/s10802-013-9712-5 (DOI)000320279900007 ()23344701 (PubMedID)
    Tillgänglig från: 2013-04-23 Skapad: 2013-04-23 Senast uppdaterad: 2021-05-18
    2. A Comparison of Adolescents Engaging in Self-Injurious Behaviors With and Without Suicidal Intent: Self-Reported Experiences of Adverse Life Events and Trauma Symptoms
    Öppna denna publikation i ny flik eller fönster >>A Comparison of Adolescents Engaging in Self-Injurious Behaviors With and Without Suicidal Intent: Self-Reported Experiences of Adverse Life Events and Trauma Symptoms
    2013 (Engelska)Ingår i: Journal of Youth and Adolescence, ISSN 0047-2891, E-ISSN 1573-6601, Vol. 42, nr 8, s. 1257-1272Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Research comparing adolescents engaging in suicidal and non-suicidal self-injury (NSSI), both separately and in combination, is still at an early stage. The purpose of the present study was to examine overlapping and distinguishable features in groups with different types of self-injurious behaviors, using a large community sample of 2,964 (50.6 % female) Swedish adolescents aged 15-17 years. Adolescents were grouped into six categories based on self-reported lifetime prevalence of self-injurious behaviors. Of the total sample, 1,651 (55.7 %) adolescents reported no self-injurious behavior, 630 (21.2 %) reported NSSI 1-4 times, 177 (6.0 %) reported NSSI 5-10 times, 311 (10.5 %) reported NSSI a parts per thousand yen 11 times, 26 (0.9 %) reported lifetime prevalence of suicide attempt and 169 (5.7 %) adolescents reported both NSSI and suicide attempt. After controlling for gender, parental occupation and living conditions, there were significant differences between groups. Pairwise comparisons showed that adolescents with both NSSI and suicide attempt reported significantly more adverse life events and trauma symptoms than adolescents with only NSSI, regardless of NSSI frequency. The largest differences (effect sizes) were found for interpersonal negative events and for symptoms of depression and posttraumatic stress. Adolescents with frequent NSSI reported more adversities and trauma symptoms than those with less frequent NSSI. There were also significant differences between all the NSSI groups and adolescents without any self-injurious behavior. These findings draw attention to the importance of considering the cumulative exposure of different types of adversities and trauma symptoms when describing self-injurious behaviors, with and without suicidal intent.

    Ort, förlag, år, upplaga, sidor
    Springer, 2013
    Nyckelord
    Non-suicidal self-injury, Suicide, Adolescents, Adverse life events, Trauma symptoms
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-96719 (URN)10.1007/s10964-012-9872-6 (DOI)000321973800012 ()
    Tillgänglig från: 2013-08-23 Skapad: 2013-08-23 Senast uppdaterad: 2021-05-18Bibliografiskt granskad
    3. Functions of Nonsuicidal Self-Injury: Exploratory and Confirmatory Factor Analyses in a Large Community Sample of Adolescents
    Öppna denna publikation i ny flik eller fönster >>Functions of Nonsuicidal Self-Injury: Exploratory and Confirmatory Factor Analyses in a Large Community Sample of Adolescents
    2015 (Engelska)Ingår i: Psychological Assessment, ISSN 1040-3590, E-ISSN 1939-134X, Vol. 27, nr 1, s. 302-313Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Given that nonsuicidal self-injury (NSSI) is prevalent in adolescents, structured assessment is an essential tool to guide treatment interventions. The Functional Assessment of Self-Mutilation (FASM) is a self-report scale that assesses frequency, methods, and functions of NSSI. FASM was administered to 3,097 Swedish adolescents in a community sample. With the aim of examining the underlying factor structure of the functions of FASM in this sample, the adolescents with NSSI who completed all function items (n = 836) were randomly divided into 2 subsamples for cross-validation purposes. An exploratory factor analysis (EFA) was followed by a confirmatory factor analysis (CFA) using the mean and variance adjusted weighted least squares (WLSMV) estimator in the Mplus statistical modeling program. The results of the EFA suggested a 3-factor model (social influence, automatic functions, and nonconformist peer identification), which was supported by a good fit in the CFA. Factors differentiated between social/interpersonal and automatic/intrapersonal functions. Based on learning theory and the specific concepts of negative and positive reinforcement, the nonconformist peer identification factor was then split into 2 factors (peer identification and avoiding demands). The resulting 4-factor model showed an excellent fit. Dividing social functions into separate factors (social influence, peer identification, and avoiding demands) can be helpful in clinical practice, where the assessment of NSSI functions is an important tool with direct implications for treatment.

    Ort, förlag, år, upplaga, sidor
    American Psychological Association (APA), 2015
    Nyckelord
    Non-suicidal self-injury, assessment, adolescents, functions, factor analysis
    Nationell ämneskategori
    Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Klinisk vetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-110420 (URN)10.1037/pas0000034 (DOI)25558962 (PubMedID)
    Anmärkning

    At the time for thesis presentation publication was in status: Manuscript

    Tillgänglig från: 2014-09-11 Skapad: 2014-09-11 Senast uppdaterad: 2021-05-18Bibliografiskt granskad
    4. A cross-sectional study of adolescent non-suicidal self-injury: support for a specific distress-function relationship
    Öppna denna publikation i ny flik eller fönster >>A cross-sectional study of adolescent non-suicidal self-injury: support for a specific distress-function relationship
    2014 (Engelska)Ingår i: Child and Adolescent Psychiatry and Mental Health, E-ISSN 1753-2000, Vol. 8, nr 23Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    BACKGROUND: This study has investigated the specific relationship between childhood adversities, individual trauma symptoms and the functions of non-suicidal self-injury (NSSI). The aim was to examine whether different self-reported adverse experiences and trauma symptoms predict the need to engage in NSSI, either to regulate emotions or to communicate with and influence others.

    METHOD: The participants were a community sample of 816 adolescents aged 15-17 years with NSSI. Hierarchical multiple regression was used, controlling for NSSI frequency and gender. The dependent variables were the automatic and social functions of NSSI, respectively. The predictors entered in the model were several different maltreatment and adversity experiences as well as individual trauma symptoms. Mediation analyses were also performed using the bootstrapping method with bias-corrected confidence estimates.

    RESULTS: Frequency of NSSI, gender (female), emotional abuse, prolonged illness or handicap during upbringing and symptoms of depression uniquely predicted the automatic functions of NSSI in the final regression model, but not the social functions. Symptoms of anxiety uniquely predicted social but not automatic functions. Having experienced physical abuse, having made a suicide attempt and symptoms of dissociation were significant predictors in both final models. The model for automatic functions explained more of the variance (62%) than the social model (28%). The relationship between childhood emotional, physical and sexual abuse and performing NSSI for automatic reasons was mediated by symptoms of depression and dissociation. The relationship between physical abuse and the social functions of NSSI was mediated by symptoms of anxiety and dissociation.

    CONCLUSIONS: It is important to understand the specific context in which NSSI has developed and is maintained. Experiences of emotional abuse and symptoms of depression could guide clinical work in the direction of emotion regulation skills since in this study these variables were uniquely associated with the need to engage in NSSI to regulate emotions, to self-punish or to generate feelings. The presence of physical abuse, a suicide attempt and symptoms of dissociation could alert clinicians to a broad treatment approach since they were associated with performing NSSI to regulate both social and automatic experiences.

    Ort, förlag, år, upplaga, sidor
    BioMed Central, 2014
    Nationell ämneskategori
    Psykiatri Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
    Identifikatorer
    urn:nbn:se:liu:diva-110419 (URN)10.1186/1753-2000-8-23 (DOI)25110519 (PubMedID)
    Tillgänglig från: 2014-09-11 Skapad: 2014-09-11 Senast uppdaterad: 2024-01-17Bibliografiskt granskad
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    Non-Suicidal Self-Injury in Swedish Adolescents: Prevalence, Characteristics, Functions and Associations With Childhood Adversities
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  • 13.
    Zetterqvist, Maria
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    The DSM-5 diagnosis of nonsuicidal self-injury disorder: A review of the empirical literature2015Ingår i: Child and Adolescent Psychiatry and Mental Health, E-ISSN 1753-2000, Vol. 9, nr 31, s. 1-13Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    With the presentation of nonsuicidal self-injury disorder (NSSID) criteria in the fifth version of the Statistical and Diagnostic Manual of Mental Disorders (DSM-5), empirical studies have emerged where the criteria have been operationalized on samples of children, adolescents and young adults. Since NSSID is a condition in need of further study, empirical data are crucial at this stage in order to gather information on the suggested criteria concerning prevalence rates, characteristics, clinical correlates and potential independence of the disorder. A review was conducted based on published peer-reviewed empirical studies of the DSM-5 NSSID criteria up to May 16, 2015. When the DSM-5 criteria were operationalized on both clinical and community samples, a sample of individuals was identified that had more general psychopathology and impairment than clinical controls as well as those with NSSI not meeting criteria for NSSID. Across all studies interpersonal difficulties or negative state preceding NSSI was highly endorsed by participants, while the distress or impairment criterion tended to have a lower endorsement. Results showed preliminary support for a distinct and independent NSSID diagnosis, but additional empirical data are needed with direct and structured assessment of the final DSM-5 criteria in order to reliably assess and validate a potential diagnosis of NSSID.

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    fulltext
  • 14.
    Zetterqvist, Maria
    et al.
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Bjureberg, Johan
    Department of Clinical Neuroscience, Karolinska Institutet.
    Social Processes in Nonsuicidal Self-Injury2023Ingår i: The Oxford Handbook of Nonsuicidal Self-Injury / [ed] Elizabeth E. Lloyd-Richardson; Imke Baetens; Janis L. Whitlock, Oxford University Press, 2023Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    Social interactions are critical for the health and well-being of all group-living primates, including humans, across the lifespan. Social stressors, such as perceived criticism and rejection, are common triggers of nonsuicidal self-injury (NSSI). Social processes may thus have a central role in the etiology and maintenance of NSSI. Using the Research Domain Criteria (RDoC) framework for systems for social processes, the chapter presents recent findings on NSSI, mapping them onto the four constructs: affiliation and attachment, social communication, perception and understanding of self, and perception and understanding of others. The chapter also discusses available research related to NSSI for the respective units of analysis (genes and molecules, physiology, neurocircuitry, behavior, and self-report), focusing on the effects of social exclusion, rejection sensitivity, and negative social bias. The chapter also includes an overview of overlapping features related to social exclusion and rejection sensitivity between NSSI and borderline personality disorder, a condition characterized by interpersonal difficulties. This chapter provides an account of evidence-based assessment and intervention areas of social processes in NSSI together with recommendations and future directions. The chapter concludes that social processes are relevant to NSSI across the RDoC constructs and units of analyses. Social difficulties, social problem-solving, and experiences and interpretations of social situations need to be included in the conceptualization of how NSSI is developed and maintained and ultimately assessed and treated. In an effort to bring such conceptualization to life, a case example illustrates how an understanding of social processes may guide assessment and treatment of NSSI.

  • 15.
    Zetterqvist, Maria
    et al.
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Hanell, H. Erneroth
    Stockholm City Council, Sweden.
    Wadsby, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Cocozza, Madeleine
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Gustafsson, Per
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Validation of the Systemic Clinical Outcome and Routine Evaluation (SCORE-15) self-report questionnaire: index of family functioning and change in Swedish families2020Ingår i: Journal of Family Therapy, ISSN 0163-4445, E-ISSN 1467-6427, Vol. 42, nr 1, s. 129-148Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Instruments for evaluating the progress and outcome of systemic therapeutic treatments in clinical practice need to be easily administered and have sound psychometric properties. The Systemic Clinical Outcome and Routine Evaluation, 15-item version (SCORE-15), is a self-report instrument that measures aspects of family functioning. This study investigates the psychometric qualities of a Swedish version of SCORE-15. Seventy Swedish families with healthy children and 159 families with children with psychiatric or behavioural problems were included in the study, resulting in a total of 397 individuals. Results showed that SCORE-15 differentiated clinical from non-clinical families with acceptable psychometric properties for test-retest, internal consistency, convergent and construct validity, as well as sensitivity to change for the clinical sample. The three-factor solution of strengths, difficulties and communication was tested. Results imply preliminary psychometric support for the use of the Swedish version of SCORE-15 to evaluate progress and outcome in clinical practice. Practitioner points SCORE-15 is an easily administered questionnaire suitable for use in clinical practice to evaluate systemic therapeutic progress and outcome The Swedish version of SCORE-15 has acceptable psychometric properties

    Ladda ner fulltext (pdf)
    fulltext
  • 16.
    Zetterqvist, Maria
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Barn- och ungdomspsykiatri. Linköpings universitet, Hälsouniversitetet.
    Lundh, Lars-Gunnar
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Dahlström, Örjan
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    Svedin, Carl Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Barn- och ungdomspsykiatri. Linköpings universitet, Hälsouniversitetet.
    Prevalence and Function of Non-Suicidal Self-Injury (NSSI) in a Community Sample of Adolescents, Using Suggested DSM-5 Criteria for a Potential NSSI Disorder2013Ingår i: Journal of Abnormal Child Psychology, ISSN 0091-0627, E-ISSN 1573-2835, Vol. 41, nr 5, s. 759-773Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Previous prevalence rates of non-suicidal self-injury (NSSI) in adolescents have varied considerably. In the present cross-sectional study, prevalence rates, characteristics and functions of NSSI were assessed in a large randomized community sample consisting of 3,060 (50.5 % female) Swedish adolescents aged 15-17 years. The suggested criteria for NSSI disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, (DSM-5) were used to assess prevalence rates with the aim of arriving at a more precise estimate. Out of the whole sample, 1,088 (35.6 %) adolescents (56.2 % female) reported at least one episode of NSSI during the last year, of which 205 (6.7 %) met suggested DSM-5 criteria for a potential NSSI disorder diagnosis. The NSSI disorder diagnosis was significantly more common in girls (11.1 % vs. 2.3 %, χ (2) (1, N = 3046) = 94.08, p < 0.001, cOR = 5.43, 95 % CI [3.73, 7.90]). The NSSI disorder group consisted of significantly more smokers and drug users compared to adolescents with NSSI that did not meet DSM-5 criteria for NSSI disorder, and also differed concerning demographic variables. A confirmatory factor analysis (CFA) was conducted on reported functions of NSSI, with the aim of validating Nock and Prinstein's (Journal of Consulting and Clinical Psychology 72:885-890, 2004, Journal of Abnormal Psychology 114:140-146, 2005) four-factor model on a Swedish community sample, resulting in a close to acceptable fit. A two-factor model (social and automatic reinforcement) resulted in a slightly better fit. The most frequently reported factors were positive and negative automatic reinforcement. A majority of functions were significantly more often reported by girls than boys. The implications of the suggested DSM-5 criteria and reported functions are discussed.

  • 17.
    Zetterqvist, Maria
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Barn- och ungdomspsykiatri. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Lundh, Lars-Gunnar
    Lund University, Sweden .
    Svedin, Carl Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet.
    A Comparison of Adolescents Engaging in Self-Injurious Behaviors With and Without Suicidal Intent: Self-Reported Experiences of Adverse Life Events and Trauma Symptoms2013Ingår i: Journal of Youth and Adolescence, ISSN 0047-2891, E-ISSN 1573-6601, Vol. 42, nr 8, s. 1257-1272Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Research comparing adolescents engaging in suicidal and non-suicidal self-injury (NSSI), both separately and in combination, is still at an early stage. The purpose of the present study was to examine overlapping and distinguishable features in groups with different types of self-injurious behaviors, using a large community sample of 2,964 (50.6 % female) Swedish adolescents aged 15-17 years. Adolescents were grouped into six categories based on self-reported lifetime prevalence of self-injurious behaviors. Of the total sample, 1,651 (55.7 %) adolescents reported no self-injurious behavior, 630 (21.2 %) reported NSSI 1-4 times, 177 (6.0 %) reported NSSI 5-10 times, 311 (10.5 %) reported NSSI a parts per thousand yen 11 times, 26 (0.9 %) reported lifetime prevalence of suicide attempt and 169 (5.7 %) adolescents reported both NSSI and suicide attempt. After controlling for gender, parental occupation and living conditions, there were significant differences between groups. Pairwise comparisons showed that adolescents with both NSSI and suicide attempt reported significantly more adverse life events and trauma symptoms than adolescents with only NSSI, regardless of NSSI frequency. The largest differences (effect sizes) were found for interpersonal negative events and for symptoms of depression and posttraumatic stress. Adolescents with frequent NSSI reported more adversities and trauma symptoms than those with less frequent NSSI. There were also significant differences between all the NSSI groups and adolescents without any self-injurious behavior. These findings draw attention to the importance of considering the cumulative exposure of different types of adversities and trauma symptoms when describing self-injurious behaviors, with and without suicidal intent.

  • 18.
    Zetterqvist, Maria
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Lundh, Lars-Gunnar
    Department of Psychology, Lund University, Sweden.
    Svedin, Carl Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    A cross-sectional study of adolescent non-suicidal self-injury: support for a specific distress-function relationship2014Ingår i: Child and Adolescent Psychiatry and Mental Health, E-ISSN 1753-2000, Vol. 8, nr 23Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: This study has investigated the specific relationship between childhood adversities, individual trauma symptoms and the functions of non-suicidal self-injury (NSSI). The aim was to examine whether different self-reported adverse experiences and trauma symptoms predict the need to engage in NSSI, either to regulate emotions or to communicate with and influence others.

    METHOD: The participants were a community sample of 816 adolescents aged 15-17 years with NSSI. Hierarchical multiple regression was used, controlling for NSSI frequency and gender. The dependent variables were the automatic and social functions of NSSI, respectively. The predictors entered in the model were several different maltreatment and adversity experiences as well as individual trauma symptoms. Mediation analyses were also performed using the bootstrapping method with bias-corrected confidence estimates.

    RESULTS: Frequency of NSSI, gender (female), emotional abuse, prolonged illness or handicap during upbringing and symptoms of depression uniquely predicted the automatic functions of NSSI in the final regression model, but not the social functions. Symptoms of anxiety uniquely predicted social but not automatic functions. Having experienced physical abuse, having made a suicide attempt and symptoms of dissociation were significant predictors in both final models. The model for automatic functions explained more of the variance (62%) than the social model (28%). The relationship between childhood emotional, physical and sexual abuse and performing NSSI for automatic reasons was mediated by symptoms of depression and dissociation. The relationship between physical abuse and the social functions of NSSI was mediated by symptoms of anxiety and dissociation.

    CONCLUSIONS: It is important to understand the specific context in which NSSI has developed and is maintained. Experiences of emotional abuse and symptoms of depression could guide clinical work in the direction of emotion regulation skills since in this study these variables were uniquely associated with the need to engage in NSSI to regulate emotions, to self-punish or to generate feelings. The presence of physical abuse, a suicide attempt and symptoms of dissociation could alert clinicians to a broad treatment approach since they were associated with performing NSSI to regulate both social and automatic experiences.

  • 19.
    Zetterqvist, Maria
    et al.
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Perini, Irene
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten.
    Mayo, Leah
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten.
    Gustafsson, Per A
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Barn- och ungdomspsykiatriska kliniken Linköping.
    Nonsuicidal Self-Injury Disorder in Adolescents: Clinical Utility of the Diagnosis Using the Clinical Assessment of Nonsuicidal Self-Injury Disorder Index2020Ingår i: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 11, artikel-id 8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Nonsuicidal self-injury disorder (NSSID) is a condition in need of further study, especially in adolescent and clinical populations where it is particularly prevalent and studies are limited. Twenty-nine clinical self-injuring adolescents were included in the study. The Clinical Assessment of Nonsuicidal Self-Injury Disorder Index (CANDI) was used to assess prevalence of NSSID. The NSSID diagnosis criteria were met by 62.1% of adolescents. The impairment or distress criterion was least often met. Criteria B and C (assessing reasons for NSSI and cognitions/emotions prior to NSSI) were confirmed by 96-100% of all participants. Adolescents with NSSI in this clinical sample had several comorbidities and high levels of psychopathology. NSSID occurred both in combination with and independently of borderline personality disorder traits as well as suicide plans and attempts. Those with NSSID had a significantly higher cutting frequency than those not meeting full NSSID criteria. Other NSSI characteristics, comorbidity, psychopathology, and trauma experiences did not differ between groups. CANDI was a feasible tool to assess NSSID in adolescents. It is important to use structured measures to assess the validity of the NSSID diagnosis across development in both community and clinical samples. The clinical utility of the NSSID diagnosis is discussed.

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  • 20.
    Zetterqvist, Maria
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Svedin, Carl Göran
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Barnafrid. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Fredlund, Cecilia
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Psykiatriska kliniken.
    Priebe, Gisela
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Barnafrid. Linköpings universitet, Medicinska fakulteten. Lund Univ, Sweden.
    Wadsby, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten.
    Jonsson, Linda
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Barnafrid. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Self-reported nonsuicidal self-injury (NSSI) and sex as self-injury (SASI): Relationship to abuse, risk behaviors, trauma symptoms, self-esteem and attachment2018Ingår i: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 265, s. 309-316Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study focuses on a conceptually unexplored behavior among adolescents who report deliberately using sex as a means of self-injury. In a large high school-based sample (n = 5743), adolescents who engaged in sex as self injury (SASI, n = 43) were compared to adolescents who reported direct nonsuicidal self-injury (NSSI, n = 933) and those who reported both NSSI and SASI (n = 82). Re.sults showed that significantly more adolescents with SASI had experience of penetrating sexual abuse, as well as more sexual partners compared to those with NSSI. The SASI group also had higher levels of self-reported trauma symptoms, such as dissociation, posttraumatic stress and sexual concerns compared to those with NSSI, suggesting a distinct relationship between sexual abuse, trauma symptoms and engaging in sex as self-injury. There was no difference between the SASI and NSSI groups regarding experiences of emotional and physical abuse, self-esteem, parental care or overprotection or symptoms of depression, anxiety and anger. Adolescents who engaged in both NSSI + SASI stood out as a more severe and burdened group, with more experience of abuse, risk behaviors and impaired psychosocial health. Adolescents with traumatic experiences such as sexual abuse need to be assessed for SASI and vice versa.

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