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  • 201.
    Fredlund, Cecilia
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Dahlström, Örjan
    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.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Jonsson, Linda
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Pribe, Gisela
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Lund Univ, Sweden.
    Adolescents motives for selling sex in a welfare state - A Swedish national study2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 81, p. 286-295Article in journal (Refereed)
    Abstract [en]

    In addition to money or other compensation, other motives for selling sex may be important in a welfare country such as Sweden. The aim of this study was to carry out an exploratory investigation of adolescents motives for selling sex in a population-based survey in Sweden. A total of 5839 adolescents from the third year of Swedish high school, mean age 18.0 years, participated in the study. The response rate was 59.7% and 51 students (0.9%) reported having sold sex. Exploratory factor analysis and hierarchical cluster analysis were used to identify groups of adolescents according to underlying motives for selling sex. Further analyses were carried out for characteristics of selling sex and risk factors. Three groups of adolescents were categorized according to their motives for selling sex: Adolescents reporting; 1) Emotional reasons, being at a greater risk of sexual abuse, using sex as a means of self-injury and having a non-heterosexual orientation. 2) Material but no Emotional reasons, who more often receive money as compensation and selling sex to a person over 25 years of age, and 3) Pleasure or no underlying motive for selling sex reported, who were mostly heterosexual males selling sex to a person under 25 years of age, the buyer was not known from the Internet, the reward was seldom money and this group was less exposed to penetrative sexual abuse or using sex as a means of self-injury. In conclusion, adolescents selling sex are a heterogeneous group in regard to underlying motives.

    The full text will be freely available from 2021-05-05 00:01
  • 202.
    Frodlund, Martina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Kastbom, Alf
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Skogh, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Sjöwall, Christopher
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Associations between antinuclear antibody staining patterns and clinical features of systemic lupus erythematosus: analysis of a regional Swedish register2013In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Objective Antinuclear antibody (ANA) analysis by immunofluorescence (IF) microscopy remains a diagnostic hallmark of systemic lupus erythematosus (SLE). The clinical relevance of ANA fine-specificities in SLE has been addressed repeatedly, whereas studies on IF-ANA staining patterns in relation to disease manifestations are very scarce. This study was performed to elucidate whether different staining patterns associate with distinct SLE phenotypes.

    Design Observational cohort study.

    Setting One university hospital rheumatology unit in Sweden.

    Participants The study population consisted of 222 cases (89% women; 93% Caucasians), where of 178 met ≥4/11 of the 1982 American College of Rheumatology (ACR-82) criteria. The remaining 20% had an SLE diagnosis based on positive IF-ANA (HEp-2 cells) and ≥2 typical organ manifestations at the time of diagnosis (Fries’ criteria).

    Outcome measures The IF-ANA staining patterns homogenous (H-ANA), speckled (S-ANA), combined homogenous and speckled (HS-ANA), centromeric (C-ANA), nucleolar (N-ANA)±other patterns and other nuclear patterns (oANA) were related to disease manifestations and laboratory measures. Antigen-specificities were also considered regarding double-stranded DNA (Crithidia luciliae) and the following extractable nuclear antigens: Ro/SSA, La/SSB, Smith antigen (Sm), small nuclear RNP (snRNP), Scl-70 and Jo-1 (immunodiffusion and/or line-blot technique).

    Results 54% of the patients with SLE displayed H-ANA, 22% S-ANA, 11% HS-ANA, 9% N-ANA, 1% C-ANA, 2% oANA and 1% were never IF-ANA positive. Staining patterns among patients meeting Fries’ criteria alone did not differ from those fulfilling ACR-82. H-ANA was significantly associated with the 10th criterion according to ACR-82 (‘immunological disorder’). S-ANA was inversely associated with arthritis, ‘immunological disorder’ and signs of organ damage.

    Conclusions H-ANA is the dominant IF-ANA pattern among Swedish patients with SLE, and was found to associate with ‘immunological disorder’ according to ACR-82. The second most common pattern, S-ANA, associated negatively with arthritis and organ damage.

  • 203.
    Frodlund, Martina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine.
    Dahlström, Örjan
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research.
    Skogh, Thomas
    Linköping University, Department of Clinical and Experimental Medicine.
    Sjöwall, Christopher
    Linköping University, Department of Clinical and Experimental Medicine.
    Associations between antinuclear antibody staining patterns and clinical features of systemic lupus erythematosus2013Conference paper (Refereed)
  • 204.
    Frodlund, Martina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Vikerfors, A.
    Karolinska Univ Hosp, Sweden; Swedish Med Prod Agcy, Sweden.
    Grosso, G.
    Karolinska Univ Hosp, Sweden.
    Skogh, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Wetterö, Jonas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Elvin, K.
    Karolinska Inst, Sweden.
    Gunnarsson, I.
    Karolinska Univ Hosp, Sweden.
    Kastbom, Alf
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Dahlström, Örjan
    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.
    Ronnelid, J.
    Uppsala Univ, Sweden.
    Svenungsson, E.
    Karolinska Univ Hosp, Sweden.
    Sjöwall, Christopher
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Immunoglobulin A anti-phospholipid antibodies in Swedish cases of systemic lupus erythematosus: associations with disease phenotypes, vascular events and damage accrual2018In: Clinical and Experimental Immunology, ISSN 0009-9104, E-ISSN 1365-2249, Vol. 194, no 1, p. 27-38Article in journal (Refereed)
    Abstract [en]

    Immunoglobulin (Ig) G- and IgM-class anti-cardiolipin antibodies (aCL) and lupus anti-coagulant (LA) are included in the 1997 update of the American College of Rheumatology (ACR-97) systemic lupus erythematosus (SLE) criteria. Despite limited evidence, IgA-aCL and IgA anti-(2)-glycoprotein-I (anti-(2)GPI) were included in the 2012 Systemic Lupus International Collaborating Clinics criteria. The present study aimed to evaluate IgG-/IgA-/IgM-aCL and anti-(2)GPI occurrence in relation to disease phenotype, smoking habits, pharmacotherapy, anti-phospholipid syndrome (APS) and organ damage among 526 Swedish SLE patients meeting ACR-97. Patients with rheumatoid arthritis (n=100), primary Sjogrens syndrome (n=50) and blood donors (n=507) served as controls. Anti-phospholipid antibodies (aPL) were analysed by fluoroenzyme-immunoassays detecting aCL/anti-(2)GPI. Seventy-six (14%) SLE cases fulfilled the Sydney APS-criteria, and 1 aCL/anti-(2)GPI isotype (IgG/IgA/IgM) occurred in 138 SLE patients (26%). Forty-five (9%) of the SLE cases had IgA-aCL, 20 of whom (4%) lacked IgG-/IgM-aCL. Seventy-four (14%) tested positive for IgA anti-(2)GPI, 34 (6%) being seronegative regarding IgG/IgM anti-(2)GPI. Six (1%) had APS manifestations but were seropositive regarding IgA-aCL and/or IgA anti-(2)GPI in the absence of IgG/IgM-aPL and LA. Positive LA and IgG-aPL tests were associated with most APS-related events and organ damage. Exclusive IgA anti-(2)GPI occurrence associated inversely with Caucasian ethnicity [odds ratio (OR)=021, 95% confidence interval (CI)=006-072) and photosensitivity (OR=019, 95% CI=005-072). Nephritis, smoking, LA-positivity and statin/corticosteroid-medication associated strongly with organ damage, whereas hydroxychloroquine-medication was protective. In conclusion, IgA-aPL is not rare in SLE (16%) and IgA-aPL analysis may have additional value among SLE cases with suspected APS testing negative for other isotypes of aPL and LA.

  • 205.
    Frölander, Hans Erik
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. University of Örebro, Sweden; Örebro University Hospital, Sweden.
    Moller, Claes
    Linköping University, The Swedish Institute for Disability Research. University of Örebro, Sweden; Örebro University Hospital, Sweden; Örebro University Hospital, Sweden.
    Rudner, Mary
    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.
    Mishra, Sushmit
    Utkal University, India.
    Marshall, Jan D.
    Jackson Lab, ME 04609 USA; Alstrom Syndrome Int, ME USA.
    Piacentini, Heather
    Alstrom Syndrome Int, ME USA.
    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.
    Theory-of-mind in individuals with Alstrom syndrome is related to executive functions, and verbal ability2015In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 6, no 1426, p. 1-11Article in journal (Refereed)
    Abstract [en]

    Objective: This study focuses on cognitive prerequisites for the development of theory-of-mind (ToM), the ability to impute mental states to self and others in young adults with Alstrom syndrome (AS). AS is a rare and quite recently described recessively inherited ciliopathic disorder which causes progressive sensorineural hearing loss and juvenile blindness, as well as many other organ dysfunctions. Two cognitive abilities were considered; Phonological working memory (WM) and executive functions (EF), both of importance in speech development. Methods: Ten individuals (18-37 years) diagnosed with AS, and 20 individuals with no known impairment matched for age, gender, and educational level participated. Sensory functions were measured. Information about motor functions and communicative skills was obtained from responses to a questionnaire. ToM was assessed using Happes strange stories, verbal ability by a vocabulary test, phonological WM by means of an auditory presented non-word serial recall task and EF by tests of updating and inhibition. Results: The AS group performed at a significantly lower level than the control group in both the ToM task and the EF tasks. A significant correlation was observed between recall of non-words and EF in the AS group. Updating, but not inhibition, correlated significantly with verbal ability, whereas both updating and inhibition were significantly related to the ability to initiate and sustain communication. Poorer performance in the ToM and EF tasks were related to language perseverance and motor mannerisms. Conclusion: The AS group displayed a delayed ToM as well as reduced phonological WM, EF, and verbal ability. A significant association between ToM and EF, suggests a compensatory role of EF. This association may reflect the importance of EF to perceive and process input from the social environment when the social interaction is challenged by dual sensory loss. We argue that limitations in EF capacity in individuals with AS, to some extent, may be related to early blindness and progressive hearing loss, but maybe also to gene specific abnormalities.

  • 206.
    Frölander, Hans Erik
    et al.
    Linköping University, The Swedish Institute for Disability Research. Örebro University; Örebro University Hospital, Sweden.
    Möller, Claes
    Linköping University, The Swedish Institute for Disability Research. Örebro University; Örebro University Hospital, Sweden.
    Marshall, Jan D.
    Jackson laboratory, Bar Harbor, ME, USA.
    Sundqvist, Anett
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rönnåsen, Berit
    Linköping University, The Swedish Institute for Disability Research. Örebro University; Örebro University Hospital, Sweden.
    Falkensson, Lil
    National Resource Centre, Lund, Sweden.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Theory-of-mind in adolescents and young adults with Alström syndrome2014In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 78, no 3, p. 530-536Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    The study focuses on theory-of-mind in adolescents and young adults with Alström syndrome (ALMS). ALMS, an autosomal recessive syndrome causes juvenile blindness, sensorineural hearing loss, cardiomyopathy, endocrinological disorders and metabolic dysfunction. Theory-of-mind (ToM) refers to the ability to impute mental states to one self and to others. Clinical observations have revealed an increased occurrence of deviances in mental state understanding in ALMS. In the present study ToM will be examined and related to working memory (WM), verbal ability and sensory loss.

    METHODS:

    Twelve young individuals (16-37 years) with ALMS and 24 nondisabled individuals matched on age, gender and educational level participated. ToM was assessed by means of a multiple task that taxes the ability to understand thoughts and feelings of story characters'. WM was examined by means of a reading span task and verbal ability by means of a vocabulary test.

    RESULTS:

    The ALMS group performed at significantly lower levels in ToM tasks and displayed a higher variability in performance than the control group. Individuals with ALMS and a relatively poor level performance provided fewer correct mental state inferences in ToM tasks than ALMS individuals with relatively higher performance levels. ALMS individuals with relatively high performance levels made as many correct inferences in ToM tasks as the control group, but their inferences were more often incomplete. Vocabulary skills and educational level, but not WM-capacity predicted ToM performance. Degree of deafblindness did not have an impact on ToM. Age of onset of visual loss but not hearing loss related to ToM.

    CONCLUSIONS:

    The individuals with ALMS display a high degree of heterogeneity in terms of ToM, where some individuals reached performance levels comparable to nondisabled individuals. The results are discussed with respect to how cognitive and verbal abilities and factors related to the disability affect ToM.

  • 207.
    Frölander, Hans-Erik
    et al.
    School of Health and medical sciences, Örebro University.
    Möller, Claes
    School of Health and medical sciences, Örebro University.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Marshall, J.D
    The Jackson Laboratory, Maine, United States.
    Rönnåsen, Berit
    School of Health and medical sciences, Örebro University.
    Falkensson, L.
    The National Resource Centre for Matters regarding Deafblindness, Norrköping, Sweden.
    Theory-of-mind in adolescents and young adults with Alströms syndrome2012Conference paper (Refereed)
  • 208.
    Frölander, Hans-Erik
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Rönnås, Berit
    Institutionen för hälsovetenskap och medicin, Örebro University.
    Möller, Claes
    Örebro Universitetssjukhus, audiologiskt forskningscentrum, Örebro Universitet.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Developmental, Cognitive and behavioral issues in Alströms syndrome2010Conference paper (Refereed)
  • 209.
    Frölander, Hans-Erik
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Rönnås, Berit
    Institutionen för hälsovetenskap och medicin, Örebro University.
    Möller, Claes
    Örebro Universitetssjukhus, audiologiskt forskningscentrum, Örebro Universitet.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    The Theory-of-Mind - perspective: How the psysical manifestations of ALMS may shape relationships and interactions with others2013Conference paper (Refereed)
  • 210.
    Gauffin, Helena
    et al.
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences.
    van Ettinger-Veenstra, Helene
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Ulrici, Daniel
    Linköping University, Department of Clinical and Experimental Medicine, Neurology. Linköping University, Faculty of Health Sciences.
    McAllister, Anita
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Karlsson, Thomas
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Engström, Maria
    Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Medical and Health Sciences, Radiology. Linköping University, Faculty of Health Sciences.
    Impaired language function in generalized epilepsy: Inadequate suppression of the default mode network2013In: Epilepsy & Behavior, ISSN 1525-5050, E-ISSN 1525-5069, Vol. 28, no 1, p. 26-35Article in journal (Refereed)
    Abstract [en]

    We aimed to study the effect of a potential default mode network (DMN) dysfunction on language performance in epilepsy. Language dysfunction in focal epilepsy has previously been connected to brain damage in language-associated cortical areas. In this work, we studied generalized epilepsy (GE) without focal brain damage to see if the language function was impaired. We used functional magnetic resonance imaging (fMRI) to investigate if the DMN was involved. Eleven persons with GE and 28 healthy controls were examined with fMRI during a sentence-reading task. We demonstrated impaired language function, reduced suppression of DMN, and, specifically, an inadequate suppression of activation in the left anterior temporal lobe and the posterior cingulate cortex, as well as an aberrant activation in the right hippocampal formation. Our results highlight the presence of language decline in people with epilepsy of not only focal but also generalized origin.

  • 211.
    Gerdle, Björn
    et al.
    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.
    Molander, Peter
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Stenberg, Gunilla
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Stålnacke, Britt-Marie
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Enthoven, Paul
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. 5 Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden.
    Weak outcome predictors of multimodal rehabilitation at one-year follow-up in patients with chronic pain-a practice based evidence study from two SQRP centres.2016In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 17, no 1, article id 490Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: For patients with chronic pain, the heterogeneity of clinical presentations makes it difficult to identify patients who would benefit from multimodal rehabilitation programs (MMRP). Yet, there is limited knowledge regarding the predictors of MMRP's outcomes. This study identifies predictors of outcome of MMRPs at a 12-month follow-up (FU-12) based on data from the Swedish Quality Registry for Pain Rehabilitation (SQRP).

    METHODS: Patients with chronic pain from two clinical departments in Sweden completed the SQRP questionnaires-background, pain characteristics, psychological symptoms, function, activity/participation, health and quality of life-on three occasions: 1) during their first visit; 2) immediately after the completion of their MMRP; and 3) 12 months after completing the MMRP (n = 227). During the FU-12, the patients also retrospectively reported their global impressions of any changes in their perception of pain and their ability to handle their life situation in general.

    RESULTS: Significant improvements were found for pain, psychological symptoms, activity/participation, health, and quality of life aspects with low/medium strong effects. A general pattern was observed from the analyses of the changes from baseline to FU-12; the largest improvements in outcomes were significantly associated with poor situations according to their respective baseline scores. Although significant regressors of the investigated outcomes were found, the significant predictors were weak and explained a minor part of the variation in outcomes (15-25%). At the FU-12, 53.6% of the patients reported that their pain had decreased and 80.1% reported that their life situation in general had improved. These improvements were associated with high education, low pain intensity, high health level, and work importance (only pain perception). The explained variations were low (9-11%).

    CONCLUSIONS: Representing patients in real-world clinical settings, this study confirmed systematic reviews that outcomes of MMRP are associated with broad positive effects. A mix of background and baseline variables influenced the outcomes investigated, but the explained variations in outcomes were low. There is still a need to develop standardized and relatively simple outcomes that can be used to evaluate MMRP in trials, in clinical evaluations at group level, and for individual patients.

  • 212.
    Germundsson, Per
    et al.
    Malmo Univ, Sweden.
    Manchaiah, Vinaya
    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. Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Ratinaud, Pierre
    Univ Toulouse, France.
    Tympas, Aristotle
    Univ Athens, Greece.
    Danermark, Berth
    Orebro Univ, Sweden.
    Patterns in the social representation of "hearing loss" across countries: how do demographic factors influence this representation?2018In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 57, no 12, p. 925-932Article in journal (Refereed)
    Abstract [en]

    This study aims to understand patterns in the social representation of hearing loss reported by adults across different countries and explore the impact of different demographic factors on response patterns. The study used a cross-sectional survey design. Data were collected using a free association task and analysed using qualitative content analysis, cluster analysis and chi-square analysis. The study sample included 404 adults (18 years and over) in the general population from four countries (India, Iran, Portugal and UK). The cluster analysis included 380 responses out of 404 (94.06%) and resulted in five clusters. The clusters were named: (1) individual aspects; (2) aetiology; (3) the surrounding society; (4) limitations and (5) exposed. Various demographic factors (age, occupation type, education and country) showed an association with different clusters, although country of origin seemed to be associated with most clusters. The study results suggest that how hearing loss is represented in adults in general population varies and is mainly related to country of origin. These findings strengthen the argument about cross-cultural differences in perception of hearing loss, which calls for a need to make necessary accommodations while developing public health strategies about hearing loss.

  • 213.
    Green-Landell, Malin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Hesser, Hugo
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Persson, Stefan
    3Örebro University, School of Law, Psychology and Social work, Örebro, Sweden.
    Furmark, Tomas
    Uppsala University, Department of Psychology, Uppsala, Sweden.
    Bohlin, Gunilla
    Uppsala University, Department of Psychology, Uppsala, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Tillfors, Maria
    Örebro University, School of Law, Psychology and Social work, Örebro, Sweden.
    Longitudinal associations between social anxiety, depressive symptoms and peer victimization in adolescence: A prospective community studyManuscript (preprint) (Other academic)
    Abstract [en]

    Self-reported social anxiety, depressive symptoms and peer victimization was investigated in 350 students in grade 7 and then in grade 8, 9 and 11. Using latent growth modeling, social anxiety was found to be stable over time and to have a time-invariant association with depressive symptoms. Further, social anxiety predicted subsequent depressive symptoms but not vice versa. Support was found for a meditational model. That is, peer victimization in grade 7 was related to higher level of social anxiety, which in turn was associated with more depressive symptoms in grade 8, 9 and 11. The development of social anxiety and depression symptomatology among adolescents can thus be described as one sequential longitudinal process initiated by peer victimization.

  • 214.
    Gren Landell, Malin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Aho, Nikolas
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Carlsson, Elisabeth
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Jones, Annica
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Posttraumatic stress symptoms and mental health services utilization in adolescents with social anxiety disorder and experiences of victimization2013In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 22, no 3, p. 177-184Article in journal (Refereed)
    Abstract [en]

    Recent findings from studies on adults show similarities between social anxiety disorder (SAD) and posttraumatic stress in the form of recurrent memories and intrusive and distressing images of earlier aversive events. Further, treatment models for SAD in adults have been successfully developed by using transdiagnostic knowledge on posttraumatic stress symptoms (PTSS). Studies on adolescents are though missing. The present study aimed at exploring the association between PTSS and SAD in Swedish adolescents. A second aim was to study mental health services utilization in relation to these conditions. A total of 5,960 high-school students participated and reported on SAD, life time victimization, PTSS and mental health service utilization. Socially anxious adolescents reported significantly higher levels of PTSS than adolescents not reporting SAD and this difference was seen in victimized as well as non-victimized subjects. Contact with a school counselor was the most common mental health service utilization in subjects with SAD and those with elevated PTSS. In the prediction of contact with a CAP-clinic, significant odds ratios were found for a condition of SAD and elevated PTSS (OR = 4.88, 95 % CI = 3.53–6.73) but not for SAD only. Screening of PTSS in adolescents with SAD is recommended. The service of school counselors is important in detecting and helping young people with SAD and elevated PTSS. Clinical studies on SAD and PTSS in adolescents could aid in modifying treatment models for SAD.

  • 215.
    Grenness, Caitlin
    et al.
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Hickson, Louise
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Davidson, Bronwyn
    University of Melbourne, Carlton, Australia.
    Patient-centred audiological rehabilitation: Perspectives of older adults who own hearing aids2014In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no S1, p. S68-S75Article in journal (Refereed)
    Abstract [en]

    Objective: Patient-centred care is a term frequently associated with quality health care. Despite extensive literature from a range of health-care professions that provide description and measurement of patient-centred care, a definition of patient-centredness in audiological rehabilitation is lacking. The current study aimed to define patient-centred care specific to audiological rehabilitation from the perspective of older adults who have owned hearing aids for at least one year. Design: Research interviews were conducted with a purposive sample of older adults concerning their perceptions of patient-centredness in audiological rehabilitation, and qualitative content analysis was undertaken. Study sample: The participant sample included ten adults over the age of 60 years who had owned hearing aids for at least one year. Results: Data analysis revealed three dimensions to patient-centred audiological rehabilitation: the therapeutic relationship, the players (audiologist and patient), and clinical processes. Individualised care was seen as an overarching theme linking each of these dimensions. Conclusions: This study reported two models: the first model describes what older adults with hearing aids believe constitutes patient-centred audiological rehabilitation. The second provides a guide to operationalised patient-centred care. Further research is required to address questions pertaining to the presence, nature, and impact of patient-centred audiological rehabilitation.

  • 216.
    Grenness, Caitlin
    et al.
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Hickson, Louise
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Snekkersten, Denmark.
    Davidson, Bronwyn
    University of Melbourne, Australia.
    Patient-centred care: A review for rehabilitative audiologists2014In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no S1, p. S60-S67Article in journal (Refereed)
    Abstract [en]

    Objective: This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Design: Literature review and synthesis. Study sample: Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Results: Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. Conclusion: This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

  • 217.
    Grenness, Caitlin
    et al.
    HEARing CRC, Australia; University of Melbourne, Australia.
    Hickson, Louise
    HEARing CRC, Australia; University of Queensland, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Center, Oticon AS, Denmark.
    Meyer, Carly
    HEARing CRC, Australia; University of Queensland, Australia.
    Davidson, Bronwyn
    University of Melbourne, Australia.
    Communication Patterns in Audiologic Rehabilitation History-Taking: Audiologists, Patients, and Their Companions2015In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, no 2, p. 191-204Article in journal (Refereed)
    Abstract [en]

    Objectives: The nature of communication between patient and practitioner influences patient outcomes. Specifically, the history-taking phase of a consultation plays a role in the development of a relationship and in the success of subsequent shared decision making. There is limited research investigating patient-centered communication in audiology, and this study may be the first to investigate verbal communication in an adult audiologic rehabilitation context. This research aimed, first, to describe the nature of verbal communication involving audiologists, patients, and companions in the history-taking phase of initial audiology consultations and, second, to determine factors associated with communication dynamics. Design: Sixty-three initial audiology consultations involving patients over the age of 55, their companions when present, and audiologists were audio-video recorded. Consultations were coded using the Roter Interaction Analysis System and divided into three consultation phases: history, examination, and counseling. This study analyzed only the history-taking phase in terms of opening structure, communication profiles of each speaker, and communication dynamics. Associations between communication dynamics (verbal dominance, content balance, and communication control) and 11 variables were evaluated using Linear Mixed Model methods. Results: The mean length of the history-taking phase was 8.8 min (range 1.7 to 22.6). A companion was present in 27% of consultations. Results were grouped into three areas of communication: opening structure, information exchange, and relationship building. Examination of the history opening structure revealed audiologists tendency to control the agenda by initiating consultations with a closed-ended question 62% of the time, followed by interruption of patient talk after 21.3 sec, on average. The aforementioned behaviors were associated with increased verbal dominance throughout the history and increased control over the content of questions. For the remainder of the history, audiologists asked 97% of the questions and did so primarily in closed-ended form. This resulted in the audiologist talking as much as the patient and much more than the companions when they were present. Questions asked by the audiologist were balanced in topic: biomedical and psychosocial/lifestyle; however, few emotionally focused utterances were observed from any speaker (less than 5% of utter ances). Conclusions: Analysis of verbal communication involving audiologists, patients, and companions in the history-taking phase in 63 initial audiology consultations revealed a communicative exchange that was audiologist-controlled and structured, but covered both medical and lifestyle content. Audiologists often attempted to create a relationship with their patients; however, little emotional relationship building occurred, which may have implications later in the consultation when management decisions are being made. These results are not in line with patient-centered communication principles. Further research and changes to clinical practice are warranted to transform patient-centered communication from an ideal to a reality.

  • 218.
    Grenness, Caitlin
    et al.
    HEARing CRC, Australia; University of Melbourne, Australia.
    Hickson, Louise
    HEARing CRC, Australia; University of Queensland, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Meyer, Carly
    HEARing CRC, Australia; University of Queensland, Australia.
    Davidsont, Bronwyn
    University of Melbourne, Australia.
    The Nature of Communication throughout Diagnosis and Management Planning in Initial Audiologic Rehabilitation Consultations2015In: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY, ISSN 1050-0545, Vol. 26, no 1, p. 36-50Article in journal (Refereed)
    Abstract [en]

    Background: Effective practitioner-patient communication throughout diagnosis and management planning positively influences patient outcomes. A patient-centered approach whereby patient involvement in decision making is facilitated, a therapeutic relationship is developed, and information is bilaterally exchanged in an appropriate manner, leads to improved patient satisfaction, adherence to treatment, and self-management. Despite this knowledge, little is known about the nature of audiologist-patient communication throughout diagnosis and management planning. Purpose: This research aimed to explore verbal communication between audiologists and patients/ companions throughout diagnosis and management planning in initial audiology consultations. Specifically, this study aimed to describe the nature and dynamics of communication by examining the number, proportion, and type of verbal utterances by all speakers (audiologist, patient, and companion when present). In addition, this study aimed to investigate the influence of audiologist, patient, and consultation factors, such as verbal dominance, content balance, and communication control, on the dynamics of communication. Study Sample: A total of 62 initial audiological rehabilitation consultations (involving 26 different audiologists) were filmed and analyzed using the Roter Interaction Analysis System. All patients were older than 55 yr, and a companion was present in 17 consultations. Data Collection and Analysis: This study focused solely on the communication relating to diagnosis and management planning (referred to as the "counseling phase"). Diagnosis, recommendations, rehabilitation options, and patient decisions were recorded along with the communication profiles and communication dynamics measured using the Rotor Interaction Analysis System. Associations between communication dynamics (content balance, communication control, and verbal dominance) and eight variables were evaluated with Linear Mixed Model methods. Results: The mean length of time for diagnosis and management planning was 29.0 min (range, 2.2- 78.5 min). Communication profiles revealed that patient-centered communication was infrequently observed. First, opportunities to build a relationship were missed, such that patients psychosocial concerns were rarely addressed and patients/companions showed little involvement in management planning. Second, the amount of talk was asymmetrical and the majority of audiologists education and counseling utterances related to hearing aids; yet, only 56% of patients decided to obtain hearing aids at the conclusion of the consultation. Hearing aids were recommended in 83% of consultations where a hearing loss was diagnosed and alternative options were rarely provided. Thus, shared decision making rarely occurred, and audiologists often diagnosed a hearing loss and recommended hearing aids without patient involvement. In addition, when a greater proportion of time was dedicated to diagnosis and management planning, patients had greater input and control by asking more questions and requesting further information. Conclusions: Patient-centered communication was rarely observed in the 62 consultations. Thus, although not measured in this study, patient outcomes are likely to be affected. Future research should examine the influence of audiologist communication on outcomes and encourage a shift toward patient-centered audiological rehabilitation.

  • 219.
    Gustafson, Stefan
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Ferreira, Janna
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Rönnberg, Jerker
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Phonological or orthographic training for children with phonological or orthographic decoding deficits2007In: Dyslexia, ISSN 1076-9242, Vol. 13, no 3, p. 211-229Article in journal (Refereed)
    Abstract [en]

    In a longitudinal intervention study, Swedish reading disabled children in grades 2-3 received either a phonological (n = 41) or an orthographic (n = 39) training program. Both programs were computerized and interventions took place in ordinary school settings with trained special instruction teachers. Two comparison groups, ordinary special instruction and normal readers, were also included in the study. Results showed strong average training effects on text reading and general word decoding for both phonological and orthographic training, but not significantly higher improvements than for the comparison groups. The main research finding was a double dissociation: children with pronounced phonological problems improved their general word decoding skill more from phonological than from orthographic training, whereas the opposite was observed for children with pronounced orthographic problems. Thus, in this population of children, training should focus on children's relative weakness rather than their relative strength in word decoding.

  • 220.
    Gustafson, Stefan
    et al.
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Samuelsson, Stefan
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Rönnberg, Jerker
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Why Do Some Resist Phonological Intervention?: A Swedish longitudinal study of poor readers in Grade 42000In: Scandinavian Journal of Educational Research, ISSN 0031-3831, E-ISSN 1470-1170, Vol. 44, no 2, p. 145 -162Article in journal (Refereed)
    Abstract [en]

    n a longitudinal intervention study, 33 Swedish poor readers in Grade 4 received phonological awareness instruction over 1 year. Three control groups were included in the study: Grade 4 controls, Grade 2 controls (both comparable in reading skill) and normal readers. The results showed that the phonological training group made the most progress in phonological awareness but did not improve their reading skills any more than the controls. However, a re-analysis of the results revealed important individual differences within the phonological training group. Some children improved their reading ability considerably, while others seemed resistant to the intervention. One critical difference between improved and resistant readers was identified. For the improved readers, both orthographic and phonological word decoding predicted text reading performance. For the resistant readers, only orthographic decoding skills predicted text reading before, during and after the intervention, in spite of a steady increase in phonological awareness.

  • 221.
    Gustafsson, Berit M.
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Danielsson, Henrik
    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.
    Granlund, Mats
    CHILD research environment, SIDR, Jönköping University, Sweden and Department of Special Education, Oslo University, Norway.
    Gustafsson, Per A
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Proczkowska, Marie
    Psychiatric Clinic, Hospital of Jönköping, Division of Psychiatrics and Rehabilitation/Jönköping County, Sweden..
    Hyperactivity precedes conduct problems in preschool children: a longitudinal study.2018In: BJPsych Open, E-ISSN 2056-4724, Vol. 4, no 4, p. 186-191Article in journal (Refereed)
    Abstract [en]

    Background: Externalising problems are among the most common symptoms of mental health problems in preschool children.

    Aims: To investigate the development of externalising problems in preschool children over time, and the way in which conduct problems are linked to hyperactivity problems.

    Method: In this longitudinal study, 195 preschool children were included. Latent growth modelling of conduct problems was carried out, with gender and hyperactivity at year 1 as time-invariant predictors.

    Results: Hyperactivity was a significant predictor for the intercept and slope of conduct problems. Children with more hyperactivity at year 1 had more conduct problems and a slower reduction in conduct problems. Gender was a significant predictor for the slope of conduct problems.

    Conclusions: Children with more initial hyperactivity have less of a reduction in conduct problems over time. It is important to consider the role of hyperactivity in studies of the development of conduct problems.

    Declaration of interest: None.

  • 222.
    Gutenberg, Johanna
    et al.
    Oticon AS, Denmark.
    Katrakazas, Panagiotis
    Natl Tech Univ Athens, Greece.
    Trenkova, Lyubov
    Pazardzhik Reg Adm, Bulgaria.
    Murdin, Louisa
    Guys and St Thomas NHS Fdn Trust, England.
    Brdaric, Dario
    Inst Publ Hlth Osijek Baranya Cty, Croatia.
    Koloutsou, Nina
    Univ London, England.
    Ploumidou, Katherine
    Athens Med Grp, Greece.
    Pontoppidan, Niels Henrik
    Oticon AS, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon Med, Denmark.
    Big Data for Sound Policies: Toward Evidence-Informed Hearing Health Policies2018In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 27, no 3, p. 493-502Article in journal (Refereed)
    Abstract [en]

    Purpose: The scarcity of health care resources calls for their rational allocation, including within hearing health care. Policies define the course of action to reach specific goals such as optimal hearing health. The process of policy making can be divided into 4 steps: (a) problem identification and issue recognition, (b) policy formulation, (c) policy implementation, and (d) policy evaluation. Data and evidence, especially Big Data, can inform each of the steps of this process. Big Data can inform the macrolevel (policies that determine the general goals and actions), mesolevel (specific services and guidelines in organizations), and microlevel (clinical care) of hearing health care services. The research project EVOTION applies Big Data collection and analysis to form an evidence base for future hearing health care policies. Method: The EVOTION research project collects heterogeneous data both from retrospective and prospective cohorts (clinical validation) of people with hearing impairment. Retrospective data from clinical repositories in the United Kingdom and Denmark will be combined. As part of a clinical validation, over 1,000 people with hearing impairment will receive smart EVOTION hearing aids and a mobile phone application from clinics located in the United Kingdom and Greece. These clients will also complete a battery of assessments, and a subsample will also receive a smartwatch including biosensors. Big Data analytics will identify associations between client characteristics, context, and hearing aid outcomes. Results: The evidence EVOTION will generate is relevant especially for the first 2 steps of the policy-making process, namely, problem identification and issue recognition, as well as policy formulation. EVOTION will inform microlevel, mesolevel, and macrolevel of hearing health care services through evidence-informed policies, clinical guidelines, and clinical care. Conclusion: In the future, Big Data can inform all steps of the hearing health policy-making process and all levels of hearing health care services.

  • 223.
    Habibi, Mojtaba
    et al.
    Shahid Beheshti University, Iran .
    Khawaja, Nigar G.
    Queensland University of Technology, Australia .
    Moradi, Shahram
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Dehghani, Mohsen
    Shahid Beheshti University, Iran .
    Fadaei, Zahra
    Shahid Beheshti University, Iran .
    University Student Depression Inventory: Measurement model and psychometric properties2014In: Australian journal of psychology, ISSN 0004-9530, E-ISSN 1742-9536, Vol. 66, no 3, p. 149-157Article in journal (Refereed)
    Abstract [en]

    University Student Depression Inventory (USDI) was developed to assess the symptoms of depression among the university students. Considering the debilitating nature of depression among university students globally, USDI was translated in Persian and validated using university students from Iran. A battery including the Persian version of USDI and scales measuring suicide, depression, and stress was administered to a normative sample of 359 undergraduate students, and an additional clinical sample of 150 students referred to the universitys mental health centre. The results supported the factor structure and the psychometric properties of the translated version. Confirmatory factor analysis upheld the previously reported three-factor first-order and one-factor second-order structure. The internal consistency, test-retest reliability, and concurrent and discriminant validity of the Persian version were supported. Cut-off points using receiver operating characteristic curve analysis were established to identify students at risk. Gender differences on the symptoms of depression were evident only in the normative sample, where male participants, compared with female students, had higher mean scores in lethargy, cognitive/emotion, and academic motivation subscales. The translated scale can be used with Persian-speaking students in Iran and the neighbouring countries as well as those settled in the West to identify symptoms of depression for further evaluation and management.

  • 224.
    Hall, Deborah A.
    et al.
    Natl Inst Hlth Res NIHR, England; Univ Nottingham, England.
    Domingo, Silvia Zaragoza
    Neuropsychol Res Org, Spain.
    Hamdache, Leila Z.
    Carlton Acad, England.
    Manchaiah, Vinaya
    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. Lamar State Univ, TX USA; Manipal Univ, India; All India Inst Speech and Hearing, India.
    Thammaiah, Spoorthi
    All India Inst Speech and Hearing, India.
    Evans, Chris
    Univ Roehampton, England.
    Wong, Lena L. N.
    Univ Hong Kong, Peoples R China.
    A good practice guide for translating and adapting hearing-related questionnaires for different languages and cultures2018In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 57, no 3, p. 161-175Article, review/survey (Refereed)
    Abstract [en]

    Objectives: To raise awareness and propose a good practice guide for translating and adapting any hearing-related questionnaire to be used for comparisons across populations divided by language or culture, and to encourage investigators to publish detailed steps. Design: From a synthesis of existing guidelines, we propose important considerations for getting started, followed by six early steps: (1) Preparation, (2, 3) Translation steps, (4) Committee Review, (5) Field testing and (6) Reviewing and finalising the translation. Study sample: Not applicable. Results: Across these six steps, 22 different items are specified for creating a questionnaire that promotes equivalence to the original by accounting for any cultural differences. Published examples illustrate how these steps have been implemented and reported, with shared experiences from the authors, members of the International Collegium of Rehabilitative Audiology and TINnitus research NETwork. Conclusions: A checklist of the preferred reporting items is included to help researchers and clinicians make informed choices about conducting or omitting any items. We also recommend using the checklist to document these decisions in any resulting report or publication. Following this step-by-step guide would promote quality assurance in multinational trials and outcome evaluations but, to confirm functional equivalence, large-scale evaluation of psychometric properties should follow.

  • 225.
    Hallert, Eva
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Björk, Mathilda
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Dahlström, Örjan
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Health Sciences.
    Skogh, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Rheumatology.
    Disease activity and disability in women and men with early rheumatoid arthritis: An 8-year follow-up of the Swedish TIRA project2012In: Arthritis Care and Research, ISSN 0893-7524, E-ISSN 1529-0123, Vol. 64, no 8, p. 1101-1107Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To compare women and men regarding course of disease activity and disability over 8 years from diagnosis of recent onset rheumatoid arthritis (RA). PATIENTS AND METHODS: 149 patients were followed for 8 years from RA diagnosis (1996-98) regarding 28-joint count disease activity score (DAS28), pain (visual analogue scale, VAS), grip force, Grip Ability Test (GAT), Signals of Functional Impairment (SOFI hand, upper/lower extremity), walking speed, activity limitation (Health Assessment Questionnaire, HAQ) and prescribed disease-modifying anti-rheumatic drugs (DMARDs). RESULTS: Disease activity pattern over time was similar in women and men, showing improvement during the first year and thereafter a stable situation during 6 years. However, at the 7- and 8-year follow-ups deterioration was seen with a less favourable course in women. HAQ did not differ between sexes at diagnosis, but at all follow-ups women had significantly higher scores than men. Women also had lower grip force and lower walking speed, but higher upper extremity mobility. DMARD prescription was similar for both sexes. Over eight years, disease duration, sex, biologics, grip force, SOFI-hand and pain intensity together explained 43% of the variation in DAS, while grip force, SOFI-lower, GAT and pain intensity could together explain 55% of variations in HAQ. CONCLUSIONS: Disease activity was fairly well managed, but disability gradually deteriorated. Despite similar medication, women had more disability than men. The discrepancy between disease activity and disability indicates unmet needs for multi-professional interventions to prevent progressing disability and patients at risk for disability need to be identified early in the process. © 2012 by the American College of Rheumatology.

  • 226.
    Hallert, Eva
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Björk, Mathilda
    Department of Rehabilitation, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Disability in women and men with early rheumatoid arthritis during 8 years after diagnosis 8the Swedish TIRA-study2010Conference paper (Other academic)
  • 227.
    Harder, Henrik
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Norrköping.
    Speech-perception in elderly implant recipients2010In: 11th International Conference on Cochlear Implants and Other Implantable Auditory Technologies, 2010, p. 339-Conference paper (Other academic)
  • 228.
    Haukedal, Christiane Lingas
    et al.
    Univ Oslo, Norway.
    Torkildsen, Janne von Koss
    Univ Oslo, Norway.
    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.
    Wie, Ona Bo
    Univ Oslo, Norway; Oslo Univ Hosp, Norway.
    Parents Perception of Health-Related Quality of Life in Children With Cochlear Implants: The Impact of Language Skills and Hearing2018In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 61, no 8Article in journal (Refereed)
    Abstract [en]

    Purpose: The study compared how parents of children with cochlear implants (CIs) and parents of children with normal hearing perceive their childrens health-related quality of life (HR-QOL). Method: The sample consisted of 186 Norwegian-speaking children in the age span of 5; 0-12; 11 (years; months): 106 children with CIs (53% boys, 47% girls) and 80 children with normal hearing (44% boys, 56% girls). No children had known additional disabilities affecting language, cognitive development, or HR-QOL. Parents completed the generic questionnaire Pediatric Quality of Life Inventory (Varni, Seid, amp; Kurtin, 2001), whereas children completed a test battery measuring different aspects of language and hearing. Results: Parents of children with CIs reported statistically significantly poorer HR-QOL in their children, on Pediatric Quality of Life Inventory total score and the subdomains social functioning and school functioning. Roughly 50% of parents of children with CIs reported HR-QOL levels (total score) within normal limits. No significant differences between groups emerged on the physical health and emotional functioning subscales. For the children in the group with CIs, better speech perception in everyday situations was associated with higher proxy-ratings of HR-QOL. Better spoken language skills were weakly to moderately associated with higher HR-QOL. Conclusions: The findings suggest that the social and school situation is not yet resolved satisfactorily for children with CIs. Habilitation focusing on spoken language skills and better sound environment may improve social interactions with peers and overall school functioning.

  • 229.
    Heimann, Mikael
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Developmental Psychology. Linköping University, Faculty of Arts and Sciences.
    Nordqvist, Emelie
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research.
    Johansson, Mikael
    Lunds universitet.
    Lindgren, Magnus
    Lunds universitet.
    Behavioral and electrophysiological indices of learning in 14-month-old infants: Deferred imitation correlates with the Nc component2010In: Developmental Psychobiology, Volume 52, Issue 7, 2010, p. 702-702Conference paper (Other academic)
    Abstract [en]

     Deferred imitation (DI) is an established memory paradigm that reflects early individual differences but the neural activity underlying DI is to a large extent uncharted. Thus, the present study investigated the relationship between event-related potentials (ERP) and behavioral (DI) indices of learning.

    Thirty 14-months-old children participated in the study, of which 15 (9 boys) had acceptable ERP data to be included in the analysis. DI was measured with the observation-only design using three actions and a 30 min delay. ERP was recorded with a High Density Net (128 electrodes) and the learning phase consisted of two pairs of pictures presented six times (PRES 1, 2, 3, 4, 5, and 6) while the test phase consisted of two violations: Associating two familiar pictures in a new combination (ASSO) or associating one familiar picture with a novel picture (NOV).

    The mean score of DI was 1.87 (SD = 1.06) and ERP data revealed an Nc within 300-600 ms post stimuli. The mean amplitude was higher for ASSO compared with PRES 5 and 6 (p < .05) but not between NOV and PRES 5 (p = .055) and PRES 6 (ns). Larger Nc change scores (ASSO - PRES5) correlated with better DI performance, rs (15) = .57; p < .05.

    These findings, if upheld in further analyses, suggest that behavioral memory performance is related to attention processes as reflected in the observed Nc.

     

    (FUNDING: Swedish Council for Working Life and Social Research # 2006-1040)

  • 230.
    Heimann, Mikael
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Nordqvist, Emelie
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Developmental Psychology. Linköping University, Faculty of Arts and Sciences.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Johansson, Mikael
    Institutionen för psykologi, Lunds universitet.
    Lindgren, Magnus
    Institutionen för psykologi, Lunds universitet.
    Associative learning measured with ERP predicts deferred imitation using a strict observation only design in 14 to 15 month old children2013In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 54, no 1, p. 33-40Article in journal (Refereed)
    Abstract [en]

    Deferred imitation is an established procedure for behavioural measurement of early declarative-like memories in infancy and previous work has indicated a link between this type of memory and brain potentials in infants. The present study compared infants’ memory performance in this paradigm with electrophysiological indices of associative learning. Thirty children (mean age: 14.5 months) participated, of which 15 (9 boys) had acceptable ERP recordings that could be included in the final analysis. Deferred imitation was measured with an observation-only procedure using three actions and a 30 min delay. ERP was recorded with a High Density Net (128 electrodes) during associative learning. Change scores based on Nc, a middle latency component associated with attentional processes, predicted deferred imitation performance. Thus, associative learning measured with ERP predicts deferred imitation using a strict observation only design in 14 to15 month old children.

  • 231.
    Heimann, Mikael
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Nordqvist, Emelie
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Tjus, Tomas
    Psykologiska institutionen, Göteborgs universitet.
    Further exploration into the infant’s mind: Early memory, individual differences and electrophysiological correlates2011Conference paper (Other academic)
    Abstract [en]

    Deferred imitation is an established method used to study how several cognitive processes evolve during early infancy: Imitation, event-like memory and intentional understanding. In addition, deferred imitation has also been linked to early individual differences, which is the main aim of the current presentation: To further explore early individual differences as reflected by deferred imitation performance. Three strands of information that has come out of our Swedish research program will be presented. Firstly, published studies from our lab have demonstrated that deferred imitation observed between 9 and 14 months acts as an early marker of cognitive performance observed years later. Second, new observations show that electrophysiological (ERP) indices of associative learning is strongly related to memory as measured by deferred imitation at 14 months. The ERP procedure consisted of a learning phase  (several pairs of pictures were presented) and a test phase introducing two violations (a new association or a completely new picture). Larger Nc change scores (learning phase compared with the test phase) correlated strongly (rs = .57) with deferred imitation. Thirdly, some preliminary findings from an ongoing longitudinal study observing memory, imitation and intentional understanding in 9 to 16 months old children will be presented. It is our hypotheses that the cognitive processes captured by deferred imitation observed early will be linked to individual differences intentional understanding observed when the child is 16 months old. 

  • 232.
    Heimann, Mikael
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Tjus, Tomas
    Psykologiska institutionen, Göteborgs universitet.
    Nordqvist, Emelie
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Kognitiv utveckling2012In: Kognitionsvetenskap / [ed] Jens Allwood & Mikael Jensen, Lund: Studentlitteratur, 2012, 1, p. 349-367Chapter in book (Other academic)
    Abstract [sv]

    Kognitionsvetenskapär den första boken på svenska som beskriver kärnan i kognitionsvetenskap - att förstå hur människor tänker. Den spänner därmed över ett brett tvärvetenskapligt fält som inrymmer filosofi, lingvistik, psykologi, antropologi, datavetenskap och neurovetenskap. Författarna beskriver hur ämnet har vuxit fram och hur man kan studera kognition utifrån filosofiska, psykologiska och neurovetenskapliga aspekter. Även språkvetenskapliga och sociala aspekter på tänkande presenteras. Författarna tar dessutom upp relationen mellan mänskligt tänkande och djurs tänkande, samt utvecklingen av kognition från barndom till vuxen ålder. Avslutningsvis berörs flera aspekter av tänkande i förhållande till teknologi, både som stöd för tänkande och som simulering av tänkande. Boken vänder sig till studenter som läser introduktionskurs eller grundkurs i kognitionsvetenskap, men är även lämplig för beteendevetenskapliga eller språkinriktade utbildningar. Den kan även vara av intresse för alla som vill förstå mer om mänskligt tänkande

  • 233.
    Heinrich, Sarah
    et al.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Rozental, Alexander
    Department of Psychology, Stockholm University, Sweden.
    Carlbring, Per
    Division of Clinical Psychology, Department of Psychology, Stockholm University, Stockholm, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm, Sweden.
    Cotter, Katherine
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Weise, Cornelia
    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. Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Germany.
    Treating tinnitus distress via the Internet: A mixed methods approach of what makes patients seek help and stay motivated during Internet-based cognitive behavior therapy2016In: Internet Interventions, ISSN 2214-7829, Vol. 4, no 2, p. 120-130Article in journal (Refereed)
    Abstract [en]

    Background

    Internet-based cognitive behavioral therapy (ICBT) has proven to be an effective treatment in improving patients' ability to cope with tinnitus. However, some patients prefer face-to-face therapy to ICBT, and a few studies have shown considerable dropout rates if the treatment is not guided. This renders it important to identify factors that contribute to the commencement and continuation of ICBT programs.

    Aims

    Because treatment motivation and expectations are important factors in psychological treatment, the aim of our study was to investigate what leads tinnitus patients to seek out ICBT, what helps them to keep up with the treatment, and what (if any) impact these factors have on dropout rates and treatment outcomes.

    Method

    112 tinnitus patients taking part in ICBT for tinnitus responded to symptom-related questionnaires at three points in time (pre-treatment, post-treatment, and one-year-follow-up) and to a questionnaire consisting of open-ended questions about their treatment motivation and expectations before beginning treatment. Data were analyzed using qualitative content analysis, and the results were used to divide the participants into groups. The treatment outcomes of these groups were compared using t-tests, χ2-tests, and both one-factorial and mixed ANOVAs.

    Results

    Four main categories emerged as factors conducive to starting treatment: 1) Targets participants wanted to address, 2) circumstances that led to participation, 3) attitudes towards the treatment, and 4) training features. Participants identified six facilitators for continuing the treatment: success, training, individual attitude, hope, evidence, and support. Naming specific tinnitus-associated problems as targets was associated with greater improvement from pre-treatment to 1-year-follow-up. Describing an active involvement in the treatment was related to increased improvement from post-treatment to follow-up.

    Conclusion

    There are several motivational factors that tinnitus patients consider relevant for beginning and continuing ICBT. Particularly, focusing on specific targets that do not involve the tinnitus itself, and encouraging participants to take an active role in treatment may increase treatment effectiveness. However, further hypothesis-guided research is necessary to confirm our explorative results.

  • 234.
    Hemati Alamdarloo, Ghorban
    et al.
    Shiraz University.
    Moradi, Shahram
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Disability Research.
    Dehshiri, Gholam reza
    Alzahra University.
    The Relationship between Students’ Conceptions of Learning and Their Academic Achievement2013In: Psychology, ISSN 2152-7180, E-ISSN 2152-7199, Vol. 4, no 1, p. 44-49Article in journal (Refereed)
    Abstract [en]

    This study investigates the relationship between pre-university students’ conceptions of learning with their academic achievement. The sample consisted of 309 students (165 males and 144 females) in Tehran city. Among them, 104 individuals were in Mathematics, 110 in Experimental Science, and 95 in Literature (Humanities). The participants were selected through multistage cluster sampling. To assess their conceptions of learning, Purdie and Hattie’s (2002) questionnaire was used, and to measure their academic achievement, the total mean of high school diploma was considered. The results showed a significant relationship between students’ conceptions of learning and their academic achievement. There is also a meaningful relationship between students’ number of conceptions of learning and their academic achievement.

  • 235.
    Henricson, Cecilia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Frölander, Hans Erik
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Institutionen för hälsovetenskap och medicin, Örebro universitet.
    Möller, Claes
    Örebro Universitetssjukhus, audiologiskt forskningscentrum, Örebro Universitet.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Theory-of-mind and cognitive function in adults with Usher and Alström syndromes2016In: Journal of Visual Impairment & Blindness, ISSN 0145-482X, E-ISSN 1559-1476, Vol. 110, no 5, p. 349-366Article in journal (Refereed)
    Abstract [en]

    Objective: Theory-of-Mind (ToM) refers to the ability to impute mental states to one self and to others. ToM was investigated in adults with Usher syndrome type II (USH2) and Alström syndrome (AS) - two syndromes causing acquired deafblindness. The syndromes differ with regard to onset and degree of sensory loss. Individuals with AS in contrast to individuals with USH2 display a high incidence of additional physical diseases. Cognitive shortcomings are generally not observed in USH2 or in AS, but cognitive delay and a delay in receptive language have been reported in AS. The results were compared to adults with normal hearing and vision (NHV).

    Methods: Thirteen persons with USH2, 12 persons with AS, and 33 persons with NHV participated. All participants performed a test of working memory capacity and verbal ability. ToM was tested with Happe´s Strange Stories test, taxing the ability to understand the emotions and actions of story characters, comprising a mental condition. The test also include a section of matched stories, tapping verbal problem solving ability in a physical condition, and a set of tasks tapping the ability to recall verbal material.

    Results: There were no differences between the three groups in the ability to recall verbal material. Significant differences were however established on working memory, and on verbal problem solving in a physical condition, with higher results for the NHV group. The two groups with deafblindness also displayed poorer ToM performance than the NHV group, by producing fewer correct mental references. The two groups with deafblindness differed from each other also in the ability to produce mental inferences as such, where the USH group outperformed the AS group. Intra-group variability in this ability was also observed within the two syndromal groups. Differences were related to verbal ability, complex working memory capacity, visual status, and to a minor extent auditory capacity. The prevalence and severity of additional physical diseases in AS was not related to ToM performance.

    Conclusions: A limited access to information as a function of sensory loss could influence degree of experience of the physical world, but also of social situations and of communication, affecting ToM development negatively. Early loss of visual field and visual acuity was related to ToM performance in individuals with USH2 and AS. Access to information also requires processing skills promoted by effective cognitive skills. Working memory capacity was related to ToM in USH. This relation also points to the contribution of hearing in development of ToM. Differences between the two groups could be a function of genetic conditions, where the gene causing USH2 only affects the ear and the eye, while AS in addition has a multi-systemic pathology with varying onset and degree. Differences in ToM performance in the AS group could however not be directly attributed to health conditions.

  • 236.
    Henricson, Cecilia
    et al.
    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.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research.
    Moller, Claes
    Örebro University Hospital, Sweden.
    Cognitive skills and reading in adults with Usher syndrome type 22015In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 6, no 326Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate working memory (WM), phonological skills, lexical skills, and reading comprehension in adults with Usher syndrome type 2 (USH2). Design: The participants performed tests of phonological processing, lexical access, WM, and reading comprehension. The design of the test situation and tests was specifically considered for use with persons with low vision in combination with hearing impairment. The performance of the group with USH2 on the different cognitive measures was compared to that of a matched control group with normal hearing and vision (NVH). Study Sample: Thirteen participants with USH2 aged 21-60 years and a control group of 10 individuals with NVH, matched on age and level of education. Results: The group with USH2 displayed significantly lower performance on tests of phonological processing, and on measures requiring both fast visual judgment and phonological processing. There was a larger variation in performance among the individuals with USH2 than in the matched control group. Conclusion: The performance of the group with USH2 indicated similar problems with phonological processing skills and phonological WM as in individuals with long-term hearing loss. The group with USH2 also had significantly longer reaction times, indicating that processing of visual stimuli is difficult due to the visual impairment. These findings point toward the difficulties in accessing information that persons with USH2 experience, and could be part of the explanation of why individuals with USH2 report high levels of fatigue and feelings of stress (Wahlqvist et al., 2013).

  • 237.
    Henricson, Cecilia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Lidestam, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Fonologiska och lexikala färdigheter samt arbetsminneskapacitet hos barn med ushers syndrom typ 1 och cochleaimplantat2012Conference paper (Other academic)
  • 238.
    Henricson, Cecilia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Möller, Claes
    Örebro Universitetssjukhus, audiologiskt forskningscentrum, Örebro Universitet.
    Reading skill in five children with Usher Syndrome type 1 and Cochlear implants2015Manuscript (preprint) (Other academic)
    Abstract [en]

    Objective: The aim of this study was to explore and describe reading skill in children with Usher syndrome type 1 and who have cochlear implants (USH1+CI), and to position their performance in relation to that of three control groups: children with normal hearing (NH), children with hearing impairment and hearing aids (HI+HA), and children with other types of deafness and CI (other CI).

    Method: Reading comprehension and decoding was measured in five children with USH1+CI in the ages 7.5–16 years. The children participated during a test session of 2–2.5 hours and performed tests including reading skill, WM, phonological skills, and lexical skills.

    Results: Four of the children with USH1+CI achieved results similar to those of the control group with NH on the measures of reading skill. One child with USH1+CI performed below all control groups. Three of the children with USH1+CI had high performance on both the measures of phonological skill and on the tests of reading skill. The groups perform similar results on the tests of reading skill.

    Conclusions: Three of the children with USH1+CI decode non-words with a phonological decoding strategy, similar to the strategy applied by the control group with NH. Two of the children with USH1+CI relied on an orthographic decoding strategy, possibly relying on other cognitive skills than the phonological strategy.

  • 239.
    Henricson, Cecilia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Möller, Claes
    Örebro Universitetssjukhus, audiologiskt forskningscentrum, Örebro Universitet.
    Phonology, Lexical skills, and working memory in children with Usher type 1 and CI2010Conference paper (Other academic)
  • 240.
    Henricson, Cecilia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Möller, Claes
    Audiological Research Centre, Örebro University Hospital, Örebro University, Sweden.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Cognitive skills in children with Usher syndrome type 1 and cochlear implants2011Conference paper (Other academic)
  • 241.
    Henricson, Cecilia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Möller, Claes
    Örebro Universitetssjukhus, audiologiskt forskningscentrum, Örebro Universitet.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Ongoing project: Phonological and lexical skills, and working memory in children with Usher type 1 and CI2009Conference paper (Other academic)
  • 242.
    Henricson, Cecilia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Möller, Claes
    Örebro Universitetssjukhus, audiologiskt forskningscentrum, Örebro Universitet.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Phonological skills and working memory in children with Usher type 1 and C12012Conference paper (Refereed)
  • 243.
    Henricson, Cecilia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Lyxell, Björn
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Möller, Claes
    Örebro Universitetssjukhus, audiologiskt forskningscentrum, Örebro Universitet.
    Lidestam, Björn
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Wass, Malin
    Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research.
    Cognitive skills in children with Usher syndrome type 1 and cochlear implants2012In: International Journal of Pediatric Otorhinolaryngology, ISSN 0165-5876, E-ISSN 1872-8464, Vol. 76, no 10, p. 1449-1457Article in journal (Refereed)
    Abstract [en]

    Introduction: Usher syndrome is a genetic condition causing deaf-blindness and is one of the most common causes of syndromic deafness. Individuals with USH1 in Sweden born during the last 15 years have typically received cochlear implants (CI) as treatment for their congenital, profound hearing loss. Recent research in genetics indicate that the cause of deafness in individuals with Usher type 1 (USH1) could be beneficial for the outcome with cochlear implants (CI). This population has not previously been the focus of cognitive research.

    Objective: The present study aims to examine the phonological and lexical skills and working memory capacity (WMC) in children with USH1 and CI and to compare their performance with children with NH, children with hearing-impairment using hearing-aids and to children with non-USH1 deafness using CI. The participants were 7 children aged 7-16 years with USH1 and CI.

    Methods: The participants performed 10 sets of tasks measuring phonological and lexical skills and working memory capacity.

    Conclusions: The results indicate that children with USH1 and CI as a group in general have a similar level of performance on the cognitive tasks as children with hearing impairment and hearing aids. The group with USH1 and CI has a different performance profile on the tests of working memory, phonological skill and lexical skill than children with non-USH1 deafness using CI, on tasks of phonological working memory and phonological skill.

  • 244.
    Hervais-Adelman, Alexis G.
    et al.
    Functional Brain Mapping Lab .
    Davis, Matthew H.
    MRC Cognition and Brain Sciences Unit, Cambridge, UK.
    Johnsrude, Ingrid
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Taylor, Karen J.
    Carlyon, Robert P.
    MRC Cognition and Brain Sciences Unit, Cambridge, UK.
    Generalization of perceptual learning of vocoded speech2011In: Journal of Experimental Psychology: Human Perception and Performance, ISSN 0096-1523, E-ISSN 1939-1277, Vol. 37, no 1, p. 283-295Article in journal (Refereed)
    Abstract [en]

    Recent work demonstrates that learning to understand noise-vocoded (NV) speech alters sublexical perceptual processes but is enhanced by the simultaneous provision of higher-level, phonological, but not lexical content (Hervais-Adelman, Davis, Johnsrude, & Carlyon, 2008), consistent with top-down learning (Davis, Johnsrude, Hervais-Adelman, Taylor, & McGettigan, 2005; Hervais-Adelman et al., 2008). Here, we investigate whether training listeners with specific types of NV speech improves intelligibility of vocoded speech with different acoustic characteristics. Transfer of perceptual learning would provide evidence for abstraction from variable properties of the speech input. In Experiment 1, we demonstrate that learning of NV speech in one frequency region generalizes to an untrained frequency region. In Experiment 2, we assessed generalization among three carrier signals used to create NV speech: noise bands, pulse trains, and sine waves. Stimuli created using these three carriers possess the same slow, time-varying amplitude information and are equated for naïve intelligibility but differ in their temporal fine structure. Perceptual learning generalized partially, but not completely, among different carrier signals. These results delimit the functional and neural locus of perceptual learning of vocoded speech. Generalization across frequency regions suggests that learning occurs at a stage of processing at which some abstraction from the physical signal has occurred, while incomplete transfer across carriers indicates that learning occurs at a stage of processing that is sensitive to acoustic features critical for speech perception (e.g., noise, periodicity).

  • 245.
    Hesser, Hugo
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Comment: Methodological considerations in treatment evaluations of tinnitus distress:: a call for guidelines2010In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 69, no 3, p. 305-307Article in journal (Refereed)
    Abstract [en]

    n/a

  • 246.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Tinnitus in Context: A Contemporary Contextual Behavioral Approach2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Tinnitus is the experience of sounds in the ears without any external auditory source and is a common, debilitating, chronic symptom for which we have yet to develop sufficiently efficacious interventions. Cognitive behavioral therapy (CBT) has evolved over the last 20 years to become the most empirically supported treatment for treating the adverse effects of tinnitus. Nevertheless, a significant proportion of individuals do not benefit from CBT-based treatments. In addition, the theoretical underpinnings of the CBT-model are poorly developed, the relative efficacy of isolated procedures has not yet been demonstrated, and the mechanisms of therapeutic change are largely unknown. These significant limitations preclude scientific progression and, as a consequence, leave many individuals with tinnitus suffering.

    To address some of these issues, a contextual multi-method, principle-focused inductive scientific strategy, based on pragmatic philosophy, was employed in the present thesis project. The overarching aim of the thesis was to explore the utility of a functional dimensional process in tinnitus: Experiential avoidance—experiential openness/acceptance (EA). EA is defined as the inclination to avoid or alter the frequency, duration, or intensity of unwanted internal sensations, including thoughts, feelings or physical sensations. The thesis is based on experimental work (Study II, VI), process and mediation studies (Study I, III, V), and on randomized controlled trials (Study III, IV).

    Three main sets of findings supported the utility of EA in tinnitus. First, an acceptance-based treatment (i.e.,Acceptance and Commitment Therapy, ACT) was found to be effective in controlled trials. Study III demonstrated that face-to-face ACT was more effective than a wait-list control and a habituation-based sound therapy. Study IV showed that internet-delivered ACT was more effective than an active control condition (internet-discussion forum) and equally effective as an established internet-delivered CBT treatment. Second, processes research (Study I, III, V) showed that key postulated processes of change were linked to the specific technology of ACT and that these changes in processes were associated with therapeutic outcomes. Specifically, Study V found evidence to that decreases in suppression of thoughts and feelings over the course of treatment were uniquely associated with therapeutic gains in ACT as compared with CBT. Third, experimental manipulations of experiential avoidance and acceptance processes provided support to the underlying dimension (Study II, VI). That is, Study II, employing an experimental manipulation, found that controlling background sounds were associated with reduced cognitive efficiency and increased tinnitus interference over repeated experimental trials. In addition, in normal hearing participants, experimentally induced mindfulness counteracted reduced persistence in a mentally challenging task in the presence of a tinnitus-like sound stemming from initial effortful suppression of the same sound (Study VI). It is concluded that a principle-, contextual-focused approach to treatment development may represent an efficient strategy for scientific progression in the field of psychological treatments of tinnitus severity.

    List of papers
    1. Clients' in-session acceptance and cognitive defusion behaviors in acceptance-based treatment of tinnitus distress.
    Open this publication in new window or tab >>Clients' in-session acceptance and cognitive defusion behaviors in acceptance-based treatment of tinnitus distress.
    2009 (English)In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 47, no 6, p. 523-8Article in journal (Refereed) Published
    Abstract [en]

    Cognitive-behavioral treatment (CBT) is considered to be an effective treatment of distress associated with tinnitus (perception of internal noises without any outer auditory stimulation), but the processes by which the therapy works remain unclear. Mindfulness and acceptance is receiving increased attention in the treatment literature for chronic medical conditions. However, few studies have examined these and related processes with behavioral or observer measures. In the present study 57 videotapes (a total of 1710min) from 19 clients who participated in a controlled trial of an acceptance-based treatment for tinnitus distress, were coded for frequency and peak level of verbal behaviors expressing either acceptance or cognitive defusion. Frequency of cognitive defusion behaviors and peak level of cognitive defusion as well as peak level of acceptance rated in Session 2, predicted symptom reduction 6 month following treatment. These relationships were not accounted for by the improvement that had occurred prior to the measurement point of the process variables. Moreover, prior symptom changes could not predict process variables rated later in therapy (after most of the improvement in therapy had occurred). Thus, clients' in-session acceptance and cognitive defusion behaviors appear to play an important role in the reduction of negative impact of tinnitus.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-18989 (URN)10.1016/j.brat.2009.02.002 (DOI)19268281 (PubMedID)
    Available from: 2009-06-07 Created: 2009-06-07 Last updated: 2018-12-12Bibliographically approved
    2. Consequences of Controlling Background Sounds: The Effect of Experiential Avoidance on Tinnitus Interference
    Open this publication in new window or tab >>Consequences of Controlling Background Sounds: The Effect of Experiential Avoidance on Tinnitus Interference
    2009 (English)In: REHABILITATION PSYCHOLOGY, ISSN 0090-5550, Vol. 54, no 4, p. 381-389Article in journal (Refereed) Published
    Abstract [en]

    Objective: Masking by the use of sounds has been one of the most commonly applied means of coping with tinnitus. The ability to control auditory stimulation represents a potentially important process involved in tinnitus masking strategies. Little is, however, known about the consequences of control on tinnitus experience. The present study investigated the effects of control of background sounds (type and loudness) on perceived intrusiveness of tinnitus and cognitive performance. Design: Using an experimental design with a series of trials, participants with clinically significant tinnitus (N = 35) were randomly assigned to I of 2 experimental manipulation conditions (control of sounds vs. no control of sounds). Measures: Self-reported tinnitus interference and the Digit-Symbol subtest served as dependent measures. Results: Latent growth curve modeling showed that individuals assigned to the condition with control exhibited faster growth rates on tinnitus interference (increased interference) and demonstrated slower rates of improvement on cognitive performance measures over trials compared to individuals assigned to the condition with no control. Conclusion: These results suggest that efforts to control tinnitus through sounds can be associated with increased disability in individuals with tinnitus.

    Keywords
    tinnitus, control, tinnitus interference, cognitive functioning, experiential avoidance
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-52818 (URN)10.1037/a0017565 (DOI)
    Available from: 2010-01-12 Created: 2010-01-12 Last updated: 2018-12-12
    3. Acceptance and Commitment Therapy versus Tinnitus Retraining Therapy in the treatment of tinnitus: A randomised controlled trial
    Open this publication in new window or tab >>Acceptance and Commitment Therapy versus Tinnitus Retraining Therapy in the treatment of tinnitus: A randomised controlled trial
    Show others...
    2011 (English)In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 49, no 11, p. 737-747Article in journal (Refereed) Published
    Abstract [en]

    The study compared the effects of Acceptance and Commitment Therapy (ACT) with Tinnitus Retraining Therapy (TRT) on tinnitus impact in a randomised controlled trial. Sixty-four normal hearing subjects with tinnitus were randomised to one of the active treatments or a wait-list control (WLC). The ACT treatment consisted of 10 weekly 60min sessions. The TRT treatment consisted of one 150min session, one 30min follow-up and continued daily use of wearable sound generators for a recommended period of at least 8h/day for 18 months. Assessments were made at baseline, 10 weeks, 6 months and 18 months. At 10 weeks, results showed a superior effect of ACT in comparison with the WLC regarding tinnitus impact (Cohen's d=1.04), problems with sleep and anxiety. The results were mediated by tinnitus acceptance. A comparison between the active treatments, including all assessment points, revealed significant differences in favour of ACT regarding tinnitus impact (Cohen's d=0.75) and problems with sleep. At 6 months, reliable improvement on the main outcome measure was found for 54.5% in the ACT condition and 20% in the TRT condition. The results suggest that ACT can reduce tinnitus distress and impact in a group of normal hearing tinnitus patients.

    Place, publisher, year, edition, pages
    Elsevier, 2011
    Keywords
    Acceptance and commitment therapy; Stress; Social workers; Burnout; Randomized controlled trial; Stress management
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-71844 (URN)10.1016/j.brat.2011.08.001 (DOI)000296941700003 ()21864830 (PubMedID)
    Available from: 2011-11-07 Created: 2011-11-07 Last updated: 2018-12-12
    4. A Randomized Controlled Trial of Internet-Delivered Cognitive Behavior Therapy and Acceptance and Commitment Therapy in the Treatment of Tinnitus
    Open this publication in new window or tab >>A Randomized Controlled Trial of Internet-Delivered Cognitive Behavior Therapy and Acceptance and Commitment Therapy in the Treatment of Tinnitus
    Show others...
    2012 (English)In: Journal of Consulting and Clinical Psychology, ISSN 0022-006X, E-ISSN 1939-2117, Vol. 80, no 4, p. 649-661Article in journal (Refereed) Published
    Abstract [en]

    Objective: Our aim in this randomized controlled trial was to investigate the effects on global tinnitus severity of 2 Internet-delivered psychological treatments, acceptance and commitment therapy (ACT) and cognitive behavior therapy (CBT), in guided self-help format. Method: Ninety-nine participants (mean age = 48.5 years; 43% female) who were significantly distressed by tinnitus were recruited from the community. Participants were randomly assigned to CBT (n = 32), ACT (n = 35), or a control condition (monitored Internet discussion forum; n = 32), and they were assessed with standardized self-report measures (Tinnitus Handicap Inventory; Hospital Anxiety and Depression Scale; Quality of Life Inventory; Perceived Stress Scale; Tinnitus Acceptance Questionnaire) at pre-, posttreatment (8 weeks), and 1-year follow-up. Results: Mixed-effects linear regression analysis of all randomized participants showed significant effects on the primary outcome (Tinnitus Handicap Inventory) for CBT and for ACT compared with control at posttreatment (95% CI [-17.03, -2.94], d = 0.70, and 95% CI [-16.29, -2.53], d = 0.68, respectively). Within-group effects were substantial from pretreatment through 1-year-follow-up for both treatments (95% CI [-44.65, -20.45], d = 1.34), with no significant difference between treatments (95% CI [-14.87, 11.21], d = 0.16). Conclusions: Acceptance-based procedures may be a viable alternative to traditional CBT techniques in the management of tinnitus. The Internet can improve access to psychological interventions for tinnitus.

    Place, publisher, year, edition, pages
    Washington, DC, USA: American Psychological Association (APA), 2012
    National Category
    Applied Psychology
    Identifiers
    urn:nbn:se:liu:diva-76865 (URN)10.1037/a0027021 (DOI)000306861800011 ()22250855 (PubMedID)
    Available from: 2012-04-20 Created: 2012-04-20 Last updated: 2018-12-12Bibliographically approved
    5. Acceptance as a Mediator in Internet-delivered Acceptance and Commitment Therapy and Cognitive Behavior Therapy for Tinnitus
    Open this publication in new window or tab >>Acceptance as a Mediator in Internet-delivered Acceptance and Commitment Therapy and Cognitive Behavior Therapy for Tinnitus
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Despite demonstrated efficacy of behavioral and cognitive techniques in treating the impact of tinnitus (constant ringing in the ears), little is known about the mechanisms by which these techniques achieve their effect. The present study examined acceptance of tinnitus as a potential mediator of treatment changes on global tinnitus severity in internet-delivered acceptance and commitment therapy (iACT) and internet-delivered cognitive behavior therapy (iCBT). Data from 67 participants who were distressed by tinnitus and who were randomly assigned to 1 of the 2 treatments were analyzed using a multilevel moderated mediation model. We predicted that acceptance as measured with the two subscales of the tinnitus acceptance questionnaire (i.e., activity engagement and tinnitus suppression) would mediate the outcome in iACT, but not in iCBT. Results provided partial support to the notion that mediation was moderated by treatment: tinnitus suppression mediated changes in tinnitus severity in iACT, but not in iCBT. However, inconsistent with the view that the treatments worked through different processes of change, activity engagement mediated treatment changes across both iACT and iCBT. Acceptance is identified as a key source of therapeutic change in behavioral-based treatments for tinnitus.

    Keywords
    Tinnitus, acceptance, mechanisms of change, internet-delivered selfhelp, cognitive behavior therapy
    National Category
    Applied Psychology
    Identifiers
    urn:nbn:se:liu:diva-88336 (URN)
    Available from: 2013-02-03 Created: 2013-02-03 Last updated: 2014-11-28Bibliographically approved
    6. Costs of Suppressing Emotional Sound and Countereffects of a Mindfulness Induction: An Experimental Analog of Tinnitus Impact
    Open this publication in new window or tab >>Costs of Suppressing Emotional Sound and Countereffects of a Mindfulness Induction: An Experimental Analog of Tinnitus Impact
    2013 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 5, p. e64540-Article in journal (Other academic) Published
    Abstract [en]

    Tinnitus is the experience of sounds without an appropriate external auditory source. These auditory sensations are intertwined with emotional and attentional processing. Drawing on theories of mental control, we predicted that suppressing an affectively negative sound mimicking the psychoacoustic features of tinnitus would result in decreased persistence in a mentally challenging task (mental arithmetic) that required participants to ignore the same sound, but that receiving a mindfulness exercise would reduce this effect. Normal hearing participants (N = 119) were instructed to suppress an affectively negative sound under cognitive load or were given no such instructions. Next, participants received either a mindfulness induction or an attention control task. Finally, all participants worked with mental arithmetic while exposed to the same sound. The length of time participants could persist in the second task served as the dependent variable. As hypothesized, results indicated that an auditory suppression rationale reduced time of persistence relative to no such rationale, and that a mindfulness induction counteracted this detrimental effect. The study may offer new insights into the mechanisms involved in the development of tinnitus interference. Implications are also discussed in the broader context of attention control strategies and the effects of emotional sound on task performance. The ironic processes of mental control may have an analog in the experience of sounds.

    Keywords
    Mental control, tinnitus, emotional sound, mindfulness, suppression
    National Category
    Applied Psychology
    Identifiers
    urn:nbn:se:liu:diva-88337 (URN)10.1371/journal.pone.0064540 (DOI)000318852400071 ()
    Note

    On the day of the defence date the status of this article was Manuscript.

    Available from: 2013-02-03 Created: 2013-02-03 Last updated: 2018-12-12Bibliographically approved
  • 247.
    Hesser, Hugo
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Gustafsson, Tore
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lundén, Charlotte
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Henrikson, Oskar
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Fattahi, Kidjan
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Johnsson, Erik
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Westin Zetterqvist, Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Carlbring, Per
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Kaldo, Viktor
    Department of Clinical Neuroscience, Psychiatric Section, Karolinska Institutet, Stockholm, Sweden.
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    A Randomized Controlled Trial of Internet-Delivered Cognitive Behavior Therapy and Acceptance and Commitment Therapy in the Treatment of Tinnitus2012In: Journal of Consulting and Clinical Psychology, ISSN 0022-006X, E-ISSN 1939-2117, Vol. 80, no 4, p. 649-661Article in journal (Refereed)
    Abstract [en]

    Objective: Our aim in this randomized controlled trial was to investigate the effects on global tinnitus severity of 2 Internet-delivered psychological treatments, acceptance and commitment therapy (ACT) and cognitive behavior therapy (CBT), in guided self-help format. Method: Ninety-nine participants (mean age = 48.5 years; 43% female) who were significantly distressed by tinnitus were recruited from the community. Participants were randomly assigned to CBT (n = 32), ACT (n = 35), or a control condition (monitored Internet discussion forum; n = 32), and they were assessed with standardized self-report measures (Tinnitus Handicap Inventory; Hospital Anxiety and Depression Scale; Quality of Life Inventory; Perceived Stress Scale; Tinnitus Acceptance Questionnaire) at pre-, posttreatment (8 weeks), and 1-year follow-up. Results: Mixed-effects linear regression analysis of all randomized participants showed significant effects on the primary outcome (Tinnitus Handicap Inventory) for CBT and for ACT compared with control at posttreatment (95% CI [-17.03, -2.94], d = 0.70, and 95% CI [-16.29, -2.53], d = 0.68, respectively). Within-group effects were substantial from pretreatment through 1-year-follow-up for both treatments (95% CI [-44.65, -20.45], d = 1.34), with no significant difference between treatments (95% CI [-14.87, 11.21], d = 0.16). Conclusions: Acceptance-based procedures may be a viable alternative to traditional CBT techniques in the management of tinnitus. The Internet can improve access to psychological interventions for tinnitus.

  • 248.
    Hesser, Hugo
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Weise, Cornelia
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Rief, Winfried
    University of Marburg.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    The effect of waiting: A meta-analysis of wait-list control groups in trials for tinnitus distress2011In: JOURNAL OF PSYCHOSOMATIC RESEARCH, ISSN 0022-3999, Vol. 70, no 4, p. 378-384Article, review/survey (Refereed)
    Abstract [en]

    Objective: The response rates and effects of being placed on a wait-list control condition are well documented in psychiatric populations. Despite the usefulness of such estimates and the frequent use of no-treatment controls in clinical trials for tinnitus, the effect of waiting in a tinnitus trial has not been investigated systematically. The aim of the present study was to quantify the overall effect of wait-list control groups on tinnitus distress. Methods: Studies were retrieved via a systematic review of randomised controlled trials of cognitive behaviour therapy for tinnitus distress. Outcomes of psychometrically robust tinnitus-specific measures (Tinnitus Handicap Inventory, Tinnitus Questionnaire, Tinnitus Reaction Questionnaire) from wait-list control groups were quantified using meta-analytic techniques. Percentage of change and standard mean difference effect sizes were calculated using the pre and post wait period. Results: Eleven studies involving 314 wait-list subjects with tinnitus were located. The analysis for a waiting period of 6 to 12 weeks revealed a mean decrease in scores on tinnitus-specific measures of 3% to 8%. Across studies, a statically significant small mean within-group effect size was obtained (Hedges g=.17). The effects were moderated by methodological quality of the trial, sample characteristics (i.e., age, tinnitus duration), time of the wait-list and how diagnosis was established. Conclusion: Subjects in a tinnitus trial improve in tinnitus distress over a short waiting phase. The effects of waiting are highly variable and depend on the characteristics of the sample and of the trial.

  • 249.
    Hesser, Hugo
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Weise, Cornelia
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist Westin, Vendela
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Educational Sciences.
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    A Systematic Review and Meta-Analysis of Cognitive-Behavioral Therapy for Tinnitus Distress2010Conference paper (Other academic)
  • 250.
    Hesser, Hugo
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Weise, Cornelia
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist Westin, Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress2011In: CLINICAL PSYCHOLOGY REVIEW, ISSN 0272-7358, Vol. 31, no 4, p. 545-553Article, review/survey (Refereed)
    Abstract [en]

    Tinnitus is defined as a sound in the ear(s) and/or head without external origin and is a serious health concern for millions worldwide. The aim of the present study was to determine whether Cognitive Behavior Therapy (CBT) is effective in reducing distress associated with tinnitus. Randomized, controlled trials that assessed the efficacy of CBT for tinnitus-related distress in adults were identified by searching electronic databases (PsychINFO, PubMed, the Cochrane Library), and by manual searches. Fifteen studies (total of 1091 participants) were included in the meta-analysis. CBT compared with a passive and active control at post-assessment yielded statistically significant mean effect sizes for tinnitus-specific measures (Hedgess g = 0.70. and Hedgess g = 0.44, respectively). The average weighted pre-to-follow-up effect size for the CBT group suggested that these effects were maintained over time. Smaller but yet statistically significant effects of CBT were found for mood outcome measures. Characteristics of the studies were unrelated to effect sizes. Methodological rigor, publication bias, and a series of sensitivity analyses did not influence the findings. The results suggest that CBT is an effective treatment of tinnitus distress. However, caution is warranted given that few large-scale, well-controlled trials were identified.

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