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  • 1.
    Ferm, Margit
    et al.
    Riksförbundet för suicidprevention och efterlevandestöd.
    Lindegaard, Tomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Norrköping.
    Sarkohi, Ali
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Att leva i dödsskugga: närståendes erfarenheter av suicidalitet2024Ingår i: Ögonblick av suicidalitet / [ed] Ali Sarkohi, Jan Beskow, Lund: Studentlitteratur AB, 2024, Vol. Sidorna 297-320, s. 297-320Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [sv]

    I detta kapitel går vi igenom Margits egna erfarenheter av suicid som förälder till sonen Martin. Berättelsen om honom finns i kapitel 4.

  • 2.
    Lindegaard, Tomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Norrköping.
    Do Psychedelics Facilitate Emergence of Unconscious Psychological Processes?2023Ingår i: Psychodynamic psychiatry, ISSN 2162-2590, Vol. 51, nr 3, s. 270-286Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Psychedelic substances have a long history of use in traditional healing and religious ceremonies worldwide and are increasingly being investigated for their possible therapeutic usage. However, there is still a lack of consensus regarding how best to characterize the psychological effects of psychedelics and how they bring about the positive therapeutic outcomes observed in clinical studies. The aim of this article is to review available evidence from quantitative and qualitative studies on psychedelic-assisted therapy, as well as neurobiological studies, in relation to the hypothesis that psychedelics facilitate the emergence of emotionally charged unconscious material, originally proposed by pioneering psychedelics researcher Stanislav Grof. The reviewed process studies of therapeutic mechanisms in psychedelic-assisted therapy and qualitative studies of treatment participants clearly indicate that the psychedelic experience is associated with the subjective experience of having increased access to and awareness of emotions, memories, and perceptions that are normally avoided or outside of conscious awareness. Brain-imaging studies point to several different neurobiological effects of psychedelics that might be related to these subjective psychological experiences. Available evidence also indicates that this process might constitute an important therapeutic mechanism in psychedelic-assisted therapy, worthy of further investigation.

  • 3.
    Demetry, Youstina
    et al.
    Karolinska Inst, Sweden; Karolinska Inst, Sweden.
    Wasteson, Elisabet
    Mid Sweden Univ, Sweden.
    Lindegaard, Tomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Abuleil, Amjad
    Competence Team migrat Hlth, Sweden.
    Geranmayeh, Anahita
    Karolinska Inst, Sweden.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Shahnavaz, Shervin
    Karolinska Inst, Sweden.
    Individually Tailored and Culturally Adapted Internet-Based Cognitive Behavioral Therapy for Arabic-Speaking Youths With Mental Health Problems in Sweden: Qualitative Feasibility Study2023Ingår i: JMIR Formative Research, E-ISSN 2561-326X, Vol. 7, artikel-id e46253Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 4.
    Woodward, Aniek
    et al.
    KIT Hlth, Netherlands; Vrije Univ Amsterdam, Netherlands.
    Burchert, Sebastian
    Free Univ Berlin, Germany.
    Barry, Alexandra S.
    KIT Hlth, Netherlands; NHS England, England.
    Broerse, Jacqueline E. W.
    Vrije Univ Amsterdam, Netherlands.
    Sondorp, Egbert
    KIT Hlth, Netherlands.
    Bold, Anoushka
    KIT Hlth, Netherlands; Inuka Coaching, Netherlands.
    Ruberl, Alexander
    Free Univ Berlin, Germany.
    Hessling, Jonas M.
    Free Univ Berlin, Germany.
    Knaevelsrud, Christine
    Free Univ Berlin, Germany.
    Roberts, Bayard
    London Sch Hyg & Trop Med, England.
    Fuhr, Daniela C.
    London Sch Hyg & Trop Med, England; Leibniz Inst Prevent Res & Epidemiol BIPS, Germany; Univ Bremen, Germany.
    Ventevogel, Peter
    United Nations High Commissioner Refugees, Switzerland.
    Hosny, Nadine
    Univ Lausanne, Switzerland.
    Lindegaard, Tomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Shahnavaz, Shervin
    Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Sijbrandij, Marit
    Vrije Univ Amsterdam, Netherlands.
    Cuijpers, Pim
    Vrije Univ Amsterdam, Netherlands; Babes Bolyai Univ, Romania.
    Mckee, Martin
    London Sch Hyg & Trop Med, England.
    Dieleman, Marjolein A.
    KIT Hlth, Netherlands; Vrije Univ Amsterdam, Netherlands.
    STRENGTHS Consortium,
    Scalability of digital psychological innovations for refugees: A comparative analysis in Egypt, Germany, and Sweden2023Ingår i: SSM-MENTAL HEALTH, ISSN 2666-5603, Vol. 4, artikel-id 100231Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    E-mental health interventions may offer innovative means to increase access to psychological support and improve the mental health of refugees. However, there is limited knowledge about how these innovations can be scaled up and integrated sustainably into routine services. This study examined the scalability of a digital psychological intervention called Step-by-Step (SbS) for refugees in Egypt, Germany, and Sweden. We conducted semi-structured interviews (n = 88) with Syrian refugees, and experts in SbS or refugee mental health systems in the three countries. Data collection and analysis were guided by a system innovation perspective. Interviewees identified three contextual factors that influenced scalability of SbS in each country: increasing use of e-health, the COVID-19 pandemic, and political instability. Nine factors lay at the interface between the innovation and potential delivery systems, and these were categorised by culture (ways of thinking), structure (ways of organising), and practice (ways of doing). Factors related to culture included: perceived need and acceptability of the innovation. Acceptability was influenced by mental health stigma and awareness, digital trust, perceived novelty of self-help interventions, and attitudes towards non-specialist (e-helper) support. Factors related to structure included financing, regulations, accessibility, competencies of e-helpers, and quality control. Factors related to practice were barriers in the initial and continued engagement of end-users. Many actors with a potential stake in the integration of SbS across the three countries were identified, with nineteen stakeholders deemed most powerful. Several context-specific integration scenarios were developed, which need to be tested. We conclude that integrating novel e-mental health interventions for refugees into routine services will be a complex task due to the many interrelated factors and actors involved. Multi-stakeholder collaboration, including the involvement of end-users, will be essential.

  • 5.
    Berg, Matilda
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Klemetz, Helena
    Psykologpartners, Linkoping, Sweden.
    Lindegaard, Tomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Self-esteem in new light: a qualitative study of experiences of internet-based cognitive behaviour therapy for low self-esteem in adolescents2023Ingår i: BMC Psychiatry, E-ISSN 1471-244X, Vol. 23, nr 1, artikel-id 810Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 6.
    Berg, Matilda
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Lindegaard, Tomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Flygare, Anna
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Sjöbrink, Julia
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Hagvall, Linn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Palmebäck, Sofia
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Klemetz, Helena
    Psykologpartners, Private practice, Linköping, Sweden.
    Ludvigsson, Mikael
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Linköping. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för hälsa, medicin och vård, Avdelningen för prevention, rehabilitering och nära vård.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    Internet-based CBT for adolescents with low self-esteem: a pilot randomized controlled trial2022Ingår i: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 51, nr 5, s. 388-407Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Low self-esteem is a common problem among adolescents and is related to psychiatric problems such as depression and anxiety. However, effective and available interventions primarily targeting low self-esteem are scarce, in particular for youths. To address this gap, the aim of this pilot study was to evaluate a novel internet-based Cognitive Behavioral Therapy (ICBT) program for low self-esteem in adolescents using a randomized controlled design. Fifty-two participants (15-19 years) were recruited and randomly allocated to seven weeks of therapist-supported ICBT (n=26) or to a waitlist control condition (n=26). The primary outcome was the Rosenberg Self-Esteem Scale (RSES). Secondary outcomes measured domain-specific aspects of self-esteem, self-compassion, quality of life, depression and anxiety. The treatment group showed significantly higher levels of self-rated self-esteem compared to the control group at post-treatment, with a large between-group effect-size (RSES, d = 1.18). Further, the treatment had significant positive impact on secondary measures of self-esteem, self-compassion, quality of life, depression and anxiety. The results of this pilot-RCT suggest that ICBT can be effective for treating low self-esteem in adolescents, decrease depression and anxiety levels, and increasing quality of life. Replication of the results in larger samples is needed.    

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  • 7. Beställ onlineKöp publikationen >>
    Lindegaard, Tomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Internet-based treatment of depression and anxiety among migrants and refugees in Sweden2022Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Antalet flyktingar och migranter världen över ökar där många drabbas av negativa psykologiska konsekvenser av traumatiska och stressande händelser som kan inträffa både före, efter eller under migrationsprocessen. Trots detta finns det begränsad forskning kring hur man bäst kan hjälpa flyktingar och migranter med den psykiska ohälsa som de ibland upplever. Internetbaserad behandling har visat på lovande resultat vid behandling av många vanliga psykiska störningar och kan översättas och anpassas till olika språkgrupper. Syftet med denna avhandling var att undersöka användbarheten och effekten av internetbaserad kognitiv beteendeterapi (IKBT) för migranter och flyktingar i Sverige som lider av depression och ångest.

    Studierna i avhandlingen visade att både vägledd och icke-vägledd IKBT kan vara acceptabla interventioner för arabisktalande vuxna med milda till måttliga symtom på depression och ångest. Resultaten visade även på positiva effekter av vägledd IKBT i termer av minskade symptom på psykisk ohälsa. När det gäller dari/farsi-talande ungdomar/unga vuxna visade det sig att strukturen i behandlingsupplägget utgjorde en viktig barriär. Framtida studier bör undersöka om ett behandlingsformat som integrerar mer behandlarkontakt kan öka acceptansen för IKBT i denna målgrupp.

    Delarbeten
    1. Development of an Internet-Based Cognitive Behavioral Therapy Self-Help Program for Arabic-Speaking Immigrants: Mixed-Methods Study
    Öppna denna publikation i ny flik eller fönster >>Development of an Internet-Based Cognitive Behavioral Therapy Self-Help Program for Arabic-Speaking Immigrants: Mixed-Methods Study
    2018 (Engelska)Ingår i: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 7, nr 12, artikel-id e11872Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Recent years have seen an increase in Arabic-speaking immigrants in Sweden and other European countries, with research showing this group to suffer from elevated levels of various forms of psychological disorders. There is a lack of treatment options for immigrants with mild to moderate mental health problems, with barriers including lack of accessible services and concerns that problems will not be understood by health care providers.

    Ort, förlag, år, upplaga, sidor
    JMIR, 2018
    Nyckelord
    Arabs; cognitive behavioral therapy; focus groups; internet
    Nationell ämneskategori
    Psykiatri
    Identifikatorer
    urn:nbn:se:liu:diva-156079 (URN)10.2196/11872 (DOI)000454265400018 ()30563819 (PubMedID)
    Tillgänglig från: 2019-04-02 Skapad: 2019-04-02 Senast uppdaterad: 2024-05-29
    2. Internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a pilot randomized controlled trial
    Öppna denna publikation i ny flik eller fönster >>Internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a pilot randomized controlled trial
    Visa övriga...
    2021 (Engelska)Ingår i: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 50, nr 1, s. 47-66Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Arabic-speaking immigrants and refugees constitute one of the largest immigrant groups in Sweden. Previous research on Arabic-speaking immigrants indicates elevated levels of psychological disorders, including depression and anxiety. The aim of the present pilot study was to examine the efficacy of an internet-delivered cognitive behavioural treatment (ICBT) in an Arabic-speaking immigrant population. The intervention was individually tailored based on self-described problems and consisted of nine modules targeting areas such as depression, anxiety and insomnia. In total, 59 individuals were included and randomized to either an 8-week treatment or wait-list control. Self-reported symptoms of depression on the PHQ-9 were used as primary outcome measure. Secondary outcome measures of anxiety, stress, insomnia, quality of life and post-traumatic stress were also used. In the intention-to-treat analysis, depressive symptoms were significantly reduced compared to the wait-list control group with a between-group effect at post-treatment of Cohensd= 0.85 [0.29, 1.41]. We also found significant between-group effects for symptoms of insomnia and stress, but not for anxiety, post-traumatic stress or quality of life measures. The results indicate that ICBT is a promising treatment approach for treating symptoms of depression, insomnia and stress, in an Arabic-speaking immigrant population. Further studies with larger samples are warranted.

    Ort, förlag, år, upplaga, sidor
    Routledge, 2021
    Nyckelord
    Depression; anxiety; internet-based cognitive behaviour therapy; transcultural; refugee
    Nationell ämneskategori
    Tillämpad psykologi
    Identifikatorer
    urn:nbn:se:liu:diva-168577 (URN)10.1080/16506073.2020.1771414 (DOI)000549638800001 ()32603632 (PubMedID)2-s2.0-85087563432 (Scopus ID)
    Anmärkning

    Funding Agencies|Sveriges Kommuner och Landsting; VetenskapsradetSwedish Research Council

    Tillgänglig från: 2020-08-27 Skapad: 2020-08-27 Senast uppdaterad: 2022-10-25Bibliografiskt granskad
    3. Experiences of internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a qualitative study
    Öppna denna publikation i ny flik eller fönster >>Experiences of internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a qualitative study
    Visa övriga...
    2021 (Engelska)Ingår i: BMC Psychiatry, E-ISSN 1471-244X, Vol. 21, nr 1, artikel-id 288Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    BackgroundInternet-delivered cognitive behavioural therapy (ICBT) is a promising treatment for refugee and immigrant populations suffering from common mental disorders. The aim of the present study was to investigate experiences of participating in a guided ICBT program among resettled Arabic-speaking individuals suffering from symptoms of anxiety and depression.MethodsTen individuals who had previously received ICBT consented to participate and were interviewed using semi-structured telephone interviews. The interviews were conducted 10months after treatment termination. Data were transcribed and analysed using a Thematic Analysis framework.ResultsThe Thematic Analysis resulted in five overarching themes 1) The importance of being seen, 2) New ways of knowing and doing, 3) Treatment format not for everyone, 4) Changing attitudes towards mental health and help-seeking and 5) The healthcare system as a complex puzzle. Participants described varying levels of success in applying the new information learned from the treatment in their everyday lives. The results also indicate that participation in the ICBT program to some extent mitigated mental health stigma and acted as a precursor to other forms of treatment seeking.ConclusionsThe findings in the present study are largely in line with previous qualitative research studies on ICBT participants. Future research should investigate whether a more explicit focus on refugee-specific stressors and barriers to treatment engagement and implementation can increase adherence to ICBT programs in this population.

    Ort, förlag, år, upplaga, sidor
    BMC, 2021
    Nyckelord
    Depression; Thematic analysis; Anxiety; Internet-based cognitive behaviour therapy; Culturally adapted psychotherapy; Qualitative; Transcultural; Refugees
    Nationell ämneskategori
    Tillämpad psykologi
    Identifikatorer
    urn:nbn:se:liu:diva-177443 (URN)10.1186/s12888-021-03297-w (DOI)000660874900001 ()34082745 (PubMedID)
    Anmärkning

    Funding Agencies|Swedish Research CouncilSwedish Research CouncilEuropean Commission [2018-05827]; Linkoping University

    Tillgänglig från: 2021-06-29 Skapad: 2021-06-29 Senast uppdaterad: 2024-01-17
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  • 8.
    Lindegaard, Tomas
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Wasteson, Elisabet
    Mid Sweden Univ, Sweden.
    Demetry, Youstina
    Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Richards, Derek
    Univ Dublin, Ireland; SilverCloud Hlth, Ireland.
    Shahnavaz, Shervin
    Karolinska Inst, Sweden; Reg Stockholm, Sweden.
    Investigating the potential of a novel internet-based cognitive behavioural intervention for Dari and Farsi speaking refugee youth: A feasibility study2022Ingår i: Internet Interventions, ISSN 2214-7829, Vol. 28, artikel-id 100533Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Over half of the worlds forcibly displaced persons are under the age of 25, with many suffering from symptoms of psychological disorders. Many refugees from Afghanistan or Iran speak either Dari or Farsi, which are mutually intelligible dialects of the Persian language. Previous research on adult refugees and immigrants have shown that internet-based cognitive behavioural therapy (ICBT) can be a valuable complement to other forms of treatment. However, there is a lack of knowledge if ICBT is a feasible and acceptable treatment for adolescents and young adults with a refugee background. Method: Fifteen Dari/Farsi-speaking adolescents and young adults between 15 and 26 years of age participated in a feasibility study of a novel individually tailored guided ICBT intervention targeting symptoms of common mental disorders such as anxiety and depression. Self-reported symptoms of anxiety and depression were assessed using the Hopkins Symptom Checklist-25 (HSCL-25) as the primary outcome measure. Four of the treatment participants and three additional non-treatment participants consented to be interviewed regarding the programmes acceptability. The interviews were analysed using Thematic Analysis. Results: The intervention suffered from low adherence, with only 3 participants completing the post-treatment assessment and with participants completing 0.9 modules on average, which meant that the intended quantitative analysis of the pre to post change was not possible. The thematic analysis resulted in two overarching categories, barriers and facilitators, that each contained four themes and related subthemes. Overall, the intervention was deemed culturally relevant and easy to understand. The most salient barriers to participation across interviews concerned interference of symptoms such as concentration difficulties, low energy, and a lack of human contact and support. Conclusion: The current version of the ICBT program demonstrated low feasibility and acceptability in the target population, which mainly seemed to be related to the delivery format. Future studies should investigate if a blended treatment format with regular phone/video calls with a therapist can increase adherence to the intervention.

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  • 9.
    Lindegaard, Tomas
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Kashoush, Fatima
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Holm, Sara
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Halaj, Asala
    Hebrew Univ Jerusalem, Israel.
    Berg, Matilda
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Experiences of internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a qualitative study2021Ingår i: BMC Psychiatry, E-ISSN 1471-244X, Vol. 21, nr 1, artikel-id 288Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundInternet-delivered cognitive behavioural therapy (ICBT) is a promising treatment for refugee and immigrant populations suffering from common mental disorders. The aim of the present study was to investigate experiences of participating in a guided ICBT program among resettled Arabic-speaking individuals suffering from symptoms of anxiety and depression.MethodsTen individuals who had previously received ICBT consented to participate and were interviewed using semi-structured telephone interviews. The interviews were conducted 10months after treatment termination. Data were transcribed and analysed using a Thematic Analysis framework.ResultsThe Thematic Analysis resulted in five overarching themes 1) The importance of being seen, 2) New ways of knowing and doing, 3) Treatment format not for everyone, 4) Changing attitudes towards mental health and help-seeking and 5) The healthcare system as a complex puzzle. Participants described varying levels of success in applying the new information learned from the treatment in their everyday lives. The results also indicate that participation in the ICBT program to some extent mitigated mental health stigma and acted as a precursor to other forms of treatment seeking.ConclusionsThe findings in the present study are largely in line with previous qualitative research studies on ICBT participants. Future research should investigate whether a more explicit focus on refugee-specific stressors and barriers to treatment engagement and implementation can increase adherence to ICBT programs in this population.

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  • 10.
    Lindegaard, Tomas
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Seaton, Felicia
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Halaj, Asala
    Hebrew Univ Jerusalem, Israel.
    Berg, Matilda
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Kashoush, Fatima
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Barchini, Rim
    Region Östergötland.
    Ludvigsson, Mikael
    Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Linköping. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken. Linköpings universitet, Institutionen för hälsa, medicin och vård.
    Sarkohi, Ali
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Inst, Sweden.
    Internet-based cognitive behavioural therapy for depression and anxiety among Arabic-speaking individuals in Sweden: a pilot randomized controlled trial2021Ingår i: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 50, nr 1, s. 47-66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Arabic-speaking immigrants and refugees constitute one of the largest immigrant groups in Sweden. Previous research on Arabic-speaking immigrants indicates elevated levels of psychological disorders, including depression and anxiety. The aim of the present pilot study was to examine the efficacy of an internet-delivered cognitive behavioural treatment (ICBT) in an Arabic-speaking immigrant population. The intervention was individually tailored based on self-described problems and consisted of nine modules targeting areas such as depression, anxiety and insomnia. In total, 59 individuals were included and randomized to either an 8-week treatment or wait-list control. Self-reported symptoms of depression on the PHQ-9 were used as primary outcome measure. Secondary outcome measures of anxiety, stress, insomnia, quality of life and post-traumatic stress were also used. In the intention-to-treat analysis, depressive symptoms were significantly reduced compared to the wait-list control group with a between-group effect at post-treatment of Cohensd= 0.85 [0.29, 1.41]. We also found significant between-group effects for symptoms of insomnia and stress, but not for anxiety, post-traumatic stress or quality of life measures. The results indicate that ICBT is a promising treatment approach for treating symptoms of depression, insomnia and stress, in an Arabic-speaking immigrant population. Further studies with larger samples are warranted.

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  • 11.
    Käll, Anton
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Bäck, Malin
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Welin, Camilla
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Åman, Hanna
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Bjerkander, Rasmus
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Wanman, Matilda
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Lindegaard, Tomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Berg, Matilda
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Moche, Hajdi
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Shafran, Roz
    UCL Great Ormond St Inst Child Hlth, England.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Karolinska Inst, Sweden.
    Therapist-Guided Internet-Based Treatments for Loneliness: A Randomized Controlled Three-Arm Trial Comparing Cognitive Behavioral Therapy and Interpersonal Psychotherapy2021Ingår i: Psychotherapy and Psychosomatics, ISSN 0033-3190, E-ISSN 1423-0348, Vol. 90, nr 5, s. 351-358Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Chronic loneliness has been linked to many adverse outcomes, including mental health problems. Psychological treatment of loneliness can be effective, but the evidence base is limited. Objective: To investigate the efficacy of 2 internet-based interventions based on cognitive behavioral therapy (ICBT) and interpersonal psychotherapy (IIPT) relative to a wait-list control group and each other. Methods: A total of 170 participants were recruited and randomized to either 9 weeks of ICBT (n = 68), IIPT (n = 68), or a wait-list condition (n = 34). The primary outcome was loneliness, measured using the UCLA Loneliness Scale before, during, and after treatment. Secondary measures of psychiatric disorders and quality of life were administered before and after treatment. Follow-up was conducted 4 months after the treatment had ended. Primary outcome data were analyzed using growth curve modeling. Secondary outcomes were analyzed using robust regression models. The trial was preregistered (ClinicalTrials.gov ID: NCT03807154). Results: The ICBT condition had a significantly greater impact on loneliness compared to the wait-list and IIPT conditions. Effect sizes were moderate to large (Cohen d = 0.71) compared to the wait-list and moderate (d = 0.53) compared to IIPT. The IIPT condition did not differ significantly from the wait-list. Both active treatments led to significant increases in quality of life. Only the ICBT group had significantly lower symptoms of depression and generalized anxiety compared to the wait-list group. Treatment gains were maintained but not improved at follow-up. Conclusions: ICBT can be an efficacious option for alleviating loneliness. The IIPT intervention was not as effective.

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  • 12.
    Käll, Anton
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Shafran, Roz
    UCL Great Ormond St Inst Child Hlth, England.
    Lindegaard, Tomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Bennett, Sophie
    UCL Great Ormond St Inst Child Hlth, England.
    Cooper, Zafra
    Univ Oxford, England; Yale Univ, CT 06520 USA.
    Coughtrey, Anna
    UCL Great Ormond St Inst Child Hlth, England.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Inst, Sweden.
    A Common Elements Approach to the Development of a Modular Cognitive Behavioral Theory for Chronic Loneliness2020Ingår i: Journal of Consulting and Clinical Psychology, ISSN 0022-006X, E-ISSN 1939-2117, Vol. 88, nr 3, s. 269-282Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Loneliness is a transdiagnostic clinical phenomenon that can significantly impact mental health and well-being across the lifespan. Objective: The aim was to combine existing theory and evidence-based treatment approaches to propose a comprehensive transdiagnostic cognitive-behavioral analysis of the maintenance of chronic loneliness relevant across disorders, age groups, and populations. Method: A distillation and matching model-framework approach was taken to identify interventions designed to reduce loneliness. Eligible studies were coded for the presence of practice elements. The findings were combined with an analysis of the broader literature on loneliness and psychopathology to derive a comprehensive cognitive-behavioral analysis of the maintenance of loneliness over time across populations. Results: The search yielded 11 studies containing 14 practice elements with relative frequencies ranging from 7% to 64%. The identified practice elements target putative mechanisms such as negative interpersonal appraisals. anxiety, and social skills deficits. Counterproductive behavior and cognitive processes such as sell-focused attention were identified as maintenance factors based on the broader literature. A modular transdiagnostic model with multiple pathways is proposed to be consistent with the existing theoretical and treatment literature. Conclusions: Combining the distillation and matching model framework with existing theory from the literature is a novel approach for developing a model of factors that maintain loneliness over time. The model has varying treatment implications for different populations including children with autism spectrum disorders and bereaved older adults. Targeting transdiagnostic processes has the potential to transform interventions for loneliness across a range of formats and settings.

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  • 13.
    Valeriani, Giuseppe
    et al.
    Ostergotland Cty Council, Sweden.
    Vukovic, Iris Sarajlic
    Sahlgrens Univ Hosp, Sweden.
    Lindegaard, Tomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Felizia, Roberto
    Ostergotland Cty Council, Sweden.
    Mollica, Richard
    Harvard Med Sch, MA 02115 USA.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Addressing Healthcare Gaps in Sweden during the COVID-19 Outbreak: On Community Outreach and Empowering Ethnic Minority Groups in a Digitalized Context2020Ingår i: Healthcare, E-ISSN 2227-9032, Vol. 8, nr 4, artikel-id 445Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Since its early stages, the COVID-19 pandemic has interacted with existing divides by ethnicity and socioeconomic statuses, exacerbating further inequalities in high-income countries. The Swedish public health strategy, built on mutual trust between the government and the society and giving the responsibility to the individual, has been criticized for not applying a dedicated and more diverse strategy for most disadvantaged migrants in dealing with the pandemic. In order to mitigate the unequal burden on the marginalized members of society, increasing efforts have been addressed to digital health technologies. Despite the strong potential of providing collective public health benefits, especially in a highly digitalized context as Sweden, need for a stronger cooperation between the public health authorities and migrant community leaders, representatives of migrant associations, religious leaders and other influencers of disadvantaged groups has emerged. Suggestions are presented on more culturally congruent, patient-centered health care services aimed to empower people to participate in a more effective public health response to the COVID-19 crisis.

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  • 14.
    Lindegaard, Tomas
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Norrköping.
    Berg, Matilda
    Clinical Psychology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden..
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Professor in Clinical Psychology, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden, and Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden..
    Efficacy of Internet-Delivered Psychodynamic Therapy: Systematic Review and Meta-Analysis2020Ingår i: Psychodynamic Psychiatry, ISSN 2162-2590, Vol. 48, nr 4, s. 437-454Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Recent years have seen an increase of internet-delivered interventions based on psychodynamic treatment models. To test the efficacy of internet-delivered psychodynamic therapy (IPDT), we conducted a systematic review and meta-analysis of randomized controlled trials. Following literature searches, we identified seven studies meeting inclusion criteria. The total number of participants was 528 in the treatment group and 552 in the control conditions. We found small effects favoring IPDT compared to inactive control conditions for main outcomes (g = 0.44), depression (g = 0.46), anxiety (g = 0.20), and quality of life (g = 0.40). There was significant heterogeneity between studies for main outcomes and depression. Within-group effects ranged from Hedges's g = 0.32–0.99. The effects of IPDT were maintained or increased at follow-up. Study quality varied but was generally high. No indications of publication bias were found. In conclusion, IPDT is a promising treatment alternative, especially for depression, although the small number of studies limits the generalizability of the findings.

  • 15.
    Lindegaard, Tomas
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Hesslow, Thomas
    Stockholm Univ, Sweden.
    Nilsson, Maja
    Stockholm Univ, Sweden.
    Johansson, Robert
    Stockholm Univ, Sweden.
    Carlbring, Per
    Stockholm Univ, Sweden.
    Lilliengren, Peter
    Ersta Skondal Bracke Univ Coll, Sweden.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken. Karolinska Inst, Sweden.
    Internet-based psychodynamic therapy vs cognitive behavioural therapy for social anxiety disorder: A preference study2020Ingår i: Internet Interventions, ISSN 2214-7829, Vol. 20, artikel-id 100316Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Both Internet-delivered cognitive behavioural therapy (ICBT) and Internet-delivered psychodynamic psychotherapy (IPDT) have shown promise in the treatment of social anxiety disorder (SAD). However, little is known about client preferences and what predicts treatment outcome. The objective of the present pilot study was to examine preference for ICBT versus IPDT in the treatment of SAD and whether participants preference strength and therapeutic alliance predicted treatment response. Further, we also investigated the effect of the two treatments, including 6-months follow-up. Method: Thirty-six participants were instructed to choose between either IPDT or ICBT based on a brief description. Both treatments were 10 weeks long. Liebowitz Social Anxiety Scale - Self Report was used as the primary outcome measure. Results: IPDT (N = 23; 63.9%) was preferred more often than ICBT (N = 13; 36.1%), but the difference did not reach statistical significance (p =.10). Preference strength did not predict the treatment effect but therapeutic alliance did. The observed within-group effects for the treatment period were d = 0.40 [-0.21, 0.99] for the IPDT group and d = 0.53 [-0.29, 1.31] for the ICBT group. An intention-to-treat (ITT) analysis revealed no significant difference between the two treatments on any outcome measure at either post-treatment or at six months follow-up. Conclusion: The present pilot study did not find a difference in preference for IPDT or ICBT in the treatment of SAD and both treatments resulted in small to moderate improvements in symptoms of SAD. Preference strength might not predict treatment effect, but this needs to be tested in larger studies.

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  • 16.
    Nygren, Tomas
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Brohede, David
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten. ing, SE-58183 Linkoping, Sweden.
    Koshnaw, Kocher
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Osman, Shevan Sherzad
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Johansson, Robert
    Stockholm Univ, Sweden.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Karolinska Inst, Sweden.
    Internet-based treatment of depressive symptoms in a Kurdish population: A randomized controlled trial2019Ingår i: Journal of Clinical Psychology, ISSN 0021-9762, E-ISSN 1097-4679, Vol. 75, nr 6, s. 985-998Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective Kurdish immigrants in Sweden have a doubled risk of mental health problems, and refugee and immigrant populations underutilize mental health services. The present study investigated the efficacy of culturally adapted guided internet-based cognitive behavior therapy (ICBT) for depressive symptoms in a Kurdish population. Method We included 50 individuals who were randomized to either an 8-week treatment or a wait-list. The Beck Depression Inventory-II was the primary outcome measure, and measures of anxiety and insomnia were secondary outcomes. Results Depressive symptoms were significantly reduced (intention-to-treat analysis) in the treatment group, with a between-group effect size at posttreatment of Cohens d = 1.27. Moderate to large between-group effects were also observed on all secondary outcome measures. Treatment effects were sustained at 11-month follow-up. Conclusion The results provide preliminary support for culturally adapted ICBT as a complement to other treatment formats for treating symptoms of depression in a Kurdish population.

  • 17.
    Nygren (Lindegaard), Tomas
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Berg, Matilda
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Sarkohi, Ali
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Development of an Internet-Based Cognitive Behavioral Therapy Self-Help Program for Arabic-Speaking Immigrants: Mixed-Methods Study2018Ingår i: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 7, nr 12, artikel-id e11872Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Recent years have seen an increase in Arabic-speaking immigrants in Sweden and other European countries, with research showing this group to suffer from elevated levels of various forms of psychological disorders. There is a lack of treatment options for immigrants with mild to moderate mental health problems, with barriers including lack of accessible services and concerns that problems will not be understood by health care providers.

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