Biomedical subjects

Gerhard Andersson

Publications and source records attributed to Gerhard Andersson.

At least 37 records · Page 2Linked to original sources

PubMed2005

Fear-avoidance in recovered burn patients: association with psychological and somatic symptoms.

Fear-avoidance, an important model in the understanding of chronic pain, has not yet been studied in patients with burns. The purpose of this study was to investigate if recovered burn patients have fear-avoidance beliefs and to explore the association with psychological and somatic symptoms. Eighty-four recovered burn patients completed self-report questionnaires. The results showed that there were fear-avoidance beliefs, but not to a large extent. Beta coefficients from multiple regression analyses indicated a strong association between fear-avoidance and problems with work, heat sensitivity and arousal symptoms. The model was capable of explaining 73 per cent of the variance in fear-avoidance beliefs.

Adaptation, Psychological↗

PubMed2005

Internet-based self-help for depression: randomised controlled trial.

BACKGROUND: Major depression can be treated by means of cognitive-behavioural therapy, but as skilled therapists are in short supply there is a need for self-help approaches. Many individuals with depression use the internet for discussion of symptoms and to share their experience. AIMS: To investigate the effects of an internet-administered self-help programme including participation in a monitored, web-based discussion group, compared with participation in web-based discussion group only. METHOD: A randomised controlled trial was conducted to compare the effects of internet-based cognitive-behavioural therapy with minimal therapist contact (plus participation in a discussion group) with the effects of participation in a discussion group only. RESULTS: Internet-based therapy with minimal therapist contact, combined with activity in a discussion group, resulted in greater reductions of depressive symptoms compared with activity in a discussion group only (waiting-list control group). At 6 months' follow-up, improvement was maintained to a large extent. CONCLUSIONS: Internet-delivered cognitive cognitive-behavioural therapy should be pursued further as a complement or treatment alternative for mild-to-moderate depression.

Adult↗

PubMed2005

The use of the Internet in the treatment of anxiety disorders.

PURPOSE OF REVIEW: The aim of this article is to review the emerging literature on the use of the Internet in the treatment of anxiety disorders. The questions asked are: (1) are Internet-delivered treatments for anxiety disorders supported by the research literature? (2) what is the quality of the evidence as it stands? (3) is there any evidence to suggest that Internet interventions can be harmful? RECENT FINDINGS: Recent and ongoing trials on panic disorder show that Internet-based self-help with minimal therapist contact is a promising approach in the treatment of panic disorder. However, trials have been small and there is a need for large-scale trials and studies conducted in psychiatric settings as most studies have recruited patients via advertisement. There is no evidence in the literature that Internet intervention is harmful, but most likely a stepped-care approach would be feasible to handle cases who fail to respond. SUMMARY: Internet-delivered interventions for anxiety disorders, and in particular panic disorder, are promising. There is however a need for further research and evaluation and there is also a need to find a proper place for such interventions in the clinical management of anxiety disorders, preferably using a stepped-care approach.

Journal Article↗

PubMed2004

Stroop interference for food- and body-related words: a meta-analysis.

According to cognitive theories of eating disorders, biased information processing in favour of dysfunctional attitudes about food and body appearance plays a vital role in the development and maintenance of such disorders. Data from 27 studies evaluating Stroop interference for food- and body-related words with negative overtones were included in a meta-analysis in order to investigate whether such processing biases are specific to eating disordered samples. Participants were females characterised as eating disordered, non-eating disordered but nevertheless over-concerned with body appearance and eating, and normal controls. Mean Stroop interference for eating disordered females was of medium effect size (Cohen's d=0.48) and significantly larger than for both non-eating disordered females concerned with body appearance and eating, and normal control females (both d=0.21). Stroop interference for eating disordered females was thus of fairly modest magnitude where it was unclear whether such interference is specific to this sample.

Anorexia Nervosa↗

PubMed2004

Treatment of panic disorder: live therapy vs. self-help via the Internet.

A randomized trial was conducted comparing 10 individual weekly sessions of cognitive behaviour therapy for panic disorder (PD) with or without agoraphobia with a 10-module self-help program on the Internet. After confirming the PD diagnosis with an in-person structured clinical interview (SCID) 49 participants were randomized. Overall, the results suggest that Internet-administered self-help plus minimal therapist contact via e-mail can be equally effective as traditional individual cognitive behaviour therapy. Composite within-group effect sizes were high in both groups, while the between-group effect size was small (Cohen's d=16). One-year follow-up confirmed the results, with a within-group effect size of Cohen's d=0.80 for the Internet group and d=0.93 for the live group. The results from this study generally provide evidence to support the continued use and development of Internet-distributed self-help programs.

Adult↗

PubMed2004

[Cognitive behavior therapy via Internet. Patients with tinnitus are helped to manage their problem--simpler and cheaper].

Cognitive-behavioural therapy (CBT) is effective in reducing distress in tinnitus patients. To make CBT more available, an Internet-based self-help treatment has been used since 1999 at the department of Audiology, Uppsala University hospital. After initial medical and psychological assessment the patients get access to the Internet treatment. The treatment programme is divided into six weeks, and each week the patient chooses treatment components, reads information and instructions, plans the training and then practises during one week. The patient prints out registration sheets and reports the progress at the web site, receiving E-mail feedback from the therapist. It is important to keep in contact with the patient. The efficacy of the treatment has been shown in two randomised controlled studies, showing significantly better result then a waiting-list control group and equal result compared to a CBT group treatment respectively. A recent replication showed that the results can be generalised to a clinical setting.

Cognitive Behavioral Therapy↗

PubMed2004

Internet-based cognitive behavioral therapy for tinnitus.

Tinnitus is a common otological problem that is often resistant to surgical or medical interventions. In common with chronic pain, cognitive-behavioral treatment has been found to alleviate the distress and improve the functioning of tinnitus patients. Recently, a self-help treatment has been developed for use via the Internet. In this article, we describe the self-help program and apply it to a middle-aged woman with tinnitus. We report the case formulation, which was done in a structured interview, and the treatment interactions, which were conducted via e-mail. The self-help program was presented on Web pages, and weekly diaries were submitted to follow progress and give feedback. The treatment was successful with reductions of tinnitus-related annoyance and anxious and depressive mood. Implications for Internet administration of self-help treatment are discussed.

Adult↗

PubMed2004

Breast cancer on the Internet: the quality of Swedish breast cancer websites.

The aim of this study was to investigate the quality of Swedish-language breast cancer information available on the Internet. The questions explored were the extent and type of breast cancer information available, the coverage and correctness of that information, and whether the websites fulfilled the European Commission quality criteria for health-related websites. Three search engines were used to find websites containing medical information on breast cancer. An oncologist then evaluated the 29 relevant sites. Only seven of these were judged suitable for breast cancer patients. The coverage and correctness of the medical information varied considerably. None of the websites fulfilled the European Commission quality criteria. Therefore, considerable effort will be required before the Internet can serve as a valuable and up-to-date source of information on breast cancer for both professionals and laypersons. Our findings broadly match the results of earlier studies of English-language websites.

Breast Neoplasms↗

PubMed2004

The role of sensitivity to external food cues in attentional allocation to food words on dot probe and Stroop tasks.

The role of sensitivity of external food cues in producing attentional bias toward food-, body-weight-, and shape-related words on the Stroop and the dot probe tasks was examined. Contrary to expectations, individuals high in responsiveness to external food cues directed attention away from food words, whereas individuals low in responsiveness to external food cues directed their attention toward food words on the dot probe task. No significant differences were found between the groups high and low in sensitivity to external food cues for body words on the dot probe task or for food or body words on the Stroop task. Results are discussed with reference to theoretical views of differences between the Stroop and the dot probe tasks.

Adult↗

PubMed2004

Autobiographical memories in patients treated for breast cancer.

OBJECTIVE: Previous research has shown that several clinical groups have difficulties with generating specific autobiographical memories. The aim of this study was to investigate autobiographical memory function in women who had been treated for breast cancer and to compare those patients who had undergone mastectomy only with those who had undergone breast reconstruction surgery after mastectomy. METHOD: A sample of 26 women treated for breast cancer were tested via telephone using the Autobiographical Memory Test (AMT). RESULTS: Breast cancer patients had difficulty retrieving specific autobiographical memories compared to a group of age-matched controls without any history of breast cancer. There were essentially no differences between the two patient groups. CONCLUSION: Since breast cancer patients are vulnerable to emotional distress, autobiographical memory deficits should be investigated further.

Adolescent↗

PubMed2004

Controlled trial of Internet-based treatment with telephone support for chronic back pain.

The purpose of this study was to investigate the effects of an Internet-based cognitive-behavioral intervention with telephone support for chronic back pain. Participants who met the criteria for chronic back pain (N=56) were randomly assigned to either an Internet-based cognitive behavioral self-help treatment or to a waiting-list control condition. The study period lasted 8 weeks and consisted of 1 week of self-monitoring prior to the intervention, 6 weeks of intervention, and 1 week of post-intervention assessment. Treatment consisted of education, cognitive skill acquisition, behavioral rehearsal, generalization and maintenance. The dropout rate was 9% (N=5). Results showed statistically significant improvements in catastrophizing, control over pain and ability to decrease pain. Some improvement was found in both the control group and the treatment group. A follow-up of 3 months after treatment termination was completed in 92% (N=47) of the participants who completed the treatment intervention. Follow-up results showed that some improvement was maintained. Findings indicate that Internet-based self-help with telephone support, based on established psychological treatment methods, holds promise as an effective approach for treating disability in association with pain.

Adult↗

PubMed2004

Internet-based treatment for insomnia: a controlled evaluation.

This study investigated the effects of an Internet-based intervention for insomnia. Participants who met criteria for insomnia (N = 109) were randomly assigned to either a cognitive-behavioral self-help treatment or a waiting list control condition. The 5-week intervention mainly consisted of sleep restriction, stimulus control, and cognitive restructuring. Sleep diary data were collected for 2 weeks at baseline and at posttreatment. The dropout rate was 24% (n = 28). Results showed statistically significant improvements in the treatment group on many outcome measures, including total sleep time, total wake time in bed, and sleep efficiency. However, improvements were also found in the control group. Overall, between-groups effect sizes were low, with the exception of the Beliefs and Attitudes About Sleep Scale (Cohen's d =.81).

Adolescent↗

PubMed2004

Internet-based cognitive-behavioral self-help treatment of tinnitus: clinical effectiveness and predictors of outcome.

The aim of this investigation was to evaluate Internet-based cognitive-behavioral therapy for tinnitus in a nonrandomized clinical effectiveness study with a sample of consecutive patients referred for psychological treatment (N = 77). Results were calculated at a group level on an intention-to-treat basis and showed significant reductions of distress on the Tinnitus Reaction Questionnaire (P. H. Wilson, J. Henry, M. Bowen, & G. Haralambous, 1991), the Hospital Anxiety and Depression Scale (A. S. Zigmond & R. P. Snaith, 1983), and on the Insomnia Severity Index (C. H. Bastien, A. Vallières, & C. M. Morin, 2001). A 3-month follow-up showed that patients remained improved. The dropout rate was 30%. Treatment compliance, external referral to the treatment, and number of earlier treatments for tinnitus were associated with positive outcome. The number of e-mails between therapist and patient concerning treatment problems was associated with worse outcome. Internet-based cognitive-behavioral therapy holds some promise as a treatment modality for tinnitus. Future research should focus on further controlled evaluations of the treatment technique and evaluate the cost-effectiveness compared to other forms of tinnitus treatments.

Adult↗

PubMed2004

Pruritus, personality traits and coping in long-term follow-up of burn-injured patients.

Pruritus is a major problem after burn injury; however, prevalence and predictors of prolonged pruritus are not known. The aims were to assess frequency of pruritus and the role of personality traits and coping in prolonged pruritus. The participants were burn patients injured 1-18 years earlier (n=248). Pruritus was assessed with an item from the Abbreviated Burn Specific Health Scale, personality was assessed with the Swedish universities Scales of Personality, and coping with the Coping with Burns Questionnaire. In all, 60% of the participants had pruritus at follow-up, however as the time after injury increased, the number of patients with persistent itch decreased. In logistic regression, 39% of the likelihood of having persistent pruritus was explained by greater extent of burn, less time after injury, and psychological features (being less assertive, and using more instrumental but less emotional support). In summary, chronic burn-related pruritus is rather common and psychological factors such as anxiety-related traits and coping are significantly associated with its presence.

Adaptation, Psychological↗

PubMed2004

Screening of psychiatric disorders via the Internet. A pilot study with tinnitus patients.

Tinnitus has been associated with psychiatric disorders and more recently diagnostic tools have been used in a systematic manner. In the present study, we administered the World Health Organisation's Composite International Diagnostic Interview--Short form (CIDI-SF) in a computerized Internet-based version to a self-selected sample of tinnitus patients (n=48). Using the cut-off for 'probable case' (12-month prevalence), 69% of the tinnitus patients fulfilled the criteria for depression, 60% for generalized anxiety disorder, 83% for specific phobia, 67% for social phobia, 58% for agoraphobia, 21% panic attack, 83% obsessive-compulsive disorder, 2% alcohol dependence and 0% drug dependence. Decreased percentages were found for depression (4%), specific phobia (62%) and social phobia (27%) when applying a more conservative criteria (maximum case criteria). In conclusion, the findings suggest that the Internet version of CIDI-SF can be used as a screening tool for psychiatric disturbance in somatic patients, but that diagnostic criteria need to be adjusted for Internet use.

Female↗

PubMed2004

Cognitive bias in dizziness: emotional Stroop and autobiographical memories.

Dizziness is commonly associated with anxiety, and is often caused by a dysfunction of the balance system. While a link between dizziness and both anxiety disorders and depression has been established, less is known about information processing in dizziness. In the first experiment we tested whether 15 patients with dizziness would display an emotional Stroop effect for panic-related words. Also included was a control group of 15 persons. The Stroop task was preceded by ratings of personal relevance of the Stroop words and followed by a surprise free recall of the words. Results showed a Stroop effect for panic-related words in the dizziness group, but the interaction did not reach significance (p = 0.08). Separate analysis of dizziness-related panic words however resulted in a significant group x condition interaction. In the free recall of Stroop words a main effect of word category was found, with more panic-related words being recalled. The second experiment investigated autobiographical memories in 14 patients with dizziness and 14 matched controls. Results showed a group x condition interaction with less specific memories being recalled following positive cue-words in the dizziness group. The overall pattern of results suggests that dizziness is related to deficits in information processing, which could be targeted in treatment.

Adult↗

PubMed2004

Prediction of psychological health after an accidental burn.

BACKGROUND: Burn victims often display psychological symptoms that can impede recovery, but knowledge about risk factors for psychopathology is limited. This study aimed to predict psychological health 3 months after burn injury from coping and trauma-related factors assessed early in hospitalization. METHODS: For this study, 34 burn patients were interviewed during hospitalization about their accident and coping. Questionnaires were administered during hospitalization and 3 months after the burn including the Impact of Event Scale-Revised for posttraumatic stress symptoms (intrusion, avoidance, arousal) and the Hospital Anxiety and Depression Scale for mood. RESULTS: Anxiety, depressive, and avoidant symptoms at 3 months were highly predicted by baseline levels of these symptoms and avoidant coping. The life threat at the burn event predicted intrusive and arousal symptoms, and coping by self-control predicted less intrusive symptoms. Burn severity was not predictive of psychological health. CONCLUSIONS: Coping style, life threat during the accident, and early symptoms are strong predictors of psychopathology after a burn.

Accidents↗

PubMed2003

[Tinnitus affects 15 percent--today's environmental noise a risk factor. Early treatment can prevent chronic problems].

A substantial proportion of individuals in the general population have tinnitus and 1-3% suffer from severe tinnitus affecting sleep, concentration, and mood. For a majority of patients with tinnitus degree of hearing loss plays a significant role. Several potential causes and aggravating factors have been suggested, but there is still not a single theory available to explain why tinnitus is so bothersome for some individuals. Recent research has investigated neural correlates of tinnitus, mainly involving primary and secondary auditory cortex. Several treatments have been tested with modest results. However, for the alleviation of tinnitus-related distress there is now empirical support for the use of cognitive-behavioural treatment methods. Future efforts should focus on prevention of noise-induced hearing loss and ways to foster habituation to tinnitus.

Behavior Therapy↗