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Biomedical subjects

Gerhard Andersson

Publications and source records attributed to Gerhard Andersson.

At least 55 records · Page 3Linked to original sources

Treatment of panic disorder via the Internet: a randomized trial of CBT vs. applied relaxation.

A randomized trial was conducted of two different self-help programs for panic disorder (PD) on the Internet. After confirming the PD-diagnosis with an in-person structured clinical interview for DSM-IV (SCID) interview 22 participants were randomized to either applied relaxation (AR) or a multimodal treatment package based on cognitive behavioral therapy (CBT). Overall, the results suggest that Internet-administered self-help plus minimal therapist contact via e-mail has a significant medium to large effect (Cohen's d=0.71 for AR and d=0.42 for CBT). The results from this study generally provide evidence to support the continued use and development of Internet-distributed self-help programs.

Adult↗

Internet administration of the Hospital Anxiety and Depression Scale in a sample of tinnitus patients.

OBJECTIVE: To administer and validate the Hospital Anxiety and Depression Scale (HADS) via the Internet to a sample of persons with tinnitus. METHOD: The HADS was converted into a Web page and administered via the Internet to a sample of 157 persons with tinnitus who were recruited for participation in a treatment trial. Also included were the Tinnitus Reaction Questionnaire (TRQ) and the Anxiety Sensitivity Index (ASI). A clinical comparison sample (n=86) was also recruited who completed the same tests in a paper-and-pencil format. RESULTS: Both the Internet and the paper-and-pencil version yielded comparable results in terms of psychometric properties. When using the cut-off of 11 points suggested by Zigmond and Snaith [Acta Psychiatr. Scand. 67 (1983) 361] a 25% (n=40) prevalence of probable anxiety and a 17% (n=27) prevalence of probable depression were found in the Internet group. In the clinic sample, the prevalence was only 15% for both anxiety and depression, suggesting that Internet administration might result in higher percentages. The HADS correlated with both tinnitus distress and anxiety sensitivity. CONCLUSIONS: Internet administration of the HADS results in meaningful and valid data. Consistent with previous research anxiety and depression are common comorbid conditions in individuals with tinnitus, but norms should be developed for Internet based screening.

Adult↗

Social competence and behaviour problems in burned children.

The aim of this study was to collect follow-up data on social competence and behavioural problems in a sample of Swedish burned children and to compare the results with normative data from a reference group of children comparable in age, socio-economic status and gender. Parents of 44 children (55% response rate) aged 7-12 years were asked to complete a questionnaire booklet including the Children's Behaviour Questionnaire (CBQ) and the Social Competence Inventory (SCI). Data from the children's teachers were also collected for 20 children using the same booklet. In addition, data on TBSA, localisation of injury, and other background factors were collected. Results showed that the burned children were rated by their parents as showing lesser degrees of social initiative and more externalising problems and concentration problems compared with the control group. Teachers rated the burn injured children as having less prosocial orientation, more externalising problems, and more concentration problems. No clear effects were found for gender and characteristics of the burn injury. Results on the Social Competence Inventory were associated with scores on the Children's Behaviour Questionnaire.The findings are consistent with previous research in that the differences found were relatively small. However, they do call for attention to the possible adverse effects of growing up with a burn injury, but also to the possible pre-morbid characteristics that may be related to the injury.

Analysis of Variance↗

Tinnitus loudness matchings in relation to annoyance and grading of severity.

OBJECTIVE: To measure and compare different parameters of tinnitus loudness obtained via matching and to investigate their associations with self-reported severity of tinnitus. METHODS: From the audiology department 18 patients with unilateral tinnitus of sensorineural origin were selected. They underwent pure-tone audiometry, and in a matching paradigm their tinnitus pitch was estimated. Loudness was assessed at tinnitus frequency and at the frequency of best hearing and both were expressed in sensation level (SL) and hearing level (HL). Moreover, minimal masking level (MML) with white noise was assessed as well as thresholds for the tinnitus tone and a comparison tone in the contralateral ear when tinnitus was masked. RESULTS: Annoyance and grading of severity were associated with measures of loudness expressed in HL, MML, and pure-tone audiometry. Loudness in SL was not associated with self-reported severity. Tinnitus loudness, matched at the frequency of best hearing instead of the tinnitus frequency, appears to be less dependent on HL, while still being associated with distress and grading of severity. CONCLUSION: Severity of tinnitus is related to hearing thresholds, and loudness in SL provides little clinically useful information.

Auditory Threshold↗

Personalized pain words and Stroop interference in chronic pain patients.

Attentional bias in patients with chronic pain was investigated using the emotional Stroop task with personalized pain words. A group of 20 chronic pain patients with 20 matched controls participated in the experiment. Before administration of the emotional Stroop patients were asked to select the five best descriptors of their pain from a list of 19 sensory pain descriptors. These words were later used in the computerized Stroop test. Also included in the Stroop task were threat words and color words with corresponding control conditions. Apart from the emotional Stroop, measures of pain related distress, anxiety, and depression symptoms were included. Results showed a weak Stroop interference effect with slower reaction times to pain words in the patient group, but they did not differ significantly from the controls. Both groups were slower on the threat words and displayed the classical Stroop interference effect for color words. The overall pattern of results are in line with previous Stroop studies on pain patients showing weak support for the attentional bias hypothesis.

Adult↗

Internet-based treatment of headache: does telephone contact add anything?

OBJECTIVE: To study the contribution of therapist-initiated telephone contact in the treatment of recurrent headache via the Internet. BACKGROUND: Internet-based cognitive behavioral self-help is a promising new venue for the treatment of recurrent headache. While cost-effective, there are indications that this modality may be associated with high dropout rates. DESIGN AND METHODS: The role of therapist-initiated contact was investigated in a randomized controlled trial in which 44 self-recruited headache sufferers were randomized to either a Web-based self-help program with e-mail support or to a group receiving, in addition, weekly individual telephone calls. An additional 8 control subjects were recruited to receive similar treatment outside of the study. RESULTS: Dropout rates were 29% in the telephone support group and 35% in the control group, suggesting that the telephone calls did not affect dropout. Results showed significant reductions in headache-related disability, depression, maladaptive coping strategies, and perceived stress but little to indicate any superior performance in the Internet-only group and little improvement in the headache index. In short, therapist-initiated telephone calls did not influence the results. CONCLUSIONS: Internet-based treatment for headache is not affected by minimal therapist-initiated telephone contact.

Adult↗

Randomized controlled trial of internet-based stress management.

This study investigated the effects of an internet-based self-help stress management program with a randomized controlled design. Of 85 participants, 26% dropped out, leaving a final sample of 63 participants with 23 in the treatment group and 40 in the waiting list control group. Treatment included applied relaxation, problem solving, time management and cognitive restructuring. All information and treatment interventions were provided via the internet. Results were evaluated with the Perceived Stress Scale and the Hospital Anxiety and Depression Scale. Improvements were seen in both groups, with greater improvements in the self-help treatment group. It is concluded that the internet can be used to provide stress management techniques and result in stress relief. However, spontaneous improvement, differential dropout rate and compliance need to be monitored in future studies.

Journal Article↗

Dual-task study of cognitive and postural interference in patients with vestibular disorders.

OBJECTIVE: To study the relation between a mental task (silent backward counting) and posture in patients with vestibular deficits and to study the role of attention. STUDY DESIGN: In Experiment 1, postural sway and performance on the mental task were measured in a 2 x 2 dual-task design (with or without mental task and calf stimulation). In Experiment 2 a similar design was used, the only difference being that during trials without the mental task, patients were instructed to focus on their balance and provide a rating of body sway. SETTING: The study was carried out at a tertiary referral outpatient audiology clinic. PATIENTS: The first experiment included 20 patients and the second experiment 10 patients seen consecutively at the clinic on account of vertigo and dizziness. MAIN OUTCOME MEASURES: Performance on a mental task and on a force platform for measurement of anterior-posterior and lateral sway. RESULTS: Results showed no effect of the balance conditions on the cognitive task in Experiments 1 and 2. The mental task led to less body sway during calf stimulation in Experiment 1. In Experiment 2, when attention was focused on body sway, an opposite result was found, with more sway during the mental task in the condition of no calf stimulation. CONCLUSIONS: Control of body sway and cognitive functioning are to some extent related, most likely because of postural stability being prioritized in dual-task conditions.

Attention↗

What is coping? A critical review of the construct and its application in audiology.

The term 'coping' is increasingly used in audiology, in particular by researchers and clinicians interested in the psychosocial aspects of hearing disorders. Coping has been defined as the process of managing demands (external or internal) that are appraised as taxing or exceeding the resources of the person. It is seen as a process involving at least two stages: primary appraisal (is this something to bother about?), and secondary appraisal (what can I do about it?). It is proposed to serve two distinct purposes: to do away with the problem (i.e. problem-focused coping), and to regulate emotional reactions (emotion-focused coping). The following observations are made: (1) there is a lack of correspondence between what people in general mean by coping and how the concept is used in research; (2) coping is most often measured by checklists with questionable validity; (3) the outcome of using different coping strategies is largely unexplored; and (4) what is regarded as coping in some circumstances (e.g. telling about your hearing impairment) can become a problem in another situation, or even the same situation (e.g. stigma). Finally, some recommendations regarding the future use of the coping construct in audiology are made.

Adaptation, Psychological↗

12-month prevalence of panic disorder with or without agoraphobia in the Swedish general population.

OBJECTIVE: The present study examined the prevalence of panic disorder with or without agoraphobia according to DSM-IV criteria in the Swedish general population. METHOD: Data were obtained by means of a postal survey administrated to 1000 randomly selected adults. The panic disorder module of the World Health Organization's Composite International Diagnostic Interview (CIDI) was included in the survey. RESULTS: 12-month prevalence was estimated at 2.2 % (CI 95 % 1.02 % - 3.38 %). There was a significant sex difference, with a greater prevalence for women (5.6 %) compared to men (1 %). CONCLUSION: The Swedish panic disorder prevalence is relatively consistent with findings in most other parts of the western world.

Adult↗

Psychological aspects of tinnitus and the application of cognitive-behavioral therapy.

This article presents an overview of tinnitus (ringing or buzzing in the ears), its psychological effects, and the application of cognitive-behavioral therapy (CBT) for its treatment. Several studies have confirmed an association between psychological factors, such as anxiety and depression, and severe tinnitus and preliminary reports suggest that a proportion of tinnitus patients suffer from mental illness. Assessment strategies used in CBT for tinnitus include structured interviews, daily diary ratings, and validated self-report questionnaires. The treatment approach described in this article includes applied relaxation, imagery and distraction techniques, advice regarding environmental sounds, management of sleep, cognitive restructuring of thoughts and beliefs associated with tinnitus, and relapse prevention. The literature pertinent to CBT approaches to treating tinnitus is reviewed, and it is concluded that CBT shows promise as a treatment of tinnitus-related distress. Future research directions are discussed.

Anxiety Disorders↗

Cognitive distortions in recovered burn patients: the emotional Stroop task and autobiographical memory test.

The aim of the study was to explore cognitive distortions in recovered burn patients. Previous studies in trauma patients have shown trauma-specific attentional bias, long response latencies, and deficits in memory specificity. Eighteen former patients, burn injured 5-19 years ago and 18 matched controls performed the emotional Stroop task, including burn and general trauma-related words, and the autobiographical memory test (AMT). In addition, verbal fluency, life events, and current mood were assessed. Regarding the Stroop task, the recovered patients had longer response latencies to burn words than to neutral and trauma words, a difference not seen in the control subjects. Regarding the AMT, the memory specificity did not differ between the groups. Overall, the former patients had longer latencies than the controls and poorer verbal fluency. The present study showed that recovered burn patients display a moderate Stroop effect, i.e. an attentional bias, in spite of the fact that the injury occurred several years before the testing. This may imply that the recovered burn patients consider the burn an important issue in life. The post-burn patients also presented signs of a slight cognitive slowness as compared to the controls. This finding deserves further attention in the rehabilitation of burn patients.

Adolescent↗

Health status in Swedish burn patients. Assessment utilising three variants of the Burn Specific Health Scale.

Perceived health in a consecutive group of major burn patients treated at the Uppsala University Hospital Burn Unit from 1980 to 1995 is reported. The three published variants of the Burn Specific Health Scale (BSHS), i.e. BSHS-Abbreviated (BSHS-A); BSHS-Revised (BSHS-R); BSHS-Brief (BSHS-B) were used in concert for this purpose in order to allow for a comparison of the instruments. Two hundred and forty-eight of 350 former patients (response rate 70.9%; mean total body surface area (TBSA) 23.1% (S.D.=16.2%)) responded to 94 items from previous versions of the BSHS at a mean of 9.3 (S.D.=4.8) years after injury. All three versions of the BSHS gave similar results with respect to global outcome on a group level. Correlations among the three different instruments were high, but were strongest between BSHS-B and BSHS-R (r=0.99). The largest impact on health was seen for Role Activities in BSHS-A, and Heat Sensitivity and Work in both BSHS-R and BSHS-B. There were significant relationships between sociodemographic variables (e.g. work, partnership and living) and self-reported outcome. Men reported better overall outcome than women did. The presence of a full thickness burn was associated with worse outcome with respect to several domains. The apparent variability in outcome pattern between different domains underscores the importance of utilising a broad instrument with adequate content validity.

Activities of Daily Living↗

Effect of cognitive load on postural control.

The present study reports findings from two experiments on the relation between a mental task (silent backward counting) and posture. The first experiment included 30 normal subjects and the second experiment 20 normal subjects. In Experiment 1 postural sway and performance of the mental task were measured in a 2 x 2 dual-task design (with or without mental task and calf stimulation). In Experiment 2 a similar design was used, the only difference being that during trials without the mental task, subjects were instructed to focus on their balance and provide a rating of body sway. Results showed that balance perturbation led to decreased performance on the cognitive task in Experiment 1, but not in Experiment 2. The mental task led to less body sway, while focused attention attenuated the effect. In conclusion, control of body sway and cognitive functioning are to some extent related.

Adult↗

Hypersensitivity to sound (hyperacusis): a prevalence study conducted via the Internet and post.

The present study explored the prevalence and descriptive characteristics of hyperacusis, defined as unusual intolerance of ordinary environmental sounds. Two ways of collecting data were used in the study: the first was a postal survey of a random sample, to which 589 responded (59.7% response rate); the second was the internet, and 595 self-recruited individuals responded to a call for participants via a banner on a web page (51.9% response rate). The point prevalence rates of hyperacusis were 9% in the internet group and 8% in the postal group. Exclusion of participants who reported hearing impairment resulted in point prevalence rates of 7.7% (n = 39) and 5.9% (n = 28) respectively. The data collection format did not result in any substantial differences. Hyperacusis was associated with concentration difficulties, use of ear protection, avoidance, tension, and sensitivity to light/colours. The present data suggest that hyperacusis is a common problem.

Adolescent↗