Section A provides an overview of the role of family caregivers of individuals with chronic illness, and describes key conceptualisations and theories posited in the caregiver literature. This is followed by an overview of research conducted with caregivers of children with chronic kidney disease (CKD), a summary of the limitations of this research, and suggestions for future research. Section B Despite a recognised need to monitor caregiver burden in caregivers of children with CKD, there is no measurement tool currently available to meet this aim. The present research documents the development of a measure of caregiver burden specific to family caregivers of children with CKD. Methods: Interviews were conducted with 16 caregivers of children with CKD and 10 healthcare professionals in order to generate measure items. A provisional version of the measure was developed and piloted with 18 caregivers of children with CKD and five healthcare professionals. Results: An initial pool of 97 items was generated from the content of interviews, which was reduced to 60 items following review for item redundancy. A piloting exercise provided preliminary evidence for the usability, readability, and relevance of measure items; adaptations further to piloting resulted in the 51-item ‘Paediatric Renal Caregiver Burden Scale’ (PR-CBS). Conclusions: It is hoped that the PR-CBS will serve to identify areas of need amongst caregivers of children with CKD, and in turn improve outcomes for this caregiver population and children with CKD. Section C is a critical appraisal of the conducted research study, and includes an overview of research abilities acquired during its completion, reflections on how the research may have been conducted differently, implications for future clinical practice, and ideas for future research.

Inledning: Personer med intellektuell funktionsnedsättning drabbas oftare än andra av psykisk ohälsa och hamnar lätt i destruktiva livsmönster. De upplever ofta att de har svårt att få adekvat och anpassad behandling. Syfte: Syftet med denna studie var att undersöka psykoterapeuters upplevelse av psykodynamisk psykoterapi med personer med lindrig till måttlig intellektuell funktionsnedsättning som lider av psykisk ohälsa. Frågeställningar: Hur beskriver psykodynamiskt inriktade psykoterapeuter den psykoterapeutiska processen i arbetet med personer med lindrig till måttlig intellektuell funktionsnedsättning? Vad beskriver terapeuterna som verksamt och hur ser de på behandlingsresultaten med målgruppen? Metod: Sex psykoterapeuter intervjuades utifrån en kvalitativ, deskriptiv ansats. Resultat: Vid analys av materialet framträdde ett antal teman. 1. Terapeuternas beskrivning av de olika faserna i den terapeutiska processen. 2. Yttre faktorer som kan påverka terapierna med målgruppen. 3. Den intellektuella funktionsnedsättningens betydelse. 4. Terapeutiska utmaningar i arbetet med målgruppen. 5. Det verksamma i terapierna. 6. Förutsättningarna runt terapeuten. Diskussion: Resultatet visar att de intervjuade terapeuterna upplever att psykodynamisk psykoterapi med lindrig-måttlig intellektuell funktionsnedsättning kan vara meningsfullt och verksamt. Vissa aspekter och behovet av att anpassa det terapeutiska arbetet beskrivs som centrala i arbetet med målgruppen. / Introduction: People with intellectual disabilities are affected more than others by mental illness and can easily fall into destructive patterns of life. They often feel that they have difficulty getting adequate and appropriate treatment. Aim: The purpose of this study was to investigate psychotherapists experience of psychodynamic psychotherapy with individuals with mild to moderate intellectual disabilities who suffer from mental illness. Issues:How do psychodynamic oriented psychotherapists describe the psychotherapeutic process in working with people with mild to moderate intellectual disabilities? What do the therapists describe as active and helpful and how do they look at the results of treatment? Method: Six psychotherapists were interviewed based on a qualitative, descriptive approach. Results: When analyzing the material a number of themes appeared: 1. The therapist description of the phases of the therapeutic process. 2. External factors that can influence therapies with the target group. 3. The intellectual disabilities significance. 4. Therapeutic challenges in the work with the target group. 5. The active and helpful. 6. The conditions around the therapist. Discussion: The result shows that the interviewed therapists feel that psychodynamic psychotherapy with mild-moderate intellectual disabilities can be meaningful and effective. Some specific aspects and the need to adapt the therapeutic work is described as central in the work with the target group.

Coaches play a central role in shaping the sport environment for young athletes. This thesis is focused on the leadership process in sports and how coaches’ autonomy-supportive and controlling interpersonal styles longitudinally are related to young athletes’ motivation and ill- and well-being. The aim is also to examine psychometric multidimensionality in measures of coaches’ need-supportive and controlling interpersonal styles. Questionnaire data from young athletes were used in the empirical studies. In Study 1, we examined an adaptive motivational process (i.e., longitudinal associations between autonomy support, need satisfaction, self-determined motivation, and well-being). The results showed that within-person changes in perceived autonomy support, need satisfaction, self-determined motivation, and well-being were all positively correlated. Higher self-determined motivation and well-being early in the season longitudinally predicted higher levels of perceived autonomy support from the coach. Higher self-determined motivation was also a positive predictor of within-person changes in perceived autonomy support and well-being over the season. In Study 2, we examined a maladaptive motivational process (i.e., longitudinal associations between coaches’ controlling behaviors, controlled motivation, and ill-being). The findings demonstrated that athletes who perceived their coach as more controlling reported higher controlled motivation at the end of the season and that higher controlled motivation early in the season predicted higher ill-being at the end of the season. Controlled motivation was also a positive predictor of athletes’ perceptions of coaches’ controlling behaviors at the within-person level. Study 1 and 2 suggest that individual factors (e.g., motivation and well-being) seemed to function as important determinants of how athletes perceived their coach and future research should explore the underlying mechanisms through which these processes occur. In Study 3, we examined psychometric multidimensionality in measures of athletes’ perceptions of coaches’ need-supportive (Interpersonal Supportiveness Scale-Coach [ISS-C]) and controlling (Controlling Coach Behaviors Scale [CCBS]) interpersonal styles. The analyses indicated that the ISS-C is not multidimensional; it appears to comprise a single factor. Three of the four subscales of the CCBS appear to share a common core, whereas the fourth subscale (i.e., controlling use of rewards) seems to represent a slightly different aspect of a controlling interpersonal style. These results bring into question the multidimensionality in measures of athletes’ perceptions of coaches’ interpersonal styles. Neither measure displayed a coherent multidimensional pattern, indicating a need for better alignment between theory and measurement.

Föreliggande studie är en utvärdering av behandlingsmetoden Affektskola inom ramen för vuxenpsykiatrin. Syftet är att undersöka vilka effekter Affektskola har med avseende på psykisk ohälsa och affektmedvetenhet samt hur bestående dessa effekter är. Deltagarna är 13 patienter inom den psykiatriska öppenvården med varierande problematik, inkluderandes förstämningssyndrom, ADHD samt personlighetsstörningar. Mätningar med mätinstrumenten TAS-20, HADS samt KASAM-29 genomfördes vid fyra tillfällen; Affektskolas start, Affektskolans avslut samt åtta respektive sexton veckor efter avslut. Utöver detta distribuerades vid sista mättillfället ett kompletterande frågeformulär gällande subjektiv upplevelse av effekterna av Affektskolan. Resultaten tyder på tendenser till en ökad affektmedvetenhet samt en minskad psykisk ohälsa och att dessa effekter består och ökar över tid. Deltagarna rapporterar en måttlig grad av subjektivt upplevd förändring gällande känslor respektive psykisk hälsa samt att de i måttlig till stor grad tillskrev Affektskola dessa förändringar. Sammantaget indikerar studien att Affektskola har en positiv effekt på affektmedvetenhet och psykisk ohälsa. / The present study is an evaluation of the treatment method Affect School in the context of adult psychiatry. The aim is to examine the effects of the Affect School on mental ill-health and affect consciousness, and how stable these effects are. The participants consist of 13 patients in psychiatric outpatient care with varying disorders, including mood disorders, ADHD and personality disorders. Assessments with the instruments TAS-20, HADS and KASAM-29 were performed on four occasions; before the start and by the completion of the Affect School and eight and sixteen weeks after completion. At the end of the study, an additional questionnaire regarding subjective experiences of the effect of the Affect School was distributed. The results indicate trends of increased affect consciousness as well as reduced mental ill-health and that these effects are stable and increases over time. Participants report a moderate degree of subjectively perceived change regarding emotions and mental health, and that they attributed Affect School these changes in a moderate to large extent. Overall, the study indicates that the Affect School has a positive effect on affect consciousness and mental health.

Inledning: Forskning om sorg handlar idag om att erövra en annan relation till den döde och kunna hantera separationen. Forskning om drömmar visar på drömmens funktion som stressreducering, lösandet av konflikter och minneskonsolidering. Men också som ett fönster för representativa processer och inre modeller av relationer, för att skapa ett sammanhang. Kan psykoterapeuten få ytterligare verktyg i förståelsen av klientens sorgeprocess om drömmen lyfts in i sorgeterapin? Frågeställningar: Hur använder psykoterapeuter drömmar i förståelsen av klientens sorgeprocess? Vad upplever psykoterapeuten är verksamt när de använder sig av klienternas drömmar vid sorgeterapi? Metod: En kvalitativ studie gjordes då fyra legitimerade psykodynamiska psykoterapeuter och en legitimerad sjuksköterska intervjuades. Resultat: Det framkommer att när psykoterapeuten identifierar olika teman i drömmarna, fångar de hur drömmen gestaltar sorgeprocessen. Det som blir verksamt i terapierna, är att klienten får hjälp att sätta ord på sorgen, får tillgång till omedvetet material och kan identifiera inre konflikter. Det hjälper även klienten att integrera och normalisera sin sorg och att känna tryggheten då drömmaterialet bekräftar att sorgeprocessen går framåt. Diskussion: Studien visar att tidigare forskning om sorg och drömmar bekräftas av de intervjuades kliniska erfarenheter. / Summary: Contemporary research about grief focuses on achieving a different relationship to the deceased and managing the separation. The purposes of dreams are to reduce stress, solve conflicts, and consolidate memories. But it’s also a window into representative processes and inner models of relationships, to create a context. Can psychotherapists enhance their understanding of the clients mourning, by using dreams in grief therapy? Questions: How do psychotherapists use dreams in their understanding of the clients mourning? What do the psychotherapist feel is working when using the clients dreams in therapy? Method: A qualitative studie by interviewing four licensed psychodynamic psychotherapists and one licensed nurse. Result: When psychotherapists identify different themes in the dreams, they capture how the dreams frame the clients mourning. What works well when using the dreams in the therapy, is when is it aiding the client in putting words to their grief, getting access to subconscious material and identifying internal conflict. It also helps the client to integrate and normalise the grief, and feeling the comfort of progress, because the dreams confirm it. Discussion: The study shows that existing research about grief and dreams is confirmed by the clinical experiences of the interviewees.

Inledning: Det finns få forskningsreferenser när det gäller psykoterapeuters känslomässiga och kroppsliga reaktioner i patientarbete. Denna tematiska forskningsanalys utgår från psykoterapeuter som arbetar med personer som lider av trauma, då tidigare studier visar på kraftfulla kroppsliga och känslomässiga reaktioner i arbetet med denna målgrupp. Syftet med studien är att belysa hur psykoterapeuter beskriver sina upplevelser, negativa såväl som positiva, och hur de hanterar dem. Frågeställningar: Hur beskriver psykodynamiskt inriktade psykoterapeuter sina kroppsliga och känslomässiga reaktioner i arbetet med traumatiserade patienter? Hur hanterar de sina egna reaktioner? Metod: Fem legitimerade psykoterapeuter med psykodynamisk utbildning i Sverige och som arbetar med patienter med trauma har intervjuats. Till studien valdes en kvalitativ forskningsansats som bearbetades utifrån en tematisk analysmetod. Resultat: Psykoterapeuterna beskriver svårigheterna att möta det ofattbara våldet i patienternas berättelser, hur de skyddar sig, hur de bär hoppet, hur de kan stå ut och hur de kan använda sina reaktioner i terapin. Här lyfts också konsekvenser för dem och behovet av återhämtning. Diskussion: Resultatet diskuteras utifrån de teoretiska begreppen motöverföring, projektiv identifikation, härbärgering och trauma. Terapeuternas reaktioner bekräftar tidigare forskning av kroppsliga och känslomässiga reaktioner och diskuteras utifrån den omfattande påverkan reaktionerna har på terapeuterna yrkesmässigt och för privatliv. / Introduction: There are few research references on psychotherapists physical and emotional reactions in the patient work. This thematic analysis is based on psychotherapists who work with people suffering from trauma, as previous studies indicate powerful physical and emotional reactions in the work with this target group. The purpose of the study is to illustrate how psychotherapists describe their experiences, both negative and positive, and how they handle them. Questions: How do psychodynamic psychotherapists describe theirphysical and emotional reactions in the work with traumatized patients? How do they handle their own reactions? Method: Five licensed psychotherapists with psychodynamic training in Sweden working with patients with trauma were interviewed. This qualitative researchapproach was processed with a thematic analysis. Results: Psychotherapists describe difficulties facing the unimaginable violence in the patients' stories, how to protect themselves, how they carry hope, how they can cope with it and how they can use their reactions in therapy sessions. It also highlights the consequences regarding themselves and the need for recovery. Discussion: The result is discussed from the theoretical concepts of countertransference, projective identification, containment and trauma. The psychotherapists´ reactions confirm earlier research of physical and emotional reactions, and isbeing discussed out of the wide impact the reactions have on psychotherapists´ professional and personal life.

The purpose of this study was to investigate how generation Y in RGB (fictional name) describes different leadership preferences and to further evaluate whether RGB´s recruitment strategy aligns with those preferences. A targeted selection of organization was made followed by a targeted selection of participants which resulted in eight respondents (n=8). A qualitative approach designed as a case study was conducted. The study included both unstructured and semi-structured interviews. A pilot study was carried out to get a wider view and understanding of the complexity of the organization. A complementary interview was also performed since the organization showed an interest in comparing their recruitment strategy with the participants´ descriptions of leadership preferences. The distribution of the sample was six women and two men with varying occupational roles but with two things in common, social work and the exercise of public authority. The Pilot study, main data collection and the complementary interview was analyzed using elements from both thematic- and pragmatic analysis. The result of the study showed that the overall recruitment strategy in wide terms aligned with the leadership preferences presented by generation Y. Social competence, self-awareness and presence were central aspects which were mentioned by both participants, recruitment officer and HR-consultant.

Oro är ett vanligt förekommande fenomen i kliniska såväl som subkliniska populationer. Föreliggande studie är en uppföljning av behandlingsresultaten publicerade i Westerström-Nygren och Persson (2016), inom ramen för Orosstudien på Karolinska Institutet, gällande internetförmedlad exponering med responsprevention avseende tröstetankar (iERPt) respektive internetförmedlad stresshanteringsbehandling (iSHB) vid oro hos en transdiagnostisk population. Syftet var att undersöka långtidseffekten av iERPt (n = 125) i förhållande till iSHB (n = 118) fyra respektive 12 månader efter behandlingsavslut. Behandlingseffekt mättes med Penn State Worry Questionnaire (PSWQ), Cognitive Avoidance Questionnaire (CAQ), Montgomery Åsberg Depression Rating Scale–Self rated (MADRS-S) och Brunnsviken Brief Quality of Life Inventory (BBQ). Data beräknades med ANOVA med upprepade mätningar samt oberoende t-test. Resultatet visade att de goda behandlingseffekterna som uppmättes med PSWQ och CAQ för iERPt och iSHB vid behandlingsavslut fortsatte att förbättras inom båda betingelserna från behandlingsavslut till fyramånadersmätning. Inom iERPt-betingelsen vidmakthölls dessa behandlingseffekter till 12-månadersuppföljning. Inom iSHB-betingelsen vidmakthölls behandlingseffekten avseende PSWQ från fyra- till 12-månadersuppföljning, men behandlingsresultaten avseende CAQ försämrades. Behandlingseffekterna uppmätta med MADRS-S och BBQ vid behandlingsavslut vidmakthölls för båda betingelserna till fyra- och 12-månadersuppföljning. Ingen skillnad i behandlingseffekt påvisades mellan betingelserna på något utfallsmått vid 12-månadersmätning. I sin helhet påvisades behandlingseffekten för båda betingelserna hålla i sig över tid. Både iERPt och iSHB kan således förstås som effektiva behandlingsmetoder för att på kort liksom lång sikt reducera överdriven oro.

Since the concept was popularized by McKinsey & Company in the late 1990s, talent management initiatives have been pushed with urgency to the forefront of organizational priorities, and businesses have exerted considerable effort in locating and developing the upper echelon talent pools. Much emphasis has been put on the need to identify and attract top talent, focus has shifted away from developing ordinary talent into extra-ordinary talent through broad human resource development initiatives. This research examines a global training initiative implemented in a multi-national corporation, and sets out to identify the primary impediments to its effectiveness. After a literature review, and a focus group, six factors were identified as crucial to this situation: accuracy, communication, feedback, motivation, organizational support, and time. A survey was then disseminated to the relevant organizational members to identify which of these six issues was the most pressing. Based on the results, the author concludes by extrapolating the potential organizational implications, as well as providing some accommodating solutions.

Among adolescents, the day-to-day functioning of the hypothalamo-pituitary-adrenal-axis (HPA-axis) and of the autonomic nervous system (ANS) and their relationships with stress, subjective health complaints and psychological factors such as self-esteem, studied in naturalistic settings, have been largely unexplored. This thesis aimed to investigate the diurnal activity of the HPA-axis (Studies I &amp; II) in terms of salivary cortisol and the ANS/SNS system (Study III) in terms of salivary alpha-amylase (sAA) in mid-adolescent girls and boys. Additionally, linkages between self-reported stress, self-esteem, recurrent pain and biomarkers were investigated. A further aim was to describe potential differences between girls and boys respectively. Study I showed that both girls and boys exhibited the typical diurnal cortisol profile with high levels in the morning that decreased throughout the day. Girls had higher total cortisol levels, while no differences emerged for measures of the cortisol increase. Study II showed no significant linkages between self-ratings of stress and cortisol. However, stress was associated with recurrent pain in girls. Study III showed that, for girls, both self-esteem and self-reported stress were related to morning levels of both cortisol and sAA, to the diurnal sAA output and to a conjoint measure of amylase over cortisol, AOC. To conclude, the findings suggest that both stress and self-esteem may be linked to different measures of ANS and HPA-axis activity, but also to measures of ANS and HPA-axis dysregulation, particularly among mid-adolescent girls. / <p>At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 2: Manuscript. Paper 3: Manuscript.</p>