No description available.

In recent years, kindness-based meditation practices, including loving-kindness meditation (LKM), have gained empirical support for decreasing depression and anxiety symptoms. LKM is defined as the intentional transmission of unselfish kindness toward all beings. It is practiced by contemplating an object of meditation (e.g., self, difficult person) and offering goodwill by silently repeating phrases (e.g., “May you be happy”). Given LKM’s focus on cultivating positive emotional states, researchers have hypothesized that LKM may work by increasing positive affect (PA), promoting cognitive and behavioral flexibility, and reducing negative affect (NA). This study was the first to employ a multiple baseline, single-case design to evaluate the acceptability and clinical efficacy of a brief, individual LKM intervention for individuals (N = 9) with unipolar depressive disorders, social anxiety disorder, or generalized anxiety disorder and low PA. Participants were randomized to a 2-, 4-, or 6-week baseline and completed weekly assessments during baseline, 7 weeks of treatment, and at 1-, 2- and 4-week follow-up. LKM was hypothesized to be acceptable and effective for reducing depression and anxiety symptoms and increasing PA. Secondary hypotheses were that (1) improvements in PA would precede disorder symptom improvement and (2) LKM would lead to improvements in other treatment variables (e.g., NA, anger, mindfulness, affective regulation styles, quality of life, etc.) Results revealed that the study intervention had good feasibility and acceptability. Per visual inspection, LKM led to improvements in principal disorder symptoms for four participants during treatment and five participants at follow-up (three of whom showed clinically reliable change). Contrary to study hypotheses, only one participant demonstrated reliable improvements in PA during treatment. For this participant, increases in PA occurred simultaneously with reductions in depression. Across participants, LKM exerted moderate to large effects on disorder severity, depression and anxiety symptoms, quality of life, mindful nonreactivity, and tolerating affective style. Overall, individuals with principal unipolar depressive disorders showed the strongest response to the study intervention. In summary, this study provided preliminary evidence for the effectiveness of brief, individual LKM for reducing depression and anxiety in a transdiagnostic outpatient sample with low positive affect.

SammanfattningLångvarig smärta orsakar stort lidande för individen och belastar samhället ekonomiskt. Syftet med denna uppsats var att undersöka om en exponering in vivo-behandling inspirerad av Dialektisk beteendeterapi (DBT) för människor med långvarig ländryggssmärta var görbar samt om behandlingen gav effekt på smärtrelaterad problematik. Designen var en single case experimental design vilket är en beprövad design för att testa nya terapimetoder. Studien bestod av sex deltagare, alla med hög grad av smärtrelaterade katastroftankar, något som litteraturen visat predicera sämre behandlingsutfall. Behandlingen var DBT-inspirerad och indelad i tre faser; en första valideringsfas, en andra färdighetsfas och en tredje exponeringsfas. Fem av sex deltagare fick förbättringar på alla de primära utfallsmått, tre av sex deltagare fick förbättringar på samtliga primära- och sekundära utfallsmått. Framtida replikationer är motiverade. / AbstractChronic pain causes great suffering for the individual and burden society economically. The aim of this study was to examine whether an exposure in vivo treatment inspired by Dialectical Behavior Therapy (DBT) for people with chronic low back pain was feasible and whether the treatment had effect on pain-related problems. The design was a single case experimental design, which is a widely used design to test new therapy methods. The study consisted of six participants, all with high levels of pain catastrophizing, something that in the literature been linked to poor treatment outcomes. The treatment was inspired by DBT and divided into three phases: an initial validation phase, a second phase for skills training and a third exposure phase. The results were promising: five out of six participants had improved in all primary outcome measures. Three out of six participants had improvements in all primary and secondary outcome measures. Future replications are warranted.

Depression och insomni är två vanliga former av psykisk ohälsa. I den här studien undersöktes om en bevisat effektiv behandling för insomni, (KBT-I), påverkade grad av depressiva symtom hos personer med konstaterade symtom på såväl depression som insomni. I studien kontrollerades för en minskning av nedstämdhet kunde tillskrivas en ökad fysisk aktivitetsnivå. En single case experimental design användes för ändamålet, med dagliga skattningar av sömn, nedstämdhet och fysisk aktivitetsnivå. Symtom på såväl insomi som nedstämdhet minskade signifikant hos tre av sex deltagare. Minskad nedstämdhet kunde inte förklaras av ökad fysisk aktivitetsnivå. Samvariation observerades mellan depression och insomni. Resultaten visar att insomni och depression kan påverkas av samma behandling, vilket antyder förekomst av gemensamma vidmakthållande mekanismer. / Insomnia and depression are two common mental health problems. This study investigated whether a proven effective treatment for insomnia CBT-I, would change the severity of depressive symptoms, for participants with comorbid insomnia and depression. It was controlled for, whether a reduction in depressive symptoms could be the result of increased physical activity. A single case experimental design, including daily measurements of sleep, depression and physical activity, was used as a means to answer the research questions. Symptoms of both depression and insomnia were significantly reduced for three out of six participants. Increased physical activity was not able to explain the decrease in depression scores. A correlation was observed, between depression and insomnia. The results shows that insomnia and depression can be affected by the same treatment, which implies existence of common perpetual mechanisms.

No description available.

Nonsuicidal self-injury (NSSI; i.e., the deliberate destruction of one’s own bodily tissue without suicidal intent and for reasons not socially sanctioned) is prevalent and associated with clinically serious consequences. There is a need for evidence-based, stand-alone treatments for this behavior as it presents across the full range of psychiatric disorders. Developing time-efficient and cost-effective interventions for NSSI has proven difficult given that the core components of treatment remain largely unknown. The aim of this study was to examine the specific effects on NSSI of mindful emotion awareness training and cognitive reappraisal, two transdiagnostic treatment strategies that directly address the functional processes that often maintain self-injury (i.e., relief or escape from aversive thoughts or feelings). Using a counterbalanced, combined series (multiple baseline and phase change) single-case experimental design, the unique and combined impact of these two four-week interventions was evaluated among diagnostically heterogeneous, self-injuring adults (N = 10; mean age = 21.3, range = 18 to 30 years). Hypotheses were that each intervention would produce clinically meaningful reductions in NSSI; adding the alternative intervention would have additive benefit for those who did not respond to the initial intervention alone; and reductions in NSSI would be maintained over a four-week follow-up phase. Results showed that 8 of 10 participants demonstrated clinically meaningful reductions in NSSI by the follow-up phase; six participants responded to one intervention alone, whereas adding the alternative intervention was associated with additive benefit for two participants. Group-based analyses indicated a statistically significant effect of study phase on NSSI (p < .001), with fewer NSSI urges and acts occurring after the interventions were introduced. The interventions were also associated with moderate to large reductions in anxiety (d = 0.89 – 1.09), depression (d = 0.79 – 1.09), and interference caused by symptoms (d = 0.61), and with improvements in skills-based mechanisms: mindful emotion awareness (d = 1.44) and reappraisal (d = 1.30). The results suggest that increasing mindful emotion awareness and cognitive reappraisal may be two key therapeutic strategies for reducing NSSI. Transdiagnostic, emotion-focused interventions delivered in time-limited formats can serve as practical yet powerful treatment approaches, especially for lower-risk self-injuring individuals.

More than half of both men and women living in the United States report experiencing at least one traumatic event in their lifetime (Kessler et al., 1995). While not all individuals who experience a traumatic event will develop posttraumatic stress disorder, individuals with traumatic experience exhibit higher levels of functional impairment, suicidality, and are more likely to meet criteria for anxiety, depressive, and alcohol use disorders (Beckham et al., 1998; Marshall et al., 2001). Acceptance and Commitment Therapy (ACT) may aid those who have experienced a traumatic event in reducing avoidance and engaging in valued action in the presence of distressing private experiences (Walser & Hayes, 2006). Those who receive an ACT-oriented treatment may learn behavioral skills consistent with six processes that foster non-judgment, broadened perspective, and acceptance of experiences occurring in the here-and-now (Hayes et al., 2012). Few studies have been conducted to examine the relative effects of component processes within the ACT framework, and among the existing literature little attention has been given to self as context (Carrasquillo & Zettle, 2014; Hayes et al., 2006). All six processes are considered to have some degree of overlap (Hayes et al., 2006). Namely, self as context, a process that involves broadening present moment perspective and objectively relating to self-oriented content, shares similarities with defusion, a process involving objective observation of cognitive phenomenon. Evidenced and conceptual overlap among component processes may lead to measurement concerns, fluid used of interventions, and lack of clinical clarity. The current study examined the relative effects of defusion and self as context in persons who have experienced a traumatic event, using a novel treatment design (counterbalanced alternating treatments SCED) and measurement plan (Ecological Momentary Assessment). Specifically, this study assessed treatment utility of self as context and defusion for individuals who have experienced a traumatic event, evaluated the validity of component interventions, and examined effects of self as context in particular as a core ACT process. This study did not provide evidence that self as context is more or equally as efficacious as defusion as an intervention for persons with past traumatic experience. Several factors may have impacted results of the current study, including individual variability, lack of a clinical sample, and significant time spent explaining intervention rationale and processing intervention experience (all of which was beyond the scope of the current study). Further research is needed to assess unique contributions of component processes of change within the ACT model.

No description available.

Kognitiv beteendeterapi (KBT) har mest evidens vid social fobi, och på senare år har även guidad självhjälp baserad på KBT visat goda resultat. Acceptance and commitment therapy (ACT) är en del av den tredje vågens KBT och har visat lovande resultat vid ångestsyndrom. Företrädare för ACT har varnat för riskerna med tekniker för att utmana negativa automatiska tankar. Studien syftar till att med en single case experimentell design med multipel baslinje (N=9) studera effekterna av kognitiv omstrukturering (KO) och kognitiv defusion (KD) i form av guidad självhjälp på social ångest, socialt undvikande, psykologisk flexibilitet, defusion, samt frekvens av och trovärdighet hos negativa automatiska tankar. Resultaten visade att KO och KD inte enbart påverkade de processer som teorierna predicerar utan även den andra behandlingens processer.

Bakgrund: Smärta från axelleden är vanligt förekommande hos simmare, därav finns begreppet ”simmaraxel”. Etiologin till tillståndet och smärtan är dock ännu inte fastställd, flertalet studier visar på varierande orsaker och symtom. Den oklara etiologin, skapar delade meningar sett till lämplig behandling för simmaraxlar. Flera teorier finns kring den bästa behandlingsmetoden för axelsmärta hos simmare. Många olika studier har gjorts med syfte att undersöka sambandet mellan axelspecifik styrketräning på axelfunktion hos simmare med axelsmärta. Få studier har gjorts med syfte att undersöka effekten av axelspecifik styrketräning på just smärtan vid simmaraxlar. Syfte: Syftet med denna studie var att på individnivå undersöka hur axelspecifik styrketräning påverkar simmare med axelsmärta gällande smärta och funktion. Metod: Studien baseras på single-case experimentell design (SCED), med en AB-design. I studien medverkade tre deltagare från en simklubb i Stockholm. Deltagarna fick under totalt nio veckor skatta smärta via Numeric Rating Scale (NRS) och axelfunktion via Western Ontario Shoulder Instability Index (WOSI), för att undersöka förändringen på smärta och funktion över tid. Resultatsammanfattning: En deltagare uppnådde signifikant förbättring sett till självskattad smärta. Sett till självskattad funktion fanns signifikant försämring hos två deltagare. En deltagare uppnådde en stabil baslinje. Resterande två deltagare uppgav spridda värden under samtliga faser för NRS och WOSI.  Slutsats: Inga specifika slutsatser går att dras utifrån studiens resultat eftersom endast en deltagare uppnådde en stabil baslinje och på grund av oklarheten kring orsakerna till deltagarnas smärta. / Background: Pain originating from the shoulder joint is frequent among swimmers, therefore the term “swimmer’s shoulder” was constructed. However, the etiology of the condition has not yet been established and numerous studies indicate varying origins. Divided opinions have formed about effective interventions due to the confusion regarding swimmer’s shoulder. Several studies have investigated the interaction between various interventions and their effect on swimmer’s shoulders, however only a few have studied the effect strength training has on pain in the shoulder joint due to the condition.  Purpose: The aim of this study was to investigate at an individual level, how strength training of the shoulders affects active swimmers with shoulder pain, concerning pain and function. Method: This study is designed after a single-case experimental design (SCED), with an AB-design. Three swimmers from a swimming club in Stockholm participated. During a total of nine weeks, the participants had to assess pain via the numeric rating scale (NRS) and shoulder function via the Western Ontario Shoulder Instability Index (WOSI). Results: One participant acquired significant improvement in self-rated pain. Regarding self-rated function two participants showed significant impairment. One participant acquired a stable baseline. The remaining two participants reported scattered values during all phases for both NRS and WOSI.  Conclusion: No specific conclusions can be made based on the results of the study as only one participant achieved a stabile baseline, and there is ambiguity regarding the causes of pain among the swimmers.