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The purpose of this study is to examine whether different types of home protection/guardianship behavior have any influence on worry about burglary, using the Seattle, Washington data collected by Terrance Miethe in 1990. This study also examines whether gender and previous victimization have any moderating effect on the relationship between home guardianship and worry about burglary. Logistic regression was used to analyze the relationships. The findings in the main model showed that four of the seven types of home guardianship significantly predicted higher likelihoods of worry of about burglary. When gender was treated as a moderator, only one type of home protection significantly predicted higher chances of worry for females whereas four types of home protection significantly predicted higher odds of worry for males. When previous victimization was treated as a moderator, findings in the non-victims’ model were the same as findings in the main model. Findings in the previous victims’ model showed that one type of home guardianship predicted higher chances of worry about burglary. Limitations and suggestions for future research are discussed.

Insomnia is a common health complaint that often becomes a persistent problem. The theoretical frameworks for understanding and treating insomnia have mostly been behavioural, yet the importance of cognitive processes has received greater attention over the years. The overall aim of this dissertation was to expand the knowledge on the processes from the Cognitive Model of Insomnia by investigating them in novel contexts. Study I examined the outcomes from cognitive therapy for insomnia on adolescents. Study II explored the relationship between cognitive processes and the association with remission and persistence of insomnia in the general population. Lastly, Study III investigated if cognitive processes mediated between cognitive behavioural therapy for insomnia (CBT-I) and outcomes of insomnia and depressive severity in a sample of people with insomnia comorbid with depressive problems. The findings show that cognitive therapy for insomnia affected sleep for adolescents, thus this is a promising treatment option for this age group. Further, it was found that cognitive processes distinguished between adults with normal sleep and persistent insomnia. For people with insomnia, elevated sleep-related worry at baseline increased the risk of reporting persistent insomnia later on, whereas a lowering of selective attention and monitoring, and safety behaviours over time increased the likelihood of remission from insomnia. This has clinical implications for insomnia assessment and treatment, as well as theoretical implications, and warrants further research. CBT-I was associated with greater reductions in dysfunctional beliefs and sleep-related safety behaviours compared to control treatment. Dysfunctional beliefs mediated between CBT-I and insomnia severity and depressive severity respectively. This supports the importance of negative thought content in both insomnia and depression.

Despite the success of available medical and psychosocial treatments, a sizable subgroup of individuals with commonly co-occurring disorders, generalized anxiety disorder (GAD) and major depressive disorder (MDD), fail to make sufficient treatment gains thereby prolonging their deficits in life functioning and satisfaction. Clinically, these patients often display temperamental features reflecting heightened sensitivity to underlying motivational systems related to threat/safety and reward/loss (e.g., somatic anxiety) as well as inordinate negative self-referential processing (e.g., worry, rumination). This profile may reflect disruption in two important neural networks associated with emotional/motivational salience (e.g., salience network) and self-referentiality (e.g., default network, DN). Emotion Regulation Therapy (ERT) was developed to target this hypothesized profile and its neurobehavioral markers. In the present study, 22 GAD patients (with and without MDD) completed resting state MRI scans before receiving 16 sessions of ERT. To test study these hypotheses, we examined the associations between baseline patterns of intrinsic functional connectivity (iFC) of the insula and of hubs within the DN (anterior and dorsal medial prefrontal cortex [MPFC] and posterior cingulate cortex [PCC]) and treatment-related changes in worry, somatic anxiety symptoms and decentering. Results suggest that greater treatment linked reductions in worry were associated with iFC clusters in both the insular and parietal cortices. Greater treatment linked gains in decentering, a metacognitive process that involves the capacity to observe items that arise in the mind with healthy psychological distance that is targeted by ERT, was associated with iFC clusters in the anterior and posterior DN. The current study adds to the growing body of research implicating disruptions in the default and salience networks as promising targets of treatment for GAD with and without co-occurring MDD.

I dag föds färre barn med ryggmärgsbråck på grund av att skadan kan upptäckas med fosterdiagnostik. Kunskapen om ryggmärgbråck utanför specialistklinikerna är bristande och kommunikationsproblemen mellan vårdpersonal och föräldrar är inte ovanligt. Det symtom som mest påverkar vardagen hos den som har ryggmärgsbråck är blåsrubbning.Syftet är att beskriva upplevelser av vara förälder till ungdomar och unga vuxna födda med ryggmärgsbråck, och hur ungdomen och den unge vuxne själv upplever att leva med skadan.Vi har använt oss av en kvalitativ metod och resultatet bygger framförallt på vetenskapliga artiklar och avhandlingar. Materialet analyserades med hjälp av Evans (2003) analysmodell. Resultatet visar att föräldrarna upplever olika sorters oro under barnets uppväxt och att det ofta förekommer brister i samarbetet mellan föräldrar och vårdpersonal. I resultatet framkommer att ungdomarna inte upplever sig som annorlunda utan det är snarare omgivningen som påminner dem om deras funktionsnedsättning. Ryggmärgsbråcket kan dock påverka det dagliga livet i större eller mindre utsträckning. I diskussionen diskuteras först metodval. Vi valde att diskutera dagens fosterdiagnostik, och vilka signaler det sänder ut till samhället. Vi diskuterar om det bristande samarbetet mellan föräldrar och vårdpersonal. Vi tar upp föräldrarnas oro och ungdomars upplevelser av sin funktionsnedsättning och kopplar det till begreppet subjektiv kropp. / <p>Program: Sjuksköterskeutbildning</p><p>Uppsatsnivå: C</p>

<p>Hovedmålet med avhandlingen var å undersøke risikopersepsjon i den norske befolkningen. I tillegg ble relaterte prioriteringer av sikkerhet og krav om risikoreduserende tiltak undersøkt. Avhandlingen består av en introduksjonsdel og tre artikler. Alle er basert på to spørreskjemaundersøkelser gjennomført i 2004 (n= 1730 og 510).</p><p>Den første artikkelen hadde som hovedmål å undersøke risikopersepsjon. Resultatene viser at transportrisiko er delt i to hovedkategorier: offentlig og privat transport. Bekymring ble funnet å være den viktigste predikatoren på risikopersepsjon. Ved nærmere undersøkelse ble det funnet kjønnsforskjeller hvor kvinner la størst vekt på bekymring relatert til både offentlig og privat transport. For menn derimot var sannsynlighetsvurderinger (dvs. kognitive evalueringer) viktigst for privat transport, mens bekymring var viktigst for offentlig transport. Dette impliserer en forskjell i hvordan risikoen blir oppfattet, og dermed er det ansett som hensiktsmessig å differensiere hvordan risiko blir kommunisert til de ulike gruppene.</p><p>Den andre artikkelen foreslår en modell for potensielle faktorer som kan predikere prioritering av sikkerhet. Effekten av personlighetstrekkene angst, sensasjonssøking og tillit ble undersøkt. I tillegg var føreroptimisme, bekymring relatert til transportrisiko, betalingsvillighet for å redusere risiko og negative holdninger mot regler inkludert i modellen. Bekymring var den viktigste predikatoren for prioritering av sikkerhet. Den foreslåtte modellen forklarte 44% av variansen i sikkerhetsprioriteringer. Denne kunnskapen kan øke suksessen relater til intervensjoner fordi det kan øke sjansen for å treffe de som prioriterer sikkerhet lavt og dermed veilede dem til å forandre sin atferd.</p><p>Den tredje artikkelen undersøker hvorvidt det teorietiske rammeverket til ’risk-as-feelings’ hypotesen kunne brukes til å forklare krav om risikoreduserende tiltak. Modelltilpasningen til den teoretiske modellen var tilfredsstillende og resultatene viste at 30% av variasjonen til krav om risikoreduserende tiltak kunne forklares av denne modellen. Den viktigste predikatoren var atferdsmessige intensjoner om å prioritere sikkerhet. Sannsynlighetsvurdering og evaluering av konsekvenser ble funnet å være viktige for både kognitiv vurdering og følelser.</p> / <p>The aims of the PhD-thesis were to examine perceived risk in the Norwegian public as well as related priorities of safety and demands for risk mitigation. The thesis consists of a theoretical introduction and three papers. They are all based on two questionnaire surveys conducted in 2004 (n=1730 and 510 respectively).</p><p>The first paper aims to explore risk perception. The results showed that transport risks consisted of two main categories: public and private means of transportation. Related to risk perception, worry was found to be the most important predictor. On further scrutiny, a gender difference was found. Females were found to emphasize worry related to both public and private transportation as highest. For men, probability assessments (i.e. cognitive evaluations) were found to be most important to private means of transportation whereas worry was found to be most important for public transportation. This implies a difference in perceived risk, and hence how risk is communicated to the public should dependent on the target group.</p><p>The second paper proposed a model for potential predictors of priorities of safety. Several factors were investigated. First, the personality traits anxiety, excitement-seeking, and trust were included. Further factors were driver optimism, worry related to transport risks, willingness to pay to increase safety, and negative attitudes towards traffic rules. Worry was found to be the most important predictor of safety priorities, and the proposed model explained 44% of the variance in priority of safety. This knowledge gives additional information to improve the success of interventions because it can help targeting those who consider safety a low priority and guide them to modify their behaviour.</p><p>The third paper investigated the applicability of the risk-as-feeling framework to explain demand for risk mitigation. The fit of the data to the theoretical model was found to be satisfactory. The results showed that the risk-as-feelings framework explained 30 per cent of the variance of demand for risk mitigation. Behavioural intentions as priorities were found to be an important predictor of mitigation demands. Probability assessment and consequence evaluation were found to be important to cognitive risk assessment and feelings.</p>

Hovedmålet med avhandlingen var å undersøke risikopersepsjon i den norske befolkningen. I tillegg ble relaterte prioriteringer av sikkerhet og krav om risikoreduserende tiltak undersøkt. Avhandlingen består av en introduksjonsdel og tre artikler. Alle er basert på to spørreskjemaundersøkelser gjennomført i 2004 (n= 1730 og 510). Den første artikkelen hadde som hovedmål å undersøke risikopersepsjon. Resultatene viser at transportrisiko er delt i to hovedkategorier: offentlig og privat transport. Bekymring ble funnet å være den viktigste predikatoren på risikopersepsjon. Ved nærmere undersøkelse ble det funnet kjønnsforskjeller hvor kvinner la størst vekt på bekymring relatert til både offentlig og privat transport. For menn derimot var sannsynlighetsvurderinger (dvs. kognitive evalueringer) viktigst for privat transport, mens bekymring var viktigst for offentlig transport. Dette impliserer en forskjell i hvordan risikoen blir oppfattet, og dermed er det ansett som hensiktsmessig å differensiere hvordan risiko blir kommunisert til de ulike gruppene. Den andre artikkelen foreslår en modell for potensielle faktorer som kan predikere prioritering av sikkerhet. Effekten av personlighetstrekkene angst, sensasjonssøking og tillit ble undersøkt. I tillegg var føreroptimisme, bekymring relatert til transportrisiko, betalingsvillighet for å redusere risiko og negative holdninger mot regler inkludert i modellen. Bekymring var den viktigste predikatoren for prioritering av sikkerhet. Den foreslåtte modellen forklarte 44% av variansen i sikkerhetsprioriteringer. Denne kunnskapen kan øke suksessen relater til intervensjoner fordi det kan øke sjansen for å treffe de som prioriterer sikkerhet lavt og dermed veilede dem til å forandre sin atferd. Den tredje artikkelen undersøker hvorvidt det teorietiske rammeverket til ’risk-as-feelings’ hypotesen kunne brukes til å forklare krav om risikoreduserende tiltak. Modelltilpasningen til den teoretiske modellen var tilfredsstillende og resultatene viste at 30% av variasjonen til krav om risikoreduserende tiltak kunne forklares av denne modellen. Den viktigste predikatoren var atferdsmessige intensjoner om å prioritere sikkerhet. Sannsynlighetsvurdering og evaluering av konsekvenser ble funnet å være viktige for både kognitiv vurdering og følelser. / The aims of the PhD-thesis were to examine perceived risk in the Norwegian public as well as related priorities of safety and demands for risk mitigation. The thesis consists of a theoretical introduction and three papers. They are all based on two questionnaire surveys conducted in 2004 (n=1730 and 510 respectively). The first paper aims to explore risk perception. The results showed that transport risks consisted of two main categories: public and private means of transportation. Related to risk perception, worry was found to be the most important predictor. On further scrutiny, a gender difference was found. Females were found to emphasize worry related to both public and private transportation as highest. For men, probability assessments (i.e. cognitive evaluations) were found to be most important to private means of transportation whereas worry was found to be most important for public transportation. This implies a difference in perceived risk, and hence how risk is communicated to the public should dependent on the target group. The second paper proposed a model for potential predictors of priorities of safety. Several factors were investigated. First, the personality traits anxiety, excitement-seeking, and trust were included. Further factors were driver optimism, worry related to transport risks, willingness to pay to increase safety, and negative attitudes towards traffic rules. Worry was found to be the most important predictor of safety priorities, and the proposed model explained 44% of the variance in priority of safety. This knowledge gives additional information to improve the success of interventions because it can help targeting those who consider safety a low priority and guide them to modify their behaviour. The third paper investigated the applicability of the risk-as-feeling framework to explain demand for risk mitigation. The fit of the data to the theoretical model was found to be satisfactory. The results showed that the risk-as-feelings framework explained 30 per cent of the variance of demand for risk mitigation. Behavioural intentions as priorities were found to be an important predictor of mitigation demands. Probability assessment and consequence evaluation were found to be important to cognitive risk assessment and feelings.

The main aims were to: explore whether there is a relation between doctors’ ability to identify patients’ worry and wish for information and self-efficacy with regard to communicating with patients about difficult matters; describe which cues doctors consider when estimating patients’ worry and wish for information, and investigate whether there is a relation between patients’ satisfaction with doctors’ care and patients’ psychosocial function. Eleven doctors and 69 patients (of which 36 patients participated in the longitudinal study) with carcinoid tumours participated. Doctors’ self-efficacy, and ability to identify patients’ worry/wish for information were investigated at patients’ first admission. Doctors were interviewed about which cues they considered when estimating patients worry/wish for information. Patients’ satisfaction with care (CASC SF 4.0) and psychosocial function (EORTC QLQ-C30, HADS) were measured longitudinally, during the first year after diagnosis. Doctors reported higher self-efficacy when showing good ability to identify patients’ wish for information, than when showing less good ability, overestimated patients’ worry and underestimated patients’ wish for information. Doctors considered patients’ verbal behaviour and body language together with knowledge and experience when estimating patients worry and wish for information. Patients who met doctors showing good ability to identify their wish for information, reported a higher cognitive function than patients who met doctors showing less good ability. At all assessments patients expressed high satisfaction with doctor’ care and patients’ satisfaction did not change over time. Patients’ satisfaction with doctors’ care were related to their psychosocial function shortly after the first three admissions to specialist care. Patients with carcinoid tumours in some respects reported a worse HRQoL than the general Swedish population. Fatigue, diarrhoea, limited possibilities to work/pursue daily activities, and worry that the illness will get worse were among the most prevalent, and worst, aspects of disease- and treatment related distress.

Theoretischer Hintergrund: Die diagnostischen Kriterien der Generalisierten Angststörung (GAS) und ihr Status als eigenständige psychische Störung waren lange umstritten. Inzwischen liegen neuere epidemiologische Daten vor, die ein präziseres Bild dieser Störung und ihrer Besonderheiten ermöglichen. Methode: Es wird ein systematischer Überblick zu Prävalenz, Verlauf und Komorbidität, zur Beeinträchtigung und zum Inanspruchnahmeverhalten sowie zur Spezifität des Kernsymptoms (Sorgen) erstellt. Ergebnisse: GAS ist eine häufige Störung, die im jungen Erwachsenenalter einsetzt, jedoch auch – anders als andere Angststörungen – hohe Inzidenzraten im mittleren Lebensalter aufweist. Der Verlauf ist eher chronisch. Trotz hoher Komorbidität lässt sich die Störung valide abgrenzen. Klinisch relevante Sorgen erweisen sich als störungsspezifisch. Die Beeinträchtigungen sind auch bei GAS-Patienten ohne Komorbidität beträchtlich. Schlussfolgerung: Der Forschungsstand spricht für die Bedeutung und Eigenständigkeit der Diagnose sowie für die stärkere Beachtung offener Forschungsfragen. / Background: The diagnostic criteria for generalized anxiety disorder (GAD) and its status as an independent mental disorder have been controversial. More recent epidemiological data provide a more precise picture of this disorder and its specific features. Methods: A systematic overview is given in regard to prevalence, course and comorbidity, impairment, and help-seeking behavior as well as to specificity of the core symptom (worries). Results: GAD is a frequent disorder with high incidence rates in middle-age groups, which are not seen in other anxiety disorders. Despite the high comorbidity GAD can be validly distinguished. Clinically relevant worries have been proven as specific for the disorder. The impairments are also considerable for patients without comorbid disorders. Conclusions: Research supports the independent status of GAD and the importance of this diagnosis. Unsolved questions are to be analyzed in future research.

Thesis (Ph. D.)--University of Missouri-Columbia, 2001. / Typescript. Vita. Includes bibliographical references (leaves 76-85). Also available on the Internet.