The first part of this thesis explores the potential role of metacognitive beliefs and strategies in functional somatic symptoms. Current models (for example, Brown, 2004; Deary, Chalder and Sharpe, 2007) and treatments of functional somatic symptoms focus on cognitive models and cognitive behavioural treatments which show modest treatment effects. A metacognitive account is discussed based upon supervisory regulatory executive function theory (SREF; Wells and Matthews, 1994) and research is systematically reviewed which may support such an account. Current research offers limited indirect support for metacognitive factors playing a role in the difficulties of people suffering from functional somatic symptoms. This paper concludes that further research is needed in this promising area. The second part of the thesis describes a cross-sectional correlational study which examines the relationship of somatic symptom reporting in primary care with metacognitive beliefs, finding a significant association for the first time. Fifty patients were recruited from general practice surgeries took part in the study. Support for the novel Metacognitive Health Questionnaire measure was also found. This measure showed significant associations between health specific metacognitive beliefs and body focussed attention, health preoccupation and distress. This measure also showed significant associations with illness behaviours and thought control strategies. Each of these findings is in line with SREF theory. This study provides preliminary support for the role of metacognition in symptom reporting. The third part of the thesis critically evaluated issues salient to the study including methodologically, supervisory, ethical and clinical issues. The interpretations of the literature review and findings of the research paper are limited by the lack of direct findings to support a metacognitive account, and the cross sectional nature of this study. It is hoped that the prospective study which the research study reported forms part, will offer more robust insights into the role of metacognition in symptom reporting, and that future studies will examine this area further.

Proaktiv interferens (PI) uppstår när äldre, irrelevant minnesinformation stör nyinlärning ellerframplockning av relevant information. PI påverkas av faktorer som familjaritet ochinkodning av kontextuell information. Tidigare forskning indikerar att PI har en koppling tillminnets åldrande och negativa tankeprocesser, såsom oro och ruminering. Studien undersökteom ett anpassat arbetsminnestest (2-back) kan inducera PI och om irrelevant information medolika grader av familjaritet ger olika grad av PI. Studien syftade också till att undersöka omäldre upplever mer PI än yngre samt om PI går att koppla till grad av oro och ruminering. 15yngre vuxna (20-30 år) och 10 äldre vuxna (65-69 år) genomförde ett datoriserat 2-back-testoch fyllde i skattningsformulär (PSWQ och RRS-BR). Resultatet visade att PI inducerades avtestet och att PI minskade när familjariteten minskade. Resultatet visade också att äldreupplevde en signifikant högre grad av PI på ett mått, men inte på ett annat. Ingen signifikantkoppling mellan PI och oro eller ruminering hittades. Resultaten bör dock tolkas medförsiktighet. / Proactive interference (PI) occurs when older and irrelevant memory information interfereswith new learning or retrieval of relevant information. PI is influenced by factors such asfamiliarity and the encoding of contextual information. Previous research indicates that PI hasa link to age-related memory decline and negative thought processes such as worry andrumination. The study investigated whether a modified working memory test (2-back) caninduce PI and if irrelevant information with different degrees of familiarity induces differentdegrees of PI. The study also aimed to investigate whether older adults experience more PIthan younger adults and whether PI can be linked to the degree of worry and rumination. 15younger adults (20-30 years) and 10 older adults (65-69 years) performed a computerized 2-back test and completed self-report questionnaires (PSWQ and RRS-BR). The result showedthat PI was induced by the test and that PI decreased as familiarity decreased. The results alsoshowed that the older adults experienced a significantly higher degree of PI in one measure,but not in another. No significant association between PI and worry or rumination was found.The results should be interpreted with caution.

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Climate change is one of the biggest threats facing the world, connected to rising oceanlevels, droughts, and other natural disasters. The aim of this study was to explore if and howclimate worry, climate coping and experiential avoidance are connected to climate friendlybehaviour among Swedish adolescents in their third year of upper-secondary school (N=470).A questionnaire was used to measure the factors of interest, which were analysed withcorrelation and mediation analysis. Four main results were found. The first was that climatefriendly behaviour related to climate worry and climate coping in a similar way to howpro-environmental behaviour has done in previous studies. The second finding was thatproblem focused climate coping mediated the relationship between meaning focused climatecoping and climate friendly behaviour. The third result was that distancing was positivelyrelated to experiential avoidance and climate worry in contrast to de-emphasizing which wasonly related negatively to climate friendly behaviour. Lastly the results showed thatexperiential avoidance was related to distancing but not to any other variables. Our findingscontribute to a greater understanding of the field in that they support and extend previousfindings as well as highlight new angles for future research.

Generalized anxiety disorder (GAD) is a prevalent anxiety disorder that is characterized by persistent excessive worrying that is often difficult to control. The pathology of GAD has been associated with abnormal neural activity and functional connectivity. This systematic review has examined the central neural correlates of GAD which are the prefrontal cortex (PFC), the anterior cingulate cortex (ACC) and the amygdala and how activation and functional connectivity in these brain areas differ between patients with GAD and healthy controls. This review also investigated how abnormal functional connectivity and activation in these brain regions relates to worry which is the most prominent psychological symptom in patients with GAD. A systematic review was conducted and seven original functional magnetic resonance imaging (fMRI) studies were included after a literature search on PubMed, Scopus and, Web of Science. The main findings from this review revealed decreased activation in the PFC and ACC and enhanced activation in the amygdala during the viewing of negative stimuli in patients with GAD. Identifying the neural correlates of GAD and how it relates to worry may provide improved treatment in the future such as developing more effective psychotropic drugs or improved psychotherapy. GAD has been associated with lower well-being and life satisfaction and may even be a risk factor for suicidal thoughts. One of the limitations from this review is that several of the included studies recruited patients with comorbidities and for that reason results from these studies cannot be generalized and applied to individuals with GAD.

Syftet med studien var att undersöka om lättnader av corona-restriktioner har påverkat individers sociala interaktion och känslor gentemot att återgå till ett normalt samhälle.“Hur ser strukturen ut för människors stress och oro efter lättade covid-19 restriktioner och vad relaterar de till?”. Då det har visat sig att social distansering och att arbeta hemifrån kan ha negativa konsekvenser på den psykiska hälsan. Studien skapade ett mätinstrument som mäter människors känslor och upplevelser gentemot Sveriges lättade covid-19 restriktioner. En kvalitativ förstudie utfördes med två öppna frågor för att undersöka om individer upplever stress och oro inför återgång till ett normalt samhälle efter restriktioner. Därefter utfördes en kvantitativ enkätundersökning med ett icke slumpmässigt bekvämlighetsurval som var baserad på resultatet från förstudien. Urvalet (n=242) bestod av individer som har levt i Sverige under rådande restriktioner. En faktoranalys utfördes och resulterade i skalan Stress och Oro Efter Lättade covid-19 Restriktioner [SOELR] med fyra subskalor. Följaktligen utfördes en korrelationsanalys som visade att det fanns signifikanta samband mellan SOELR och subskalorna. Sammanfattningsvis känner individer i samhället en viss stress och oro inför sociala interaktioner och relationer, covid-19, hantering av symtom och ökade miljöombyten till följd av lättade restriktioner i samhället. / The aim of the study was to investigate if alleviated covid-19 restrictions has made an impact on individuals’ social interaction and feelings towards returning to a normal society. “How does the structure look like for individuals´ stress and worry post alleviated covid-19 restrictions and what do they relate to?”. Since it has previously shown that social distancing and working from home may have negative consequences on mental health. The study created a measurement that measures peoples’ feelings and experiences towards Sweden’s alleviated covid-19 restrictions. A qualitative pre-study was conducted with two open-ended questions in order to measure if individuals feel stress and worry towards returning to a normal society post restrictions. Thereafter a quantitative survey with a non-random convenience sample that was based on results from the pre-study. The sample (n=242) consisted of individuals’ that has lived in Sweden during the current restrictions. A factor analysis was conducted and resulted in the scale stress and worry post alleviated covid-19 restrictions [SOELR] containing four subscales. Consequently a correlational analysis showed significant correlations between SOELR and the subscales. In summary, individuals in society feel a certain amount of stress and worry for social interactions and relations, covid-19, dealing with symptoms and increase of changes in the setting post alleviated restrictions in society.

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