Negativa hemförhållanden har tidigare visats bidra till depressivasymptom. Syftet med denna studie var att undersöka: 1) omförhållanden som oro och katastroftänkande är mediatorer mellannegativa hemförhållanden och depressiva symptom, 2) om det finnsnågra könsskillnader i detta avseende. Studien baserades påinsamlade data från ett pågående projekt vid Örebro universitet. Enenkätundersökning utfördes på 18 högstadieskolor i tre mellansvenskastäder med totalt 2749 elever i årskurs 7 och 8. Resultaten visade enpositiv korrelation mellan negativa hemförhållanden och depressivasymptom, samt att båda faktorerna oro och katastroftänkande partielltmedierade mellan negativa hemförhållanden och depressiva symptom.Det fanns könsskillnader som visade att flickor som blev utsatta förpsykologisk kontroll speciellt hade ett katastroftänkande, somkorrelerade högt med depressiva symptom. Slutsatsen är attförhållanden hos människor, som uttalad oro och katastroftänkande,till väsentlig grad förklarar varför negativa hemförhållanden har såkraftig effekt på ungdomars depressiva symptom. / Negative home conditions have previously been shown to contributeto depressive symptoms. The purpose of this study was to examinewhether the conditions worry and catastrophic thinking are mediatorsbetween negative home conditions and depressive symptoms. Thedata was selected from an existing survey conducted among studentsin grades 7-8 at secondary schools in three Swedish cities. A total of2749 secondary school students participated in this cross-sectionalstudy. The results showed a positive correlation between negativehome conditions and depressive symptoms, and both factors worryand catastrophic thinking partially mediated between negative homeconditions and depressive symptoms. The conclusion is thatconditions in humans, such as pronounced worry and catastrophicthinking, to a substantial degreee explains why negative homeconditions have so powerful effects on young people’s depressivesymptoms.

No description available.

Utan förmågan att uppleva vare sig stress eller smärta hade mänskligheten inte överlevt fram tills idag. Dessvärre uppstår stress- och/eller smärtreaktioner för oss människor vid icke livshotande situationer och tenderar i vissa fall att få motsatt effekt. Detta bidrar till lidande på individnivå, men leder också till stora kostnader för samhället, framförallt i form av sjukskrivning. Problemen hänger ofta ihop, många arbetstagare lider både av stress- och smärtproblematik. Enligt den transdiagnostiska modellen vidmakthåller liknande (s.k. transdiagnostiska) faktorer både stress- och smärtrelaterad ohälsa. Det skulle vara användbart ur flera olika perspektiv att undersöka och förstå mer exakt vilka transdiagnostiska faktorer som förekommer vid stress- och smärtproblematik samt hur kopplingen till arbetsförmåga ter sig. Föreliggande studie utgick från tvärsnittsdata, N=139 (100% kvinnor) svarade via internetbaserade enkäter. Analysen visar samband mellan stress och/eller smärta och arbetsförmåga, både stress och smärta visar unika negativa effekter på arbetsförmåga. Vi fann tre olika undergrupper baserat på relativa nivåer av stress- och smärtproblematik. Gruppen med höga nivåer av självskattad stress- och smärtproblematik visade låga nivåer av problemlösningsförmåga och höga nivåer av katastrofiering. Det diskuterades kring dessa transdiagnostiska faktorers koppling till stress- och smärtproblematik. Transdiagnostiska faktorer kan med fördel beaktas för effektivare behandling och bör undersökas vidare i framtida forskning. / Without the ability to experience neither stress nor pain, humanity would not survive. Unfortunately, stress and pain reactions sometimes occur in non-life-threatening situations and seem to be less functional in some cases. This contributes to suffering for individuals and enormous costs for society. The problems are often related, many workers suffer from both stress and pain problems. Similar (so-called transdiagnostic) factors maintain both stress and pain related illness according to the transdiagnostic model. It would be useful from several perspectives to investigate and understand which transdiagnostic factors are present in stress and pain problems, as well as how the connection to work ability expresses itself. This study was based on cross-sectional data, N=139 (100% females) responded to an internet-based survey. Analysis shows that pain and stress together predict work ability, both stress and pain show unique negative effects on work ability. We found three subgroups, one of the groups stood out from the others with high levels of stress and pain. The same group showed low problem-solving ability and high on catastrophizing, which are theoretical transdiagnostic factors. These factors and their relationship to stress and pain problems were discussed. Future research and eventual treatment need to take transdiagnostic factors into consideration.

För att bättre kunna förstå och hjälpa de som drabbas av långvarig smärtproblematik är detviktigt att applicera ett biopsykosocialt perspektiv. En tidigare studie föreslog att en vissskattning av smärtintensitet i ett cold pressor test (CPT) var en biomarkör för utvecklingen avlångvarig smärtproblematik. Denna studie syftade till att undersöka huruvida dennaföreslagna biomarkör, samt variansen i sammanlagd smärtintensitet under CPT, kan förklarasav uppfattad stress respektive utmattningssymtom, utöver demografiska faktorer ochsymtomkatastrofiering. Deltagarna (n = 35) genomförde ett CPT. CPT-skattningaranalyserades tillsammans med demografiska faktorer, symtomkatastrofiering, uppfattad stressoch utmattningssymtom i hierarkiska regressionsanalyser och hierarkiska binära logistiskaregressionsanalyser. Resultaten visade att högre grad av uppfattad stress predicerade lägresmärtintensitet, utöver övriga faktorer. Utmattningssymtom hade ingen signifikant effekt påsmärtintensitet. Inga undersökta faktorer kunde förklara den föreslagna biomarkören.Resultatet indikerar att det finns en suppressoreffekt där katastrofiering och uppfattad stresspåverkar varandra ömsesidigt. Detta visar på det komplexa biopsykosociala samspel sompåverkar upplevelsen av smärta. Denna komplexitet och interaktion är viktig att ha i åtankenär individer i riskzonen för att utveckla smärtproblematik ska identifieras. / In order to help and understand patients with chronic pain, it is important to apply abiopsychosocial perspective. One previous study proposed a specific rating in a cold pressortest (CPT) as a biomarker for the development of persistent pain. This study aimed to explorewhether this proposed biomarker, and the sum of pain intensity ratings during CPT, could beexplained by perceived stress and exhaustion symptoms respectively, above and beyonddemographic factors and symptom catastrophizing. The participants (n = 35) performed aCPT. CPT-ratings were analyzed, together with demographic factors, symptomcatastrophizing, perceived stress and exhaustion symptoms, using hierarchical regressionanalyses and hierarchical binary logistic regression analyses. The results showed that higherlevels of perceived stress predicted lower pain intensity, above and beyond the other variablesexamined. Exhaustion symptoms showed no significant effect on pain intensity. None of thevariables could explain the proposed biomarker. The results indicate a suppressor effectwhere symptom catastrophizing and perceived stress interact and influence each othersimultaneously. This highlights the biopsychosocial interplay which influences painexperience. This complexity and interaction is an important factor to consider in the processof identifying individuals who are at risk for developing persistent pain.

Introdução: Crenças de autoeficácia e de medo da dor e evitação do movimento influem na incapacidade em pacientes com lombalgia crônica e estratégia que as modifiquem são desejáveis. Objetivo: Analisar o efeito de um Programa de educação e exposição ao movimento (PROAME) na modificação dessas crenças, estilo de pensamento, humor e incapacidade em pacientes com lombalgia crônica. Método: Ensaio clínico randomizado, cegado para a avaliação do desfecho, realizado com 81 pacientes divididos em três grupos: Grupo A (três sessões de exposição e três sessões de educação), Grupo B (três sessões de educação) e Grupo C (controle). Foram elegíveis pacientes com lombalgia 6 meses,com pontuação na Escala Tampa de Cinesiofobia 51 pontos e na Escala de Autoeficácia para Dor Crônica 182 pontos. Os pontos de corte das crenças foram estabelecidos neste estudo. Autoeficácia e medo da dor e evitação do movimento foram desfechos primários. Pensamentos catastróficos, ansiedade, depressão, incapacidade e dor, desfechos secundários. A comparação dos desfechos entre os Grupos A, B e C foi feita por meio dos testes Qui-quadrado, Exato de Fisher, Equação de Estimação Generalizada, ANOVA e Kruskal Wallis. Resultado: Os pacientes dos Grupos A e B melhoraram a autoeficácia, o medo da dor e evitação do movimento, pensamentos catastróficos, ansiedade, depressão e incapacidade (p<0,001). Os doentes do Grupo C ficaram estáveis em todas essas variáveis. O Grupo A melhorou a intensidade dolorosa e características neuropáticas, quando comparado aos Grupos B e C (p<0,001). Na análise do Ciclo Vicioso do Medo da Dor e Evitação do Movimento, atividades do dia a dia (53,7%) e o movimento de curvar a coluna (48,2%) foram os que mais causavam dor. A dor com componente neuropático ocorreu em 39,2% dos relatos e em 71,4% das vezes havia pensamentos catastróficos. Medo exagerado estava presente em 44,4% dos que tinham incapacidade limitada e em 27,8% dos que apresentavam incapacidade maior. A hierarquização do medo no termômetro do prejuízo (escore de 0-100) mostrou que o medo acima de 50 pontos foi descrito em 24 de 40 atividades. .As atividades mais escolhidas para a exposição foram trabalhar com a pá (33,3%), correr (33,3%), carregar sacolas de compras uma em cada mão (25,9%), esfregar o chão com rodo (25,9%) e realizar abdominal no chão (25,9%). Houve redução dos escores de medo e ansiedade, após a primeira exposição (p<0,001) e segunda exposição (p<0,001). Conclusão: A parte educativa do PROAME foi capaz de melhorar as crenças disfuncionais, o humor e a incapacidade dos doentes, mas não a intensidade dolorosa. No entanto, somente a exposição ao movimento melhorou a intensidade da dor. A análise do Ciclo Vicioso mostrou a presença de medo exagerado ao movimento, catastrofização e incapacidade. / Introduction: Self-efficacy and fear of pain and avoidance of movement beliefs influence on disability in chronic low back pain patients and strategies for changing them are desirable. Objective: To analyze the effect of an educational and exposure to movement Program (PROAME) in modifying those beliefs, style of thinking, mood, and disability in chronic low back pain patients. Methods: Randomized clinical trial, blinded to outcome assessment, conducted with 81 patients divided into three groups: Group A (three exposure sessions and three educational sessions), group B (three education sessions) and Group C (control). Were eligible patients with low back pain 6 months with scores on Tampa Scale of kinesiophobia 51 points and Chronic Pain Self-efficacy Scale 182 points. Cutoff points of the beliefs were established in this study. Self-efficacy and fear of pain and avoidance of movement were primary outcomes. Catastrophic thoughts, anxiety, depression, disability and pain, secondary outcomes. The comparison of outcomes between groups A, B and C was made using the chi-square test, Fisher\'s exact, Generalized Estimation Equation, ANOVA and Kruskal Wallis. Results: Patients in Groups A and B improved self-efficacy, fear of pain and avoidance movement, catastrophic thoughts, anxiety, depression and disability (p <0.001). The Group C patients were stable in all these variables. Group A improved pain intensity and neuropathic characteristics when compared to Groups B and C (p <0.001). In Vicious Cycle of Fear of Pain and Avoidance of Movement analysis, daily activities (53.7%) and the movement of bending the spine (48.2%) were the ones that caused pain. The pain with a neuropathic component occurred in 39.2% of the reports and in 71.4% of cases had catastrophic thoughts. Exaggerated fear was present in 44.4% of those with limited disability, while 27.8% of those with greater disability. The fear hierarchy in thermometer harm (score 0-100) showed that fear above 50 has been reported in 24 of 40 activities. The activities most chosen for exposure were \"working with the shovel\" (33.3%), \"running\" (33.3%), \"carrying shopping bags - one in each hand\" (25.9%), \"mop the floor with squeegee\" (25.9%) and \"abdominal hold down\" (25.9%). There was a reduction of fear and anxiety scores after the first exposure (p <0.001) and second exposure (p <0.001). Conclusion: The educational part of PROAME was able to improve dysfunctional beliefs, mood and disability of patients, but not pain intensity. However, only the exposure to movement improved pain intensity. Analysis of the Vicious Cycle showed the presence of exaggerated fear of movement, catastrophizing and disability.

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.

No description available.

Introdução: Crenças de autoeficácia e de medo da dor e evitação do movimento influem na incapacidade em pacientes com lombalgia crônica e estratégia que as modifiquem são desejáveis. Objetivo: Analisar o efeito de um Programa de educação e exposição ao movimento (PROAME) na modificação dessas crenças, estilo de pensamento, humor e incapacidade em pacientes com lombalgia crônica. Método: Ensaio clínico randomizado, cegado para a avaliação do desfecho, realizado com 81 pacientes divididos em três grupos: Grupo A (três sessões de exposição e três sessões de educação), Grupo B (três sessões de educação) e Grupo C (controle). Foram elegíveis pacientes com lombalgia 6 meses,com pontuação na Escala Tampa de Cinesiofobia 51 pontos e na Escala de Autoeficácia para Dor Crônica 182 pontos. Os pontos de corte das crenças foram estabelecidos neste estudo. Autoeficácia e medo da dor e evitação do movimento foram desfechos primários. Pensamentos catastróficos, ansiedade, depressão, incapacidade e dor, desfechos secundários. A comparação dos desfechos entre os Grupos A, B e C foi feita por meio dos testes Qui-quadrado, Exato de Fisher, Equação de Estimação Generalizada, ANOVA e Kruskal Wallis. Resultado: Os pacientes dos Grupos A e B melhoraram a autoeficácia, o medo da dor e evitação do movimento, pensamentos catastróficos, ansiedade, depressão e incapacidade (p<0,001). Os doentes do Grupo C ficaram estáveis em todas essas variáveis. O Grupo A melhorou a intensidade dolorosa e características neuropáticas, quando comparado aos Grupos B e C (p<0,001). Na análise do Ciclo Vicioso do Medo da Dor e Evitação do Movimento, atividades do dia a dia (53,7%) e o movimento de curvar a coluna (48,2%) foram os que mais causavam dor. A dor com componente neuropático ocorreu em 39,2% dos relatos e em 71,4% das vezes havia pensamentos catastróficos. Medo exagerado estava presente em 44,4% dos que tinham incapacidade limitada e em 27,8% dos que apresentavam incapacidade maior. A hierarquização do medo no termômetro do prejuízo (escore de 0-100) mostrou que o medo acima de 50 pontos foi descrito em 24 de 40 atividades. .As atividades mais escolhidas para a exposição foram trabalhar com a pá (33,3%), correr (33,3%), carregar sacolas de compras uma em cada mão (25,9%), esfregar o chão com rodo (25,9%) e realizar abdominal no chão (25,9%). Houve redução dos escores de medo e ansiedade, após a primeira exposição (p<0,001) e segunda exposição (p<0,001). Conclusão: A parte educativa do PROAME foi capaz de melhorar as crenças disfuncionais, o humor e a incapacidade dos doentes, mas não a intensidade dolorosa. No entanto, somente a exposição ao movimento melhorou a intensidade da dor. A análise do Ciclo Vicioso mostrou a presença de medo exagerado ao movimento, catastrofização e incapacidade. / Introduction: Self-efficacy and fear of pain and avoidance of movement beliefs influence on disability in chronic low back pain patients and strategies for changing them are desirable. Objective: To analyze the effect of an educational and exposure to movement Program (PROAME) in modifying those beliefs, style of thinking, mood, and disability in chronic low back pain patients. Methods: Randomized clinical trial, blinded to outcome assessment, conducted with 81 patients divided into three groups: Group A (three exposure sessions and three educational sessions), group B (three education sessions) and Group C (control). Were eligible patients with low back pain 6 months with scores on Tampa Scale of kinesiophobia 51 points and Chronic Pain Self-efficacy Scale 182 points. Cutoff points of the beliefs were established in this study. Self-efficacy and fear of pain and avoidance of movement were primary outcomes. Catastrophic thoughts, anxiety, depression, disability and pain, secondary outcomes. The comparison of outcomes between groups A, B and C was made using the chi-square test, Fisher\'s exact, Generalized Estimation Equation, ANOVA and Kruskal Wallis. Results: Patients in Groups A and B improved self-efficacy, fear of pain and avoidance movement, catastrophic thoughts, anxiety, depression and disability (p <0.001). The Group C patients were stable in all these variables. Group A improved pain intensity and neuropathic characteristics when compared to Groups B and C (p <0.001). In Vicious Cycle of Fear of Pain and Avoidance of Movement analysis, daily activities (53.7%) and the movement of bending the spine (48.2%) were the ones that caused pain. The pain with a neuropathic component occurred in 39.2% of the reports and in 71.4% of cases had catastrophic thoughts. Exaggerated fear was present in 44.4% of those with limited disability, while 27.8% of those with greater disability. The fear hierarchy in thermometer harm (score 0-100) showed that fear above 50 has been reported in 24 of 40 activities. The activities most chosen for exposure were \"working with the shovel\" (33.3%), \"running\" (33.3%), \"carrying shopping bags - one in each hand\" (25.9%), \"mop the floor with squeegee\" (25.9%) and \"abdominal hold down\" (25.9%). There was a reduction of fear and anxiety scores after the first exposure (p <0.001) and second exposure (p <0.001). Conclusion: The educational part of PROAME was able to improve dysfunctional beliefs, mood and disability of patients, but not pain intensity. However, only the exposure to movement improved pain intensity. Analysis of the Vicious Cycle showed the presence of exaggerated fear of movement, catastrophizing and disability.

Intolerance of uncertainty concerns how one views and reacts touncertainty, where one who’s highly intolerant would find it verydiscomforting when confronted with uncertain situations. The purposeof this study was to examine the associations between intolerance ofuncertainty, pain catastrophizing, emotion regulation andpsychopathic traits. These variables were to be examined in thecontext of a Beads Task and a Cold Pressor Test (CPT). Wehypothesized that there would be a positive significant associationbetween intolerance of uncertainty, pain catastrophizing, emotionregulation, psychopathic traits. We also hypothesized that there wouldbe a difference depending on the difficulty of the Beads Task. To doso, data was collected from 60 university students (32 females and 28males). The results showed that there was a significant, positiveassociation between intolerance of uncertainty, pain catastrophizing,emotion regulation and the Beads Task measurements. Some of theseresults were similar to previous studies. / Intolerans mot osäkerhet berör hur en person uppfattar och reagerarpå osäkerhet, där någon som är intolerant upplever osäkra situationersom obehagliga. Syftet med denna studie var att undersökaassociationerna mellan intolerans mot osäkerhet,smärtkatastrofiering, känsloreglering och psykopatiskapersonlighetsdrag. Dessa variabler undersöktes i sammanhang medBeads Task och ett Kallvattentest. Där några av hypoteserna var attdet finns positiva signifikanta associationer mellan intolerans motosäkerhet, smärtkatastrofiering, känsloreglering och psykopatiskapersonlighetsdrag. Vi hade också en hypotes att det kommer finnas enskillnad beroende på svårighetsgraden av Beads Task. För att göradetta samlades data in från 60 universitetsstudenter (32 kvinnor och28 män). Resultaten visade på en signifikant, positiv associationmellan intolerans mot osäkerhet, smärtkatastrofiering,känsloreglering och Beads Task-måtten. Några av dessa resultat varlikt de i tidigare studier.

No description available.