Matrices reasoning tests, which contain missing pieces in matrices that participants attempt to figure out, are one of the most popular types of tests to measure general intelligence. This thesis introduces several methods to develop matrices items, and presents them in different test forms to assess general intelligence. Part 1 introduces the development of a matrices test with reference to Carpenter’s five rules of Raven’s Progressive Matrices. The test items developed were administered together with the Standard Ravens’ Progressive Matrices (SPM). Results based on confirmatory factor analysis and inter-item correlation demonstrate good construct validity and reliability. Item characteristics are explored with Item-Response Theory (IRT) analyses. Part 2 introduces the development of a large item bank with multiple alternatives for each SPM item, with reference to the item components of the original SPM. Results showed satisfactory test validity and reliability when using the alternative items in a test. Findings also support the hypothesis that the combination of item components accounts for item difficulty. The work lays the foundation for the future development of computer adaptive versions of Raven’s Progressive Matrices. Part 3 introduces the development of an automatic matrix item generator and illustrates the results of the analyses of the items generated using the distribution-of-three rule. Psychometric properties of the items generated are explored to support the validity of the generator. Figural complexity, features, and the frequency at which certain rules were used are discussed to account for the difficulty of the items. Results of further analyses to explore the underlying factors of the difficulty of the generated items are presented and discussed. Results showed that the suggested factors explain a substantial amount of the variance of item difficulty, but are insufficient to predict the item difficulty. Adaptive on-the-fly item generation is yet to be possible for the test at this stage. Overall, the methods for creating matrices reasoning tests introduced in the dissertation provide a useful reference for research on abstract reasoning and fluid intelligence measurements. Implications for other areas of psychometric research are also discussed.

This thesis consists of four self-contained papers. Essay I (with Linuz Aggeborn): Fluoridation of the drinking water is a public policy whose aim is to improve dental health. Although the evidence is clear that fluoride is good for dental health, concerns have been raised regarding potential negative effects on cognitive development. We study the effects of fluoride exposure through the drinking water in early life on cognitive and non-cognitive ability, education and labor market outcomes in a large-scale setting. We use a rich Swedish register dataset for the cohorts born 1985-1992, together with drinking water fluoride data. To estimate the effects, we exploit intra-municipality variation of fluoride, stemming from an exogenous variation in the bedrock. First, we investigate and confirm the long-established positive relationship between fluoride and dental health. Second, we find precisely estimated zero-effects on cognitive ability, non-cognitive ability and education for fluoride levels below 1.5 mg/l. Third, we find evidence that fluoride improves later labor market outcomes, which indicates that good dental health is a positive factor on the labor market. Essay II: I study the associations between cognitive and non-cognitive abilities and mortality using a population-wide dataset of almost 700,000 Swedish men born between 1950 and 1965. The abilities were measured at the Swedish military enlistment at age 18-20. In addition, I investigate if income and education are good proxies for the abilities. The results suggest that both cognitive and non-cognitive abilities are strongly associated with mortality, but that non-cognitive ability is a stronger predictor. The associations are only partly mediated through income and education. For middle and high income earners and individuals with a college education there are no associations with mortality. However, for low income earners and individuals without a college education, both abilities are strongly associated with mortality. The associations are mainly driven by the bottom of the distributions. Essay III (with Matz Dahlberg, Kevin Mani and Anders Wanhainen): We examine how health information affects individuals' well-being using a regression discontinuity design on data from a screening program for an asymptomatic disease, abdominal aortic aneurysm (AAA). The information provided to the individuals is guided by the measured aorta size and its relation to pre-determined levels. When comparing individuals that receive information that they are healthy with those that receive information that they are in the risk zone for AAA, we find no effects. However, when comparing those that receive information that they have a small AAA, and will be under increased surveillance, with those who receive information that they are in the risk zone, we find a weak positive effect on well-being. This indicates that the positive information about increased surveillance may outweigh the negative information about worse health. Essay IV: I estimate the effect of SSRI antidepressants on the risk of mortality for myocardial infarction (MI) patients using Propensity Score Matching on individual health variables such as pharmaceutical drug prescription, patient history and severity of the MI. The effect of antidepressants on mortality is a heavily debated topic. MI patients have an elevated risk of developing depression, and antidepressants are among the most common treatments for depression and anxiety. However, there are indications that some classes of antidepressants may have drug-induced cardiovascular effects and could be harmful for individuals with heart problems, but there is a lack of large-scale studies using credible identification strategies. My findings indicate no increased risk of two-year mortality for MI patients using SSRI. The results are stable for several specifications and robustness checks.

Essay I (with Mattias Öhman): Fluoridation of the drinking water is a public policy whose aim is to improve dental health. Although the evidence is clear that fluoride is good for dental health, concerns have been raised regarding potential negative effects on cognitive development. We study the effects of fluoride exposure through the drinking water in early life on cognitive and non-cognitive ability, education and labor market outcomes in a large-scale setting. We use a rich Swedish register dataset for the cohorts born 1985-1992, together with drinking water fluoride data. To estimate the effect we exploit intra-municipality variation of fluoride, stemming from an exogenous variation in the bedrock. First, we investigate and confirm the long-established positive relationship between fluoride and dental health. Second, we find precisely estimated zero effects on cognitive ability, non-cognitive ability and education. We do not find any evidence that fluoride levels below 1.5 mg/l have negative effects. Third, we find evidence that fluoride improves labor market outcome later in life, which indicates that good dental health is a positive factor on the labor market. / Essay II: Motivated by the intense public debate in the United States regarding politicians’ backgrounds, I investigate the effects of electing a candidate with earlier experience from elective office to the House of Representatives. The U.S. two-party-system with single-member election districts enables me to estimate the causal effect in a RD design where the outcomes are measured at the election district level. I find some indications that candidates with earlier elective experience are more likely to be members of important congressional committees. I also find some indications that directed federal spending (pork barrel spending) is higher in those districts were the elected representative had earlier elective experience prior of being elected to the House, but the effect manifests itself some years after the election. In contrast, I find no robust or statistically significant effects for personal income per capita or unemployment rate in the home district. / Essay III: This paper uses Swedish and Finnish municipal data to investigate the effect of changes in voter turnout on the tax rate, public spending and vote-shares. A reform in Sweden in 1970, which overall lowered the cost of voting, is applied as an instrument for voter turnout in local elections. The reform increased voter turnout in Sweden. The higher voter turnout resulted in higher municipal taxes and greater per capita local public spending. There are also indications that higher turnout decreased the vote share for right-wing parties. I use an individual survey data set to conclude that it was in particular low income earners that began to vote to a greater extent after the reform. / Essay IV (with Lovisa Persson): In a theoretical model where voters and politicians have different preferences for how much to spend on basic welfare services contra reception services for asylum seekers, we conclude that established politicians that are challenged by right-wing populists will implement a policy with no spending on asylum seekers if the cost is high enough. Additionally, adjustment to right-wing populist policy is more likely when the economy is in a recession. Voters differ in their level of private consumption in such a way that lower private consumption implies higher demand for basic welfare services at the expense of reception of asylum seekers, and thus stronger disposition to support right-wing populist policies. We propose that this within-budget-distributional conflict can arise as an electorally decisive conflict dimension if parties have converged to the median voter on the size-of-government issue.

No description available.

There has been much controversy concerning the comparability of the Wechsler Intelligence Scales for Children-Revised (WISC-R) and the Woodcock-Johnson Tests of Cognitive Ability (WJTCA). Previous research has raised the issue of a mean score discrepancy between the tests when used with the learning disabled. This study analyzed and compared performances on these two tests by re-evaluated and newly referred LD students and newly referred non-LD students. In addition, subtypes of LD students were formed on the basis of achievement test scores. These students' test performances were also analyzed and compared. The results of this study were consistent with previous research. The Full Scale scores from the two tests were highly correlated in all three groups, but the WISC-R was significantly higher than the WJTCA for each group. Across the identified LD subtypes there was a significant difference between the Full Scale scores from the two tests. However, meaningful patterns of strengths and weaknesses across aspects of cognitive functioning were not uncovered. These results indicate that the WISC-R and WJTCA result in significantly different estimates of the cognitive ability of LD and referred students. This difference can be attributed to a combination of three possible explanations--the effects of the use of non-random samples, the use of different norm groups when the tests were standardized, and the tests contain different content.

Bakgrund: Mycket i litteraturen tyder på att ouppmärksammad och underbehandlad smärta hos äldre demenssjuka är vanligt förekommande. Detta strider mot principerna om människors lika värde, den enskildes värdighet och det humana i att lindra. Det finns många typer av demenssjukdom och attityden förekommer att demenssjuka inte känner smärta. Demenssjuka har ofta problem med att kommunicera eller lokalisera smärtan. Observations- och självsmärtskattningsinstrument används inte i större utsträckning. Syfte: Syftet med denna litteraturstudie var att belysa smärtproblematik och smärtlindring i omvårdnaden av äldre personer med demenssjukdom. Metod: Detta är en litteraturstudie där tio kvantitativa vetenskapliga artiklar har analyserats med hjälp av en manifest innehållanalys. Artiklarnas resultat presenteras i fyra kategorier med underkategorier som beskriver smärtproblematik och smärtlindring hos äldre patienter med demenssjukdom. Resultat: Äldre med demenssjukdom var ofta underbehandlade för smärta och risken ökade med stigande kognitiv nedsättning. Underskattning av smärta var vanligt förekommande även när smärtskattningsinstrument användes. Personer med förmodad vaskulär demens rapporterade ofta mer smärta och med Alzheimers sjukdom mindre smärta än icke-dementa äldre. Hos en del demenssjuka uteblev förväntningseffekten av analgetika. Slutsats: Underbehandling av smärta hos demenssjuka äldre var vanligt förekommande och mer forskning behövs om smärtbedömning hos kognitivt nedsatta personer. / Background: Literature reveals that undiagnosed and untreated pain among older persons with dementia are common occurrences. This is in contrast to the principles of equal value among human beings, the dignity of the individual, and the alleviation of human suffering. There are many types of dementia, and there exists a belief that persons with dementia feel no pain. A common consequence of dementia is inability to communicate or locate the origin of pain. Selfassessment and observational pain scales are frequently not used. Aim: The aim of this literature review was to shed light upon the challenges associated with pain and the practice of pain relief in the care of older adults with dementia. Method: This is literature review study, where ten quantitative scientific articles have been analyzed using manifest context analysis. The results of the articles were sorted into four categories, each with subcategories, that describe the challenges associated with pain and the practice of pain relief. Results: The following result was obtained. Older persons with dementia often received inadequate pain relief, and the risk for under treatment increased with increasing level of cognitive impairment. Under treatment of pain was common even when pain assessment scales were used. Persons with assumed vascular and Alzheimer's dementia often stated that they felt more pain and less pain, respectively, than older adults with no cognitive impairment did. A group of persons with dementia were shown to experience no anticipatory effect of analgesics. Conclusion: Under treatment of pain was a common occurrence among older persons with dementia and more research is needed regarding how to estimate pain in persons with cognitive impairment.

Dementia incidence is rising as our population is ageing. There is growing evidence for the protective effect of physical activity against cognitive decline. However, there are inconsistent results across studies despite the large number of high quality trials. The role of psychosocial factors on cognitive outcomes was investigated in the present thesis due to the evidence of their relationship with physical activity and for their effect on cognitive ability in other contexts. The psychosocial factors investigated were attitudes towards ageing, perceived control, mental health, and self-efficacy using cross-sectional studies and pilot randomised controlled exercise trials to test proof of concept. Study 1a found that more positive attitudes towards ageing were associated with better self-reported subjective and functional health. Perceived control mediated the effect of attitudes related to psychosocial loss with ageing and physical activity level mediated the effect of attitudes related to psychological growth with ageing on subjective health. Attitudes towards ageing mediated the effect of perceived control on functional health. Study 1b and 1c explored attitudes towards ageing in more detail and found that older adults attitudes towards ageing were similarly negative to those held by young adults in the UK. A substantial proportion of attitudes reported by older adults related to physical functioning and cognitive ability. Attitudes towards ageing in China were more positive than those in the UK which suggested a potential relationship with socio-cultural and environmental factors and possible scope for attitude change from an intervention. A higher proportion of attitudes towards ageing reported in the UK were related to physical functioning and cognitive ability compared to China. These findings highlighted the potential for attitudes towards ageing and perceived control to play a role in the context of physical activity, cognitive ability and subjective health. Study 2a found that physical, social, and mental activities were independently associated with cognitive ability which informed the study design of exercises to include a pseudo control group that controlled for social interaction and mental stimulation. Study 2b found that mental health partially mediated the association between walking and cognitive ability. In older adults with better mental health, walking was not associated with cognitive ability. In older adults with poorer mental health walking was associated with better cognitive ability. Study 3 utilised available data from a pilot resistance training randomised controlled trial with middle-aged adults to test proof of concept for the role of psychosocial factors in this context. Preliminary evidence was provided for a potential association between improvements on some psychosocial factors and cognitive performance improvements. The associations of cognitive gains with psychosocial factors were independent to those of physical fitness improvements, which may indicate a potentially additive effect. Study 4 assessed the feasibility of the pilot randomised controlled trial of resistance training with older adults. Recruitment was successful but high drop-out rates lead to between group differences in age and baseline cognitive ability. Adaption of exercise to suit individual capabilities increased participation and adherence of those who completed the programmes was high. The limited usefulness of analysis by group was highlighted due to the large variation in response to exercise within groups on psychosocial and cognitive measures. Older participants were more likely to report a negative effect of resistance training on psychosocial measures, which indicated a potential confound on outcomes of exercise interventions with older adult populations. Preliminary analysis indicated that improvements on some psychosocial factors were associated with domain specific cognitive gains. This association could be due to a variety of mechanisms, such as meta-cognitive motivational processes, for example sustained effort and attention and the use of memory strategies. However, these findings need to be interpreted with caution due to the parallel change of variables, small sample size and feasibility and pilot nature of the interventions. There is a potential implication for the design of exercise programmes if they facilitate improvements in psychosocial factors as well as physical fitness, then this could enhance the effect of exercise on cognitive outcomes. Future research should replicate these studies with larger sample sizes to further understand the role of psychosocial factors in cognitive gains during exercise interventions in older adults.

Background: It is now well established that there are core cognitive impairments associated with a diagnosis of schizophrenia. In parallel with our increased understanding of these core deficits, our awareness that mentally ill offenders (MIOs) are at additional risk of cognitive impairment due to an increased rate of traumatic brain injury and substance abuse has also grown. Absent from the literature is evidence of whether these cognitive impairments change over longer periods of time in MIO’s and whether these changes, or baseline abilities, impact an individual’s risk of violence. Furthermore, the negative impact head injury has on an individuals’ cognitive, behavioural and psychological functioning is well documented. These changes can lead to an increased likelihood of violence and crime, yet there is currently a scarcity of knowledge regarding the prevalence of head injury within mentally ill offenders in Scotland and its association with risk-related outcomes. Aims: The aims of the present thesis were to; (a) Examine the course of cognition in N=49 mentally ill offenders who underwent neuropsychological assessment while in the State Hospital, Scotland in 2004-5, and assess whether baseline or change in cognition predicts violent incidents or risk at follow-up, and; (b) Examine the cross-sectional association between head injury, substance abuse and risk-related outcomes of all individuals within the forensic network in Scotland for whom data could be extracted (N=428). Hypotheses: (a) We hypothesized that processing speed, verbal comprehension, working memory, delayed verbal memory, delayed non-verbal memory, impulsivity, inattention and problem-solving would decline over a 10-year period, and that deficits in impulsivity, emotion recognition, working memory and delayed memory would predict patients’ risk-related outcomes in a sample of mentally ill offenders. (b) It was also hypothesized that the presence of head injury and/or substance abuse within patients would predict worse risk-related outcomes, namely: quantity of violent offences, risk of harm to self, risk of harm to others and severity of violent offences. Analysis: We conducted a series of repeated measures MANOVAs, MANCOVAs and hierarchical linear regressions in SPSS Statistics to test our hypotheses. Individuals with a primary or secondary diagnosis of a learning disability were excluded. Results: (a) Our results propose that cognitive abilities significantly change over time (F(1.51, 30.1) = 5.98, p = .011), but direction of change is ability dependent. We found that impulsivity (Effect Size (ES) = .253), inattention (ES = .233), working memory (ES = .288) and auditory delayed memory (ES= .268) worsen over time. Measures of impulsivity and working memory significantly predicted some, but not all, risk-related outcomes, however these effects became diluted once additional variables with shared variance were added into the predictive models. We did not find that traumatic brain injury, substance misuse or alcohol misuse significantly mediated change in cognition over time. (b) In the national cohort study, results suggested that head injury had a significant effect on HCR total scores, F(1,259) = 6.679, p = .010 (partial eta square = .025), violence during admission (χ2 = 5.545, p = .022) and violent offences at a .1 p-value only, F(1,259) = 3.495, p = .063 (partial eta square = .013). Drug misuse only had a significant impact on total violent offences, F(1,259) = 8.933, p = .003 (partial eta square = .033) and nothing else. Furthermore, the interaction between alcohol misuse and schizophrenia also only had impact on total violent offences, F(1, 259) = 7.516, p = .007 (partial eta square = .028). Head injury was not significantly associated with either historical or current self-harm, however alcohol misuse, drug misuse and schizophrenia were. Conclusions: Our results highlight the unstable nature of cognition in mentally ill offenders and the impact that head injury has on violence-related outcomes, over and above substance misuse and a diagnosis of schizophrenia. This has potentially renovating implications for clinical practice regarding risk management, assessment, and treatment planning.

<p>Nondirective counseling is to listen, support, and advise, without directing a client’s course of action. It has been influenced by humanistic theories in the tradition of Carl Rogers, but techniques used in nondirective counseling are common in many forms of psychological counseling and treatment today. There are, however, few conclusions as to what the results of training nondirective counseling are. The purpose of the present thesis is to examine effects of nondirective counseling training, and to analyze how such effects are moderated by the characteristics of clients. Three quasi-experimental or experimental studies (Paper I­III) are presented. In Paper I, trained and untrained insurance company employees were compared on their Reflective listening (RL; a subskill of nondirective counseling) skills before and after a training program. Training increased RL, and the skills were transferred to authentic settings. Trained employees were, however, not evaluated differently than untrained. In Paper II, psychology students were compared before and after RL training of three time lengths. All training times increased skills equally, but clients disclosed more information to those with longer training, the students remembered the information better, and external judges perceived the therapeutic relationship as better, especially if the judge was socially competent. In Paper III, two nondirective counseling techniques, RL and open-ended questions, were evaluated by judges who differed in social skills and cognitive ability. RL received positive ratings, whereas open-ended questions did not, and the judges’ ratings were moderated by their social skills and cognitive ability. In the Discussion, it is proposed that even short training has effects, that trained skills generalize to authentic contexts, but that the usefulness of the examined subskills of nondirective counseling depends on client characteristics such as social skills and cognitive ability.</p>

Nondirective counseling is to listen, support, and advise, without directing a client’s course of action. It has been influenced by humanistic theories in the tradition of Carl Rogers, but techniques used in nondirective counseling are common in many forms of psychological counseling and treatment today. There are, however, few conclusions as to what the results of training nondirective counseling are. The purpose of the present thesis is to examine effects of nondirective counseling training, and to analyze how such effects are moderated by the characteristics of clients. Three quasi-experimental or experimental studies (Paper I­III) are presented. In Paper I, trained and untrained insurance company employees were compared on their Reflective listening (RL; a subskill of nondirective counseling) skills before and after a training program. Training increased RL, and the skills were transferred to authentic settings. Trained employees were, however, not evaluated differently than untrained. In Paper II, psychology students were compared before and after RL training of three time lengths. All training times increased skills equally, but clients disclosed more information to those with longer training, the students remembered the information better, and external judges perceived the therapeutic relationship as better, especially if the judge was socially competent. In Paper III, two nondirective counseling techniques, RL and open-ended questions, were evaluated by judges who differed in social skills and cognitive ability. RL received positive ratings, whereas open-ended questions did not, and the judges’ ratings were moderated by their social skills and cognitive ability. In the Discussion, it is proposed that even short training has effects, that trained skills generalize to authentic contexts, but that the usefulness of the examined subskills of nondirective counseling depends on client characteristics such as social skills and cognitive ability.