Background: Financial constraints challenge evidence of the effectiveness of dermatological inpatient management. Objective: To evaluate the effectiveness of hospitalization in atopic dermatitis and psoriasis regarding initial and sustained benefits. Methods: Prospective study on adults with psoriasis vulgaris (n = 22) and atopic dermatitis (n = 14). At admission, discharge, and 3 months after discharge, validated outcomes of objective and subjective disease severity were assessed by trained investigators. Results: Hospitalization resulted in substantial benefit in quality of life and clinical disease severity. Looking at mean scores, the observed benefit appeared stable until 3-month follow-up. The analysis of individual patient data revealed significant changes in disease severity between discharge and 3-month follow-up with some patients relapsing, others further improving. Reasons for hospitalization and treatment performed were not related to sustained benefit. Conclusions: In psoriasis vulgaris and atopic dermatitis, hospitalization effectively improved quality of life and clinical disease severity. Further research should focus on prognostic factors for sustained improvement. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Addiction Severity Index (ASI) är tänkt att användas både för klientarbete på individnivå och för forskning på gruppnivå. Denna studie undersöker i vilken omfattning ASI-Uppföljning genomförs samt vilka individ- och organisationsfaktorer som påverkar användningen. Studien är kvantitativ dvs presenterar statistiska analyser. Data samlades in på två sätt. Tillgång till ASI-data gjordes möjlig genom en avidentifierad fil från databasen ASI-Net och omfattade data från elva kommuner i Jönköpings län. ASI-data bestod av 1964 intervjuer från ASI-Grund och ASI-Uppföljning och behövdes för undersökningen av individfaktorerna. Data angående organisationsfaktorerna samlades in genom webbenkäter till cheferna inom Individ- och Familjeomsorg (IFO) i samma elva kommuner. Resultatet visar att andelen uppföljningsintervjuer ökar för varje år och att det föreligger stora skillnader mellan kommuner i genomförande av andelen uppföljningsintervjuer. Analysen av individfaktorerna tyder på att de äldre, med högre utbildning och ett yrke återintervjuas i högre utsträckning. Klienterna med stora problem och hjälpbehov med alkohol genomgår i högre grad en uppföljningsintervju, medan mer problem med narkotika och rättsliga problem tenderar att följas upp i mindre grad. Analysen av organisationsfaktorerna kunde ej på meningsfullt sätt signifikansprövas då populationen för webbenkäten var liten. Dock upptäcktes korrelation mellan andelen uppföljningsintervjuer för varje kommun och två organisationsfaktorer, befolkningsmängd i kommunerna samt personalomsättning. Organisationsfaktorerna visar tvärtemot förväntat att små kommuner följer upp en högre andel, och att faktorer som personalomsättning, utbildning och ärendemängd inte förklarar de skillnader som finns.  Studiens slutsats visar att andelen genomförda ASI-Uppföljning ökar kontinuerligt. Även om ASI-Uppföljning ökar så är det långt kvar till dess att ens hälften av alla ärenden med ASI-Grund återintervjuas. För att öka motivationen att genomföra uppföljningsintervjuer kan det vara viktigt att socialsekreterarna får mer tillbaka i form av sammanställningar och analyser på gruppnivå. / Addiction Severity Index (ASI) is thought to be used both for client work at the individual level and for research at a group level. This study examines the extent to which the ASI Follow-up is carried out, and the individual and organizational factors influencing the usage. The study is quantitative, i.e. presents statistical analyzes. Data were collected in two ways. Access to ASI data was made possible by an anonymous file from the database ASI-Net and included data from eleven municipalities in Jönköping County. ASI data consisted of 1,964 interviews from ASI Basic and ASI Follow-up and was needed for the investigation of individual factors. Data regarding organizational factors was collected through web surveys to managers in Individual and Family Care (IFO) in the same eleven municipalities. The result shows that the percentage of follow-up interviews is increasing every year and that there are large differences between municipalities in the usage of the percentage of follow-up interviews. The analysis of individual factors suggest that the elderly, with higher education and a profession are interviewed to a greater extent. Clients with serious problems and in need of help with alcohol also undergo follow-up interviews more frequently, while more problems with drugs and legal problems tend to be followed-up to a lesser degree. The analysis of organizational factors could not in a meaningful way be tested for significance since the population for the web survey was small, however, correlation was discovered between the percentage of follow-up interviews for each municipality and organizational factors of population in municipalities and employee turnover. Organizational factors show the contrary as expected that small municipalities follow up to higher degree, and that factors such as staff turnover, training and case quantity does not explain the existing differences. The study's conclusions are that the percentage of ASI Follow-up is continuously increasing. Although the ASI follow-up is increasing, it is a long way until the even half of all cases with ASI Basic are re-interviewed. To increase the motivation to carry out follow-up interviews, it may be important for the social workers to get back more in the form of summaries and analyzes at the group level.

Pour appréhender l'ensemble du problème addictif et proposer une prise en charge appropriée, une évaluation multifactorielle est nécessaire. Les données récentes soulignent que le champ des addictions aux substances doit être étendu au champ des addictions comportementales. Une des lacunes dans la compréhension des troubles addictifs et de leur prise en charge pourrait être due à un manque d'outils d'évaluation standardisés qui évaluent l'ensemble des composantes de l'addiction et leurs répercussions dans différents domaines de la vie du sujet. Dans le champ des addictions aux substances, l'Addiction Severity Index (ASI) est l'outil le plus utilisé mondialement. L'ASI est un instrument qui évaluent les sujets pour la clinique ou la recherche. En France, notre groupe de recherche utilise l'ASI depuis 1992 pour la clinique et la recherche. Nous avons décidé de modifier l'ASI en y ajoutant de nouvelles sections. Depuis 2006, la version française modifiée de l'ASI présente donc des items évaluant l'usage de tabac (Section Tabac) et également des items permettant l'évaluation des comportements addictifs sans substance comme le jeu, le jeu d'argent et de hasard et les troubles du comportement alimentaire. L'objectif général de cette thèse était d'étudier la validité de la version française modifiée de l'Addiction Severity Index (ASI) chez des sujets pris en charge pour au moins une addiction dans des centres de soins spécialisés en addictologie. Les résultats montraient une très bonne validité des données de consommations de substances rapportées par les sujets. Les sections Tabac et Jeu / Jeu d'argent et de hasard avaient été montrées comme valides. La version modifiée de l'ASI semble être un bon outil permettant l'évaluation de la sévérité de l'ensemble des comportements addictifs. Cette adaptation fait de l'ASI modifié le premier outil qui permet d'évaluer l'ensemble des troubles addictifs et qui ne mesure pas uniquement la quantité, la durée et l'intensité de ces troubles. Elle va permettre d'aider le clinicien à mettre en place une prise en charge la plus adaptée et aux chercheurs de caractériser et de comparer les différentes addictions afin de dégager des différences et des similitudes. / A multidimensional assessment is key to understand the addiction problem and to develop an appropriate treatment plan. Recent findings support the scope that addictive disorders should include non-substance use disorders. A significant problem in understanding and managing the addictive disorders may be related to the lack of standardized instruments for assessing problems or other aspects of life that are affected by these pathologies. For the assessment of substance users exists a widely used instrument, the Addiction Severity Index (ASI). The ASI is an instrument that assesses subjects for both clinical and research purposes. In France, our research group used the ASI since 1992 for both clinical and research purposes. We decided to modify the French translation of the ASI and added some new items. Since 2006, the French modified ASI includes items to assess tobacco use but also non-substance addictive behaviors including gaming, gambling and eating disorders. The overall objective of this dissertation was to assess the validity of the French modified ASI in several samples of clients who sought treatment in outpatient addiction clinics. The findings showed a good validity of the self-reported substance use. The validity of the Tobacco section as well as the Gaming/Gambling section have been shown. The French modified ASI is a suitable instrument for assessing any type of addiction-related disorders. This adaptation makes the modified ASI the first instrument that assesses all possible addictive behaviors regardless of the type of the addiction and that measures more than just the quantity, duration, and intensity of addictive behaviors. ASI may be helpful for clinicians in helping them to design the best treatment plans for a patient, for policy makers to objectively understand the need in treatment, care centers or other institutions but also for researchers to measure contemporary issues in addiction treatment and to find similarities and differences between type of addiction.

A importância da aplicação de índices de gravidade em vítimas de trauma admitidas em Unidade de Terapia Intensiva (UTI), para comunicar a gravidade das lesões e avaliar a assistência prestada, motivou este estudo que teve como objetivos: caracterizar essas vítimas quanto aos dados demográficos e clínicos, incluindo as informações relacionadas aos índices prognósticos; comparar o desempenho do Injury Severity Score (ISS) perante ao New Injury Severity Score (NISS) e, também do Simplified Acute Physiology Score II (SAPS II) perante o Logistic Organ Dysfunction System (LODS) para predizer a mortalidade, o tempo de permanência em UTIs, e, identificar quais índices foram os mais efetivos para estimar esses desfechos. Foram estudadas, retrospectivamente, vítimas de trauma, maiores de 18 anos, admitidas nas UTIs do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo entre, junho a dezembro de 2006, pela análise dos prontuários. A casuística compôs-se de 185 vítimas. Os resultados mostraram maior freqüência de indivíduos jovens (idade média de 38,95 anos), do sexo masculino (76,76%), procedentes do Centro Cirúrgico (57,84%) e submetidos a algum tipo de tratamento cirúrgico (79,46%). As causas externas predominantes foram os acidentes de transporte (63,79%), quedas (15,13%) e agressões (11,90%). A taxa de mortalidade na UTI foi de 21,08% e no hospital, 21,62%. Dos que receberam alta da UTI, a maior parte foi encaminhada à unidade de internação. A média de tempo de internação na UTI foi de 16,55 dias e, no hospital, 21,71 dias. Um total de 14,60% das vítimas permaneceu internado por mais de 30 dias na UTI e, 21,08%, no hospital. Na análise dos indicadores de gravidade, a pontuação média do risco de morte calculado pelo SAPS II foi de 22,85% e, pelo LODS, 21,14%. O LODS superou o SAPS II nessa pontuação em 106 vítimas (57,30%). De acordo com o ISS e o NISS, vítimas com escore >= 16 totalizaram 61,62% e 84,33%, respectivamente. A pontuação NISS foi superior a ISS em 127 vítimas (68,65%). A maior parte das vítimas teve três regiões corpóreas lesadas (27,02%), sendo a região da cabeça/pescoço a mais atingida (61,08%). Quanto aos resultados do LODS, a maior parte apresentou dois sistemas comprometidos (29,72%), sendo o pulmonar o mais afetado (70,81%). ISS e NISS apresentaram desempenho semelhante e não mostraram boa capacidade discriminatória para ocorrência de óbito e tempo de permanência em UTIs. SAPS II e LODS, também, foram semelhantes em seu desempenho e não discriminaram adequadamente os pacientes, segundo o tempo de internação, embora mostrassem boa capacidade discriminatória para ocorrência de óbito nas UTIs. Ao comparar os quatro índices, identificou-se que SAPS II e LODS estimaram melhor a mortalidade em UTIs, porém, quanto ao tempo de permanência nas unidades, não houve diferenças entre os índices. Como conclusão, os resultados apontaram para o uso preferencial do SAPS II e do LODS quando vítimas de trauma são internadas em UTI / The importance of the application of severity indexes for trauma victims admitted to Intensive Care Units (ICU), to communicate the severity of the injuries and evaluate the assistance rendered, motivated this study which had as its objective; to characterize these victims according to demographic and clinical data including information related to the prognostic indexes; to compare the performance of the Injury Severity Score (ISS) against the New Injury Severity Score (NISS) and also the Simplified Acute Physiology Score II (SAPS II) against the Logistic Organ Dysfunction System (LODS) to predict mortality and the Length of Stay (LOS) in the ICUs, and to identify which of these indexes were more effective in estimating the outcomes. This retrospective study included 185 trauma victims, over the age of 18, admitted to Intensive Care Units of the \"Hospital das Clinicas\" of the Medical School of the University of Sao Paulo, between the months of June to December 2006 through the use of patient records. The results showed that the largest frequency was young adults (average age 38.95 years) male gender (76.76%) coming from operating rooms (57.84%) who underwent some type of surgical treatment (79.46%). The external causes were predominantly from motor vehicle accidents (63.79%), falls (15.13%) and acts of aggression (11.90%). The mortality rate in the ICU and in the hospital was 21.08% and 21.62% respectively. Of those who were discharged from the ICU, the majority were transferred to other units of the hospital. The average LOS in the ICU and in the hospital was 16.55 days and 21.71 days respectively. A total of 14.60% of the victims remained in the ICU for more than 30 days and 21.08% remained in the hospital. During analysis of the severity indexes, the average score for risk of mortality, calculated by SAPS II, was 22.85% and by LODS 21.14% which surpassed SAPS II in 106 of the victims (57.30%). According to ISS and NISS, the victims with scores equal to or greater than 16 totaled 61.62% and 84.33 % respectively. NISS scores were superior to ISS in 127 of the victims (68.65%). The majority of the victims had 3 corporal regions with injuries (27.02%) with the head/neck being the most prevalent (61.08%). According to the LODS results, the majority showed 2 systems compromised (29.72%), with the lungs being the most affected (70.81%). ISS and NISS presented a similar performance and did not present a good capacity to discriminate mortality and LOS in the ICUs. SAPS II and LODS were also similar in their performance and did not adequately discriminate the patients in reference to LOS, although it did show a good capacity to discriminate mortality in the ICUs. When comparing the 4 indexes, SAPS II and LODS better estimated the mortality in the ICUs however, regarding the LOS; there were no differences between the indexes. In conclusion, the results indicate a preferential use of SAPS II and LODS when trauma victims are interned in the ICU

Evidensbaserad praktik inom socialtjänsten förutsätter att de professionella ställer sig positiva till forskningsbaserad kunskap om insatser och användandet av bedömningsinstrument. I vår studie undersöks vilken tilltro socialarbetare på vuxenenheten i en mindre stad har till bedömningsinstrumentet Addiction Severity Index (ASI). Studien är en kvalitativ undersökning och semistrukturerade intervjuer valdes som metod för att besvara syfte och frågeställningarna. Sammanlagt har sex respondenter intervjuats varav fyra handläggare, en projektledare samt enhetschefen på verksamheten. Forskning visar att handläggare upplever olika fördelar och nackdelar i användandet av ASI. Av resultatet framgår att handläggarna använder ASI Grund regelbundet i sitt arbete men att det finns svårigheter med att implementera ASI Uppföljning. Samtliga handläggare upplever att ASI Grund är tidskrävande och har en del invändningar mot vissa av frågorna. Trots detta uttrycker de ändå att användandet av ASI kan bidra till ett rättsäkerhetsperspektiv, ett strukturerat arbetssätt och en bra grund inför behandlingsplaneringen. I studien diskuteras även förbättringsområden inom ASI. / Evidence-based practice in social services presupposes that the professionals are in favor of research-based knowledge on services an the use of assessment instruments. The purpose of this study is to examining the confidence of social workers in an adult unit, in a small town has to assess the instrument Addiction Severity Index (ASI). The study is a qualitative survey ans semi-structured interviews were chosen as a method to answer the purpose and research questions. A total of six respondents were interviewed; four social workers, one project manager and the head of unit in operation. Research shows that social workers experience different advantages and disadvantages in the use of ASI. The results show that social workers use the ASI on a regular basis in their work, but there are difficulties in implementing the ASI follow-up interview. All social workers feel that the ASI base interview is time consuming and has concerns with some of the questions. Nevertheless, they express that the use of the ASI can contribute to a legal security perspective, a structured approach and a good basis for treatment planning. The study also discusses areas for improvement in the ASI.

The purpose of this paper was to examine how clients on the unit for adults at Södemalms district administration (Stockholm, Sweden) with severe mental illness and substance abuse differs from other clients with substance abuse at the baseline and at follow-up one year later. We have used a quantitative method and analyzed material from ASI-interviews performed at the adult drug abuse unit at Södermalm during the time period 2002-2010. At the baseline the clients with substance abuse and co-occurring severe mental illness have more problems than other clients, primarily in the area of mental health. They spend more time alone and are more likely to engage in illegal activities. Interviewers assess their situation as more serious and that they need more help in all of ASI's areas of life than other clients. Persons with severe mental illness have improved during the follow-up. However, the numbers of homeless people have increased and fewer have jobs. Meanwhile, more people have a regular income from the social security, their somatic status has improved, fewer hang out with people who have an active addiction, they engaged not so much in crime. Furthermore, the proportion of heavy use alcohol and narcotics has declined. Mental health improved significantly. The proportion meeting the threshold of severe mental disorder is reduced from 47% to 29%. The risk of suicide attempts in the last month reduced from 5% to 1%.

A importância da aplicação de índices de gravidade em vítimas de trauma admitidas em Unidade de Terapia Intensiva (UTI), para comunicar a gravidade das lesões e avaliar a assistência prestada, motivou este estudo que teve como objetivos: caracterizar essas vítimas quanto aos dados demográficos e clínicos, incluindo as informações relacionadas aos índices prognósticos; comparar o desempenho do Injury Severity Score (ISS) perante ao New Injury Severity Score (NISS) e, também do Simplified Acute Physiology Score II (SAPS II) perante o Logistic Organ Dysfunction System (LODS) para predizer a mortalidade, o tempo de permanência em UTIs, e, identificar quais índices foram os mais efetivos para estimar esses desfechos. Foram estudadas, retrospectivamente, vítimas de trauma, maiores de 18 anos, admitidas nas UTIs do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo entre, junho a dezembro de 2006, pela análise dos prontuários. A casuística compôs-se de 185 vítimas. Os resultados mostraram maior freqüência de indivíduos jovens (idade média de 38,95 anos), do sexo masculino (76,76%), procedentes do Centro Cirúrgico (57,84%) e submetidos a algum tipo de tratamento cirúrgico (79,46%). As causas externas predominantes foram os acidentes de transporte (63,79%), quedas (15,13%) e agressões (11,90%). A taxa de mortalidade na UTI foi de 21,08% e no hospital, 21,62%. Dos que receberam alta da UTI, a maior parte foi encaminhada à unidade de internação. A média de tempo de internação na UTI foi de 16,55 dias e, no hospital, 21,71 dias. Um total de 14,60% das vítimas permaneceu internado por mais de 30 dias na UTI e, 21,08%, no hospital. Na análise dos indicadores de gravidade, a pontuação média do risco de morte calculado pelo SAPS II foi de 22,85% e, pelo LODS, 21,14%. O LODS superou o SAPS II nessa pontuação em 106 vítimas (57,30%). De acordo com o ISS e o NISS, vítimas com escore >= 16 totalizaram 61,62% e 84,33%, respectivamente. A pontuação NISS foi superior a ISS em 127 vítimas (68,65%). A maior parte das vítimas teve três regiões corpóreas lesadas (27,02%), sendo a região da cabeça/pescoço a mais atingida (61,08%). Quanto aos resultados do LODS, a maior parte apresentou dois sistemas comprometidos (29,72%), sendo o pulmonar o mais afetado (70,81%). ISS e NISS apresentaram desempenho semelhante e não mostraram boa capacidade discriminatória para ocorrência de óbito e tempo de permanência em UTIs. SAPS II e LODS, também, foram semelhantes em seu desempenho e não discriminaram adequadamente os pacientes, segundo o tempo de internação, embora mostrassem boa capacidade discriminatória para ocorrência de óbito nas UTIs. Ao comparar os quatro índices, identificou-se que SAPS II e LODS estimaram melhor a mortalidade em UTIs, porém, quanto ao tempo de permanência nas unidades, não houve diferenças entre os índices. Como conclusão, os resultados apontaram para o uso preferencial do SAPS II e do LODS quando vítimas de trauma são internadas em UTI / The importance of the application of severity indexes for trauma victims admitted to Intensive Care Units (ICU), to communicate the severity of the injuries and evaluate the assistance rendered, motivated this study which had as its objective; to characterize these victims according to demographic and clinical data including information related to the prognostic indexes; to compare the performance of the Injury Severity Score (ISS) against the New Injury Severity Score (NISS) and also the Simplified Acute Physiology Score II (SAPS II) against the Logistic Organ Dysfunction System (LODS) to predict mortality and the Length of Stay (LOS) in the ICUs, and to identify which of these indexes were more effective in estimating the outcomes. This retrospective study included 185 trauma victims, over the age of 18, admitted to Intensive Care Units of the \"Hospital das Clinicas\" of the Medical School of the University of Sao Paulo, between the months of June to December 2006 through the use of patient records. The results showed that the largest frequency was young adults (average age 38.95 years) male gender (76.76%) coming from operating rooms (57.84%) who underwent some type of surgical treatment (79.46%). The external causes were predominantly from motor vehicle accidents (63.79%), falls (15.13%) and acts of aggression (11.90%). The mortality rate in the ICU and in the hospital was 21.08% and 21.62% respectively. Of those who were discharged from the ICU, the majority were transferred to other units of the hospital. The average LOS in the ICU and in the hospital was 16.55 days and 21.71 days respectively. A total of 14.60% of the victims remained in the ICU for more than 30 days and 21.08% remained in the hospital. During analysis of the severity indexes, the average score for risk of mortality, calculated by SAPS II, was 22.85% and by LODS 21.14% which surpassed SAPS II in 106 of the victims (57.30%). According to ISS and NISS, the victims with scores equal to or greater than 16 totaled 61.62% and 84.33 % respectively. NISS scores were superior to ISS in 127 of the victims (68.65%). The majority of the victims had 3 corporal regions with injuries (27.02%) with the head/neck being the most prevalent (61.08%). According to the LODS results, the majority showed 2 systems compromised (29.72%), with the lungs being the most affected (70.81%). ISS and NISS presented a similar performance and did not present a good capacity to discriminate mortality and LOS in the ICUs. SAPS II and LODS were also similar in their performance and did not adequately discriminate the patients in reference to LOS, although it did show a good capacity to discriminate mortality in the ICUs. When comparing the 4 indexes, SAPS II and LODS better estimated the mortality in the ICUs however, regarding the LOS; there were no differences between the indexes. In conclusion, the results indicate a preferential use of SAPS II and LODS when trauma victims are interned in the ICU

Many people with the incurable and often times fatal motor neuron diseases have pain, but there is lack of knowledge about people’s experiences of living with pain. Further, the correlation between pain and their quality of life is not well understood, and previous studies have not used individual quality of life, namely that people with their own words express what quality of life is.   The aim of these studies was to explore the experiences of pain and the association between pain and quality of life in people with MND. Methods: Study I was explorative about the individual experience of pain, while study II was correlational between pain, pain severity, disease severity and IQOL. Study I was qualitative, whereas study II used both qualitative and quantitative analysis. Results and conclusions: People with motor neuron diseases experienced pain to have multiple characteristics and impact. However, the results emphasise that the individual experienced some pain characteristics as difficult and that pain could worsen functions that were already affected by the disease. The experience was also that it could be challenging to manage pain. However, the symptom of pain could pass unnoticed in contacts with healthcare professionals (study I). The three most important areas for individual quality of life in both participants with and without pain were: Social relations, followed by Activities for amusement and relaxations, and Being in the outdoor environment. Individual quality of life was noticed to be good regardless of pain. Pain and pain severity were not found to be associated with satisfaction of individual quality of life in patients with motor neuron diseases, neither was disease severity. The results support previous findings, that strong associations between symptoms of MND and IQoL are not obvious. However, this does not infer that pain in people with MNDs should be neglected and undertreated. On the contrary, it seems to be important for healthcare to pay more attention to pain in people with motor neuron diseases and that pain continuously is measured, individually treated and followed. Regardless of whether persons with MND have pain or not, the results point to the importance of healthcare professionals providing support to not only the patient but also the patient’s family and friends, as well as assisting in various forms of relaxing activities and possibility of being in the outdoor environment.

Personer som drabbats av depression återfaller/återinsjuknar ofta en eller flera gånger i livet. Forskning har visat att b la demografiska faktorer, residualsymtom och insomni är prediktorer för återfall. Syftet med studien var därför att undersöka betydelsen av demografiska faktorer, residualsymtom och insomni för nivån av depression 6-12 månader efter avslutad behandling på en psykiatrisk specialistmottagning. Urvalet var alla patienter som diagnosticerats med depression eller recidiverande depression och genomgått KBT-terapi under perioden 2008 – september 2013, och som hade uppföljningsdata vid sex eller tolv-månader, vilket sammanlagt var 111 patienter. Beroendevariabel var resultat på formuläret Patient Health Questionnaire (PHQ-9). Resultaten visade att patienter med residualsymtom inte försämrades signifikant mellan eftermätningen och uppföjningsmätningen, ett fynd som inte överensstämmer med forskning på området. Regressionsanalyser visade ingen signifikant påverkan av kön, ålder och utbildningsnivå på senare nivå av depression vid uppföljningsmätning. Däremot visade regressionsanalyser att sömnbesvär, mätt med formuläret Insomnia Severity Index (ISI), vid framför allt eftermätning hade ett samband med senare nivå av depression vid uppföljningsmätningen. Resultaten indikerade att kvarstående sömnbesvär då behandlingen avslutades predicerade senare nivå av depression. Slutsatsen är att ett tillägg av en sömnintervention för de patienter som har insomni då behandlingen avslutas kan minska sannolikheten för återfall i depression. Då många patienter saknade uppföljningsdata kunde inga säkra slutsatser dras.

Master of Science / Department of Psychology / Satoris S. Culbertson / Performance appraisals are an important component to any organization’s performance management system. They require supervisors to observe and retain information regarding employee performance. This study sought to investigate the effects of appraisal purpose in this process. This extension and replication of Williams, DeNisi, Meglino, and Cafferty’s (1986) lab study of appraisal purpose investigated whether designating an employee for a positive outcome results in lenient performance ratings and vice-versa for a negative designation. This outcome would indicate assimilation, whereby the designation acts as an anchor creating bias in the direction of the anchor. However, the negative and positive designations may both result in leniency, indicating a universal tendency toward leniency when memory for performance is limited. Furthermore, I investigated whether making a deservedness rating for each employee would result in less lenient or severe ratings, relative to the designation conditions. Finally, I investigated whether self-reported rater expertise would moderate the assimilation effect. A total of 108 undergraduate students from a large Midwestern university viewed confederates performing cardio-pulmonary resuscitation (CPR) on a dummy and were instructed to observe performance in order to make a designation (positive or negative) or deservedness rating, or were given no instructions (control). They made an initial decision and were then asked to return two days later and rate each confederate’s performance again. Consistent with previous findings, raters making positive designations tended to give lenient ratings, relative to other conditions. Furthermore, as expected, those making negative designations gave relatively severe ratings. Finally, the results also partially supported my expectation that rater expertise in the performance domain moderates the biasing effects of appraisal purpose. Implications for practice and recommendations for future research are discussed.