Aktuell forskning har visat att psykologiska faktorer spelar en viktig roll för upplevelsen av långvarig smärta. Denna studie undersökte effekterna av en KBT-behandling bestående av introceptiv exponering och avslappning för patienter med långvarig smärta. Studien använde en single-subject design där sex smärtpatienter genomgick en sex veckor lång individuell behandling. De variabler studien undersökte var i första hand förändringar gällande grad av acceptans samt upplevd smärtintensitet, i andra hand förändringar gällande smärtrelaterad ångest, rörelserädsla, katastroftankar samt funktion. Deltagande i behandlingen var förknippat med ökad acceptans, förbättrad funktion, minskad smärtintensitet, minskad smärtrelaterad ångest, mindre katastroftankar samt minskad rörelserädsla. Studien tyder på att denna behandling kan leda till positiva förändringar hos smärtpatienter för såväl kognitiva och känslomässiga komponenter som beteendemässiga komponenter. / Current research has shown that psychological factors play an important role in the experience of chronic pain. This study examined the effects of a CBT treatment containing interoceptive exposure and relaxation for patients with chronic pain. The study used a single-subject design where six patients underwent a six week long individual treatment. The variables the study examined were changes concerning degree of acceptance, pain intensity, changes concerning pain related anxiety, kinesiophobia, catastrophizing and function. Participation in the treatment was associated with increased acceptance, improved function, reduced pain intensity, reduced pain related anxiety, less catastrophizing and reduced kinesiophobia. The study indicates that this treatment can lead to positive changes with pain patients in both cognitive and emotional components as well as behavioral components.

Background: Pain may involve physical, emotional and psychological reactions. Chronic pain can lead to restrictions and problems in everyday life. One of the most common pain states is low back pain. A form of treatment that has been marketed as a charitable and pain reliefing alternative is the Shakti mat. Currently there are no studies on its effects published. Purpose: To see whether treatment with Shakti mat in a person with low back pain has an effect on the experience of the ability in activities of daily life and to see if the psychological factors will change. Method: The participant had to lie on a Shakti mat once a day for four weeks. The participant was asked to complete five questionnaires two weeks before, during intervention and two weeks after treatment. The Tampa Scale: a Measure of Kinesiophobia measures to what degree the participant experiencing pain for movement or to harm itself in motion, Coping Strategies Questionnaire - Catastrophizing scale investigating catastrophizing thoughts in connection with pain perception, Pain Disability Index investigates how the participants’ everyday affected/hampered by pain, Self-Efficacy Scale investigates how sure the participant is in his ability to carry out a task despite pain and a Self-monitoring diary where the perception of its ability in everyday activities, experience after treatment, the type of underlay and if the participant could lie longer on the Shakti mat were judged. Results: The participant’s pain in some everyday activities mitigated while the degree of ability in these increased after four weeks of treatment. The psychological factors had not changed much.

Recently graph theory has been successfully applied to magnetic resonance imaging data. However, it remains unclear as to what the nodes and edges in a network should represent. This problem is particularly difficult when extracting morphological networks (i.e., from grey matter segmentations). Existing morphological network studies have used anatomical regions as nodes that are connected by edges when these regions covary in thickness or volume across a sample of subjects. Covariance in cortical thickness or volume has been hypothesised to be caused by anatomical connectivity, experience driven plasticity and/or mutual trophic influences. A limitation of this approach is that it requires magnetic resonance imaging (MRI) scans to be warped into a standard template. These warping processes could filter out subtle structural differences that are of most interest in, for example, clinical studies. The focus of the work in this thesis was to address these limitations by contributing a new method to extract morphological networks from individual cortices. Briefly, this method divides the cortex into small regions of interest that keep the three-dimensional structure intact, and edges are placed between any two regions that have a statistically similar grey matter structure. The method was developed in a sample of 14 healthy individuals, who were scanned at two different time points. For the first time individual grey matter networks based on intracortical similarity were studied. The topological organisation of intracortical similarities was significantly different from random topology. Additionally, the graph theoretical properties were reproducible over time supporting the robustness of the method. All network properties closely resembled those reported in other imaging studies. The second study in this thesis focussed on the question whether extracting networks from individual scans would be more sensitive than traditional methods (that use warping procedures) to subtle grey matter differences in MRI data. In order to investigate this question, the method was applied to the first round of scans from the Edinburgh High Risk study of Schizophrenia (EHRS), before any of the subjects was diagnosed with (symptoms of) the disease. Where traditional methods failed to find differences at the whole brain level between the high risk group and healthy controls, the new method did find subtle disruptions of global network topology between the groups. Finally, the diagnostic value of the networks was studied with exploratory analyses that found that, in comparison to healthy controls, people at high risk of schizophrenia showed more intracortical similarities in the left angular gyrus. Furthermore within the high risk group an increase of intracortical similarities could predict disease outcome up to 74% accuracy. The main conclusion of this thesis was that the new method provides a robust and concise statistical description of the grey matter structure in individual cortices, that is of particular importance for the study of clinical populations when structural disruptions are subtle.

Playing with toys as a means of environmental engagement has long been considered important in early child development (Messer, Rachford, McCarthy, & Yarrow, 1987; Wolery & Werts, 1994). However, children with highly significant disabilities often engage in toy play less frequently than their peers without disabilities (Blasco, Bailey, & Burchinal, 1993; Langley, 1985) and frequently need specialized support to promote toy play (Ivory & McCollum, 1999; Langley, 1985). Preference assessment technology was used to identify preferred sensory attributes. Those sensory attributes were embedded into a toy previously identified as nonpreferred based on selection and amount of toy play. Differences were noted in caregiver opinion of sensory preference when compared to a sensory attribute preference assessment. The initial paired-item presentation consisted of a rotation of 4 toys from the natural environment using a child-directed approach, which consisted of choice, prompting, and praise for completion of functional toy play. An additional condition added the child's preferred sensory attribute to a nonpreferred toy using the above-mentioned procedures. Results indicated that the addition of a preferred sensory attribute increased selection of that toy with 2 of 3 children, and resulted in increased independent functional toy play for all 3 children.

Students with emotional disturbance experience many problems that affect their academic and social success in the school environment, including academic performance, relationships with teachers and peers, and a lack of engagement in the school community (Anderson, Kutash, & Duchnowski, 2001; Villarreal, 2015). Currently, a handful of interventions exist to assist students with behavioral challenges. Many of these interventions aim to increase academic achievement, or to curb disruptive behavior in students with ED so that they can achieve improved school success (Algozzine, Wang, & Violette, 2011). Research with students with emotional disabilities also suggests that improving their self-determination skills and providing opportunities for self-determination are also effective in improving school success (Green, Mays, & Jolivette, 2011; Sebag, 2010; Skerbetz & Kostewicz, 2013). While some research has been conducted with middle and high school students with ED, fewer research studies exist on strategies that promote self-determination in elementary students. This purpose of this study was to explore the effect of a choice-making intervention on the academic engagement and disruptive behaviors of elementary students with ED. Findings revealed a functional relationship between the offering of choice and the students' disruptive behaviors and academic engagement. Students also increased in their work completion and social interactions with one another and with the adults. Social validity data indicated that the teacher viewed the intervention as being feasible and valuable in his classroom.

Treatment for adulthood stuttering traditionally focuses on some combination of stuttering management and fluency management and may also target emotional and cognitive reactions to stuttering. However, long-term gains are often limited, and there is a need for continued development of approaches for mitigating impacts of stuttering. We know of no evidence-based therapy approaches designed to target functional communication in adults who stutter (AWS), despite widespread interest in improving functional communication in members of this speaker group. Script training is an intervention approach designed to improve accuracy and automaticity in functional communication. Script training was originally designed for use with adults with aphasia and was also recently applied successfully with adults with apraxia of speech. The aim of this study was to determine effects of script training in AWS. Three males participated, one who stuttered mildly, one moderately, and one severely. Using a single-subject, multiple-baseline design, treatment and maintenance performance was compared to baseline performance on three dependent variables: Script accuracy, percentage of syllables stuttered, and speaking rate. Results indicate that script training may benefit AWS. Script accuracy increased and percentage of syllables stuttered decreased in all three individuals. Speaking rate increased for one participant, whose pre-treatment stuttering was rated as mild in severity. All participants reported a self-perceived increase in confidence communicating. These effects indicate that additional research is warranted to continue investigating effects of script training in people who stutter.

Children with hearing loss have limited auditory access to their native language and struggle to develop appropriate language skills. These children consistently demonstrate less complex oral language output, smaller vocabulary inventories, and delays in overall communicative proficiency. With the extensive implications hearing loss has on language development, a child with hearing loss requires immediate access to appropriate and effective intervention to address deficits and curb long-term language delays. However, there is a paucity of research investigating the effects of various language intervention programs with children with hearing loss. Much of the existing research focuses on the consequences of a selected language modality or lacks the rigor needed to produce conclusive evidence. While it has not been extensively investigated with children with hearing loss, narrative language intervention has been effective at improving a number of language skills of children with a variety of disabilities and language needs. Therefore, the purpose of this study was to investigate the effect of narrative language intervention on the narrative retelling skills and vocabulary use of children with hearing loss. To do so, a multiple baseline research design and a repeated acquisition research design were implemented. Participants included two children ages 5 and 9 diagnosed with bilateral sensorineural hearing loss and fitted to an amplification device. Each child received weekly, individualized narrative language intervention with a focus on use of target vocabulary words. Both participants demonstrated weekly increases in narrative retell scores and repeated pre-test to post-test gains in the use of targeted vocabulary. Results suggest narrative language intervention improved the narrative retell ability and vocabulary use of children with hearing loss.

The present study was conducted as a systematic replication of earlier work investigating the phenomenon of behavioral contrast. Behavioral contrast has been consistently reported in alternating two component multiple schedules using infra-human subjects. The present study was interested in answering the question, "Does behavioral contrast exist in humans?" Two experiments were performed which investigated the behavioral contrast and sequential contrast phenomena in children. In both experiments, lever press responses were analyzed using an ABA single-subject design. The children were instructed to press a lever to obtain as many tokens as possible. In Experiment I, six Ss were equally divided into two groups of three subjects each. Group I, the mult VI EXT group began the experiment by responding on an alternating two component multiple variable interval (VI) 20 seconds, extinction (EXT), mult VI EXT, schedule of reinforcement. Following stabilization of response rates on a mult VI EXT schedule, Phase I, the three Ss in this group progressed through Phase II, a mult VI 20 second schedule of reinforcement, and Phase III, a mult VI 20 second EXT schedule of reinforcement. Group II, the mult VI VI group began the experiment by responding on a mult VI 20 second VI 20 second schedule of reinforcement. Following stabilization of response rate on the mult VI VI schedule, Phase I, the three Ss in this group progressed through Phase II, the mult VI 20-sec EXT schedule of reinforcement, and Phase III, a mult VI 20 second VI 20 second schedule of reinforcement. Behavioral contrast, in an alternating two component multiple schedule, defined as an increase in response rate in one component accompanying a decrease in response rate in the alternate component was observed in Experiment I. Regardless of the sequence of exposure to the multiple schedule, all Ss showed similar response patterns under the same multiple schedules. For example, an increase in response rate in the unchanged VI component was observed in all Ss when the response rate in the alternating EXT (previously VI) component decreased (positive behavioral contrast). A decrease in response rate in the unchanged VI component was also observed in all Ss when an increase in response rate in the alternating VI (previously EXT) component occurred (negative behavioral contrast). The appropriate change in response rate in the second component of a multiple schedule appeared to be prerequisite for the occurrence of behavioral contrast whether it be a decrease in responding when the second component programmed EXT or a stable response rate when the second component programmed a VI 20 second reinforcement schedule. In Experiment II, three Ss were exposed to a mult VI 20 second EXT schedule of reinforcement the components of which were presented in a random sequence. Sequential contrast, defined as a greater response rate during S+ when an S+ is preceded by an S- component than when S+ is preceded by other S+ components was not consistently observed in the present experiment. One of three subjects exposed to the sequential contrast experiment showed a consistently higher rate of responding during S+ components that followed an S- component than when an S+ component followed another S+ component, but the other two Ss in the experiment failed to emit response patterns characteristic of sequential contrast.

In the ongoing discussion of treatment efficacy, some researchers have argued for the use of evidence from randomized controlled trials while others have argued the case for the use of non-randomized designs (Ingham 2003) in the study of the treatment of stuttering. Few attempts have been made to integrate findings from the research on stuttering intervention {Andrews, et al.1980; Howard, Nye, & Vanryckegbem, 2005; Herder, Howard, Nye & Vanryckeghem 2006; Thomas and Howell, 2001). Since the usual approach to the study of treatment efficacy uses experimental and quasi-experimental sources, a summary of the data available from single subject design {SSD) studies would seem warranted. The purpose of this project was to conduct a systematic review and meta-analysis of the effectiveness of stuttering treatment for children and adults by summarizing studies and determining an overall effect by calculating the percentage of non-overlapping data points (PND). The resulting review provides a summary of the effects of stuttering treatment, the nature of the treatment program characteristics and their associated effectiveness, and a general mapping of the research landscape in stuttering treatment terms of its' strengths and weaknesses and areas of need for future research.

<p>Sömnsvårigheter hos ungdomar är ett växande problem i Sverige men det saknas forskning om behandlingsmetoder för åldersgruppen. Syftet med studien var att testa kognitiv terapi med beteendeexperiment (KT-I) på gymnasieungdomar med primär insomni. Studien genomfördes enligt en Single Subject design med för- och eftermätning. Tre ungdomar i åldern 16-18 genomgick en sju veckor lång behandling efter 1-2 veckors baslinjemätning. Resultatet visade att svårighetsgrad av insomni minskade, att funktionsförmågan dagtid förbättrades och behandlingsmålen uppfylldes i hög grad. Dagliga mätningar visade att förändring av sömnrelaterade symtom och dagtidssymtom varierade mellan deltagarna. Graden av vidmakthållande kognitiva processvariabler minskade. Slutsatser som kan dras är att KT-I är en lovande behandlingsmetod för ungdomar med insomni och att metoden bör testas ytterligare i randomiserade kontrollerade studier.</p> / <p>Sleeping difficulties are an increasing problem in Sweden for youths today, but there is a lack of research on treatments for this age group. The aim of the study was to investigate the effects from Cognitive Therapy with Behavioural Experiments (CT-I) on youths with primary insomnia in upper secondary school. The study was conducted according to a Single-Subject design with pre- and posttests. Three youths between the ages of 16-18 participated in a seven week long treatment, after 1-2 weeks of baseline measures. The results showed that the degree of insomnia decreased, that the ability to function during daytime increased, and that the treatment goals were met to a large extent. Daily measures showed that changes in sleep related symptoms and daytime symptoms varied among the participants. The degree of maintaining cognitive processes decreased. The conclusions that can be drawn are that CT-I is a promising treatment for youths with insomnia and that the method should be tested further in randomized controlled studies.</p>