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Demetry Y, Wasteson E, Lindegaard T, Abuleil A, Geranmayeh A, Andersson G, Shahnavaz S. Individually Tailored and Culturally Adapted Internet-Based Cognitive Behavioral Therapy for Arabic-Speaking Youths With Mental Health Problems in Sweden: Qualitative Feasibility Study. JMIR Form Res 2023; 7:e46253. [PMID: 37999955 DOI: 10.2196/46253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/28/2023] [Accepted: 09/21/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Most forcibly displaced refugees in Sweden originate from the Arab Republic of Syria and Iraq. Approximately half of all refugees are aged between 15 and 26 years. This particular group of youths is at a higher risk for developing various mental disorders. However, low use of mental health services across Europe has been reported. Previous research indicates that culturally adapted psychological interventions may be suitable for refugee youths. However, little is known about the feasibility, acceptability, and efficacy of such psychological interventions. OBJECTIVE This study aimed to explore the feasibility, acceptability, and preliminary efficacy of an individually tailored and culturally adapted internet-based cognitive behavioral therapy for Arabic-speaking refugees and immigrant youths in Sweden. METHODS A total of 17 participants were included to participate in an open trial study of an individually tailored and culturally adapted internet-based cognitive behavioral therapy targeting common mental health problems. To assess the intervention outcome, the Hopkins Symptom Checklist was used. To explore the acceptability of the intervention, in-depth interviews were conducted with 12 participants using thematic analysis. Feasibility was assessed by measuring treatment adherence and by calculating recruitment and retention rates. RESULTS The intervention had a high dropout rate and low feasibility. Quantitative analyses of the treatment efficacy were not possible because of the high dropout rate. The qualitative analysis resulted in 3 overarching categories: experiences with SahaUng (the treatment), attitudes toward psychological interventions, and personal factors important for adherence. CONCLUSIONS The findings from this study indicate that the feasibility and acceptability of the current intervention were low and, based on the qualitative analysis, could be increased by a refinement of recruitment strategies, further simplification of the treatment content, and modifications to the cultural adaptation.
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Affiliation(s)
- Youstina Demetry
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Elisabet Wasteson
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Tomas Lindegaard
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Amjad Abuleil
- Competence Team for migration health, Region Jämtland Härjedalen, Östersund, Sweden
| | - Anahita Geranmayeh
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Gerhard Andersson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Shervin Shahnavaz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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Singh L, Kanstrup M, Gamble B, Geranmayeh A, Göransson KE, Rudman A, Dahl O, Lindström V, Hörberg A, Holmes EA, Moulds ML. A first remotely-delivered guided brief intervention to reduce intrusive memories of psychological trauma for healthcare staff working during the ongoing COVID-19 pandemic: Study protocol for a randomised controlled trial. Contemp Clin Trials Commun 2022; 26:100884. [PMID: 35036626 PMCID: PMC8752164 DOI: 10.1016/j.conctc.2022.100884] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/26/2021] [Accepted: 01/07/2022] [Indexed: 01/10/2023] Open
Abstract
Addressing the mental health needs of healthcare staff exposed to psychologically traumatic events at work during the COVID-19 pandemic is a pressing global priority. We need to swiftly develop interventions to target the psychological consequences (e.g., persistent intrusive memories of trauma). Interventions for healthcare staff must be brief, flexible, fitted around the reality and demands of working life under the pandemic, and repeatable during ongoing/further trauma exposure. Intervention delivery during the pandemic should be remote to mitigate risk of infection; e.g., here using a blend of digitalized self-administered materials (e.g., video instructions) and guided (remote) support from a researcher. This parallel groups, two-arm, randomised controlled trial (RCT) with healthcare staff working during the COVID-19 pandemic is the first evaluation of whether a digitalized form of a brief cognitive task intervention, which is remotely-delivered (guided), reduces intrusive memories. Healthcare staff who experience intrusive memories of work-related traumatic event(s) during the COVID-19 pandemic (≥2 in the week before inclusion) will be randomly allocated (1:1) to receive either the cognitive task intervention or an active (attention placebo) control, and followed up at 1-week, 1-month, 3-months, and 6-months post-intervention. The primary outcome will be the number of intrusive memories reported during Week 5; secondary and other outcomes include the number of intrusive memories reported during Week 1, and other intrusive symptoms. Findings will inform further development and dissemination of a brief cognitive task intervention to target intrusive memories.
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Affiliation(s)
- Laura Singh
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Swedish Collegium for Advanced Study, Uppsala, Sweden
| | - Marie Kanstrup
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Functional Area Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
| | - Beau Gamble
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Anahita Geranmayeh
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Katarina E Göransson
- Emergency and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Ann Rudman
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Oili Dahl
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Veronica Lindström
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Department for Health Promoting Science Sophiahemmet University Stockholm, Sweden.,Samariten, Ambulance Stockholm, Sweden
| | - Anna Hörberg
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Emily A Holmes
- Department of Psychology, Uppsala University, Uppsala, Sweden.,Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Michelle L Moulds
- School of Psychology, The University of New South Wales, UNSW Sydney, Australia
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Härdelin G, Holding BC, Reess T, Geranmayeh A, Axelsson J, Sundelin T. Do Mothers Have Worse Sleep Than Fathers? Sleep Imbalance, Parental Stress, and Relationship Satisfaction in Working Parents. Nat Sci Sleep 2021; 13:1955-1966. [PMID: 34764711 PMCID: PMC8576759 DOI: 10.2147/nss.s323991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/07/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Previous research indicates that mothers take a larger responsibility for child care during the night and that they have more disturbed sleep than fathers. The purpose of this study was to determine whether such a sleep imbalance exists in working parents of young children, and the extent to which it depends on the way sleep is measured. The study also examined whether imbalanced sleep between parents predicts parental stress and relationship satisfaction. METHODS Sleep was measured for seven consecutive days in 60 parenting couples (average age of the youngest child: 3.3 years ± SD 2.5 years). Actigraphs were worn across the week, and ratings of sleep, parental stress, and relationship satisfaction were made daily. RESULTS Mothers perceived their sleep quality as worse (b= -0.38 scale units, p<0.001), with more wake periods (b= +0.96 awakenings, p<0.001) but with longer sleep duration (b= +32.4 min, p<0.01) than fathers. Actigraphy data confirmed that mothers slept longer than fathers (b= +28.03 min, p<0.001), but no significant differences were found for wake time, number of awakenings or who woke up first during shared awakenings. Furthermore, there was no difference in whether mothers and fathers slept sufficiently. The level of sleep imbalance between parents did not predict parental stress. A larger imbalance in subjective sleep sufficiency predicted decreased relationship satisfaction for fathers (b= -0.13 scale units, p<0.01) but increased relationship satisfaction for mothers (b= 0.14 scale units, p<0.05). No other sleep imbalance measures predicted relationship satisfaction. CONCLUSION Our findings are in line with previous research on sleep in men and women in general, with longer sleep and subjective reports of sleep disturbances in women, rather than previous research on sleep in parents of young children. Thus, we found no evidence of a sleep imbalance when both parents have similar working responsibilities.
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Affiliation(s)
- Göran Härdelin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Benjamin C Holding
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Sociology, University of Copenhagen, Copenhagen, Denmark
| | - Tim Reess
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Anahita Geranmayeh
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Stockholm University, Stockholm, Sweden
| | - John Axelsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Tina Sundelin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Stockholm University, Stockholm, Sweden
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Kanstrup M, Kontio E, Geranmayeh A, Olofsdotter Lauri K, Moulds ML, Holmes EA. A single case series using visuospatial task interference to reduce the number of visual intrusive memories of trauma with refugees. Clin Psychol Psychother 2020; 28:109-123. [PMID: 32525244 DOI: 10.1002/cpp.2489] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/07/2022]
Abstract
The current worldwide so-called "refugee crisis" has led to an unprecedented increase in migration globally. Because of stigma and language barriers, mental health care for refugees is limited. There is a need for novel, scalable psychological interventions. We investigated whether a brief behavioural intervention involving a memory reminder cue and Tetris gameplay on a smartphone reduces intrusive memories in refugees using a single case (N = 4) ABAB withdrawal design. The baseline phase (A) included a no-intervention week; the intervention phase (B) included an in-person session with the researchers, comprised of the behavioural intervention followed by self-guided use in daily life the following week. All participants reported a decrease in intrusive memories after the intervention, as well as functional improvements (e.g., in concentration). Importantly, participants rated the intervention as feasible and acceptable. As one in-person session was effective in persistent intrusion reduction, ABAB proved not to be the optimal design as intrusions did not rebound in the withdrawal phase. Findings are promising and highlight the need for further evaluation of novel interventions for mental health problems in refugees.
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Affiliation(s)
- Marie Kanstrup
- Department of Clinical Neuroscience (CNS), K8, Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Evelina Kontio
- Department of Clinical Neuroscience (CNS), K8, Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Anahita Geranmayeh
- Department of Clinical Neuroscience (CNS), K8, Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Klara Olofsdotter Lauri
- Department of Clinical Neuroscience (CNS), K8, Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Michelle L Moulds
- Department of Psychology, Uppsala University, Uppsala, Sweden.,School of Psychology, The University of New South Wales, UNSW, Sydney, New South Wales, Australia
| | - Emily A Holmes
- Department of Clinical Neuroscience (CNS), K8, Psychology, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Uppsala University, Uppsala, Sweden
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Geranmayeh A, Mowla A, Rajaei H, Esmaeilzadeh F, Kaljahi JF. Extraction of hydrocarbons from the contaminated soil of Pazanan II production unit by supercritical carbon dioxide. J Supercrit Fluids 2012. [DOI: 10.1016/j.supflu.2012.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
Comparisons of data from 298 preclinical and 104 clinical dental students in 1981 and 1982 on the Work Environment Scale are significant for Staff Support, Task Orientation, Work Pressure, and Clarity. Test results have been used to understand how students perceive their work environment. Baseline data should facilitate decisions about work environments.
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