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Østergaard T, Lundgren T, Rosendahl I, Zettle RD, Jonassen R, Harmer CJ, Stiles TC, Landrø NI, Haaland VØ. Corrigendum: Acceptance and commitment therapy preceded by attention bias modification on residual symptoms in depression: a 12-month follow-up. Front Psychol 2023; 14:1233621. [PMID: 37599729 PMCID: PMC10436102 DOI: 10.3389/fpsyg.2023.1233621] [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: 06/02/2023] [Accepted: 07/04/2023] [Indexed: 08/22/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyg.2019.01995.].
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Affiliation(s)
- Tom Østergaard
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
| | - Tobias Lundgren
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Ingvar Rosendahl
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Robert D Zettle
- Department of Psychology, Wichita State University, Wichita, KS, United States
| | - Rune Jonassen
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
| | - Catherine J Harmer
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
- Psychopharmacology and Emotion Research Laboratory, University Department of Psychiatry, Oxford, United Kingdom
| | - Tore C Stiles
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nils Inge Landrø
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
- Division of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Vegard Øksendal Haaland
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
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Sunde T, Hummelen B, Himle JA, Walseth LT, Vogel PA, Launes G, Haaland VØ, Haaland ÅT. Correction to: Early maladaptive schemas impact on long-term outcome in patients treated with group behavioral therapy for obsessive-compulsive disorder. BMC Psychiatry 2022; 22:291. [PMID: 35459167 PMCID: PMC9034582 DOI: 10.1186/s12888-022-03776-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Tor Sunde
- DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604, Kristiansand, Norway.
| | - Benjamin Hummelen
- grid.55325.340000 0004 0389 8485Clinic of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Joseph A. Himle
- grid.214458.e0000000086837370School of Social Work and School of Medicine-Psychiatry, University of Michigan, Ann Arbor, USA
| | - Liv Tveit Walseth
- grid.417290.90000 0004 0627 3712DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
| | - Patrick A. Vogel
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunvor Launes
- grid.417290.90000 0004 0627 3712DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
| | - Vegard Øksendal Haaland
- grid.417290.90000 0004 0627 3712DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway ,grid.5510.10000 0004 1936 8921Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
| | - Åshild Tellefsen Haaland
- grid.417290.90000 0004 0627 3712DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
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Abstract
BACKGROUND Suicide attempt is the most predictive risk factor of suicide. Trauma - especially sexual abuse - is a risk factor for suicide attempt and suicide. A common reaction to sexual abuse is dissociation. Higher levels of dissociation are linked to self-harm, suicide ideation, and suicide attempt, but the role of dissociation in suicidal behavior is unclear. METHODS In this naturalistic study, ninety-seven acute psychiatric patients with suicidal ideation, of whom 32 had experienced sexual abuse, were included. Suicidal behaviour was assessed with The Columbia suicide history form (CSHF). The Brief trauma questionnaire (BTQ) was used to identify sexual abuse. Dissociative symptoms were assessed with Dissociative experiences scale (DES). RESULTS Patients who had experienced sexual abuse reported higher levels of dissociation and were younger at onset of suicidal thoughts, more likely to self-harm, and more likely to have attempted suicide; and they had made more suicide attempts. Mediation analysis found dissociative experiences to significantly mediate a substantive proportion of the relationship between sexual abuse and number of suicide attempts (indirect effects = 0.17, 95% CI = 0.05, 0.28, proportion mediated = 68%). Dissociative experiences significantly mediated the role of sexual abuse as a predictor of being in the patient group with more than four suicide attempts (indirect effects = 0.11, 95% CI = 0.02, 0.19, proportion mediated = 34%). CONCLUSION The results illustrate the importance of assessment and treatment of sexual abuse and trauma-related symptoms such as dissociation in suicide prevention. Dissociation can be a contributing factor to why some people act on their suicidal thoughts.
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Affiliation(s)
- Silje Støle Brokke
- Department of Psychiatry, Sørlandet Hospital HF, Po box 416, N-4604, Kristiansand, Norway.
- Clinical Neuroscience Research Group, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.
| | | | - Nils Inge Landrø
- Clinical Neuroscience Research Group, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Vegard Øksendal Haaland
- Clinical Neuroscience Research Group, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Division of Mental Health, Sørlandet Hospital, Kristiansand, Norway
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Abstract
There is a need to understand more of the risk factors involved in the process from suicide ideation to suicide attempt. Cognitive control processes may be important factors in assessing vulnerability to suicide. A version of the Stroop procedure, Delis-Kaplan Executive Function System (D-KEFS) Color-Word Interference Test (CWIT) and Behavior Rating Inventory of Executive Function (BRIEF-A) were used in this study to test attention control and cognitive shift, as well as to assess everyday executive function of 98 acute suicidal psychiatric patients. The Columbia Suicide History Form (CSHF) was used to identify a group of suicide ideators and suicide attempters. Results showed that suicide attempters scored lower on attention control than suicide ideators who had no history of attempted suicide. The self-report in the BRIEF-A inventory did not reflect any cognitive differences between suicide ideators and suicide attempters. A logistic regression analysis showed that a poorer attention control score was associated with the suicide attempt group, whereas a poorer cognitive shift score was associated with the suicide ideation group. The results found in this study suggest that suicide attempters may struggle with control of attention or inhibiting competing responses but not with cognitive flexibility.
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Affiliation(s)
- Silje Støle Brokke
- Clinical Neuroscience Research Group, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Psychiatry, Sørlandet Hospital HF, Kristiansand, Norway
| | - Nils Inge Landrø
- Clinical Neuroscience Research Group, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Division of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Vegard Øksendal Haaland
- Clinical Neuroscience Research Group, Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Psychiatry, Sørlandet Hospital HF, Kristiansand, Norway
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Ruud T, Drivenes K, Drake RE, Haaland VØ, Landers M, Stensrud B, Heiervang KS, Tanum L, Bond GR. The Antipsychotic Medication Management Fidelity Scale: Psychometric properties. Adm Policy Ment Health 2020; 47:911-919. [PMID: 32030595 PMCID: PMC7547997 DOI: 10.1007/s10488-020-01018-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The paper describes the Antipsychotic Medication Management Fidelity Scale and its psychometric properties, including interrater reliability, frequency distribution, sensitivity to change and feasibility. Fidelity assessors conducted fidelity reviews four times over 18 months at eight sites receiving implementation support for evidence-based antipsychotic medication management. Data analyses shows good to fair interrater reliability, adequate sensitivity to change over time and good feasibility. At 18 months, item ratings varied from poor to full fidelity on most items. Use of the scale can assess fidelity to evidence-based guidelines for antipsychotic medication management and guide efforts to improve practice. Further research should improve and better calibrate some items, and improve the procedures for access to information.Trial registration: ClinicalTrials.gov Identifier: NCT03271242.
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Affiliation(s)
- Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.
- Institute of Clincial Medicine, University of Oslo, Oslo, Norway.
| | - Karin Drivenes
- Division of Mental Health, Sørlandet Hospital, Kristiansand, Norway
- South Eastern Norway Hospital Pharmacy Enterprise, Kristiansand, Norway
| | | | - Vegard Øksendal Haaland
- Sørlandet Hospital, Kristiansand, Norway
- Clinical Neuroscience Research Group, Department of Psychology, The Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | | | - Bjørn Stensrud
- Division of Mental Health, Innlandet Hospital Trust, Brumunddal, Norway
- National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Brumunddal, Norway
| | - Kristin S Heiervang
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Lars Tanum
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Oslo Metropolitan University, Oslo, Norway
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Østergaard T, Lundgren T, Zettle RD, Landrø NI, Haaland VØ. Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms. Front Psychol 2020; 11:528. [PMID: 32292369 PMCID: PMC7119364 DOI: 10.3389/fpsyg.2020.00528] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 03/05/2020] [Indexed: 01/05/2023] Open
Abstract
Relapse rates following a depressive episode are high, with limited treatments available aimed at reducing such risk. Acceptance and commitment therapy (ACT) is a cognitive-behavioral approach that has gained increased empirical support in treatment of depression, and thus represents an alternative in relapse prevention. Psychological flexibility (PF) plays an important role in mental health according to the model on which ACT is based. This study aimed to investigate the role of PF and its subprocesses in reducing residual symptoms of depression and in improving positive mental health following an 8-week group-based ACT treatment. Adult participants (75.7% female) with a history of depression, but currently exhibiting residual symptoms (N = 106) completed measures before and after intervention, and at 6 and 12-month follow-up. A growth curve model showed that positive mental health increased over 12-months. Multilevel mediation modeling revealed that PF significantly mediated these changes as well as the reduction of depressive symptoms, and that processes of acceptance, cognitive defusion, values and committed action, in turn, mediated increased PF.
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Affiliation(s)
- Tom Østergaard
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
| | - Tobias Lundgren
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Robert D. Zettle
- Department of Psychology, Wichita State University, Wichita, KS, United States
| | - Nils Inge Landrø
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
- Division of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Vegard Øksendal Haaland
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
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Drivenes K, Vederhus JK, Haaland VØ, Ruud T, Hauge YL, Regevik H, Falk RS, Tanum L. Enabling patients to cope with psychotropic medication in mental health care: Evaluation and reports of the new inventory MedSupport. Medicine (Baltimore) 2020; 99:e18635. [PMID: 31895824 PMCID: PMC6946431 DOI: 10.1097/md.0000000000018635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
This cross sectional study examined patients' perceptions of professional support regarding use of psychotropic medication in a specialist mental health care setting. The aims were to evaluate reliability and validity of the MedSupport inventory, and investigate possible associations between MedSupport scores and patient characteristics.A cross-sectional study was performed. The patients completed the MedSupport, a newly developed self-reported 6 item questionnaire on a Likert scale ranged 1 to 5 (1 = strongly disagree to 5 = strongly agree), and the Beliefs about Medicines Questionnaire. Diagnosis and treatment information were obtained at the clinical visits and from patient records.Among the 992 patients recruited, 567 patients (57%) used psychotropic medications, and 514 (91%) of these completed the MedSupport and were included in the study. The MedSupport showed an adequate internal consistency (Cronbach alpha.87; 95% CI.86-89) and a convergent validity toward the available variables. The MedSupport mean score was 3.8 (standard deviation.9, median 3.8). Increasing age and the experience of stronger needs for psychotropic medication were associated with perception of more support to cope with medication, whereas higher concern toward use of psychotropic medication was associated with perception of less support. Patients diagnosed with behavioral and emotional disorders, onset in childhood and adolescence perceived more support than patients with Mood disorders.The MedSupport inventory was suitable for assessing the patients' perceived support from health care service regarding their medication. Awareness of differences in patients' perceptions might enable the service to provide special measures for patients who perceive insufficient medication support.
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Affiliation(s)
- Karin Drivenes
- Division of Mental Health and Addiction Services Sørlandet Hospital
- South Eastern Norway Hospital Pharmacy Enterprise, Kristiansand
| | | | - Vegard Øksendal Haaland
- Addiction Unit, Sørlandet Hospital
- Clinical Neuroscience Research Group, Department of Psychology, The Faculty of Social Sciences
| | - Torleif Ruud
- Clinic for Health Services Research and Psychiatry, Institute of clinical medicine, University of Oslo
- Department of R&D in Mental health service, Akershus university hospital
| | - Yina Luk Hauge
- South Eastern Norway Hospital Pharmacy Enterprise, Kristiansand
| | - Hilde Regevik
- Division of Mental Health and Addiction Services Sørlandet Hospital
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo
| | - Lars Tanum
- Department of R&D in Mental health service, Akershus university hospital
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Norway
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Drivenes K, Haaland VØ, Mesel T, Tanum L. Practitioners' positive attitudes promote shared decision-making in mental health care. J Eval Clin Pract 2019; 25:1041-1049. [PMID: 31508872 DOI: 10.1111/jep.13275] [Citation(s) in RCA: 10] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/05/2019] [Accepted: 08/21/2019] [Indexed: 11/27/2022]
Abstract
RATIONALE AND AIMS There is a growing expectation of implementing shared decision making (SDM) in today's health care service, including mental health care. Traditional understanding of SDM may be too narrow to capture the complexity of treatments of mental health problems. Although the patients' contribution to SDM is well described, the contribution from the health care practitioners is less explored. Therefore, our aim was to explore the attitudes of practitioners in mental health care and the associations between practitioners' attitudes and SDM. METHOD We performed a cross-sectional study where practitioners reported their sharing and caring attitudes on the Patient-Practitioner Orientation Scale (PPOS) and age, gender, profession, and clinical working site. The patients reported SDM using the CollaboRate tool. We used a mixed effect model linking the data from each practitioner to one or more patients. We presented the findings and used them as background for a more philosophic reflection. RESULTS We included 312 practitioners with mean age 46.1 years. Of the practitioners, 60 held a medical doctors degree, 97 were psychologists, and 127 held a college degree in nursing, social science, or pedagogy. Female practitioners reported higher sharing (4.79 vs 4.67 [range 1-6], P = .04) and caring scores (4.77 vs 4.65 [range 1-6], P = .02) than males. The regression model contained 206 practitioners and 772 patients. We found a higher probability for the patient to report high SDM score if the practitioner reported higher sharing scores, and lower probability if the practitioner worked in ambulatory care. CONCLUSIONS SDM in mental health care is complex and demands multifaceted preparations from practitioners as well as patients. The practitioners' attitudes are not sufficiently explored using one instrument. The positive association between practitioners' patient-centred attitudes and SDM found in this study implies a relevance of the practitioners' attitudes for accomplishment of SDM processes in mental health care.
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Affiliation(s)
- Karin Drivenes
- Division of Mental Health, Sørlandet Hospital HF, Norway.,South Eastern Norway Hospital Pharmacy Enterprise, Kristiansand, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Vegard Øksendal Haaland
- Division of Mental Health, Sørlandet Hospital HF, Norway.,Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
| | - Terje Mesel
- Division of Mental Health, Sørlandet Hospital HF, Norway.,Department of Religion Philosophy and History, University of Agder, Kristiansand, Norway
| | - Lars Tanum
- Research and Development Department Mental Health, Akershus University Hospital, Lorenskog, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Sunde T, Hummelen B, Himle JA, Walseth LT, Vogel PA, Launes G, Haaland VØ, Haaland ÅT. Early maladaptive schemas impact on long-term outcome in patients treated with group behavioral therapy for obsessive-compulsive disorder. BMC Psychiatry 2019; 19:318. [PMID: 31655556 PMCID: PMC6815412 DOI: 10.1186/s12888-019-2285-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/11/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Some studies have previously found that certain elevated early maladaptive schemas (EMSs) are negative predictors for outcome for patients with obsessive-compulsive disorder (OCD) treated with Cognitive-Behavioral Therapy (CBT) or Exposure and Response Prevention (ERP). The current study explores whether EMS were related to reductions in OCD symptom severity at long-term follow-up (Mean = 8 years) after group ERP for patients with OCD. The central hypothesis was that patients with no response to treatment or patients who relapsed during the follow-up period were more likely to have elevated pre-treatment EMSs compared to those who responded to initial treatment and maintained gains over time. We also investigated whether there were any differences in change over time of overall EMS between patients who were recovered versus patients who were not recovered at extended follow-up. METHODS Young Schema Questionnaire -Short Form (YSQ-SF), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI) were measured in 40 OCD patients in a general outpatient clinic before and after group ERP, after 12-months and at extended follow-up. To analyze the predictors, a multiple regression analyses was conducted. Changes in overall EMS was analyzed by mixed models procedures. RESULTS The major finding is that patients with high pre-treatment YSQ-SF total scores were less likely to respond to initial treatment or were more likely to relapse between post-treatment and the extended follow-up. The YSQ-SF total score at pre-treatment explained 10.5% of the variance of extended long-term follow-up outcome. The entire sample experienced a significant reduction in overall EMS over time with largest reduction from pre- to post-test. There were no statistically significant differences in total EMS change trajectories between the patients who were recovered at the extended follow-up compared to those who were not. CONCLUSION The results from the present study suggest that patients with higher pre-treatment EMSs score are less likely to recover in the long-term after receiving group ERP for OCD. A combined treatment that also targets early maladaptive schemas may be a more effective approach for OCD patients with elevated EMS who don't respond to standard ERP.
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Affiliation(s)
- Tor Sunde
- DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
| | - Benjamin Hummelen
- Clinic of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Joseph A. Himle
- School of Social Work and School of Medicine-Psychiatry, University of Michigan, Ann Arbor, USA
| | - Liv Tveit Walseth
- DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
| | - Patrick A. Vogel
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunvor Launes
- DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
| | - Vegard Øksendal Haaland
- DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
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Østergaard T, Lundgren T, Rosendahl I, Zettle RD, Jonassen R, Harmer CJ, Stiles TC, Landrø NI, Haaland VØ. Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-Month Follow-Up. Front Psychol 2019; 10:1995. [PMID: 31555180 PMCID: PMC6727662 DOI: 10.3389/fpsyg.2019.01995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/14/2019] [Indexed: 12/25/2022] Open
Abstract
Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, participants with a history of depression, currently in remission (N = 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N = 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse.
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Affiliation(s)
- Tom Østergaard
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
| | - Tobias Lundgren
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Ingvar Rosendahl
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Robert D. Zettle
- Department of Psychology, Wichita State University, Wichita, KS, United States
| | - Rune Jonassen
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
| | - Catherine J. Harmer
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
- Psychopharmacology and Emotion Research Laboratory, University Department of Psychiatry, Oxford, United Kingdom
| | - Tore C. Stiles
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nils Inge Landrø
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
- Division of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Vegard Øksendal Haaland
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
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11
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Østergaard T, Lundgren T, Zettle R, Jonassen R, Harmer CJ, Stiles TC, Landrø NI, Haaland VØ. Acceptance and Commitment Therapy preceded by an experimental Attention Bias Modification procedure in recurrent depression: study protocol for a randomized controlled trial. Trials 2018; 19:203. [PMID: 29587807 PMCID: PMC5870819 DOI: 10.1186/s13063-018-2515-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/31/2018] [Indexed: 11/10/2022] Open
Abstract
Background This project studies the effect of group-based Acceptance and Commitment Therapy (ACT) following Attention Bias Modification (ABM) on residual symptoms in recurrent depression. ACT is a cognitive-behavioral intervention combining acceptance and mindfulness processes with commitment and behavior-change processes. ACT enjoys modest empirical support in treating depression and has also shown promising results in secondary prevention of depression. The experimental cognitive bias modification (ABM) procedure has been shown to reduce surrogate markers of depression vulnerability in patients in remission from depression. The aim of the current project is to investigate if the effect of group-based ACT on reducing residual depressive symptoms can be enhanced by preceding it with ABM. Also, assessment of the relationship between conceptually relevant therapeutic processes and outcome will be investigated. Methods/design An invitation to participate in this project was extended to 120 individuals within a larger sample who had just completed a separate randomized, multisite, clinical trial (referred to hereafter as Phase 1) in which they received either ABM (n = 60) or a control condition without bias modification (n = 60). This larger Phase-1 sample consisted of 220 persons with a history of at least two episodes of major depression who were currently in remission or not fulfilling the criteria of major depression. After its inclusion, Phase-1 participants from the Sørlandet site (n = 120) were also recruited for this study in which they received an 8-week group-based ACT intervention. Measures will be taken immediately after Phase 1, 1 month, 2 months, 6 months, and 1 year after the conclusion of Phase 1. Discussion This study sequentially combines acceptable, nondrug interventions from neuropsychology and cognitive-behavioral psychology in treating residual symptoms in depression. The results will provide information about the effectiveness of treatment and on mechanisms and processes of change that may be valuable in understanding and further developing ABM and ACT, combined and alone. Trial registration ClinicalTrials.gov, Identifier: NCT02648165. Registered on 6 January 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2515-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tom Østergaard
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway. .,Clinical Neuroscience Research Group Department of Psychology, University of Oslo, Oslo, Norway.
| | - Tobias Lundgren
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm Health Care services, Stockholm, Sweden
| | - Robert Zettle
- Department of Psychology, Wichita State University, Wichita, KS, USA
| | - Rune Jonassen
- Clinical Neuroscience Research Group Department of Psychology, University of Oslo, Oslo, Norway
| | - Catherine J Harmer
- Psychopharmacology and Emotional Research Lab (PERL), University Department of Psychiatry, Oxford, UK
| | - Tore C Stiles
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Nils Inge Landrø
- Clinical Neuroscience Research Group Department of Psychology, University of Oslo, Oslo, Norway
| | - Vegard Øksendal Haaland
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway.,Clinical Neuroscience Research Group Department of Psychology, University of Oslo, Oslo, Norway
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Haaland VØ, Bjørkholt M, Freuchen A, Ness E, Walby FA. Suicides, mental health care and interdisciplinary specialised addiction services in the Agder counties 2004-13. Tidsskr Nor Laegeforen 2017; 137:16-0503. [PMID: 28972328 DOI: 10.4045/tidsskr.16.0503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Most of those who commit suicide suffer from one or more mental disorders. We wished to identify the proportion that had been in contact with mental health care or interdisciplinary specialised addiction services during their lifetime and in the year prior to their death, and to describe characteristics of these patients. MATERIAL AND METHOD Information on suicides in the Agder counties in the years 2004–2013 was retrieved from the Cause of Death Registry. Patient records from Sørlandet Hospital were reviewed with the aid of a structured form. RESULTS Altogether 329 suicides were included in the study. Of these, 66.6 % had at some point in life been in contact with mental health care or interdisciplinary specialised addiction services, 46.2 % during the year preceding their suicide. Altogether 28.6 % were actively undergoing treatment. The proportion who had been in contact in the preceding year tended to be lower among patients younger than 20 when compared to other age groups. Among those who had completed their treatment, there were more patients with adaptation disorder than in the group that remained in treatment; among those who remained in treatment there were more patients with psychotic disorders than among those who had completed their treatment. INTERPRETATION A higher proportion of those who committed suicide in the Agder counties were in contact with mental health care and interdisciplinary specialised addiction services than what has been found in equivalent international studies. The findings underscore the need to develop effective measures to prevent suicides in these groups of patients.
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Lystad JU, Falkum E, Mohn C, Haaland VØ, Bull H, Evensen S, Rund BR, Ueland T. The MATRICS Consensus Cognitive Battery (MCCB): performance and functional correlates. Psychiatry Res 2014; 220:1094-101. [PMID: 25242432 DOI: 10.1016/j.psychres.2014.08.060] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 08/27/2014] [Accepted: 08/29/2014] [Indexed: 02/01/2023]
Abstract
Neurocognitive impairment is a core feature in psychotic disorders and the MATRICS Consensus Cognitive Battery (MCCB) is now widely used to assess neurocognition in this group. The MATRICS has been translated into several languages, including Norwegian; although this version has yet to be investigated in an adult clinical population. Further, the relationship between the MATRICS and different measures of functioning needs examination. The purpose of this study was to describe neurocognition assessed with the Norwegian version of the MATRICS battery in a sample of patients with psychotic disorders compared to age and gender matched healthy controls and to examine the association with educational-, occupational- and social-functioning in the patient group. One hundred and thirty one patients and 137 healthy controls completed the battery. The Norwegian version of the MATRICS was sensitive to the magnitude of neurocognitive impairments in patients with psychotic disorders, with patients displaying significant impairments on all domains relative to healthy controls. Neurocognition was also related to both self-rated and objective functional measures such as social functioning, educational- and employment-history.
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Affiliation(s)
- June Ullevoldsæter Lystad
- Division of Mental Health and Addiction, Oslo University Hospital, Bygg 12, Gaustad Sykehus, PO Box 4956, Nydalen, 0424 Oslo, Norway.
| | - Erik Falkum
- Division of Mental Health and Addiction, Oslo University Hospital, Bygg 12, Gaustad Sykehus, PO Box 4956, Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Norway
| | - Christine Mohn
- Department of Research, Vestre Viken Hospital Trust, Drammen, Norway
| | - Vegard Øksendal Haaland
- Department of Psychology, University of Oslo, Norway; Department of Psychiatry, Sørlandet Hospital Trust, Kristiansand, Norway
| | - Helen Bull
- Division of Mental Health and Addiction, Oslo University Hospital, Bygg 12, Gaustad Sykehus, PO Box 4956, Nydalen, 0424 Oslo, Norway
| | - Stig Evensen
- Division of Mental Health and Addiction, Oslo University Hospital, Bygg 12, Gaustad Sykehus, PO Box 4956, Nydalen, 0424 Oslo, Norway
| | - Bjørn Rishovd Rund
- Department of Psychology, University of Oslo, Norway; Department of Research, Vestre Viken Hospital Trust, Drammen, Norway
| | - Torill Ueland
- Division of Mental Health and Addiction, Oslo University Hospital, Bygg 12, Gaustad Sykehus, PO Box 4956, Nydalen, 0424 Oslo, Norway
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Haaland AT, Vogel PA, Launes G, Haaland VØ, Hansen B, Solem S, Himle JA. The role of early maladaptive schemas in predicting exposure and response prevention outcome for obsessive-compulsive disorder. Behav Res Ther 2011; 49:781-8. [DOI: 10.1016/j.brat.2011.08.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 08/19/2011] [Accepted: 08/30/2011] [Indexed: 10/17/2022]
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Abstract
BACKGROUND The aim of this study was to investigate the functioning of patients with borderline personality disorder (BPD) compared to healthy controls on five neuropsychological domains, with regard to the possible effect of differences in IQ.MethodOut-patients and in-patients with BPD (n=35) and healthy comparison subjects (n=35) were tested with an extensive neuropsychological battery, where most cognitive domains were covered by several tests. RESULTS When controlling for the effect of IQ, patients were found to have reduced executive functioning as compared to healthy controls. With regard to the other neuropsychological domains (working memory, attention, long-term verbal memory, and long-term non-verbal memory), no differences were found between the two groups. Within-subject analyses also identified executive functioning as a selective deficit among patients whereas long-term verbal memory was identified as a relative strength. An association was identified between the covariate general intellectual functioning and every neuropsychological domain. No statistically significant differences were found between the subgroups of patients with and without co-morbid post-traumatic stress disorder (PTSD) or between those with and without co-morbid major depression, or between the medicated and unmedicated subgroups on any of the neuropsychological domains. CONCLUSIONS Patients with BPD demonstrate a selective deficit in executive functioning. This corroborates studies that have identified frontal regions as potential neurobiological substrates of the BPD syndrome. The relative strength of the verbal long-term memory function raises pertinent questions regarding the presumed importance of hippocampal structures.
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Affiliation(s)
- V Ø Haaland
- Department of Psychiatry, Sørlandet Hospital HF, Kristiansand, Norway.
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Abstract
OBJECTIVE Transient, stress-related severe dissociative symptoms or paranoid ideation is one of the criteria defining the borderline personality disorder (BPD). Examinations of the neuropsychological correlates of BPD reveal various findings. The purpose of this study was to investigate the association between dissociation and neuropsychological functioning in patients with BPD. METHOD The performance on an extensive neuropsychological battery of patients with BPD with (n=10) and without (n=20) pathological dissociation was compared with that of healthy controls (n=30). RESULTS Patients with pathological dissociation were found to have reduced functioning on every neuropsychological domain when compared with healthy controls. Patients without pathological dissociation were found to have reduced executive functioning, but no other differences were found. CONCLUSION Pathological dissociation is a clinical variable that differentiates patients with BPD with regard to cognitive functioning.
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Affiliation(s)
- V Ø Haaland
- Department of Psychiatry, Sørlandet Hospital HF, Kristiansand, Norway.
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Haaland VØ, Landrø NI. Decision making as measured with the Iowa Gambling Task in patients with borderline personality disorder. J Int Neuropsychol Soc 2007; 13:699-703. [PMID: 17521489 DOI: 10.1017/s1355617707070890] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Revised: 01/17/2007] [Accepted: 01/18/2007] [Indexed: 11/06/2022]
Abstract
Affective instability is a core dimension of borderline personality disorder. The somatic marker hypothesis suggests that emotions play a crucial role in decision making. In this preliminary study, decision making was assessed in individuals with borderline personality disorder. Patients with borderline personality disorder (n = 20) and healthy comparison subjects (n = 15) were tested with the Iowa Gambling Task (IGT). The patients showed less advantageous choices on the IGT than did the healthy comparison subjects. The results could not be explained by indicators of general cognitive function or by symptoms of depression. These findings demonstrate that deficits in decision making in borderline personality disorder may manifest themselves in an ecologically valid neuropsychological test. Future studies should address whether those deficits are related to the behavioral characteristics of affective dysregulation and/or impulsivity, to the proposed dysfunctions and reduced volume of the orbitofrontal cortex and/or the amygdala, and to other neuropsychological functions.
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