miun.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Karlsson, Andreas
Publications (8 of 8) Show all publications
Thomtén, J. & Karlsson, A. (2014). Psychological factors in genital pain: The role of fear-avoidance, pain catastrophizing and anxiety sensitivity among women living in Sweden. Scandinavian Journal of Pain, 5(3), 193-199
Open this publication in new window or tab >>Psychological factors in genital pain: The role of fear-avoidance, pain catastrophizing and anxiety sensitivity among women living in Sweden
2014 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 5, no 3, p. 193-199Article in journal (Refereed) Published
Abstract [en]

Objectives: One in five women under the age of 30 report recurrent genital pain and pain during sexual intercourse. Female genital pain negatively affects sexual and general health, as well as dyadic function and quality of life. Although the current field of research and clinical expertise in general agree upon a biopsychosocial conceptualization, there is still a lack of theoretical models describing the psychosocial mechanisms involved in the development of genital pain. Originally developed to outline the transition from acute to chronic back pain, the fear avoidance (FA) model has lately been proposed as a possible tool in illustrating the mechanisms involved in genital pain. However, only few studies have empirically tested the components of the FA model empirically. The aim of the present study is to examine fear avoidance beliefs, pain catastrophizing, and symptoms of depression and anxiety among women reporting genital pain, and to relate these concepts to sexual satisfaction/function and the characteristics of pain. Methods: The study was a population-based study using a postal questionnaire administered to 4052 women (age 18-35). Of these 944 (response rate: 23%) took part in the study. Results: Genital pain of six months duration was reported by 16.1% of the women. Women with pain reported elevated levels of symptoms of anxiety, fear avoidance beliefs, pain catastrophizing and anxiety sensitivity. Symptoms of anxiety also predicted pain in the explanatory model together with vaginal tension and fungal infection. Vaginal tension has previously been described as a fear-response to painful intercourse and the results thereby seem to give further support to viewing genital pain from a fear avoidance perspective. Furthermore, fear avoidance beliefs seem to be of similar importance as lack of desire for the experience of sexual satisfaction and could also predict pain during specific activities among women with pain. The results also indicate that sexual satisfaction is related to a specific pain-related fear, rather than a heightened level of general anxiety. Conclusions: The study had a low response rate, but still indicates that genital pain is common and is associated with several aspects of fear and avoidance. In sum, the results support the FA model by giving strong support for fear reactions (vaginal tension) and fear avoidance beliefs, and moderate support for negative affect. In the model negative affect drives pain catastrophizing. Implications: It seems that the experience of genital pain among women in the general population is common and could be associated with increased levels of anxiety and fear-avoidance beliefs. However, the associations should not be understood in isolation from physiological mechanisms but seem to indicate interactions between, e.g. fungal infections, negative appraisals of pain and symptoms, lack of sexual function and satisfaction and increased pain experience. It is possible that psychological mechanisms work in the transition from acute physiological pain to chronic psychologically maintained pain in terms of secondary reactions to, e.g. repeated fungal infections by adding emotional distress, fear of pain and avoidance behaviours. © 2014 Scandinavian Association for the Study of Pain.

Keywords
Anxiety, Fear avoidance, Genital pain, Pain catastrophizing, Sexual satisfaction, Women
National Category
Obstetrics, Gynecology and Reproductive Medicine Psychology
Identifiers
urn:nbn:se:miun:diva-22641 (URN)10.1016/j.sjpain.2014.01.003 (DOI)2-s2.0-84904052192 (Scopus ID)
Note

Correspondence Address: Karlsson, A.; Örebro University, School of Law, Psychology and Social Work, 701 82 Örebro, Sweden; email: johanna.thomten@miun.se

Available from: 2014-09-19 Created: 2014-08-20 Last updated: 2019-05-24Bibliographically approved
Costa, D., Soares, J. J. F., Lindert, J., Hatzidimitriadou, E., Karlsson, A., Sundin, Ö., . . . Barros, H. (2013). Intimate partner violence in Europe: design and methods of a multinational study.: La violencia de pareja en Europa: diseño y métodos de un estudio multinacional. Gaceta Sanitaria, 27(6), 558-561
Open this publication in new window or tab >>Intimate partner violence in Europe: design and methods of a multinational study.: La violencia de pareja en Europa: diseño y métodos de un estudio multinacional
Show others...
2013 (English)In: Gaceta Sanitaria, ISSN 0213-9111, E-ISSN 1578-1283, Vol. 27, no 6, p. 558-561Article in journal (Refereed) Published
Abstract [en]

Objective To describe the design, methods, procedures and characteristics of the population involved in a study designed to compare Intimate Partner Violence (IPV) in eight European countries.

Methods Women and men aged 18–65, living in Ghent-Belgium (n = 245), Stuttgart-Germany (n = 546), Athens-Greece (n = 548), Budapest-Hungary (n = 604), Porto-Portugal (n = 635), Granada-Spain (n = 138), Östersund-Sweden (n = 592), London-United Kingdom (n = 571), were sampled and administered a common questionnaire. Chi-square goodness of fit and five-age strata population fractions ratios for sex and education were computed to evaluate samples' representativeness.

Results Differences in the age distributions were found among women from Sweden and Portugal and among men from Belgium, Hungary, Portugal and Sweden. Over-recruitment of more educated respondents was noted in all sites.

Conclusion The use of a common research protocol with the same structured questionnaire is likely to provide accurate estimates of the general population IPV frequency, despite limitations in probabilistic sampling and restrictions in methods of administration.

Abstract [es]

Objetivo

Describir el diseño, los métodos, los procedimientos y las características de la población participante en un estudio diseñado para comparar la violencia de la pareja íntima en ocho países.

Método

Formaron parte de la muestra mujeres y hombres (18–65 años de edad), residentes en Ghent-Bélgica (n = 245), Stuttgart-Alemania (n = 546), Atenas-Grecia (n = 548), Budapest-Hungría (n = 604), Porto-Portugal (n = 635), Granada-España (n = 138), Östersund-Suecia (n = 592) y Londres-Reino Unido (UK) (n = 571). Se les administró un cuestionario común. Se calcularon la prueba de ji al cuadrado de bondad de ajuste y razones de fracciones poblacionales de cinco estratos de edad, según sexo y nivel educativo, con la finalidad de evaluar su representatividad.

Resultados

Se encontraron diferencias en las distribuciones de edad en las mujeres de Suecia y Portugal, y en los hombres de Bélgica, Hungría, Portugal y Suecia. Ha habido un exceso de reclutamiento de encuestados con un nivel educativo más alto en todos los países.

Conclusiones

Un protocolo común de investigación con el mismo cuestionario estructurado puede proporcionar estimaciones precisas de la frecuencia de violencia de la pareja íntima en la población general, a pesar de las limitaciones existentes en la creación de muestras probabilísticas y en los métodos de administración.

Keywords
Intimate partner violence, Methods, Multi-centre study, Men, Women, Europe, Violencia infligida por la pareja, Métodos, Estudio multicéntrico, Hombres, Mujeres, Europa
National Category
Medical and Health Sciences Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:miun:diva-18623 (URN)10.1016/j.gaceta.2013.03.001 (DOI)000327361900017 ()23643717 (PubMedID)2-s2.0-84887616524 (Scopus ID)
Available from: 2013-03-15 Created: 2013-03-15 Last updated: 2017-12-06Bibliographically approved
Bergstrom, J., Andersson, G., Ljotsson, B., Ruck, C., Andreewitch, S., Karlsson, A., . . . Lindefors, N. (2010). Internet-versus group-administered cognitive behaviour therapy for panic disorder in a psychiatric setting: a randomised trial. BMC Psychiatry, 10, article 54
Open this publication in new window or tab >>Internet-versus group-administered cognitive behaviour therapy for panic disorder in a psychiatric setting: a randomised trial
Show others...
2010 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 10, p. article 54-Article in journal (Refereed) Published
Abstract [en]

Background: Internet administered cognitive behaviour therapy (CBT) is a promising new way to deliver psychological treatment, but its effectiveness in regular care settings and in relation to more traditional CBT group treatment has not yet been determined. The primary aim of this study was to compare the effectiveness of Internet- and group administered CBT for panic disorder (with or without agoraphobia) in a randomised trial within a regular psychiatric care setting. The second aim of the study was to establish the cost-effectiveness of these interventions. Methods: Patients referred for treatment by their physician, or self-referred, were telephone-screened by a psychiatric nurse. Patients fulfilling screening criteria underwent an in-person structured clinical interview carried out by a psychiatrist. A total of 113 consecutive patients were then randomly assigned to 10 weeks of either guided Internet delivered CBT (n = 53) or group CBT (n = 60). After treatment, and at a 6-month follow-up, patients were again assessed by the psychiatrist, blind to treatment condition. Results: Immediately after randomization 9 patients dropped out, leaving 104 patients who started treatment. Patients in both treatment conditions showed significant improvement on the main outcome measure, the Panic Disorder Severity Scale (PDSS) after treatment. For the Internet treatment the within-group effect size (pre-post) on the PDSS was Cohen's d = 1.73, and for the group treatment it was d = 1.63. Between group effect sizes were low and treatment effects were maintained at 6-months follow-up. We found no statistically significant differences between the two treatment conditions using a mixed models approach to account for missing data. Group CBT utilised considerably more therapist time than did Internet CBT. Defining effect as proportion of PDSS responders, the cost-effectiveness analysis concerning therapist time showed that Internet treatment had superior cost-effectiveness ratios in relation to group treatment both at post-treatment and follow-up. Conclusions: This study provides support for the effectiveness of Internet CBT in a psychiatric setting for patients with panic disorder, and suggests that it is equally effective as the more widely used group administered CBT in reducing panic-and agoraphobic symptoms, as well as being more cost effective with respect to therapist time.

National Category
Psychology
Identifiers
urn:nbn:se:miun:diva-11957 (URN)10.1186/1471-244X-10-54 (DOI)000280843500001 ()2-s2.0-77955119015 (Scopus ID)
Available from: 2010-09-07 Created: 2010-09-07 Last updated: 2017-12-12Bibliographically approved
Bergström, J., Andersson, G., Karlsson, A., Andreevitch, S., Ruck, C., Carlbring, P. & Lindefors, N. (2009). An open study of the effectiveness of Internet treatment for panic disorder delivered in a psychiatric setting. Nordic Journal of Psychiatry, 63(1), 44-50
Open this publication in new window or tab >>An open study of the effectiveness of Internet treatment for panic disorder delivered in a psychiatric setting
Show others...
2009 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, no 1, p. 44-50Article in journal (Refereed) Published
Abstract [en]

Panic Disorder with or without or without agoraphobia (PD/A) is common and can be treated effectively with SSRI medication or cognitive behavior therapy (CBT). There is however a great lack of access to CBT services, which has motivated the development of self-help approaches requiring less therapist contact. A novel treatment modality in this field, showing efficacy in several randomised trials but until now not evaluated within the context of regular psychiatric care, is Internet-based treatment. The present study evaluated the effectiveness of Internet-based CBT for 20 consecutively referred PD patients in a psychiatric setting. At post-treatment, 94% of patients no longer met DSM-IV criteria for PD (82% at 6-month follow up). The within-group effect sizes (for the main outcome PDSS; Panic Disorder Severity Scale) were Cohens d=2.5 (pre- to posttreatment) and 2.8 (pre-treatment to follow up) respectively. The proportion of responders on the PDSS was 75% at posttreatment and 70% at 6-month follow up. These results indicate that Internet-based CBT can be both an effective, feasible and potentially cost-effective alternative within regular psychiatric care for patients with PD.

Keywords
Panic disorder, CBT, Internet, Self help
National Category
Psychology
Identifiers
urn:nbn:se:miun:diva-4390 (URN)10.1080/08039480802191132 (DOI)000262789300006 ()5308 (Local ID)5308 (Archive number)5308 (OAI)
Available from: 2008-09-30 Created: 2008-09-30 Last updated: 2017-12-12Bibliographically approved
Ruck, C., Karlsson, A., Douglas Steele, J., Edman, G., Meyersson, B., Ericsson, K., . . . Svanborg, P. (2008). Capsulotomy for Obsessive-Compulsive Disorder: long term follow up of 25 patients. Archives of General Psychiatry, 65(8), 914-922
Open this publication in new window or tab >>Capsulotomy for Obsessive-Compulsive Disorder: long term follow up of 25 patients
Show others...
2008 (English)In: Archives of General Psychiatry, ISSN 0003-990X, E-ISSN 1538-3636, Vol. 65, no 8, p. 914-922Article in journal (Refereed) Published
Abstract [en]

Abstract Context: Capsulotomy is sometimes used as a treatment of last resort in severe and treatment refractory cases of Obsessive-Compulsive Disorder (OCD). Objective: To evaluate the long-term efficacy and safety of capsulotomy in OCD. Design: Non-controlled long-term follow-up trial (mean 10.9 years after surgery). Setting: University hospital referral center. Patients: 25 consecutive OCD patients having undergone capsulotomy between the years 1988 and 2000. Intervention: Unilateral or bilateral capsulotomy. Lesions were created either by conventional heating or by gamma-radiation (radiosurgery). Main Outcome Measure: Yale-Brown Obsessive-Compulsive Rating Scale (Y-BOCS). Results: Mean Y-BOCS was 34 preoperatively and dropped to 18 at long-term follow-up (p<0.0001). Response (defined as ≥ 35 % reduction at long-term compared to baseline) was seen in 12 patients at long-term. Eight patients were in remission (Y-BOCS < 16) at long-term follow-up. Response rates did not differ between surgical method. A mean weight gain of 6 kg was reported in the first postoperative year. Ten patients were considered to sufferer from significant problems in the area of executive functioning, apathy or disinhibition. Six of these ten patients had either had high doses of radiation or multiple surgical procedures. Our MRI analysis of 11 patients suggests that the OCD symptom reduction may be increased by reducing the lateral extension of the lesions, and a reduction in the medial and posterior extension may limit the risk of side effects, that is, smaller lesions may produce better results. Conclusions: Capsulotomy is effective in reducing OCD symptoms. There is a substantial risk of side effects and the risk may vary between surgical methods. Our findings suggest that smaller lesions are safer and that high radiation doses and multiple procedures should be avoided.

Keywords
capsulotomy, OCD, long term follow up, neuropsychology
National Category
Psychology
Identifiers
urn:nbn:se:miun:diva-5015 (URN)000258225400007 ()18678796 (PubMedID)2-s2.0-48949088454 (Scopus ID)5307 (Local ID)5307 (Archive number)5307 (OAI)
Note

VR-Neuroscience

Available from: 2008-11-30 Created: 2008-11-19 Last updated: 2017-12-12Bibliographically approved
Mörtberg, E., Karlsson, A., Fyring, C. & Sundin, Ö. (2006). Intense Cognitive-Behavioural Group Treatment (CBGT) of Social Phobia: A randomized controlled study. Journal of Anxiety Disorders, 20(5), 646-660
Open this publication in new window or tab >>Intense Cognitive-Behavioural Group Treatment (CBGT) of Social Phobia: A randomized controlled study
2006 (English)In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 20, no 5, p. 646-660Article in journal (Refereed) Published
Abstract [en]

The effects of intensive cognitive-behavioral group treatment (CBGT) for social phobia (DSM-IV) were studied in 26 patients randomly assigned either to a treatment group (TG) or to a 6-month waiting list control group (WG). Treatment involved 2 weeks of daily treatment sessions separated by 1 week of homework assignments. TG was superior to WG at all assessment points, i.e., at 3 weeks and at 3 and 6 months of post-treatment. After 6 months, significant treatment effects were found in the majority of social phobia measures indicating decreased levels of social anxiety and avoidance, safety-behaviors and symptoms influence on daily life. The WG received treatment following the waiting list period and was combined with the TG in order to evaluate the outcome in a larger sample. Treatment gains at 3 weeks were maintained or improved at 1-year follow-up. Average effect sizes of social phobia measures ranged from 0.56 at post-treatment, 0.68 at 3 months and 0.81 at 6 months and 1 year, respectively.

Keywords
CBT, Psychological treatment; Cognitive and behavioral treatment; Social phobia; Group treatment; Clinical practice
National Category
Psychology
Identifiers
urn:nbn:se:miun:diva-1190 (URN)10.1016/j.janxdis.2005.07.005 (DOI)5184 (Local ID)5184 (Archive number)5184 (OAI)
Available from: 2008-09-30 Created: 2008-09-30 Last updated: 2017-12-13Bibliographically approved
Juth, P., Lundquist, D., Karlsson, A. & Öhman, A. (2005). Looking for foes and friends: Perceptual and Emotional factors when Finding a Face in the Crowd. Emotion, 5(4), 379-395
Open this publication in new window or tab >>Looking for foes and friends: Perceptual and Emotional factors when Finding a Face in the Crowd
2005 (English)In: Emotion, ISSN 1528-3542, E-ISSN 1931-1516, Vol. 5, no 4, p. 379-395Article in journal (Refereed) Published
Keywords
Emotinal content, facial expressions, visual search, social anxiety
National Category
Psychology
Identifiers
urn:nbn:se:miun:diva-4714 (URN)10.1037/1528-3542.5.4.379 (DOI)5068 (Local ID)5068 (Archive number)5068 (OAI)
Available from: 2008-09-30 Created: 2008-09-30 Last updated: 2017-12-12Bibliographically approved
Carlsson, K., Petersson, K. M., Lundqvist, D., Karlsson, A., Ingvar, M. & Öhman, A. (2004). Fear and the Amygdala: Manipulation of Awareness Generates Differential Cerebral Responses to Phobic and Fear-Relevant (but Nonfeared) Stimuli. Emotion, 4(4), 340-353
Open this publication in new window or tab >>Fear and the Amygdala: Manipulation of Awareness Generates Differential Cerebral Responses to Phobic and Fear-Relevant (but Nonfeared) Stimuli
Show others...
2004 (English)In: Emotion, ISSN 1528-3542, Vol. 4, no 4, p. 340-353Article in journal (Refereed) Published
Abstract [en]

Rapid response to danger holds an evolutionary advantage. In this positron emission tomography study, phobics were exposed to masked visual stimuli with timings that either allowed awareness or not of either phobic, fear-relevant (e.g., spiders to snake phobics), or neutral images. When the timing did not permit awareness, the amygdala responded to both phobic and fear-relevant stimuli. With time for more elaborate processing, phobic stimuli resulted in an addition of an affective processing network to the amygdala activity, whereas no activity was found in response to fear-relevant stimuli. Also, right prefrontal areas appeared deactivated, comparing aware phobic and fear-relevant conditions. Thus, a shift from top-down control to an affectively driven system optimized for speed was observed in phobic relative to fear-relevant aware processing. (PsycINFO Database Record (c) 2006 APA, all rights reserved) (journal abstract)

Keywords
aware processing, amygdala, fear-relevant stimuli, phobics, positron emission tomography, affective processing, masked visual stimuli, timings, phobic images, prefrontal areas, rapid response
National Category
Psychology
Identifiers
urn:nbn:se:miun:diva-5008 (URN)10.1037/1528-3542.4.4.340 (DOI)000225383900002 ()5070 (Local ID)5070 (Archive number)5070 (OAI)
Available from: 2008-09-30 Created: 2008-09-30Bibliographically approved
Organisations

Search in DiVA

Show all publications