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  • 1.
    Abbasi, Seyed H
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    De Leon, AP
    Division of Social Medicine, Department of Public Health Sciences, Karolinska Intitutet, Sweden.
    Kassaian, SE
    Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Karimi.,, AA
    Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Soares, Joaquim J. F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Gender Differences in the Risk of Coronary Artery Disease in Iran2012In: Iranian Journal of Public Health, ISSN 0304-4556, Vol. 41, no 3, p. 36-47Article in journal (Refereed)
    Abstract [en]

    Background: Given gender differences in the risk of coronary artery disease (CAD), the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Methods: Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre-procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as postprocedural data were collected. The data were, subsequently, compared between the men and women. Results: Out of the 44,820 patients (16,378 women), who underwent coronary angiography, 37,358 patients (11,995 women) had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, highdensity lipoprotein, and fasting blood sugar (P< 0.001). Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients (OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26- 2.48, respectively). Acute coronary syndrome was more prevalent in the men (76.1% vs. 68.6%, P< 0.001), and chronic stable angina was more frequent in the females (31.4% vs. 23.9%, P< 0.001). With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females (20.1% vs. 18.6%, P< 0.001). Conclusion: Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often.

  • 2.
    Abbasi, Seyed H
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Tehran University of Medical Sciences, Tehran, Iran.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Jalali, Arash
    Teheran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Högskolan i Gävle.
    Ethnic differences in the risk factors and severity of coronary artery disease: a patient-based study in Iran2018In: Journal of Racial and Ethnic Health Disparities, ISSN 2197-3792, Vol. 5, no 3, p. 623-631Article in journal (Refereed)
    Abstract [en]

    Background Diverse ethnic groups may differ regarding the risk factors and severity of coronary artery disease (CAD). This study sought to assess the association between ethnicity and CAD risk and severity in six major Iranian ethnic groups.

    Methods In this study, 20,165 documented coronary artery disease patients who underwent coronary angiography at a tertiary referral heart center were recruited. The demographic, laboratory, clinical, and risk factor data of all the patients were retrieved. The Gensini score (an indicator of CAD severity) was calculated for all, and the risk factors and severity of CAD were compared between the ethnical groups, using adjusted standardized residuals, Kruskal–Wallis test, and multivariable regression analysis.

    Results The mean age of the participants (14,131 [70.1%] men and 6034 [29.9%] women) was 60.7 ± 10.8 years. The Fars (8.7%) and Gilak (8.6%) ethnic groups had the highest prevalence of ≥4 simultaneous risk factors. The mean Gensini score was the highest for the Gilaks (77.1 ± 55.9) and the lowest among the Lors (67.5 ± 52.8). The multivariable regression analysis showed that the Gilaks had the worst severity (β 0.056, 95% CI 0.009 to 0.102; P = 0.018), followed by the Torks (β 0.032, 95% CI 0.005 to 0.059; P = 0.020). Meanwhile, the Lors showed the lowest severity (β −0.087, 95% CI −0.146 to −0.027; P = 0.004).

    Conclusions This study found that there was heterogeneity in CAD severity and a diverse distribution in its well-known traditional risk factors among major Iranian ethnic groups.

  • 3.
    Abbasi, Seyed
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ponce De Leon, Antonio
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Kassaian, Seyed Ebrahim
    Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Karimi, Abbasali
    Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Jalali, Arash
    Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden .
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden .
    Socioeconomic status and in hospital mortality of acute corony syndrome: Can education and occupation serves as preventive measures?2015In: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 6, article id Art. no. 6:36Article in journal (Refereed)
    Abstract [en]

    Background: Socioeconomic status (SES) can greatly affect the clinical outcome of medical problems. We sought to assess the in‑hospital mortality of patients with the acute coronarysyndrome (ACS) according to their SES.

    Methods: All patients admitted to Tehran Heart Center due to 1st‑time ACS between March 2004 and August 2011 were assessed. The patients who were illiterate/lowly educated (≤5 years attained education) and were unemployed were considered low‑SES patients and those who were employed and had high educational levels (>5 years attained education) were regarded as high‑SES patients. Demographic, clinical, paraclinical, and in‑hospital medical progress data were recorded. Death during the course of hospitalization was considered the end point, and the impact of SES on in‑hospital mortality was evaluated.

    Results: A total of 6246 hospitalized patients (3290 low SES and 2956 high SES) were included (mean age = 60.3 ± 12.1 years, male = 2772 [44.4%]). Among them, 79 (1.26%) patients died. Univariable analysis showed a significantly higher mortality rate in the low‑SES group (1.9% vs. 0.6%; P < 0.001). After adjustment for possible cofounders, SES still showed a significant effect on the in‑hospital mortality of the ACS patients in that the high‑SES patients had a lower in‑hospital mortality rate (odds ratio: 0.304, 95% confidence interval: 0.094–0.980; P = 0.046).

    Conclusions: This study found that patients with low SES were at a higher risk of in‑hospital mortality due to the ACS. Furthermore, the results suggest the need for increased availability of jobs as well as improved levels of education as preventive measures to curb the unfolding deaths owing to coronary artery syndrome.

  • 4.
    Abbasi, Seyed
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Jalali, A
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Mortality by acute Coronary syndrome in Iran: Does place of residence matter?In: Article in journal (Refereed)
  • 5.
    Almén, Niclas
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Effects of a Recovery-Focused Intervention for Stress Management: A Randomized Controlled Trial2015Conference paper (Refereed)
    Abstract [en]

    Abstract

    INTRODUCTION

    Stress symptoms, burnout, poor mental health and long-term sick leave related to these are major problems in Sweden and elsewhere. Evidence-based prevention and treatment efforts are lacking. Research indicates that stress related health problems primarily could be conceptualized as deficiencies in recovery responses between stress periods rather than high level of stress responses per se. Therefore it is relevant to examine whether it is effective to intervene the recovery behavior – instead of the stress behavior - of people with stress symptoms.

    OBJECTIVES

    The primary purpose of this study was to investigate if a behavioral oriented recovery management intervention could enhance “recovery behaviors” and experiences of recovery and reduce stress related ill health.

    METHODS A group based intervention program focusing exclusively on “recovery behavior” in everyday life (earlier developed and tested in two pilot studies) was evaluated in an experimental group study. The intervention consisted of seven group sessions of 2.5 hours over a period of approximately 10 weeks supplemented by an internet based treatment support system. Self- referred subjects with scores above 24.4 on the Perceived stress scale were randomized to the intervention (n=26) or a waiting-list (n=33).

    RESUL T

    Statistically significant and clinically relevant effects were achieved for the intervention group compare to the waiting-list group: recovery behaviors and experiences of recovery were increased, and levels of perceived stress, worry, anxiety, depression and exhaustion were decreased.

    DISCUSSION These results are in line with two previous pilot studies that we have done. A behavioral and recovery oriented intervention seems to be effective to increase the recovery of the individual and decrease stress related ill health. There are reasons to continue to explore the potential of recovery-oriented interventions for example for different populations (such as people with more extensive clinical health problems) and in different contexts. 

  • 6.
    Almén, Niclas
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Lundberg, Hanna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Jansson, Billy
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    The reliability and factorial validity of the Swedish version of the Recovery Experience Questionnaire2018In: Nordic Psychology, ISSN 1901-2276, E-ISSN 1904-0016, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Recent research has indicated that recovery from work stress and effort might be crucial for health and well-being. Thus, a valid measurement of recovery becomes important. The main purpose of the present study was to empirically evaluate and seeking support for the hypothesized four-factor model of the Swedish version of Recovery Experience Questionnaire (REQ). The total sample (N = 680) was randomly split into two subsamples. The first subsample was used for finding the best-fitting model using an exploratory factor analysis and the second subsample was used to test the a priori model using confirmatory factor analysis. The results support the proposed four-factor structure of the scale for both males and females. Additionally, apart from high reliability estimates, this instrument proved to have good convergent and discriminant validity for all four factors. Implications for the use of the REQ in conjunction with recovery-focused interventions were discussed, as were limitations such as low response rate. 

  • 7.
    Bernhardsson, Jens
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Bjärtå, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Esteves, Francisco
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    INDEPENDENT COMPONENT ANALYSIS OF N2pc DURING FEAR PROCESSING2013In: Psychophysiology, ISSN 0048-5772, E-ISSN 1469-8986, Vol. 50, p. S119-S119Article in journal (Other academic)
  • 8.
    Bernhardsson, Jens
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Bjärtå, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Esteves, Francisco
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Make no mistake: You are being watched2017Conference paper (Refereed)
  • 9.
    Bernhardsson, Jens
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Bjärtå, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Changes in Event Related Potentials after exposure therapy for spider phobic individuals2016In: International Journal of Psychophysiology, ISSN 0167-8760, E-ISSN 1872-7697, Vol. 108, p. 105-106Article in journal (Other academic)
    Abstract [en]

    The present study was conducted in order to investigate treatment effects in spider phobic individuals on EEG and eye movements. A previous study has shown larger ERP amplitudes in the late positive complex (LPC) post treatment compared to pre treatment during exposure of spider pictures (Leutgeb, Schäfer, & Schienle, 2009). The authors hypothesize that the result might mirror an increase in attention towards the stimuli and reduced attentional avoidance generating enhanced LPC amplitude as a consequence of directing attention to the spider pictures post treatment. In the present study spider fearful individuals (treatment and waitlist group) and control individuals were measured with EEG and Eye tracking during exposure to pictures of spiders, snakes and flowers pre and post treatment. Based on behavioral and self-assessed measures treatment effects were high. Contrary to Leutgeb et al. (2009), our results showed relatively smaller LPC amplitudes post treatment during presentations of spider pictures. Moreover, the eye movement data indicated no avoidance from spider pictures compared to other pictures, neither pre nor post treatment. These results indicate that when individuals attend to visual threat stimuli, LPC amplitude differences follow the pattern of emotional significance and attention allocation.

  • 10.
    Bjärtå, Anna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Bernhardsson, Jens
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Ekström, Johan
    Tedgård, Tomas
    Flykt, Anders
    Högskolan i Gävle.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Threat of threat changes processing of fear-relevant stimuli2010Conference paper (Other academic)
  • 11.
    Bjärtå, Anna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Flykt, Anders
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Concurrent cognitive demands influence allocation of attention resources during fear processing.Manuscript (preprint) (Other academic)
    Abstract [en]

    Influences of a concurrent cognitive demand on allocation of attentional resources and physiological responses to threatening stimuli was investigated. In two secondary task experiments, pictures of fear-relevant and fear-irrelevant stimuli (Experiment 1), as well as feared and non-feared stimuli (Experiment 2), were used as backgrounds in a discrimination task. The cognitive manipulation was provided by a constraint, induced with a threat of punishment motivating participants to respond quick and accurately. The control condition imposed no such constraint. Results showed a larger allocation of attentional resources for both fear-relevant and feared stimuli. More importantly, it was also shown that resources allocated to threatening stimuli could be manipulated by a concurrent cognitive demand. However, both response accuracy and physiological reactions persisted the manipulation when a feared versus a non-feared animal was shown, indicating that attentional resources can be manipulated by an internal cognitive demand even though a fear reaction occurs.

  • 12.
    Bjärtå, Anna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Flykt, Anders
    Department of Social Work and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Sweden .
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    The effect of using different distractor sets in visual search with spiders and snakes on spider-sensitive and non-fearful participants.2013In: Swiss Journal of Psychology, ISSN 1421-0185, E-ISSN 1662-0879, Vol. 72, no 4, p. 171-179Article in journal (Refereed)
    Abstract [en]

    In two visual search experiments, the impact of distractor sets on fear relevant stimuli was investigated.  A search set with spiders, snakes, flowers, and mushrooms was compared to a search set with spiders, snakes, rabbits, and turtles. Speeded responses to spider and snake targets were found when flowers and mushrooms served as distractors, but no such effect occurred with rabbit and turtle distractors. In Experiment 2, spider sensitive individuals were compared to non-fearful individuals. Spider sensitive individuals responded faster to spider targets than did non-fearful individuals, but only in the set with flowers and mushrooms.  When using rabbit and turtle distractors, spider sensitive individuals did not show any speeded responses to their feared animal. These results indicate that behavioural expressions of the visual search task depends not only on the individual’s relationship to the stimuli included in a search set, but also on the context in which feared or fear relevant objects are presented.

  • 13.
    Burell, Gunilla
    et al.
    Uppsala universitet.
    Öhman, Arne
    Karolinska institutet.
    Sundin, Örjan
    Uppsala universitet.
    Ström, G
    Ramund, B
    ICullhed,
    C EThoresen,
    Modification of the type A behavior pattern in post-myocardial infarction patients: A route to cardiac rehabilitation1994In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 1, no 1, p. 32-54Article in journal (Refereed)
  • 14.
    Collste, Olov
    et al.
    Departments of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Tornvall, Per
    Departments of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Alam,l, Mahbubul
    Departments of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden .
    Frick, Mats
    Departments of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
    No Myocardial Vulnerability to Mental Stress in Takotsubo Stress Cardiomyopathy2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 4, p. Art. no. e93697-Article in journal (Refereed)
    Abstract [en]

    Objectives: Due to the frequent use of coronary angiography the awareness of Takotsubo stress cardiomyopathy (TSC) has increased although the exact pathophysiology of TSC is still largely unknown. Our objective was to investigate the effects of mental stress on myocardial function, heart rate variability (HRV) and salivary cortisol (SC) in TSC patients. Design: This study is a case-control study and a sub-study of the Stockholm Myocardial Infarction with Normal Coronaries (SMINC) study. Setting: Mental stress test was performed more than 6 months after the acute event in TSC patients and age- and sex-matched controls. Standard echocardiography and tissue Doppler imaging (TDI) - derived time-phases of cardiac cycle were recorded to calculate myocardial performance index (MPI) to assess ventricular function before and during mental stress. Holter-ECG recording was made to estimate HRV before, during and after mental stress. SC was measured at baseline, before and 20 minutes after mental stress. Subjects: Twenty-two TSC patients and 22 sex-and age- matched controls were recruited from the SMINC-study and investigated with a mental stress test. All TSC patients had a previous normal cardiovascular magnetic resonance investigation. Results: There were no significant differences at rest or during mental stress for left and right ventricular MPI or other standard diastolic variables between TSC patients and controls. HRV did not differ between TSC patients and controls. There was a trend towards less increase in SC after mental stress in TSC patients compared to controls. Conclusion: Mental stress did not induce a significant difference in myocardial function or HRV response between TSC and controls. Moreover, no significant difference could be seen in SC response at baseline, during or after mental stress. This study indicates that myocardial vulnerability to mental stress does not persist in TSC patients.

  • 15.
    Costa, D
    et al.
    University of Porto, Porto, Portugal.
    Hatzidimitriadou, E
    Canterbury Christ Church University, Canterbury, Kent, UK.
    Ioannidi-Kapolo, E
    National School of Public Health Athens, Athens, Greece.
    Lindert, J
    Protestant University of Applied Sciences Ludwigsburg, Ludwigsburg, Germany; University of Applied Sciences Emden, Emden, Germany; WRSC, Brandeis University, Waltham, MA, USA.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Toth, O
    Hungarian Academy of Sciences, Budapest, Hungary.
    Barros, H
    University of Porto and University of Porto Medical School, Porto, Portugal.
    The impact of intimate partner violence on forgone healthcare: a population-based, multicentre European study2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360XArticle in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    To examine the relationship between forgone healthcare and involvement in intimate partner violence (IPV) as victims, perpetrators or both.

    METHODS:

    This cross-sectional multicentre study assessed community non-institutionalized residents (n = 3496, aged 18-64) randomly selected from six European cities: Athens, Budapest, London, Östersund, Porto, Stuttgart. A common questionnaire was used, including self-reports of IPV and forgone healthcare ('Have you been in need of a certain care service in the past year, but did not seek any help?'). Odds ratios (ORs), 95% confidence intervals (CIs) were computed fitting logistic regression models adjusted for city, chronic disease, self-assessed health status and financial strain.

    RESULTS:

    Participants experiencing past year IPV (vs. no violence) reported more often to forgone healthcare (n = 3279, 18.6% vs. 15.3%, P = 0.016). IPV experienced as both a victim and perpetrator was associated with forgone healthcare (adjusted OR, 95%CI: 1.32, 1.02-1.70).

    CONCLUSION:

    IPV was associated with forgone healthcare, particularly for those experiencing violence as both victims and perpetrators. Results suggest that preventing IPV among adults may improve timely healthcare uptake.

  • 16.
    Costa, D.
    et al.
    Institute of Public Health, University of Porto, Porto, Portugal.
    Hatzidimitriadou, E.
    Faculty of Health and Social Care Sciences, Kingston University, London, United Kingdom.
    Ioannidi-Kapolou, E.
    Department of Sociology, National School of Public Health, Athens, Greece.
    Lindert, J.
    University of Emden, Emden, Germany.
    Soares, Joaquim J.F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Toth, O.
    Institute of Sociology, Hungarian Academy of Sciences, Budapest, Hungary.
    Barros, H.
    Institute of Public Health, University of Porto, Porto, Portugal.
    Male and female physical intimate partner violence and socio-economic position: a cross-sectional international multicentre study in Europe2016In: Journal of Public Health, ISSN 2198-1833, E-ISSN 1613-2238, Vol. 139, p. 44-52Article in journal (Refereed)
    Abstract [en]

    Objectives

    This work explores the association between socio-economic position (SEP) and intimate partner violence (IPV) considering the perspectives of men and women as victims, perpetrators and as both (bidirectional).

    Study design

    Cross-sectional international multicentre study.

    Methods

    A sample of 3496 men and women, (aged 18–64 years), randomly selected from the general population of residents from six European cities was assessed: Athens; Budapest; London; Östersund; Porto; and Stuttgart. Their education (primary, secondary and university), occupation (upper white collar, lower white collar and blue collar) and unemployment duration (never, ≤12 months and >12 months) were considered as SEP indicators and physical IPV was measured with the Revised Conflict Tactics Scales.

    Results

    Past year physical IPV was declared by 17.7% of women (3.5% victims, 4.2% perpetrators and 10.0% bidirectional) and 19.8% of men (4.1% victims, 3.8% perpetrators and 11.9% bidirectional). Low educational level (primary vs university) was associated with female victimisation (adjusted odds ratio, 95% confidence interval: 3.2; 1.3–8.0) and with female bidirectional IPV (4.1, 2.4–7.1). Blue collar occupation (vs upper white) was associated with female victimisation (2.1, 1.1–4.0), female perpetration (3.0, 1.3–6.8) and female bidirectional IPV (4.0, 2.3–7.0). Unemployment duration was associated with male perpetration (>12 months of unemployment vs never unemployed: 3.8; 1.7–8.7) and with bidirectional IPV in both sex (women: 1.8, 1.2–2.7; men: 1.7, 1.0–2.8).

    Conclusions

    In these European centres, physical IPV was associated with a disadvantaged SEP. A consistent socio-economic gradient was observed in female bidirectional involvement, but victims or perpetrators-only presented gender specificities according to levels of education, occupation differentiation and unemployment duration potentially useful for designing interventions.

  • 17.
    Costa, D
    et al.
    Institute of Public Health, University of Porto, Rua das Taipas, 135, Porto, 4050-600, Portugal .
    Hatzidimitriadou, E
    Faculty of Health and Social Care Sciences, Kingston University and St George's, University of London, London, United Kingdom .
    Ioannidi-Kapolou, E
    Department of Sociology, National School of Public Health, Athens, Greece .
    Lindert, J
    University of Emden, Emden, Germany .
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Toth, O
    Institute of Sociology, Hungarian Academy of Sciences, Budapest, Hungary .
    Barros, H
    Institute of Public Health, University of Porto, Rua das Taipas, 135, Porto, 4050-600, Portugal .
    Intimate partner violence and health-related quality of life in European men and women: Findings from the DOVE study2015In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 24, no 2, p. 463-473Article in journal (Refereed)
    Abstract [en]

    Abstract

    Purpose

    Little is known on the specific relation between

    being a perpetrator or both a victim and perpetrator of

    intimate partner violence (IPV) and health-related quality

    of life (HRQoL). We assessed the association between

    HRQoL and abuse, considering men and women as victims,

    perpetrators or reciprocally.

    Methods

    Participants were adult men and women

    (

    n=

    3,496), randomly selected from the general population

    of six European cities. The Revised-Conflict-Tactics-Scales

    and the Medical-Outcomes-Study 36-item Short-Form

    Health Survey (SF-36) were used to measure IPV and

    HRQoL. The age-, education-, and city-adjusted mean

    scores[standard error] of the physical and of the mental SF-

    36 component summaries were used to compare victimsonly,

    perpetrators-only, and those involved in both (bidirectional

    or reciprocal cases) with those not involved in pastyear

    and lifetime physical assault and/or sexual coercion.

    Results

    The physical component summary was significantly

    lower in women involved in past-year bidirectional

    physical assault compared with non-abused women. The

    mental component summary in women not involved in IPV

    was significantly higher than in those physically abused,

    regardless of type of involvement. Women victims-only of

    past-year sexual coercion and victims or involved in bidirectional

    concomitant physical and sexual IPV also presented

    lower scores in the mental component summary than

    women not involved in IPV. In men, significantly lower

    scores in the mental component summary were found in the

    past-year bidirectional physically assaulted group and

    among those involved bidirectionally in both physical and

    sexual IPV compared with men not involved in IPV.

  • 18.
    Costa, D.
    et al.
    Univ Porto, P-4100 Oporto, Portugal..
    Hatzidimitriadou, E.
    Univ Kingston, London, England.
    Ioannidi-Kapolou, E.
    Natl Sch Publ Hlth, Athens, Greece..
    Lindert, J.
    Univ Emden, Emden, Germany.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Mid Sweden Univ, Sundsvall, Sweden..
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology. Mid Sweden Univ, Ostersund, Sweden..
    Toth, O.
    Hungarian Acad Sci, Budapest, Hungary..
    Barros, H.
    Univ Porto, Inst Publ Hlth, P-4100 Oporto, Portugal..
    Physical Intimate Partner Violence in Europe: Results from a Population-Based Multi-Center Study in Six Countries.2015In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 44, no S1, p. 264-264, article id 3583Article in journal (Other academic)
  • 19.
    Costa, D
    et al.
    EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal .
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Lindert, J
    University of Emden, Emden, Germany .
    Hatzidimitriadou, E
    Faculty of Health and Social Care Sciences, Kingston University, London, United Kingdom .
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Toth, O
    Institute of Sociology, Hungarian Academy of Sciences, Budapest, Hungary .
    Ioannidi-Kapolo, E
    National School of Public Health Athens, Athens, Greece .
    Barros, H
    EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal .
    Intimate partner violence: a study in men and women from six European countries2015In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 60, no 4, p. 467-478Article in journal (Refereed)
    Abstract [en]

    Objectives We aimed to assess intimate partner violence

    (IPV) among men and women from six cities in six European

    countries.

    Methods Four IPV types were measured in a populationbased

    multicentre study of adults (18–64 years;

    n = 3,496). Sex- and city-differences in past year prevalence

    were examined considering victims, perpetrators or

    both and considering violent acts’ severity and repetition.

    Results Male victimization of psychological aggression

    ranged from 48.8 % (Porto) to 71.8 % (Athens) and female

    victimization from 46.4 % (Budapest) to 70.5 % (Athens).

    Male and female victimization of sexual coercion ranged

    from 5.4 and 8.9 %, respectively, in Budapest to 27.1 and

    25.3 % in Stuttgart. Male and female victims of physical

    assault ranged from 9.7 and 8.5 %, respectively, in Porto,

    to 31.2 and 23.1 % in Athens. Male victims of injury were

    2.7 % in O¨ stersund and 6.3 % in London and female victims

    were 1.4 % in O¨ stersund and 8.5 % in Stuttgart. IPV

    differed significantly across cities (p\0.05). Men and

    women predominantly experienced IPV as both victims

    and perpetrators with few significant sex-differences within

    cities.

    Conclusions Results support the need to consider men

    and women as both potential victims and perpetrators when

    approaching IPV.

  • 20. Costa, Diogo
    et al.
    Hatzidimitriadou, Eleni
    Ioannidi-Kapolou, Elli
    Lindert, Jutta
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Toth, Olga
    Barros, Henrique
    Forgone healthcare and intimate partner violence: A study in six European urban centres2014Conference paper (Refereed)
    Abstract [en]

    Background: Victims of intimate partner violence (IPV) are known to refrain from seeking care when in need. Whether the impact on forgone care differs according to the victim-perpetrator role remains unexplored. We aimed to describe the relation between past-year IPV and forgone healthcare according to victims, perpetrators or both (bidirectional). Methods: Adult men and women (n=3496, aged 18-64), randomly sampled from the general population of Athens, Porto, London, Budapest, Östersund and Stuttgart were assessed using a common questionnaire. IPV was ascertained with the Revised-Conflict-Tactics-Scales. The association between IPV and forgone healthcare (“Have you been in need of a certain care service in the past year, but did not seek any help?”), sociodemographics (sex, age, education, city) and health factors (self-assessed health, public or private healthcare sector use), in victims, perpetrators and both was estimated using adjusted logistic regression odds ratios (AOR, 95% confidence intervals). Results: Forgone healthcare ranged from 12.6% (Budapest) to 22.4% (Stuttgart) and was associated with bidirectional involvement in IPV (AOR, 95%CI= 1.37, 1.05-1.78). A lower educational level was associated with forgone care in multivariate models fitted for victims of and for bidirectional involvement in IPV. A fair/poor self-assessed health (contrasting to a good/very good/excellent health) was significantly associated with forgone care in victims (AOR, 95%CI=2.61, 1.96-3.47), in bidirectional IPV (AOR, 95%CI=2.94, 2.27-3.82) and for perpetrators (AOR, 95%CI=2.58, 1.96-3.40). Conclusion: Beside the known barriers identified for inequalities and access to healthcare, the role of IPV in forgone healthcare should be considered.

     

  • 21.
    Costa, Diogo
    et al.
    Institute of Public Health, University of Porto, Porto, Portugal.
    Soares, Joaquim J. F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Lindert, Jutta
    Department of Public Health, Protestant University of Applied Sciences Ludwigsburg, Ludwigsburg, Germany.
    Hatzidimitriadou, Eleni
    Faculty of Health and Social Care Sciences, Kingston University and St George's, University of London, London, United Kingdom.
    Karlsson, Andreas
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Toth, Olga
    Institute of Sociology, Hungarian Academy of Sciences, Budapest, Hungary.
    Ioannidi-Kapolo, Ellisabeth
    Institute of Sociology, Hungarian Academy of Sciences, Budapest, Hungary.
    Degomme, Oliver
    International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium.
    Cervilla, Jorge
    Departmental Section of Psychiatry and Psychological Medicine, University of Granada, Granada, Spain.
    Barros, Henrique
    Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
    Intimate partner violence in Europe: design and methods of a multinational study.: La violencia de pareja en Europa: diseño y métodos de un estudio multinacional2013In: Gaceta Sanitaria, ISSN 0213-9111, E-ISSN 1578-1283, Vol. 27, no 6, p. 558-561Article in journal (Refereed)
    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.

  • 22.
    Daniel, M.
    et al.
    Karolinska Institutet, Stockholm.
    Agewall, S.
    University of Oslo, Norway, Norway.
    Berglund, F.
    Karolinska Institutet, Stockholm.
    Caidahl, K.
    Karolinska Institutet, Stockholm; Sahlgrenska Academy, University of Gothenburg.
    Collste, O.
    Karolinska Institutet, Stockholm.
    Ekenbäck, C.
    Danderyd Hospital.
    Frick, M.
    Karolinska Institutet, Stockholm.
    Henareh, L.
    Department of Medicine, Huddinge.
    Jernberg, T.
    Danderyd Hospital.
    Malmqvist, K.
    Danderyd Hospital.
    Schenck-Gustafsson, K.
    Cardiac Unit, Solna; Karolinska Institutet, Stockholm.
    Spaak, J.
    Danderyd Hospital.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sörensson, P.
    Cardiac Unit, Solna.
    Y-Hassan, S.
    Department of Medicine, Huddinge.
    Hofman-Bang, C.
    Danderyd Hospital.
    Tornvall, P.
    Karolinska Institutet, Stockholm.
    Prevalence of Anxiety and Depression Symptoms in Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries2018In: American Journal of Medicine, ISSN 0002-9343, E-ISSN 1555-7162, Vol. 131, no 9, p. 1118-1124Article in journal (Refereed)
    Abstract [en]

    Background: Myocardial infarction with non-obstructive coronary arteries is a working diagnosis for several heart disorders. Previous studies on anxiety and depression in patients with myocardial infarction with non-obstructive coronary arteries are lacking. Our aim was to investigate the prevalence of anxiety and depression among patients with myocardial infarction with non-obstructive coronary arteries. Methods: We included 99 patients with myocardial infarction with non-obstructive coronary arteries together with age- and sex-matched control groups who completed the Beck Depression Inventory and the Hospital Anxiety and Depression Scale (HADS) 3 months after the acute event. Results: Using the Beck Depression Inventory, we found that the prevalence of depression in patients with myocardial infarction with non-obstructive coronary arteries (35%) was higher than in healthy controls (9%; P =.006) and similar to that of patients with coronary heart disease (30%; P =.954). Using the HADS anxiety subscale, we found that the prevalence of anxiety in patients with myocardial infarction with non-obstructive coronary arteries (27%) was higher than in healthy controls (9%; P =.002) and similar to that of patients with coronary heart disease (21%; P =.409). Using the HADS depression subscale, we found that the prevalence of depression in patients with myocardial infarction with non-obstructive coronary arteries (17%) was higher than in healthy controls (4%; P =.003) and similar to that of patients with coronary heart disease (13%; P =.466). Patients with myocardial infarction with non-obstructive coronary arteries and takotsubo syndrome scored higher on the HADS anxiety subscale than those without (P =.028). Conclusions: This is the first study on the mental health of patients with myocardial infarction with non-obstructive coronary arteries to show that prevalence rates of anxiety and depression are similar to those in patients with coronary heart disease. 

  • 23.
    Daniel, Maria
    et al.
    Karolinska Institutet, Stockholm.
    Agewall, Stefan
    Karolinska Institutet, Stockholm.
    Caidahl, Kenneth
    Karolinska Institutet, Stockholm.
    Collste, Olov
    Karolinska Institutet, Stockholm.
    Ekenbäck, Christina
    Karolinska Institutet, Stockholm.
    Frick, Mats
    Karolinska Institutet, Stockholm.
    Y-Hassan, Shams
    Karolinska Institutet, Stockholm.
    Henareh, Logman
    Karolinska Institutet, Stockholm.
    Jernberg, Tomas
    Karolinska Institutet, Stockholm.
    Malmqvist, Karin
    Karolinska Institutet, Stockholm.
    Schenck-Gustafsson, Karin
    Karolinska Institutet, Stockholm.
    Sörensson, Peder
    Karolinska Institutet, Stockholm.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Hofman-Bang, Claes
    Karolinska Institutet, Stockholm.
    Tornvall, Per
    Karolinska Institutet, Stockholm.
    Effect of Myocardial Infarction With Nonobstructive Coronary Arteries on Physical Capacity and Quality-of-Life2017In: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 120, no 3, p. 341-346Article in journal (Refereed)
    Abstract [en]

    Patients with myocardial infarction with nonobstructive coronary arteries (MINOCA), including Takotsubo syndrome (TS), are considered to have a better survival compared with those with coronary heart disease (CHD). Studies of patients with MINOCA measuring physical and mental function including matched control groups are lacking. The aim of this study was to determine the physical capacity and quality of life in patients with MINOCA. One-hundred patients with MINOCA along with TS (25%) were investigated from 2007 to 2011. A bicycle exercise stress test was performed 6 weeks after hospitalization and QoL was investigated by the Short Form Survey 36 at 3 months' follow-up. Both a healthy and a CHD group that were age and gender matched were used as controls. The MINOCA group had a lower physical capacity (139 ± 42 W) compared with the healthy control group (167 ± 53 W, p <0.001) but better than the CHD control group (124 ± 39 W, p = 0.023). Patients with MINOCA had lower physical and mental component summary scores compared with the healthy controls (p <0.001) and lower mental component summary (p = 0.012), mental health (p = 0.016), and vitality (p = 0.008) scores compared with the CHD controls. In conclusion, the findings of this first study on exercise capacity and QoL in patients with MINOCA showed both physical and mental distress from 6 weeks to 3 months after the acute event similar to CHD controls and in some perspectives even lower scores especially in the mental component of QoL.

  • 24.
    Dias, NG
    et al.
    EpiUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal; Departamento de Saúde Coletiva da Faculdade de Medicina da Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil.
    Costa, D
    EpiUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
    Soares, Joaquim
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. EpiUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
    Hatzidimitriadou, E
    Faculty of Health and Social Care Sciences, Kingston University and St George’s, University of London, London, UK.
    Ioannidi-Kapolou, E
    Department of Sociology, National School of Public Health Athens, Athens, Greece.
    Lindert, J
    University of Applied Sciences Emden, Emden, Germany Women’s Studies Research Center, Brandeis University, Waltham, MA, USA.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Toth, O
    Institute of Sociology, Hungarian Academy of Sciences, Budapest, Hungary.
    Barros, H
    EpiUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
    Fraga, S
    EpiUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.
    Social support and the intimate partner violence victimization among adults from six European countries2018In: Article in journal (Refereed)
    Abstract [en]

    Background

    Social support may buffer the negative effects of violence on physical and mental health. Family medicine providers play an essential role in identifying the available social support and intervening in intimate partner violence (IPV).

    Objective

    This study aimed at assessing the association between social support and the IPV victimization among adults from six European countries.

    Methods

    This is a cross-sectional multi-centre study that included individuals from Athens (Greece), Budapest (Hungary), London (UK), Östersund (Sweden), Porto (Portugal) and Stuttgart (Germany). Data collection was carried out between September 2010 and May 2011. The sample consisted of 3496 adults aged 18–64 years randomly selected from the general population in each city. The revised Conflict Tactics Scales was used to assess IPV victimization. Social support was assessed with the Multidimensional Scale of Perceived Social Support.

    Results

    Participants reporting physical assault victimization experienced lower social support (mean ± SD) than their counterparts, 66.1 ± 13.96 versus 71.7 ± 12.90, P< 0.001, for women; and 67.1 ± 13.69 versus 69.5 ± 13.52, P = 0.002 for men. Similar results were found regarding sexual coercion victimization, 69.1 ± 14.03 versus 71.3 ± 12.97, P = 0.005 for women and 68.0 ± 13.29 versus 69.3 ± 13.62, P= 0.021 for men. This study revealed lower levels of social support among participants reporting lifetime and past year victimization, independent of demographic, social and health-related factors.

    Conclusion

    Results showed a statistically significant association between low social support and IPV victimization. Although the specific mechanisms linking social support with experiences of violence need further investigation, it seems that both informal and formal networks may be associated with lower levels of abusive situations.

  • 25.
    Eriksson, Lina J. K.
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Jansson, Billy
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    The interactive effect of the Behavioral Inhibition System (BIS) and response inhibition on accuracy in a modified stop-signal task2016In: Personality and Individual Differences, ISSN 0191-8869, E-ISSN 1873-3549, Vol. 97, p. 198-202Article in journal (Refereed)
    Abstract [en]

    The ability to adjust to a changing environment is an important aspect of every-day life and successful goal directed behavior requires the ability to suppress responses that are no longer appropriate. The main purpose of the present study was to examine if the relationship between inhibitory control (as indexed by stop-signal reaction time, SSRT) and behavioral precision is dependent on levels of Gray and McNaughton's Behavioral Inhibition System (BIS). Additionally, the relationship between BIS and electrodermal activity, and the Behavioral Approach System (BAS) and heart rate activity was investigated. A modified stop-signal task was used. The results showed that there was an interaction effect of BIS and SSRT on accuracy, suggesting that among individuals with higher levels of BIS, longer SSRT (i.e. poorer inhibitory ability) was associated with decreased accuracy. There were no significant correlations between trait variables and physiological variables. The results were discussed in terms of higher levels of BIS being a vulnerability factor when the individual's inhibitory ability simultaneously is poor in situations where the ability to inhibit inappropriate behavioral routines is important for task performance.

  • 26.
    Eslami, Bahareh
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden .
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Khankeh, HR
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim J. F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Public Health Sciences, Institution of Social Medicine, Karolinska Institutet, Stockholm, Sweden .
    Quality of life and life satisfaction among adults with and without congenital heart disease in a developing country2015In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 22, no 2, p. 169-179Article in journal (Refereed)
    Abstract [en]

    Background Life-expectancy of adults with congenital heart disease (CHD) has improved world-wide, but there are limited data on these patients' experiences of quality of life (QoL), life satisfaction (LS), and their determinants (e.g. social support), particularly among patients from developing countries.

    Design Cross-sectional case-control.

    Methods A total of 347 CHD patients (18-64 years, 52.2% women) and 353 non-CHD participants, matched by sex/age, were recruited from two heart hospitals in Tehran, Iran. LS and QoL served as dependent variables, and demographic/socioeconomic status, mental-somatic symptoms, social support, and clinical factors (e.g. defect category) served as independent variables in multiple regression analyses once among all participants, and once only among CHD patients.

    Results The CHD patients had significantly lower scores in LS and all domains of QoL than the control group. However, having CHD was independently negatively associated only with overall QoL, physical health, and life and health satisfaction. Additionally, multivariate analyses among the CHD patients revealed that female sex, younger age, being employed, less emotional distress, and higher social support were significantly associated with higher perceived QoL in most domains, while LS was associated with female sex, being employed, less emotional distress, and better social support. Neither QoL nor LS was associated with cardiac defect severity.

    Conclusions The adults with CHD had poorer QoL and LS than their non-CHD peers in our developing country. Socio-demographics, emotional health, and social support were important 'determinants' of QoL and LS among the CHD patients. Longitudinal studies are warranted to establish causal links.

  • 27.
    Eslami, Bahareh
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Occupational and Public Health Sciences University of Gävle Gävle Sweden .
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Khankeh, HR
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim J. F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Public Health Sciences Institution of Social Medicine, Karolinska Institutet Stockholm Sweden .
    Style of Coping and its Determinants in Adults with Congenital Heart Disease in a Developing Country2014In: Congenital Heart Disease, ISSN 1747-079X, E-ISSN 1747-0803, Vol. 9, no 4, p. 349-360Article in journal (Refereed)
    Abstract [en]

    Objective The objective of this study is to compare coping strategies between adults with and without congenital heart disease and to scrutinize the associations between different available resources (e.g., social support) and adoption of certain coping strategies.

    DesignThe study has a cross-sectional case-control design.

    SettingThe study was conducted in two university-affilliated heart hospitals in Tehran, Iran.

    Patients The participants comprised 347 persons (18–64 years) with and 353 individuals without congenital heart disease, matched by gender and age.

    Outcome Measures Coping strategies, assessed with the Utrecht Coping List-short form, were compared between both groups. Block-wise multiple regression analyses were conducted to scrutinize the associations between different independent variables (e.g., demographic/socioeconomic statuses) and adoption of certain styles of coping (dependent variables) among all participants and separately for each group.

    Results The styles of coping in the patients were comparable with those of the control group. Multivariate analyses revealed that congenital heart disease per se was not associated with style of coping except for palliative reaction pattern. The active problem-solving coping style was associated with never married marital status, parenthood, unemployment, higher level of anxiety/somatic symptoms, lower level of depressive symptoms, and better social support. The avoidance behavior style was associated with having a low income, whereas the expression of emotion style was associated with higher anxiety symptoms, experience of financial strain, and income. None of the adopted coping strategies was related to the heart disease variables.

    Conclusions The adults with congenital heart disease coped as well as adults without congenital heart disease. Marital status, parenthood, annual income, financial strain, psychological adjustment, and perceived social support were important explanatory factors in adopting a certain style of coping among adults with congenital heart disease. However, longitudinal studies with repeated measures are warranted.

  • 28.
    Eslami, Bahareh
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran .
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden .
    Khankeh, Hamid Reza
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim J. F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Division of Social Medicine, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden .
    Gender differences in health conditions and socio-economic status of adults with congenital heart disease in a developing country2013In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 23, no 02, p. 209-218Article in journal (Refereed)
    Abstract [en]

    Background Providing appropriate care for adults with congenital heart disease requires the evaluation of their current situation. There is limited research in Iran about these patients, particularly in relation to gender differences in the demographic/socio-economic and lifestyle factors, as well as disease parameters.

    Materials and methods The sample consisted of 347 congenital heart disease patients in the age group of 18–64 years, including 181 women, assessed by an analytical cross-sectional study. The patients were recruited from the two major heart hospitals in Tehran. Data were collected using questionnaires.

    Results The mean age of the patients was 33.24 years. Women were more often married and more often had offspring than men (p < 0.001). Educational level and annual income were similar between women and men. Unemployment was higher among women (p < 0.001), but financial strain was higher among men (p < 0.001). Smoking, alcohol, and water-pipe use was higher among men than among women (p < 0.001). Cardiac factors, for example number of cardiac defects, were similar among women and men, except that there were more hospitalisations owing to cardiac problems, for example arrhythmia, among men. Disease was diagnosed mostly at the hospital (57.4%). Most medical care was provided by cardiologists (65.1%). Only 50.1% of patients had knowledge about their type of cardiac defect.

    Conclusion Gender differences exist in the socio-economic and lifestyle characteristics of adults with congenital heart disease, in some cases related to the disease severity. Our findings also point to the need for interventions to increase patients’ knowledge about, and use of, healthier lifestyle behaviours, irrespective of gender. Furthermore, providing appropriate jobs, vocational training, and career counselling may help patients to be more productive.

  • 29.
    Eslami, Bahareh
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Macassa, Gloria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Khankeh, HR
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim J. F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Anxiety, depressive and somatic symptoms in adults with congenital heart disease2013In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 74, no 1, p. 49-56Article in journal (Refereed)
    Abstract [en]

    Objective

    Despite the improvement in life-expectancy of adults with congenital heart disease, they may experience unique medical and social challenges that could impact on their psychological functioning. The aims of this study were to address the experience of anxiety, depressive and somatic symptoms among adults with congenital heart disease in comparison with that of non-heart diseased persons considering the role of various factors (e.g. socio-economic).

    Methods

    In cross-sectional case–control study, the participants consisted of 347 patients with congenital heart disease (18–64 years, 52.2% female) and 353 matched (by sex/age) non-heart diseased persons. The participants completed a questionnaire. The data were analyzed with bivariate and multivariate methods.

    Results

    In bivariate analyses, scores in anxiety and somatic symptoms were higher among patients than the healthy controls (both at p ≤ 0.001), whereas the groups did not differ in depressive symptoms. Following multiple-linear-regression-analyses, only the association between congenital heart disease and somatic symptoms was confirmed. Among the patients, perceived financial strain was significantly related to anxiety, depressive and somatic symptoms; lower perceived social support to anxiety and depression; and low annual income to somatic symptoms. Additionally, somatic symptoms were associated with anxiety and depressive symptoms, and vice versa. And no medical variables were related to anxiety, depressive and somatic symptoms.

    Conclusions

    Congenital heart disease was only independently associated with somatic symptoms. Financial strain, social support and co-existence of emotional distress with somatic symptoms should be considered in developing appropriate interventions to improve the well-being of patients with congenital heart disease. However, longitudinal research is warranted to clarify causality.

  • 30.
    Esteves, Francisco
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Bernhardsson, Jens
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Jansson, Billy
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Emotional arousal and attention bias to female body shapes2017Conference paper (Refereed)
  • 31.
    Fredrikson, Mats
    et al.
    Uppsala universitet.
    Danilsons, Tomas
    Uppsala universitet.
    Iremark, Henrik
    Stockholms universitet.
    Sundin, Örjan
    Uppsala universitet.
    Autonomic nervous blockade and phobic fear responses1987In: Journal of Psychophysiology, ISSN 0269-8803, E-ISSN 2151-2124, Vol. 1, p. 35-43Article in journal (Refereed)
  • 32. Fredrikson, Mats
    et al.
    Linton, Steven J
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Melin, Lennart
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Öhman, Arne
    Öst, Lars-Göran
    Bohman, B
    Lundin, C
    Regeringens storsatsning mot psykisk ohälsa äventyrar patientsäkerheten.2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, p. 946-947Article in journal (Other academic)
  • 33.
    Fredrikson, Mats
    et al.
    Uppsala universitet.
    Tuomisto, Martti
    University of Tampere.
    Sundin, Örjan
    Classical conditioning of vascular responses in mild hypertensives and normotensives1990In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, no 8, p. 1105-1109Article in journal (Refereed)
  • 34.
    Gerdner, Arne
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Social Work.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Dubbel trubbel: nya vinklingar på gamla problem1998In: Dubbel trubbel: nya rön och erfarenheter i diagnos och behandling av samtidigt beroende och psykisk störning, Örebro: Behandlingshemmet Runnagården , 1998, p. 202-Chapter in book (Other academic)
  • 35.
    Grensman, Astrid
    et al.
    Karolinska Institutet.
    Acharya, Bikash Dev
    Karolinska Institutet.
    Wändell, Per
    Karolinska Institutet.
    Nilsson, Gunnar H.
    Karolinska Institutet.
    Falkenberg, Torkel
    Karolinska Institutet.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Werner, Sigbritt
    Karolinska Institutet.
    Effect of traditional yoga, mindfulness-based cognitive therapy, and cognitive behavioral therapy, on health related quality of life: A randomized controlled trial on patients on sick leave because of burnout2018In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 18, no 1, article id 80Article in journal (Refereed)
    Abstract [en]

    Background: To explore if health related quality of life(HRQoL) increased after traditional yoga(TY), mindfulness based cognitive therapy(MBCT), or cognitive behavioral therapy(CBT), in patients on sick leave because of burnout. Methods: Randomized controlled trial, blinded, in ninety-four primary health care patients, block randomized to TY, MBCT or CBT (active control) between September 2007 and November 2009. Patients were living in the Stockholm metropolitan area, Sweden, were aged 18-65 years and were on 50%-100% sick leave. A group treatment for 20 weeks, three hours per week, with homework four hours per week. HRQoL was measured by the SWED-QUAL questionnaire, comprising 67 items grouped into 13 subscales, each with a separate index, and scores from 0 (worse) to 100 (best). SWED-QUAL covers aspects of physical and emotional well-being, cognitive function, sleep, general health and social and sexual functioning. Statistics: Wilcoxon's rank sum and Wilcoxon's sign rank tests, Bonett-Price for medians and confidence intervals, and Cohen's D. Results: Twenty-six patients in the TY (21 women), and 27 patients in both the MBCT (24 women) and in the CBT (25 women), were analyzed. Ten subscales in TY and seven subscales in MBCT and CBT showed improvements, p <0.05, in several of the main domains affected in burnout, e.g. emotional well-being, physical well-being, cognitive function and sleep. The median improvement ranged from 0 to 27 points in TY, from 4 to 25 points in CBT and from 0 to 25 points in MBCT. The effect size was mainly medium or large. Comparison of treatments showed no statistical differences, but better effect (small) of both TY and MBCT compared to CBT. When comparing the effect of TY and MBCT, both showed a better effect (small) in two subscales each. Conclusions: A 20 week group treatment with TY, CBT or MBCT had equal effects on HRQoL, and particularly on main domains affected in burnout. This indicates that TY, MBCT and CBT can be used as both treatment and prevention, to improve HRQoL in patients on sick leave because of burnout, reducing the risk of future morbidity. 

  • 36.
    Grossi, Georgio
    et al.
    Inst Stressforskning Stockholms universitet.
    Thomten, Johanna
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Fandino-Losada, Andres
    Department of Public Health, Karolinska Institute.
    Soares, Joaquim J.F.
    Department of Public Health, Karolinska Institute.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Does burnout predict changes in pain experiences among women living in Sweden?: A longitudinal study2009In: Stress and Health, ISSN 1532-3005, E-ISSN 1532-2998, Vol. 25, no 4, p. 297-311Article in journal (Refereed)
    Abstract [en]

    The study investigated the associations between burnout—conceptualized as a syndrome of emotional exhaustion/physical fatigue and cognitive weariness—and pain parameters (overall pain, pain sites, intensity and frequency, and perceived disability) among 2,300 women living in Stockholm County. The study was a longitudinal panel survey with two assessments by means of questionnaires, 1 year apart. After adjustment for socio-demographic and work characteristics, smoking, psychological distress, physical health and basal pain parameters, T1 levels of burnout and/or their change scores were the most important predictors of overall pain, neck–shoulderpain, back pain and disability. Pain frequency was related to increases in tension and listlessness.

    The results indicated that burnout contributes to the onset and maintenance of pain and to the functional impairment that it causes. Further studies are needed to evaluate the extent to which pain and burnout, may be mutually reinforcing.

     

  • 37.
    Gunther, A. C.
    et al.
    Karolinska Inst, Dept Physiol & Pharmacol, Sect Anesthesiol & Intens Care, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Cardiothorac Surg & Anesthesiol, S-17176 Stockholm, Sweden..
    Schandl, A. R.
    Karolinska Inst, Dept Physiol & Pharmacol, Sect Anesthesiol & Intens Care, Stockholm; Karolinska Univ Hosp Solna, Dept Anesthesiol Surg Serv & Intens Care Med, Stockholm.
    Bernhardsson, Jens
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Bjärtå, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Wållgren, M.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Alvarsson, J.
    Royal Inst Technol, Marcus Wallenberg Lab, Dept Aeronaut & Vehicle Engn, Sch Engn Sci, Stockholm.
    Bottai, M.
    Karolinska Inst, Unit Biostat, Dept Environm Med, Stockholm.
    Martling, C. -R
    Karolinska Inst, Dept Physiol & Pharmacol, Sect Anesthesiol & Intens Care, Stockholm; Karolinska Univ Hosp Solna, Dept Anesthesiol Surg Serv & Intens Care Med, Stockholm.
    Sackey, P. V.
    Karolinska Inst, Dept Physiol & Pharmacol, Sect Anesthesiol & Intens Care, Stockholm; Karolinska Univ Hosp Solna, Dept Anesthesiol Surg Serv & Intens Care Med, Stockholm.
    Pain rather than induced emotions and ICU sound increases skin conductance variability in healthy volunteers2016In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 60, no 8, p. 1111-1120Article in journal (Refereed)
    Abstract [en]

    Background: Assessing pain in critically ill patients is difficult. Skin conductance variability (SCV), induced by the sympathetic response to pain, has been suggested as a method to identify pain in poorly communicating patients. However, SCV, a derivate of conventional skin conductance, could potentially also be sensitive to emotional stress. The purpose of the study was to investigate if pain and emotional stress can be distinguished with SCV.

    Methods: In a series of twelve 1-min sessions with SCV recording, 18 healthy volunteers were exposed to standardized electric pain stimulation during blocks of positive, negative, or neutral emotion, induced with pictures from the International Affective PictureSystem (IAPS). Additionally, authentic intensive care unit (ICU) sound was included in half of the sessions. All possible combinations of pain and sound occurred in each block of emotion, and blocks were presented in randomized order.

    Results: Pain stimulation resulted in increases in the number of skin conductance fluctuations (NSCF) in all but one participant. During pain-free baseline sessions, the median NSCF was 0.068 (interquartile range 0.013-0.089) and during pain stimulation median NSCF increased to 0.225 (interquartile range 0.146-0.3175). Only small increases in NSCF were found during negative emotions. Pain, assessed with the numeric rating scale, during the sessions with pain stimulation was not altered significantly by other ongoing sensory input.

    Conclusion: In healthy volunteers, NSCF appears to reflect ongoing autonomous reactions mainly to pain and to a lesser extent, reactions to emotion induced with IAPS pictures or ICU sound.

  • 38.
    Gunther, Anders
    et al.
    Karolinska Univ Hosp, Perioperat Med & Intes Care, Stockholm.
    Sackey, Peter
    Karolinska Univ Hosp, Perioperat Med & Intes Care, Stockholm.
    Storm, Hanne
    Univ Oslo, Inst Clin Med, Oslo, Norway.
    Wallgren, Max
    Bernhardsson, Jens
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Bjärtå, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Validation of physiological and self-rated pain assessment tools; how do they act when compared to the nociceptive spinal reflex?: A comparison between physiological and self-rated pain assessment during different affective states2017In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 61, no 8, p. 1047-1047, article id 137Article in journal (Other academic)
  • 39.
    Günther, A
    et al.
    Karolinska University Hospital.
    Hansen, J. O.
    University of Oslo, Oslo, Norway.
    Sackey, P
    Karolinska University Hospital.
    Storm, H
    University of Oslo, Oslo, Norway.
    Bernhardsson, Jensbe
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Bjärtå, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Measuring pain - A validation of physiological and self-rated pain, and an investigation of the relationship between them2016Conference paper (Other academic)
  • 40. Hofman-Bang, Claes
    et al.
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Nordlander, Rolf
    Nygren, Åke
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Öhman, Arne
    Rydén, Lars
    Two year results of a controlled study of a residential rehabilitation for patients treated with percutaneous transluminal coronary angioplasty: A randomized study of a multifactorial programme1999In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 20, no 20, p. 1465-1474Article in journal (Refereed)
    Abstract [en]

    Aims In a multifactorial lifestyle behaviour programme, of 2 years duration, to study the maintenance of achieved behaviour and risk factor-related changes. Methods and Results Out of a consecutive population of 151 patients treated with percutaneous transluminal angioplasty under 65 years of age, 87 were randomly allocated to an intervention group (n=46) or to a control group (n=41). The programme started with a 4 week residential stay, which was focused on health education and the achievement of behaviour change. During the first year of follow-up, a maintenance programme included regular contacts with a nurse, while no further rehabilitative efforts were offered during the second year. One patient died (control). During the second year the proportion of hospitalized patients was lower in the intervention group (4% vs 20%;P<0·05). Patients in the intervention group improved several lifestyle dependent behaviours: diet (index at 0, 12 and 24 months): 10·5±3·4, 12·9±2·5 and 12·4±2·6 in the intervention group (I) vs 10·1±3·2, 10·7±3·0 and 11·8±3·2 in the control group (C);P<0·05, exercise sessions per week: 2·5±2·3, 4·5±1·9 and 4·4±2·1 (I) vs 3·1±2·2, 3·5±2·3 and 3·7±2·7 (C);P<0·05, and smoking; 18%, 6% and 9% (I) vs 12%, 21% and 18% (C);P<0·05. This corresponded to improvement in exercise capacity (0, 12 and 24 months): 156±42, 174±49 and 165±47W (I) vs 164±40, 163±49 and 156±48 watts (C);P<0·05. There were no significant differences between the two groups with regard to serum cholesterol levels at 0 and 24 months: 5·4±0·8 and 5·2±0·9mmol.l–1(I) vs 5·4±1·0 and 4·9±0·9mmol.l–1(C); ns, low density lipoprotein cholesterol level: 3·6±0·8 and 3·4±0·8mmol.l–1(I) vs 3·7±0·9 and 3·3±0·7mmol.l–1(C); ns, triglyceride level: 2·2±1·6 and 1·8±1·3mmol.l–1(I) vs 2·2±1·4 and 1·6±0·6mmol.l–1(C); ns, body mass index (0, 12 and 24 months): 27·5±4·5, 27·0±4·3 and 27·4± 4·5kg.m–2(I) vs 26·8±2·8, 26·9±2·7 and 26·9± 3·2kg.m–2(C); ns, waist/hip ratio or blood pressure. The two groups did not differ in quality of life, or psychological factors. Return to work after 12 and 24 months was 74% and 78% (I) vs 68% and 61% (C); ns. Conclusion This rehabilitation programme influenced important lifestyle behaviour and reduced some, but not all, important risk factors Key Words: Rehabilitation, risk factors

  • 41. Högberg, G
    et al.
    Pagani, M
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Soares, J
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
    Åberg-Wistedt, A
    Tärnell, B
    Hällström, T
    Treatment of post-traumatic stress disorder with eye movement desensitization and reprocessing: Outcome is stable in 35-month follow-up2008In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 159, no 1-2, p. 101-108Article in journal (Refereed)
    Abstract [en]

    Post-traumatic stress disorder (PTSD) is an anxiety disorder that may follow major psychological trauma. The disorder is longstanding, even chronic, and there is a need for effective treatment. The most effective short-term treatments are cognitive behavioural therapy and eye movement desensitization and reprocessing (EMDR). Twenty subjects with chronic PTSD following occupational health hazards from "person under train" accidents or assault at work were treated with five sessions of EMDR. They were assessed with psychometric scales and diagnostic interviews before treatment, directly after treatment, at 8 months, and at 35 months after the end of Therapy. The primary outcome variable was full diagnosis of PTSD according to the DSM-IV diagnostic criteria. Results from interview-based and self-evaluation psychometric scales were used as secondary outcome variables. Immediately following treatment, the patients were divided up into two groups, initial remitters (12 of 20) and non-remitters (8 of 20). There were no drop-outs during therapy, but three patients withdrew during follow-up. The initial result was maintained at the 35-month follow-up. The secondary outcome variables also showed a significant immediate change towards normality that was stable during the long-term follow-up. After 3

  • 42. Högberg, Göran
    et al.
    Pagani, Marco
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Soares, Joaquim
    Åberg-Wistedt, Anna
    Tärnell, Berit
    Hällström, Tore
    On treatment with eye movement desensitization and reprocessing of chronic post-traumatic stress disorder in public transportation workers: a randomized controlled trial2007In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 61, no 1, p. 54-61Article in journal (Refereed)
    Abstract [en]

    Previous studies on post-traumatic stress disorder (PTSD) investigated a variety of treatments and included mostly patients victims of sexual and combat assault. This study aimed to determine the short-term efficacy of eye movement desensitization and reprocessing (EMDR) in occupation-based PTSD. Employees of the public transportation system in Stockholm, who had been experiencing a person-under-train accident or had been assaulted at work were recruited. Subjects with trauma exposure since more than 3 months but less than 6 years were included. Twenty-four subjects who fulfilled the DSM-IV criteria for PTSD were randomized to either EMDR therapy (n=13) or waiting list (WL, n=11). They were assessed pre-treatment and shortly after completion of treatment or WL period. The pre-defined primary outcome variable was full PTSD diagnosis. Secondary outcome variables were the results of various psychometric scales. Twelve participants began and completed five sessions of EMDR and nine completed the WL. After therapy, eight subjects in the EMDR group (67%) and one (11%) in WL did not fulfil the criteria for PTSD diagnosis (difference, P=0.02). Among the secondary outcome variables, there were significant differences post-treatment between the groups EMDR/WL in Global Assessment of Function (GAF) score and Hamilton Depression (HAM-D) score. This study indicates that EMDR has a short-term effect on PTSD in public transportation workers exposed to occupational traumatic events. Such intensive and brief therapy might be further validated in larger samples of exposed workers with longer periods of follow-up.

  • 43. Jablonska, Beata
    et al.
    Soares, Joaquim J F
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Pain among women: Association with socioeconomics and work conditions2006In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 10, no 5, p. 435-447Article in journal (Refereed)
    Abstract [en]

    We examined pain prevalence (general/body sites) and its characteristics/consequences among a randomised sample of women from the general population between 18 and 64 years (n=3,616). We also scrutinised associations between pain and various factors (e.g. socio-economic) by means of multivariate logistic/linear regression analyses. The women completed a questionnaire assessing various areas (e.g. pain). The design was cross-sectional and data were collected during 8 consecutive weeks. Sixty-three per cent of women reported pain during the last 3 months, of which 65% during more than 3 months. The multivariate analyses revealed associations between various socio-economic factors (e.g. financial strain) and pain in general/all studied body sites. In addition, psychosocial work conditions (i.e. work strain and social support) were significantly related to pain. Moreover, the multivariate analyses conducted among women with pain indicated relationships between socio-economic/psychosocial work conditions, and pain characteristics (e.g. intensity) and consequences (i.e. disability). A large number of women from the general population suffer from pain, in particularly prolonged pain. Women in a deprived socio-economic situation not only run a higher pain risk, but also experience their pain as more severe/disabling than their more privileged counterparts. Improvements of, for example, the socio-economic status among women living in deprived social and material circumstances, along with improved working environment may be crucial to reduce women's pain problems.

  • 44.
    Jansson, Billy
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    The reliability and factorial validity of the Swedish version of the Revised Controlling Behaviors Scale2016In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518Article in journal (Refereed)
    Abstract [en]

    This study focused on the factor structure of the victimization form of the revised Controlling Behaviors Scale (CBS-R). Data from 1,218 women and men were analyzed in the study. Results of confirmatory factor analysis (CFA) failed to find support for the proposed five-factor structure of the scale, as the items on the scale were better represented by one common factor. In addition, when examining if controlling behaviors are distinct from psychological aggression, the CFA indicated that the items on the CBS-R are clearly distinguishable from the items on the psychological aggression (as measured with the subscales of the revised Conflict Tactic Scales [CTS2]), and that this holds for both males and females. Implications for the general use of the CBS-R and for use in conjunction with psychological aggression and physical aggression in intimate partner violence were discussed.

  • 45. Jinder, D
    et al.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Behandlingsstrategier vid stress och utmattningstillstånd2002In: Uppdukat, ISSN 1101-5624, no 3, p. 22-25Article in journal (Other scientific)
  • 46. Jinder, M
    et al.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Flogstaprojektet: Effektivisering av vårdkedjan för patienter med psykisk ohälsa2006Report (Other scientific)
  • 47. Kallionen, Markus
    et al.
    Bernhardsson, Jens
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Grohp, Magnus
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Psykisk ohälsa ett stort problem hos primärvårdens patienter. Enkät besvarad av över 2000 patienter2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 23, p. 1545-1547Article in journal (Refereed)
    Abstract [en]

    A survey comprising more than 2000 patients visiting primary care units during a 2-week period in November 2008 was carried out in the county of Västernorrland, Sweden. The results show that approximately 18.5 % of the patients came on account of psychological ill health, either as sole reason (1.5%) or in combination with other cause(s). Roughly 14.7 % (309) of these scored higher or equivalent to clinically meaningful cut off scores on scales measuring anxiety, depression and exhaustion (burnout). An additional 322 of the remaining sample (27 % of the females and 16 % of the males) had high scores on scales measuring psychological ill health.

     

  • 48. Kalloinen, M
    et al.
    Bernhardson, J
    Grohp, M
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Mental health a problem among primary care patients. A Questionnaire comprising more than 2000 patients.2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, p. 1545-1547Article in journal (Refereed)
  • 49.
    Koertge, J
    et al.
    Karolinska institutet.
    Janszky, I
    Karolinska institutet.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Blom, M
    Karolinska institutet.
    Georgiades, A
    Karolinska institutet.
    Alinagizadeh, H
    Karolinska institutet.
    Ahnve, S
    Karolinska institutet.
    Effects of a cognitive-behavioral stress management program on vital exhaustion and depression in women with coronary heart disease - a randomized intervention study2008In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 263, no 3, p. 281-293Article in journal (Refereed)
    Abstract [en]

    Objectives.  Psychosocial factors, including depression and vital exhaustion (VE) are associated with adverse outcome in coronary heart disease (CHD). Women with CHD are poor responders to psychosocial treatment and knowledge regarding which treatment modality works in them is limited. This randomized controlled clinical study evaluated the effect of a 1-year stress management program, aimed at reducing symptoms of depression and VE in CHD women.

    Design.  Patients were 247 women, ≤75 years, recruited consecutively after a cardiac event and randomly assigned to either stress management (20 2-h sessions) and medical care by a cardiologist, or to obtaining usual health care as controls. Measurements at; baseline (6–8 weeks after randomization), 10 weeks (after 10 intervention sessions), 1 year (end of intervention) and 1–2 years follow-up.

    Results.  For VE, intention to treat analysis showed effects for time (P < 0.001) and time × treatment interaction (P = 0.005), reflecting that both groups improved over time, and that the decrease of VE was more pronounced in the intervention group. However, the level of VE was higher in the intervention group than amongst controls at baseline, 22.7 vs. 19.4 (P = 0.036) but it did not differ later. The change in depressive symptoms did not differ between the groups.

    Conclusions.  CHD women attending our program experienced a more pronounced decrease in VE than controls. However, as they had higher baseline levels, due to regression towards the mean we cannot attribute the decrease in VE to the intervention. Whether the program has long-term beneficial effects needs to be evaluated.

  • 50. Koertge, J
    et al.
    Wamala, SP
    Janszky, I
    Ahvne, S
    Al-Khalili, F
    Blom, M
    Chesney, M
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Svane, B
    Schenk-Gustafsson, K
    Vital exhaustion and recurrence of CHD in women with acute myocardial infarction2002In: Psychology, Health & Medicine, ISSN 1354-8506, E-ISSN 1465-3966, Vol. 7, no 2, p. 117-126Article in journal (Refereed)
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