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  • 1.
    Alverbratt, Catrin
    et al.
    University West, Department of Health Sciences, Specialist Nursing programme.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Åström, Sture
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Kauffeldt, Anders
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    A New Working Method in Psychiatric Care: the impact of implementation2016In: International Journal of Public Administration, ISSN 0190-0692, E-ISSN 1532-4265, Vol. 40, no 3, p. 295-304Article in journal (Refereed)
    Abstract [en]

    An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.

  • 2.
    Andersson, Liselotte
    et al.
    University West, Department of Nursing, Health and Culture.
    Jakum, Päivi
    University West, Department of Nursing, Health and Culture.
    Inte som i Gökboet: sjuksköterskors beskrivningar av omvårdnadsprocessen inom den rättspsykiatriska vården : en kvalitativ studie2009Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Forensic psyhiatric care protects the society by giving patients care to diminish risks of serious crimes. In their work the nurses use different care methods to help and support the patient in managing his or her life situation. To clarify how a group of nurses describe the nursing process in forensic psychiatric care. A qualitative study based on interviews. Six nurses were interviewed about their work in four different forensic psychiatric care units. The nursing process in is divided into four categories: evaluation, planning, implementation and assessment. The results are based on the way the interviewed nurses described the essential roles of nurse-patient relationship and structured routines in nursing process. The study also shows some specific difficulties in nursing work, for example the mental dysfunctions of patients, the level of competence among staff and the patients need for social interaction and existence beyond their specific needs.

  • 3.
    Bador, Kourosh
    et al.
    AGERA KBT AB, Gothenburg, Sweden.
    Kerekes, Nora
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Evaluation of an Integrated Intensive Cognitive Behavioral Therapy Treatment Within Addiction Care2019In: Journal of Behavioral Health Services & Research, ISSN 1094-3412, E-ISSN 1556-3308Article in journal (Refereed)
    Abstract [en]

    The study aimed to evaluate an integrated intensive cognitive behavioral therapy (CBT) group treatment for people with substance-related syndrome in outpatient care and to identify eventual gender differences. The study population consisted of 35 outpatients (18 male, 17 female) at a clinic in Western Sweden. The patients completed a four-month period of intensive group therapy and participated in the data collection at admission and discharge. The data were collected using the following inventories: Beck Depression and Anxiety Inventories, Rosenberg Self-Esteem Scale,Hopelessness Scale, and Trait Hope Scale. Results showed decreases in anxiety, depression and experience of hopelessness, and increases in self-esteem and hope. In females, the most dramatic improvement was measured for the anxiety and depression attributes, while in males the strongest effect was measured for hope and self-esteem. This study provides clinical evidence of the positive effects of integrated intensive CBT in outpatient care of people with substance-related syndrome.

  • 4.
    Dåderman, Anna Maria
    University West, Department of Social and Behavioural Studies, Division of Psychology and Organisation Studies. Karolinska Institutet.
    Det har blivit populärt att vara psykiskt sjuk i Kalifornien: konsekvenser av den nya lagen Three-strikes and you're out law2000In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 97, no 51-52, p. 6038-6039Article in journal (Refereed)
    Abstract [en]

    The primary goal of the new Three-strikes and you're out law, the law which first came into effect on 1994, was to protect innocent members of the community. A person convicted of his or her third conviction after two prior serious convictions under Three-strikes will typically receive a sentence of no less than 25 years to life in state prison. This law is well-known in California among criminals, especially repeat offenders and many of them left the state. The rate of homicides in the state has decreased by 50%. Many repeat offenders remained in California and continued to commit new crimes. Before Three-strikes was enacted, it was very uncommon for forensic psychiatrists to see criminals malingering symptoms of mental illness in any but the most serious of cases of murder or rape. Since the implementation of the new law, it has been found malingering to be much more common. Hundreds of patients at state mental hospitals fake insanity to avoid prison, costing taxpayers far more than the cost of incarceration in a prison. The most common types of malingers are discussed.

  • 5.
    Dåderman, Anna Maria
    et al.
    Karolinska Institutet, Stockholm University.
    Edman, Gunnar
    Department of Psychiatry, Research and Development, Danderyd’s Hospital, Danderyd, Sweden.
    Flunitrazepam abuse and personality characteristics inmale forensic psychiatric patients2001In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 103, no 1, p. 27-42Article in journal (Refereed)
    Abstract [en]

    Sixty male non-psychotic forensic psychiatric patients, aged 16-35 years, were studied after they completed their ordinary forensic psychiatric assessment (FPA). The prevalence of flunitrazepam (FZ) abuse was investigated by using both structured and in-depth interviews with the objective of studying the relationship between the abuse and personality traits. The patient’s characteristics, DSM-IV disorders, and actual sentences were obtained by studying their files. In order to obtain measures on their personality traits, self-report inventories were administered to the patients. Eighteen out of 60 patients were FZ abusers, but only 4 of them received a diagnosis related to the FZ abuse during the ordinary FPA. In almost all cases, however, indications of the FZ abuse were found in the files. No differences in personality traits were found between the groups. The frequency of previous admissions to an FPA and actual sentences of robbery, weapons offenses, narcotic-related offenses, and other crimes, such as theft, among the FZ abusers deviated significantly from forensic non-FZ abusers. Therefore, the FZ abuse per se might be more responsible for their tendency to commit crimes characterized by danger and thrill-seeking, such as robbery, weapons offences, and theft, than personality. The most important conclusion is that assessment of FZ abuse is needed in forensic psychiatry.

  • 6.
    Dåderman, Anna Maria
    et al.
    Department of Forensic Psychiatry, Stockholm; Stockholm University, Sweden.
    Fredriksson, Björn
    Department of Forensic Psychiatry, Stockholm, Sweden.
    Kristiansson, Marianne
    Department of Forensic Psychiatry, Stockholm, Sweden.
    Nilsson, Lars-Håkan
    Department of Forensic Psychiatry, Stockholm, Sweden.
    Lidberg, Lars
    Department of Forensic Psychiatry, Stockholm, Sweden.
    Violent behavior, impulsive decision-making, and anterograde amnesia while intoxicated with Flunitrazepam and alcohol or other drugs: A case study in forensic psychiatric patients2002In: The journal of the American Academy of Psychiatry and the Law, ISSN 1093-6793, E-ISSN 1943-3662, Vol. 30, no 2, p. 238-251Article in journal (Refereed)
    Abstract [en]

    It is known that many male juvenile delinquents commit violent crimes while intoxicated with flunitrazepam (FZ), often in combination with alcohol or other drugs. We have also noted the combined abuse of FZ with, for example, alcohol in male forensic psychiatric patients. Our objective was to study violent behavior, impulsive decision making, and amnesia in male forensic psychiatric patients who were intoxicated predominantly with FZ, to increase knowledge of the abuse of FZ in vulnerable subjects. We studied five forensic psychiatric patients, all of whom were assessed in 1998. All of the subjects reported earlier reactions to FZ, including hostility and anterograde amnesia. At the time of their crimes they were all intoxicated with FZ, often in combination with alcohol or other drugs, such as amphetamine or cannabis. In contrast to their behavior based on their ordinary psychological characteristics, their crimes were extremely violent, and the subjects lacked both the ability to think clearly and to have empathy with their victims. Our observations support the view that FZ abuse can lead to serious violent behavior in subjects characterized by vulnerable personality traits, and that this effect is confounded by the concurrent use of alcohol or other drugs. It is evident that FZ causes anterograde amnesia. Previous research and the results presented herein allow us to draw the following conclusion: on the basis of the neuropsychopharmacologic properties of FZ, legal decisions, such as declaring FZ an illegal drug, are needed in countries where it is now legal.

  • 7.
    Dåderman, Anna Maria
    et al.
    The Swedish National Police Academy.
    Jonson, Carin
    Karolinska Institutet.
    Lack of psychopathic character (Rorschach) in forensic psychiatric rapists2008In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 62, no 3, p. 176-185Article in journal (Refereed)
    Abstract [en]

    Previous research using Rorschach is sparse in rapists. The aim of this study of 10 violent male forensic psychiatric rapists was to describe them on a set of Rorschach variables, which are assumed to reflect psychopathic character, in order to increase our understanding of rapists. The participants were involved in a long-term psychodynamic sexual offender treatment program. They were previously assessed on dyslexia and ADHD, and the results showed an overrepresentation of these disorders in this sample. Compared with normative samples, the participants scored significantly lower on three of the Rorschach variables; Lambda, WSum6 and Afr. The participants did not meet criteria for psychopathic character. Although the generalization of the results from 10 rapists is severely limited, our results suggest helplessness in managing emotionally laden situations and hint at the problems experienced by this sample of forensic psychiatric rapists. Clinicians should be aware of the lack of psychopathic character in some rapists and that effective treatment programs should focus on training this type of rapists to be able to react appropriately to emotional stimuli.

  • 8. Dåderman, Anna Maria
    et al.
    Kristiansson, Marianne
    The National Board of Forensic Medicine, Huddinge, Sweden.
    Degree of psychopathy: implications for treatment in male juvenile delinquents2003In: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 26, no 3, p. 301-315Article in journal (Refereed)
    Abstract [en]

    Longitudinal studies have consistently shown that psychopathy in adulthood has its roots in childhood. The psychopathy concept described by Cleckley (1976) involves interpersonal, affective, and behavioral aspects. Moreover, children who show low levels of anxiety respond more poorly to treatment. The aim of the present study was to assess psychopathy in 56 male juvenile delinquents with conduct disorder, treated in youth correctional institutions for severe offenders. We used a modified Psychopathy Checklist-Revised (PCL-R) that has been used for young people (Forth et al., 1990). Each participant received PCL-R assessments from one rater, based on the file information and an extensive interview. Twenty-eight participants (50%) were rated by the second rater. Both the ICC and Cohens’s kappa revealed that the PCL-R ratings were reliable: the ICC(2,1) of the PCL-R total scores was 0.90, F(27, 28) = 11.70, P < .0001; Cohen’s kappa = 0.64, P < .001. The final scores on the PCL-R showed that the base rate for psychopathy (defined as a score of 30 or more) in the sample was 59% (33 of 56 juvenile delinquents). The mean PCL-R total score for all 56 participants was 29.3 (S.D. = 7.8), and ranged between 12 and 40. The high rates of psychopathy found in juvenile delinquents with conduct disorder should alert clinicians to the necessity of psychopathy scoring, and shows that high-quality treatment programs are needed. Psychopathy is not currently considered when assessing and treating young people in state-administered observational and correctional institutions for juvenile delinquents in Sweden.

  • 9.
    Dåderman, Anna Maria
    et al.
    Stockholm University.
    Kristiansson, Marianne
    The National Board of Forensic Medicine, Huddinge, Sweden.
    Psychopathy-related personality traits in male juvenile delinquents: an application of a person-oriented approach2004In: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 27, no 1, p. 45-64Article in journal (Refereed)
    Abstract [en]

    Some personality characteristics, such as impulsiveness, thrill seeking, and the need for change, are clearly relevant when studying psychopathy. Psychopaths are certainly avid sensation seekers. The primary aim of the present study was to identify common patterns with respect to psychopathy-related personality traits in a sample of 56 juveniles from four Swedish national correctional institutions for juvenile delinquents. Karolinska Scales of Personality (KSP), the Impulsiveness scale from the Impulsiveness–Venturesomeness–Empathy (IVE) inventory and the Total Sensation-Seeking scale from the SSS-V were used to determine personality traits. Cluster analysis was performed with SLEIPNER. Ward’s hierarchical minimum variance clustering method was used. We discovered seven clusters of participants. The mean T scores of the profiles of personality traits in the clusters (the cluster centroids) have been used to describe the clusters. Three multideviant clusters emerged, into which 31 (63%) of the classified participants could be placed. To describe the clusters, the prevalence of participants with a high degree of psychopathy (cutoff PCL-R score 27or above) was computed for each cluster and was complemented with data on previous treatment occasions and reoffending. The results indicated that psychopaths may develop different personality pattern; each cluster contained participants with high values of the PCL-R. Deviant personality is not currently considered when assessing and treating people in state administered observational and correctional institutions for juvenile delinquents in Sweden. The present results suggest that young people with psychopathy are not a homogenous group but may develop various personality traits. This should have implications for risk assessment and treatment.

  • 10.
    Dåderman, Anna Maria
    et al.
    Karolinska Institutet.
    Lidberg, Lars
    Relapse in violent crime in relation to cerebrospinal fluid monoamine metabolites (5-HIAA, HVA and HMPG) in male forensic psychiatric patients convicted of murder: a 16-year follow-up2002In: Acta Psychiatrica Scandinavica Supplementum, ISSN 0065-1591, E-ISSN 1600-5473, Vol. 412, no 106, p. 71-74Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Our purpose was to investigate if low levels of cerebrospinal fluid (CSF)monoamine metabolites of 5-HIAA, HVA and HMPG predict relapse in violent crimes. METHOD: Relapse in crime and level of CSF monoamine metabolites (5-HIAA, HVA and HMPG) was studied in a group of 29 murderers. The follow-up was 16 years. RESULTS: Fourteen of the 29 murderers were convicted of crime; nine of them committed violent crimes; one was convicted of a new murder. The differences in mean CSF monoamine metabolites were lower in subjects who relapsed into any type of crime, but only the difference in mean CSF HVA was statistically significant. CONCLUSION: The risk to commit new murder is very small in males who earlier have been convicted of murder. Low levels of CSF HVA is associated with an increased risk for relapse in any type of crime.

  • 11.
    Emilsson, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Berndtsson, Ina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Gustafsson, Per A
    Linköping University, Department of Clinical and Experimental Medicine and Department of Child and Adolescent Psychiatry, Center for Social and Affective Neuroscience, Linköping , Sweden..
    Horne, Robert
    University College London, Centre for Behavioural Medicine, UCL School of Pharmacy, London , UK.
    Marteinsdottir, Ina
    Linnæus University, Department of Medicine and Optometry Faculty of Health and Life Sciences, , Kalmar , Sweden.
    Reliability and validation of Swedish translation of Beliefs about Medication Specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with attention-deficit hyperactivity disorder.2019In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725Article in journal (Refereed)
    Abstract [en]

    Objectives: The purpose of this study was to assess the reliability and validity of Swedish translations of the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with ADHD. Methods: Forward and backward translations of the BMQ-Specific and B-IPQ scales to Swedish were conducted and reviewed by adolescents with ADHD and professionals. The validity and reliability of both questionnaires were investigated in a cross-sectional study of 101 adolescents (13-17 years) on a long-term prescription of ADHD medication recruited from two child and adolescent psychiatric outpatient clinics in Sweden. Results: Regarding the BMQ-Specific, principal component analysis (PCA) loadings confirmed the previously defined components of Specific-Necessity and Specific-Concern. The PCA for B-IPQ revealed two components, the first one, B-IPQ Consequences, captured questions regarding perceptions of the implication of having ADHD (items 1, 2, 5, 6 and 8) and the second one, B-IPQ-Control, the perceptions of the capability to manage the ADHD disorder (items 3, 4 and 7). The Cronbach alpha coefficients for BMQ-Specific-Necessity scale was α = 0.80, for BMQ-Specific-Concern scale α = 0.75, B-IPQ Consequences α = 0.74 and for B-IPQ-Control α = 0.44. Conclusions: The present results prove the Swedish translation of BMQ-Specific and B-IPQ to be valid and reliable for utilization in adolescents with ADHD. The PCA confirmed the original components for BMQ-Specific and the recent findings of two main B-IPQ components describing emotional and cognitive implications versus the capability for self-care maintenance of ADHD.

  • 12.
    Emilsson, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Gustafsson, P.A.
    Department of Clinical and Experimental Medicine and Department of Child and Adolescent Psychiatry, Center for Social and Affective Neuroscience, Linköping University.
    Öhnström, G.
    Department of Clinical and Experimental Medicine and Department of Child and Adolescent Psychiatry, Center for Social and Affective Neuroscience, Linköping University.
    Marteinsdottir, I.
    Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience, Linköping University.
    Beliefs regarding medication and side effects influence treatment adherence in adolescents with attention deficit hyperactivity disorder2016In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, p. 1-13Article in journal (Refereed)
    Abstract [en]

    Adherence to attention deficit hyperactivity disorder (ADHD) treatment is important because, when untreated, it may have serious consequences with lifelong effects. In the case of adolescents on long-term medicine prescription, more knowledge is needed regarding adherence and factors influencing adherence, which was the purpose of this study. Adolescents (n = 101) on ADHD medication ≥6 months were administrated questionnaires at amonitoring appointment: Medication Adherence Report Scale (MARS), beliefs about medicines (BMQ) and the Brief Illness Perception Questionnaire (B-IPQ). Adherencewas high, the mean value was 88% of the maximum MARS score, and correlated positively with the "BMQ necessity-concerns differential" but negatively with "BMQ concerns"and "BMQ-side effects". Adolescents with more belief in the necessity of the medication, less concerns and less experience of side effects tended to be more adherent to medication prescription ("intentional non-adherence"),while "unintentional non-adherence" (forgetfulness) was associated with how much they perceived that their ADHD affected their lives. In a multiple regression model, the variance of MARS total (R2 = 0.21) and “intentional nonadherence” (R2 = 0.24) was explained by the “BMQ-necessity–concern differential” and “BMQ-experienced side effects”. The variance of “unintentional non-adherence” (R2 = 0.12) was explained by the “BMQ-necessity–concern differential” and “B-IPQ-consequences of ADHD”. In conclusion, adolescents on long-term medication reported good adherence, mainly influenced by more beliefs in the necessity versus concerns of the medications, less experienced side effects and more perceived consequences of ADHD. BMQ could be useful to identify risks of low adherence, which should be counteracted by partially gender-specific interventions.

  • 13.
    Gustafsson, Erika
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Holm, Maritha
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Rättspsykiatrisk vård: En svängdörr? 2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Everyone in forensic care has some type of psychiatric disability and has carried out one or more criminal acts. The care is regulated in a number of laws. One part of the patient’s rehabilitation is the transition from closed to open care by so-called leave. A number of the patients that are on leave are sometimes readmitted to closed care for different reasons. These patients are sometimes referred to as “revolving door patients”.

    Aim: The aim was to determine different concerned personnel groups’ opinions and experiences of what is important, if a patient that is cared for according to the law of forensic care, is to be successful or unsuccessful with his/her leave.

    Method: A qualitative approach was chosen and two focus group interviews, with six participants in each group, were performed. The text was analyzed with the help of a qualitative content analysis.

    Results: Three main themes came to light that have significance as to how successful a leave is: comorbidity, how fundamental needs are taken care of and collaboration concerning the patient. 14 subthemes were found under the three main themes: correct psychiatric diagnosis, concurrent misuses, compliance in medication, social networks, employment, safe accommodation, the patient’s economy, seeing the patients needs, clear planning, knowledge and motivation, indistinct line of responsibility, collaboration prior to leave, contacts and follow-up in open care.

    Conclusion: Many functions are adequate in the care of patients within forensic care. Though there are deficiencies that need to be improved and developed. It is important that the patients participate in the care and that different authorities create individual conditions and flexible solutions if a leave is to be successful. Arranged economy is important if a leave is to be successful, as much of the patient’s everyday existence is affected. When the patient is unsuccessful with a leave, the reason could be that the patient’s real needs are not known, or not enough consideration has been taken to the patients needs when planning the leave. Inadequate public recourses sometimes contribute to patients, in forensic care, not receiving correct or sufficient measures (help), which is a problem.

  • 14. Hovey, D.
    et al.
    Lindstedt, M.
    Zettergren, A.
    Jonsson, L.
    Johansson, A.
    Melke, J.
    Kerekes, Nora
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Anckarsäter, Henrik
    Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden, Forensic psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Ragarden, House 1, SU – East Hospital, SE-416 85 Gothenburg, Sweden, Department of Forensic Psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg.
    Lichtenstein, P.
    Lundström, S.
    Westberg, L.
    Antisocial behavior and polymorphisms in the oxytocin receptor gene: findings in two independent samples2016In: Molecular Psychiatry, ISSN 1359-4184, E-ISSN 1476-5578, Vol. 21, no July, p. 983-988Article in journal (Refereed)
    Abstract [en]

    The quantitative genetic contribution to antisocial behavior is well established, but few, if any, genetic variants are established as risk factors. Emerging evidence suggests that the neuropeptide oxytocin (OXT) may modulate interpersonal aggression. We here investigated whether single-nucleotide polymorphisms (SNPs) in the OXT receptor gene (OXTR) are associated with the expression of antisocial behavior. A discovery sample, including both sexes, was drawn from the Child and Adolescent Twin Study in Sweden (CATSS; n=2372), and a sample from the Twin Study of Child and Adolescent Development (TCHAD; n=1232) was used for replication. Eight SNPs in OXTR, selected on previous associations with social and antisocial behavior, were genotyped in the participants of CATSS. Significant polymorphisms were subsequently genotyped in TCHAD for replication. Participants completed self-assessment questionnaires—Life History of Aggression (LHA; available only in CATSS), and Self-Reported Delinquency (SRD; available in both samples)—designed to capture antisocial behavior as continuous traits. In the discovery sample, the rs7632287 AA genotype was associated with higher frequency of antisocial behavior in boys, and this was then replicated in the second sample. In particular, overt aggression (directly targeting another individual) was strongly associated with this genotype in boys (P=6.2 × 10−7 in the discovery sample). Meta-analysis of the results for antisocial behavior from both samples yielded P=2.5 × 10−5. Furthermore, an association between rs4564970 and LHA (P=0.00013) survived correction in the discovery sample, but there was no association with the SRD in the replication sample. We conclude that the rs7632287 and rs4564970 polymorphisms in OXTR may independently influence antisocial behavior in adolescent boys. Further replication of our results will be crucial to understanding how aberrant social behavior arises, and would support the OXT receptor as one potential target in the treatment of aggressive antisocial behavior.

  • 15.
    Hällgren Graneheim, Ulla
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Åström, Sture
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Until Death Do Us Part: Adult Relatives' Experiences of Everyday Life Close to Persons with Mental Ill-Health2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 8, p. 602-608Article in journal (Refereed)
    Abstract [en]

    This study illuminates adult relatives' experiences of everyday life close to a person with mental ill-health. The study was based on nine diaries and four narrative interviews with relatives of people with mental ill-health. Data were subjected to qualitative content analysis. The participants experienced everyday life as a constant fight, for better and for worse, with psychiatric care. They were fighting for the mentally ill person's right to care; sometimes they felt resigned, but yet they had a confidence in the care. Their mission in life was to sacrifice themselves, meaning that they felt indispensable and became lonely and socially isolated. They considered their mission to last until death set them apart because they were keeping a family secret, and had great worries about the future. We conclude that relatives experience a two-folded stigma in living close to a person with mental ill-health and in becoming lonely and socially isolated.

  • 16.
    Joelsson, Britta
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johansson, Linnéa
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Samverkan mellan primärvård och specialistpsykiatri: Två sidor av samma mynt2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental illness is increasing in society. Collaboration between primary care and specialist psychiatry is ongoing. The experience is that many people with mental illness refer to different activities and being left without treatment. Good interaction is important for persons seeking mental health care to get the right help.

    Aim: to describe the primary care nurse's experience of collaboration with specialist psychiatry.

    Method: a qualitative study based on semistructured interviews of primary care nurses. The material was analyzed by qualitative content analysis.

    Results: appeared in the following categories; Collaboration characterized by differences with the subcategories Good collaboration for emergency transfers and poor accessibility and inadequate feedback between the activities. Unclear division of responsibilities with the subcategories care different assessments of the same person, Inadequate knowledge on the division of responsibilities between the professions and gray zone patient - primary care or specialist psychiatry. Last category are resource shortage and low interest in mental health with the subcategories Inadequacy and Interest and respect for psychiatry.

    Conclusion: Working according to the division of responsibilities can be an obstacle to cooperation in such a way that the nurse expires blindly from the division of responsibilities without knowing what he/she refers to. Resource shortage, in turn, leads to experiences of insufficiency of nurses. Increased knowledge of each other's activities could lead to closer cooperation and understanding of each other. The person-centered care would benefit from the fact that both instances took care of more people than they actually consider to be part of their area of responsibility.

  • 17.
    Kerekes, Nora
    et al.
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Brändström, Sven
    Washington University School of Medicine, Clinical Associate of the Center for Well-Being, St. Louis, MO, United States.
    Nilsson, Thomas
    University of Gothenburg, Centre for Ethics, Law and Mental Health (CELAM), Institute of Neuroscience and Physiology, Gothenburg, Sweden.
    Imprisoning Yoga: Yoga Practice May Increase the Character Maturity of Male Prison Inmates.2019In: Frontiers in Psychiatry, ISSN 1664-0640, E-ISSN 1664-0640, Vol. 10, article id 406Article in journal (Refereed)
    Abstract [en]

    Background: A specific personality profile, characterized by low character maturity (low scores on the self-directedness and cooperativeness character dimensions) and high scores on the novelty seeking temperament dimension of the temperament and character inventory (TCI), has been associated with aggressive antisocial behavior in male prison inmates. It has also been shown that yoga practiced in Swedish correctional facilities has positive effects on the inmates' well-being and on risk factors associated with criminal recidivism (e.g., antisocial behavior). In this study, we aimed to investigate whether the positive effect of yoga practice on inmates' behaviors could be extended to include eventual changes in their personality profile. Methods: Male prison inmates (N = 111) in Sweden participated in a randomized controlled 10-week long yoga intervention trial. Participants were randomly assigned to either a yoga group (one class a week; n = 57) or a control group (free of choice weekly physical activity; n = 54). All the inmates completed the TCI questionnaire before and after the intervention period as part of an assessment battery. Results: After the 10-week-long intervention period male inmates scored significantly lower on the novelty seeking and the harm avoidance and significantly higher on the self-directedness dimensions of the TCI. There was a significant medium strong interaction effect between time and group belonging for the self-directedness dimension of character favoring the yoga group. Conclusion: A 10-week-long yoga practice intervention among male inmates in Swedish correctional facilities increased the inmates' character maturity, improving such abilities as their capability to take responsibility, feel more purposeful, and being more self-acceptant-features that previously were found to be associated with decreased aggressive antisocial behavior.

  • 18. Lidberg, Lars
    et al.
    Dåderman, Anna Maria
    Karolinska Institutet.
    Nedsatt serotoninhalt predisponerar för våld: Enkelt blodprov förutsäger farlighet1997In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 94, no 39, p. 3385-3388Article in journal (Refereed)
    Abstract [en]

    Deficient serotonergic function in the brain is associated with a risk of impulsive violence. The level of serotonergic function can be assessed indirectly in several ways: 1. determination of CSF (cerebrospinal fluid) content of the serotonin metabolite 5-HIAA (5-hydroxyindoleacetic acid); 2. determination of the plasma level of the amino acid tryptophan, the serotonin precursor (passage of tryptophan into the brain is dependent on the ratio of tryptophan to other competing amino acids); 3. analysis of platelet monoamine oxidase content, a putative correlate of serotonergic capacity in the brain; 4. by determining response to an OGTT (oral glucose tolerance test), another putative correlate of serotonergic function.

  • 19.
    Lundell, Alexandra
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Gustavsson, Bodil
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Sjuksköterskors upplevelser av hur patientens kön kan påverka bemötandet av patienten inom beroendevård: En intervjustudie2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Addiction is a serious problem in the world, Sweden included. This disease can affect anyone, regardless of gender and age. People with addiction, like the rest of the population, are entitled to respectful encounters in healthcare. However, research about encounters with patients suffering from addiction is limited and research about the possible impact of the patient's gender in this process – according to our knowledge – has not yet been published.

    Aim: The aim of the present study was to describe nurses' experience about the eventual gender specific encounter of patients in addiction care units.

    Method: Data was assessed by nine semi-structured interviews which were analysed with qualitative content analysis.

    Results: The result was presented in two categories; to encounter patients regardless of their gender and to encounter patients according to their gender. The two categories consisted of several subcategories that emphasized the importance of a professional caring encounter, how patients were encountered according to individual differences and how the encounter was affected by whether the patient was a woman, man or without defined gender.

    Conclusion: Nurses felt that professional encounter was important in addiction care. Their intention was to treat patients alike, however the study revealed some differences in encountering process that could be linked to the patient's gender.

  • 20.
    Nilsson, Thomas
    et al.
    Department of Forensic Psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Centre for Ethics, Law and Mental Health, University of Gothenburg.
    Falk, Örjan
    Department of Forensic Psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Centre for Ethics, Law and Mental Health, University of Gothenburg.
    Billstedt, Eva
    Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg.
    Kerekes, Nora
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Anckarsäter, Henrik
    Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden, Forensic psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Ragarden, House 1, SU – East Hospital, SE-416 85 Gothenburg, Sweden, Department of Forensic Psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg.
    Wallinius, Märta
    Child and Adolescent Psychiatry, Faculty of Medicine, Department of Clinical Sciences, Lund, Lund University, Lund, Sweden, Research and Development Unit, Regional Forensic Psychiatric Clinic, Växjö, Sweden.
    Hofvander, Björn
    Child and Adolescent Psychiatry, Faculty of Medicine, Department of Clinical Sciences, Lund, Lund University.
    Aggressive Antisocial Behaviors Are Related to Character Maturity in Young Swedish Violent Offenders Independent of ADHD2016In: Frontiers in Psychiatry, ISSN 1664-0640, E-ISSN 1664-0640, Vol. 7, no NOV, p. 1-12, article id 185Article in journal (Refereed)
    Abstract [en]

    Background: Antisocial personality and psychopathic traits have constantly been found to accompany criminal and aggressive behaviors, but little attention has been given to aspects of character maturity and its relation to such behaviors. The present study investigated (1) whether level of character maturity (low, medium, and high) is associated with amount of aggressive antisocial behaviors (AABs) and psychopathic traits in young men imprisoned for violent criminality, and (2) whether such an association is independent of coexisting attention-deficit hyperactivity disorder (ADHD). Methods: Swedish males (N =  270, aged 18–25) sentenced to prison for violent and/or sexual criminality in the western region of the Swedish Prison and Probation Service underwent a thorough clinical examination during their in carceration. Data on character maturity, as measured by the character dimensions Self-Directedness and Cooperativeness of the Temperament and Character Inventory, were available for n = 148 subjects and were used to divide these offenders into three groups with low, medium, and high character maturity. These groups were then compared for variables reflecting criminal history, a DSM-IV diagnosis of ADHD, conduct disorder (CD) and substance use disorders (SUD), aggressive behaviors, and psychopathic traits. Results: Character maturity was consistently associated with less AABs and psychopathic personality traits; the group with the highest character maturity showed: (i) a later age at on set of criminality, (ii) a smaller number of prior violent criminal acts, (iii) lower prevalence of ADHD, CD, and SUD, (iv) less self-rated and expert-rated aggressive behaviors, and (v) less psychopathic traits. The association between character maturity and aggressive behaviors/psychopathic personality traits remained even when ADHD was controlled for. The only exception was sexual criminality, where the group with the highest character maturity contained the largest amount of sexual offenders. Conclusion: Higher character maturity appeared to be a protective factor among young male violent offenders, associated with less AABs, suggesting that character maturity isa promising target for treatment interventions for this group of individuals.

  • 21.
    Rastad, Cecilia
    et al.
    Center for Clinical Research Dalarna (CKF), Falun, Sweden.
    Wetterberg, Lennart
    Department of Clinical Neuroscience, Karolinska Institute, at St. Göran, Stockholm, Sweden and Strömstad Academy, Strömstad, Sweden.
    Martin, Cathrin
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Patients´ Experience of Winter Depression and Light Room Treatment2017Report (Other academic)
    Abstract [en]

    Background. There is a need for more knowledge on the effects of light room treatment in patients with Seasonal Affective Disorder (SAD) and to explore patients´ subjective experience of the disease and the treatment.Methods. This was a descriptive and explorative study applying qualitative content analysis. A purposeful sample of 18 psychiatric out- patients with a major depressive disorder with a seasonal pattern according to the DSM-IV and a pre-treatment score >12 on the 9-item Montgomery-Åsberg Depression self-rating scale was included (10 women and 8 men, aged 24-65 years). All patients had completed light room treatment (> 7/10 consecutive weekdays). Data was collected two weeks post-treatment using a semi-structured interview guide.Results. Patients described a profound struggle to adapt to seasonal changes during the winter. Everyday life was affected with reduced work capacity, social withdrawal and disturbed relations with family and friends. Different individual signs and symptoms marked the onset of the seasonal depression. The light room treatment resulted in a radical and rapid change for the better, with only mild and transient side effects. Patients worried about the risk of not being able to receive the light room treatment in future possible relapses.Discussion. The patients experienced a clear seasonal pattern with deterioration in sleep, daily rhythms, energy level, mood, activity and cognitive functioning. Light room treatment was described as one of the most effective and personally important coping strategies available, with improvement in all the major symptoms. The results indicate that light room treatment is essential for some patients´ ability to cope with winter depression.

  • 22.
    Ståhlberg, Ola
    et al.
    National Board of Forensic Medicine, Department of Forensic Psychiatry, Gothenburg, Sweden, Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden.
    Boman, Sofia
    Swedish Prison and Probation Services, Gothenburg, Sweden.
    Robertsson, Christina
    Child and Adolescent Psychiatry, Stenungsund/Tjorn, Kungalvs Hospital, Sweden.
    Kerekes, Nora
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Anckarsäter, Henrik
    Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden, Forensic psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Ragarden, House 1, SU – East Hospital, SE-416 85 Gothenburg, Sweden.
    Nilsson, Thomas
    Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden, Forensic psychiatry, Institute of Neuroscience and Physiology, University of Gothenburg, Ragarden, House 1, SU – East Hospital, SE-416 85 Gothenburg, Sweden.
    A 3-year follow-up study of Swedish youths committed to juvenile institutions: Frequent occurrence of criminality and health care use regardless of drug abuse2017In: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 50, p. 52-60Article in journal (Refereed)
    Abstract [en]

    This 3-year follow-up study compares background variables, extent of criminality and criminal recidivism in the form of all court convictions, the use of inpatient care, and number of early deaths in Swedish institutionalized adolescents (N = 100) with comorbid substance use disorders (SUD) and Attention-Deficit/Hyperactivity Disorder (ADHD) (n = 25) versus those with SUD but no ADHD (n = 30), and those without SUD (n = 45). In addition it aims to identify whether potential risk factors related to these groups are associated with persistence in violent criminality. Results showed almost no significant differences between the three diagnostic groups, but the SUD plus ADHD group displayed a somewhat more negative outcome with regard to criminality, and the non-SUD group stood out with very few drug related treatment episodes. However, the rate of criminal recidivism was strikingly high in all three groups, and the use of inpatient care as well as the number of untimely deaths recorded in the study population was dramatically increased compared to a age matched general population group. Finally, age at first conviction emerged as the only significant predictor of persistence in violent criminality with an AUC of .69 (CI (95%) .54–.84, p = .02). Regardless of whether SUD, with or without ADHD, is at hand or not, institutionalized adolescents describe a negative course with extensive criminality and frequent episodes of inpatient treatment, and thus requires a more effective treatment than present youth institutions seem to offer today. However, the few differences found between the three groups, do give some support that those with comorbid SUD and ADHD have the worst prognosis with regard to criminality, health, and untimely death, and as such are in need of even more extensive treatment interventions.

  • 23.
    Wennberg, Peter
    et al.
    Stockholm University.
    Dåderman, Anna Maria
    Stockholm University; Karolinska Institutet.
    Alcohol-related symptoms in a sample of male forensic psychiatric patients and a normal representative cohort of Swedish males2000In: German Journal of Psychiatry, ISSN 1433-1055, E-ISSN 1433-1055, Vol. 3, p. 21-26Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to compare alcohol habits in a forensic psychiatric sample to those of a normal representative one with respect to alcohol-related symptoms. Two male samples were compared with respect to self-reported alcohol-related symptoms, a forensic psychiatric sample (n=60; mean age 27 years) and a control sample (n=106; mean age 36 years). As expected, there was a higher proportion of alcohol-related symptoms in the forensic psychiatric sample. The frequencies of specific symptoms were compared between the samples.

  • 24.
    Wentz, Elisabet
    et al.
    Institutionen för neurovetenskap och fysiologi, Göteborgs universitet.
    Nydén, Agneta
    Institutionen för neurovetenskap och fysiologi, Göteborgs universitet.
    Osmar Swerkersdotter, Helena
    BNK.
    Niklasson, Lena
    BNK.
    Lindström, Marie
    Hakenäs-Plate, Louise
    BNK.
    Hedman Ahlström, Britt
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Internet-based support and coaching – habilitation of young adults with autism spectrum conditions and other neuropsychiatric disorders. A pilot study2010In: IX International Congress Autism-Europe, A Future for Autism, Catania, Italien 8-10 oktober 2010, 2010Conference paper (Refereed)
  • 25.
    Zouini, Btissame
    et al.
    Abdelmalek Essaadi University, Department of Biology, Faculty of Sciences, Tetouan, Morocco.
    Senhaji, Meftaha
    Abdelmalek Essaadi University, Department of Biology, Faculty of Sciences,Tetouan, Morocco.
    Kerekes, Nora
    University West, Department of Health Sciences, Section for health promotion and care sciences.
    Self-reported aggressive and antisocial behaviors in Moroccan high school students2019In: Psihologija, ISSN 1451-9283, Vol. 52, no 3, p. 235-247Article in journal (Refereed)
    Abstract [en]

    The aims of the present study were to map the level and distribution of aggressive and antisocial behaviors in a sample of Moroccan high school students and to define the level of these behaviors in adolescents who reported parental alcohol use problems and/or experienced abuse. In total, 375 high school students completed the "Mental and Somatic Health without borders (MeSHe)" survey that includes the Life History of Aggression scale. Male students had significantly higher scores for aggression and antisocial behaviors than female. The students who reported experience of abuse or parental alcohol use problems scored significantly higher for aggression, self-directed aggression, and antisocial behaviors compared to students not reporting these negative psychosocial factors. Previously shown gender-specific patterns in aggressive and antisocial behaviors, but not in self-harm behaviors were confirmed in these Moroccan high school students. Reported experience of abuse and/or parental alcohol use problems were associated with increased frequency of aggressive and antisocial behaviors.

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