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diva2:1325831
Open this publication in new window or tab >>A Randomized Controlled Study of Group-Administered Cognitive Behavioral Therapy for Hypersexual Disorder in Men
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2019 (English)In: Journal of Sexual Medicine, ISSN 1743-6095, E-ISSN 1743-6109, Vol. 16, no 5, p. 733-745Article in journal (Refereed) Published
Abstract [en]

Background: Hypersexual disorder (HD) is defined as a condition in which the individual loses control over engagement in sexual behaviors, leading to distress and negative effects on key life areas. Cognitive behavioral therapy (CBT) has been proven to reduce symptoms of hypersexual behavior; however, no randomized controlled study of CBT interventions for HD has been reported previously.

Aim: To investigate the efficacy of group-administered CBT for HD.

Methods: Male participants (n = 137) diagnosed with HD, were randomized between 7 weeks of group-administered CBT (n = 70) and a waitlist control receiving the intervention after 8 weeks (n = 67). Measurements were administered at pre-, mid-, and posttreatment, with follow-up after 3 and 6 months.

Outcomes: The primary outcome was the Hypersexual Disorder: Current Assessment Scale (HD:CAS), and secondary outcomes were the Sexual Compulsivity Scale (SCS) and measures of depression (Montgomery–Åsberg Depression Rating Scale (MADRS-S), psychological distress (Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), and treatment satisfaction (CSQ-8).

Results: A significantly greater decrease in HD symptoms and sexual compulsivity, as well as significantly greater improvements in psychiatric well-being, were found for the treatment condition compared with the waitlist. These effects remained stable at 3 and 6 months after treatment.

Clinical Implications: CBT can ameliorate HD symptoms and psychiatric distress, suggesting that the CBT program may serve as a first-line treatment in clinical settings.

Strengths & Limitations: This is the first randomized controlled study evaluating the efficacy of a CBT program in a rather large sample of HD-specific diagnosed men. The long-term treatment effects are vague due to the low response rate on follow-up measurements, and the efficacy of this program for hypersexual women remains unknown.

Conclusion: This study supports the efficacy of a group-administered CBT program as a treatment option for HD; however, future studies should include women, comprise dismantling analysis of the constituting interventions, and evaluate other treatment formats, for example, administration via the Internet.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Male Sexual Desire Disorders, Basic science male behavioral, Mental Health and Male Sexuality
National Category
Applied Psychology Psychiatry
Identifiers
urn:nbn:se:umu:diva-160310 (URN)10.1016/j.jsxm.2019.03.005 (DOI)000469936400015 ()30956109 (PubMedID)
Available from: 2019-06-17 Created: 2019-06-17 Last updated: 2019-06-17Bibliographically approved
Pahnke, J., Hirvikoski, T., Bjureberg, J., Bölte, S., Jokinen, J., Bohman, B. & Lundgren, T. (2019). Acceptance and commitment therapy for autistic adults: An open pilot study in a psychiatric outpatient context. Journal of Contextual Behavioral Science, 13, 34-41
Open this publication in new window or tab >>Acceptance and commitment therapy for autistic adults: An open pilot study in a psychiatric outpatient context
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2019 (English)In: Journal of Contextual Behavioral Science, ISSN 2212-1447, Vol. 13, p. 34-41Article in journal (Refereed) Published
Abstract [en]

Highlights:

Feasibility and credibility of the NeuroACT protocol was high.

Symptoms of stress and depression were significantly reduced.

Cognitive defusion and psychological flexibility significantly increased.

Quality of life and social functioning were significantly improved.

National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-164547 (URN)10.1016/j.jcbs.2019.04.002 (DOI)000483320600005 ()
Available from: 2019-10-23 Created: 2019-10-23 Last updated: 2019-10-23Bibliographically approved
Stenbacka, M., Moberg, T. & Jokinen, J. (2019). Adolescent criminality: multiple adverse health outcomes and mortality pattern in Swedish men. BMC Public Health, 19, Article ID 400.
Open this publication in new window or tab >>Adolescent criminality: multiple adverse health outcomes and mortality pattern in Swedish men
2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 400Article in journal (Refereed) Published
Abstract [en]

Background: To investigate the impact of adolescent violent and non-violent criminality and subsequent risk of morbidity and mortality in adulthood in a large Swedish cohort of young men conscripted for military service in 1969/70.

Methods: The cohort consisted of 49,398 18-year-old Swedish conscripts followed up for morbidity and mortality up to the age of 55 years in Swedish national registers. Information about convictions for crime before conscription was obtained from national crime registers. Data from a survey at conscription were scrutinized to get information on potential confounders.

Results: Hospitalization due to alcohol and drug related diagnoses and attempted suicide were significantly more evident in the violent group compared to non-violent criminals and non-criminals. More than one fifth (21.13%) of the young violent offenders, 12.90% of the non-violent offenders and 4.96% of the non-criminals had died during the follow-up period. In Cox proportional multivariate analyses, young violent offenders had twice the hazard (HR = 4.29) of all-cause mortality than the non-violent offenders (HR = 2.16) during the follow-up period. Alcohol and drug related mortality, suicide and fatal accidents were most evident in both violent and non-violent offenders.

Conclusions: Men with adolescent criminality received more inpatient care due to alcohol and drug related diagnoses and attempted suicide as adults. Mortality due to unnatural causes, alcohol, and drug related diagnoses, suicide and accidents was most evident in violent offenders, while these causes of death were much lower in non-criminals. Men with adolescent criminality are a high-risk group for multiple adverse health outcomes and for early death. Efforts for detection of substance use and psychiatric disorders in this group is important for the prevention work in both local- and community levels as well as national prevention programs.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Alcohol, Criminality, Violence, Substance use, Mortality
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychiatry
Identifiers
urn:nbn:se:umu:diva-158573 (URN)10.1186/s12889-019-6662-z (DOI)000464880000011 ()30975117 (PubMedID)
Available from: 2019-05-27 Created: 2019-05-27 Last updated: 2019-05-27Bibliographically approved
Bjureberg, J., Ohlis, A., Ljotsson, B., D'Onofrio, B. M., Hedman-Lagerlöf, E., Jokinen, J., . . . Hellner, C. (2019). Adolescent self-harm with and without suicidality: cross-sectional and longitudinal analyses of a Swedish regional register. Journal of Child Psychology and Psychiatry and Allied Disciplines, 60(3), 295-304
Open this publication in new window or tab >>Adolescent self-harm with and without suicidality: cross-sectional and longitudinal analyses of a Swedish regional register
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2019 (English)In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 60, no 3, p. 295-304Article in journal (Refereed) Published
Abstract [en]

Background: Self-harm is common and there is a need for studies that investigate the relevance of this behavior in clinical samples to inform risk assessment and treatment. The objectives in the current studies were to compare clinical and psychosocial correlates and subsequent adverse outcomes in youth who present to child and adolescent mental health services (CAMHS) with self-harm only (SH), self-harm with suicidality (SH+SU), with those without any indication of SH or SH+SU.

Methods: We conducted a case-control study and a longitudinal cohort study using data from a regional clinical care register, and Swedish national registers. The case-control study included all patients (5-17 years) between 2011 and 2015 (N = 25,161). SH and SH+SU cases were compared with controls (patients without SH) regarding a range of correlates. The longitudinal study included former CAMHS patients (N = 6,120) who were followed for a median time of 2.8 years after termination of CAMHS contact regarding outcomes such as clinical care consumption, social welfare recipiency, and crime conviction.

Results: In the case-control study, both the SH and SH+SU groups received more clinical care, had lower global functioning, and higher odds of having mental disorders compared to controls. In most comparisons, the SH+SU group had more problems than the SH group. In the longitudinal study, the same pattern emerged for most outcomes; for example, the adjusted hazard ratio for recurrent care due to self-harm was 23.1 (95% confidence interval [CI], 17.0-31.4) in the SH+SU group compared to 3.9 (95% CI, 2.3-6.7) in the SH group.

Conclusions: Adolescent patients presenting with self-harm have higher risks for adverse outcomes than patients without self-harm. Suicidality in addition to self-harm is associated with more severe outcomes, importantly recurrent episodes of care for self-harm.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
Self-harm, self-injurious behavior, suicidal ideation, epidemiology, cohort study
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-157201 (URN)10.1111/jcpp.12967 (DOI)000459224900008 ()30207392 (PubMedID)
Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-04-08Bibliographically approved
Budhiraja, M., Pereira, J. B., Lindner, P., Westman, E., Jokinen, J., Savic, I., . . . Hodgins, S. (2019). Cortical structure abnormalities in females with conduct disorder prior to age 15. Psychiatry Research: Neuroimaging, 289, 37-44
Open this publication in new window or tab >>Cortical structure abnormalities in females with conduct disorder prior to age 15
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2019 (English)In: Psychiatry Research: Neuroimaging, ISSN 0925-4927, E-ISSN 1872-7506, Vol. 289, p. 37-44Article in journal (Refereed) Published
Abstract [en]

Among females, conduct disorder (CD) before age 15 is associated with multiple adverse outcomes in adulthood. The few existing structural neuroimaging studies of females with CD report abnormalities of gray matter volumes. The present study compared cortical thickness and surface area of young women with childhood/adolescent CD and healthy women to determine whether cortical abnormalities were present in adulthood and whether they were related to prior CD. Structural brain images from 31 women with CD and 25 healthy women were analyzed using FreeSurfer. Group differences between cortical thickness and surface area were assessed using cluster-wise corrections with Monte Carlo simulations. Women with prior CD, relative to healthy women, showed: (1) reduced cortical thickness in left fusiform gyrus extending up to entorhinal cortex and lingual gyrus; (2) reduced surface area in right superior parietal cortex; (3) increased surface area in left superior temporal gyrus, and right precentral gyrus. These differences remained significant after adjusting for past comorbid disorders, current symptoms of anxiety and depression, current substance use as well as maltreatment. The study suggests that among females, CD prior to age 15 is associated with cortical structure abnormalities in brain regions involved in emotion processing and social interaction.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Conduct disorder, Structural MRI, Freesurfer, Cortical thickness, Surface area, Fusiform gyms
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-160596 (URN)10.1016/j.pscychresns.2018.12.004 (DOI)000470122700006 ()31101397 (PubMedID)
Funder
Stockholm County CouncilSwedish Foundation for Strategic Research VinnovaSwedish Research Council
Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-06-24Bibliographically approved
Sahlin, H., Bjureberg, J., Gratz, K. L., Tull, M. T., Hedman-Lagerlöf, E., Bjärehed, J., . . . Ljotsson, B. (2019). Predictors of improvement in an open-trial multisite evaluation of emotion regulation group therapy. Cognitive Behaviour Therapy, 48(4), 322-336
Open this publication in new window or tab >>Predictors of improvement in an open-trial multisite evaluation of emotion regulation group therapy
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2019 (English)In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 48, no 4, p. 322-336Article in journal (Refereed) Published
Abstract [en]

Emotion regulation group therapy (ERGT) is a novel treatment specifically targeting deliberate non-suicidal self-harm (DSH) in individuals with borderline personality disorder (BPD). Identifying robust predictors of positive response to ERGT could aid clinicians in treatment selection; however, to date, only one such study has been conducted. Thus, we aimed to replicate previously identified predictors of treatment response to ERGT by investigating demographic, clinical, and diagnostic predictors in 95 women with BPD or subclinical BPD who had participated in an open-trial evaluation of ERGT. Outcomes evaluated were frequency of DSH and emotion dysregulation. Assessments were conducted at pretreatment, post-treatment, and 6-month follow-up. Multilevel mixed linear models and multilevel negative binomial generalized estimated equations were used to identify significant interactions between the predictors and outcomes.

We found that greater pretreatment DSH frequency was associated with greater improvements in DSH during treatment (b = 0.998, SE = 0.00, p = 0.03) and follow-up (b = 0.997, SE = 0.00, p < 0.01) and that greater BPD severity was associated with greater improvements in DSH during treatment (b = 0.84, SE = 0.06, p = 0.02) and in emotion dysregulation at follow-up (b = −3.05, SE = 1.47, p = 0.04). Co-occurring disorders were associated with poorer treatment response during follow-up. Results were generally consistent with a previous study of the predictors of response to ERGT. The findings provide further support for the utility of this treatment across a range of BPD patients, including patients with severe DSH and BPD.

Place, publisher, year, edition, pages
Routledge, 2019
Keywords
Emotion regulation group therapy, predictors of treatment response, borderline personality disorder, deliberate self-harm, non-suicidal self-injury, emotion regulation
National Category
Psychiatry Applied Psychology
Identifiers
urn:nbn:se:umu:diva-161484 (URN)10.1080/16506073.2018.1509119 (DOI)000470850800005 ()30230412 (PubMedID)
Funder
Stockholm County Council, SLL20140428
Available from: 2019-07-09 Created: 2019-07-09 Last updated: 2019-07-09Bibliographically approved
Chatzittofis, A., Boström, A., Öberg, K., Flanagan, J., Schioth, H., Arver, S. & Jokinen, J. (2019). Testosterone, luteinizing hormone levels and methylation status in men with hypersexual disorders. Paper presented at 31st ECNP Congress, Barcelona, Spain, 6-9 October, 2018. European Neuropsychopharmacology, 29, S135-S135
Open this publication in new window or tab >>Testosterone, luteinizing hormone levels and methylation status in men with hypersexual disorders
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2019 (English)In: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 29, p. S135-S135Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Pharmacology and Toxicology
Identifiers
urn:nbn:se:umu:diva-156895 (URN)10.1016/j.euroneuro.2018.11.247 (DOI)000458400500192 ()
Conference
31st ECNP Congress, Barcelona, Spain, 6-9 October, 2018
Note

Supplement 1

Meeting abstract P.134

Available from: 2019-03-11 Created: 2019-03-11 Last updated: 2019-03-11Bibliographically approved
Lindner, P., Flodin, P., Larm, P., Budhiraja, M., Savic-Berglund, I., Jokinen, J., . . . Hodgins, S. (2018). Amygdala-orbitofrontal structural and functional connectivity in females with anxiety disorders, with and without a history of conduct disorder. Scientific Reports, 8, 1-12, Article ID 1101.
Open this publication in new window or tab >>Amygdala-orbitofrontal structural and functional connectivity in females with anxiety disorders, with and without a history of conduct disorder
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2018 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, p. 1-12, article id 1101Article in journal (Refereed) Published
Abstract [en]

Conduct disorder (CD) and anxiety disorders (ADs) are often comorbid and both are characterized by hyper-sensitivity to threat, and reduced structural and functional connectivity between the amygdala and orbitofrontal cortex (OFC). Previous studies of CD have not taken account of ADs nor directly compared connectivity in the two disorders. We examined three groups of young women: 23 presenting CD and lifetime AD; 30 presenting lifetime AD and not CD; and 17 with neither disorder (ND). Participants completed clinical assessments and diffusion-weighted and resting-state functional MRI scans. The uncinate fasciculus was reconstructed using tractography and manual dissection, and structural measures extracted. Correlations of resting-state activity between amygdala and OFC seeds were computed. The CD + AD and AD groups showed similarly reduced structural integrity of the left uncinate compared to ND, even after adjusting for IQ, psychiatric comorbidity, and childhood maltreatment. Uncinate integrity was associated with harm avoidance traits among AD-only women, and with the interaction of poor anger control and anxiety symptoms among CD + AD women. Groups did not differ in functional connectivity. Reduced uncinate integrity observed in CD + AD and AD-only women may reflect deficient emotion regulation in response to threat, common to both disorders, while other neural mechanisms determine the behavioral response.

Place, publisher, year, edition, pages
NATURE PUBLISHING GROUP, 2018
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-144347 (URN)10.1038/s41598-018-19569-7 (DOI)000422739300064 ()29348532 (PubMedID)
Available from: 2018-02-07 Created: 2018-02-07 Last updated: 2018-08-08Bibliographically approved
Lindner, P., Flodin, P., Budhiraja, M., Savic, I., Jokinen, J., Tiihonen, J. & Hodgins, S. (2018). Associations of Psychopathic Traits With Local and Global Brain Network Topology in Young Adult Women. Biological psychiatry: Cognitive neuroscience and neuroimaging, 3(12), 1003-1012
Open this publication in new window or tab >>Associations of Psychopathic Traits With Local and Global Brain Network Topology in Young Adult Women
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2018 (English)In: Biological psychiatry: Cognitive neuroscience and neuroimaging, ISSN 2451-9022, Vol. 3, no 12, p. 1003-1012Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Psychopathic traits vary dimensionally in the population and are associated with multiple negative outcomes. The impaired integration theory (IIT) proposes that psychopathic traits are associated with abnormal neural network topology, such that disturbed integration of neural networks results in a self-perpetuating impairment in rapid integration and learning from multiple components of information. The IIT is based on findings from male offenders presenting high scores on all psychopathic traits. The present study investigated whether IIT predictions of topology abnormalities were associated with psychopathic traits, measured dimensionally, in young adult women with subsyndromal scores.

METHODS: Seventy-three women, with an average age of 25 years, were assessed using the Psychopathy Checklist-Revised and completed resting-state magnetic resonance imaging. Preprocessed time series from 90 anatomical regions were extracted to form connectivity matrices and used to calculate network topology based on graph theory. Correlations between total psychopathy and factor scores with both the raw connectivity matrix and global and local graph theory measures were computed.

RESULTS: Total psychopathy scores and behavioral factor scores were related to connectivity between several pairs of regions, primarily limbic/paralimbic. Psychopathic traits were not associated with global topology measures. Topology abnormalities, robust across network formation thresholds, were found in nodes of the default mode network and in hubs connecting several resting-state networks.

CONCLUSIONS: IIT predictions of abnormal topology of hubs and default mode network nodes with dimensionally measured psychopathic traits were confirmed in a sample of young women. Regional abnormalities, accompanied by preserved global topology, may underlie context-specific abnormal information processing and integration.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Connectivity, Default mode network, Graph theory, Psychopathy, Resting state, Topology
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-156122 (URN)10.1016/j.bpsc.2018.04.010 (DOI)29945829 (PubMedID)2-s2.0-85048967797 (Scopus ID)
Available from: 2019-02-05 Created: 2019-02-05 Last updated: 2019-08-26Bibliographically approved
Asellus, P., Nordström, P., Nordström, A.-L. & Jokinen, J. (2018). CSF Apolipoprotein E in attempted suicide. Journal of Affective Disorders, 225, 246-249
Open this publication in new window or tab >>CSF Apolipoprotein E in attempted suicide
2018 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 225, p. 246-249Article in journal (Refereed) Published
Abstract [en]

Background: Cholesterol and cholesterol metabolism, involved in continued neural plasticity, has been associated to suicide and suicidal behavior. Apolipoprotein E (ApoE) plays an important role in the cholesterol metabolism. The purpose of this study was to investigate whether ApoE in cerebrospinal fluid was related to severity of suicidal behavior as measured by number of earlier suicide attempts, reversibility/interruptabilty and violent method of suicide attempt. Methods: CSF ApoE and 5-hydroxyindolacetic acid (5-HIAA) were measured in 42 medication free suicide attempters. Earlier suicide attempts and the reversibility of suicide attempt method were assessed with the Suicide Intent Scale (SIS) and the Freeman Scale. Suicide attempts were classified according to violence of method. Results: CSF ApoE levels significantly negatively correlated to the scores on Freeman Reversibility and there was a trend for lower CSF ApoE levels in suicide attempters using a violent method. Patients with at least one earlier suicide attempt (repeaters) showed a trend for higher CSF ApoE levels compared to suicide attempters debuting with suicidal behavior at inclusion in the study. The correlation between CSF ApoE and 5-HIAA was not significant. Limitations: The main limitations to this study were a relatively small sample size and lack of a healthy control group. Conclusion: Irreversible suicide attempts, representing a high risk for completed suicide, may be associated with lower level of ApoE in CSF.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Suicide attempt, Apolipoprotein E, Violence, Cholesterol, Stress
National Category
Psychiatry Neurology
Identifiers
urn:nbn:se:umu:diva-141783 (URN)10.1016/j.jad.2017.08.019 (DOI)000413405700034 ()28841487 (PubMedID)
Available from: 2017-11-29 Created: 2017-11-29 Last updated: 2019-08-26Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6766-7983

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