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  • 1.
    DeMarinis, Valerie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Cetrez, O.
    A psychosocial-, somatic- and existential health study among Assyrian-Syrian refugees in Istanbul- understanding resilience in the midst of hardship2016Ingår i: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 85, s. 61-62Artikel i tidskrift (Övrigt vetenskapligt)
  • 2. Frøkedal, Hilde
    et al.
    Sorensen, Torgeir
    Ruud, Torleif
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Innlandet Hospital Trust, Norway; Uppsala University, Sweden.
    Stifoss-Hanssen, Hans
    Addressing the existential dimension in treatment settings: Mental health professionals' and healthcare chaplains' attitudes, practices, understanding and perceptions of value2019Ingår i: Archive for the Psychology of Religion/ Archiv für Religionspsychologie, ISSN 0084-6724, E-ISSN 1573-6121, Vol. 41, nr 3, s. 253-276Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Research has shown that addressing and integrating the existential dimension in treatment settings reduce symptoms like anxiety, depression and substance abuse. Healthcare chaplains are key personnel in this practice. A nationwide, cross-sectional survey influenced by a mixed-methods approach was used to examine the attitudes, practices, understanding and perceptions of mental health professionals, including healthcare chaplains, regarding the value of addressing the existential dimension in treatment programmes. The existential group practice was led by the healthcare chaplains as an integrated part of specialist mental health services. A positive and open attitude towards addressing the existential dimension was identified among the informants. Despite this, a small gap between attitude and practice was reported. Existential, religious and spiritual concerns are reported as part of the existential dimension and as relevant topics to be discussed in specialist mental health services. The findings indicate that the existential group practice could have a positive influence on the co-leaders' competence to address existential, religious and spiritual concerns; however, this should be further investigated.

  • 3.
    Frøkedal, Hilde
    et al.
    Centre for Diaconia and Professional Practice, VID Specialized University, Oslo, Norway.
    Stifoss-Hanssen, Hans
    Centre for Diaconia and Professional Practice, VID Specialized University, Oslo, Norway.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Innlandet Hospital Trust, Brumunddal, Norway; Uppsala University, Uppsala, Sweden.
    Ruud, Torleif
    Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.
    Visser, Anja
    Associate Professor of Spiritual Care, Faculty of Theology, Religious Studies of the University of Groningen, Netherlands.
    Sørensen, Torgeir
    Centre for Diaconia and Professional Practice, VID Specialized University, Oslo, Norway; Faculty of Health Studies, VID Specialized University, Sandnes, Norway.
    Participation in Existential Groups Led by Norwegian Healthcare Chaplains: Relations to Psychological Distress, Crisis of Meaning and Meaningfulness2022Ingår i: The international journal for the psychology of religion, ISSN 1050-8619, E-ISSN 1532-7582, Vol. 32, nr 1, s. 1-15Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Spirituality groups led by healthcare chaplains have been found to aid patients' recovery processes in US psychiatric units. In Norway, existential groups (EGs) led by healthcare chaplains and co-led by healthcare staff members are offered at psychiatric units; these groups share commonalities with spirituality groups, group psychotherapy, existential therapy and clinical pastoral care, facilitating patients' reflections regarding existential, spiritual and religious issues. The study aimed to examine associations between patients' participation and topics discussed in the EGs and their experiences of psychological distress, crisis of meaning and meaningfulness. A cross-sectional design was applied among 157 patients attending EGs led by healthcare chaplains across Norway. Multivariate regression analyses assessed the strength of possible associations, adjusted for relevant demographical variables. Significant association was found between lengthier EG participation and lower levels of psychological distress, while discussion topics concerning religious and spiritual issues were significantly associated with the experience of meaningfulness.

  • 4.
    Hadding, Cecilia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Semb, Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Lehti, Arja
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    "Let me die from everything that is my own": How trauma exposure, toxic shame, and coercive bonding are linked to former cult members' mental healthManuskript (preprint) (Övrigt vetenskapligt)
  • 5.
    Hadding, Cecilia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Semb, Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Lehti, Arja
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Fahlström, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Sandlund, Mikael
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    How can I trust someone who lives in the darkness?: former cult members’ perceptions of consultations with healthcare professionals2022Ingår i: International journal of coercion, abuse, and manipulation, ISSN 2710-401X, Vol. 4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: This study explores former cult members’ perceptions of consultations with healthcare professionals for mental illness that they relate to their cult involvement. The study also aims to identify the needs, obstacles, and facilitating factors related to these consultations.

    Design: Qualitative methods using semi-structured interviews that were analyzed using systematic text condensation.

    Participants: Nineteen former cult members who had been in contact with Swedish healthcare professionals due to mental illness related to their cult involvement.

    Results: Former cult members remain affected by cult belief systems, rules, and ideations even after leaving a cult. This leads to ambivalence and inner conflict for the former cult member in a healthcare consultation. Care providers are perceived as ignoring cult experiences and lacking knowledge of a cult’s impact on an individual.

    Conclusions: To understand, help, and work with former cult members, healthcare professionals need to know about cults and the possible impacts of cult involvement. Person- and patient-centeredness in the form of non-judgmental attitudes, validation of experiences, and awareness of the psychosocial situation are important in consultations with these patients. More over, healthcare providers need to acknowledge cultural and existential aspects of a former cult member’s life, both in the present and from earlier experiences in the cult.

  • 6.
    Hadding, Cecilia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Semb, Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Lehti, Arja
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Martin, Fahlström
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Sandlund, Mikael
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Department of Adult Psychiatry, Innlandet Hospital Trust, Sanderud, Norway.
    Being in-between; exploring former cult members' experiences of an acculturation process using the cultural formulation interview (DSM-5)2023Ingår i: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 14, artikel-id 1142189Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore the experiences of acculturation into secular Swedish society of former members of cults, with particular focus on mental health, needs and resources.

    Design: Qualitative method using the Cultural Formulation Interview (CFI) from the DSM-5 as an interview guide. Analysis of participants’ experiences of acculturation through systematic text condensation.

    Participants: Eleven Swedish former members of ideological or religion-based cults.

    Setting: Swedish mainstream, secular society.

    Results: Former cult members experience an ‘in-between time’ in the period after leaving the cult and find themselves in a confusing, chaotic state. They describe having lived in an honor culture where acts of violence were normalized. In the cult, they felt disconnected from themselves, and post-cult they try to regain access to their own values and feelings as well as create new bonds with family members and friends outside the cult. They find it hard to talk about their cult background and find relief in communicating with other former cult members. In their post-cult life, they eventually start seeing the world in a brighter, more hopeful way than before. However, they are also at risk of re-experiencing cult-related traumatic events and of new traumatic experiences within the post-cult acculturation process, and of persistent psychological distress.

    Conclusion: Former cult members face a challenging acculturation process, having lost a functioning worldview upon leaving the cult but not yet gained another to take its place. While the in-between time is often transient, they may need support from the healthcare system, especially regarding mental health concerns, while establishing themselves into mainstream society.

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  • 7.
    Lilja, Aina
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Department of Theology, Psychology of Religion and Cultural Psychology, Uppsala University, Uppsala, Sweden; Mental Health Division, Innlandet Hospital Trust, Hamar, Norway.
    Lehti, Arja
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Forssén, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Experiences and explanations of mental ill health in a group of devout Christians from the ethnic majority population in secular Sweden: a qualitative study2016Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 6, nr 10, artikel-id e011647Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To explore existential meaning-making in an ethnic-majority subgroup with mental ill health and to increase knowledge about the importance of gaining access to such information in mental healthcare.

    DESIGN: Qualitative study using in-depth interviews and systematic text condensation analysis.

    PARTICIPANTS: 17 devote Christians with an ethnic-Swedish background, 12 women and 5 men, 30-73 years old, from different congregations across Sweden, having sought medical care for mental ill health of any kind.

    SETTING: The secular Swedish society.

    RESULTS: A living, although asymmetric, relationship with God often was seen as the most important relationship, giving hope and support when ill, but creating feelings of abandonment and fear if perceived as threatened. Symptoms were interpreted through an existential framework influenced by their view of God. A perceived judging God increased feelings of guilt, sinfulness and shame. A perceived merciful God soothed symptoms and promoted recovery. Existential consequences, such as being unable to pray or participate in congregational rituals, caused feelings of 'spiritual homelessness'. Participants gave biopsychosocial explanations of their mental ill health, consonant with and sometimes painfully conflicting with existential explanations, such as being attacked by demons. Three different patterns of interaction among biopsychosocial and existential dimensions in their explanatory systems of illness causation were identified: (a) comprehensive thinking and consensus; (b) division and parallel functions and (c) division and competitive functions.

    CONCLUSIONS: Prevailing medical models for understanding mental ill health do not include the individual's existential experiences, which are important for identifying risk and protective factors as well as possible resources for recovery. The various expressions of existential meaning-making identified in this devout religious subgroup illustrate that existential information cannot be generalised, even within a small, seemingly homogenous group. The three identified patterns of interactions formed a typology that may be of use in clinical settings.

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  • 8. Lloyd, Christina Sophia
    et al.
    af Klinteberg, Britt
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Uppsala university, Sweden; Innlandet Hospital Trust, Norway.
    An Assessment of Existential Worldview Function among Young Women at Risk for Depression and Anxiety-A Multi-Method Study2017Ingår i: Archive for the Psychology of Religion/ Archiv für Religionspsychologie, ISSN 0084-6724, E-ISSN 1573-6121, Vol. 39, nr 2, s. 165-203Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Increasing rates of psychiatric problems like depression and anxiety among Swedish youth, predominantly among females, are considered a serious public mental health concern. Multiple studies confirm that psychological as well as existential vulnerability manifest in different ways for youths in Sweden. This multi-method study aimed at assessing existential worldview function by three factors: 1) existential worldview, 2) ontological security, and 3) self-concept, attempting to identify possible protective and risk factors for mental ill-health among female youths at risk for depression and anxiety. The sample comprised ten females on the waiting list at an outpatient psychotherapy clinic for teens and young adults. Results indicated that both functional and dysfunctional factors related to mental health were present, where the quality and availability of significant interpersonal relations seemed to have an important influence. Examples of both an impaired worldview function and a lack of an operating existential worldview were found. Psychotherapeutic implications are discussed.

  • 9. Melder, Cecilia
    et al.
    Santamäki Fischer, Regina
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Åbo Akademi University, Finland.
    Nygren, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Uppsala University.
    Validating WHOQOL-SRPB in Sweden: instrument adaption for measuring existential aspects of health-related quality of life [HRQL] in secular contexts2016Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, nr Suppl 1, s. 100-100, artikel-id 1056Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To present the validation process of WHOQOL-SRPB andWHOQOL-SRPB BREF in Sweden, one of the most secular countriesin the world though multi-religious, thus emphasising the need forprerequisite adjustments for cultural validation of the spirituality,religiousness and personal beliefs facets [SRPB].

    Methods: Theprocess adopted here follows WHO guidelines for translation andadaptation of instruments: Forward and Back translation, Pre-testing,Cognitive Interviewing, and Final version. Four bilingually and biculturally experienced researchers worked in two groups, comprisingexperience of either the Swedish translation of WHOQOL-100, -Brefand -OLD, or research into existential public health. Based on initialindependent translations from each, a final version was then developed through consensus translation, which was then back-translated.A pre-testing phase was conducted with individuals representingdifferent religious and non-religious worldviews. The final Swedishversion was completed by 170 persons, aging between 21 and 89(m = 46.6), with 105 women, and comprising both ‘‘healthy’’ individuals and individuals with mental health or somatic issues.

    Results:It was found that the instruction and particularly SRPB items thatused religious terminology needed adjustment. For example, ‘‘Spiritual being’’ was replaced with ‘‘Spiritual dimension’’, ‘‘Belief’’ with‘‘Your belief/idea’’, and ‘‘higher and more powerful’’ (instructiontext) was translated to ‘‘force/power/dimension’’. The pre- test resultswere useful in this process, especially qualitative information fromindividuals representing secular existential worldviews includingdifferent philosophical and political traditions. The internal consistency reliability of the overall SRPB-module was high (alpha = .97)as well as for the 8 facets (alpha ranging .80–.97). Test- retest(n = 19) showed r = .83 (p\.01). There were strong correlationsbetween all facets, the overall SRPB-module, and the overall qualityof life general health perceptions. No difference was found betweenwomen and men in the overall SRPB-module but in the ‘‘Connect’’facet, women scored higher (p = .02) whereas in ‘‘Peace’’ menscored higher (p = .04).

    Conclusions: The significance found throughusing existing translation/adaption guidelines, confirms that not onlyis it possible, but also relevant to include culturally validated existential aspects in studies of HRQL even in contexts that are largelysecular.

  • 10.
    Mughal, Rabya
    et al.
    Department of Psychiatry, Cambridge Public Health, School of Clinical Medicine, University of Cambridge, Herchel Smith Building, Cambridge, United Kingdom.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Innlandet Hospital Trust, Ottestad, Norway; Center for Research on Extremism, University of Oslo, Oslo, Norway.
    Nordendahl, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Lone, Hassan
    St George’s Medical School, University of London, London, United Kingdom.
    Phillips, Veronica
    School of Clinical Medicine, University of Cambridge Medical Library, Cambridge, United Kingdom.
    Boyd-MacMillan, Eolene
    Department of Psychiatry, Cambridge Public Health, School of Clinical Medicine, University of Cambridge, Herchel Smith Building, Cambridge, United Kingdom.
    Public mental health approaches to online radicalisation: an empty systematic review2023Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, nr 16, artikel-id 6586Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    This systematic review seeks to position online radicalisation within whole system frameworks incorporating individual, family, community and wider structural influences whilst reporting evidence of public mental health approaches for individuals engaging in radical online content. Methods: the authors searched Medline (via Ovid), PsycInfo (via Ebscohost) and Web of Science (Core Collection) with the use of Boolean operators across “extremism”, “online content” and “intervention”. Results: Following full-text assessments, all retrieved papers were excluded. No publications fulfilled the primary objective of reporting public mental health interventions specifically addressing online radicalisation. However, six publications fulfilled the secondary objective of identifying theoretical and conceptual relationships amongst elements in the three inclusion criteria (online extremism, psychological outcomes and intervention strategy) that could inform interventions within public mental health frameworks. These publications were quality assessed and discussed following the Cochrane Effective Practice and Organisation of Care guide for reporting empty reviews. Conclusions: there is an immediate need for further research in this field given the increase in different factions of radicalised beliefs resulting from online, particularly social media, usage.

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  • 11. Sundvall, Maria
    et al.
    Titelman, David
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Borisova, Liubov
    Cetrez, Onver
    Safe but isolated: an interview study with Iraqi refugees in Sweden about social networks, social support, and mental health2021Ingår i: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 67, nr 4, s. 351-359Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Problems with social networks and social support are known to be associated with mental ill-health in refugees. Social support after migration promotes resilience. Aim: To study how Iraqi refugees who arrived in Sweden after the year 2000 perceived their social networks and social support, and to relate the observed network characteristics and changes to the refugees' mental health and well-being. Method: Semi-structured interviews with 31 refugees, including questions on background and migration experiences, a biographical network map, and three health assessment scales. The findings were analysed with descriptive statistics and content thematic analysis. Results: The respondents' networks were diminished. Social support was continued to be provided mainly by family members and supplemented by support from authorities. The main themes of the refugee experience of post-migration challenges were weakened social networks, barriers to integration and challenges to cultural and religious belonging. Failed reunion and worrying about relatives was described as particularly painful. Negative contacts with authority persons were often seen as humiliating or discriminating. Acquiring a new cultural belonging was described as challenging. At the same time, changing family and gender roles made it more difficult to preserve and develop the culture of origin. Traumatic experiences and mental health problems were common in this group. Family issues were more often than integration difficulties associated with mental health problems. Conclusion: In order to strengthen post-migration well-being and adaptation, authorities should support the refugees' social networks. Clinicians need to address post-migration problems and challenges, including the meaning and function of social networks.

  • 12.
    Svamo, Nina Therese Øversveen
    et al.
    Research Center for Existential Health, Innlandet Hospital Trust, Brumunddal, Norway; Inland Norway University of Applied Sciences, Lillehammer, Norway.
    Haug, Sigrid Helene Kjørven
    Research Center for Existential Health, Innlandet Hospital Trust, Brumunddal, Norway; Inland Norway University of Applied Sciences, Elverum, Norway.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Research Center for Existential Health, Innlandet Hospital Trust, Brumunddal, Norway.
    Hertzberg, Urd
    Medical Library, Innlandet Hospital Trust, Brumunddal, Norway.
    Adolescents' voices on self-engagement in mental health treatment: a scoping review2024Ingår i: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165XArtikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Introduction: According to the United Nations Convention on the Rights of the Child, adolescents' involvement in their healthcare is a fundamental right, and self-engagement in mental health treatment is vital for realizing their potential within person-centered care (PCC). Research exists that highlights barriers to involving adolescents in their care decisions. However, research on adolescents' own voices about self-engagement in mental health treatment has been scarce. This scoping review aimed to examine and summarize current knowledge on adolescents' voices regarding self-engagement in mental health treatment.

    Method: The review followed the scoping methodology of Arksey and O'Malley from 2005, updated by Levac and colleagues in 2010, involving five stages: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collating, summarizing and reporting the results. Results: Nineteen studies were included. The following themes on adolescents' voices regarding self-engagement in mental health treatment were identified: (1) the therapeutic alliance, (2) the need for active engagement in treatment, (3) different experiences due to time of data collection, (4) treatment context and healthcare system, and (5) adolescent-caregiver interaction.

    Conclusion: Adolescents' understanding of self-engagement was multilevel and comprehensive, including individual, contextual and relational factors. A strong therapeutic alliance with healthcare providers, and a need to be actively engaged in treatment were highlighted. To succeed in strengthening PCC in mental healthcare for adolescents, health professionals must take this complex understanding into consideration, as treatment without adolescents' self-engagement may worsen their clinical outcomes. Future research should explore specific PCC interventions and incorporate diverse methodologies in various clinical contexts. Additionally, insights from healthcare providers and caregivers on self-engagement in mental health treatment will complement these findings.

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  • 13. Vatto, Ingvild E.
    et al.
    Haug, Sigrid H. K.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Centre for Psychology of Religion, Innlandet Hospital Trust, Hamar, Norway; Department of Theology, Psychology of Religion and Cultural Psychology, Uppsala University, Uppsala, Sweden.
    Lien, Lars
    Danbolt, Lars J.
    The significance ascribed to contacting a diaconal suicide-prevention crisis line in Norway: a qualitative study2020Ingår i: Mental Health, Religion & Culture, ISSN 1367-4676, E-ISSN 1469-9737, Vol. 23, nr 2, s. 113-126Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Suicide-prevention crisis lines worldwide offer support to individuals in crisis, nonetheless, there is limited in-depth knowledge as to the significance of contacting these services from the service-users’ first-hand perspectives. This study aimed to provide a deeper understanding of the significance ascribed to contacting a diaconal suicide-prevention crisis line in Norway. In-depth qualitative interviews were conducted with nine callers. The material was analysed using systematic text condensation. The analysis revealed three main themes reflecting the crisis line’s emotional, relational and existential support functions in terms of providing: (i) immediate emotional availability, (ii) experiences of connectedness and acceptance, and (iii) a safe space for existential meaning-making processes. The findings point to the need for future research on the value of integrating biopsychosocio-existential perspectives into intervention models within the field of crisis support.

  • 14. Vatto, Ingvild Engh
    et al.
    Lien, Lars
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Centre for Psychology of Religon, Innlandet Hospital Trust, Hamar, Norway; Department of Theology, Psychology of Religion & Cultural Psychology, Uppsala University, Uppsala, Sweden.
    Haug, Sigrid Helene Kjorven
    Danbolt, Lars Johan
    Caught Between Expectations and the Practice Field Experiences of This Dilemma Among Volunteers Operating a Diaconal Crisis Line in Norway2019Ingår i: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 40, nr 5, s. 340-346Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Volunteer crisis tine responders are a valuable resource for suicide prevention crisis lines worldwide.

    Aim: The aim of this study was to gain a deeper understanding of how volunteers operating a diaconal crisis line in Norway experienced challenges and how these challenges were met.

    Method: A qualitative, explorative study was conducted. A total of 27 volunteers were interviewed through four focus groups. The material was analyzed using systematic text condensation.

    Results: The greatest challenge to the volunteers was the perception of a gap between their expectations and the practice field. The experience of many volunteers was that the crisis line primarily served a broad ongoing support function for loneliness or mental illness concerns, rather than a suicide prevention crisis intervention function. Limitations:The focus group design may have made the participants more reluctant to share experiences representing alternative perspectives or personally sensitive information.

    Conclusion: The findings of this study suggest that a uniform response to callers using crisis lines as a source of ongoing support is warranted and should be implemented in volunteer training programs.

  • 15. Vattoe, Ingvild E.
    et al.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Centre for psychology of religion, Innlandet Hospital Trust, Hamar, Norway; Department of Theology, Psychology of Religion and Cultural Psychology, Uppsala University, Uppsala, Sweden.
    Haug, Sigrid H. K.
    Lien, Lars
    Danbolt, Lars J.
    Emotional stressors among volunteers operating a diaconal suicide-prevention crisis line in Norway: a qualitative study2020Ingår i: British Journal of Guidance and Counselling, ISSN 0306-9885, E-ISSN 1469-3534, Vol. 48, nr 4, s. 563-575Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Despite the worldwide proliferation of suicide-prevention crisis-line networks, there is limited in-depth knowledge of how the volunteer call responders experience and manage emotional stressors. The study's purpose was to explore emotional stressors related to operating a diaconal suicide-prevention crisis line, and how these are managed in daily operations. In this qualitative study, 27 volunteers were interviewed in four focus groups. The material was analysed using systematic text condensation. The participants experienced emotional stressors related to being unable to actively intervene, encountering traumatised callers and feeling uncertain about representing the Church. They used a combination of personal coping strategies and organisational support factors. Implications for training and practice are further discussed.

  • 16.
    Wallin, Malin Idar
    et al.
    Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet (KI), Stockholm Health Care Services, Stockholm, Sweden; Transcultural Centre, Region Stockholm, Stockholm, Sweden.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Division Mental Health Care, Innlandet Hospital Trust, Hamar, Norway.
    Nevonen, Lauri
    Department of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Aleris Psychiatry Täby, Stockholm, Sweden.
    Bäärnhielm, Sofie
    Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet (KI), Stockholm Health Care Services, Stockholm, Sweden; Transcultural Centre, Region Stockholm, Stockholm, Sweden.
    A qualitative analysis of the documentation of DSM-5 Cultural Formulation Interviews with non-native speaking patients in a Swedish mental health care setting2024Ingår i: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 15, artikel-id 1298920Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Cultural variety in expressed symptom presentations of mental health problems creates difficulties in transcultural diagnostic assessments. This emphasizes the need of culturally sensitive diagnostic tools like the Cultural Formulation Interview (CFI). Although the CFI is being implemented worldwide there is a lack of studies analyzing what kind of information it provides when used with new patients in routine psychiatric assessments, and how CFI information contributes to diagnostic evaluations. This study aimed to find out what information the CFI questions revealed when used with non-native Swedish speaking patients. We also wanted to understand how the CFI may facilitate identification of psychiatric diagnoses among these patients.

    Materials and methods: The CFI was used as part of a routine clinical psychiatric assessment in an outpatient clinic in Sweden. Interpreters were used in the consultations when needed. A qualitative thematic analysis was used to analyze the documented CFI answers from non-native speaking patients.

    Results: We found that the CFI information contained contextualized descriptions of dysfunction and current life conditions, as well as expressions of emotions, often described along with somatic terms.

    Discussion: Our results indicate that the narrative approach of the CFI, giving contextualized information about distress and functioning, can facilitate clinicians’ identification of psychiatric symptoms when language, psychiatric terms and understandings are not shared between patient and clinician.

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  • 17.
    Wallin, Malin Idar
    et al.
    Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet (KI) & Stockholm Health Care Services, Stockholm, Sweden; Transcultural Centre, Region Stockholm, Stockholm, Sweden.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Division Mental Health Care, Innlandet Hospital Trust, Hamar, Norway.
    Nevonen, Lauri
    Department of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Aleris Psychiatry Täby, Stockholm, Sweden.
    Bäärnhielm, Sofie
    Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet (KI) & Stockholm Health Care Services, Stockholm, Sweden; Transcultural Centre, Region Stockholm, Stockholm, Sweden.
    What information did the DSM-5 Cultural Formulation Interviews provide when used with Swedish-speaking patients in a psychiatric setting in Stockholm?2024Ingår i: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 15, artikel-id 1377006Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Cultural and contextual factors affect communication and how psychiatric symptoms are presented, therefore psychiatric assessments need to include awareness of the patients’ culture and context. The Cultural Formulation Interview (CFI) in DSM-5 is a person-centred tool developed to support the exploration of cultural and contextual factors in an individualized and non-stereotypic way.

    Methods: The aim of this qualitative study was to find out what information the DSM-5 CFI revealed when used with native Swedish-speaking patients as part of routine clinical psychiatric assessment at an outpatient clinic. An additional aim was to enhance understanding of what kind of information the questions about background and identity yielded. The CFI was added to the psychiatric assessment of 62 native Swedish-speaking patients at an outpatient psychiatric clinic in Stockholm.

    Results: From the thematic analysis of the documented CFI answers, six central themes were found; Descriptions of distress and dysfunction, Managing problems and distress, Current life conditions affecting the person, Perceived failure in meeting social expectations, Making sense of the problem, and Experiences of, and wishes for, help. The CFI questions about identity yielded much information, mainly related to social position and feelings of social failure.

    Discussion: For further refinement of the CFI, we see a need for re-framing the questions about cultural identity and its impact on health so that they are better understood. This is needed for majority population patients as direct questions about culture may be difficult to understand when cultural norms are implicit and often unexamined. For clinical implications, our findings suggest that for cultural majority patients the DSM-5 CFI can be a useful person-centred tool for exploring cultural and, in particular, social factors and patients’ perception and understanding of distress.

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  • 18.
    Çetrez, Önver A.
    et al.
    Faculty of Theology, Uppsala University, Uppsala, Sweden.
    DeMarinis, Valerie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin. Faculty of Theology, Uppsala University, Uppsala, Sweden; Public Mental Health Promotion Research Area, Innlandet Hospital Trust, Brumunddal, Norway.
    Sundvall, Maria
    Department of Learning, Informatics, Management and Ethics, National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.
    Fernandez-Gonzalez, Manuel
    Unit for Transcultural Psychiatry, Department of Psychiatry, Uppsala University Hospital, Uppsala, Sweden.
    Borisova, Liubov
    Department of Sociology, Uppsala University, Uppsala, Sweden.
    Titelman, David
    Department of Learning, Informatics, Management and Ethics, National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet, Stockholm, Sweden.
    A Public Mental Health Study Among Iraqi Refugees in Sweden: Social Determinants, Resilience, Gender, and Cultural Context2021Ingår i: Frontiers in Sociology, E-ISSN 2297-7775, Vol. 6, artikel-id 551105Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This public mental health study highlights the interactions among social determinants and resilience on mental health, PTSD and acculturation among Iraqi refugees in Sweden 2012-2013.

    Objectives: The study aims to understand participants' health, resilience and acculturation, paying specific attention to gender differences.

    Design: The study, using a convenience sampling survey design (N = 4010, 53.2% men), included measures on social determinants, general health, coping, CD-RISC, selected questions from the EMIC, PC-PTSD, and acculturation.

    Results: Gender differences and reported differences between life experiences in Iraq and Sweden were strong. In Sweden, religious activity was more widespread among women, whereas activity reflecting religion and spirituality as a coping mechanism decreased significantly among men. A sense of belonging both to a Swedish and an Iraqi ethnic identity was frequent. Positive self-evaluation in personal and social areas and goals in life was strong. The strongest perceived source of social support was from parents and siblings, while support from authorities generally was perceived as low. Self-rated health was high and the incidence of PTSD was low. A clear majority identified multiple social determinants contributing to mental health problems. Social or situational and emotional or developmental explanations were the most common. In general, resilience (as measured with CD-RISC) was low, with women's scores lower than that of men.

    Conclusions: Vulnerability manifested itself in unemployment after a long period in Sweden, weak social networks outside the family, unsupportive authorities, gender differences in acculturation, and women showing more mental health problems. Though low socially determined personal scores of resilience were found, we also identified a strong level of resilience, when using a culture-sensitive approach and appraising resilience as expressed in coping, meaning, and goals in life. Clinicians need to be aware of the risks of poorer mental health among refugees in general and women in particular, although mental health problems should not be presumed in the individual patient. Instead clinicians need to find ways of exploring the cultural and social worlds and needs of refugee patients. Authorities need to address the described post-migration problems and unmet needs of social support, together comprising the well-established area of the social determinants of health.

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