The aim of our study was to investigate HVB-home staff's perceptions of the temporary asylum law's impact on unaccompanied minors’ motivation for integration into Swedish society. On 24 November 2015, the government presented a temporary law to reduce the number of asylum seekers. The temporary law was intended to apply for three years and meant that Sweden went from having generous asylum legislation to following the EU's line for a minimum level for receiving asylum seekers. All asylum-seeking groups, such as refugees and people in need of protection, would receive temporary residence permits, except that there were exceptions for quota refugees who could obtain permanent residence permits. In the study, we used a qualitative method and conducted semi-structured interviews with five staff who had previously worked with unaccompanied children. Results from both interviews and previous research show that there are several factors that affect the mood of unaccompanied children and their integration into Swedish society. The study showed that previous psychological trauma, long waiting times for information about residence permits, loneliness and lack of meaningful activity had a negative impact on unaccompanied children's mood and motivation for integration.

The primary goal of this study was to examine whether changes in the temporal distance of a moral dilemma affect how it is perceived and subsequently resolved. Based on Construal Level Theory (Trope & Liberman, 2003), it was predicted that the relative weight of abstract justice features should increase and the relative weight of concrete care features should decrease with temporal distance. The results showed that females became increasingly justice-oriented with greater temporal distance. However, this was not the case for males who were unaffected by temporal distance. This interaction was conceptually replicated in a follow-up experiment in which abstraction was manipulated directly by a mindset manipulation. The present results suggest that temporal distance is a contextual factor that can alter the extent to which moral judgments and reasoning are based on justice and care, although this effect seems to be moderated by gender.

Tidigare forskning av Cheng, Tracy och Henrich (2010) har identifierat samband mellan tvåfacetter av stolthet och två olika strategier för att nå social status. Dessa samband harkonceptualiserats till stolthet-statusmodellen. Den har tidigare undersökts i en amerikanskpopulation och det finns enbart en studie på en liten avgränsad svensk population. Vidarefinns det inga tidigare studier som har undersökt om stolthet-statusmodellen samvarierar medpositiva attityder till utbildning. Denna studies syften var därför att undersöka stolthet-statusmodellen på en svensk population samt undersöka hur de olika statusstrategierna ochstolthetsfacetterna samvarierar med positiva attityder kring utbildning. För att undersöka dettagjordes ett bekvämlighetsurval av 609 stycken elever på teoretiska gymnasieprogram som fickskatta sin subjektiva upplevelse av stolthetsfacetterna, statusstrategierna samt sina positivaattityder till utbildning. Gymnasieelevernas skattningar korrelerades och skillnaden mellankorrelationerna undersöktes. Resultaten visar att stolthet-statusmodellen delvis är valid på ensvensk population, att statusstrategier samvarierar signifikant med positiva attityder tillutbildning och att stolthetsfacetterna till viss del samvarierar signifikant med positiva attitydertill utbildning. Möjliga förklaringar till resultaten diskuteras tillsammans med enmetoddiskussion samt praktiska implikationer och förslag på framtida forskning om stolthet-statusmodellen och positiva attityder till utbildning.

Purpose - An increasing number of people are migrating within the borders of China. Some migrants have to leave their children behind, and 58,000,000 children are estimated to be living as left-behind children. Earlier studies have found severe mental problems in left-behind children, but different factors could influence their mental health. The aim of this study was to investigate the mental health of these left-behind children and to determine possible influencing factors.

Design/methodology/approach - Data for this study were collected in one province of the P R of China with a validated instrument, the Strengths and Difficulties Questionnaire (SDQ) to investigate behavior in 13- to 15-year old children.

Findings - No significant difference was found in total difficulty score and in any subscale score of SDQ when we compared left-behind children with children who were not left behind. A significant difference in emotional difficulty subscale score was found between girls who were left behind and girls who were not. Some socio-economic factors such as poor family economy and living with relatives, friends or grandparents, were identified as risk factors.

Originality/value - When strategies for support of the mental health in left-behind children are developed, they will need to be individualized according to the gender, social and economic situation and focused on emotional and conduct problems.

Räddningstjänsten fyller en viktig funktion i samhället och har som mål att leverera effektiva räddningsinsatser till allmänhetens nytta. Samtidigt är brandmannayrket ett högriskyrke där brandmän är utsatta för sjukdomar orsakade av den fysiska arbetsmiljön som olika cancerformer. De är också utsatta för organisatoriska hälsorisker i form av negativ stress, vilket är fokus i denna uppsats. Syftet med uppsatsen var att klarlägga om det finns samband mellan psykosocial arbetsmiljö och upplevd stress hos brandmän. Frågeställningen var om krav, kontroll och socialt stöd kan predicera brandmäns upplevda stressnivå? Totalt deltog 67 brandmän ifrån två olika städer i södra Sverige. De oberoende variablerna var krav, kontroll och stöd och de uppmättes med svenska Demand Control Support Questionnaire. Stress uppmättes med svenska Perceived Stress Scale. Resultatet av en multipel regressionsanalys visade att krav och stöd var signifikanta prediktorer. Krav hade ett positivt och stöd hade ett negativt samband med stress. Kontroll kunde inte predicera stress. Resultat överensstämmer till viss del med tidigare forskning.

Objective: The objective of this study was to analyze the effect of adherence to both specific technique factors and facilitative condition variables (e.g., therapists' involvement, understanding and support) in Cognitive Behavior Therapy (CBT) and Interpersonal Psychotherapy (IPT). In addition, we were interested in whether the effect of therapist adherence would depend on the level of the working alliance. Method: Three sessions each from 74 patients diagnosed with Major Depressive Disorder who were randomized to 14 sessions of IPT or CBT were rated for adherence using a modified version of The Collaborative Study Psychotherapy Rating Scale-6 (CSPRS-6). Data was analyzed using Multilevel Modeling. Results: No effects of adherence to specific factors on outcome were found in neither CBT nor IPT. Facilitative conditions were associated with better outcome in CBT but not in IPT, even after adjustment for the quality of the working alliance. No interaction effects were found. Conclusions: Our findings highlight the importance of relational factors in CBT, but do not support the need for specific adherence to any of the two treatments. Possible explanations of the findings and directions for future research are discussed.

Förmåga att formulera sig i text har betydelse för måluppfyllelse i skolan och elevers framtida delaktighet i samhället. Skrivande och läsning är integrerade processer, där läsning kan förbättra textens sammanhang och tydlighet. En betydande andel elever möter dock utmaningar i grundskolan på grund av läs- och skrivsvårigheter eller dyslexi. Emellertid är assisterande teknik (AT) tillgänglig i exempelvis ordbehandlingsprogram och kan stödja elevers textproduktion. Tal-till-text innebär diktering av skriftspråk, medan talsyntes möjliggör lyssning på text. Denna avhandling inom psykologi undersökte effekten av AT på elevers textproduktion. Avhandlingen fokuserade också på strategier för introduktion av tal-till-text, elevers erfarenheter av AT, samt teknikens potentiella kompletterande roll i skolors undervisning i textproduktion.

Avhandlingens fyra studier omfattar 202 elever, huvudsakligen i åldrarna 9–12 år. Studierna I-III inkluderade elever med läs- och skrivsvårigheter eller dyslexi, medan studie IV inkluderade elever med varierade läs- och skrivfärdigheter. Studie I, en randomiserad kontrollerad studie, undersökte främst effekten av en AT-intervention på läsförmåga och förmåga att lyssna på text. En uppföljning, studie II, genomfördes fem år senare. Denna studie bestod av en kvalitativ tematisk analys av intervjuer med ett urval av deltagarna från Studie I. Syftet var att beskriva deras erfarenheter av AT i skolan. Studie III tillämpade en multiple-baseline single-case-design för att undersöka effekterna av en praxisbaserad AT-intervention på textproduktion, inklusive elevers hantering av tekniken. I Studie IV, en repeated-measures group-design, jämfördes tal-till-text med tangentbordsskrivning.

Resultaten visar att tal-till-text kan stödja textproduktion hos elever med läs- och skrivsvårigheter eller dyslexi. Individuella variationer i utfallet kräver anpassat stöd. För mellanstadieelever indikerar resultaten fördelar såsom förbättrad textlängd, korrekthet och skriftspråklig variation. Talsyntes kan underlätta effektiv granskning och redigering av text. Elevernas erfarenheterav AT belyser både möjligheter och utmaningar i skolan. Dessa erfarenheter inkluderar skolans stöd, elevernas perspektiv på AT och dyslexi, samt deras användning av AT under skolgången.

Taligenkänningsfel och optimal användning av AT i skolmiljön behöver adresseras för att förebygga svårigheter i dess tillämpning. Detta tillvägagångssätt underlättar användningen av tal-till-text i syfte att överbrygga hinder och stimulera elevers utveckling i textproduktion.

Resultaten diskuteras mot bakgrund av kognitiv teori för textproduktion samt AT-teori, med praktiska implikationer för skolan och framtida forskning.

Research within discrimination against ethnic minorities and females suggest that members of these groups face discrimination during recruitment processes in organizations. However, less is known on whether leaders from these groups are discriminated against due to their ethnicity and gender by being perceived less suitable as leaders at the workplace. Moreover, most previous research has focused on discrimination and stereotypes of members of single groups rather than of multiple group categories. In this study conducted in Sweden (N=300), we investigate whether the intersection of gender and ethnicity of a leader at the workplace affects employee perception of their leadership suitability and how signaling ethnicity and gender differs for Arab (minority) versus Swedish (majority) and Male (majority) versus Female (minority). The results show clear evidence of ethnic discrimination where a male Arab is less preferred to a leadership position than male Swede. However, there is no evidence indicating discrimination based on gender nor any significant interaction between gender and ethnicity. 

Keywords: Discrimination, Gender, Ethnicity, Intersectionality, Leadership 

IMPORTANCE It is unclear whether D-cycloserine (DCS), a partial N-methyl-D-aspartate agonist that enhances fear extinction, can augment the effects of exposure-based cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD). OBJECTIVES To examine whether DCS augments the effects of CBT for OCD and to explore (post hoc) whether concomitant antidepressant medication moderates the effects of DCS. DESIGN, SETTING, AND PARTICIPANTS A 12-week, double-blind randomized clinical trial with 3-month follow-up conducted at an academic medical center between September 4, 2012, and September 26, 2013. Participants included 128 adult outpatients with a primary diagnosis of OCD and a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of 16 or higher. Concurrent antidepressant medication was permitted if the dose had been stable for at least 2 months prior to enrollment and remained unchanged during the trial. The main analysis was by intention-to-treat population. INTERVENTIONS All participants received a previously validated Internet-based CBT protocol over 12 weeks and were randomized to receive either 50 mg of DCS or placebo, administered 1 hour before each of 5 exposure and response prevention tasks. MAIN OUTCOMES AND MEASURES Clinician-administered Y-BOCS score at week 12 and at 3-month follow-up. Remission was defined as a score of 12 or lower on the Y-BOCS. RESULTS In the primary intention-to-treat analyses, DCS did not augment the effects of CBT compared with placebo (mean [SD] clinician-rated Y-BOCS score, DCS: 13.86 [6.50] at week 12 and 12.35 [7.75] at 3-month follow-up; placebo: 11.77 [5.95] at week 12 and 12.37 [6.68] at 3-month follow-up) but showed a significant interaction with antidepressants (clinician-rated Y-BOCS, B = -1.08; Z = -2.79; P = .005). Post hoc analyses revealed that antidepressants significantly impaired treatment response in the DCS group but not the placebo group, at both posttreatment and follow-up (clinician-rated Y-BOCS: t(62) = -3.00; P = .004; and t(61) = -3.49; P < .001, respectively). In the DCS group, a significantly greater proportion of antidepressant-free patients achieved remission status at follow-up (60% [95% CI, 45%-74%]) than antidepressant-medicated patients (24% [95% CI, 9%-48%]) (P = .008). Antidepressants had no effect in the placebo group (50% [95% CI, 36%-64%] remission rate in both groups). CONCLUSIONS AND RELEVANCE The findings suggest that antidepressants may interact with DCS to block its facilitating effect on fear extinction. Use of DCS may be a promising CBT augmentation strategy but only in antidepressant-free patients with OCD.

Obsessive-compulsive disorder (OCD) is a common and disabling disorder. Although evidence-based psychological treatments exists, such as cognitive behavior therapy (CBT), the cost-effectiveness of CBT has not been properly investigated. In this trial, we used health economic data from a recently conducted randomized controlled trial, where 101 OCD patients were allocated to either internet-based CBT (ICBT) or control condition (online support therapy). We analyzed treatment effectiveness in relation to costs, using both a societal- (including all direct and indirect costs) and a health care unit perspective (including only the direct treatment costs). Bootstrapped net benefit regression analyses were also conducted, comparing the difference in costs and effects between ICBT and control condition, with different willingness-to-pay scenarios. Results showed that ICBT produced one additional remission for an average societal cost of $931 and this figure was even lower ($672) when narrowing the perspective to treatment costs only. The cost-utility analysis also showed that ICBT generated one additional QALY to an average price of $7186 from a societal perspective and $4800 when just analyzing the treatment costs. We conclude that ICBT is a cost-effective treatment and the next step in this line of research is to compare the cost-effectiveness of ICBT with face-to-face CBT. (C) 2014 Elsevier Inc. All rights reserved.

Internet-based cognitive behavior therapy (ICBT) for obsessive-compulsive disorder (OCD) has shown efficacy in randomized trials but many patients do not respond to the treatment, we therefore need to find predictors and moderators of treatment response. In this study, we analyzed predictors of ICBT response using both post-treatment as well as 24-month outcome data. As half of the participants were randomized to receive an Internet-based booster program as an adjunct to ICBT, we also investigated moderators of ICBT with or without booster. Results showed that more severe baseline OCD symptoms predicted worse end state outcome but also higher degree of change. Furthermore, high degree of working alliance predicted better outcome but patients with primary disgust emotions had worse treatment effects. The moderator analysis also indicated that scoring high on the obsessing subscale on the Obsessive-Compulsive Inventory-Revised predicted worse treatment outcome in the booster group. In conclusion, there are some possible predictors and moderators of ICBT for OCD but more research is needed with larger and clinically representative samples. (C) 2014 Elsevier Inc. All rights reserved.

Although cognitive interventions for obsessive-compulsive disorder (OCD) have been tested in randomized trials, there are few trials that have tested the specific mechanisms of cognitive interventions, i.e. how they achieve their effects. In this study, we aimed to investigate the mediating effects of a short cognitive intervention in the treatment of OCD and used data from a recently conducted randomized controlled trial where 101 participants were allocated to either Internet-based CBT (ICBT) or to a control condition. Obsessive beliefs were measured at pre-treatment, at the time they had received the cognitive intervention, and also at post-treatment. Weekly OCD symptoms were measured throughout the 10 weeks of treatment. We hypothesized that (1) the ICBT group would have greater reductions in obsessive beliefs (controlling for change in OCD symptoms) after completing the cognitive intervention, and that (2) this reduction would, in turn, predict greater OCD symptom reduction throughout the rest of the treatment period. Contrary to our expectations, the longitudinal mediation analysis indicated that (1) being randomized to ICBT actually increased the degree of obsessive beliefs after receiving the cognitive intervention at weeks 1-3, and (2) increase in obsessive beliefs predicted better outcome later in treatment. However, when repeating the analysis using cross-sectional data at post-treatment, the results were in line with the initial hypotheses. Results were replicated when the control condition received ICBT. We conclude that, although obsessive beliefs were significantly reduced at post-treatment for the ICBT group, early increase rather than decrease in obsessive beliefs predicted favourable outcome. Copyright (C) 2014 John Wiley & Sons, Ltd.

Cognitive behavior therapy (CBT) is an effective treatment for OCD when delivered face-to-face, in group-format and also via the internet. However, despite overall large effect sizes, a considerable amount of the patients relapse. One intervention that has the potential to reduce these relapse rates is booster programs, but if booster program is a cost-effective method of preventing relapse is still unknown. We used health economical data from a recent randomized controlled trial, where patients who had undergone an internet-based CBT were randomly allocated to receive an additional booster program. Assessment points were 4-, 7-, 12- and 24-month. Health economical data were primarily analyzed using a societal perspective. Results showed that the booster program was effective in preventing relapse, and the cost of one avoided relapse was estimated to $1066-1489. Cost-effectiveness acceptability curves showed that the booster program had a 90% probability of being cost-effective given a willingness to pay of $1000-1050 the first year, but this figure grew considerably after two years ($2500-5500). We conclude that internet-based booster programs are probably a cost-effective alternative within one-year time frame and that more treatment may be needed to maintain adequate cost-effectiveness up to two years. (C) 2014 Elsevier Inc. All rights reserved.

Background. As relapse after completed cognitive behavior therapy (CBT) for obsessive-compulsive disorder (OCD) is common, many treatment protocols include booster programs to improve the long-term effects. However, the effects of booster programs are not well studied. In this study, we investigated the long-term efficacy of Internet-based CBT (ICBT) with therapist support for OCD with or without an Internet-based booster program. Method. A total of 101 participants were included in the long-term follow-up analysis of ICBT. Of these, 93 were randomized to a booster program or no booster program. Outcome assessments were collected at 4, 7, 12 and 24 months after receiving ICBT. Results. The entire sample had sustained long-term effects from pre-treatment to all follow-up assessments, with large within-group effect sizes (Cohen's d=1.58-2.09). The booster group had a significant mean reduction in OCD symptoms compared to the control condition from booster baseline (4 months) to 7 months, but not at 12 or 24 months. Participants in the booster group improved significantly in terms of general functioning at 7, 12 and 24 months, and had fewer relapses. Kaplan-Meier analysis also indicated a significantly slower relapse rate in the booster group. Conclusions. The results suggest that ICBT has sustained long-term effects and that adding an Internet-based booster program can further improve long-term outcome and prevent relapse for some OCD patients.

Att gå i pension är något alla arbetstagare förr eller senare ställs inför. Syftet med denna kvalitativa intervjustudie var att undersöka hur den subjektiva upplevelsen av övergången mellan arbetsliv och pension kan se ut ut hos pensionärer och arbetstagare i övergångsfasen, samt hur den fysiska, psykiska och sociala hälsan påverkas av att gå i pension. Syftet undersöktes genom tolv semistrukturerade intervjuer, vilka analyserades med hjälp av tematisk innehållsanalys. Deltagarna bestod av nio män och tre kvinnor, vilka representerade en pensionärsverksamhet och ett företag i en mindre ort i södra Sverige. Det var sex personer i båda deltagargrupperna. Den tematiska analysen resulterade i tre teman, vilka svarade mot aktuell studies syfte: Ambivalent nyfikenhet, Relationer och Hälsa. Det har även identifierats subteman. Dessa är; Rollförvirring, Egna villkor, Engagemang, Att känna mening samt Aktiviteter. Deltagarna upplevde övergångsfasen och anpassningen till pensionen olika och det framkom en ambivalent nyfikenhet gällande pensionen. Vidare upplevdes att relationer var viktiga och fungerade som stöd under- och efter övergången samt att god hälsa var en nyckelfaktor för en lyckad pensionering. Sammantaget överensstämmer resultatet med tidigare forskning. 

Arbetsmotivation är en viktig aspekt i arbetet med att skapa välfungerande arbetsplatser. Särskilt hos HR-personal, som på olika sätt har ansvar över all personal i verksamheten. Tidigare forskning har visat indikationer på att personlighet till viss grad kan predicera arbetsmotivation. Syftet med studien var därför att undersöka detta samband bland HR-anställda i Sverige. Studien utfördes via en kvantitativ undersökning, där 408 respondenter fick värdera sin arbetsmotivation och personlighet utifrån två validerade instrument; Multidimensional Work Motivation Scale (MWMS), samt Ten Item Personality Measure TIPI. Dessa mätte arbetsmotivation med fyra olika typer av reglering utifrån Self determination-teorin, och personlighet med fem olika personlighetsdrag utifrån Big five-teorin. Resultatet visade att en högre grad av neuroticism kunde predicera en högre grad av externt och introjicerat reglerade arbetsmotivationsfaktorer samt en lägre grad av internt reglerade arbetsmotivationsfaktorer. Extraversion visades vara en positiv prediktor för internt reglerad arbetsmotivation. Öppenhet och samvetsgrannhet visades vara positiva prediktorer för både internt och identifierat reglerad arbetsmotivation. Sammanfattningsvis drogs slutsatsen att neuroticism, extraversion, öppenhet och samvetsgrannhet är prediktorer för extern och intern reglering av arbetsmotivation. 

The study focused on the relationship between management styles and job satisfaction

of employees in the organization. The aim of this study was to investigate the relationship

between management style, using Theory X and Y management style and job satisfaction as

moderated by employees’ self-efficacy and gender. The study involved N = 137 participants

from two different Swedish organizations in the engineering and manufacturing sector based

in Stockholm and Växjö, Sweden. The data was collected through surveys from each

participant. Study findings showed that there was a positive correlation between self-efficacy

and job satisfaction. Additionally, results revealed that the relationship between theory X and

Y and job satisfaction is not moderated by either self-efficacy and gender. Based on the study,

it was observed that job satisfaction is greatly impacted by management styles which are

oriented more towards theory Y than theory X in the relationship between management and

employees in organizations in Sweden. Thus, the study highlights the importance of

employee-oriented leadership style for the organizations and how this influences job

satisfaction of employees.

Correspondence and vignette experiments have already been an important part of measuring discrimination in hiring decisions for several decades, especially in terms of ethnic discrimination. Although the body of evidence is growing, no study has provided a systematic overview of age discrimination in recruitment before. Therefore, the present systematic review investigates the effect of age on discrimination levels experienced in the recruitment process, based on 14 correspondence and vignette studies in 12 distinct articles conducted between 2010 and 2019. We assess age discrimination by looking at call-back rates or indicators of hiring/interview invitation likelihood. Data was analyzedin age groups entailing 30-to 35-year-olds as comparators, and 40-to 49-, 50-to 59-, 60-to 65-and over 65-year-olds as experimental groups. Calculating log odds ratios for the respective comparisons, it was concluded that age discrimination in recruitment is indeed an observable issue, with greatest disparities apparent for participants over the age of 60. Certain limitations of this review will have to be overcome in future; such as restrictions in sample sizes and reported issues on the risk of bias.

The law of small numbers bias is a representativeness heuristic that often leads individuals to draw extensive conclusions from small samples while underestimating the generalizability in larger ones. This study investigated whether individuals overestimate perceived discrimination in small employment samples and underestimate it in large ones. A pre-registered scenario-based experiment was conducted, where participants (N = 874) estimated probability of discrimination versus chance in skewed hiring distributions. We manipulated employment sample size (filling four vs. 100 positions) and ethnic majority (hiring more immigrants or Swedes) using a 2x2 between-subject design. A tendency for people to overestimate perceived discrimination by underestimating the impact of chance in small employment samples was revealed. Conversely, in large employment samples, people tended to underestimate perceived discrimination by overestimating the impact of chance. Hence, results aligned with the law of small numbers. Furthermore, participants were more inclined to attribute an event as discriminatory when organizations hired more Swedes than immigrants, reflecting (accurate) prototypes of discrimination. This study's implications are discussed concerning the repercussions of underestimating and overestimating perceived discrimination in hiring situations. Future research suggestions are also provided.

Mental disorders and related behaviors such as suicidality and violence have been associated to dysregulation of e g carbohydrate metabolism. We hypothesized that patients after suicide attempt, compared to healthy controls, would have higher insulin and lower glucagon levels in plasma and cerebrospinal fluid and that these changes would be associated to violent behavior. Twenty-eight medication-free patients (10 women, 18 men), hospitalized after suicide attempt, and 19 healthy controls (7 women, 12 men) were recruited with the aim to study risk factors for suicidal behavior. Psychological/psychiatric assessment was performed with SCID I and II or the SCID interview for healthy volunteers respectively, the Karolinska Interpersonal Violence Scale (KIVS) for assessment of lifetime violence expression behavior, the Montgomery-Asberg-Depression-Scale (MADRS) and the Comprehensive Psychological Rating Scale (CPRS) for symptomatic assessment of depression and appetite. Fasting levels of insulin and glucagon were measured in plasma (P) and cerebrospinal fluid (CSF). Suicide attempters had higher insulin- and lower glucagon-levels in plasma- and CSF compared to controls. Except for P-glucagon these associations remained significant after adjusting for age and/or BMI. Patients reported significantly more expressed interpersonal violence compared to healthy volunteers. Expressed violence was significantly positively correlated with P- and CSF-insulin and showed a significant negative correlation with P-glucagon in study participants. These findings confirm and extend prior reports that higher insulin and lower glucagon levels in plasma and cerebrospinal fluid are associated with suicidal behavior pointing towards a potential autonomic dysregulation in the control of insulin and glucagon secretion in suicidal patients. (C) 2017 Elsevier Ltd. All rights reserved.

Ett av BHV:s mål är att upptäcka olika utvecklingsavvikelser för att kunna ge stöd till barnet med familj. Föräldrars oro ska alltid tas på allvar och ändamålsenliga insatser bör initieras så långt det är möjligt.

Background. The study aimed to investigate patient and spouse perception of cognitive functioning 1 to 2 years after coronary artery bypass grafting.

Methods. Seventy-six married patients who had undergone coronary artery bypass grafting were selected and sex- and age-matched with 75 concurrent married patients who had undergone percutaneous transluminal coronary angioplasty. Couples received a letter of explanation and then completed telephone interviews. Forty-seven questions assessed memory, concentration, general health, social functioning, and emotional state. Response choices were: improved, unchanged, or deteriorated function after coronary artery bypass grafting/percutaneous transluminal coronary angioplasty.

Results. Patients who had undergone coronary artery bypass grafting did not differ in subjective ratings on any measure from patients who had undergone percutaneous transluminal coronary angioplasty. There were no differences between spouses in the respective groups; spouse ratings also did not differ from patient ratings. Only in memory function did patients and spouses report a postprocedural decline.

Conclusions. No subjective differences were found in patients who had undergone either coronary artery bypass grafting or percutaneous transluminal coronary angioplasty. Spouse ratings agreed with each other and with patient ratings. Positive correlations were found between the questionnaire factors, suggesting that perceived health and well-being are associated with subjective cognition.

Debatten om Socialstyrelsens nya riktlinjer för ångest och depression har varit polariserad och inte konstruktiv. Diskussionen bör inte handla om PDT eller KBT utan om evidensbaserade metoder och kompetensbrist.

Purpose

Creative approaches to improve access to evidence-based tinnitus treatments are required. The purpose of this study was to develop an Internet-based cognitive behavioural therapy (iCBT) intervention, for those experiencing tinnitus in the United Kingdom (UK). Furthermore, it aimed, through technical functionality testing, to identify specific aspects of the iCBT that require improving.

Method

An innovative iCBT intervention for treating tinnitus in the UK has been developed using a cognitive-behavioural theoretical framework. This iCBT was evaluated by two user groups during this developmental phase. Initially, five expert reviews evaluated the intervention, prior to evaluation by a group of 29 adults experiencing significant levels of tinnitus distress. Both groups evaluated iCBT in an independent measures design, using a specifically designed satisfaction outcome measure.

Results

Overall, similar ratings were given by the expert reviewers and adults with tinnitus, showing a high level of satisfaction regarding the content, suitability, presentation, usability and exercises provided in the intervention. The iCBT intervention has been refined following technical functionality testing.

Conclusions

Rigorous testing of the developed iCBT intervention has been undertaken. These evaluations provide confidence that further clinical trials can commence in the UK, to assess the feasibility and effectiveness of this iCBT intervention for tinnitus.

Terapeuters reaktioner gentemot patienter är en viktig del i den psykoterapeutiska processen, och påverkas av terapeuters och patienters personliga egenskaper. Den här studien syftade till att utvidga förståelsen för terapeuters känslomässiga reaktioner genom att undersöka om patienters anknytning och mentaliseringsförmåga predicerar terapeuters motöverföring i psykoterapi. Multilevel-modeling användes för att analysera 87 behandlingsdyader i psykoterapi. Patienters anknytning, mätt innan behandling genom självskattning, och mentalisering operationaliserat som reflektivt fungerande (RF) förväntades predicera terapeuters självskattade emotionella upplevelser (konceptualiserat som motöverföring) över hela behandlingsperioden och i olika behandlingsfaser. Resultaten visade att lägre RF hos patienter predicerade mer negativ motöverföring hos terapeuter över hela behandlingsperioden. I mitten- och slutfaserna av terapin predicerade lägre RF mer negativ motöverföring, och högre RF predicerade mer positiv motöverföring. Högre nivåer av undvikande anknytning hos patienter predicerade mer avslappnad motöverföring hos terapeuter i slutfasen. Fynden indikerar att patienters mentaliseringsförmåga är viktigt att beakta i psykoterapi, eftersom det har informativt värde för den terapeutiska processen.

This 3-year follow-up compared insomnia treatment to depression treatment for patients with both diagnoses. Forty-three participants were randomized to either treatment, in the form of Internet-delivered therapist-guided cognitive behavior therapy (CBT), and 37 (86%) participants provided primary outcome data at the 3-year follow-up. After 3 years, reductions on depression severity were similar in both groups (between-group effect size, d = 0.33, p =.45), while the insomnia treatment had superior effects on insomnia severity (d = 0.66, p <.05). Overall, insomnia treatment was thus more beneficial than depression treatment. The implication for practitioners, supported by previous research, is that patients with co-occurring depression and insomnia should be offered CBT for insomnia, in addition to medication or psychological treatment for depression.

Study Objectives: To investigate the long-term effects of therapist-guided Internet-based insomnia treatment on insomnia severity and sleep medication use, compared with active control. Methods: This study was an 8 week randomized controlled trial with follow-up posttreatment and at 6, 12, and 36 months, set at the Internet Psychiatry Clinic, Stockholm, Sweden. Participants were 148 media-recruited nondepressed adults with insomnia. Interventions were Guided Internet-based cognitive behavioral therapy for insomnia (ICBT-i) or active control treatment (ICBT-ctrl). Primary outcome was insomnia severity, measured with the Insomnia Severity Index. Secondary outcomes were sleep medication use and use of other treatments. Results: The large pretreatment to posttreatment improvements in insomnia severity of the ICBT-i group were maintained during follow-up. ICBT-ctrl exhibited significantly less improvement posttreatment (between-Cohen d = 0.85), but after 12 and 36 months, there was no longer a significant difference. The within-group effect sizes from pretreatment to the 36-months follow-up were 1.6 (ICBT-i) and 1.7 (ICBT-ctrl), and 74% of the interviewed participants no longer had insomnia diagnosis after 36 mo. ICBT-ctrl used significantly more sleep medication (P = 0.017) and underwent significantly more other insomnia treatments (P < 0.001) during the follow-up period. Conclusions: The large improvements in the ICBT-i group were maintained after 36 months, corroborating that CBT for insomnia has long-term effects. After 36 months, the groups did not differ in insomnia severity, but ICBT-ctrl had used more sleep medication and undergone more other additional insomnia treatments during the follow-up period.

Insomnia and depression is a common and debilitating comorbidity, and treatment is usually given mainly for depression. Guided Internet-based cognitive behavioral therapy for insomnia (ICBT-i) was, in a recent study on which this report is based, found superior to a treatment for depression (ICBT-d) for this patient group, but many patients did not reach remission.

Study Objectives: To compare treatment effects when patients with insomnia and depression receive treatment for either insomnia or depression. Design: A 9-w randomized controlled trial with 6- and 12-mo follow-up. Setting: Internet Psychiatry Clinic, Stockholm, Sweden. Participants: Forty-three adults in whom comorbid insomnia and depression were diagnosed, recruited via media and assessed by psychiatrists. Interventions: Guided Internet-delivered cognitive behavior therapy (ICBT) for either insomnia or depression. Measurements and Results: Primary outcome measures were symptom self-rating scales (Insomnia Severity Index [ISI] and the Montgomery Asberg Depression Rating Scale [MADRS-S]), assessed before and after treatment with follow-up after 6 and 12 mo. The participants' use of sleep medication and need for further treatment after completion of ICBT was also investigated. The insomnia treatment was more effective than the depression treatment in reducing insomnia severity during treatment (P = 0.05), and equally effective in reducing depression severity. Group differences in insomnia severity were maintained during the 12-mo follow-up period. Post treatment, participants receiving treatment for insomnia had significantly less self-rated need for further insomnia treatment (P < 0.001) and used less sleep medication (P < 0.05) than participants receiving treatment for depression. The need for depression treatment was similar in both groups. Conclusions: In this study, Internet-delivered treatment with cognitive behavior therapy (ICBT) for insomnia was more effective than ICBT for depression for patients with both diagnoses. This indicates, in line with previous research, that insomnia when comorbid with depression is not merely a symptom of depression, but needs specific treatment.

The aim of this study was to compare guided Internet-delivered to group-delivered cognitive behavioral therapy (CBT) for insomnia. We conducted an 8-week randomized controlled non-inferiority trial with 6-months follow-up. Participants were forty-eight adults with insomnia, recruited via media. Interventions were guided Internet-delivered CBT (ICBT) and group-delivered CBT (GCBT) for insomnia. Primary outcome measure was the Insomnia Severity Index (ISI), secondary outcome measures were sleep diary data, depressive symptoms, response- and remission rates. Both treatment groups showed significant improvements and large effect sizes for ISI (Within Cohen's d: ICBT post = 1.8, 6-months follow-up = 2.1; GCBT post = 2.1, 6-months follow-up = 2.2). Confidence interval of the difference between groups posttreatment and at FU6 indicated non-inferiority of ICBT compared to GCBT. At post-treatment, two thirds of patients in both groups were considered responders (ISI-reduction > 7p). Using diagnostic criteria, 63% (ICBT) and 75% (GCBT) were in remission. Sleep diary data showed moderate to large effect sizes. We conclude that both guided Internet-CBT and group-CBT in this study were efficacious with regard to insomnia severity, sleep parameters and depressive symptoms. The results are in line with previous research, and strengthen the evidence for guided Internet-CBT for insomnia. Trial registration: The study protocol was approved by, and registered with, the regional ethics review board in Linkoping, Sweden, registration number 2010/385-31. (C) 2015 The Authors. Published by Elsevier Ltd.

Despite place attachment's prominence within the environmental psychology literature, the scales and items used to measure place attachment vary significantly, hindering the ability of researchers to rally behind a standard measure. These types of discrepancies hamper the ability of researchers to directly compare findings across communities and conduct metanalyses on the antecedents and outcomes of place attachment. Furthermore, scales consisting of more than three items may unnecessarily burden respondents, thus impeding opportunities to add new constructs to surveys so that the precursors and outcomes of place attachment can be better understood. With this in mind, the purpose of this paper is to present and test the cross-cultural reliability and validity of an Abbreviated Place Attachment Scale (APAS) (i.e., three items for place identity and three items for place dependence) across seven samples spanning five data collections and four countries (United States, Cape Verde, Nigeria and Poland) involving residents and visitors. Confirmatory factor analysis reveals that the abbreviated scales perform just as well as their extended parents, and the multi-group confirmatory factor analysis reveals full measurement invariance demonstrating that the APAS is equivalent across cultures. Based on these results, the APAS should be given full attention by place attachment researchers seeking to expand the literature on the understanding of how people connect to places and the implications that these connections have on other important constructs such as quality of life, support for tourism, and place-based conservation efforts or individual environmental behaviors.

Depression is a common, recurrent disorder. There is a need for readily available treatments with few negative side effects, that demands little resources and that are effective both in the short- and long term. Our aim was to investigate the long-term effectiveness of two different interventions; physical exercise and internet-based cognitive behavioural therapy (internet-CBT), compared to usual care in patients with mild to moderate depression in a Swedish primary care setting. We performed a register-based 3-year follow-up study of participants in the randomized controlled trial REGASSA (n = 940) using healthcare utilization and dispensed medicines as outcomes. We found no difference between the three groups regarding proportion of participants consulting healthcare due to mental illness or pain during follow-up. Regarding number of consultations, there was no difference between the groups, except for consultations related to pain. For this outcome both treatment arms had significantly fewer consultations compared to usual care, during year 2-3, the risk ratio (RR) for physical exercise and internet-CBT was 0.64 (95% CI = 0.43-0.95) and 0.61 (95% CI = 0.41-0.90), respectively. A significantly lower proportion of patients in both treatment arms were dispensed hypnotics and sedatives year 2-3 compared to the usual care arm, RR for both physical exercise and internet-CBT was 0.72 (95% CI = 0.53-0.98). No other differences between the groups were found. In conclusion, considering long-term effects, both physical exercise and internet-CBT, being resource-efficient treatments, could be considered as appropriate additions for patients with mild to moderate depression in primary care settings.

Study Objectives: Acceptance may be an important therapeutic process in sleep medicine, but valid psychometric instruments measuring acceptance related to sleep difficulties are lacking. The purpose of this study was to develop a measure of acceptance in insomnia, and to examine its factor structure as well as construct validity. Design: In a cross-sectional design, a principal component analysis for item reduction was conducted on a first sample (A) and a confirmatory factor analysis on a second sample (B). Construct validity was tested on a combined sample (C). Setting: Questionnaire items were derived from a measure of acceptance in chronic pain, and data were gathered through screening or available from pretreatment assessments in four insomnia treatment trials, administered online, via bibliotherapy and in primary care. Participants: Adults with insomnia: 372 in sample A and 215 in sample B. Sample C (n = 820) included sample A and B with another 233 participants added. Measures: Construct validity was assessed through relations with established acceptance and sleep scales. Results: The principal component analysis presented a two-factor solution with eight items, explaining 65.9% of the total variance. The confirmatory factor analysis supported the solution. Acceptance of sleep problems was more closely related to subjective symptoms and consequences of insomnia than to diary description of sleep, or to acceptance of general private events. Conclusions: The Sleep Problem Acceptance Questionnaire (SPAQ), containing the subscales "Activity Engagement" and "Willingness", is a valid tool to assess acceptance of insomnia.

Losing a loved one – a child or a spouse –is described as one of the most stressful or negative experience of a person’s life. Aging is associated with a higher risk of the death of close family members, yet few studies have investigated the impact of such losses on different health outcomes either by type of loss or by the combined loss of both a child and a spouse. This thesis is based on three studies examining the effect of bereavement on the health of older adults who have lost a child, spouse, or both and whether the different losses were associated with Life Satisfaction (LS) or mortality. The sample was collected from the Swedish National Study of Aging and Care (SNAC).

The results showed that the loss of a child, spouse or both was experienced as among the three most important negative life events in the bereaved groups. About 70% of those bereaved of a child or a spouse mentioned these losses as among their three most important negative life experiences. In the child-and-spouse-bereaved group, 48% mentioned both losses while 40% mentioned only the loss of a child or a spouse, but not both. However, only marginally effects on LS and mortality after child, spouse or child-spouse bereavement in older adults was found. Longer time since the loss was associated with higher LS and lower mortality risk, and type of loss did not seem to determine LS or mortality. Gender differences were found: child-, spouse and child-and-spouse-bereaved men had lower LS than the corresponding groups of bereaved women, and furthermore, child-bereaved men had an increased mortality risk compared to child-bereaved women. Finally, significantly more women in the child-and-spouse-bereaved group compared to the men in this group, mentioned the loss of their child but not the spouse, among the three most important negative life events.

Negative attitudes towards aging are common in society. However, few studies haveinvestigated how older adults perceive this phenomenon. This study investigated (a) how olderadults in Sweden perceive general attitudes towards the older population and whether negativeperceptions are associated with low life satisfaction, self-compassion, and health-related qualityof life (HRQL), and (b) whether perceived attitudes predict life satisfaction when controlling forHRQL, self-compassion, and age. The sample comprised 698 randomly selected participants, aged66–102 years, from the Blekinge part of the Swedish National Study on Ageing and Care. The resultsshowed that 25.7% of the participants held negative attitudes towards older adults and reportedlower life satisfaction and HRQL. Self-compassion was related to higher life satisfaction, perceivedpositive attitudes, and better mental HRQL. Overall, perceived attitudes, HRQL, self-compassion,and age predicted 44% of the participants’ life satisfaction. Understanding the factors that influenceolder adults’ life satisfaction is crucial, as health-related losses might reduce the opportunity fora successful life. Our study makes an important contribution to the field, showing that perceivedattitudes explained 1.2% of the variance of life satisfaction, whereas mental and physical HRQLaccounted for 18% of life satisfaction.

Background: Severe stress is one of the most common causes of sick leave in Sweden. Previous research hasshown that compassion interventions for healthcare professionals can decrease work-related stress through theintroduction of self-care, self-awareness, and emotion regulation abilities when experiencing difficult situations.Internet-based stress management interventions have hitherto shown promising results in reducing stress.However, further research is needed to examine the effectiveness of internet-based compassion interventions forhealthcare professionals.Objective: In the present study protocol, a randomised controlled trial is described, aiming to examine the effectsof an internet-based compassion course for healthcare professionals on work-related stress and stress ofconscience.Method: Healthcare professionals will be offered an internet-based stress management course of five modulesacross a period of five weeks. The design is a randomised controlled study consisting of three groups enrolled inone of the following: a compassion course (n = 120), a cognitive behavioural stress management course (n =120), or placed on a waitlist followed by either the compassion course or the cognitive behavioural stressmanagement course (n = 36). We hypothesise that the internet-based compassion course would reduce theparticipants’ stress of conscience to a greater degree compared to the other two groups. The secondary hypothesisis that the compassion course would increase the participants’ professional quality of life (i.e., higher jobsatisfaction and lower empathy fatigue) and self-compassion. In addition, the internet-based compassion courseis expected to reduce the participants’ work-related stress and sick leave rates to the same degree (non-inferiority)as the cognitive behavioural stress management course and to a higher degree when compared to thewaitlist condition. The primary outcome measure is the Stress of Conscience Questionnaire (SCQ) and the secondaryoutcome measures are the Professional Quality of Life Scale (PROQOL), the Work-related StressCopenhagen Psychosocial Questionnaire (COPSOQ), and the Self-compassion Scale (SCS). Assessments will beperformed at baseline, four weekly assessments during treatment, post-treatment (5 weeks), and follow-ups at 10weeks, 15 weeks, and 6 months. The repeated measures data will be analysed using a generalised estimatingequation for repeated measurements to examine whether changes over time differ between the groups andwhether the improvements persist over time.Discussion: The clinical trial is expected to provide novel data on the effects of compassion interventions and addto the existing knowledge of internet-based interventions for stress management in healthcare professionals.

Fredrickson et al. [Fredrickson BL, et al. (2013) Proc Natl Acad Sci USA 110(33):13684–13689] claimed to have observed significant differences in gene expression related to hedonic and eudaimonic dimensions of well-being. Having closely examined both their claims and their data, we draw substantially different conclusions. After identifying some important conceptual and methodological flaws in their argument, we report the results of a series of reanalyses of their dataset. We first applied a variety of exploratory and confirmatory factor analysis techniques to their self-reported well-being data. A number of plausible factor solutions emerged, but none of these corresponded to Fredrickson et al.’s claimed hedonic and eudaimonic dimensions. We next examined the regression analyses that purportedly yielded distinct differential profiles of gene expression associated with the two well-being dimensions. Using the best-fitting two-factor solution that we identified, we obtained effects almost twice as large as those found by Fredrickson et al. using their questionable hedonic and eudaimonic factors. Next, we conducted regression analyses for all possible two-factor solutions of the psychometric data; we found that 69.2% of these gave statistically significant results for both factors, whereas only 0.25% would be expected to do so if the regression process was really able to identify independent differential gene expression effects. Finally, we replaced Fredrickson et al.’s psychometric data with random numbers and continued to find very large numbers of apparently statistically significant effects. We conclude that Fredrickson et al.’s widely publicized claims about the effects of different dimensions of well-being on health-related gene expression are merely artifacts of dubious analyses and erroneous methodology.

Syftet med denna studie var att undersöka om tjänstemän och arbetare skiljer sig åt i självskattad arbetstillfredsställelse samt att studera om arbetstillfredsställelse kan prediceras utifrån prediktorerna kön, ålder, anställningstid och facklig tillhörighet. Studien utfördes på ett statligt universitet i södra Sverige. Samplet bestod av 80 anställda från fyra avdelningar, ekonomiavdelningen, personalavdelningen, IT-avdelningen och lokal- och serviceavdelningen. Av dessa var 26 arbetare och 54 tjänstemän, baserat på facklig tillhörighet. Studiens mätinstrument bestod av en enkät baserad på Sigvard Rubenowitz test om psykosocial arbetsmiljökartläggning (PAK). Testet mäter arbetstillfredsställelse utifrån subskalorna egenkontroll, stimulans från arbetet, arbetsgemenskap, arbetsledningsklimat och arbetsbelastning. Statistisk prövning med med  t-test och multipel regressionsanalys visade en signifikant skillnad mellan arbetare och tjänstemän där tjänstemän upplevde högre egenkontroll, mer stimulans från arbetet och högre arbetsbelastning. Anställningstid var en signifikant prediktor för arbetsbelastning och ålder visade sig vara en signifikant prediktor för arbetsledningsklimat och stimulans från arbetet.

Artificial intelligence (AI) is increasingly used in organizational decision-making, optimizing performance, and cutting operational costs. While AI can potentially improve decision-making processes' efficiency and reliability, empirical research highlights that AI adoption may cause people to question the fairness of algorithmic decisions. Thus, the present study investigates whether distributive and procedural fairness perceptions are influenced by human, algorithmic, and hybrid decision-makers in high versus low task complexity conditions. Participants (N = 391) assessed the perceived distributive and procedural fairness in a pre-registered scenario-based experiment. Decision-maker type (human vs. hybrid vs. AI) and task complexity (low vs. high) were manipulated using a 3x2 between-subject design. It was hypothesized that the human decision-maker would be perceived as fairer than the AI, especially in high-complexity conditions. Furthermore, hybrid decision-makers were hypothesized to be perceived as fairer than AI and human decision-makers in low and high-complexity tasks. The results indicate that people tend to perceive human decision-makers as fairer than AI in situations of high complexity. Additionally, in the high-complexity condition, the hybrid decision-maker was perceived as more distributively fair than AI and less procedural fair than the human decision-maker. In low-complexity tasks, the hybrid decision-maker does not show superiority in fairness perception over AI or humans. Hence, the results support the first hypothesis and contradict the second hypothesis that hybrid decision-makers would be perceived as more distributive and procedural fair than AI and human decision-makers. Implications regarding the consequences of implementing AI in organizational decision-making are discussed, and suggestions for further research are included. 

Gender stereotypes describe women as communal and men asagentic. Laboratory based research (Rudman & Glick 1999; 2001)suggests that trying to disconfirm such descriptive genderstereotypes (e.g., women self-promoting their agency), entails therisk of hiring discrimination due to violation of prescriptive genderstereotypes: a backlash. To examine whether backlash occurs whenapplying for real jobs, we conducted a field experiment. Gender,agency and communion were manipulated in the personal profile of5,562 applications sent to 3,342 job openings on the Swedish labormarket. The dependent variable was whether the applicationresulted in an invitation to a job interview or not. The results do notoffer any support for the backlash hypothesis at this stage in therecruitment process.

Background: A majority of psychiatric patients suffer from insomnia or insomnia-like problems. In addition to impairing quality of life, sleep problems can worsen psychiatric conditions, such as depression and anxiety, and can make treatment of various psychiatric conditions less successful. Several international guidelines recommend cognitive behavioural therapy for insomnia (CBT-I) as first line treatment. However, patients in psychiatric care are rarely offered this treatment, and there is a lack of studies evaluating the treatment in regular psychiatric settings. In this pilot study, we aimed to determine the clinical feasibility of a group-based CBT-I intervention in an outpatient clinical setting for patients with depression, bipolar disorder, anxiety disorders and PTSD. We also aimed to investigate if symptoms of insomnia, depression and anxiety changed after CBT-I. Methods: Seventeen patients at an out-patient psychiatric clinic for mixed psychiatric problems of anxiety, affective disorders and PTSD, were enrolled in a six-week long group-based CBT-I intervention. Primary outcomes were pre-defined aspects of treatment feasibility. Secondary outcomes were changes in self-reported symptoms of insomnia severity, depression, and anxiety between pre - and post intervention. Assessment of insomnia severity was also performed 3 months after treatment. Feasibility data is reported descriptively, changes in continuous data from preto post-treatment were analysed with dependent t-tests. Results: All feasibility criteria were met; there were enough patients to sustain at least one group per semester (e.g., minimum 8), 88% of included patients attended the first session, mean of attended sessions was 4.9 of 6, and dropout rate was 5.9%. Therapists, recruited from clinical staff, found the treatment manual credible, and possible to use at the clinic. Symptoms of insomnia decreased after treatment, as well as symptoms of depression and anxiety. Conclusion: CBT-I could prove as a clinically feasible treatment option for insomnia in a psychiatric outpatient setting.

Older people constitute an important category of eyewitnesses. Episodic memory performance in older persons is poorer than in younger adults, but little research has been made on older persons' metacognitive judgments. Since more persons of advanced age will likely be called upon as witnesses in coming years, it is critical to characterize this population's metacognitive abilities. We compared event memory metacognition in old adults (66-year-old, n = 74) to very old adults (87 or 90 years old, n = 55). Participants were tested on their memory of a film, using questions with two answer alternatives and the confidence in their answer. As expected, the very old group had a lower accuracy rate than the old group (d = 0.59). The very old group, however, monitored this impairment, since their over-/underconfidence and calibration did not differ from the old group but they displayed a poorer ability to separate correct from incorrect answers (discrimination ability). Possibly, the very old group was able to monitor the level of their over-/underconfidence because they applied general self-knowledge about their memory skills. In contrast, the discrimination of correct from incorrect answers may be more dependent on ability to attend to the features of each retrieved memory.

Objectives. The aim of the study was to assess long-term state and trait anxiety in cardiac surgical risk patients. Design. Thirty two patients with serum S100B > 0.3 µg/l 48 hours after cardiac surgery with cardiopulmonary bypass were matched according to age, gender, type, date and length of surgery with 35 operated patients without elevated S100B. They completed Spielberger's Anxiety Inventory (STAI). Results. Patients with elevated S100B reported more state anxiety and trait anxiety. S100B was an independent predictor of both state and trait anxiety when controlling for perioperative variables. Conclusions. Patients with elevated S100B reported more anxiety 3–6 years after cardiac surgery. A postoperative blood sample can identify risk patients and facilitate appropriate follow-up.