Bengt-Åke Armelius

A comparative outcome study of body awareness therapy, feldenkrais, and conventional physiotherapy for patients with nonspecific musculoskeletal disorders: changes in psychological symptoms, pain, and self-image

Patients with nonspecific musculoskeletal disorders are often remitted for physiotherapy treatment in primary care. The rehabilitation effects for this patient group are generally poor and many of the treatment methods used have not been scientifically evaluated. The purpose of this study is to compare treatment effects of Body Awareness Therapy, Feldenkrais, and conventional individual treatment with respect to changes in psychological distress, pain, and self-image in patients with nonspecific musculoskeletal disorders. A total of 78 patients, 64 females and 14 males, with nonspecific musculoskeletal disorders were recruited consecutively to the different treatment groups in a quasiexperimental design. The patients were measured three times during the study period: before the interventions, after six months, and after one year. The results showed significant positive changes over time in all three treatment groups with regard to reduced psychological distress, pain, and improved negative self-image. There were few significant differences among the groups but effect-size analysis indicated that the group treatments using Body Awareness Therapy and Feldenkrais might be more effective than conventional treatment.

PLS model building: a multivariate approach to personality test data.

The aim of this study was to demonstrate how personality test data can be plotted with a multivariate method known as Partial Least Squares of Latent Structures (PLS). The basic methodology behind PLS modeling is presented and the example demonstrates how a PLS model of personality test data can be used for diagnostic prediction. Principles for validating the models are also presented. The conclusion is that PLS modeling appears to be a powerful method for extracting clinically relevant information from complex personality test data matrixes. It could be used as a complement to more hard modeling methods in the process of examining a new area of interest.

Borderline diagnosis from hospital records : reliability and validity of Gunderson's diagnostic interview for Borderlines (DIB)

Two trained and experienced clinical psychologists and two nontrained students rated the sections in Gundersons Diagnostic Interview for Borderlines (DIB) on the basis of hospital records for 16 patients (DIB-R). The results showed that both reliability and validity, i.e., correlations with an actual interview, were unexpectedly high, around .80 for the trained judges and around .55 for the nontrained judges. The conclusion is that the DIB may be used for retrospective diagnosis of borderline patients from hospital records.

The psychometric properties of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD)

The psychometric properties of the Swedish version of the Adolescent Drug Abuse Diagnosis (ADAD) instrument were evaluated in two adolescent groups. The participants in the Normal group comprised 121 adolescents aged 15–17 years and the participants in the group of adolescents with antisocial problems comprised 1168 youths aged 10–21 years detained under the Swedish Care of Young Persons Act in special youth homes. The ADAD instrument produced good interrater reliability; the subscales showed moderate internal consistency and concept validity was satisfactory and comparable with American and Swiss versions. Finally, the ADAD subscales produced meaningful correlations. The interviewer rating, the adolescents rating and the composite scores are compared and discussed. The Swedish version of ADAD appears to be a psychometrically good instrument for assessing the severity of adolescent problems and their need for treatment. However, the composite scores need to be reconstructed to be useful in future research.

Body patterns in patients with psychosomatic, musculoskeletal and schizophrenic disorders: Psychometric properties and clinical relevance of resource oriented body examination (ROBE-II)

The purpose of this paper was to study the psychometric properties and clinical relevance of the unipolarly scaled Resource Oriented Body Examination (ROBE I). Our aims were to find out if ROBE I could be reduced into a shorter version, labeled ROBE II. We also wanted to know if ROBE II would treat the variation of items in the 10 different subscales in a such a way that it also provided for discrimination between groups of patients with psychosomatic, musculoskeletal and schizophrenic disorders compared to a group of non-patients. A total of 198 subjects were body examined with a ROBE I protocol. The sample data were entered into a separate factor analysis for each domain. Principal components with varimax rotations were used, and the first two factors for each domain were extracted. The original 254 variables were reduced to 144, constituting an instrument for body examination, ROBE II, with 10 subscales. All subscales showed satisfactory internal consistency. Within all but one of the domains, the subscales showed acceptable intercorrelation. All subscales disclosed information of body patterns relevant for tracing psychosomatic symptoms in accordance with Norwegian Psychomotor Physiotherapy (NPMP). The subscales of ROBE II distinguished the bodily characteristics of patients with psychosomatic, musculoskeletal and schizophrenic disorders.

Non-specific musculoskeletal disorders in patients in primary care : subgroups with different outcome patterns

Patients with non-specific musculoskeletal disorders are considered to be a heterogeneous group with multifactorial problems. Appropriate and effective treatments for these patients have been hard ...

Psychodynamic features in borderline personality disorder identified by a subliminal test, the Defense Mechanism Test.

Twenty seven psychiatric inpatients, diagnosed according to DSM‐III and the Diagnostic Interview for Borderline (DIB), and 7 healthy controls were tested with the Defense Mechanism Test (DMT), a test of subliminal perception based on psychoanalytic theory. In the test a specific stimulus is presented subliminaily in a tachistoscope and the patients perceptual distortions are registered. Patients with borderline personality disorder (BPD) were compared with patients with other personality disorders, patients with schizophrenic disorders and healthy controls. Specific perceptual distortions were identified among patients with BPD. Some individual DMT signs correlated with some deviant behaviors as identified by the DIB. The findings supported the psychodynamic validity of the concept of borderline personality disorder. It is concluded that DMT is a promising research instrument that provides an empirical approach to crucial psychodynamic phenomena.

Clinicians' judgment of mental mealth: An international validation of HSRS

The Health-Sickness Rating Scale (HSRS), originally developed at the Menninger Foundation, was translated into French and Swedish and sent out to a relatively large group of clinicians in each of the two countries, and to a group of judges in the USA. Ratings of the 34 specimen cases were made blindly by 21 US, 62 French, and 21 Swedish clinicians for each of the seven subscales and the global rating scale of HSRS. The consistency among the judgments within each country was found to be very high (.81, .77, and .78 respectively). The consistency among the three national averages and the original Menninger judgments was found to be extremely high (.96) for the global rating. The results were interpreted to encourage further inquiries into the measurement properties and usefulness of the scale. The usefulness of HSRS as an international thermometer of mental health is strongly supported.

Integrating addiction and mental health treatment within a national addiction treatment system: Using multiple statistical methods to analyze client and interviewer assessment of co-occurring mental health problems

Aims For a Swedish national sample of 12,833 individuals assessed for a substance use disorder (SUD) (2002-2008) in the Swedish welfare system, client self-report and clinical staff Addiction Severity Index (ASI) assessment data were used to assess mental health problem severity and needs. Methods Analysis of client self-report data using regression methods identified demographic characteristics associated with reporting significant mental health problems. Clinical staff assessment data from the ASI Interviewer Severity Rating (ISR) score were used to develop a K-means cluster analysis with three client cluster profiles: Narcotics (n=4795); Alcohol (n=4380); and Alcohol and Psychiatric Problems (n=3658). Chi-square and one-way ANOVA analyses identified self-reported mental health problems for these clusters. Results 44% of clients had a history of using outpatient mental health treatment, 45% reported current mental health symptoms, and 19% reported significant mental health problems. Women were 1.6 times more likely to report significant mental health problems than men. Staff assessed that 74.8% of clients had current mental health problems and that 13.9% had significant mental health problems. Client and staff results were congruent in identifying that clients in the Alcohol profile were less likely (5%) to report having significant mental health problems compared to the other two profiles (30% each). Conclusions About 19% of clients with SUDs reported significant mental health problems, need integrated addiction and mental health treatment, and these clients are clustered in two population groups. An additional 25% of the addiction treatment population report current mental health symptoms and have at some point used mental health treatment. This national level assessment of the extent and severity of co-occurring disorders can inform decisions made regarding policy shifts towards an integrated system and the needs of clients with co-occurring disorders.

The Adolescent Drug Abuse Diagnosis Composite Scores in Swedish Normal and Antisocial Adolescents

The present study evaluates the utility and issues around the composite scores in Adolescent Drug Abuse Diagnosis (ADAD). Participants were Swedish normal adolescents (121) and adolescents manifesting antisocial problems (1,168), ages 10 to 21. The results show that the interviewer severity ratings seem to be the most appropriate outcome when the objective is to differentiate between normal and antisocial adolescents. The composite scores appear to function as an indicator of current problems in all areas except for Medical and Alcohol sections. The critical items within the Medical and Alcohol composite scores are explored and discussed.