Kerstin Armelius

Women with false positive screening mammograms: how do they cope?

Objectives To assess the long term psychological impact on women who were recalled for further investigation after mammography screening and to find any factors that might predict coping ability in order to identify those subjects who require additional support at an earlier stage. Setting Counties of Västerbotten and Västernorrland, Sweden. Methods A prospective design was used in which 252 recalled women completed questionnaires twice—once within a week of having received the all-clear and again at follow up six months later. A group of 1104 randomly selected, screen negative women were followed up in the same way for comparison. The questionnaire included the Psychological Consequences Questionnaire (PCQ) and basic sociodemographic data. The main outcome measure was the total score on the PCQ at six months. Results Of the 252 women, 235 (93%) completed both questionnaires. In the control group, 987 (89.4%) women responded. Six months after the all-clear, recalled women were still significantly more anxious (p<0.001) than those who had been screened but not recalled. The strongest predictor of psychological distress at six months was the PCQ score at the first measurement. Other predictors were a low level of education, living in high density urban areas, and having only one child or no children at all. Widows appeared to cope better than other women. Conclusions It is possible to define a group of women with false positive results who are already at risk of coping less effectively at the time of recall. Offering these women counselling or other types of support should be considered.

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.

Toward Understanding the Direct and Indirect Effects of Transformational Leadership on Well-Being A Longitudinal Study

In this two-wave longitudinal panel study, the authors strived to advance understanding of how transformational leadership affects employee well-being over time. The authors proposed a model that included both direct and indirect effects, which was tested in a sample of social service employees. Results of structural equation modeling revealed that transformational leadership had no direct effect on well-being over time. Instead, both the short-term and long-term effects of transformational leadership on well-being were mediated by a positive climate for innovation. The study contributes to knowledge about the complicated processes by which leaders influence well-being of employees.

Peer aggression and mental health problems : self-esteem as a mediator

This study examined whether self-esteem mediates the association between peer aggression and internalizing and externalizing problems in adolescents. A total of 204 Swedish adolescents aged between 12- and 16-years-old completed self-report measures; self-esteem was assessed with ‘I think I am’ (ITIA) and internalizing and externalizing problems with Youth Self-Report (YSR). Our results showed that internalizing problems in peer aggressors could be understood as problems with low self-esteem, while internalizing problems in peer victims could be understood both as problems with low self-esteem and as an effect of being victimized. Externalizing problems in peer aggressors and peer aggressor—victims could be understood as problems with being involved in peer aggression, while the same problems in peer victims could be understood as problems with low self-esteem. This article also discusses the importance of self-esteem in adolescents’ development of their own identities and for peer aggressive-related psychological psychopathology.

Countertransference feelings and the psychiatric staff's self-image.

This paper presents a study of associations between psychiatric staffs habitual feelings towards their patients and the staffs self-image. At 22 psychiatric treatment homes for psychotic and other severely disturbed patients, 163 male and female staff recurrently rated their feelings towards the individual patients on a feeling checklist. At the beginning of the study period, they also rated different aspects of their self-image (the introject and the mother and father images) using Structural Analysis of Social Behavior (SASB). Over time and over patient, correlations between the individual staff ratings on the feeling checklist and ratings on the SASB were studied for all staff and for male and female staff separately. The analyses showed a number of associations between the staffs feelings and aspects of their self-image. Staff who habitually tended to feel helpful and autonomous towards their patients had a more positive image of mother, whereas staff who tended to feel more rejecting, unhelpful, and controlled had a combination of negative images of mother and father and a protecting introject. Some notable differences between male and female staff were found. Overall, self-image accounted for larger proportions of the male staffs feelings than of the female staffs. Negative feelings for male staff were associated more with a critical father image, whereas for female staff these feelings were associated more with an image of the father as a freedom giving.

Body awareness therapy with sexually abused women. Part 2: Evaluation of body awareness in a group setting

Abstract This study examines the results of a new treatment modality described in part 1 ( JBMT , 1(5), 280–288). Seven women were studied for 20 months. Symptoms (VAS-rating), self-image (SASB) and body image were assessed at the start and 1 year after the therapy. An interview was carried out for an evaluation of the outcome of the therapy as well as to achieve extended knowledge about the consequences of CSA. The tests showed that the symptoms diminished by half. The self-image and body image improved in the majority; patients with most symptom reduction and positive changes in self-love also showed a positive personal relationship with their body. The open interpretation of the interviews generated four categories (the room, the control, the choice, and the gift) which are discussed in a closer analysis of the social dimensions of the CSA phenomena. The authors suggest how the approach with body awareness group therapy can be refined and developed in working with CSA.

Municipal middle managers: psychosocial work environment in a gender-based division of labor

The purpose of the reported study was to explore how 245 municipal middle managers perceived their psychosocial and physical work environments, and to examine psychosomatic reactions and job satisfaction in departments engaged in different types of activity, also to compare male and female managers in these respects. The way in which psychosomatic reactions and job satisfaction were related to the psychosocial and physical work environments was also investigated. The results indicated a difference between departments depending on the type of activity. Departments concerned with care and education, i.e. care of the elderly, child care and schools showed a tendency to lower values for psychosocial work environment factors and more psychosomatic reactions than the departments geared more towards maintenance and production, i.e. street maintenance, the power plant department and the recreation office. In the departments concerned with children female managers were in a majority. In the street maintenance department, the recreation office and the power plant department, male managers predominated. Compared to the men, the women had a higher level of education, lower salaries, more reactions of a psychosomatic nature, lower job satisfaction and a less satisfying psychosocial work environment. The only department with an equal number of male and female managers was the schools department. Here there were no differences between men and women in the factors studied. Two partial correlations were computed in order to separate the importance of type of activity and sex to the work environment factors and outcome variables. This indicated that the type of activity was more important than biological sex. The gendering of work activities is therefore also discussed and further investigations are suggested.

Body awareness therapy with sexually abused women:Part 1: Description of a treatment modality

Abstract Child sexual abuse (CSA) and its consequences have become highlighted and the aftermath of the trauma creates severe physical and psychological impairment. The aim of this study was to improve understanding about CSA and to describe and consider a new physiotherapeutic treatment modality led by a physiotherapist and a gynaecologist, where psychological, medical and pedagogical frameworks interweave.

Self-image patterns as predictors of change and outcome of trainee-led psychotherapy

Abstract This study investigated the outcome of undergraduate trainee-led psychotherapy and how different self-image patterns explain symptom change. Pre- and post-treatment data from 235 Swedish outpatients were used. Clients were assessed with Symptom Checklist-90 (SCL-90) and the Structural Analysis of Social Behavior (SASB). Outcome effect size was moderate and in line with earlier studies on trainees. Clinical significant change showed that 42% of all clients were recovered or improved after 18 sessions in either training condition PDT or CBT. Regression analysis showed that a more negative self-image and higher levels of self-control before treatment predicted improvement in both psychiatric symptoms and personality factors. A negative self-image, when observed before treatment, can be understood as an increased motivation for change.

Long-term effects of physiotherapeutic treatment in outpatient psychiatric care

Two consecutively selected groups of patients at an outpatient psychiatric clinic were studied (experimental (E) and control (C) groups). Both groups received conventional treatment, and in the E group psychiatric psysiotherapeutic treatment (PPT) was added. The effects of PPT were assessed immediately after termination of PPT and after a further 3.5 months. The instrument used for assessments were the SASB, measuring self-image; the SCL-90, measuring symptoms; and a semistructured interview focusing on satisfaction with treatment and treatment outcome. The patients were diagnosed on the basis of DSM-III-R, and a judgement of the level of psychologic development was made. Immediately after the E groups termination of PPT, patients in both groups had a less consistent self-image with more self-attack and lower self-control than a sample of “normals”, and the patients receiving PPT had an even less normal self-image, with more self-attack, lower self-control, and a more conflictive self-image than the C gr...