Tore Wentzel-Larsen

Norwegian Centre for Violence and Traumatic Stress Studies, Kristiania (historical), Oslo, Norway

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Publications (205)640 Total impact

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    ABSTRACT: Our aims were to investigate the effectiveness of sertraline (SRT) versus continued CBT in children and adolescents that did not respond to an initial course of CBT and to evaluate whether the presence of tic disorder is negatively associated with SRT outcomes, but not with continued CBT.The study was a part of the Nordic Long-Term OCD Treatment Study (NordLOTS). Intent-to-treat sample included 50 participants (classified as non-responders to CBT following 14 weekly sessions), age 7–17 years, with DSM-IV primary OCD, mean age 14.0 (SD = 2.7) and 48%(n=24)malesrandomizedtoCBT(n=28)orSRT(n=22). Primary outcomes were the CY-BOCS total score and clinical response (CY-BOCS \ 16). Twenty-one of 28 participants (75 %) completed continued CBT and 15 of 22 participants (69.2 %) completed SRT. Planned pairwise comparison of the CY-BOCS total score did not reveal a significant difference between the treatments (p = 0.351). Within- group effect sizes were large and significant across both treatments. Twelve (24.0 %) participants were diagnosed with comorbid tic disorder, with seven receiving continued CBT and five SRT, respectively. In pa- tients without tic disorder, results showed no significant between-group differences on average CY-BOCS scores. However, in patients with comorbid tic disorder, those who received SRT had significantly lower average CY-BOCS scores when compared to those who received con- tinued CBT.The large within-group effect sizes suggest that continued treatment for CBT non-responders is beneficial. However, there was no significant between group differences in SRT or continued CBT at post- treatment. Children and adolescents with OCD and comorbid tic disorder, who are non-responders to an initial 14-week course of CBT, may benefit more from a serotonin reuptake inhibitor (SRI) than from continued CBT.
    European Society for Child and Adolescent Psychiatry (ESCAP) International Congress 2015, Madrid, Spain; 06/2015
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    ABSTRACT: The purpose of this study was to investigate whether the presence of tic disorder is negatively associated with sertraline (SRT) outcomes, but not with continued cognitive-behavioral therapy (CBT), in a sample of youth who were unresponsive to an initial full course of CBT. In the Nordic Long-Term OCD Study, children and adolescents with OCD who were rated as nonresponders to 14 weeks of open-label CBT were randomized to continued CBT (n=28) or SRT treatment (n=22) for an additional 16 weeks of treatment. We investigated whether the presence or absence of comorbid tic disorder moderated treatment outcomes on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Twelve out of 50 (24.0%) participants were diagnosed with comorbid tic disorder, with 7 receiving continued CBT and 5 receiving SRT, respectively. In patients without tic disorder, results showed no significant between-group differences on average CY-BOCS scores. However, in patients with comorbid tic disorder, those who received SRT had significantly lower average CY-BOCS scores than those who received continued CBT. Children and adolescents with OCD and comorbid tic disorder, who are nonresponders to an initial 14 week course of CBT, may benefit more from a serotonin reuptake inhibitor (SRI) than from continued CBT.
    Journal of Child and Adolescent Psychopharmacology 06/2015; 25(5):432-439. DOI:10.1089/cap.2014.0167 · 3.07 Impact Factor
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    Åse Sagatun, Sonja Heyerdahl, Tore Wentzel-Larsen, Lars Lien
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    ABSTRACT: To examine the extent to which smoking, alcohol, physical activity and mental health problems in 15-16-year-olds are associated with receipt of medical benefits in young adulthood, after adjustment for confounders. Prospective population-based cohort survey linked to national registers. In the 'Youth studies' from the Norwegian Institute of Public Health, 15 966 10th graders in 6 Norwegian counties answered a health behaviour and mental health questionnaire; 88% were linked to National Insurance Administration Registers (FD-Trygd). Time to receipt of medical benefits, based on FD-Trygd. Follow-up was from age 18 years until participants were aged 22-26 years. We performed Cox regression analyses to examine the extent to which variations in health behaviour and mental health problems during 10th grade were associated with receipt of medical benefits during follow-up. Daily smoking at age 15-16 years was associated with a significant increase in hazard of receiving health benefits at follow-up compared with not smoking for boys, HR (95% CI) 1.56 (1.23 to 1.98), and for girls 1.47 (1.12 to 1.93). Physical activity was associated with a decrease in hazard compared with inactivity from 23% to 53% in boys and from 21% to 59% in girls, while use of alcohol showed a mixed pattern. The hazard for benefits use rose with increasing levels of emotional symptoms, peer problems, conduct problems and hyperactivity-inattention problems (Strengths and Difficulties Questionnaire) at 15-16 years among both genders. Health behaviour and mental health problems in adolescence are independent risk factors for receipt of medical benefits in young adulthood. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
    BMJ Open 05/2015; 5(5):e007139. DOI:10.1136/bmjopen-2014-007139 · 2.06 Impact Factor
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    ABSTRACT: Living with parents suffering from mental illness can influence adolescents' health and well-being, and adverse effects may persist into adulthood. The aim of this study was to investigate the relationship between parents' mental health problems reported by their 15-16-year-old adolescents, the potential protective effect of social support and long-term dependence on public welfare assistance in young adulthood. The study linked data from a youth health survey conducted during 1999-2004 among approximately 14 000 15-16-year-olds to data from high-quality, compulsory Norwegian registries that followed each participant through February 2010. Cox regression was used to compute hazard ratios for long-term welfare dependence in young adulthood based on several risk factors in 15-16-year-olds, including their parents' mental health problems. Of the total study population, 10% (1397) reported having parents who suffered from some level of mental health problems during the 12 months prior to the baseline survey; 3% (420) reported that their parents had frequent mental health problems. Adolescent report of their parents' mental health problems was associated with the adolescents' long-term welfare dependence during follow-up, with hazard ratios (HRs) of 1.49 (CI 1.29-1.71), 1.82 (1.44-2.31) and 2.13 (CI 1.59-2.85) for some trouble, moderate trouble and frequent trouble, respectively, compared with report of no trouble with mental health problems. The associations remained significant after adjusting for socio-demographic factors, although additionally correcting for the adolescents' own health status accounted for most of the effect. Perceived support from family, friends, classmates and teachers was analysed separately and each was associated with a lower risk of later welfare dependence. Family and classmate support remained a protective factor for welfare dependence after correcting for all study covariates (HR 0.84, CI 0.78-0.90 and 0.80, 0.75-0.85). We did not find evidence supporting a hypothesized buffering effect of social support. Exposure to a parent's mental health problem during adolescence may represent a risk for future welfare dependence in young adulthood. Perceived social support, from family and classmates in particular, may be a protective factor against future long-term welfare dependence.
    BMC Public Health 04/2015; 15(1):413. DOI:10.1186/s12889-015-1734-1 · 2.32 Impact Factor
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    ABSTRACT: Research on functional impairment in obsessive-compulsive disorder (OCD) based on standardized measurement lags behind compared to its prominence in diagnostic classification systems. Our aim was to evaluate the psychometric properties of the Child Obsessive Compulsive Impact Scale – Revised (COIS-R), which is a measure of OCD-related functional impairment. The sample consisted of 396 Danish, Swedish, and Norwegian youth diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders (4th edition) (48.9% boys; mean age 12.9, SD=2.7). We used confirmatory factor analysis to evaluate the initial four-factor structure of the parent-reported measure (Daily Living Skills, School, Social, Family/Activities) and the three-factor structure of the child-reported measure (School, Social, Activities). We used the robust weighted least squares mean- and variance-adjusted estimator as applied in the MPLUS program (version 7.2). The parent-report format showed acceptable fit and the structure was equivalent across gender, age, and country. The child-report format showed poor fit and equivalent results across gender, age, and country. These findings indicate that the fit for the COIS-R original factor structure was acceptable for the parent-report but not for the child-report. The measure would benefit from revisions such as split sample procedure factor analyses with a large cross-cultural sample.
    Journal of Obsessive-Compulsive and Related Disorders 04/2015; DOI:10.1016/j.jocrd.2015.03.005 · 0.81 Impact Factor
  • E. B. Forsaa, J. P. Larsen, T. Wentzel-Larsen, G. Alves
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    ABSTRACT: INTRODUCTION: Freezing of gait (FOG) is a potentially disabling motor problem in Parkinson's disease (PD) with uncertain etiology. Longitudinal studies of FOG in PD are scarce. We determined the prevalence, incidence, and associated clinical risk factors and concomitants of FOG during prospective long-term follow-up of a population-based PD cohort. METHODS: A community-based prevalent cohort of 232 PD patients was followed prospectively over 12 years. Reassessments were conducted at 4 and 8 years, and then annually. FOG, as well as severity of parkinsonism, motor complications, and psychotic symptoms were assessed by the Unified PD Rating Scale, and cognitive impairment by the Mini-Mental State Examination. Generalized estimating equations were applied to investigate baseline risk factors and concomitants of FOG over time. RESULTS: The point prevalence of FOG at baseline was 27% (95% confidence interval (95%-CI) 22-33%). By study end, 63% (95%-CI 56-69%) of patients had developed FOG. The incidence rate of FOG was 124.2 (95%-CI 101.5-152.1) per 1000 person-years. Motor fluctuations (odds ratio (OR) 3.45; p = 0.036) and higher levodopa dose (OR 1.30/100 mg, p = 0.009) at baseline were independent risk factors of incident FOG. Prevalent FOG over time was additionally associated with features thought to reflect extrastrial, non-dopaminergic pathologies, including PIGD (postural instability/gait difficulty, OR 6.30/10 points, p < 0.001) and psychosis (OR 1.85; p = 0.016). CONCLUSION: These findings demonstrate that FOG affects the majority of patients in the general PD population and provide support to the hypothesis that alterations in both basal ganglia and extrastriatal brain areas are involved in the pathogenesis of FOG in PD.
    Parkinsonism & Related Disorders 03/2015; 21(3):254-8. DOI:10.1016/j.parkreldis.2014.12.020 · 4.13 Impact Factor
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    ABSTRACT: We investigated acculturative hassles in a community cohort of Vietnamese refugees in Norway (n = 61), exploring cross-sectional data and longitudinal predictors of acculturative hassles using data from their arrival in Norway in 1982 (T1), with follow up in 1985 (T2) and in 2005-2006 (T3). To our knowledge, this is the first longitudinal study of predictors of acculturative hassles in a refugee population. Results indicated that more communication problems and less Norwegian language competence were related to most hassles at T3. Higher psychological distress, lower quality of life, lower self-reported state of health, and less education at T3 were associated with higher levels of hassles at T3. More psychological distress at T2 and less education at arrival (T1) were significant predictors for more acculturative hassles at T3. These data suggest that addressing psychological distress during the early phase in a resettlement country may promote long-term refugee adjustment and, in particular, reduce exposure to acculturative hassles. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
    Transcultural Psychiatry 02/2015; DOI:10.1177/1363461515572208 · 0.99 Impact Factor
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    ABSTRACT: In the treatment of childhood type 1 diabetes, being aware of the parents' fear of hypoglycemia is important, since the parents' fear may influence the management of treatment and the children's blood glucose regulation. The availability of proper instruments to assess the parents' fear of hypoglycemia is essential. Thus, the aim of this study was to examine the psychometric properties of the Hypoglycemia Fear Survey - Parent version (HFS-P). In a Norwegian population-based sample, 176 parents representing 102 children with type 1 diabetes (6-15 years old) completed the HFS-P, comprising a 15-item worry subscale and a 10-item behavior subscale. We performed exploratory and confirmatory factor analysis and further analysis of the scales' construct validity, content validity and reliability. The Norwegian version of the HFS-P had an acceptable factor structure and internal consistency for the worry subscale, whereas the structure and internal consistency of the behavior subscale was more questionable. The HFS-P subscales were significantly correlated (from moderately to weakly) with symptoms of emotional distress, as measured by the Hopkins Symptom Checklist - 25 items. The mothers scored higher than fathers on both HFS-P subscales, but the difference was not statistically significant for the worry subscale. The HFS-P worry subscale seems to be a valid scale for measuring anxiety-provoking aspects of hypoglycemia, and the validity of the HFS-P behavior subscale needs to be investigated further.
    BMC Endocrine Disorders 01/2015; 15(1):2. DOI:10.1186/1472-6823-15-2 · 1.67 Impact Factor
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    ABSTRACT: The comorbidity of headache and psychiatric symptoms is a well-recognized clinical phenomenon, but there are only limited data regarding the temporal relationship between headache and symptoms of anxiety and depression as well as behavioral problems in adolescents. This study investigates the relationship of anxiety and depressive symptoms and behavioral problems at baseline with recurrent headache at follow-up four years later. Within the Nord-Tr[latin small letter o with stroke]ndelag Health Study (HUNT), including repeated population-based studies conducted in Norway, 2399 adolescents in junior high schools aged 12-16 years (77% of the invited) participated in Young-HUNT1 (1995-1997) and again at follow-up four years later, in Young-HUNT2 (2000-2001). The same comprehensive questionnaire that included assessment of symptoms of anxiety and depression and behavioral problems, i.e. conduct and attention difficulties was completed in both studies. In addition 1665 of the participants were interviewed about their headache complaints in Young-HUNT2. In adjusted multivariate analyses we found that higher scores of anxiety and depressive symptoms at baseline were associated with recurrent headache at follow-up four years later (OR: 1.6, 95%CI: 1.2-2.1, p = 0.001), evident for migraine (OR: 1.8, 95%CI: 1.2-2.7, p = 0.008) and non-classifiable headache (OR: 1.7, 95%CI: 1.0-2.8, p = 0.034), but not statistically significant for tension-type headache (OR: 1.4, 95%CI: 1.0-1.9, p = 0.053). Higher scores of anxiety and depressive symptoms at baseline were significantly associated with more frequent headache at follow-up (monthly vs. no recurrent headache OR: 1.8, 95%CI: 1.3-2.5, p = 0.001, weekly or daily vs. no recurrent headache OR: 1.9, 95%CI: 1.2-2.9, p = 0.005). Among adolescents without recurrent headache at baseline, higher scores for symptoms of anxiety and depression were associated with new onset migraine four years later (OR: 2.6, 95%CI: 1.1-4.8, p = 0.036). Higher scores of attention problems at baseline were associated with non-classifiable headache at follow-up (OR: 2.0, 95%CI: 1.3-3.4, p = 0.017). Results from the present study showed that symptoms of anxiety and depression in early adolescence were associated with recurrent headache four years later. Recognizing anxiety and depressive symptoms should be considered part of the clinical assessment in young headache patients, as early identification of these associated factors may lead to improved headache management.
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    ABSTRACT: Violence in childhood is associated with mental health problems and risk of revictimisation. Less is known about the relative importance of the various types of childhood and adult victimisation for adult mental health. To estimate the associations between various types of childhood and adult violence exposure, and their combined associations to adult mental health. This study was a cross-sectional telephone survey of the Norwegian adult population; 2,435 women and 2,092 men aged 18-75 participated (19.3% of those we tried to call and 42.9% of those who answered the phone). The interview comprised a broad array of violence exposure in both childhood and adulthood. Anxiety/depression was measured by the Hopkins Symptom Check List (HSCL-10). Victimisation was commonly reported, for example, child sexual abuse (women: 10.2%, men: 3.5%), childhood-parental physical violence (women: 4.9%, men: 5.1%), and lifetime forcible rape (women: 9.4%, men: 1.1%). All categories of childhood violence were significantly associated with adult victimisation, with a 2.2-5.0 times higher occurrence in exposed children (p<0.05 for all associations). Anxiety/depression (HSCL-10) associated with adult abuse increased with the number of childhood violence categories experienced (p<0.001). All combinations of childhood violence were significantly associated with anxiety/depression (p<0.001 for all associations). Individuals reporting psychological violence/neglect had the highest levels of anxiety/depression. RESULTS should be interpreted in light of the low response rate. Childhood violence in all its forms was a risk factor for victimisation in adulthood. Adult anxiety/depression was associated with both the number of violence categories and the type of childhood violence experienced. A broad assessment of childhood and adult violence exposure is necessary both for research and prevention purposes. Psychological violence and neglect should receive more research attention, especially in combination with other types of violence.
    European Journal of Psychotraumatology 01/2015; 6:26259. DOI:10.3402/ejpt.v6.26259 · 2.40 Impact Factor
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    Dataset: Torp 2014
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    ABSTRACT: Rates of discontinuation of antipsychotic treatment for patients with schizophrenia are high and evidence is limited by selective inclusion and high attrition in randomized controlled trials. To study time to discontinuation of antipsychotic treatment for patients with schizophrenia. All patients with schizophrenia (n = 396) discharged between 2005 and 2011 were followed until discontinuation (clinician or patient decided) of antipsychotic treatment or other endpoints. Univariate and multivariate survival analyses (with time on antipsychotic treatment as the dependent variable) using time-dependent variables were performed. Clozapine displayed lower risk for all-cause (p < 0.001), clinician-decided (p = 0.012) and patient-decided (p = 0.039) discontinuation versus olanzapine oral treatment in the multivariate Cox regression. Second-generation long-acting injection antipsychotics (LAI) (p = 0.015) and first-generation long-acting injection antipsychotics (p = 0.013) showed significantly lower risks for patient-decided discontinuation than olanzapine oral. Higher effectiveness of clozapine and LAI treatment versus oral olanzapine were identified in a clinical cohort of patients with schizophrenia.
    Therapeutic Advances in Psychopharmacology 12/2014; 4(6):228-239. DOI:10.1177/2045125314545614 · 1.53 Impact Factor
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    ABSTRACT: Abstract Objective.The aim of this study was to externally validate in an up-to-date setting the predictive ability of the model for recurrence after radical treatment of clear cell renal cell carcinoma (CCRCC) published by Leibovich in 2003. Materials and methods. The study included a total of 386 consecutive patients with CCRCC between January 1997 and May 2013, treated with partial or radical nephrectomy. All patients were scored with points between 0 and 11, and further subdivided into low-, intermediate- and high-risk groups according to the original paper. Well-recognized statistical methods for the evaluation of Cox's proportional hazard-based prognostic models were applied. To validate the discriminative ability, Harrell's concordance (c) index and hazard ratios (HRs) between risk groups were used, and calibration was graphically explored. Results.The 10 year recurrence-free survival rates for the low-, intermediate- and high-risk groups were 87.3%, 63.8% and 19.8%, respectively Harrell's c index was 0.864. The HRs across risk groups for the intermediate- and high-risk groups were 5.29 and 21.56, respectively, with the low-risk group as a reference category. A gross comparison of the survival estimates between the patients showed an overall similarity. However, differences within the intermediate- and high-risk groups were seen in the first year of follow-up. Conclusions.The Leibovich model seems to discriminate well between risk groups, but for the intermediate- and high-risk groups the calibration is not optimal. This study validates the model in a present-day Nordic patient population. The model can be used as a risk stratification tool for follow-up after radical treatment of CCRCC.
    11/2014; 49(3):1-6. DOI:10.3109/21681805.2014.980844
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    ABSTRACT: Objective: The purpose of this study was to examine the acute effectiveness of manualized exposure-based CBT with a family-based treatment, as an initial treatment for pediatric OCD delivered in regular community child and adolescents outpatient clinics. The report summarizes outcome of the first treatment step in the NordLOTS, which was conducted in Denmark, Sweden and Norway. Method: 269 participants, age 7–17, with OCD, received treatment for 14 weekly sessions. Treatment response was defined as CY-BOCS score of ≤15 at post treatment. Results: 241 participants (89.6%) completed all 14 weeks of treatment. Treatment response, among the participants was 72.6% (95% CI 66.7%-77.9%). Mixed effects model revealed a statistically significant effect of time F(1,479)=130.434. Mean symptom reduction on the CY-BOCS was 52.9% (SD=30.9). The estimated within-group effect size between baseline and post treatment was 1.58 (95% CI: 1.37-1.80). Conclusion: This study found that manualized CBT can be applied effectively in community mental health clinics. These findings underscores the feasibility of implementing exposure-based CBT for pediatric OCD in a regular child and adolescent mental health setting. Clinical Trials Registration Information: This study was registered in Current Controlled Trials; Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study (www.controlled-trials.com ISRCTN66385119). Keywords: Child and adolescent; obsessive-compulsive disorder; Cognitive-behavioral therapy; Exposure and response prevention; Treatment outcome.
    Behaviour Research and Therapy 11/2014; DOI:10.1016/j.brat.2014.11.005 · 3.85 Impact Factor
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    ABSTRACT: Aims:Overweight and obesity in children and adolescents are major public health challenges associated with psychosocial adversity and unfavourable lifestyle. Exposure to interpersonal violence, such as sexual abuse, violence and bullying, could represent precursors, accelerating or sustaining factors. Methods: The Young-HUNT 3 study, 2006-2008, is a population-based, cross-sectional, cohort study of Norwegian youth that includes self-report data on exposure to interpersonal violence; pubertal status and timing; socioeconomic, psychosocial, and lifestyle factors; and clinical anthropometric measures. A cohort of 10,464 adolescents aged 12-20 years from Nord-Trøndelag County were invited to participate. Body mass index served as the outcome in the simple and multiple linear regression analyses. Results: The response rate was 72.3% (7564), and 49.9% (3777) of the respondents were girls. A robust and significant relationship between interpersonal violence and increased BMI for both genders was found. Importantly, interpersonal violence remained significantly correlated with higher BMI following adjustment for pubertal development, socioeconomic and psychosocial adversity and unfavourable lifestyle factors in both genders, although most evident in girls. Adjusted regression coefficients (95% confidence intervals) for the relationship between interpersonal violence and BMI were 0.33 (0.01, 0.65) for 1 type and 0.89 (0.37, 1.41) for 2 types, compared to no exposure in girls, and 0.40 (0.09, 0.71) for 1 type and 0.35 (-0.09, 0.79) for 2 types of interpersonal violence in boys. Conclusions: The empirical evidence of consistent associations between interpersonal violence, related psychosocial and lifestyle factors, and body fatness, indicates that these features play important roles for adolescents struggling with overweight.
    Scandinavian Journal of Public Health 11/2014; 43(1). DOI:10.1177/1403494814556176 · 3.13 Impact Factor
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    ABSTRACT: The aim of this study was to investigate the development of mother–infant interaction patterns from 3 to 12 months among three groups of mother–baby pairs recruited during pregnancy: one group from residential substance abuse treatment (n = 28), a second group from psychiatric outpatient treatment (n = 22), and a third group from well-baby clinics (n = 30). The mother–infant interaction at 3 and 12 months was assessed by the Parent–Child Early Relational Assessment (PCERA), which consists of maternal, child and dyadic subscales ( Clark, 2006). Linear mixed effects models were used to analyze group differences and the changes in mother–infant interaction from 3 to 12 months.At 3 months, pairwise comparisons showed that the group with psychiatric problems had significantly more difficulties in the mother–infant interaction than the two other groups. The group with substance abuse problems was not significantly different from the two other groups. At 12 months, the mother–infant pairs in the substance abuse group showed significantly more relational disturbances than the non-clinical pairs, as well as a poorer affective quality of interaction than the dyads in the group with psychiatric problems. Analysis of change from 3 to 12 months showed that difficulties in the interaction increased among the mother–baby pairs in the substance abuse group, while improvements were displayed in the two other groups. These results underline that mother–infant pairs at double risk due to maternal substance abuse and other non-optimal factors, are in need for long-term follow up in order to prevent the development of negative interactional patterns.
    Infant Behavior and Development 11/2014; 37(4). DOI:10.1016/j.infbeh.2014.09.003 · 1.67 Impact Factor
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    ABSTRACT: This prospective, longitudinal study with data collected at four time points investigated how maternal psychiatric symptoms, substance abuse and maternal intrusiveness in interaction were related to early child language skills. Three groups of mothers were recruited during pregnancy: One from residential treatment institutions for substance abuse (n = 18), one from psychiatric outpatient treatment (n = 22) and one from well-baby clinics (n = 30). Maternal substance abuse and anti-social and borderline personality traits were assessed during pregnancy, postpartum depression at 3 months, maternal intrusiveness in interaction at 12 months, and child language skills at 2 years. Results showed that the mothers in the substance abuse group had the lowest level of education, they were younger and they were more likely to be single mothers than the mothers in the two other groups. There was a significant difference in expressive language between children born to mothers with substance abuse problems and those born to comparison mothers, however not when controlling for maternal age, education and single parenthood. No group differences in receptive language skills were detected. Results further showed that maternal intrusiveness observed in mother-child interaction at 12 months was significantly related to child expressive language at 2 years, also when controlling for socio-demographic risk factors. This suggests that in addition to addressing substance abuse and psychiatric problems, there is a need for applying treatment models promoting sensitive caregiving, in order to enhance child expressive language skills.
    Child Psychiatry and Human Development 10/2014; DOI:10.1007/s10578-014-0512-0 · 1.93 Impact Factor
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    ABSTRACT: Expert guidelines recommend cognitive-behavior therapy (CBT) as a first-line treatment in pediatric obsessive-compulsive disorder (OCD) and the addition of selective serotonin reuptake inhibitors when CBT is not effective. However, the recommendations for CBT non-responders are not supported by empirical data. Our objective was to investigate the effectiveness of sertraline (SRT) versus continued CBT in children and adolescents that did not respond to an initial course of CBT. Randomized controlled trial conducted in five sites in Denmark, Sweden and Norway, 54 children and adolescents, age 7-17 years, with DSM-IV primary OCD were randomized to SRT or continued CBT for 16 weeks. These participants had been classified as non-responders to CBT following 14 weekly sessions. Primary outcomes were the CY-BOCS total score and clinical response (CY-BOCS <16). The study was a part of the Nordic Long-Term OCD Treatment Study (NordLOTS). Intent-to-treat sample included 50 participants, mean age 14.0 (SD = 2.7) and 48 % (n = 24) males. Twenty-one of 28 participants (75 %) completed continued CBT and 15 of 22 participants (69.2 %) completed SRT. Planned pairwise comparison of the CY-BOCS total score did not reveal a significant difference between the treatments (p = .351), the response rate was 50.0 % in the CBT group and 45.4 % in the SRT group. The multivariate χ (2) test suggested that there were no statistically significant differences between groups (p = .727). Within-group effect sizes were large and significant across both treatments. These large within-group effect sizes suggest that continued treatment for CBT non-responders is beneficial. However, there was no significant between-group differences in SRT or continued CBT at post-treatment.
    European Child & Adolescent Psychiatry 09/2014; 24(5). DOI:10.1007/s00787-014-0613-0 · 3.55 Impact Factor
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    ABSTRACT: Objective Emotional problems are common in adults with diabetes, and knowledge about how different indicators of emotional problems are related with glycemic control is required. The aim was to examine the relationships of diabetes-specific emotional distress, depression, anxiety, and overall well-being with glycosylated hemoglobin (HbA1c). Methods Of the 319 adults with type 1 diabetes attending the endocrinology outpatient clinic at a university hospital in Norway, 235 (74%) completed the Diabetes Distress Scale, the Problem Areas in Diabetes Survey, the Hospital Anxiety and Depression Scale, and the World Health Organization-Five Well-Being Index. Blood samples were taken at the time of data collection to determine HbA1c. Regression analyses examined associations of diabetes-specific emotional distress, anxiety, depression, and overall well-being with HbA1c. The relationship between diabetes-specific emotional distress and HbA1c was tested for nonlinearity. Results Diabetes-specific emotional distress was related to glycemic control (DDS total: unstandardized coefficient = 0.038, P < 0.001; PAID total: coefficient = 0.021, P = 0.007), but depression, anxiety, and overall well-being were not. On the DDS, only regimen-related distress was independently related to HbA1c (coefficient = 0.056, P < 0.001). A difference of 0.5 standard deviation of baseline regimen distress is associated with a difference of 0.6 in HbA1c. No significant nonlinearity was detected in the relationship between diabetes-specific distress and HbA1c. Conclusions To stimulate adequate care strategies, health personnel should acknowledge depression and diabetes-specific emotional distress as different conditions in clinical consultations. Addressing diabetes-specific emotional distress, in particular regimen distress, in clinical consultation might improve glycemic control.
    Journal of Psychosomatic Research 09/2014; 77(3). DOI:10.1016/j.jpsychores.2014.06.015 · 2.84 Impact Factor
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    ABSTRACT: Background Randomized controlled psychosocial treatment studies on selective mutism (SM) are lacking. Method Overall, 24 children with SM, aged 3–9 years, were randomized to 3 months treatment (n = 12) or wait list (n = 12). Primary outcome measure was the School Speech Questionnaire. ResultsA significant time by group interaction was found (p = .029) with significantly increased speech in the treatment group (p = .004) and no change in wait list controls (p = .936). A time by age interaction favoured younger children (p = .029). Clinical trail registration: Norwegian Research CouncilNCT01002196. Conclusions The treatment significantly improved speech. Greater improvement in the younger age group highlights the importance of an early intervention.
    Child and Adolescent Mental Health 09/2014; 19(3):192-194. DOI:10.1111/camh.12045 · 0.95 Impact Factor

Publication Stats

3k Citations
640.00 Total Impact Points

Institutions

  • 2011–2015
    • Norwegian Centre for Violence and Traumatic Stress Studies
      Kristiania (historical), Oslo, Norway
  • 2003–2015
    • Haukeland University Hospital
      • • Department of Heart Disease
      • • Department of Pediatrics
      • • Department of Medicine
      • • Department of Plastic Surgery and Burns
      Bergen, Hordaland, Norway
  • 2012–2014
    • Regionsenter for barn og unges psykiske helse
      Kristiania (historical), Oslo, Norway
  • 2012–2013
    • Oslo University Hospital
      • Department of Biostatistics and Epidemiology
      Kristiania (historical), Oslo County, Norway
  • 2005–2012
    • University of Bergen
      • • Institute of Medicine
      • • The Gade Institute
      Bergen, Hordaland, Norway
  • 2007
    • MRC National Institute for Medical Research
      • Division of Physical Biochemistry
      Londinium, England, United Kingdom