Sean Perrin

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Verified

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• PhD in Clinical Psychology
• Professor of Clinical Psychology at Lund University

Background Studies of individuals with non-cancer-related chronic pain, find that higher levels of psychological flexibility (PF) are associated with less distress, better functioning, and a better response to treatment. People diagnosed with cancer are at significantly increased risk of developing chronic cancer-related pain, the presence of which...

Objective: The effects of panic-specific psychotherapy on occupational functioning remain under-researched. This study tests whether two brief psychotherapies for Panic Disorder with or without Agoraphobia (PD/A) may generate improvement in work ability. Methods: Adults (N = 221) with a primary diagnosis of PD/A were randomised to wait-list, panic-...

Objective: The objective was to test the hypothesis that externalizing and internalizing helpfulness beliefs and learning styles at baseline moderate panic severity and overall mental illness as short-term and long-term outcomes of two panic-focused psychotherapies, Panic Control Treatment (PCT) and Panic-Focused Psychodynamic Psychotherapy (PFPP)....

Background: With few RCTs having compared active treatments for paediatric PTSD, little is known about whether or which baseline (i.e. pre-randomization) variables predict or moderate outcomes in the evaluated treatments. Objective: To identify predictors and moderators of paediatric PTSD outcomes for Eye Movement Desensitization and Reprocessing T...

Introduction: Post-traumatic stress disorder (PTSD) and substance use disorder frequently co-occur and tend to have their onset during adolescence. Although research has highlighted the importance of treating these disorders in an integrated fashion, there is a dearth of empirically validated integrated treatment options for adolescents with this c...

Background Attention Deficit Hyperactivity Disorder (ADHD) is a commonly occurring neurodevelopmental disorder associated with impairments in numerous aspects of functioning and quality of life. There is a growing recognition that brief and effective psychosocial interventions are needed for youth with ADHD. Objective The aim of this study was to...

Background Little is known about whether the recommended, non-pharmacological treatments for chronic pain yield reductions in healthcare utilization, social costs and increased productivity in actual practice. Methods The primary aim of this study ( n = 232) was to conduct secondary analyses of health economic outcomes using data from national reg...

Children and adolescents exposed to traumatic events are at high risk of developing post-traumatic stress disorder (PTSD). With the rare exception of young children, their PTSD presentations at the symptom level are similar to those of trauma-exposed adults, as are their patterns of psychiatric comorbidity, particularly for adolescents. Untreated,...

Background Implementation of evidence-based practice (EBP) in child and adolescent mental health services (CAMHS) is a priority to improve service delivery and outcomes. Clinicians’ EBP attitudes are likely to play a crucial role in implementation but are poorly understood. This study aimed to assess variation in EBP attitudes in a large national s...

Background Despite efforts to promote guideline use, guideline adoption is often suboptimal due to failure to identify and address relevant barriers. Barriers vary not only between guidelines but also between settings, intended users, and targeted patients. Multi-professional guidelines are often used in child and adolescent mental health services...

Background/Objectives: This study explores the relationship between cognitive performance measured by the Symbol Digit Modality Test (SDMT) and the severity of self-reported head injury, traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), depression, pain, and psychosocial dysfunction in a population of trauma-affected refugees. Re...

Background: Implementation of evidence-based practice (EBP) in child and adolescent mental health services (CAMHS) is a priority to improve service delivery and outcomes. Clinicians’ EBP attitudes are likely to play a crucial role in implementation but are poorly understood. This study aimed to assess variation in EBP attitudes in a large national...

Purpose Adolescence and emerging adulthood are key developmental stages with high risk for trauma exposure and the development of mental and substance-use disorders (SUDs). This study aims to compare the clinical profiles of adolescents (aged 12–17 years) and emerging adults (aged 18–25 years) presenting for treatment of posttraumatic stress disord...

Introduction Improvements in virtual reality (VR) have made it possible to create realistic, virtual settings for behavioral assessment and skills training that cannot otherwise be accessed in a safe way in forensic psychiatric settings. VR interventions are under development but little is known how forensic psychiatric patients with severe mental...

Objectives Cancer related pain (CRP) is among the most frequent collateral effects of cancer, with chronic CRP, lasting at least three months, affecting >40% of cancer survivors. Evidencebased treatments, including pain-focused Cognitive Behavioral Therapy (CBT) are available, but it appears that cancer patients/survivors are often poorly informed...

Background Despite efforts to promote guideline use, guideline adoption is often suboptimal due to failure to identify and address relevant barriers. Barriers vary not only between guidelines but also between settings, intended users, and targeted patients. Multi-professional guidelines are often used in child and adolescent mental health services...

Background Few scales designed to assess factors that facilitate and/or impede the uptake of guidelines in routine care are valid, reliable, and cover multiple domains. The Barriers and Facilitators Assessment Instrument (BFAI) measures barriers on four scales: Innovation, Provider, Patient, and Context and is one of few evaluated for psychometric...

Objectives: Little is known about how intensity and interference of pain relates to the major symptom clusters of posttraumatic stress disorder (PTSD) and whether these relations differ across clinical groups. The present study examined unique relations between pain and re-experiencing, avoidance, numbing, and hyperarousal in three clinical samples...

Aim: A person's ability to tolerate negative emotional states (Distress Tolerance - DT), uncertainty in their everyday lives (Intolerance of Uncertainty - IU), and a tendency to appraise their own feelings of anxiety as harmful (Anxiety Sensitivity - AS) have all been identified as vulnerability factors for anxiety and depressive disorders. Howeve...

Abstract in English: People with a refugee background are at significantly increased risk of mental health difficulties, including Post-Traumatic Stress Disorder (PTSD). There is a large evidence base showing that trauma-focused psychological treatments for PTSD are effective. However, the majority of trials do not include refugees and less is know...

Background: Survivors of Pediatric Brain Tumors (PBTs) treated with cranial radiation therapy (CRT) often experience a decline in neurocognitive test scores. Less is known about neurocognitive development of non-irradiated survivors of PBT. The aim of this study was to statistically model neurocognitive development after PBT in both irradiated and...

There remains a knowledge gap concerning the persistence of attention deficit hyperactivity disorder (ADHD) over the longer term. The current study aimed to investigate the change in parent-rated, and performance-based metrics of executive functioning (EF) and the relationship between these EF metrics and ADHD symptoms in individuals with ADHD from...

While Virtual Reality (VR) interventions can have many potential benefits for mental healthcare, implementation outcomes are often disappointing. To improve implementation outcomes, a better understanding of complex, dynamic interactions between implementation-related factors is needed.

RELEVANCE The current studies describe a new intervention for VR-assisted aggression treatment and indicate that intelligence, although important for the rehabilitation of offenders, is not necessarily relevant to understanding AAB in young offenders with psychopathic and callous unemotional traits. My doctoral dissertation will contribute to the d...

Background: Further knowledge is needed regarding long-term outcome of emotional symptoms, and the interplay between these symptoms and neuropsychological functioning in youth with attention deficit hyperactivity disorder (ADHD). Objective: We aimed to explore the effect of performance-based neurocognitive functions and parent-rated behavioral exec...

Aggression is a known problem in individuals being cared for in forensic settings, yet the evidence base for its treatment is scarce. Virtual Reality (VR) has been proposed as a promising addition to interventions in forensic settings, as it may increase the motivation among participants, bridge the gap between real life, therapeutic and laboratory...

Objectives: It is unclear how to address PTSD in the context of chronic pain management. Here we examine the potential benefits of an addition of prolonged exposure (PE) therapy for PTSD for adults attending multidisciplinary CBT for chronic pain. Methods: Four adults seeking treatment for chronic pain from a specialized pain rehabilitation serv...

Previous studies have found an association between excessive worrying and negative beliefs about worry. It is unclear if change in these beliefs mediate worry reduction. This study aimed to examine (1) if a simplified online metacognitive intervention can reduce worry, (2) whether changes in negative beliefs about worry mediate changes in worry sev...

Post-traumatic stress disorder (PTSD) and substance use disorder (SUD) occur frequently as comorbid diagnoses among adolescents. Historically, these conditions have been treated using a sequential model; however, emerging evidence suggests that an integrated treatment model may be most effective. This article presents two de-identified clinical cas...

Objective: Termination in psychodynamic therapy (PDT) is a potentially conflictual and turbulent phase for patients, with a risk for increases in symptoms. However, few studies of PDT have assessed symptoms frequently enough during the treatment to determine whether such setbacks are in fact common in PDT. Method: In a doubly randomized clinical...

Obsessive-Compulsive Disorder (OCD) is a leading cause of disability world-wide (World Health Organization, 2008). Treatment of OCD is a specialized field whose aim is recovery from illness for as many patients as possible. The evidence-based psychotherapeutic treatment for OCD is specialized cognitive behavior therapy (CBT, NICE, 2005, Koran and S...

Objective: Few studies have examined factors associated with patient’s choice of particular psychological treatments. The present study explores possible associations to, and the reasons given for, patient’s choice of Panic Control Treatment (PCT) or Panic-Focused Psychodynamic Psychotherapy (PFPP) for Panic Disorder with or without Agoraphobia (PD...

Background Children with ADHD tend to present with poorer cognitive functioning leaving them more vulnerable to a range of negative outcomes. To date, only a handful of longitudinal studies have examined the stability of Wechsler composite scores in children and adolescents with ADHD, and none of them used a more recent version of the Wechsler Inte...

Background. Efforts to identify specific variables that impact most on outcomes from interdisciplinary pain rehabilitation are challenged by the complexity of chronic pain. Methods to manage this complexity are needed. The purpose of the study was to determine the network structure entailed in a set of self-reported variables, examine change, and l...

Fear has been assigned a central role in models of obsessive-compulsive disorder (OCD), but empirical investigations into the emotions that underpin OCD symptoms are few, especially in pediatric samples. Using validated, clinician-led structured interviews, 124 youth with OCD reported on the presence and severity of symptoms across the main symptom...

There is now a consensus in the literature that future improvements in outcomes obtained from cognitive behavioral therapy (CBT) for chronic pain will require research to identify patient and treatment variables that help explain outcomes. The first aim of this study was to assess whether pre-treatment scores on measures of psychological (in)flexib...

Obsessive-Compulsive Disorder (OCD) is a leading cause of disability world-wide (World Health Organization, 2008). Treatment of OCD is a specialized field whose aim is recovery from illnessfor as many patients as possible. The evidence-based psychotherapeutic treatment for OCD is specialized cognitive behavior therapy (CBT, NICE, 2005, Koran and Si...

School bullying among young adolescents is a globally pervasive problem, but is less common when bystanders are motivated to defend victims. Thus, the focus of this experimental study is on motivation to defend victims of bullying. Methods: A total of 388 students (M age = 12.22 years, 49.7% girls) from two Turkish public schools (5th–8th grade) pa...

Over the last 20 years, our knowledge and understanding of the epidemiology of trauma exposure and associated mental health problems in children and adolescents, of risks for developing and maintaining posttraumatic stress disorder (PTSD), and of effective treatments for PTSD have increased considerably for this population. This book article discus...

Background There is a call for valid and reliable instruments to evaluate implementation of evidence-based practices (EBP). The 15-item Evidence-Based Practice Attitude Scale (EBPAS) measures attitude toward EBP, incorporating four lower-order factor subscales (Appeal, Requirements, Openness, and Divergence) and a Total scale (General Attitudes). I...

Introduction: It remains unclear whether offering psychiatric patients their preferred treatment influences outcomes at the symptom level. Objective: To assess whether offering patients with Panic Disorder with/without Agoraphobia (PD/A) a choice between two psychotherapies yields superior outcomes to random assignment. Methods: In a doubly randomi...

Children with generalized anxiety disorder (GAD) are often described by their parents or teachers as “little adults,” in part because of the seemingly adult‐like themes that populate their child's worries; for example, the health of family members or family finances and concerns about performance. Younger children may experience more vague worries...

Network estimation, plotting, accuracy, and changes in relation to pain intensity, pain interference, extent of pain, depression, anxiety, insomnia, pain catastrophizing, pain acceptance, kinesiophobia, and life control. Participants (N = 2,421, mean age = 43.8 years, % women = 82.2%) were consecutive cases providing pre- and post-treatment data in...

Bouts of excessive worry are common across the lifespan, increasing in frequency and complexity during adolescence and adulthood, and are found in several psychiatric disorders, particularly the anxiety disorders. There are evidence-based treatments for adolescents with anxiety disorders but psychological treatments designed specifically to target...

Background: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous disorder. Currently, the Obsessive Compulsive Inventory-Child Version (OCI-CV) is the only self-report measure that fully captures this symptom heterogeneity in children and adolescents. The psychometric properties of the OCI-CV are promising but evaluations in large clin...

Increasing evidence suggests that pediatric obsessive-compulsive disorder (OCD) is motivated not only by fear but also by feelings of incompleteness and disgust. However, it is currently unclear whether emotion-involvement in OCD symptoms is associated with treatment response in youth with OCD. The present study investigates whether treatment outco...

Psychological models of pediatric obsessive-compulsive disorder (OCD) place a heavy emphasis on harm avoidance as a maintaining factor and target for treatment. Incompleteness and disgust may also play a role in pediatric OCD but remain under studied. Youth with OCD (n=100), anxiety disorders (n=96), and no psychiatric disorder (n=25) completed sel...

Background: The relevance of PTSD symptoms to outcomes of Cognitive Behavioral Therapy (CBT) for chronic pain is unclear. This study examines whether (a) traumatic exposure or the severity of PTSD symptoms at pre-treatment predict outcomes (pain intensity/interference) (b) participation in this treatment is associated with reduced PTSD symptoms, a...

Background: One in twenty adolescents experience excessive worry and evidence-based psychological therapies are not sufficiently widespread to reach most of those affected. In this multiple baseline evaluation, we assess the feasibility and preliminary efficacy of a scalable, online cognitive-behavioral intervention for adolescents with excessive...

Cognitive behavioral therapy (CBT) designed to target Generalized Anxiety Disorder (GAD) in youth was examined in a pilot feasibility trial. Participants (aged 10-18 years) were randomized to either 10 weeks of individual CBT (n = 20) or supported wait-list (n = 20). Diagnostic status (primary outcome) was assessed blindly at post-treatment for bot...

Background: Chronic pain is a common comorbid complaint in traumatized refugees seeking treatment for posttraumatic stress disorder (PTSD) and depression. However, the effect of comorbid pain on treatment remains under investigated. Objective: To investigate whether pre-treatment pain (severity/interference) predicts outcomes in a multimodal treatm...

Introduction School‐based bullying is an omnipresent problem, but is less frequent when bystanders are inclined to defend victims. This makes it important to focus on motivation to intervene in bullying. Methods 202 students (Mage = 16.44 years, 52% boys) from public Swedish high schools participated in a vignette experiment. Students were randomi...

Background: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous disorder. Currently, the Obsessive Compulsive Inventory-Child Version (OCI-CV) is the only self-report measure that fully captures this symptom heterogeneity in children and adolescents. The psychometric properties of the OCI-CV are promising but evaluations in large clin...

We found that the effect of psychopathy on aggression was, in general, not moderated by offenders’ intelligence. That is, intelligence may not necessarily be pertinent to understand aggressive antisocial behaviors. Offenders' temperament and character, on the other hand, showed a complex relation with the different facets of psychopathy and aggress...

Objective: Obsessive-compulsive disorder (OCD) is a heterogeneous condition with well-established symptom dimensions across the lifespan. The objective of the present study was to use network analysis to investigate the internal structure of these dimensions in unselected schoolchildren and in youth with OCD. Method: We estimated the network struc...

Background: High-quality instruments are essential for implementation practitioners and researcher; only valid and reliable measures can confidently and consistently measure what they are intended to measure. Psychometrically sound and pragmatic measures have the potential to guide the tailoring and evaluation of an implementation program thus cont...

Background and Aim: Postpartum-specific obsessions and compulsions are common in postpartum women, but validated measures to comprehensively assess such symptoms are few. Therefore, the aim of the present study was to investigate the psychometric properties of a self-report version of the Parental Thoughts and Behaviors Checklist (PTBC) that assess...

Background: For up to 50% of adolescents experiencing PTSD, the course of their illness is further complicated by co-occurring substance use. Despite this,evidence-based integrated treatment options for adolescents with this comorbidity remain sparse. To address this gap, we are conducting an RCT examining the efficacy of exposure-based therapy for...

Background We need to better understand how the use of different substances and psychiatric comorbidity influence premature death generally and cause-specific death by overdose, intoxication and somatic disorders in people with substance use disorders. Method A cohort of 1405 patients consecutively admitted to a Swedish detoxification unit for sub...

Background Traumatized refugees with comorbid pain report more severe posttraumatic stress disorder (PTSD), respond less well to PTSD‐focused treatments, and exhibit greater disability. A mutually maintaining relationship may exist between pain and PTSD, that may be partly accounted for by depression, but no prior studies have tested this assumptio...

Alongside harm avoidance, incompleteness and disgust have been proposed as important emotion-related motivators underlying the symptoms of obsessive-compulsive disorder (OCD). The aim of the present study was to investigate the validity of self-report and interview-based measures of these constructs in youth with OCD (N=100) and anxiety disorders (...

Background: Panic disorder, with or without agoraphobia (PDA or PD, respectively), is a major public health problem. After having established a PD diagnosis based on the DSM or the ICD systems, the Panic Disorder Severity Scale (PDSS) is the most widely used interview-based instrument for assessing disorder severity. There is also a self-report ver...

There is a growing body of evidence suggesting that individuals with obsessive-compulsive disorder (OCD) may be sub-typed along different symptom dimensions. These dimensions may help explain responsiveness to current treatments. The Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) is a validated instrument involving a self-report screen...

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Background: There is a large body of literature identifying risk factors for the long-term cognitive alterations found in survivors of pediatric brain tumors. Less is known about baseline cognitive functioning in this population, but studies suggest that cognitive dysfunctions are often present at the time of diagnosis. This study aimed to identif...

Objectives: The symptoms of Posttraumatic Stress Disorder (PTSD) and chronic pain are thought to interact to increase the severity and impact of both conditions, but the mechanisms by which they interact remain unclear. This study examines the relationship between PTSD and chronic pain and whether indices of psychological flexibility mediate the r...

Abstract Background Practice guidelines for childhood posttraumatic stress disorder (PTSD) recommend trauma-focused psychotherapies, mainly cognitive behavioral therapy (CBT). Eye movement desensitization and reprocessing (EMDR) therapy is a brief trauma-focused, evidence-based treatment for PTSD in adults, but with few well-designed trials invol...

Purpose: Value based action is an important process in the psychological flexibility model, is associated with daily functioning in people with chronic pain, but measures of it are not well-developed. The purpose of the present study was to examine the reliability and validity of a Swedish-language version of the Chronic Pain Values Inventory (CPVI...

Purpose: The purpose of this study was to assess the psychometric properties of a Swedish version of the Posttraumatic Diagnostic Scale (PDS); to investigate the prevalence of traumatic experiences, trauma types, and posttraumatic stress disorder (PTSD) in a sample of patients seeking treatment for chronic pain; and to examine how indices of pain-...

This treatment is based on a developmentally sensitive adaptation of Ehlers and Clark’s (2000) model of PTSD, empirical evidence and our own clinical experience. Central to this model is the experience of a sense of current threat despite the fact the traumatic event happened in the past and which arises from two sources:

Cognitive-behavioral therapy (CBT) is the most frequently delivered psychological intervention for adults with chronic pain. The treatment yields modest effect sizes, and the mechanisms of action remain understudied and unclear. Efforts are needed to identify treatment mediators that could be used to refine CBT and improve outcomes. The primary aim...

Background: Patients treated for Pediatric Brain Tumors (PBTs) often experience a decline/stagnation in their cognitive functioning.Anumber of potential risk factors for cognitive decline have been identified including gender (female), young age-at-diagnosis, higher baseline IQ, hydrocephalus at diagnosis, treatment with Whole Brain Radiation Thera...

Purpose: Psychological flexibility is the theoretical model that underpins Acceptance Commitment Therapy (ACT). There is a growing body of evidence indicating that ACT is an effective treatment for chronic pain but one component of the model, committed action, has not been sufficiently researched. The purpose of this study is to validate Swedish-l...

Background Panic disorder with or without agoraphobia is a commonly occurring disorder affecting 2 to 3% of the population in Sweden. Untreated, panic disorder is a chronic condition that significantly increases the risk for psychiatric comorbidity, morbidity and mortality, employment difficulties, and healthcare utilization. Cognitive behavioral a...

Unlabelled: Cognitive-behavioral therapy (CBT) is the most frequently delivered psychological intervention for adults with chronic pain. The treatment yields modest effect sizes, and the mechanisms of action remain understudied and unclear. Efforts are needed to identify treatment mediators that could be used to refine CBT and improve outcomes. Th...

AIM: To explore the relationship between neuropsychological outcome and magnetic resonance imaging (MRI) findings in paediatric brain tumour patients surviving more than 10 years. BACKGROUND: Cognitive late sequelae after paediatric brain tumour have a multifactorial origin. Low age at diagnosis, cranial radiation therapy, intrathecal methotrexate...

BACKGROUND: Young age at diagnosis and treatment with cranial radiation therapy are well studied risk factors for cognitive impairment in pediatric brain tumor survivors. Other risk factors are hydrocephalus, surgery complications and treatment with intrathecal chemotherapy. Female gender vulnerability to cognitive sequelae after cancer treatment h...

Individuals with autism spectrum disorder (ASD) experience high levels of anxiety symptomatology with an estimated prevalence rate of anxiety disorders as high as 40 %. It is likely that anxiety is prominent in individuals with ASD throughout the life-span and that factors such as age, IQ, and ASD symptoms may influence the rates, symptoms, or anxi...

Prolonged exposure (PE) therapy is an established treatment for posttraumatic stress disorder (PTSD) in adults, having been used effectively in a variety of clinical contexts and with a wide range of trauma-exposed groups (ie, combat veterans and survivors of violence and man-made and natural disasters).1 Prolonged exposure is a theory-driven appro...

The psychometric properties of the Child PTSD Symptom Scale (CPSS) were examined in 2 samples. Sample 1 (N = 185, ages 6-17 years) consisted of children recruited from hospitals after accidental injury, assault, and road traffic trauma, and assessed 6 months posttrauma. Sample 2 (N = 68, ages 6-17 years) comprised treatment-seeking children who had...

We review recent evidence regarding risk factors for childhood posttraumatic stress disorder (PTSD) and treatment outcome studies from 2010 to 2012 including dissemination studies, early intervention studies and studies involving preschool children. Recent large-scale epidemiological surveys confirm that PTSD occurs in a minority of children and yo...

Children react to severe and acute stress in ways that are very similar to adults. Until people started to interview children directly, this was not obvious and initially it had been thought that children rarely developed post traumatic stress disorder. Now it is recognised that even pre-school children manifest symptoms of PTSD and slightly differ...

Intolerance of uncertainly (IU), cognitive avoidance (CA) and positive beliefs about worry (PB) independently predict worry frequency in older adolescents and adults, and when targeted together in treatment produce significant reductions in both worry and anxiety in this age range. The present study addresses a gap in the literature by testing whet...

Anxiety disorders are among the most prevalent mental health problems in childhood. In this timely book, an international team of psychiatrists and psychologists review the most recent theoretical and empirical developments in the field and indicate how these may inform research and clinical practice. Following a historical introduction, chapters r...

Introduction The concept of post-traumatic stress disorder (PTSD) as “a normal reaction to an abnormal event” is appealing in its simplicity, but does not do justice to the complexity of children's responses to traumatic events. Recent epidemiological investigations have confirmed that far from being “abnormal, ” exposure to trauma in childhood and...

Introduction Anxiety problems have been recognized and discussed throughout the ages under various expressions and from different perspectives. Yet, their study as a specific form of childhood and adolescence psychopathology was largely neglected prior to the second half of the twentieth century. Only during the last 50 years have consistent effort...

There is considerable evidence that children and adolescents with autistic spectrum disorders (ASD) are at increased risk of anxiety and anxiety disorders. However, it is less clear which of the specific DSM-IV anxiety disorders occur most in this population. The present study used meta-analytic techniques to help clarify this issue. A systematic r...

Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to evaluate effect...