Sverre Urnes Johnson

University of Oslo & Modum Bad · Department of Psychology

Background Little is known regarding the mental health impact of having a significant person (family member and/or close friend) with COVID-19 of different severity. Methods The study included five prospective cohorts from four countries (Iceland, Norway, Sweden, and the UK) with self-reported data on COVID-19 and symptoms of depression and anxiet...

This study was designed to examine the impact of the COVID-19 pandemic on the mental health of migrants living in Norway. We conducted a longitudinal two-wave survey among a sample of 574 migrants and multilevel modelling was used to analyse general anxiety, health anxiety and depressive symptoms. Demographic and psychological predictors were inves...

Background: Psychological distress experienced during pregnancy is a well-documented risk factor for adverse maternal outcomes. Pandemic-related distress may exacerbate vulnerability to negative mental health outcomes for pregnant women. Aim: To investigate pregnant women's subjective experiences of mental health outcomes, pandemic-related challeng...

Within-person network dynamics on a monthly or yearly level have been difficult to study due to the lack of suitable analytic methods. In this study, a new method for estimating networks from panel data was used to investigate how symptoms of depression, mechanisms proposed in the meta-cognitive therapy (MCT) model, and loneliness interact across a...

Background: Patients with eating disorders and childhood trauma have clinical presentations that make them less suitable for standard eating disorder treatment. This might be due to high levels of shame and self-criticism. Self-compassion can be a mechanism of change, especially for patients with eating disorders and childhood trauma. Method: A...

De therapeutische alliantie of werkrelatie heeft in de psychotherapie de status ‘gemeenschappelijke factor’ gekregen, vanwege het robuuste verband met de uitkomst van behandelingen. De opdracht voor ons werkveld is nu om een genuanceerder beeld te krijgen van de invloed van de alliantie op de mate waarin tijdens de therapie vooruitgang wordt geboek...

Objective. Post-traumatic stress disorder (PTSD) remains a growing public health challenge across the globe and is associated with negative and persistent long-term consequences. The last decades of research identified different mechanisms associated with the development and persistence of PTSD, including maladaptive coping strategies, cognitive an...

This 17-month longitudinal study on a representative sample of 4,361 Norwegian adults employs an observational ABAB design across 6 repeated assessments and 3 pandemic waves to systematically investigate the evolution of depressive symptomatology across all modifications of social distancing protocols (SDPs) from their onset to termination. Using L...

To understand the interplay between anxiety symptoms and their maintaining psychological processes in the population, an analysis of longitudinal within-person relationships is required. A sample of 1706 individuals completed daily measures during a 40-day period with strict mitigation protocols. Data of 1368 individuals who completed at least 30 a...

The social distancing protocols (SDPs) implemented as a response to the COVID-19 pandemic may seriously influence peoples’ mental health. We used a sample of 4361 Norwegian adults recruited online and stratified to be nationally representative to investigate the evolution of anxiety following each modification in national SDPs across a 20-month per...

Background: Investigating psychopathological processes and how these are connected to psychiatric symptoms is important to understand how disorder states emerge and are maintained over time. Focusing on within-person relationships between variables further allows investigation of how these relations on average unfold within individuals. Methods: T...

The COVID-19 pandemic and living under social distancing restrictions have been hypothesized to impact well-being and mental health in the general population. This study investigated the general Norwegian adult population's well-being after implementing and lifting strict social distancing restrictions. The study was conducted through digital surve...

The present study investigates differences in the trajectories of anxiety, depression, and sleep problems among infected versus non-infected case-controlled individuals. Patients who tested positive for COVID-19 were selected from a representative sample in Norway (N > 10,000). In total, 126 of these individuals were infected during the project per...

To enhance formulation and interventions for emotional distress symptoms, research should aim to identify factors that contribute to distress and disorder. One way to formulate emotional distress symptoms is to view them as state manifestations of underlying personality traits. However, the metacognitive model suggests that emotional distress is ma...

To address the increased levels of depressive symptoms during the COVID-19 and other pandemics, it is useful to identify the psychological processes that may explain the relationship between pandemic-related stressors and symptoms. In this study, both the combined network of metacognitions and maladaptive coping strategies derived from the metacogn...

In a Norwegian study of 73 couples attending a residential couple therapy program lasting between 6 and 12 weeks, weekly self-report data on therapy alliance and couple satisfaction were collected using routine outcome monitoring (ROM). The aim was to show how dyadic analyses could be applied to examine the predictive association between alliances...

Background Depression highly impairs function and reduces quality of life. Therefore, both symptomatic and functional recovery are important treatment goals. Depression consists of several cognitive, somatic, and affective symptom factors that differently affect function. However, it is unclear whether changes in these domains predict return to wor...

In the present study we aim to increase our knowledge of the relationship between childhood trauma and outcome in couple therapy. We sampled participants based on their sub-optimal responses to treatment as well as one member of the dyad having reported experiences of childhood trauma. Six participants constituting three couples were included. All...

Background Long-term mental and physical health consequences of COVID-19 (long COVID) are a persistent public health concern. Little is still known about the long-term mental health of non-hospitalised patients with COVID-19 with varying illness severities. Our aim was to assess the prevalence of adverse mental health symptoms among individuals dia...

With the fluctuations in anxious and depressive symptomatology accompanied by the pandemic crises, studies on the trajectories of these symptom domains are warranted to monitor the development of mental health problems in the population. This pre-registered longitudinal study examines stable factors and mechanistic processes covarying with the traj...

This 17-month longitudinal study on a representative sample of 4,361 Norwegian adults employs an observational ABAB design across six repeated assessments and three pandemic waves to systematically investigate the evolution of depressive symptomatology across all modifications of viral mitigation protocols (VMPs) from their onset to termination. Us...

BACKGROUND The aim of this multinational study was to assess the development of adverse mental health symptoms among individuals diagnosed with COVID-19 in the general population by acute infection severity up to 16 months after diagnosis. METHODS Participants consisted of 247 249 individuals from seven cohorts across six countries (Denmark, Estoni...

Increased and long-term parental stress related to one's parental role can lead to parental burnout. In the early phase of the COVID-19 pandemic, families experienced intensified pressure due to the government-initiated contact restrictions applied to prevent the spread of the virus in the population. This study investigates the risk factors and pr...

Drawing on the tenets of family stress theory, the aim of this study is to examine parents’ perceived stress, symptoms of anxiety, depression, and associated risk- and protective factors across demographic subgroups during in the first wave of the COVID-19 pandemic. Norwegian parents (N = 2,868; 79.5% mothers) with > 1 child under 18 years of age c...

Background: The 2020-2021 COVID-19 pandemic has added to the mental health strain on individuals and groups across the world in a variety of ways. Viral mitigation protocols and viral spread affect people on all continents every day, but at widely different degrees. To understand more about the mental health consequences of the pandemic, it is impo...

Background This study extends previous research by exploring whether changes in obsessive beliefs and metacognitions that were associated with changes in obsessive–compulsive disorder (OCD) symptom severity over the course of group behavioral treatment were maintained at long-term follow-up.Methods Forty patients with a primary diagnosis of OCD par...

Background In order to understand the intricate patterns of interplay connected to the formation and maintenance of depressive symptomatology, repeated measures investigations focusing on within-person relationships between psychopathological mechanisms and depressive components are required. Methods This large-scale preregistered intensive longit...

With the fluctuations in anxious and depressive symptomatology accompanied by the pandemic crises, studies on the trajectories of these symptom domains are warranted to monitor the development of mental health problems in the population. This pre-registered longitudinal study examines stable factors and mechanistic processes covarying with the traj...

This empirical study aims to investigate factors associated with insomnia symptoms during the COVID-19 pandemic in 4,921 Norwegian adults. Participants were queried across two time-points, between March 31st and April the 7th 2020, and between June 22nd and July 13th, 2020. Relevant risk factors and psychological correlates at the first time-point...

In order to understand the intricate patterns of interplay connected to the formation and maintenance of depressive symptomatology, repeated measures investigations focusing on within-person relationships between psychopathological mechanisms and depressive components are required. This large-scale preregistered intensive longitudinal study conduct...

The present study aimed to explore the relationship between changes in depressive symptoms and the capacity to mentalize over the course of a 3-month inpatient psychodynamic therapy in a sample of 56 patients with depression. Depressive symptoms and mentalizing were assessed weekly during treatment and at 1-year follow-up with the Beck Depression I...

Objective: To investigate the factors associated with adherence to viral mitigation protocols during the COVID-19 pandemic. Design: This epidemiological cross-sectional study examines adherence to behaviour in 4158 adults and its relationship with sources of information. Main outcome measures: Adherence to social distancing protocols (SDPs) and a...

Background: The prevalent co-occurrence between parental stress and depression has been previously established prior to and during the COVID-19 pandemic outbreak. However, no studies to date have identified the connections through which these symptom domains interact with each other to emerge into a complex and detrimental mental health state, alon...

Background and Objectives The COVID-19 pandemic and the social distancing protocols designed to impede transmission of the corona virus have severe mental health consequences. This study examine changes in loneliness in the general adult population when the corona-related social distancing protocols were largely discontinued (T2) following a period...

Background: The pace at which the present pandemic and future public health crises involving viral infections are eradicated heavily depends on the availability and routine implementation of vaccines. This process is further affected by a willingness to vaccinate, embedded in the phenomenon of vaccine hesitancy. The World Health Organization has li...

Background: The coronavirus (COVID-19) pandemic and the social distancing protocols used to impede the spread of the virus may have severe mental health consequences. The purpose of this study was to investigate the network of components of pandemic-related negative psychological states (i.e., fear of infection, financial worries, loneliness) and s...

Background In these unpredictable times of the global coronavirus disease 2019 (COVID-19) pandemic, parents worldwide are affected by the stress and strain caused by the physical distancing protocols that have been put in place. Objective In a two‐wave longitudinal survey, we investigated the levels of parental stress and symptoms of anxiety and d...

This study aimed to examine if survivors of childhood abuse responded differently to couple and family therapy compared with patients without such experiences. The study included 36 couples and nine individuals (N = 81). Of these participants, 30.3% had disclosed being exposed to and/or physical or sexual abuse during childhood. All participants of...

Background: Central components of psychological functioning, such as difficulties in emotion regulation and interpersonal problems are likely to have been substantially impacted by COVID-19 and amelioration measures of societal lock-down and social distancing. In turn, these factors are likely to predict mental health outcomes, such as symptoms of...

The prevalent co-occurrence between parental stress and depression has been previously established prior to and during the COVID-19 pandemic outbreak. However, no studies to date have identified the connections through which these symptom domains interact with each other to emerge into a complex and detrimental mental health state, along with the p...

Background: The pace at which the present pandemic and future public health crises involving viral infections are eradicated heavily depends on the availability and routine implementation of vaccines. This process is further affected by a willingness to vaccinate, embedded in the phenomenon of vaccine hesitancy. The World Health Organization has li...

Background: Central components of psychological functioning, such as difficulties in emotion regulation and interpersonal problems are likely to have been substantially impacted by COVID-19 and the amelioration measures of societal lock-down and social distancing. In turn, these factors are likely to predict mental health outcomes, such as symptoms...

In this epidemiological investigation, we assessed the prevalence of depression and anxiety symptoms during the COVID-19 pandemic. A total of 10,061 adults participated in the study. Symptoms of depression and anxiety were 2 to 3 times higher compared with prepandemic samples. Participants who predominantly socially distanced themselves revealed su...

BACKGROUND The 2020-2021 COVID-19 pandemic has added to the mental health strain on individuals and groups across the world in a variety of ways. Viral mitigation protocols and viral spread affect people on all continents every day, but at widely different degrees. To understand more about the mental health consequences of the pandemic, it is impor...

The COVID-19 pandemic has consequences for mental health in the general population and for health care personnel in particular. This study aimed to investigate the changes in PTSD symptoms, anxiety, and depression when the social distancing protocols were lifted (T2) following a period with strict protocols (T1). At T1, 1773 vulnerable professional...

The 2020-2021 COVID-19 pandemic has added to the mental health strain on individuals and groups across the world. Viral mitigation protocols and viral spread affect millions every day, but to widely different degrees. How individuals gather information about the pandemic might have an effect on levels of mental distress in the population. In this c...

The therapeutic alliance has gained status as a common factor in psychotherapy due to its robust predictive relationship with outcome. The current challenge in our field is to gain a more nuanced understanding of alliance's impact on the progress of treatment over the course of therapy. In the current study, alliance was measured on 3 dimensions: (...

Objective In couple therapy clients often suffer from a blend of individual psychiatric symptoms as well as severe relational distress. However, research is inconclusive on whether relational change predicts symptom change or vice versa. Because answers to this question could have important clinical implications on what to focus on in couple therap...

Background: Internationally, the Patient Health Questionnaire-9 (PHQ-9) is commonly used to assess the frequency and severity of depressive symptoms. However, psychometric properties of the Norwegian version of the PHQ-9 have only been assessed in adolescents. We present normative data for women and an evaluation of the psychometric properties (in...

Background: In the unpredictable times of the ongoing global coronavirus disease (COVID-19), parents worldwide are affected by stressors and strains that follow in the wake of the government-initiated distancing protocols. Objective: In a two‐wave longitudinal survey, we examined levels of parental perceived stress and symptoms of anxiety and depr...

Background. The coronavirus (COVID-19) pandemic and the social distancing protocols used to impede the spread of the virus may have severe mental health consequences. The purpose of this study was to investigate the network of components of pandemic-related negative psychological states (i.e., fear of infection, financial worries, loneliness) and s...

Psychotherapy research aims to investigate predictors and moderators of treatment outcome, but there are few consistent findings. This study aimed to investigate cytokines in patients undergoing treatment for anxiety disorders and whether the level of cytokines moderated the treatment outcome. Thirty-seven patients with comorbid and treatment-resis...

Objective: The main aim of the study was to examine levels of parental stress and symptoms of depression and anxiety in the general parental population (N = 2868) during the strict government-initiated physical distancing protocols following the onset of the COVID-19 pandemic. We further investigated specific predictors of parental distress, includ...

Objective: To investigate factors associated with adherence to viral mitigation strategies recommended by the WHO during the COVID-19 pandemic, including adherence to social distancing protocols (SDPs) and adherence to hygienic behavior recommendations (HB). Design: This pre-registered epidemiological study of 4158 adults examines the association...

Background: The mitigation strategies employed against the COVID-19 pandemic have severe mental health consequences. In particular, as a result of the social distancing protocols, loneliness is likely to increase. This study investigates (a) potential risk and resilience factors for loneliness in the Norwegian population during the strict social di...

Assessment of depression is a routine task in clinical practice in Norway. National guidelines (Helsedirektoratet, 2009) recommend the use of measurement instruments in assessment of depression. PHQ-9 is widely used in research and practice. The official PHQ-9 manual provides practical guidance on interpreting test results with the use of clinical...

In the frontline of the pandemic stand healthcare workers and public service providers, occupations which have proven to be associated with increased mental health problems during pandemic crises. This cross-sectional, survey-based study collected data from 1773 healthcare workers and public service providers throughout Norway between March 31, 202...

Analysis of longitudinal within-person networks over the course of therapy allows an identification of possible targets of treatment. This study examined within-person networks of clinical features in social anxiety disorder (SAD) patients during cognitive (CT) and interpersonal (IPT) therapy. Patients (n = 80) were randomized to either CT or IPT i...

Background: The mitigation strategies employed against the COVID-19 pandemic have severe mental health consequences. In particular, as a result of the social distancing protocols, loneliness is likely to increase. The aim of the present study was to investigate (a) the levels of loneliness in the Norwegian population during the strict social distan...

In this theoretical study, we examined whether and how a latent trait, a latent-trait state, and a network conceptualization of mental problems account for their descriptive features and causal mechanisms. The latent-trait approach is restricted to between-persons relations and thus provides no direct tests of mechanisms, which involve within-perso...

In the frontline of the pandemic stand healthcare workers and public service providers, occupations which have proven to be associated with increased mental health problems during pandemic crises. The objective of current study was to determine the level and predictors of post-traumatic stress disorder, anxiety and depression symptoms among healthc...

As the current pandemic situation evolves, urges have been made to focus efforts toward examining the mental health status of the general population. This large-scale epidemiological investigation assesses the prevalence of depression and anxiety associated with the mitigation strategies aimed at impeding viral transmission chains during the COVID-...

The GAD-7 is commonly used as a measure of general anxiety symptoms across various settings and populations. However, there has been disagreement regarding the factor structure of the GAD-7, and there is a need for larger studies investigating the psychometric properties of the measure. Patients undergoing treatment (N = 1201), both inpatient and o...

This replication study examined the change over time and the relationship between depressive symptoms and dyadic adjustment during residential couple therapy and at one- and three-year follow-up. Mixed models were used in the analyses, and a disaggregation procedure was applied to examine the results on a between-person as well as on a within-perso...

Background: Analysis of dynamic (temporal) networks allows an identification of important targets of treatment. Objective: This study examined the dynamic network of symptoms in patients diagnosed with post-traumatic stress disorder (PTSD) during exposure therapy. Method: Patients (n = 65) were randomized to either standard prolonged exposure, whic...

Complex posttraumatic stress disorder (CPTSD) is currently used as a diagnostic term and has been widely used in clinical disciplines. This article aims to discuss the concept and classification of CPTSD as a separate diagnosis. The traditional latent variable model is presented and an alternative understanding of CPTSD is exemplified through netwo...

This study aimed to investigate whether two theoretically derived moderators of treatment, degree of worry and avoidance at pretreatment, moderated anxiety from pretreatment to posttreatment in a randomized controlled trial comparing metacognitive therapy (MCT) and cognitive behavioral therapy (CBT). Personality problems, degree of comorbidity, and...

A network perspective on mental problems represents a new alternative to the latent variable perspective. Diagnoses are assumed to refer to a causal network of observable mental problems or symptoms (observables). The observable symptoms that traditionally have been considered indicators of latent traits (disorders) are taken to be directly related...

Metacognitive therapy (MCT) has shown promising outcomes across disorders, but, currently, little is known about the mechanisms of change in MCT as well as their specificity compared to those of cognitive behavioral therapy (CBT). The main purpose of this study was to examine the within-person relationships between features of the cognitive attenti...

The aim of this paper is to present how clinical significance as a scientifically founded and clinically relevant methodology can be implemented to monitor specific treatment goals in clinical practice. The rationale, clinical use, and implementation of clinical significance are described. Examples illustrate how clinical significance provides rele...

The purpose of this study was to examine the conceptualization of mental problems and disorders inherent in the therapeutic theories used in psychodynamic (PDT) and cognitive-behavioral therapy (CBT). Supportive-expressive (SET) and cognitive (CT) therapy for social anxiety disorder (SAD) were used as representative examples. Based on the typology...

There is a lack of knowledge regarding the long-term effect of evidence-based CBT/ ERP treatment for OCD that is delivered in routine clinical care. The aim of this study was to examine the long-term effectiveness of behavioral treatment for OCD in a Norwegian general outpatient clinic. In the current study, 62% (N = 40) of the original patients tr...