Tore Wentzel-Larsen

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

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Publications (227)667.43 Total impact

  • Åse Sagatun · Tore Wentzel-Larsen · Sonja Heyerdahl · Lars Lien
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    ABSTRACT: Background: Mental health problems in adolescence are associated with impaired function in young adulthood. Our aim was to assess how a hypothetical reduction in mental health problems in adolescence was related to medical benefits in young adulthood and to examine the mediating role of completion of upper secondary school. Methods: We used a population-based sample of more than 10,000 10th-grade adolescents with self-reported data on internalizing and externalizing mental health problems. The sample was linked to the Norwegian national registers of education and medical benefits. The mediation analysis was based on a causal inference framework. Results: During a three-year period in young adulthood, 6.4% of men and 5.9% of women received medical benefits. A two-point hypothetical reduction in externalizing problems was related to a lower probability of receiving medical benefits of 1.5 (95% confidence interval (CI) 1.0-2.1) percentage points in young men and 1.8 (95% CI 1.3-2.3) percentage points in young women. The proportion mediated by the completion of upper secondary school was 52% (95% CI 36-76) among boys and 42% (95% CI 29-60) among girls. The corresponding reduction in the probability of receiving medical benefits was 1.8 percentage points for internalizing problems in both sexes (95% CI boys 1.2-2.4 and girls 1.4-2.2). The proportion mediated was lower for internalizing problems and was only significant among girls (19%). Conclusions: Intervention and prevention strategies targeting internalizing and externalizing problems in adolescents may have the potential to reduce the receipt of medical benefits in young adulthood. The completion of upper secondary school seems to be a mechanism for this association, especially for externalizing problems.
    No preview · Article · Jan 2016 · Scandinavian Journal of Public Health
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    Siri Thoresen · Tine K. Jensen · Tore Wentzel-Larsen · Grete Dyb
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    ABSTRACT: Background and aims: Little is known about parents' health following their children's exposure to trauma. We investigated the mental health of parents of young terrorist survivors and assessed parental distress and guilt as potential predictors of mental health. Method: Mothers and fathers (N=531) participated in two study waves 4-5 and 14-15 months after the shooting. Posttraumatic stress reactions (PTSS) and anxiety/depression were compared with age- and gender-adjusted expected scores that were calculated from a concurrent population study. Mixed effects models investigated the associations between parental distress, parental guilt, and mental health. Results: Parents' level of anxiety/depression was three times higher and PTSS was five times higher than that of the general population. Parental distress and guilt about their child's traumatic experience contributed uniquely to symptoms at both time points. Conclusions: Parents of traumatized youth constitute a vulnerable group that has been overlooked in the literature. Intervention strategies following trauma should include both survivors and their parents.
    Preview · Article · Jan 2016 · Journal of Anxiety Disorders
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    Jon Magnus Haga · Lise Eilin Stene · Tore Wentzel-Larsen · Siri Thoresen · Grete Dyb
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    ABSTRACT: Objectives This study investigated whether the early outreach programme following the Utøya massacre reached out to the parents of the young survivors. Additionally, we explored whether specialised mental healthcare services were provided to parents presenting elevated levels of PTSD and depression reactions. Design Cross-sectional survey, face-to-face interviews and questionnaires. Setting Norway, aftermath of the Utøya massacre, 4–7 months postdisaster. Background Following the Utøya massacre, proactive early outreach programmes were launched in all municipalities that were affected, facilitating access to appropriate healthcare services. Participants A total of 453 parents of the Utøya survivors aged 13–33 years took part. Overall, 59.8% of the survivors were represented by one or more parent in our study. Main outcome measures Engagement with the proactive early outreach programme (psychosocial crisis teams and contact persons in the municipalities), utilisation of healthcare services (general practitioner and specialised mental healthcare services) and mental distress (UCLA PTSD-RI and HSCL-8). Results A majority of the participants reported contact with the proactive early outreach programme (crisis team, 73.9%; and contact person, 73.0%). Failure of outreach to parents was significantly associated with non-intact family structure (crisis team: OR 1.69, 95% CI 1.05 to 2.72, p=0.032) and non-Norwegian origin (crisis team: OR 2.39, 95% CI 1.14 to 4.98, p=0.021). Gender of the parent was not significantly associated with failure of the outreach programme (p≥0.075). Provision of specialised mental healthcare services was significantly associated with higher levels of PTSD (OR 2.08, 95% CI 1.55 to 2.79, p<0.001) and depression (OR 2.42, 95% CI 1.71 to 3.43, p<0.001) and not with the sociodemography (p≥0.122). Conclusions Proactive early outreach strategies may be helpful in identifying healthcare needs and facilitating access to the required services in a population struck by disaster. Our findings prompt increased attention to the complexity of family structures in reaching out universally to modern families following a disaster.
    Full-text · Article · Dec 2015 · BMJ Open
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    ABSTRACT: Most studies examining couple agreement on intimate partner violence (IPV) have found low agreement on levels of violence. This study explored agreement on male-perpetrated IPV in a sample of 93 couples where the man was voluntarily seeking IPV treatment. Five different types of violence were assessed: physical, physically controlling, psychological, property, and sexual. The results were mixed. When disagreement was found, this resulted from men attending IPV treatment reporting less violence than their partners. However, only psychological violence was consistently reported differently. Reliability estimates ranged from poor to moderate. Couples reported on sexual violence with less reliability than physical or physically controlling violence when referring to a typical month last year. Measurement of different types of violence among both partners in a couple is recommended in clinical and research settings as well as thorough discussions with clients voluntarily enrolled in treatment for IPV on what constitutes violence.
    Full-text · Article · Dec 2015 · Violence and Victims
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    Lisbeth Valla · Tore Wentzel-Larsen · Dag Hofoss · Kari Slinning

    Preview · Article · Dec 2015 · BMC Pediatrics
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    Marianne Opaas · Ellen Hartmann · Tore Wentzel-Larsen · Sverre Varvin
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    ABSTRACT: Response to mental health treatment varies highly among refugee patients. Research has not established which factors relate to differences in outcome. This study is a follow-up of Opaas and Hartmann's (2013) Rorschach Inkblot Method (RIM; Exner, 2003) pretreatment study of traumatized refugees, where 2 RIM principal components, Trauma Response and Reality Testing, were found descriptive of participants' trauma-related personality functioning. This study's aims were to examine relationships of the RIM components with measures of anxiety, depression, posttraumatic stress, quality of life (QOL), employment, and exile language skills throughout 3 years. We found that impaired Reality Testing was related to more mental health symptoms and poorer QOL; furthermore, individuals with adequate Reality Testing improved in posttraumatic stress symptoms the first year and retained their improvement. Individuals with impaired Reality Testing deteriorated the first year and improved only slightly the next 2 years. The results of this study imply that traumatized refugee patients with impaired Reality Testing might need specific treatment approaches. Research follow-up periods should be long enough to detect changes. The reality testing impairment revealed by the RIM, mainly perceptual in quality, might not be easily detected by diagnostic interviews and self-report.
    Full-text · Article · Nov 2015 · Journal of Personality Assessment
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    ABSTRACT: Objective: 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. Method: 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) males randomized to CBT (n=28) or SRT (n=22). Primary outcomes were the CY-BOCS total score and clinical response (CY-BOCS<16). Results: Twenty-one (75%) completed CBT and 15 (69.2%) completed SRT. The CY-BOCS total score did not reveal a significant difference between the treatments (p=.351). Within-group effect sizes were large and significant across both treatments. Twelve out of 50 (24.0%) participants were diagnosed with comorbid tic disorder, with seven receiving continued CBT and five SRT, respectively. In patients without tic disorder, results showed no significant between-group differences. However, in patients with comorbid tic disorder, those who received SRT had significantly lower average CY-BOCS scores when compared to those who received CBT. Conclusion: The large within-group effect sizes suggest that continued treatment is beneficial. However, there was no significant between group differences in SRT or 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 CBT.
    Full-text · Conference Paper · Sep 2015
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    Silje M Ormhaug · Stephen R Shirk · Tore Wentzel-Larsen
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    ABSTRACT: Client ratings of the therapeutic alliance are an important predictor of outcome in the treatment of traumatized adolescents and adults, but less is known about the therapists' perspective. The aim of this study was to investigate how therapists' ratings relate to the adolescents' perspective, how individual therapist and adolescent ratings relate to change in symptoms and treatment satisfaction, and whether discrepant alliance perspectives impact treatment outcome. The sample consisted of 156 youth (mean age 15.1, range 10-18), randomized to trauma-focused cognitive behavioral therapy or treatment as usual, and alliance ratings from 62 therapists. Alliance was measured midtreatment with the Therapeutic Alliance Scale for Children, and the factor structure of the two scales was analyzed with exploratory factor analyses. A change in posttraumatic symptoms was assessed with the Child PTSD Symptom Scale (CPSS) and the Clinicial-Administered PTSD Scale for Children and Adolescents (CAPS-CA). Therapist and client perspectives on the alliance were significantly, but moderately, associated (intraclass correlations [ICC]=0.54, p<0.001). Both scales predicted adolescent treatment satisfaction but only the client scale was significantly related to change in symptoms. Factor analyses revealed differences in factor structure with therapist ratings organized around bond and task dimensions and adolescent ratings organized by item valence. Higher therapist ratings compared to adolescent ratings predicted higher residual PTS symptoms. Although adolescent and therapist alliance ratings are moderately associated, results suggest that the ratings are differentially associated with outcomes. These findings, along with results indicating important differences in factor structure, imply that adolescent and therapist ratings are not interchangeable. Future studies should investigate how therapists can improve their judgments of adolescents' perceptions of the alliance as an overestimation of the quality of the relationship seems to be negatively related to outcome.
    Full-text · Article · Sep 2015 · European Journal of Psychotraumatology
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    ABSTRACT: Objective: The objective of the study was to investigate the relationship between physical injury (no, moderate and severe) and posttraumatic stress reactions (PTSR) at 4-5 months after the attack in survivors of the terror attack at Utoya Island, Norway, 22 July 2011, adjusting for sociodemographic, psychosocial and trauma-related factors. Methods: Overall, 325 young survivors (47% women, mean age 19.4 years) were interviewed 4-5 months (T1) and 14-15 months (12) after the attack. Variables concerning physical injury, PTSR (UCLA PTSD-RI scale, 0-4), peritraumatic exposure, sociodemographic and psychosocial backgrounds were measured. To evaluate the role of injury, multiple linear regression analyses were conducted. Results: The physically injured (n = 60) reported higher levels of PTSR than did the non-injured. The difference was statistically significant between the moderately injured (n = 37, mean 1.9) and the non-injured (n = 265, mean 1.5). No significant differences were found between the moderately and the severely (n = 23, mean 1.8) injured. Higher levels of peritraumatic events, peritraumatic reactions and loss of close, female sex and non-Norwegian ethnicity were significantly related to higher levels of PTSR in the full regression model. Conclusion: Physical injury was associated with higher PTSR after the terror attack. Moderately injured survivors may, as those severely injured, exhibit high levels of PTSR, and this should be taken into account when targeting early psychosocial health care after terror.
    No preview · Article · Sep 2015 · Journal of Psychosomatic Research
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    ABSTRACT: Detailed and reliable methods may be important for discussions on the importance of pneumothorax size in clinical decision-making. Rhea's method is widely used to estimate pneumothorax size in percent based on chest X-rays (CXRs) from three measure points. Choi's addendum is used for anterioposterior projections. The aim of this study was to examine the intrarater and interrater reliability of the Rhea and Choi method using digital CXR in the ward based PACS monitors. Three physicians examined a retrospective series of 80 digital CXRs showing pneumothorax, using Rhea and Choi's method, then repeated in a random order two weeks later. We used the analysis of variance technique by Eliasziw et al. to assess the intrarater and interrater reliability in altogether 480 estimations of pneumothorax size. Estimated pneumothorax sizes ranged between 5% and 100%. The intrarater reliability coefficient was 0.98 (95% one-sided lower-limit confidence interval C 0.96), and the interrater reliability coefficient was 0.95 (95% one-sided lower-limit confidence interval 0.93). This study has shown that the Rhea and Choi method for calculating pneumothorax size has high intrarater and interrater reliability. These results are valid across gender, side of pneumothorax and whether the patient is diagnosed with primary or secondary pneumothorax. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    No preview · Article · Jul 2015 · European journal of radiology
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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.
    Full-text · Conference Paper · Jun 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.
    Full-text · Article · Jun 2015 · Journal of Child and Adolescent Psychopharmacology
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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.
    Full-text · Article · May 2015 · BMJ Open
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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.
    Full-text · Article · Apr 2015 · BMC Public Health
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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.
    No preview · Article · Apr 2015 · Journal of Obsessive-Compulsive and Related Disorders
  • 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.
    No preview · Article · Mar 2015 · Parkinsonism & Related Disorders
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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.
    Full-text · Article · Feb 2015 · Transcultural Psychiatry
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    Anne Haugstvedt · Tore Wentzel-Larsen · Morten Aarflot · Berit Rokne · Marit Graue
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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.
    Full-text · Article · Jan 2015 · BMC Endocrine Disorders
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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.
    Full-text · Article · Jan 2015 · The Journal of Headache and Pain
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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.
    Full-text · Article · Jan 2015 · European Journal of Psychotraumatology

Publication Stats

4k Citations
667.43 Total Impact Points

Institutions

  • 2012-2015
    • Norwegian Centre for Violence and Traumatic Stress Studies
      Kristiania (historical), Oslo, Norway
  • 2011-2015
    • Regionsenter for barn og unges psykiske helse
      Kristiania (historical), Oslo, Norway
  • 2003-2015
    • Haukeland University Hospital
      • • Department of Neurology
      • • Department of Heart Disease
      • • Department of Pediatrics
      • • Department of Medicine
      • • Department of Plastic Surgery and Burns
      Bergen, Hordaland, Norway
  • 2012-2014
    • University of Oslo
      Kristiania (historical), Oslo, Norway
  • 2012-2013
    • Oslo University Hospital
      • Department of Biostatistics and Epidemiology
      Kristiania (historical), Oslo County, Norway
  • 2001-2012
    • University of Bergen
      • Institute of Medicine
      Bergen, Hordaland, Norway
  • 2007
    • MRC National Institute for Medical Research
      • Division of Physical Biochemistry
      Londinium, England, United Kingdom