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Biomedical subjects

Are Holen

Publications and source records attributed to Are Holen.

14 recordsLinked to original sources

Reported maltreatment in childhood in relation to the personality features of Norwegian adult psychiatric outpatients.

To explore long-term associations between maltreatment in childhood and personality features in adulthood, 160 consecutive adult psychiatric outpatients completed self-administered questionnaires. Maltreatment was defined as either child abuse or neglect exerted by parents or other adults, coldness and overprotection by parents, or bullying by peers. The Childhood Trauma Questionnaire was used to detect childhood abuse by parents or other adults, while dimensions of parental coldness and overprotection were captured by the Parental Bonding Instrument. Bullying by peers was measured by an inventory used in schools. Personality variables were covered by the 5-PFa related to the "Big Five," The Rosenberg Self-Esteem Scale, and the Locus of Control of Behavior. Reports of bullying by peers were linked to poor self-esteem and external locus of control. Child maltreatment by parents or other adults were linked to the Big Five personality dimensions; bullying by peers was not.

Adult↗

Childhood maltreatment in adult female psychiatric outpatients with eating disorders.

To explore possible relations between maltreatment in childhood and subsequent eating disorders in adult life, 107 consecutive adult psychiatric female outpatients were screened for eating disorders. They also completed questionnaires about harassment by adults and bullying by peers in childhood. The Childhood Trauma Questionnaire measured childhood abuse by parents or other adults, and the Parental Bonding Instrument captured parental coldness and overprotection. Bullying by peers was measured by an inventory used in schools. Outpatients who met the criteria for bulimia nervosa reported far more bullying by peers, more coldness and overprotection from fathers, and more childhood emotional, physical and sexual abuse. The findings suggest associations between childhood maltreatment, especially bullying by peers, and bulimia nervosa.

Adult↗

Comparing self-reported communication skills of medical students in traditional and integrated curricula: a nationwide study.

OBJECTIVES: To investigate medical students' self-assessments of their communication skills through medical school related to background factors, curriculum design and perceived medical school stress. METHODS: Medical students at all year levels attending Norwegian universities in the spring of 2003 were mailed the Oslo Inventory of Self-reported Communication Skills (OSISCS) developed by the authors. Of the total number of students (N=3055), 60% responded. One school had a traditional curriculum, the other three ran integrated models. RESULTS: Students assessed their instrumental communication skills to increase linearly year by year, while the relational skills showed a curve-linear trajectory reaching the optimum level half-way into the curriculum. Students attending the traditional school reported lower levels of instrumental skills compared to the students from the integrated schools. In relational skills, a similar difference was maintained half-way into the curriculum, but disappeared towards the end. Perceived medical school stress correlated to the self-reported end point levels of the two types of communication skills. DISCUSSION: The trajectories of self-reported instrumental and relational skills indicate significant variations in facilitating mechanisms between curricula, cognitive processing and perceived medical school stress. CONCLUSIONS: Self-reported instrumental and relational communication skills develop differently in medical students over the years according to the type of curriculum. PRACTICE IMPLICATIONS: Curricula should be evaluated for improvement implementations.

Adolescent↗

Depression and diabetes: a large population-based study of sociodemographic, lifestyle, and clinical factors associated with depression in type 1 and type 2 diabetes.

OBJECTIVE: The purpose of this study was to investigate factors associated with depression in type 1 and type 2 diabetes and test whether these differ from factors associated with depression in the nondiabetic population. RESEARCH DESIGN AND METHODS: In an unselected population study comprising 60,869 individuals, potential sociodemographic, lifestyle, and clinical factors were investigated in participants with and without diabetes. The associations between hyperglycemia and depression in types 1 and 2 diabetes were also studied. The levels of depression were self-rated by using the Hospital Anxiety and Depression Scale. RESULTS: Several factors were correlated with depression in types 1 and 2 diabetes. However, these factors were not different from those of the nondiabetic population. Comorbid chronic somatic diseases were associated with depression in type 2 but not type 1 diabetes. In type 2 diabetes, those without comorbidity had the same odds of depression as the nondiabetic population with no chronic somatic diseases. No significant associations were found for hyperglycemia in relation to depression in type 1 and type 2 diabetes. CONCLUSIONS: Type 2 diabetes without other chronic somatic diseases did not increase the risk of depression. Factors associated with depression in type 1 and type 2 diabetes were shared with the nondiabetic population.

Adult↗

The effects of long meditation on plasma melatonin and blood serotonin.

BACKGROUND: The benefits of meditation are well documented, but the biochemical mechanisms have not been fully identified. One effect mechanism may be via influence on neurotransmitters. MATERIAL/METHODS: Therefore, plasma melatonin and blood serotonin concentrations were measured before and after one hour of meditation in advanced male meditators (n=27, mean age 46 years). They were compared with a matched reference group (n=29, mean age 43 years) who rested for one hour. In the meditators, melatonin and serotonin from before and after three consecutive hours of meditation were also compared. RESULTS: Initially, the median melatonin level was 4.9 pg/ml-1 in the meditators and 3.1 pg/ml-1 in the reference group (p<0.01). After one hour of practice, melatonin had decreased to a median of 3.4 pg/ml-1 in the meditators (p<0.0001), but was unchanged in the reference group. After three hours of meditation, melatonin had declined further in the meditators. After one hour of practice, serotonin concentrations decreased in both the meditators and the reference group (p<0.01). CONCLUSIONS: The findings suggest that advanced meditators have higher melatonin levels than non-meditators. Melatonin decreases during long meditation, a finding the study does not explain. Serotonin declines after both one-hour meditation and rest, indicating that serotonin may be a marker of general rest and not meditation-specific relaxation.

Adult↗

Hemodynamic changes during long meditation.

Changes in heart rate (HR) and blood pressure (BP) in advanced male meditators during 1 hr of meditation were compared with matched control participants resting for 1 hr. Also, changes in HR and BP during 3-hr meditation were analyzed. HR was recorded continuously during meditation (n = 38) and the control rest (n = 21). BP was measured before and after the meditation (n = 44) and the rest (n = 30). During the first hour, HR declined more in the meditators than the controls (p < .01). Within participant variability of HR was significantly lower during meditation than rest (p < .05). In the second hour of meditation, HR declined further (p = .01). BP was unaffected by either meditation or rest. In conclusion, meditation reduced the level of HR and within participant variability of HR more than rest. HR continued to decline during the second hour of meditation.

Adult↗

Cohabitation, education, and occupation of psychiatric outpatients bullied as children.

Few studies have explored adult psychiatric outpatients who were bullied in childhood. The aim of this study was to contrast social-demographic variables of adult psychiatric outpatients who reported bullying in childhood with those without such reports. One hundred sixty consecutive adult patients from a psychiatric outpatient clinic completed self-administered questionnaires about cohabitation status, level of education, work status, and occupation. Bullying was measured by an inventory used in schools. The results showed that psychiatric outpatients bullied in childhood were more often singles, had significantly lower levels of education, often received social benefits, and worked as shop assistants rather than as engineers and schoolteachers. Those bullied in childhood showed poorer psychosocial adjustment as adults.

Adaptation, Psychological↗

[Teaching clinical communication to medical students in Norway].

BACKGROUND: Clinical communication as part of the doctor-patient relationship has gained increased attention in the undergraduate medical education in Norway. Such teaching programmes require considerable resources, as much of the instruction has to be carried out in small groups, and they should be subjected to a thorough assessment from a cost-benefit perspective. MATERIALS AND METHODS: A working group representing the four medical faculties in Norway initiated EKKO, a project designed as a quality assurance of the instruction in clinical communication. In this paper comparable data are presented relating to the extent, form and content of the instruction. RESULTS AND INTERPRETATION: There are great variations as to what part of the curriculum the instruction is placed in, the extent of faculty-based teaching, training periods in general practice and hospital settings with feed-back on communication skills, as well as in faculty development. To what degree these variations influence doctors' communication skills when fully qualified could be assessed in a further stage of this project, which could also provide an empirical basis for improvements in the instruction given.

Clinical Competence↗

Alleged sexual abuse at a day care center: impact on parents.

OBJECTIVE: This report describes the cascade of stressful events and secondary life changes experienced by parents in a case of alleged sexual abuse at a day care program. The study evaluated parents' Posttraumatic Stress Disorder (PTSD) symptoms and general psychological responses to the stressful events 4 years after the alleged abuse, and explored predictive factors of parental distress. METHODS: A total of 39 parents were interviewed about stressful events, life changes, and social support. Current distress reactions, psychological wellbeing, and locus of control were assessed with a battery of standardized measures. RESULTS: Hearing about the sexual abuse, testifying in court, hearing the verdict, and being exposed in media reports were all rated by the parents as distressing events. The majority of the parents experienced secondary life changes after the alleged sexual abuse. Four years after the alleged sexual abuse, one-third of the parents reported a high level of PTSD Intrusive symptoms and one-fourth reported a high level of PTSD Avoidance symptoms. There was a significant positive correlation between a measure of psychological wellbeing and PTSD. Secondary life changes and locus of control significantly predicted PTSD. CONCLUSION: This study demonstrates that the alleged sexual abuse of children in day care and the resulting events in the legal system and the media constitute significant and chronic stressors in the lives of the children's parents. These findings underscore the need to expand the focus of trauma-related sequelae from the child victim to their parents and family.

Adult↗

Predicting academic success by group behaviour in PBL.

The aim of this study was to explore predictors of medical students' academic success by variables covering group behaviour, individual work and personality measures. The working hypothesis was that peer evaluation of behaviours in group work was of major importance. First-year medical students (n=199) at the Norwegian University of Science and Technology were included. All variables were derived by questionnaires and tested in relation to academic success in the written exam at the end of the first year. In multiple regression analyses, the group work behaviour 'improving learning' emerged as a significant predictor together with 'limiting good group process'. In the bivariate analyses, individual work variables such as constructive learning styles were also found to be related to academic success. External 'locus of control' was negatively associated with constructive learning styles and positively with dysfunctional ones.

Educational Status↗

Parent-child discrepancy in reporting children's post-traumatic stress reactions after a traffic accident.

This study examines possible parent-child discrepancies in the reporting of post-traumatic stress reactions in children after a traffic accident. Sixteen children exposed to the same traffic accident were interviewed about post-traumatic stress reactions at 5 weeks and at 6 months after the event, utilizing the Child Posttraumatic Stress Reaction Index (CPTS-RI). Independently, the parents' reported their child's degree of post-traumatic stress reactions on the CPTS-RI: Parent questionnaire, at the same two times. Clinicians also assessed the children's level of general functioning on the Children's Global Assessment Scale. The children reported significantly more post-traumatic stress reactions than observed by their parents 4 weeks after the accident. The parent-child discrepancy was more pronounced among younger children. The level of children's self-reported post-traumatic stress reactions decreased significantly from the first to the second assessment. At the second assessment, 6 months after the accident, there was no significant parent-child discrepancy observed. The children showed a normal level of functioning despite their post-traumatic stress reactions. The reported parent-child discrepancy indicates that information about children's post-traumatic stress reactions after an accident is best obtained directly from the children.

Accidents, Traffic↗

From clinical towards research interview: parenting problems with troubled adolescents.

The aim of this study was to investigate whether clusters of common questions asked in clinical parenting interviews with parents of troubled adolescents could contribute to the empirical assessment of parenting dimensions. Questions were derived from clinical experience and theory, and were presented in an interview with 101 parents of adolescents referred to child psychiatric outpatient clinics for emotional and behavioral disorders. Fourteen questions were formed within the parenting domain of warmth, 12 questions from the domain of control, five questions were about autonomy granting and six questions were about commitment. Scores clustered into nine subgroups: Contact, Empathy, Appreciation, Setting Limits, Consistency, Monitoring, Parenting Priority, Involvement and Autonomy Granting. Raters also made an overall judgment of the presence of parental negative attributions during the interview. The inter-rater reliability, internal consistency, and convergent validity of the subgroups were satisfactory, and the bias of socially desirable responding was limited. Directions for further research are suggested.

Adolescent↗

Childhood environment of adult psychiatric outpatients in Norway having been bullied in school.

OBJECTIVE: The goal of this study was to contrast the childhood environment of adult psychiatric outpatients reporting to have been bullied at school with those who were not. METHOD: One-hundred-sixty consecutive adult outpatients from a psychiatric clinic in Norway completed self-administered questionnaires about their psychosocial environment during childhood and adolescence. The frequency of being bullied was measured with an inventory used in schools. Also, the Parental Bonding Instrument (PBI) and the Childhood Trauma Questionnaire (CTQ) were used. RESULTS: Men who were bullied in childhood tended to grow up without biological fathers. Women who were bullied scored significantly lower on Father Care on the PBI and significantly higher on Emotional Neglect, Emotional and Physical Abuse and Physical Neglect on CTQ than those who weren't. CONCLUSIONS: The findings suggest that to be bullied in school years is associated with characteristic psychosocial features in the environment of early childhood and adolescence.

Adult↗

Methotrexate infusions as central nervous system prophylaxis in children with acute lymphocytic leukemia: the Norwegian experience.

This study included all 690 children in Norway diagnosed as having acute lymphocytic leukemia (ALL) from July 1975 till the end of 1997. Relapses and deaths were monitored until the end of 2000. Neuroleukemia prophylaxis was intravenous methotrexate (MTX) infusions as intermediate-dose methotrexate (IDM) or high-dose methotrexate (HDM) combined with intrathecal MTX. From 1992, systemic therapy was considerably intensified, and, in addition, patients in a subgroup of the high-risk and very high-risk groups were given prophylactic cranial irradiation. The overall findings showed that MTX significantly reduced central nervous system (CNS)-related relapses, and, in general, reinforced systemic therapy reduced significantly non-CNS relapses and deaths. The overall crude survival was 75%. During the study period, the crude survival improved for patients on standard protocols from initially 65 to 90%. Forty patients (6%) developed isolated CNS relapse, 27 (4%) had combined CNS relapse, whereas 180 (26%) had non-CNS relapse. When IDM and HDM were compared, the cumulative risk for isolated CNS relapse was significantly lower with HDM, 12 and 5%, respectively. For any relapses that involved the CNS, the risk remained significantly lower for HDM, 8 versus 18%. Of the 40 patients with isolated CNS relapse, 23 survived (58%).

Antimetabolites, Antineoplastic↗