Biomedical subjects

Hans Christian Larsen

Publications and source records attributed to Hans Christian Larsen.

9 recordsLinked to original sources

PubMed2005

A controlled trial of cognitive-behavior therapy combined with vestibular rehabilitation in the treatment of dizziness.

Dizziness is a common and often untreated symptom in the general population. The aim of this study was to investigate the effects of a combined cognitive-behavioral/vestibular rehabilitation (VR) program, using a randomized control design. A total of 29 participants were randomized to treatment consisting of psychoeducation, vestibular exercises, relaxation and cognitive interventions, or to serve as waiting list controls. Measures of dizziness-related handicap, dizziness-provoking movements, and daily diary registrations of dizziness symptoms at pre- and post-treatment showed statistically significant improvements in many domains, which translated to moderate effect sizes. These findings provide preliminary support for the combination of Cognitive-behavioral therapy (CBT) and VR methods in the treatment of dizziness.

Adult↗

PubMed2005

Treatment of tinnitus in the elderly: a controlled trial of cognitive behavior therapy.

The aim of the study was to investigate the effects of cognitive behavioral therapy (CBT) in elderly people with tinnitus (<65 years). Thirty-seven patients were called in for a structured interview. Following exclusion, twenty-three participated in the trial. All participants underwent medical ear, nose, and throat (ENT) examination, audiometry, and tinnitus matchings. A randomized controlled design with a waiting list control group was used. A CBT treatment package was delivered in six weekly two hour group sessions. Outcome was measured using validated self-report inventories and daily diary ratings of annoyance, loudness and sleep quality for one week pretreatment, post-treatment. A three month follow-up was included at which time all participants had received treatment, but in a shorter format for the control group. Results showed statistically significant reductions of tinnitus-related distress. Thus, CBT was better than no treatment, but the particular aspects of CBT that contributed to the effects can not be established. In conclusion, the findings give some support for the use of group CBT for elderly people with tinnitus.

Aged↗

PubMed2004

[Cognitive behavior therapy via Internet. Patients with tinnitus are helped to manage their problem--simpler and cheaper].

Cognitive-behavioural therapy (CBT) is effective in reducing distress in tinnitus patients. To make CBT more available, an Internet-based self-help treatment has been used since 1999 at the department of Audiology, Uppsala University hospital. After initial medical and psychological assessment the patients get access to the Internet treatment. The treatment programme is divided into six weeks, and each week the patient chooses treatment components, reads information and instructions, plans the training and then practises during one week. The patient prints out registration sheets and reports the progress at the web site, receiving E-mail feedback from the therapist. It is important to keep in contact with the patient. The efficacy of the treatment has been shown in two randomised controlled studies, showing significantly better result then a waiting-list control group and equal result compared to a CBT group treatment respectively. A recent replication showed that the results can be generalised to a clinical setting.

Cognitive Behavioral Therapy↗

PubMed2004

Internet-based cognitive-behavioral self-help treatment of tinnitus: clinical effectiveness and predictors of outcome.

The aim of this investigation was to evaluate Internet-based cognitive-behavioral therapy for tinnitus in a nonrandomized clinical effectiveness study with a sample of consecutive patients referred for psychological treatment (N = 77). Results were calculated at a group level on an intention-to-treat basis and showed significant reductions of distress on the Tinnitus Reaction Questionnaire (P. H. Wilson, J. Henry, M. Bowen, & G. Haralambous, 1991), the Hospital Anxiety and Depression Scale (A. S. Zigmond & R. P. Snaith, 1983), and on the Insomnia Severity Index (C. H. Bastien, A. Vallières, & C. M. Morin, 2001). A 3-month follow-up showed that patients remained improved. The dropout rate was 30%. Treatment compliance, external referral to the treatment, and number of earlier treatments for tinnitus were associated with positive outcome. The number of e-mails between therapist and patient concerning treatment problems was associated with worse outcome. Internet-based cognitive-behavioral therapy holds some promise as a treatment modality for tinnitus. Future research should focus on further controlled evaluations of the treatment technique and evaluate the cost-effectiveness compared to other forms of tinnitus treatments.

Adult↗

PubMed2004

Cognitive bias in dizziness: emotional Stroop and autobiographical memories.

Dizziness is commonly associated with anxiety, and is often caused by a dysfunction of the balance system. While a link between dizziness and both anxiety disorders and depression has been established, less is known about information processing in dizziness. In the first experiment we tested whether 15 patients with dizziness would display an emotional Stroop effect for panic-related words. Also included was a control group of 15 persons. The Stroop task was preceded by ratings of personal relevance of the Stroop words and followed by a surprise free recall of the words. Results showed a Stroop effect for panic-related words in the dizziness group, but the interaction did not reach significance (p = 0.08). Separate analysis of dizziness-related panic words however resulted in a significant group x condition interaction. In the free recall of Stroop words a main effect of word category was found, with more panic-related words being recalled. The second experiment investigated autobiographical memories in 14 patients with dizziness and 14 matched controls. Results showed a group x condition interaction with less specific memories being recalled following positive cue-words in the dizziness group. The overall pattern of results suggests that dizziness is related to deficits in information processing, which could be targeted in treatment.

Adult↗

PubMed2003

[Tinnitus affects 15 percent--today's environmental noise a risk factor. Early treatment can prevent chronic problems].

A substantial proportion of individuals in the general population have tinnitus and 1-3% suffer from severe tinnitus affecting sleep, concentration, and mood. For a majority of patients with tinnitus degree of hearing loss plays a significant role. Several potential causes and aggravating factors have been suggested, but there is still not a single theory available to explain why tinnitus is so bothersome for some individuals. Recent research has investigated neural correlates of tinnitus, mainly involving primary and secondary auditory cortex. Several treatments have been tested with modest results. However, for the alleviation of tinnitus-related distress there is now empirical support for the use of cognitive-behavioural treatment methods. Future efforts should focus on prevention of noise-induced hearing loss and ways to foster habituation to tinnitus.

Behavior Therapy↗

PubMed2003

Dual-task study of cognitive and postural interference in patients with vestibular disorders.

OBJECTIVE: To study the relation between a mental task (silent backward counting) and posture in patients with vestibular deficits and to study the role of attention. STUDY DESIGN: In Experiment 1, postural sway and performance on the mental task were measured in a 2 x 2 dual-task design (with or without mental task and calf stimulation). In Experiment 2 a similar design was used, the only difference being that during trials without the mental task, patients were instructed to focus on their balance and provide a rating of body sway. SETTING: The study was carried out at a tertiary referral outpatient audiology clinic. PATIENTS: The first experiment included 20 patients and the second experiment 10 patients seen consecutively at the clinic on account of vertigo and dizziness. MAIN OUTCOME MEASURES: Performance on a mental task and on a force platform for measurement of anterior-posterior and lateral sway. RESULTS: Results showed no effect of the balance conditions on the cognitive task in Experiments 1 and 2. The mental task led to less body sway during calf stimulation in Experiment 1. In Experiment 2, when attention was focused on body sway, an opposite result was found, with more sway during the mental task in the condition of no calf stimulation. CONCLUSIONS: Control of body sway and cognitive functioning are to some extent related, most likely because of postural stability being prioritized in dual-task conditions.

Attention↗

PubMed2002

Effect of cognitive load on postural control.

The present study reports findings from two experiments on the relation between a mental task (silent backward counting) and posture. The first experiment included 30 normal subjects and the second experiment 20 normal subjects. In Experiment 1 postural sway and performance of the mental task were measured in a 2 x 2 dual-task design (with or without mental task and calf stimulation). In Experiment 2 a similar design was used, the only difference being that during trials without the mental task, subjects were instructed to focus on their balance and provide a rating of body sway. Results showed that balance perturbation led to decreased performance on the cognitive task in Experiment 1, but not in Experiment 2. The mental task led to less body sway, while focused attention attenuated the effect. In conclusion, control of body sway and cognitive functioning are to some extent related.

Adult↗

PubMedDate not supplied

[Hyperacusis--an unexplored field. Cognitive behavior therapy can relieve problems in auditory intolerance, a condition with many questions].

Hyperacusis is defined as unusual intolerance to ordinary environmental sounds, and is commonly reported in the general population and in association with a range of medical conditions. These include neurological deficits (e.g. migraine), psychiatric conditions (e.g. depression), and several ear, nose and throat diagnoses such as tinnitus, noise-induced hearing loss, and middle ear malfunctions. However, extreme sensitivity to noise has also been studied from a public health perspective, but with a focus on noise sensitivity in general. In this review a distinction is proposed between three different aspects of the experience of hyperacusis. The first is the sensitivity, with the pain sensations reported in association with sounds. The second is the annoyance, which can be unrelated to loudness, but still cause marked distress. The third aspect deals with the fear of being harmed by sounds, which promotes avoidance and the unmotivated use of ear protection. The natural course of hyperacusis is largely unknown and there are no published randomized outcome studies on the available treatment options for the condition. In this paper we propose that cognitive behavioral therapy, presented in a multidisciplinary setting, could be a useful treatment. This treatment includes relaxation methods, advice regarding sound, and gradual exposure to everyday sounds.

Biomedical Research↗