Forskning

 

 

Här är olika forskningsområden jag hittills intresserat mig för, samt psykoterapiforskning

scholar.google.com

(Obs, årtalen indikerar forskningsprojekt)

1) 1986–87 Förskolebarns personlighet och temperamentsdrag relaterat till Typ A-beteende (stress)

 

2) 1989–91 Insomniapatienters och normalsovares subjektiva uppfattning om prestationer och objektiva resultat i neuropsykologiska tester

 

3) 1993–94 Drogmissbrukares ångesttillstånd jämfört med panikångestpatienter

 

4) 1995–2007 Personlighetsdiagnostik av drogmissbrukares personlighetsdrag, personlighetsstörningar, och försvarsmekanismer

7) 2007– 08 Objektrelationskvaliteter, alexitymi och försvarsmekanismer hos antisociala missbrukare

 

8) 2007–08 Psykopati och narcissism

 

9) 2008–> Evidensbaserad psykoterapi

10) 2010–11 Om lesbiskhet och mental hälsa: empiriska studier och diskussioner

 

11) 2010–> Prestationsbaserad självkänsla

 

12) 2014—> Om autonomi, kunskap och självkännedom i relationer

 

13) 2016—> Om etiologi, process och mentala rockader i otrohet

 

 

Senaste forskningsprojekt

Longitudinella studier av personlighetsdrag och prestationsbaserad självkänsla relaterat till utbrändhet 

Under många decennier i USA har man trott att olika program, terapier etc skulle höja självkänslan och leda till bättre hälsa hos folk som i sin tur skulle leda till färre sjukskrivningar, kriminalitet etc. Samtidigt var det också tänkt att människor med hög självkänsla skulle bidra med stabilare och bättre löner till samhället. I de senaste seriösa meta-analyser som gjorts där man evaluerar dessa fenomen i relation till objektiva fakta (t ex sjukskrivningar, löner, utbrändhet, psykiatriska diagnoser, arbetslöshet etc) visar det sig att ovanligt få fördelar faktiskt verifieras hos människor som på olika sätt skattas inneha hög självkänsla.

Utifrån amerikansk historia tror forskare att Kalvinism och meritokraci kan ha bidragit till att befolkningen måste bevisa sitt värde som individer i USA. Detta i sin tur kan leda till vad man skulle kunna översätta som "prestationsbaserad" självkänsla. Individen validerar sina olika egenskaper och kapaciteter i relation till, exempelvis, akademiska studier, hur man ter sig i sociala sammanhang, utseende, materialism, hög moral, och t o m statusgör partner samt barn. Detta medför allvarliga konsekvenser, såsom; att man prioriterar bort vänner och landar i självupptagenhet (narcissism, även depression och ångesttillstånd) för att sträva efter självkänsla, svårigheter i inlärningsprocesser (vid hot om misslyckande vid kunskapsprövning, skyddar man sitt själv genom att undvika just den kunskap man är rädd att inte hantera), fysisk ohälsa tex hjärt- och kärlsjukdomar samt hjärnblödningar (pga förhöjt kortisolvärde vilket är ett stresshormon). Prestationsbaserad självkänsla transformeras ofta till ett slags missbruksbeteende där t ex relationer i sig inte fyller någon djupare mening, såvida den inte bekräftar det repetitiva strävandet efter självkänsla. Studier har bedrivits på avdelningen för klinisk neurovetenskap, sektionen för psykologi vid Karolinska sjukhuset, avseende dessa strävanden efter (prestationsbaserad) självkänsla i relation till personlighetsdrag (Five Factor Model) samt till utbränningssyndrom (MBI) utifrån två kohorter (n= 1800).

 

Senaste internationella forskningen på psykodynamiska terapier

A) Effectiveness of Long-term Psychodynamic Psychotherapy—A Meta-analysis

Falk Leichsenring, DSc, Sven Rabung, PhD

Context The place of long-term psychodynamic psychotherapy (LTPP) within psychiatry is controversial. Convincing outcome research for LTPP has been lacking. Objective To examine the effects of LTPP, especially in complex mental disorders, ie, patients with personality disorders, chronic mental disorders, multiple mental disorders, and complex depressive and anxiety disorders (ie, associated with chronic course and/or multiple mental disorders), by performing a meta-analysis.

Data Sources Studies of LTPP published between January 1, 1960, and May 31, 2008, were identified by a computerized search using MEDLINE, PsycINFO, and Current Contents, supplemented by contact with experts in the field. Study Selection Only studies that used individual psychodynamic psychotherapy lasting for at least a year, or 50 sessions; had a prospective design; and reported reliable outcome measures were included. Randomized controlled trials (RCTs) and observational studies were considered. Twenty-three studies involving a total of 1053 patients were included (11 RCTs and 12 observational studies). Data Extraction Information on study characteristics and treatment outcome was extracted by 2 independent raters. Effect sizes were calculated for overall effectiveness, target problems, general psychiatric symptoms, personality functioning, and social functioning. To examine the stability of outcome, effect sizes were calculated separately for end-of-therapy and follow-up assessment.

Results According to comparative analyses of controlled trials, LTPP showed significantly higher outcomes in overall effectiveness, target problems, and personality functioning than shorter forms of psychotherapy. With regard to overall effectiveness, a between-group effect size of 1.8 (95% confidence interval [CI], 0.7-3.4) indicated that after treatment with LTPP patients with complex mental disorders on average were better off than 96% of the patients in the comparison groups (P = .002). According to subgroup analyses, LTPP yielded significant, large, and stable within-group effect sizes across various and particularly complex mental disorders (range, 0.78-1.98).

Conclusions There is evidence that LTPP is an effective treatment for complex mental disorders. Further research should address the outcome of LTPP in specific mental disorders and should include cost-effectiveness analyses.

 

B) The Efficacy of Psychodynamic Psychotherapy

© 2010 American Psychologist, American Psychological Association, Vol. 65, No. 2, 98–109

Jonathan Shedler, University of Colorado Denver School of Medicine

Empirical evidence supports the efficacy of psychodynamic therapy. Effect sizes for psychodynamic therapy are as large as those reported for other therapies that have been actively promoted as “empirically supported” and “evidence based.” In addition, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends. Finally, nonpsychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence and may reflect selective dissemination of research findings.

 

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