David Forsström

David Forsström


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Arbetar vid Institutionen för folkhälsovetenskap
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Besöksadress Sveavägen 160, Sveaplan
Rum 354
Postadress Institutionen för folkhälsovetenskap 106 91 Stockholm


I urval från Stockholms universitets publikationsdatabas
  • 2016. Philip Lindner (et al.). EABCT 2016 Abstract Book, 748-748

    Social anxiety disorder (SAD) is a common disorder associated with impaired quality of life (QoL), that indexes anxious distress and avoidance related to social situations. The DSM-5 features a specifier to delineate those with only performance-related social anxiety, yet little is known whether performance- and interaction-related anxieties have a differential impact on total QoL and on different QoL domains. To investigate this, we pooled screening data from eight intervention studies for SAD (n = 2017). Total sample mean age was 35.28 (SD = 12.26) and 69% were female. SAD symptoms were measured using the self-rated Liebowitz Social Anxiety Scale with items classified as measuring either performance or interaction anxiety. QoL, both total and across four domains, was measured using the Quality of Life Inventory. Data was analyzed using multiple regression models featuring the two anxiety scores as predictors, and by simulating the Performance-only specifier through 2˙2 median-split subgrouping and standard ANOVAs. Both interaction and performance anxieties were independently associated with lower QoL in general and across domains. Interaction anxiety had a larger negative impact on Personal Growth- and Achievement-related QoL than performance anxiety. The High-Performance/Low-Interaction-group rated higher Achievement-related QoL compared to the Low-Performance/High-Interaction-group (p = .012), yet groups were matched on total QoL and on other domains. Other group differences were in the expected direction.

    QoL impairments in SAD is primarily driven by number of feared social situations, and only secondarily by types of fear social situations, with interaction anxiety having a larger, negative impact on some QoL domains.

  • 2016. Philip Lindner (et al.). Cognitive Behaviour Therapy 45 (3), 182-195

    Measurements of subjective quality of life (QoL) are an important complement to symptom ratings in clinical research and practice. Despite there being several established QoL self-rating scales, we identified a need for a freely accessible, easy-to-use inventory, validated for use with both clinical and non-clinical samples, based on the overall life satisfaction conceptualization of QoL. The Brunnsviken Brief Quality of life scale (BBQ) was designed to meet these requirements. Items were selected by performing a factor analysis on a large data-set of QoL ratings collected previously. Six life areas (Leisure time, View on life, Creativity, Learning, Friends and Friendship, and View of self) were identified as important for overall QoL and were included in the BBQ. A psychometric evaluation was performed using two independent samples: healthy undergraduate students (n = 163), and a sample seeking treatment for social anxiety disorder (n = 568). Results suggested a unifactorial structure, with good concurrent and convergent validity, high internal and test-retest reliability, and accurate classification ability. We conclude that the BBQ is a valid and reliable measure of subjective QoL for use in clinical and research settings. The BBQ is presently available in 31 languages and can be freely downloaded from

  • 2016. David Forsström, Hugo Hesser, Per Carlbring. Journal of Gambling Studies 32 (3), 889-904

    Gambling is a common pastime around the world. Most gamblers can engage in gambling activities without negative consequences, but some run the risk of developing an excessive gambling pattern. Excessive gambling has severe negative economic and psychological consequences, which makes the development of responsible gambling strategies vital to protecting individuals from these risks. One such strategy is responsible gambling (RG) tools. These tools track an individual’s gambling history and supplies personalized feedback and might be one way to decrease excessive gambling behavior. However, research is lacking in this area and little is known about the usage of these tools. The aim of this article is to describe user behavior and to investigate if there are different subclasses of users by conducting a latent class analysis. The user behaviour of 9528 online gamblers who voluntarily used a RG tool was analysed. Number of visits to the site, self-tests made, and advice used were the observed variables included in the latent class analysis. Descriptive statistics show that overall the functions of the tool had a high initial usage and a low repeated usage. Latent class analysis yielded five distinct classes of users: self-testers, multi-function users, advice users, site visitors, and non-users. Multinomial regression revealed that classes were associated with different risk levels of excessive gambling. The self-testers and multi-function users used the tool to a higher extent and were found to have a greater risk of excessive gambling than the other classes.

  • 2015. Alexander Rozental (et al.). Cognitive Behaviour Therapy 44 (6), 480-490

    Procrastination refers to the tendency to postpone the initiation and completion of a given course of action. Approximately one-fifth of the adult population and half of the student population perceive themselves as being severe and chronic procrastinators. Albeit not a psychiatric diagnosis, procrastination has been shown to be associated with increased stress and anxiety, exacerbation of illness, and poorer performance in school and work. However, despite being severely debilitating, little is known about the population of procrastinators in terms of possible subgroups, and previous research has mainly investigated procrastination among university students. The current study examined data from a screening process recruiting participants to a randomized controlled trial of Internet-based cognitive behavior therapy for procrastination (Rozental et al., in press). In total, 710 treatment-seeking individuals completed self-report measures of procrastination, depression, anxiety, and quality of life. The results suggest that there might exist five separate subgroups, or clusters, of procrastinators: “Mild procrastinators” (24.93%), “Average procrastinators” (27.89%), “Well-adjusted procrastinators” (13.94%), “Severe procrastinators” (21.69%), and “Primarily depressed” (11.55%). Hence, there seems to be marked differences among procrastinators in terms of levels of severity, as well as a possible subgroup for which procrastinatory problems are primarily related to depression. Tailoring the treatment interventions to the specific procrastination profile of the individual could thus become important, as well as screening for comorbid psychiatric diagnoses in order to target difficulties associated with, for instance, depression.

  • 2015. Alexander Rozental (et al.). Internet Interventions 2 (3), 314-322

    Internet interventions constitute a promising and cost-effective treatment alternative for a wide range of psychiatric disorders and somatic conditions. Several clinical trials have provided evidence for its efficacy and effectiveness, and recent research also indicate that it can be helpful in the treatment of conditions that are debilitating, but do not necessarily warrant more immediate care, for instance, procrastination, a self-regulatory failure that is associated with decreased well-being and mental health. However, providing treatment interventions for procrastination via the Internet is a novel approach, making it unclear how the participants themselves perceive their experiences. The current study thus investigated participants' own apprehension of undergoing Internet-based cognitive behavior therapy for procrastination by distributing open-ended questions at the post-treatment assessment, for instance, “What did you think about the readability of the texts”, “How valuable do you believe that this treatment has been for you?”, and “The thing that I am most displeased with (and how it could be improved) is …”. In total, 75 participants (50%) responded, and the material was examined using thematic analysis. The results indicate that there exist both positive and negative aspects of the treatment program. Many participants increased their self-efficacy and were able to gain momentum on many tasks and assignments that had been deferred in their everyday life. Meanwhile, several participants lacked motivation to complete the exercises, had too many conflicting commitments, and were unable to keep up with the tight treatment schedule. Hence, the results suggest that Internet interventions for procrastination could profit from individual tailoring, shorter and more manageable modules, and that the content need to be adapted to the reading comprehension and motivational level of the participant.

  • 2015. Andrzej Werbart, Sonja Levander, David Forsström. Book of Abstracts, 56-56

    Aim: Treatment goals in psychoanalysis often include changes in underlying psychological structures. Different patterns of change have been demonstrated in anaclitic and introjective patients. This study takes a further step and examines changes in the anaclitic-introjective personality configurations following psychoanalysis, as well as patients’ experiences of these changes in a series of 14 cases. Method: Outcome measures included SCL-90, SASB and SOC pretreatment, at termination and at 2-year follow-up. Personality assessments were based on repeated interviews and applying prototype-matching methodology. Patients’ experiences were explored by applying inductive thematic analysis. Results: We found a moderate increase in the other polarity, with more mature and integrated expressions of relatedness and self-definition, while still maintaining the basic personality configuration. These changes were more pronounced in the anaclitic group. On the group level, the patients improved on all self-report measures, with outcomes comparable to meta-analytic data, and the improvements continued after termination. However, outcomes on the self-report measures were more favorable in the introjective group. Patients described their experienced changes in terms of complementary personality configuration, but the introjective group described more benefits from psychoanalysis. Several patients expressed their ambivalence to these changes and a feeling of loss of their former selves. The patients’ view of their analysts and the analytic method were congruent with the patients’ primary personality configuration. Discussion: In order to reactivate developmental processes, the psychoanalytic technique has to be adjusted to the anaclitic and introjective patients’ different needs and defenses.

  • 2015. David Forsström (et al.). Abstracts from the 7th Swedish Congress on internet interventions (SWEsrii), 20-20

    Procrastination can be defined as a voluntarily delay of an intended course of action despite expecting to be worse-off for the delay, and is considered a persistent behavior pattern that can result in major psychological suffering, which in turn can constitute a major problem for many individuals. There a not many studies available on treating procrastination. A previous Internet based RCT with guided and unguided treatment aimed to decrease procrastination yielded positive results for individuals who volunteered to receive treatment. This current study has the aim to further increase the knowledge regarding treatment for procrastination. It is a RCT comparing unguided and group treatment aimed to decrease procrastination in a student population. Demographic data from the included participants and preliminary outcome data is presented. These results are discussed and compared to the previous RCT and other studies evaluating the effect of treatment aimed to decrease procrastination.

  • 2015. Philip Lindner (et al.).
  • 2015. Per Binde, David Forsström. Nordisk Alkohol- og narkotikatidsskrift (NAT) 32 (2), 219-226

    In this commentary we discuss the translation into Swedish of the term Gambling Disorder (GD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2015). An earlier commentary in this journal described and discussed the translation into Finnish (Castrén, Salonen, Alho, & Lahti, 2014).

  • 2015. Alexander Rozental (et al.).

    Prokrastinering definieras som beteendet att medvetet förhala ett tilltänkt handlingsförlopp, trots medvetenhet om att det kan medföra negativa konsekvenser. Utöver att påverka prestationen på en given uppgift eller aktivitet har prokrastinering även visat sig vara associerat med sämre psykisk och fysisk hälsa. Trots detta är forskning på effektiva behandlingsinterventioner för prokrastinering ytterst begränsat. Aktuellt symposium syftar till att delge resultaten från två kliniska studier där kognitiv beteendeterapi har använts i behandling av personer med svåra problem av prokrastinering, dels i form av Internetbaserad självhjälpsbehandling, dels i form av gruppbehandling. Utöver en presentation av utfallet ges dessutom en genomgång av en klusteranalys av de deltagare som har sökt hjälp för prokrastinering, vilken visar på behovet av noggrann screening och god differentialdiagnostik inför en behandling.

Visa alla publikationer av David Forsström vid Stockholms universitet

Senast uppdaterad: 23 februari 2018

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