I urval från Stockholms universitets publikationsdatabas

• Seeing beyond the diagnostic and statistical manual: A function-centered review of obsessive-compulsive disorder and anxiety disorders

  2025. Jón Ingi Hlynsson, Jan Bergström, Per Carlbring. Journal of Obsessive-Compulsive and Related Disorders 46

  Artikel

  Obsessive-compulsive disorder (OCD) is classified within its own diagnostic category, separate from anxiety disorders, yet clinical practitioners still treat it as an anxiety disorder; both conceptually and therapeutically. This paper examines the rationale for seperating OCD from the anxiety disorders by contrasting cognitive models of anxiety disorders and OCD, and reviewing phenomenological and psychobiological evidence for OCD's distinctiveness. We compare OCD's behavioral functions with those of specific phobia, panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder, and health anxiety disorder. Our review finds no compelling evidence that OCD differs sufficiently from anxiety disorders to warrant its own category. The same functional behaviors are evident in OCD and other anxiety disorders, with the foci of threat being the differentiating factor between disorders (e.g., fear of public speaking vs. fear of contamination in social anxiety and contamination-OCD, respectively). Consequently, we conclude by emphasizing that future research should focus on behavioral function when studying mental disorders, since descriptive similarities may not indicate clinical or functional equivalence. For diagnostic manuals to maintain validity and clinical utility, they must incorporate a functional analytic perspective. Failure to do so may result in inadequate diagnostic categories and stagnant treatment advances (cf. clinical guidelines for OCD have remained unchanged since 2005). While diagnostic manuals are meant to guide treatment selection, descriptive diagnoses need complementary theory-driven case conceptualizations to advance our understanding of maintaining factors and mechanisms of change during treatment. Without this approach, theoretical progress in OCD may stall, ultimately affecting patient outcomes.

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• A double-edged sword: Insights from practitioners on the short and long-term negative effects of psilocybin-assisted psychological interventions

  2024. Moa Nordin (et al.). Journal of Psychedelic Studies 8 (2), 196-203

  Artikel

  Background and aims: Interest in psychedelic research has grown significantly in recent years and the naturally derived substance psilocybin, in combination with therapy, has shown promising results as a treatment for a range of psychiatric conditions. However, the negative effects and risks of psilocybin-assisted treatment are not well-established. The purpose of this study was to investigate the potential negative effects of psilocybin-assisted psychological interventions in both the short and long term.

  Method: Semi-structured interviews were conducted with eight psychedelic treatment providers and facilitators. Their content was thematically interpreted.

  Results: Three themes of short-term negative effects were identified. They included negative reactions to psilocybin dosing sessions, undesirable processes in the therapeutic relationship, and difficult self-experiences. Four themes of long-term negative effects were identified. They included destabilization of the client, difficulties adapting to life post-treatment, complications in the treatment relationship, and undesirable outcomes.

  Conclusions: These results highlight the multifaceted challenges clients may face, emphasizing the need for thorough pre-intervention assessment and post-intervention support. The findings both confirm previous research and highlight new aspects that can contribute to increased safety and be relevant for clinical implementation. Further rigorous research is needed to ensure safety, establish ethical guidelines, and optimize the positive effects of these experimental medicines. Integrating various research approaches and types of measurements will be vital to further our understanding of negative effects of psychedelic-assisted therapy.

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• Evaluating the necessity of booster sessions in relapse prevention for depression: a longitudinal study

  2025. Jón Ingi Hlynsson (et al.). Frontiers in Psychology 16

  Artikel

  Introduction: Major depression is a highly prevalent and heterogenous mental disorder. Although therapeutic advances for major depressive disorder over the past quarter-century have been incremental rather than transformative, booster sessions have been proposed as a means of solidifying acute treatment gains and lowering relapse risk. However, evidence for the effectiveness of these treatment booster sessions remains inconclusive. This study therefore evaluated the long-term effectiveness of relapse prevention treatment booster sessions for major depression.

  Method: In a two-arm, parallel-group, maintenance-phase randomized controlled trial (RCT) with repeated longitudinal measures, the sample consisted of participants in Sweden who had received acute treatment for depression (internet-based behavioral activation or physical activity) and were then randomly assigned to either an 8-week relapse prevention program (n = 119) or control group (n = 143). Participants were followed-up for 24-months with both monthly self-report questionnaires (Patient Health Questionnaire 9-item & Generalized Anxiety Disorder 7-item) and quarterly diagnostic interviews (Mini-International Neuropsychiatric Interview; MINI).

  Results: Both the relapse prevention group and control group exhibited similar depression-free trends over the course of the study period, with over 95% of participants in each group maintaining remission at the 24-month follow-up. Furthermore, all pre-hypothesized predictors of relapse were non-significant in differentiating the two groups at 24-month follow-up.

  Discussion: These findings raise the question of whether treatment booster sessions are uniformly advisable for all mild–moderate cases of depression. For instance, preferentially recommending treatment boosters for psychotherapy-naïve individuals with depression may yield greater effects compared to individuals with difficult-to-treat depression. Our findings indicate that the efficacy of behavioral activation and physical activity may be even greater than previously reported, a testament to the lasting effects of internet-based psychotherapy.

  Clinical trail registration: ClinicalTrials.gov, identifier NCT01619930.

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• Evaluating the reliability and validity of the Questionnaire on Well-Being: a validation study for a clinically informed measurement of subjective well-being

  2025. Jón Ingi Hlynsson (et al.). Cognitive Behaviour Therapy 54 (2), 208-230

  Artikel

  Researchers and clinicians are becoming increasingly aware of the importance of assessing positive functioning to inform clinical outcomes. This paper evaluates the Questionnaire on Well-Being (QWB, available for free https://doi.org/10.17605/OSF.IO/GSC3R), a clinically informed instrument that assesses subjective well-being, across two studies. Study One, consisting of treatment-seeking individuals in an assertiveness training sample (n = 495), explored the factorial structure of the QWB, assessed the four-week test-retest reliability, criterion-related validity, and identified a preliminary cutoff point for the QWB with clinical significance. Study Two, including participants from the general public (n = 1561), confirmed the factorial structure of the QWB and further evaluated criterion-related validity. The results provided support for a unidimensional structure for the QWB. Furthermore, the QWB exhibited excellent internal reliability (Cronbach’s alpha = 0.93 and 0.94 in Study One and Two, respectively), high test-retest reliability (ICC₃ = .50 at a four-week follow-up in Study One), and appropriate criterion-related validity demonstrating positive correlations with positive affect and negative correlations with psychopathology. Finally, a cutoff point on the QWB below 50 was associated with marked psychopathology. These findings provide preliminary support for the usage of the QWB in clinical and non-clinical settings, establishing the QWB as a reliable indicator of subjective well-being.

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• To be or not to be satisfied in your romantic relationship: evaluating the reliability and validity of the Valentine scale

  2025. Jón Ingi Hlynsson (et al.). Cognitive Behaviour Therapy 54 (4), 477-501

  Artikel

  An intimate partner relationship is one of the most significant life goals for humans. Romantic relationships can promote healthy behavior and buffer against the development of psychiatric disorders. However, reliable and valid measures of relationship satisfaction are lacking. The Valentine scale is a freely available brief measure of relationship satisfaction (https://osf.io/fb72s), intended to provide an easily interpretable index of relationship satisfaction. Across two studies, we evaluated the reliability, validity, and factor structure of the Valentine scale. Study One (n = 851) explored the factor structure of the Valentine scale, assessed its test–retest reliability, and criterion-related validity. Study Two (n = 527) confirmed the factor structure of the Valentine scale, explored its measurement invariance, and further evaluated criterion-related validity. The results supported a unidimensional structure of the Valentine scale. Furthermore, the Valentine scale exhibited good internal reliability (Cronbach’s alpha = .75 and .81 in Study One and Two, respectively), high test–retest reliability (ICC₃ = .80 at a two-week follow-up in Study One), and appropriate criterion-related validity demonstrating positive correlations with other measures of relationship satisfaction and positive affect, as well as and negative correlations with measures of psychopathology. Together, these findings provide good support for the usage of the Valentine scale to quantify relationship satisfaction.

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