Mikael Thastum - Academia.edu (original) (raw)

Papers by Mikael Thastum

Behavioural and cognitive psychotherapy, Jan 15, 2016

Transdiagnostic Cognitive Behaviour Therapy (CBT) seeks to identify core cognitive-behavioural pr... more Transdiagnostic Cognitive Behaviour Therapy (CBT) seeks to identify core cognitive-behavioural processes hypothesized to be important across a range of disorders and to develop a treatment that targets these. This contrasts with standard CBT approaches that are disorder-specific. Proponents of transdiagnostic CBT suggest that it may offer advantages over disorder-specific CBT, but little is known about the effectiveness of this approach. The review aimed to summarize trial-based clinical and cost-effectiveness data on transdiagnostic CBT for anxiety and depression. A systematic review of electronic databases, including peer-reviewed and grey literature sources, was conducted (n = 1167 unique citations). Eight trials were eligible for inclusion in the review. There was evidence of an effect for transdiagnostic CBT when compared to a control condition. There were no differences between transdiagnostic CBT and active treatments in two studies. We found no evidence of cost-effectiveness...

The Journal of Rheumatology, May 1, 2013

To examine the pain threshold in children with juvenile idiopathic arthritis (JIA) compared with ... more To examine the pain threshold in children with juvenile idiopathic arthritis (JIA) compared with healthy children by using a digital pressure algometer. Methods. Fifty-eight children with JIA born between 1995 and 2000 and 91 age-related healthy children participated in the study. We used a digital pressure algometer to measure the pain threshold on 17 symmetric, anatomically predefined joint-related or bone-related areas. All children were asked to rate their current pain on a Faces Pain Scale, and parents of children with JIA were asked to complete a parental revised version of the Child Health Assessment Questionnaire (CHAQ-R). Clinical data were registered on children with JIA. Results. The pain threshold was significantly lower among children with JIA (total mean PT = 1.33 ± 0.69 kg/cm 2) when compared with the healthy control group (total mean PT = 1.77 ± 0.67 kg/cm 2). The same pattern was found in all areas measured, including negative control areas that are normally unaffected in JIA (p = 0.0001 to 0.005). Overall, the pain threshold was 34% lower in females than in males in both groups (p < 0.0001). We found no correlation between pain threshold and age, current pain experience, disease duration, or disease activity. Conclusion. Children with JIA had a substantially lower pain threshold even in areas usually unaffected by arthritis. Our findings suggest that JIA alters the pain perception and causes decreased pain threshold.

Trials, Dec 1, 2019

Background: Social anxiety disorder (SAD) is a common disorder in adolescence associated with ext... more Background: Social anxiety disorder (SAD) is a common disorder in adolescence associated with extensive distress and long-term impairment. Generic cognitive behavior therapy (CBT) programs for anxiety disorders have shown poorer outcomes for adolescents with SAD than for other anxiety disorders. Aim: The aim of the present study is to investigate the efficacy of a disorder-specific group cognitive behavior therapy (G-CBT

Rheumatology International, Jan 29, 2020

The aim of this study is to investigate whether methotrexate-induced nausea is associated with an... more The aim of this study is to investigate whether methotrexate-induced nausea is associated with anxiety or the use of coping strategies in children with juvenile idiopathic arthritis (JIA) treated with methotrexate (MTX). This is an observational study of children diagnosed with JIA (ILAR criteria), treated with MTX and aged 9 years or above. MTX-induced nausea was determined by the children's completion of a nausea diary and the parents' completion of the Methotrexate Intolerance Severity Score (MISS). Anxiety was assessed by the Beck Youth Inventories-Anxiety Inventory (BYI-A) and coping strategies were evaluated by an adapted Nausea Coping Questionnaire. Enrolled were 121 children (82 girls: 39 boys) with a median age (IQR) of 13.3 (11.3-15.1) years. The median MTX-dose (IQR) was 9.7 (9.0-10.9) mg/m 2 /week. The median treatment duration (IQR) was 340 (142-766) days. The MISS was completed for 120 children; 77 children completed the nausea diary for at least 7 days. MTX-induced nausea was present in 61% (73/120) of the children according to the MISS and in 73% (56/77) of the children according to the nausea diary. MTX-induced nausea was associated with a more frequent use of the coping strategy internalizing/catastrophizing (MISS, p = 0.012; diary, p < 0.0001) and higher BYI-A raw scores (diary, p = 0.016). MTX-induced nausea was associated with anxiety and the use of coping strategies in children with JIA. These psychological factors may be part of the mechanism behind the inter-individual variation in the level of nausea to MTX treatment.

Scandinavian Journal of Rheumatology, Mar 21, 2013

The Childhood Health Assessment Questionnaire (CHAQ) is widely used to measure functional impairm... more The Childhood Health Assessment Questionnaire (CHAQ) is widely used to measure functional impairment in juvenile idiopathic arthritis (JIA). However, the original version (CHAQ30) has reduced overall validity in terms of an increasing ceiling effect and decreasing discriminative ability because of considerable improvements in functional ability of children with JIA. The aim of this study was to validate a revised CHAQ including eight new physically demanding questions (CHAQ38) with two categorical response and scoring models (CAT1 and CAT2) in Danish children with JIA and healthy controls of a comparable age and gender. The CHAQ versions with both response models were validated in relation to distribution of data, evaluation of the ceiling effect, sensitivity, and discriminative ability. Four different version of the CHAQ were completed by 68 patients and 118 controls aged 10-16 years. Demographic data in both groups and disease-specific data among patients were obtained. Statistical analysis of all CHAQ versions was performed to evaluate score distribution and to test the ability to distinguish between patients and controls. The use of the CHAQ38 broadened the range of scores and reduced the number of scores at zero. The ceiling effect, which was high in all versions, was best reduced using the CAT2 response model. Adding the new questions increased the sensitivity to discriminate between physically well-functioning JIA patients and healthy controls in either of the CAT models used. Overall, the CHAQ38 and to some extent the CAT2 had the best outcomes. The discriminative validity increased with the CHAQ38, though still not optimally.

PubMed, May 1, 2001

Objective: To compare reactions to cold pressor pain and pain coping strategies of patients with ... more Objective: To compare reactions to cold pressor pain and pain coping strategies of patients with juvenile idiopathic arthritis (JIA), healthy children, and their parents. Methods: We studied 16 children with JIA and one of their parents and 14 healthy children and one of their parents. Patients with JIA were selected from the patient population by fulfilling criteria for inclusion in a "high pain" group (n = 7) of patients with modest clinical arthritis activity, but who presented daily reports of pain in connection with everyday activities, and a "low pain" group (n = 9) who presented significant clinical arthritis activity, but who had only a few complaints of pain related to everyday activities. Dependent variables included pain threshold, discomfort, intensity and tolerance to cold pressor pain, and pain coping strategies. Results: Patients with JIA exhibited significantly lower mean pain tolerance than healthy children. Disease duration correlated with both experimental and clinical pain measures, and JIA patients used significantly more Behavioral Distraction than healthy children. Correlations were found between children's and parents' use of Approach and Distraction related coping strategies. Correlations were also found for the coping strategy of Catastrophizing in the JIA patient group. For experimental pain coping strategies, a significant correlation was found between the JIA patients' and their parents' use of Distraction. For the JIA patients Positive Self-statements and Behavioral Distraction were inversely correlated with the clinical pain measures. In both children and parents the experimental pain coping strategies of Catastrophizing and Distraction were associated with the experimental pain response measures, and low pain JIA patients tended to use more Distraction pain coping strategies than high pain patients. Conclusion: The results indicate that JIA patients may differ from healthy children with regard to their responses to experimental pain as well as to their use of pain coping strategies. Pain coping strategies of JIA patients were associated with pain coping strategies of their parents, and use of pain coping strategies was associated with both experimental and clinical pain experience.

Internet interventions, Mar 1, 2019

Background: Guided internet-based cognitive behavioral therapy (ICBT) has been found efficacious ... more Background: Guided internet-based cognitive behavioral therapy (ICBT) has been found efficacious in reducing symptoms of anxiety in adolescents with anxiety disorders, but not all respond equally well. Objective: In this study, we explored candidate predictors of ICBT treatment response within the frame of a randomized controlled trial. Methods: Sixty-five adolescents (13-17 years) with anxiety disorders according to DSM-IV received 14 weeks of therapist-guided ICBT. Outcome was evaluated as improvement (continuous change score) from pre-treatment to 12-month follow-up according to self-reported anxiety symptoms and clinician-rated diagnostic severity. Clinical predictors included baseline self-and parent-reported anxiety symptom levels, baseline clinician-rated severity of primary diagnosis, summed baseline clinician-rated severity of all anxiety diagnoses, baseline self-rated depressive symptoms, age of onset, and primary diagnosis of social phobia. Demographic predictors included age, gender and computer comfortability. Therapy process-related predictors included number of completed modules and therapist phone calls, summed duration of therapist phone calls, degree of parent support, and therapeutic alliance. Multi-level models were used to test the prediction effects over time. Results: Higher levels of self-and clinician-rated baseline anxiety and self-rated depressive symptoms, female gender, and higher levels of computer comfortability were associated with increased treatment response. None of the proposed therapy process-related predictors significantly predicted treatment response. Conclusion: The present findings indicate that ICBT may be an acceptable choice of treatment for youths, even those with relative high levels of anxiety and depressive symptoms.

PLOS ONE, Sep 18, 2019

Background Anxiety disorders are highly prevalent in adolescence, but access to health care servi... more Background Anxiety disorders are highly prevalent in adolescence, but access to health care services is limited and only few receive professional help. Internet-based cognitive behavioral therapy (ICBT) has been proposed to increase accessibility and reduce costs of treatment. Objective The study evaluated the efficacy of a Danish version of the guided ICBT program ChilledOut

Acta Psychiatrica Scandinavica, May 27, 2015

This is the accepted manuscript (post-print version) of the article. Contentwise, the post-print ... more This is the accepted manuscript (post-print version) of the article. Contentwise, the post-print version is identical to the final published version, but there may be differences in typography and layout. How to cite this publication (APA)

Clinical Child Psychology and Psychiatry, 2008

The purpose of this qualitative study of families where a parent has cancer was to explore ways o... more The purpose of this qualitative study of families where a parent has cancer was to explore ways of informing the child of the parent's illness, how the child perceives the parent's emotional state, how the child copes with the parent's illness, and how this coping relates to the parent's coping and concerns for the child. Twenty-one children from 15 families and their parents were interviewed. In 13 families the mother was ill, in two the father. Children were aware of the facts of the illness, but there was limited emotional communication between the generations. The children were very observant of both the ill and the healthy parent's emotional condition. The children's observations and expressions led us to identify five coping strategies the younger generation used: Helping others, parentification, distraction, keeping it in the head, and wishful thinking. Both adaptive and destructive examples of parentification were found. Communication patterns and parental coping seemed to be highly related to the child's coping repertoire. Even though most children seemed to manage rather well, all children were strongly affected by the illness. The `healthiest' adaptation related to factors within the family system, which has implications for the provision of help.

European Neuropsychopharmacology, 2017

Background: Panic disorder (PD) is one of the most common anxiety disorders with a lifetime preva... more Background: Panic disorder (PD) is one of the most common anxiety disorders with a lifetime prevalence of about 4%. The disorder is characterized by recurrent episodes of abrupt intense fear accompanied by additional physiological or cognitive symptoms. Although PD shows moderate heritability estimates of 30-54%, the specific genetic variants

Internet interventions, Mar 1, 2018

Background: Cognitive behavioral therapy (CBT) is a well-documented effective method for the trea... more Background: Cognitive behavioral therapy (CBT) is a well-documented effective method for the treatment of anxiety disorders in children and adolescents. While internet based CBT (ICBT) programs for adults have been widely investigated, research on ICBT programs for anxiety disorders in youth is still in an early phase: To date, no such program has been developed or evaluated in Denmark. Aim: As preparation for a randomized controlled efficacy trial, this study aimed at evaluating the feasibility of a translated and adapted version of the ICBT program 'Chilled Out' for adolescents with anxiety disorders, developed at Macquarie University, Australia. Methods: At the University Clinic in Aarhus, Denmark, we conducted a feasibility study with six adolescents with a primary anxiety disorder. The 12-week ICBT intervention consisted of eight online modules. Participants received weekly phone calls from a clinical psychologist. Semi-structured interviews on participant's experiences of the program were administered post-treatment and at three-month follow-up. Outcome was evaluated posttreatment and at follow-up using diagnostic interview and questionnaires. Results: Five of the six participants completed the program. Participants were generally satisfied with the program and the majority would recommend it to others. Preliminary clinical outcome results indicated moderate to large improvements (e.g., a standardized mean difference from pre-to post-treatment of d = 1.54 on the clinical severity rating of their primary anxiety disorder). Conclusion: Results from this study indicate that a translated and revised version of the Chilled Out program could be a feasible psychological intervention for Danish adolescents with anxiety disorders.

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PubMed, Feb 18, 2008

Pain is one of the primary symptoms of juvenile idiopathic arthritis (JIA). JIA patients have red... more Pain is one of the primary symptoms of juvenile idiopathic arthritis (JIA). JIA patients have reduced pain tolerance and pain threshold compared to healthy controls. In children with JIA the greater use of coping strategies such as problem-solving, positive self-statements and distraction consistently have predicted less arthritis-related pain, even after controlling for relevant medical and demographic variables. Interventions specifically designed to modify maladaptive pain coping strategies and pain-related health beliefs may be effective in reducing pain in children with JIA.

European Neuropsychopharmacology, Sep 1, 2023

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 2022

Background: Social anxiety disorder (SAD) is one of the most common anxiety disorders among adole... more Background: Social anxiety disorder (SAD) is one of the most common anxiety disorders among adolescents. It is associated with extensive distress and negative long-term consequences. Generic cognitive behavioral therapy (CBT) is one of the preferred treatments for anxiety disorders, but it has shown poorer outcome for adolescents with SAD than for other anxiety disorders. Aim: As preparation for a randomized controlled trial the aim of the present study was to examine the feasibility of an adjusted diagnosis-specific CBT group intervention for adolescents with SAD, and provide preliminary information on adolescent and family outcomes. Method: Thirteen adolescents (age 12-17 years) diagnosed with SAD received a group therapy version of the Cool Kids Anxiety Program, Social Enhanced (CK-E), a program developed at Macquarie University, Sydney, Australia. The treatment is a diagnosis-specific manualized CBT treatment for adolescents with SAD. Semi-diagnostic interviews and questionnaires were completed at baseline, post, 3-month follow-up and 1-year follow-up. Results: Thirteen adolescents participated with no drop-outs. Most families attended all 10 intervention sessions. The families were generally satisfied with the treatment and would recommend it to others in need. Preliminary outcomes showed that participants had marked improvements in their anxiety symptoms and life interference, with significant medium to large baseline-post effect sizes durable at 1-year follow-up. Two of the adolescents were free of their SAD diagnosis at 3-month follow-up. Conclusion: Results from this feasibility study indicate that the Danish-translated and revised version of Cool Kids Anxiety Program-Social Enhanced could be a feasible intervention for Danish adolescents with SAD. The intervention will be investigated further in a randomized controlled trial.