Silje S Hukkelberg - Academia.edu (original) (raw)

Papers by Silje S Hukkelberg

Purpose: To study 1) how smoking relates to constellations of risk and protective behaviours, and... more Purpose: To study 1) how smoking relates to constellations of risk and protective behaviours, and psychosocial factors related to school, family, and peers, and 2) the potential mediating effect of risk and protective behaviours, in the relation between psychosocial factors on smoking . Methods: Survey data from the youth part of the Oslo Health Study (UNGHUBRO), collected from urban Norwegian pupils aged 16 (N=5,049) in Oslo. Structural equation modelling was used to investigate the hypothesised model of mediation, where parental socioeconomic status and psychosocial factors were specified as distal variables, and constellations of risk and protective behaviours were specified as mediating variables. Results: Adolescent smoking was closely related to the risk behaviours, but less so to the protective behaviours. All the assessed psychosocial factors were significantly related with adolescent smoking, but most of these associations were absent when risk and protective behaviours wer...

Journal of Social and Personal Relationships

Although fathers are increasingly involved in childrearing, less is known about how parental stre... more Although fathers are increasingly involved in childrearing, less is known about how parental stress is perceived among mothers and fathers separately. The present study investigated the construct validity of the PSS in a community-based sample of Norwegian father–mother dyads with a child aged 4. A total of 1030 mothers and fathers ( N = 515 dyads) responded to the PSS, which is a much used instrument that assesses stress related to childrearing across 18 items. Construct validity was investigated using exploratory and confirmatory factor analyses and the multitrait–multimethod approach (MTMM). The results revealed that six of the items showed extensive ceiling-effects for both parents, and were excluded from further analysis. Dimensionality was examined for the remaining 12 PSS items. The results supported a two-factor solution for both fathers and mothers, reflecting parental stressors (9 items) and lack of rewards (3 items). The MTMM approach indicated convergent and discriminant...

Children and Youth Services Review

Abstract The Parent Management Training - Oregon model (PMTO) and the adaption of PMTO, the Brief... more Abstract The Parent Management Training - Oregon model (PMTO) and the adaption of PMTO, the Brief Parent Training (BPT), are two versions of parent management training, proven effective to reduce emerging or present child conduct problems through modifying child-parent interaction. Research, however, indicates substantial comorbidity between high levels of conduct problems, low social competence, and depression/anxiety. The aim of this study was to examine to what extent PMTO and BPT have treatment effects beyond conduct problems, that is, additionally reduce the level of depression/anxiety and increase social competence. We investigated cross-domain effects in two independent randomized-controlled samples, receiving either PMTO or BPT, which differed with regard to treatment mode, intensity, and target groups. Participants (BPT: N = 216, PMTO: N = 137) were Norwegian parents of children (age 3–12) with emerging or present conduct problems, randomly assigned to either the intervention or control condition. Results showed that both BPT and PMTO reduced conduct problems and increased social competence, but only BPT reduced the level of depression/anxiety. Implications and limitations of the results are discussed.

BMC Psychiatry

Background Previous studies have shown that children who display behavioral problems also tend to... more Background Previous studies have shown that children who display behavioral problems also tend to display low social competence. The relation does however vary according to type of behavior being measured, as well as demographic characteristics of the respondent. The present meta-analysis examined the correlation between different types of behavioral problems and social competence among children aged 3–13, and investigated possible moderators in this relation. Methods A systematic literature search was conducted for English language studies from January 2008 to January 2018 that reported correlations between three types of behavioral problems (i.e., externalizing behaviors, conduct problems, or aggression) and two types of social competence (i.e., social competence or social skills). The studies included reports from parents and teachers, or both as a dyad. The review included data from 54 independent studies and a total of 46,828 participants. Effect sizes were estimated using a ra...

Scandinavian Journal of Psychology, 2016

The Eyberg Child Behavior Inventory (ECBI) assesses problem behaviors in children, and is a widel... more The Eyberg Child Behavior Inventory (ECBI) assesses problem behaviors in children, and is a widely used instrument in both clinical work and research. Evidence suggests that the short ECBI version, comprising 22 items, can be reduced into the three oblique factors: Oppositional defiant behavior; Conduct problem behavior; and Inattentive behavior. The present study aimed to evaluate this three-factor model in a Norwegian sample of 554 children, and examine multi-group invariance across gender and age. Consistent with previous research, results confirmed a tripartite model, with the same residual covariances and cross-loading appearing across groups. Multi-group confirmatory factor analysis demonstrated partial measurement invariance across gender and age. Overall, findings support a meaningful comparison of the short ECBI across gender and age. The study makes a contribution to the generalizability issue of the ECBI.

European Journal of Psychological Assessment, 2016

Emotional and Behavioural Difficulties, 2016

Psychotherapy research : journal of the Society for Psychotherapy Research, 2016

The purposes of the present study were twofold: (a) to examine the factor structure of the Workin... more The purposes of the present study were twofold: (a) to examine the factor structure of the Working Alliance Inventory, Short (WAI-S) and (b) to investigate if factor loadings and thresholds fulfilled properties of longitudinal measurement invariance across two waves of data. The study sample consisted of 259 Norwegian parents receiving Parent Management Training, the Oregon model. Parents rated alliance at sessions 3 and 12 during the therapy. Confirmatory factor analyses to assess the fit of a one-, two-, and three-factor model were performed using robust weighted least squares estimation for categorical indicators. The results showed that data provided best fit for the three-factor solution with goal, task, and bond. Furthermore, results demonstrated satisfactory invariance for factor loadings and thresholds across time. Overall, the results indicate that the WAI-S three-factor solution has acceptable psychometric properties for longitudinal measurement comparisons.

Psychological Trauma: Theory, Research, Practice, and Policy, 2014

Journal of Clinical Child Adolescent Psychology, May 2, 2014

The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several ra... more The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several randomized controlled trials. However, few trials have been conducted in community clinics, few have used therapy as usual (TAU) as a comparison group, and none have been conducted outside of the United States. The objective of this study was to evaluate the effectiveness of TF-CBT in regular community settings compared with TAU. One hundred fifty-six traumatized youth (M age ¼ 15.1 years, range ¼ 10-18; 79.5% girls) were randomly assigned to TF-CBT or TAU. Intent-to-treat analysis using mixed effects models showed that youth receiving TF-CBT reported significantly lower levels of posttraumatic stress symptoms (est. ¼ 5.78, d ¼ 0.51), 95% CI [2.32, 9.23]; depression (est. ¼ 7.00, d ¼ 0.54), 95% CI [2.04, 11.96]; and general mental health symptoms (est. ¼ 2.54, d ¼ 0.45), 95% CI [0.50, 4.58], compared with youth in the TAU group. Youth assigned to TF-CBT showed significantly greater improvements in functional impairment (est. ¼ À1.05, d ¼ À0.55), 95% CI [À1.67, À0.42]. Although the same trend was found for anxiety reduction, this difference was not statistically significant (est. ¼ 4.34, d ¼ 0.30), 95% CI [À1 .50, 10.19]. Significantly fewer youths in the TF-CBT condition were diagnosed with posttraumatic stress disorder compared to youths in the TAU condition, v 2 (1, N ¼ 116) ¼ 4.61, p ¼ .031, Phi ¼ .20). Findings indicate that TF-CBT is effective in treating traumatized youth in community mental health clinics and that the program may also be successfully implemented in countries outside the United States.

Introduction: Common factors, as opposed to specific program factors, are non-specific treatment ... more Introduction: Common factors, as opposed to specific program factors, are non-specific treatment ingredients that are unrelated to method and therapeutic orientation. The extent to which common factors, or specific factors account for treatment effects is an issue of great debate. In particular, the role of alliance as a common factor is interesting in regards to evidence-based treatments, in which specific treatment factors are empirically identified and supported. The present study investigated the role of work alliance between parents and therapists in Parent Management Training- the Oregon model (PMTO) and how alliance relates to problem behavior in children. Method: Participants were 331 Norwegian parents who rated client-therapist working alliance at three time points (session 3, 12, and 20). Competent adherence to the PMTO treatment protocol was assessed by PMTO specialists from evaluations of videotaped therapy sessions. Parents and teachers reported children’s problem behav...

Journal of Traumatic Stress, 2011

The aims of the study were twofold: to investigate 6 different factor structures in posttraumatic... more The aims of the study were twofold: to investigate 6 different factor structures in posttraumatic stress symptoms using confirmatory factor analyses with polychoric correlations, and to examine to what extent posttraumatic stress disorder (PTSD) is different from depression. The study was based on a clinical sample of 312 children and adolescents 10 to 18 years old who had experienced different types of traumatic events. Results showed that 3 out of the 6 models demonstrated good fit, but the dysphoria model provided the best fit to the data. Furthermore, correlations between depression and subscales of the dysphoria and numbing models provided additional support for the dysphoria model.

Journal of Consulting and Clinical Psychology, 2013

The study investigated treatment fidelity and working alliance in the Parent Management Training-... more The study investigated treatment fidelity and working alliance in the Parent Management Training-Oregon model (PMTO) and investigated how these relate to children's externalizing problem behaviors, as reported by parents and teachers. Participants were 331 Norwegian parents who rated the client-therapist working alliance at 3 time points (Sessions 3, 12, and 20). Competent adherence to the PMTO treatment protocol was assessed by PMTO specialists from evaluations of videotaped therapy sessions using the Fidelity of Implementation (FIMP) system (Knutson, Forgatch, & Rains, 2003). Parents and teachers reported children's problem behaviors at baseline and at the end of therapy. Structural equation modeling was used to analyze the repeated measures data. Parents reported high and stable levels of alliance and fidelity from Time 1 to Time 3, with no correlational or direct relations between the 2. Treatment fidelity predicted reductions in parent-reported externalizing behavior, whereas working alliance was related to less change in problem behavior. Alliance and fidelity were unrelated to teacher-reported behavior problems. The findings point to treatment fidelity as an active ingredient in PMTO and working alliance as a negative predictor of postassessment parent-reported externalizing behavior. More research is needed to investigate whether these findings can be replicated and extended beyond PMTO.

Journal of Clinical Child & Adolescent Psychology, 2014

The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several ra... more The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several randomized controlled trials. However, few trials have been conducted in community clinics, few have used therapy as usual (TAU) as a comparison group, and none have been conducted outside of the United States. The objective of this study was to evaluate the effectiveness of TF-CBT in regular community settings compared with TAU. One hundred fifty-six traumatized youth (M age ¼ 15.1 years, range ¼ 10-18; 79.5% girls) were randomly assigned to TF-CBT or TAU. Intent-to-treat analysis using mixed effects models showed that youth receiving TF-CBT reported significantly lower levels of posttraumatic stress symptoms (est. ¼ 5.78, d ¼ 0.51), 95% CI [2.32, 9.23]; depression (est. ¼ 7.00, d ¼ 0.54), 95% CI [2.04, 11.96]; and general mental health symptoms (est. ¼ 2.54, d ¼ 0.45), 95% CI [0.50, 4.58], compared with youth in the TAU group. Youth assigned to TF-CBT showed significantly greater improvements in functional impairment (est. ¼ À1.05, d ¼ À0.55), 95% CI [À1.67, À0.42]. Although the same trend was found for anxiety reduction, this difference was not statistically significant (est. ¼ 4.34, d ¼ 0.30), 95% CI [À1 .50, 10.19]. Significantly fewer youths in the TF-CBT condition were diagnosed with posttraumatic stress disorder compared to youths in the TAU condition, v 2 (1, N ¼ 116) ¼ 4.61, p ¼ .031, Phi ¼ .20). Findings indicate that TF-CBT is effective in treating traumatized youth in community mental health clinics and that the program may also be successfully implemented in countries outside the United States.

Journal of Applied Social Psychology, 2000

The present study used meta-analysis to evaluate the role of self-identity in the theory of plann... more The present study used meta-analysis to evaluate the role of self-identity in the theory of planned behavior (TPB). Altogether, 40 independent tests (N = 11607) could be included in the review. A large, sample-weighted average correlation between self-identity and behavioral intention was observed (r+ = .47). Multiple regression analyses showed that self-identity explained an increment of 6% of the variance in intention after controlling for the TPB components, and explained an increment of 9% of the variance when past behavior and the TPB components were controlled. The influence of self-identity on behavior was largely mediated by the strength of behavioral intentions. Theoretical implications of the findings are discussed.j asp_611 1085..1105

Journal of Anxiety Disorders, 2014

This study compared the diagnostic utility of the symptom part of the child PTSD symptom scale (C... more This study compared the diagnostic utility of the symptom part of the child PTSD symptom scale (CPSS) screening instrument with the clinician-administered PTSD scale for children and adolescents (CAPS-CA). The study included a clinical sample of traumatized children and adolescents (mean age 15.1, range 10-18) living in Norway, who were assessed for posttraumatic stress symptoms using the CPSS and the CAPS-CA. Diagnostic utility was investigated using receiver operating characteristic analyses. The results showed that CPSS reached medium effect sizes (AUC from .63 to .76). The sensitivity was good (.80), but the specificity was relatively low (.56). Kappa between CPSS and CAPS-CA was low (κ=.27). Findings suggests that CPSS is a good tool for screening purposes, but not as a diagnostic instrument in an early phase of assessment. Implications and limitations of the findings are discussed.

BMC Public Health, 2011

Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervi... more Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervical screening in an organized screening program: a cross-sectional study of 12,058 Norwegian women Abstract Background: Cervical cancer incidence and mortality may be reduced by organized screening. Participant compliance with the attendance recommendations of the screening program is necessary to achieve this. Knowledge about the predictors of compliance is needed in order to enhance screening attendance. Methods: The Norwegian Co-ordinated Cervical Cancer Screening Program (NCCSP) registers all cervix cytology diagnoses in Norway and individually reminds women who have no registered smear for the past three years to make an appointment for screening. In the present study, a questionnaire on lifestyle and health was administered to a random sample of Norwegian women. The response rate was 68%. To address the predictors of screening attendance for the 12,058 women aged 25-45 who were eligible for this study, individual questionnaire data was linked to the cytology registry of the NCCSP. We distinguished between non-attendees, opportunistic attendees and reminded attendees to screening for a period of four years. Predictors of non-attendance versus attendance and reminded versus opportunistic attendance were established by multivariate logistic regression.

Behaviour Research and Therapy, 2013

and sharing with colleagues.

Addictive Behaviors, 2009

a b s t r a c t a r t i c l e i n f o Keywords: P/W model Smoking Adolescents Prototypes Cognition

British Journal of Health Psychology, 2014

Objectives. This study applies three latent interaction models in the theory of planned behaviour... more Objectives. This study applies three latent interaction models in the theory of planned behaviour (TPB; Ajzen, 1988, Attitudes, personality, and behavior. Homewood, IL: Dorsey Press; Ajzen, 1991, Organ. Behav. Hum. Decis. Process., 50, 179) to quitting smoking: (1) attitude 9 perceived behavioural control on intention; (2) subjective norms (SN) 9 attitude on intention; and (3) perceived behavioural control 9 intention on quitting behaviour. Methods. The data derive from a longitudinal Internet survey of 939 smokers aged 15-74 over a period of 4 months. Latent interaction effects were estimated using the double-meancentred unconstrained approach (Lin et al., 2010, Struct. Equ. Modeling, 17, 374) in LISREL.

Purpose: To study 1) how smoking relates to constellations of risk and protective behaviours, and... more Purpose: To study 1) how smoking relates to constellations of risk and protective behaviours, and psychosocial factors related to school, family, and peers, and 2) the potential mediating effect of risk and protective behaviours, in the relation between psychosocial factors on smoking . Methods: Survey data from the youth part of the Oslo Health Study (UNGHUBRO), collected from urban Norwegian pupils aged 16 (N=5,049) in Oslo. Structural equation modelling was used to investigate the hypothesised model of mediation, where parental socioeconomic status and psychosocial factors were specified as distal variables, and constellations of risk and protective behaviours were specified as mediating variables. Results: Adolescent smoking was closely related to the risk behaviours, but less so to the protective behaviours. All the assessed psychosocial factors were significantly related with adolescent smoking, but most of these associations were absent when risk and protective behaviours wer...

Journal of Social and Personal Relationships

Although fathers are increasingly involved in childrearing, less is known about how parental stre... more Although fathers are increasingly involved in childrearing, less is known about how parental stress is perceived among mothers and fathers separately. The present study investigated the construct validity of the PSS in a community-based sample of Norwegian father–mother dyads with a child aged 4. A total of 1030 mothers and fathers ( N = 515 dyads) responded to the PSS, which is a much used instrument that assesses stress related to childrearing across 18 items. Construct validity was investigated using exploratory and confirmatory factor analyses and the multitrait–multimethod approach (MTMM). The results revealed that six of the items showed extensive ceiling-effects for both parents, and were excluded from further analysis. Dimensionality was examined for the remaining 12 PSS items. The results supported a two-factor solution for both fathers and mothers, reflecting parental stressors (9 items) and lack of rewards (3 items). The MTMM approach indicated convergent and discriminant...

Children and Youth Services Review

Abstract The Parent Management Training - Oregon model (PMTO) and the adaption of PMTO, the Brief... more Abstract The Parent Management Training - Oregon model (PMTO) and the adaption of PMTO, the Brief Parent Training (BPT), are two versions of parent management training, proven effective to reduce emerging or present child conduct problems through modifying child-parent interaction. Research, however, indicates substantial comorbidity between high levels of conduct problems, low social competence, and depression/anxiety. The aim of this study was to examine to what extent PMTO and BPT have treatment effects beyond conduct problems, that is, additionally reduce the level of depression/anxiety and increase social competence. We investigated cross-domain effects in two independent randomized-controlled samples, receiving either PMTO or BPT, which differed with regard to treatment mode, intensity, and target groups. Participants (BPT: N = 216, PMTO: N = 137) were Norwegian parents of children (age 3–12) with emerging or present conduct problems, randomly assigned to either the intervention or control condition. Results showed that both BPT and PMTO reduced conduct problems and increased social competence, but only BPT reduced the level of depression/anxiety. Implications and limitations of the results are discussed.

BMC Psychiatry

Background Previous studies have shown that children who display behavioral problems also tend to... more Background Previous studies have shown that children who display behavioral problems also tend to display low social competence. The relation does however vary according to type of behavior being measured, as well as demographic characteristics of the respondent. The present meta-analysis examined the correlation between different types of behavioral problems and social competence among children aged 3–13, and investigated possible moderators in this relation. Methods A systematic literature search was conducted for English language studies from January 2008 to January 2018 that reported correlations between three types of behavioral problems (i.e., externalizing behaviors, conduct problems, or aggression) and two types of social competence (i.e., social competence or social skills). The studies included reports from parents and teachers, or both as a dyad. The review included data from 54 independent studies and a total of 46,828 participants. Effect sizes were estimated using a ra...

Scandinavian Journal of Psychology, 2016

The Eyberg Child Behavior Inventory (ECBI) assesses problem behaviors in children, and is a widel... more The Eyberg Child Behavior Inventory (ECBI) assesses problem behaviors in children, and is a widely used instrument in both clinical work and research. Evidence suggests that the short ECBI version, comprising 22 items, can be reduced into the three oblique factors: Oppositional defiant behavior; Conduct problem behavior; and Inattentive behavior. The present study aimed to evaluate this three-factor model in a Norwegian sample of 554 children, and examine multi-group invariance across gender and age. Consistent with previous research, results confirmed a tripartite model, with the same residual covariances and cross-loading appearing across groups. Multi-group confirmatory factor analysis demonstrated partial measurement invariance across gender and age. Overall, findings support a meaningful comparison of the short ECBI across gender and age. The study makes a contribution to the generalizability issue of the ECBI.

European Journal of Psychological Assessment, 2016

Emotional and Behavioural Difficulties, 2016

Psychotherapy research : journal of the Society for Psychotherapy Research, 2016

The purposes of the present study were twofold: (a) to examine the factor structure of the Workin... more The purposes of the present study were twofold: (a) to examine the factor structure of the Working Alliance Inventory, Short (WAI-S) and (b) to investigate if factor loadings and thresholds fulfilled properties of longitudinal measurement invariance across two waves of data. The study sample consisted of 259 Norwegian parents receiving Parent Management Training, the Oregon model. Parents rated alliance at sessions 3 and 12 during the therapy. Confirmatory factor analyses to assess the fit of a one-, two-, and three-factor model were performed using robust weighted least squares estimation for categorical indicators. The results showed that data provided best fit for the three-factor solution with goal, task, and bond. Furthermore, results demonstrated satisfactory invariance for factor loadings and thresholds across time. Overall, the results indicate that the WAI-S three-factor solution has acceptable psychometric properties for longitudinal measurement comparisons.

Psychological Trauma: Theory, Research, Practice, and Policy, 2014

Journal of Clinical Child Adolescent Psychology, May 2, 2014

The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several ra... more The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several randomized controlled trials. However, few trials have been conducted in community clinics, few have used therapy as usual (TAU) as a comparison group, and none have been conducted outside of the United States. The objective of this study was to evaluate the effectiveness of TF-CBT in regular community settings compared with TAU. One hundred fifty-six traumatized youth (M age ¼ 15.1 years, range ¼ 10-18; 79.5% girls) were randomly assigned to TF-CBT or TAU. Intent-to-treat analysis using mixed effects models showed that youth receiving TF-CBT reported significantly lower levels of posttraumatic stress symptoms (est. ¼ 5.78, d ¼ 0.51), 95% CI [2.32, 9.23]; depression (est. ¼ 7.00, d ¼ 0.54), 95% CI [2.04, 11.96]; and general mental health symptoms (est. ¼ 2.54, d ¼ 0.45), 95% CI [0.50, 4.58], compared with youth in the TAU group. Youth assigned to TF-CBT showed significantly greater improvements in functional impairment (est. ¼ À1.05, d ¼ À0.55), 95% CI [À1.67, À0.42]. Although the same trend was found for anxiety reduction, this difference was not statistically significant (est. ¼ 4.34, d ¼ 0.30), 95% CI [À1 .50, 10.19]. Significantly fewer youths in the TF-CBT condition were diagnosed with posttraumatic stress disorder compared to youths in the TAU condition, v 2 (1, N ¼ 116) ¼ 4.61, p ¼ .031, Phi ¼ .20). Findings indicate that TF-CBT is effective in treating traumatized youth in community mental health clinics and that the program may also be successfully implemented in countries outside the United States.

Introduction: Common factors, as opposed to specific program factors, are non-specific treatment ... more Introduction: Common factors, as opposed to specific program factors, are non-specific treatment ingredients that are unrelated to method and therapeutic orientation. The extent to which common factors, or specific factors account for treatment effects is an issue of great debate. In particular, the role of alliance as a common factor is interesting in regards to evidence-based treatments, in which specific treatment factors are empirically identified and supported. The present study investigated the role of work alliance between parents and therapists in Parent Management Training- the Oregon model (PMTO) and how alliance relates to problem behavior in children. Method: Participants were 331 Norwegian parents who rated client-therapist working alliance at three time points (session 3, 12, and 20). Competent adherence to the PMTO treatment protocol was assessed by PMTO specialists from evaluations of videotaped therapy sessions. Parents and teachers reported children’s problem behav...

Journal of Traumatic Stress, 2011

The aims of the study were twofold: to investigate 6 different factor structures in posttraumatic... more The aims of the study were twofold: to investigate 6 different factor structures in posttraumatic stress symptoms using confirmatory factor analyses with polychoric correlations, and to examine to what extent posttraumatic stress disorder (PTSD) is different from depression. The study was based on a clinical sample of 312 children and adolescents 10 to 18 years old who had experienced different types of traumatic events. Results showed that 3 out of the 6 models demonstrated good fit, but the dysphoria model provided the best fit to the data. Furthermore, correlations between depression and subscales of the dysphoria and numbing models provided additional support for the dysphoria model.

Journal of Consulting and Clinical Psychology, 2013

The study investigated treatment fidelity and working alliance in the Parent Management Training-... more The study investigated treatment fidelity and working alliance in the Parent Management Training-Oregon model (PMTO) and investigated how these relate to children's externalizing problem behaviors, as reported by parents and teachers. Participants were 331 Norwegian parents who rated the client-therapist working alliance at 3 time points (Sessions 3, 12, and 20). Competent adherence to the PMTO treatment protocol was assessed by PMTO specialists from evaluations of videotaped therapy sessions using the Fidelity of Implementation (FIMP) system (Knutson, Forgatch, & Rains, 2003). Parents and teachers reported children's problem behaviors at baseline and at the end of therapy. Structural equation modeling was used to analyze the repeated measures data. Parents reported high and stable levels of alliance and fidelity from Time 1 to Time 3, with no correlational or direct relations between the 2. Treatment fidelity predicted reductions in parent-reported externalizing behavior, whereas working alliance was related to less change in problem behavior. Alliance and fidelity were unrelated to teacher-reported behavior problems. The findings point to treatment fidelity as an active ingredient in PMTO and working alliance as a negative predictor of postassessment parent-reported externalizing behavior. More research is needed to investigate whether these findings can be replicated and extended beyond PMTO.

Journal of Clinical Child & Adolescent Psychology, 2014

The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several ra... more The efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) has been shown in several randomized controlled trials. However, few trials have been conducted in community clinics, few have used therapy as usual (TAU) as a comparison group, and none have been conducted outside of the United States. The objective of this study was to evaluate the effectiveness of TF-CBT in regular community settings compared with TAU. One hundred fifty-six traumatized youth (M age ¼ 15.1 years, range ¼ 10-18; 79.5% girls) were randomly assigned to TF-CBT or TAU. Intent-to-treat analysis using mixed effects models showed that youth receiving TF-CBT reported significantly lower levels of posttraumatic stress symptoms (est. ¼ 5.78, d ¼ 0.51), 95% CI [2.32, 9.23]; depression (est. ¼ 7.00, d ¼ 0.54), 95% CI [2.04, 11.96]; and general mental health symptoms (est. ¼ 2.54, d ¼ 0.45), 95% CI [0.50, 4.58], compared with youth in the TAU group. Youth assigned to TF-CBT showed significantly greater improvements in functional impairment (est. ¼ À1.05, d ¼ À0.55), 95% CI [À1.67, À0.42]. Although the same trend was found for anxiety reduction, this difference was not statistically significant (est. ¼ 4.34, d ¼ 0.30), 95% CI [À1 .50, 10.19]. Significantly fewer youths in the TF-CBT condition were diagnosed with posttraumatic stress disorder compared to youths in the TAU condition, v 2 (1, N ¼ 116) ¼ 4.61, p ¼ .031, Phi ¼ .20). Findings indicate that TF-CBT is effective in treating traumatized youth in community mental health clinics and that the program may also be successfully implemented in countries outside the United States.

Journal of Applied Social Psychology, 2000

The present study used meta-analysis to evaluate the role of self-identity in the theory of plann... more The present study used meta-analysis to evaluate the role of self-identity in the theory of planned behavior (TPB). Altogether, 40 independent tests (N = 11607) could be included in the review. A large, sample-weighted average correlation between self-identity and behavioral intention was observed (r+ = .47). Multiple regression analyses showed that self-identity explained an increment of 6% of the variance in intention after controlling for the TPB components, and explained an increment of 9% of the variance when past behavior and the TPB components were controlled. The influence of self-identity on behavior was largely mediated by the strength of behavioral intentions. Theoretical implications of the findings are discussed.j asp_611 1085..1105

Journal of Anxiety Disorders, 2014

This study compared the diagnostic utility of the symptom part of the child PTSD symptom scale (C... more This study compared the diagnostic utility of the symptom part of the child PTSD symptom scale (CPSS) screening instrument with the clinician-administered PTSD scale for children and adolescents (CAPS-CA). The study included a clinical sample of traumatized children and adolescents (mean age 15.1, range 10-18) living in Norway, who were assessed for posttraumatic stress symptoms using the CPSS and the CAPS-CA. Diagnostic utility was investigated using receiver operating characteristic analyses. The results showed that CPSS reached medium effect sizes (AUC from .63 to .76). The sensitivity was good (.80), but the specificity was relatively low (.56). Kappa between CPSS and CAPS-CA was low (κ=.27). Findings suggests that CPSS is a good tool for screening purposes, but not as a diagnostic instrument in an early phase of assessment. Implications and limitations of the findings are discussed.

BMC Public Health, 2011

Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervi... more Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervical screening in an organized screening program: a cross-sectional study of 12,058 Norwegian women Abstract Background: Cervical cancer incidence and mortality may be reduced by organized screening. Participant compliance with the attendance recommendations of the screening program is necessary to achieve this. Knowledge about the predictors of compliance is needed in order to enhance screening attendance. Methods: The Norwegian Co-ordinated Cervical Cancer Screening Program (NCCSP) registers all cervix cytology diagnoses in Norway and individually reminds women who have no registered smear for the past three years to make an appointment for screening. In the present study, a questionnaire on lifestyle and health was administered to a random sample of Norwegian women. The response rate was 68%. To address the predictors of screening attendance for the 12,058 women aged 25-45 who were eligible for this study, individual questionnaire data was linked to the cytology registry of the NCCSP. We distinguished between non-attendees, opportunistic attendees and reminded attendees to screening for a period of four years. Predictors of non-attendance versus attendance and reminded versus opportunistic attendance were established by multivariate logistic regression.

Behaviour Research and Therapy, 2013

and sharing with colleagues.

Addictive Behaviors, 2009

a b s t r a c t a r t i c l e i n f o Keywords: P/W model Smoking Adolescents Prototypes Cognition

British Journal of Health Psychology, 2014

Objectives. This study applies three latent interaction models in the theory of planned behaviour... more Objectives. This study applies three latent interaction models in the theory of planned behaviour (TPB; Ajzen, 1988, Attitudes, personality, and behavior. Homewood, IL: Dorsey Press; Ajzen, 1991, Organ. Behav. Hum. Decis. Process., 50, 179) to quitting smoking: (1) attitude 9 perceived behavioural control on intention; (2) subjective norms (SN) 9 attitude on intention; and (3) perceived behavioural control 9 intention on quitting behaviour. Methods. The data derive from a longitudinal Internet survey of 939 smokers aged 15-74 over a period of 4 months. Latent interaction effects were estimated using the double-meancentred unconstrained approach (Lin et al., 2010, Struct. Equ. Modeling, 17, 374) in LISREL.