Anne H Berman | Karolinska Institutet (original) (raw)

Papers by Anne H Berman

Research paper thumbnail of Nordic Studies on Alcohol and Drugs NAD 2/11 Volumed 28

Research paper thumbnail of Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems: Results from the Mental Disorder, Substance Abuse and Crime study

Journal of Substance Abuse Treatment, Dec 1, 2010

Substance abuse is common among offenders. One method widely used for the detection of substance ... more Substance abuse is common among offenders. One method widely used for the detection of substance abuse is screening. This study explored the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) screening tools in relation to (a) substance abuse and dependency diagnoses and (b) three problem severity domains of the sixth version of the Addiction Severity Index in a sample of 181 suspected offenders with signs of mental health problems. The screening tools showed moderate to high accuracy for identification of dependency diagnoses. The AUDIT was associated with alcohol problem severity, whereas the DUDIT was associated with drug and legal problem severity. Administering the screening tools in the current population yields valid results. However, the suggested cutoff scores should be applied with caution due to the discrepancy between present and previous findings.

Research paper thumbnail of Drug Use Disorders Identification Test--Extended

Research paper thumbnail of Web-Based Self-Help for Problematic Alcohol Use: a Large Naturalistic Study

International Journal of Behavioral Medicine, Nov 29, 2016

Purpose This observational study examined user characteristics, intervention use patterns, and va... more Purpose This observational study examined user characteristics, intervention use patterns, and variables associated with reductions in alcohol consumption for anonymous Internet help-seekers using a Web-based self-help program. Method A Web-based cognitive behavioral therapy (CBT) program with eight modules delivered over 10 weeks was offered to participants with at least hazardous use of alcohol according to the Alcohol Use Disorders Identification Test (AUDIT) (n = 4165). At baseline and 10-week follow-up, participants completed the Timeline-followback (TLFB), AUDIT, Drug Use Disorders Identification Test (DUDIT), Hospital Anxiety and Depression Scale (HADS), EuroQol-5 dimension (EQ-5D), World Health Organization Quality of Life Scale-abbreviated version (WHOQOL-BREF), Readiness to Change Questionnaire (RCQ), and Readiness Ruler. Follow-up completers and non-completers were compared at baseline, and follow-up completer outcomes were reported. Predictors of change in drinking behavior were evaluated at follow-up. Results Registered users were 41.88 years old on average (SD = 12.36), and 52 % were women; the mean baseline number of drinks during the past week was 27.27 (SD = 17.92) with 62 % in the AUDIT category of probable dependence and only 7 % having low-risk consumption according to public health guidelines. At follow-up (n = 1043), 53 % showed a clinically significant change to a lower level of alcohol use (χ 2 = 254.403, p < 0.001); the mean alcohol consumption fell (t = 22.841, p < 0.001) and the proportion with low-risk consumption rose to 40 %. Being male, scoring higher on baseline readiness, completing the program, and accessing other support predicted low-risk drinking and clinically significant change to a lower level of alcohol use at follow-up. Conclusion A publicly available Web-based program for managing problematic alcohol use attracted users with considerable alcohol-and health-related problems, which were changed to lower severity for follow-up completers.

Research paper thumbnail of Improvement in mental and physical well-being among problematic substance users in Internet-based intervention trials

Addiction Science & Clinical Practice, 2013

Research paper thumbnail of Effectiveness and treatment moderators of internet interventions for adult problem drinking: An individual patient data meta-analysis of 19 randomised controlled trials

PLOS Medicine, 2018

Effectiveness and treatment moderators of internet interventions for adult problem drinking: An i... more Effectiveness and treatment moderators of internet interventions for adult problem drinking: An individual patient data meta-analysis of 19 randomised controlled trials. PLoS Med 15(12): e1002714.

Research paper thumbnail of Counselor and Drug Detox Inpatient Verbal Behaviors in a Single Session of Motivational Interviewing and Subsequent Substance Use-Related Patient Outcomes

International Journal of Mental Health and Addiction, 2018

Effects of counselor and client verbal behaviors, in a single motivational interviewing (MI) sess... more Effects of counselor and client verbal behaviors, in a single motivational interviewing (MI) session during inpatient detoxification, were evaluated in relation to 17 study participants' self-reported drug use 3 months later. Also, counselor-to-client transitions in the single MI session were explored for 24 participants, using the Motivational Interviewing Sequential Code for Observing Process Exchanges (MI-SCOPE) coding instrument. Surprisingly, counselor neutral/double-sided reflections predicted lower levels of drug use (r = − 0.42), higher treatment interest (r = 0.40), and self-efficacy for abstaining from drug use when experiencing positive feelings (r = 0.48) and negative feelings or craving (r = 0.40). Client change talk predicted motivation to change (r = 0.42) and perceptions of negative aspects of drug use (r = 0.44), while higher levels of client sustain talk predicted lower levels of drug use (r = − 0.45) and lower interest in treatment (r = − 0.68). The counselor-client transition analysis showed an odds ratio (OR) of 13.84 (95% CI 9.75; 19.66) for client change talk in response to counselor reflections on change talk (RCT), and an OR of 55.98 (95% CI 26.53;

Research paper thumbnail of Skills Training via Smartphone App for University Students with Excessive Alcohol Consumption: a Randomized Controlled Trial

International Journal of Behavioral Medicine, 2017

Purpose University students in a study on estimated blood alcohol concentration (eBAC) feedback a... more Purpose University students in a study on estimated blood alcohol concentration (eBAC) feedback apps were offered participation in a second study, if reporting continued excessive consumption at 6-week follow-up. This study evaluated the effects on excessive alcohol consumption of offering access to an additional skills training app. Method A total of 186 students with excessive alcohol consumption were randomized to an intervention group or a wait list group. Both groups completed online follow-ups regarding alcohol consumption after 6 and 12 weeks. Wait list participants were given access to the intervention at 6-week follow-up. Assessment-only controls (n = 144) with excessive alcohol consumption from the ongoing study were used for comparison. Results The proportion of participants with excessive alcohol consumption declined in both intervention and wait list groups compared to controls at first (p < 0.001) and second followups (p = 0.054). Secondary analyses showed reductions for the intervention group in quantity of drinking at first followup (−4.76, 95% CI [−6.67, −2.85], Z = −2.09, p = 0.037) and in frequency of drinking at both follow-ups (−0.83, 95% CI [−1.14, −0.52], Z = −2.04, p = 0.041; −0.89, 95% CI [−1.16, −0.62], Z = −2.12, p = 0.034). The odds ratio for not having excessive alcohol consumption among men in the intervention group compared to male controls was 2.68, 95% CI [1.37, 5.25] (Z = 2.88, p = 0.004); the figure for women was 1.71, 95% CI [1.11, 2.64] (Z = 2.41, p = 0.016). Conclusion Skills training apps have potential for reducing excessive alcohol use among university students. Future research is still needed to disentangle effects of app use from emailed feedback on excessive alcohol consumption and study participation. Trial Registration NCT02064998

Research paper thumbnail of Risky consumption of alcohol and drugs among employees at ski resorts

Nordic Studies on Alcohol and Drugs, 2017

Aim: To evaluate risky consumption of alcohol and drugs among Swedish men and women who are emplo... more Aim: To evaluate risky consumption of alcohol and drugs among Swedish men and women who are employed at ski resorts. Methods: A cross-sectional sample of 611 employees in 48 small and medium-sized enterprises responded to a questionnaire covering alcohol and drug use, social aspects around work and working conditions. Consumption of alcohol and drugs in the study sample was compared to population data. Data were analysed using Mann–Whitney U-tests and logistic regression analyses. Results: Compared to the general population, the study group of ski resort employees had higher scores on the Alcohol Use Disorders Identification Test (AUDIT) in all age groups except 35+ for men. Regarding the Drug Use Disorders Identification Test (DUDIT) scores, only men in the 18–24 age group had higher scores compared to the general population. The prevalence of risky alcohol and drug use was higher among seasonally employed individuals; 82.9%, compared to 58.0% among other employees for alcohol; 8.3...

Research paper thumbnail of Proceedings of the 14th annual conference of INEBRIA

Addiction Science & Clinical Practice, 2017

Background: Addressing alcohol harm in prisons can potentially reduce the risk of re-offending, a... more Background: Addressing alcohol harm in prisons can potentially reduce the risk of re-offending, and costs to society, whilst tackling health inequalities. Health savings of £4.3 m and crime savings of £100 m per year can be a result of appropriate alcohol interventions. Prison therefore offers an opportunity for the identification, response and/or referral to treatment for those male remand prisoners who are consuming alcohol above recommended levels. There is however, limited evidence for the effectiveness, optimum timing of delivery, recommended length, content, implementation and economic benefit of Alcohol Brief Interventions (ABI) in the prison setting for male remand prisoners. As part of the PRISM-A study, we aimed to explore the 'elements' of an acceptable ABI for delivery, experiences of engagement with services/health professionals about alcohol use, alongside barriers and facilitators to implementation within the prison setting for male remand prisoners. Materials and methods: Twenty-four in-depth interviews were conducted with adult male remand prisoners at one Scottish prison (n = 12) and one English prison (n = 12). A focus group at each of the prison sites was held with key stakeholders (e.g. prison nurses, prison officers, voluntary alcohol/addiction services, health service managers and commissioners). Thematic analysis techniques utilizing NViVo 10 were employed. Results: A thematic content analysis of the interviews consistently highlighted that the majority of prisoners reflected about the connection between alcohol consumption and criminal offending, particularly in relation to offenses involving physical assaults. They also expressed motivation to change their alcohol consumption. Both prisoner interviews and focus groups with stakeholders (N = 2), indicated the value of continuous follow-up support outside of the prison system and also the need to address the lack of stable social environments, which is often associated with alcohol and drug consumption. Stakeholders further identified organizational barriers to the delivery of ABI, such as limited funding and manageable workloads. Conclusions: The importance of interpersonal trust indicated that intervention delivery by external organizations and nurses were favored in comparison to intervention delivery by prison staff and peer-prisoners. A2 Does perceived risk of harm mediate the effects of a primary care alcohol screening and brief advice intervention for adolescents?

Research paper thumbnail of Erratum to: Key Intervention Characteristics in e-Health: Steps Towards Standardized Communication

International journal of behavioral medicine, Dec 6, 2017

In the original publication, Mette T. Høybye's and Christopher Sundström's names were misspelled ... more In the original publication, Mette T. Høybye's and Christopher Sundström's names were misspelled as Mette T. Hoybye and Christopher Sundstrom. The original article has been corrected.

Research paper thumbnail of Key Intervention Characteristics in e-Health: Steps Towards Standardized Communication

International journal of behavioral medicine, Oct 12, 2017

This paper reports expert opinion on e-health intervention characteristics that enable effective ... more This paper reports expert opinion on e-health intervention characteristics that enable effective communication of characteristics across the diverse field of e-health interventions. The paper presents a visualization tool to support communication of the defining characteristics. An initial list of e-health intervention characteristics was developed through an iterative process of item generation and discussion among the 12 authors. The list was distributed to 123 experts in the field, who were emailed an invitation to assess and rank the items. Participants were asked to evaluate these characteristics in three separate ways. A total of 50 responses were received for a response rate of 40.7%. Six respondents who reported having little or no expertise in e-health research were removed from the dataset. Our results suggest that 10 specific intervention characteristics were consistently supported as of central importance by the panel of 44 e-intervention experts. The weight and perceive...

Research paper thumbnail of Web-Based Self-Help for Problematic Alcohol Use: a Large Naturalistic Study

International journal of behavioral medicine, Jan 29, 2016

This observational study examined user characteristics, intervention use patterns, and variables ... more This observational study examined user characteristics, intervention use patterns, and variables associated with reductions in alcohol consumption for anonymous Internet help-seekers using a Web-based self-help program. A Web-based cognitive behavioral therapy (CBT) program with eight modules delivered over 10 weeks was offered to participants with at least hazardous use of alcohol according to the Alcohol Use Disorders Identification Test (AUDIT) (n = 4165). At baseline and 10-week follow-up, participants completed the Timeline-followback (TLFB), AUDIT, Drug Use Disorders Identification Test (DUDIT), Hospital Anxiety and Depression Scale (HADS), EuroQol-5 dimension (EQ-5D), World Health Organization Quality of Life Scale-abbreviated version (WHOQOL-BREF), Readiness to Change Questionnaire (RCQ), and Readiness Ruler. Follow-up completers and non-completers were compared at baseline, and follow-up completer outcomes were reported. Predictors of change in drinking behavior were evalua...

Research paper thumbnail of Children of Prisoners: Their Situation and Role in Long-Term Crime Prevention

Women and Children as Victims and Offenders: Background, Prevention, Reintegration, 2016

Studies suggest that maintaining family ties can help reduce the likelihood of reoffending, and t... more Studies suggest that maintaining family ties can help reduce the likelihood of reoffending, and that while parental imprisonment can increase a child's likelihood to offend, positive responses to the situation can aid the children's well-being, attitude and attainment. Drawing on findings from the recently completed EU-funded COPING Project on the mental health of children of prisoners, this chapter explores the factors that aid a child's ability to cope with parental imprisonment and the actions that different stakeholders can take to support them. It identifies some of the mental health impacts at different stages of parental imprisonment, the roles played by non-imprisoned parents/carers and by schools, and suggests options for further clarifying the factors that help and hinder children of prisoners in the short and long term.

Research paper thumbnail of Guided and Unguided Internet-Based Treatment for Problematic Alcohol Use - A Randomized Controlled Pilot Trial

PloS one, 2016

The Internet has increasingly been studied as mode of delivery for interventions targeting proble... more The Internet has increasingly been studied as mode of delivery for interventions targeting problematic alcohol use. Most interventions have been fully automated, but some research suggests that adding counselor guidance may improve alcohol consumption outcomes. An eight-module Internet-based self-help program based on cognitive behavioral therapy (CBT) was tested among Internet help-seekers. Eighty participants with problematic alcohol use according to the Alcohol Use Disorders Identification Test (AUDIT; scores of ≥ 6 for women and ≥ 8 for men) were recruited online from an open access website and randomized into three different groups. All groups were offered the same self-help program, but participants in two of the three groups received Internet-based counselor guidance in addition to the self-help program. One of the guidance groups was given a choice between guidance via asynchronous text messages or synchronous text-based chat, while the other guidance group received counselo...

Research paper thumbnail of Mobile Interventions Targeting Risky Drinking Among University Students: A Review

Current Addiction Reports, 2016

Mobile interventions based on text messages, automated telephone programs (interactive voice resp... more Mobile interventions based on text messages, automated telephone programs (interactive voice response (IVR)), and smartphone apps offer a new approach targeting hazardous alcohol use in university students. This review covers seven recent studies involving college or university students that evaluated intervention efficacy in comparison to controls: four using text messages, one using IVR, and two smartphone apps. Only the study evaluating IVR reported positive results for the primary outcome. Two of the text message studies reported positive results on secondary outcomes, while the other two reported no differences in comparison to control groups. For smartphone apps, one study reported positive results on secondary outcomes, while the other showed no differences in comparison to controls for a web-based app and negative results for a native app. Further development of mobile interventions is needed for this at-risk population, both in terms of intervention content and use of robust research designs.

Research paper thumbnail of National Human Research Ethics: A Preliminary Comparative Case Study of Germany, Great Britain, Romania and Sweden

Ethics & Behavior, 2015

Although international research is increasing in volume and importance, there remains a dearth of... more Although international research is increasing in volume and importance, there remains a dearth of knowledge on similarities and differences in "national human research ethics" (NHREs), that is, national ethical guidelines (NEGs), Institutional Review Boards (IRBs), and research stakeholder' ethical attitudes and behaviors (EABs). We begin to address this situation by reporting upon our experiences in conducting a multinational study into the mental health of children who had a parent/carer in prison. The study was conducted in 4 countries: Germany, Great Britain, Romania, and Sweden. Data on NHREs were gathered via a questionnaire survey, two ethics-related seminars, and ongoing contact between members of the research consortium. There was correspondence but even more so divergence between countries in the availability of NEGs and IRBs and in researcher' EABs. Differences in NHREs have implications particularly in terms of harmonization but also for ethical philosophy and practice and for research integrity.

Research paper thumbnail of Implementing digital interventions in psychiatric outpatient units: a qualitative analysis of staff attitudes

Addiction Science & Clinical Practice, 2015

Research paper thumbnail of Mental Health Services and Public Safety: Substance Abuse Outpatient Visits Were Associated with Reduced Crime Rates in a Swedish Cohort

PLOS ONE, 2015

Substance abuse is related to offending and substance abuse treatment has been associated with re... more Substance abuse is related to offending and substance abuse treatment has been associated with reductions in criminal behavior. This cohort study aimed to explore the relationship between participation in substance abuse interventions and general criminal recidivism among offenders with a combination of mental health problems and substance use problems. In total, 150 Swedish offenders with self-reported mental health and substance use problems were followed for approximately three years with regard to participation in substance abuse interventions and criminal recidivism. Participants with at least three planned visits to specialized outpatient substance abuse clinics had a substantially reduced risk of reoffending as compared to those with fewer than three such visits (HR = 0.47, 95% CI 0.29-0.77). For those with at least three planned visits, general criminal recidivism was reduced by 75% during periods of participation in outpatient visits, as compared to periods of non-participation (HR = 0.25, 95% CI 0.11-0.60). For offenders with mental health problems and substance use problems, outpatient substance abuse interventions could be regarded as important from a clinical risk management perspective, and be encouraged.

Research paper thumbnail of Short-term changes in substance use among problematic alcohol and drug users from a general population sample

The International Journal of Alcohol and Drug Research, 2014

Sinadinovic, K., Wennberg, P., & Berman, A. (2014). Short-term changes in substance use among pro... more Sinadinovic, K., Wennberg, P., & Berman, A. (2014). Short-term changes in substance use among problematic alcohol and drug users from a general population sample. The International Journal Of Alcohol And Drug Research, 3(4), 277-287. doi:http://dx.doi.org/10.7895/ijadr.v3i4.186Aims: To investigate 12-month changes among individuals with baseline problematic use of alcohol or illicit drugs, by gender, age, initial level of substance use, and administration method (Internet or Interactive Voice Response, IVR).Design: 1,861 individuals from a random population sample were screened for problematic alcohol and illicit drug use. Individuals screening positive were followed up after 12 months.Setting: The Swedish general population.Participants: 423 individuals with baseline problematic alcohol (women: AUDIT ≥ 6, men: AUDIT ≥ 8) or drug use (both genders: DUDIT ≥ 1).Measures: AUDIT, DUDIT, AUDIT-C and DUDIT-C scores.Findings: AUDIT scores decreased from 10.43 to 8.62; among 239 participant...

Research paper thumbnail of Nordic Studies on Alcohol and Drugs NAD 2/11 Volumed 28

Research paper thumbnail of Validation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test in a Swedish sample of suspected offenders with signs of mental health problems: Results from the Mental Disorder, Substance Abuse and Crime study

Journal of Substance Abuse Treatment, Dec 1, 2010

Substance abuse is common among offenders. One method widely used for the detection of substance ... more Substance abuse is common among offenders. One method widely used for the detection of substance abuse is screening. This study explored the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) screening tools in relation to (a) substance abuse and dependency diagnoses and (b) three problem severity domains of the sixth version of the Addiction Severity Index in a sample of 181 suspected offenders with signs of mental health problems. The screening tools showed moderate to high accuracy for identification of dependency diagnoses. The AUDIT was associated with alcohol problem severity, whereas the DUDIT was associated with drug and legal problem severity. Administering the screening tools in the current population yields valid results. However, the suggested cutoff scores should be applied with caution due to the discrepancy between present and previous findings.

Research paper thumbnail of Drug Use Disorders Identification Test--Extended

Research paper thumbnail of Web-Based Self-Help for Problematic Alcohol Use: a Large Naturalistic Study

International Journal of Behavioral Medicine, Nov 29, 2016

Purpose This observational study examined user characteristics, intervention use patterns, and va... more Purpose This observational study examined user characteristics, intervention use patterns, and variables associated with reductions in alcohol consumption for anonymous Internet help-seekers using a Web-based self-help program. Method A Web-based cognitive behavioral therapy (CBT) program with eight modules delivered over 10 weeks was offered to participants with at least hazardous use of alcohol according to the Alcohol Use Disorders Identification Test (AUDIT) (n = 4165). At baseline and 10-week follow-up, participants completed the Timeline-followback (TLFB), AUDIT, Drug Use Disorders Identification Test (DUDIT), Hospital Anxiety and Depression Scale (HADS), EuroQol-5 dimension (EQ-5D), World Health Organization Quality of Life Scale-abbreviated version (WHOQOL-BREF), Readiness to Change Questionnaire (RCQ), and Readiness Ruler. Follow-up completers and non-completers were compared at baseline, and follow-up completer outcomes were reported. Predictors of change in drinking behavior were evaluated at follow-up. Results Registered users were 41.88 years old on average (SD = 12.36), and 52 % were women; the mean baseline number of drinks during the past week was 27.27 (SD = 17.92) with 62 % in the AUDIT category of probable dependence and only 7 % having low-risk consumption according to public health guidelines. At follow-up (n = 1043), 53 % showed a clinically significant change to a lower level of alcohol use (χ 2 = 254.403, p < 0.001); the mean alcohol consumption fell (t = 22.841, p < 0.001) and the proportion with low-risk consumption rose to 40 %. Being male, scoring higher on baseline readiness, completing the program, and accessing other support predicted low-risk drinking and clinically significant change to a lower level of alcohol use at follow-up. Conclusion A publicly available Web-based program for managing problematic alcohol use attracted users with considerable alcohol-and health-related problems, which were changed to lower severity for follow-up completers.

Research paper thumbnail of Improvement in mental and physical well-being among problematic substance users in Internet-based intervention trials

Addiction Science & Clinical Practice, 2013

Research paper thumbnail of Effectiveness and treatment moderators of internet interventions for adult problem drinking: An individual patient data meta-analysis of 19 randomised controlled trials

PLOS Medicine, 2018

Effectiveness and treatment moderators of internet interventions for adult problem drinking: An i... more Effectiveness and treatment moderators of internet interventions for adult problem drinking: An individual patient data meta-analysis of 19 randomised controlled trials. PLoS Med 15(12): e1002714.

Research paper thumbnail of Counselor and Drug Detox Inpatient Verbal Behaviors in a Single Session of Motivational Interviewing and Subsequent Substance Use-Related Patient Outcomes

International Journal of Mental Health and Addiction, 2018

Effects of counselor and client verbal behaviors, in a single motivational interviewing (MI) sess... more Effects of counselor and client verbal behaviors, in a single motivational interviewing (MI) session during inpatient detoxification, were evaluated in relation to 17 study participants' self-reported drug use 3 months later. Also, counselor-to-client transitions in the single MI session were explored for 24 participants, using the Motivational Interviewing Sequential Code for Observing Process Exchanges (MI-SCOPE) coding instrument. Surprisingly, counselor neutral/double-sided reflections predicted lower levels of drug use (r = − 0.42), higher treatment interest (r = 0.40), and self-efficacy for abstaining from drug use when experiencing positive feelings (r = 0.48) and negative feelings or craving (r = 0.40). Client change talk predicted motivation to change (r = 0.42) and perceptions of negative aspects of drug use (r = 0.44), while higher levels of client sustain talk predicted lower levels of drug use (r = − 0.45) and lower interest in treatment (r = − 0.68). The counselor-client transition analysis showed an odds ratio (OR) of 13.84 (95% CI 9.75; 19.66) for client change talk in response to counselor reflections on change talk (RCT), and an OR of 55.98 (95% CI 26.53;

Research paper thumbnail of Skills Training via Smartphone App for University Students with Excessive Alcohol Consumption: a Randomized Controlled Trial

International Journal of Behavioral Medicine, 2017

Purpose University students in a study on estimated blood alcohol concentration (eBAC) feedback a... more Purpose University students in a study on estimated blood alcohol concentration (eBAC) feedback apps were offered participation in a second study, if reporting continued excessive consumption at 6-week follow-up. This study evaluated the effects on excessive alcohol consumption of offering access to an additional skills training app. Method A total of 186 students with excessive alcohol consumption were randomized to an intervention group or a wait list group. Both groups completed online follow-ups regarding alcohol consumption after 6 and 12 weeks. Wait list participants were given access to the intervention at 6-week follow-up. Assessment-only controls (n = 144) with excessive alcohol consumption from the ongoing study were used for comparison. Results The proportion of participants with excessive alcohol consumption declined in both intervention and wait list groups compared to controls at first (p < 0.001) and second followups (p = 0.054). Secondary analyses showed reductions for the intervention group in quantity of drinking at first followup (−4.76, 95% CI [−6.67, −2.85], Z = −2.09, p = 0.037) and in frequency of drinking at both follow-ups (−0.83, 95% CI [−1.14, −0.52], Z = −2.04, p = 0.041; −0.89, 95% CI [−1.16, −0.62], Z = −2.12, p = 0.034). The odds ratio for not having excessive alcohol consumption among men in the intervention group compared to male controls was 2.68, 95% CI [1.37, 5.25] (Z = 2.88, p = 0.004); the figure for women was 1.71, 95% CI [1.11, 2.64] (Z = 2.41, p = 0.016). Conclusion Skills training apps have potential for reducing excessive alcohol use among university students. Future research is still needed to disentangle effects of app use from emailed feedback on excessive alcohol consumption and study participation. Trial Registration NCT02064998

Research paper thumbnail of Risky consumption of alcohol and drugs among employees at ski resorts

Nordic Studies on Alcohol and Drugs, 2017

Aim: To evaluate risky consumption of alcohol and drugs among Swedish men and women who are emplo... more Aim: To evaluate risky consumption of alcohol and drugs among Swedish men and women who are employed at ski resorts. Methods: A cross-sectional sample of 611 employees in 48 small and medium-sized enterprises responded to a questionnaire covering alcohol and drug use, social aspects around work and working conditions. Consumption of alcohol and drugs in the study sample was compared to population data. Data were analysed using Mann–Whitney U-tests and logistic regression analyses. Results: Compared to the general population, the study group of ski resort employees had higher scores on the Alcohol Use Disorders Identification Test (AUDIT) in all age groups except 35+ for men. Regarding the Drug Use Disorders Identification Test (DUDIT) scores, only men in the 18–24 age group had higher scores compared to the general population. The prevalence of risky alcohol and drug use was higher among seasonally employed individuals; 82.9%, compared to 58.0% among other employees for alcohol; 8.3...

Research paper thumbnail of Proceedings of the 14th annual conference of INEBRIA

Addiction Science & Clinical Practice, 2017

Background: Addressing alcohol harm in prisons can potentially reduce the risk of re-offending, a... more Background: Addressing alcohol harm in prisons can potentially reduce the risk of re-offending, and costs to society, whilst tackling health inequalities. Health savings of £4.3 m and crime savings of £100 m per year can be a result of appropriate alcohol interventions. Prison therefore offers an opportunity for the identification, response and/or referral to treatment for those male remand prisoners who are consuming alcohol above recommended levels. There is however, limited evidence for the effectiveness, optimum timing of delivery, recommended length, content, implementation and economic benefit of Alcohol Brief Interventions (ABI) in the prison setting for male remand prisoners. As part of the PRISM-A study, we aimed to explore the 'elements' of an acceptable ABI for delivery, experiences of engagement with services/health professionals about alcohol use, alongside barriers and facilitators to implementation within the prison setting for male remand prisoners. Materials and methods: Twenty-four in-depth interviews were conducted with adult male remand prisoners at one Scottish prison (n = 12) and one English prison (n = 12). A focus group at each of the prison sites was held with key stakeholders (e.g. prison nurses, prison officers, voluntary alcohol/addiction services, health service managers and commissioners). Thematic analysis techniques utilizing NViVo 10 were employed. Results: A thematic content analysis of the interviews consistently highlighted that the majority of prisoners reflected about the connection between alcohol consumption and criminal offending, particularly in relation to offenses involving physical assaults. They also expressed motivation to change their alcohol consumption. Both prisoner interviews and focus groups with stakeholders (N = 2), indicated the value of continuous follow-up support outside of the prison system and also the need to address the lack of stable social environments, which is often associated with alcohol and drug consumption. Stakeholders further identified organizational barriers to the delivery of ABI, such as limited funding and manageable workloads. Conclusions: The importance of interpersonal trust indicated that intervention delivery by external organizations and nurses were favored in comparison to intervention delivery by prison staff and peer-prisoners. A2 Does perceived risk of harm mediate the effects of a primary care alcohol screening and brief advice intervention for adolescents?

Research paper thumbnail of Erratum to: Key Intervention Characteristics in e-Health: Steps Towards Standardized Communication

International journal of behavioral medicine, Dec 6, 2017

In the original publication, Mette T. Høybye's and Christopher Sundström's names were misspelled ... more In the original publication, Mette T. Høybye's and Christopher Sundström's names were misspelled as Mette T. Hoybye and Christopher Sundstrom. The original article has been corrected.

Research paper thumbnail of Key Intervention Characteristics in e-Health: Steps Towards Standardized Communication

International journal of behavioral medicine, Oct 12, 2017

This paper reports expert opinion on e-health intervention characteristics that enable effective ... more This paper reports expert opinion on e-health intervention characteristics that enable effective communication of characteristics across the diverse field of e-health interventions. The paper presents a visualization tool to support communication of the defining characteristics. An initial list of e-health intervention characteristics was developed through an iterative process of item generation and discussion among the 12 authors. The list was distributed to 123 experts in the field, who were emailed an invitation to assess and rank the items. Participants were asked to evaluate these characteristics in three separate ways. A total of 50 responses were received for a response rate of 40.7%. Six respondents who reported having little or no expertise in e-health research were removed from the dataset. Our results suggest that 10 specific intervention characteristics were consistently supported as of central importance by the panel of 44 e-intervention experts. The weight and perceive...

Research paper thumbnail of Web-Based Self-Help for Problematic Alcohol Use: a Large Naturalistic Study

International journal of behavioral medicine, Jan 29, 2016

This observational study examined user characteristics, intervention use patterns, and variables ... more This observational study examined user characteristics, intervention use patterns, and variables associated with reductions in alcohol consumption for anonymous Internet help-seekers using a Web-based self-help program. A Web-based cognitive behavioral therapy (CBT) program with eight modules delivered over 10 weeks was offered to participants with at least hazardous use of alcohol according to the Alcohol Use Disorders Identification Test (AUDIT) (n = 4165). At baseline and 10-week follow-up, participants completed the Timeline-followback (TLFB), AUDIT, Drug Use Disorders Identification Test (DUDIT), Hospital Anxiety and Depression Scale (HADS), EuroQol-5 dimension (EQ-5D), World Health Organization Quality of Life Scale-abbreviated version (WHOQOL-BREF), Readiness to Change Questionnaire (RCQ), and Readiness Ruler. Follow-up completers and non-completers were compared at baseline, and follow-up completer outcomes were reported. Predictors of change in drinking behavior were evalua...

Research paper thumbnail of Children of Prisoners: Their Situation and Role in Long-Term Crime Prevention

Women and Children as Victims and Offenders: Background, Prevention, Reintegration, 2016

Studies suggest that maintaining family ties can help reduce the likelihood of reoffending, and t... more Studies suggest that maintaining family ties can help reduce the likelihood of reoffending, and that while parental imprisonment can increase a child's likelihood to offend, positive responses to the situation can aid the children's well-being, attitude and attainment. Drawing on findings from the recently completed EU-funded COPING Project on the mental health of children of prisoners, this chapter explores the factors that aid a child's ability to cope with parental imprisonment and the actions that different stakeholders can take to support them. It identifies some of the mental health impacts at different stages of parental imprisonment, the roles played by non-imprisoned parents/carers and by schools, and suggests options for further clarifying the factors that help and hinder children of prisoners in the short and long term.

Research paper thumbnail of Guided and Unguided Internet-Based Treatment for Problematic Alcohol Use - A Randomized Controlled Pilot Trial

PloS one, 2016

The Internet has increasingly been studied as mode of delivery for interventions targeting proble... more The Internet has increasingly been studied as mode of delivery for interventions targeting problematic alcohol use. Most interventions have been fully automated, but some research suggests that adding counselor guidance may improve alcohol consumption outcomes. An eight-module Internet-based self-help program based on cognitive behavioral therapy (CBT) was tested among Internet help-seekers. Eighty participants with problematic alcohol use according to the Alcohol Use Disorders Identification Test (AUDIT; scores of ≥ 6 for women and ≥ 8 for men) were recruited online from an open access website and randomized into three different groups. All groups were offered the same self-help program, but participants in two of the three groups received Internet-based counselor guidance in addition to the self-help program. One of the guidance groups was given a choice between guidance via asynchronous text messages or synchronous text-based chat, while the other guidance group received counselo...

Research paper thumbnail of Mobile Interventions Targeting Risky Drinking Among University Students: A Review

Current Addiction Reports, 2016

Mobile interventions based on text messages, automated telephone programs (interactive voice resp... more Mobile interventions based on text messages, automated telephone programs (interactive voice response (IVR)), and smartphone apps offer a new approach targeting hazardous alcohol use in university students. This review covers seven recent studies involving college or university students that evaluated intervention efficacy in comparison to controls: four using text messages, one using IVR, and two smartphone apps. Only the study evaluating IVR reported positive results for the primary outcome. Two of the text message studies reported positive results on secondary outcomes, while the other two reported no differences in comparison to control groups. For smartphone apps, one study reported positive results on secondary outcomes, while the other showed no differences in comparison to controls for a web-based app and negative results for a native app. Further development of mobile interventions is needed for this at-risk population, both in terms of intervention content and use of robust research designs.

Research paper thumbnail of National Human Research Ethics: A Preliminary Comparative Case Study of Germany, Great Britain, Romania and Sweden

Ethics & Behavior, 2015

Although international research is increasing in volume and importance, there remains a dearth of... more Although international research is increasing in volume and importance, there remains a dearth of knowledge on similarities and differences in "national human research ethics" (NHREs), that is, national ethical guidelines (NEGs), Institutional Review Boards (IRBs), and research stakeholder' ethical attitudes and behaviors (EABs). We begin to address this situation by reporting upon our experiences in conducting a multinational study into the mental health of children who had a parent/carer in prison. The study was conducted in 4 countries: Germany, Great Britain, Romania, and Sweden. Data on NHREs were gathered via a questionnaire survey, two ethics-related seminars, and ongoing contact between members of the research consortium. There was correspondence but even more so divergence between countries in the availability of NEGs and IRBs and in researcher' EABs. Differences in NHREs have implications particularly in terms of harmonization but also for ethical philosophy and practice and for research integrity.

Research paper thumbnail of Implementing digital interventions in psychiatric outpatient units: a qualitative analysis of staff attitudes

Addiction Science & Clinical Practice, 2015

Research paper thumbnail of Mental Health Services and Public Safety: Substance Abuse Outpatient Visits Were Associated with Reduced Crime Rates in a Swedish Cohort

PLOS ONE, 2015

Substance abuse is related to offending and substance abuse treatment has been associated with re... more Substance abuse is related to offending and substance abuse treatment has been associated with reductions in criminal behavior. This cohort study aimed to explore the relationship between participation in substance abuse interventions and general criminal recidivism among offenders with a combination of mental health problems and substance use problems. In total, 150 Swedish offenders with self-reported mental health and substance use problems were followed for approximately three years with regard to participation in substance abuse interventions and criminal recidivism. Participants with at least three planned visits to specialized outpatient substance abuse clinics had a substantially reduced risk of reoffending as compared to those with fewer than three such visits (HR = 0.47, 95% CI 0.29-0.77). For those with at least three planned visits, general criminal recidivism was reduced by 75% during periods of participation in outpatient visits, as compared to periods of non-participation (HR = 0.25, 95% CI 0.11-0.60). For offenders with mental health problems and substance use problems, outpatient substance abuse interventions could be regarded as important from a clinical risk management perspective, and be encouraged.

Research paper thumbnail of Short-term changes in substance use among problematic alcohol and drug users from a general population sample

The International Journal of Alcohol and Drug Research, 2014

Sinadinovic, K., Wennberg, P., & Berman, A. (2014). Short-term changes in substance use among pro... more Sinadinovic, K., Wennberg, P., & Berman, A. (2014). Short-term changes in substance use among problematic alcohol and drug users from a general population sample. The International Journal Of Alcohol And Drug Research, 3(4), 277-287. doi:http://dx.doi.org/10.7895/ijadr.v3i4.186Aims: To investigate 12-month changes among individuals with baseline problematic use of alcohol or illicit drugs, by gender, age, initial level of substance use, and administration method (Internet or Interactive Voice Response, IVR).Design: 1,861 individuals from a random population sample were screened for problematic alcohol and illicit drug use. Individuals screening positive were followed up after 12 months.Setting: The Swedish general population.Participants: 423 individuals with baseline problematic alcohol (women: AUDIT ≥ 6, men: AUDIT ≥ 8) or drug use (both genders: DUDIT ≥ 1).Measures: AUDIT, DUDIT, AUDIT-C and DUDIT-C scores.Findings: AUDIT scores decreased from 10.43 to 8.62; among 239 participant...

Research paper thumbnail of Children of prisoners: Their situation and role in long-term crime prevention

Oliver Robertson, Kris Christmann, Kathryn Sharratt, Anne H. Berman, Martin Manby, Elizabeth Ayre... more Oliver Robertson, Kris Christmann, Kathryn Sharratt, Anne H. Berman, Martin
Manby, Elizabeth Ayre, Liliana Foca, Romeo Asiminei, Kate Philbrick and
Cristina Gavriluta.

Studies suggest that maintaining family ties can help reduce the likelihood of reoffending, and that while parental imprisonment can increase a child’s likelihood to offend, positive responses to the situation can aid the children’s well-being, attitude and attainment. Drawing on findings from the recently completed EU-funded COPING Project on the mental health of children of prisoners, this chapter explores the factors that aid a child’s ability to cope with parental imprisonment and the actions that different stakeholders can take to support them. It identifies some of the mental health impacts at different stages of parental imprisonment, the roles played by non-imprisoned parents/carers and by schools, and suggests options for further clarifying the factors that help and hinder children of prisoners in the short and long term