Ole A Solbakken | University of Oslo (original) (raw)

Papers by Ole A Solbakken

Frontiers in Psychology, Oct 30, 2023

Introduction: Affect integration comprises the capacity to access and utilize the motivational an... more Introduction: Affect integration comprises the capacity to access and utilize the motivational and signal properties of affects. This capacity is essential for personal adjustment, mental health, and well-being. Affect integration is commonly operationalized through the Affect Integration Inventory. This study examines the psychometric properties of a short-form (AII-SF-42) of the instrument in a sample of patients with personality disorders (n = 87). Methods: Analyses of internal-consistency reliability, along with standardized mean differences-, and associations between short-and long-forms are reported. Internal structure was assessed by confirmatory factor analyses and external criterion validity was addressed by tests of associations between the AII-SF-42-scale scores and measures of alexithymia, symptom distress, interpersonal problems and level of personality dysfunction. Results: The study demonstrated satisfactory reliability and validity for scores derived from the AII-SF-42, including acceptable internal consistency and strong correspondence with long-form scores, a consistent factor structure organized according to discrete affects, and systematic patterns of convergent and discriminant associations with external measures. Conclusion: Taken together, the results of the study demonstrate that in clinical settings, including patients with personality disorders the AII-SF-42 is a valid and useful alternative to the full-length version of the instrument.

Nordic Psychology, Jan 11, 2022

Tidsskrift for Norsk psykologforening, Jul 1, 2023

Background: Equitable mental healthcare regardless of area of residence is a political aim in Nor... more Background: Equitable mental healthcare regardless of area of residence is a political aim in Norway. The purpose of this study is to evaluate geographical variation in private practitioner coverage, and explore differences between private practitioners with public reimbursement and local community mental health centers (CMHCs) in terms of diagnoses and scope of outpatient treatment, with a focus on mood and neurotic disorders. Method: Cross-sectional registry-based study of adults in outpatient mental healthcare at private practitioners or CMHCs in Norway in 2014–2018. We calculated distribution of diagnoses, geographical variation in rates of private practitioners, and analyzed scope of treatment for patients with mood and neurotic disorders (ICD-10 disorders F3, F4). We estimate cost per treated patient and report geographic variation for hospital catchment areas. Results: Patients with F3, F4 disorders accounted for 64.7 % at private practitioners, and 31.5 % at CMHCs, and received more treatment at private practitioners, five more consultations in a 42 day longer period. There is considerable geographical variation in private practitioner coverage, highest in South-East Norway and lowest in North Norway. Implications: As long as management and priority setting are differently organized for CMHCs and private practitioners in mental health care, we must expect geographical variation in access and use. It appears as an equity paradox that a group of patients, rejected by or not referred to CMHC, receive more treatment by private practitioners. Keywords: mental healthcare, outpatient consultations, private practitioners, CMHC, geographical variation, equal access, equity, priority setting

Acta Psychologica, May 1, 2022

Affect integration is defined as the capacity to comprehend emotional experiences as meaningful a... more Affect integration is defined as the capacity to comprehend emotional experiences as meaningful and to convert this knowledge into well-adjusted motivation, communication and behavior. Thus, affect integration is considered essential for personal adjustment and well-being, and it has been operationalized through the Affect Integration Inventory. However, the validity of this questionnaire has been examined only in non-clinical respondents. Therefore, the purpose of this study was to investigate the psychometric properties of the questionnaire in a sample of patients with personality disorders (n = 87). The internal structure and consistency were addressed using Cronbach's alpha and confirmatory factor analysis. To determine aspects of convergent and discriminant validity, the correlations between the scores on the questionnaire and the scores on content-related questionnaires and scales were examined. Finally, scores from the clinical respondents and existing data from a previously collected non-clinical sample (n = 157) were compared to evaluate the external validity. The overall results demonstrated satisfactory internal consistency, a consistent factor structure, and systematic patterns of convergent and discriminant validity. Additionally, the findings indicated that the instrument clearly differentiated the clinical sample from the non-clinical sample.

European Journal of Ageing, Jun 22, 2023

Emotion regulation is proposed to have a salient role in optimal aging. However, currently used m... more Emotion regulation is proposed to have a salient role in optimal aging. However, currently used measures of emotion regulation have not been validated for older adults. Therefore, we evaluated the psychometric properties of the Difficulties in Emotion Regulation Scale-short form (DERS-16) in a large Norwegian sample consisting of individuals between 70 and 95 years (n = 2525). Tests of internal consistency, reliability, assessment of intra-domain correlations, and confirmatory factor analyses were performed. Construct validity was further investigated by assessing concurrent associations between DERS-16 and well-established measures of psychological disorders, psychological health, and well-being (five-item version of Geriatric Depression Scale, Geriatric Anxiety Inventory-short form, and OECD guidelines on measuring subjective well-being). All subscales derived from the instrument showed adequate internal consistency. Furthermore, we obtained a theoretically consistent factor structure, in which a bifactor model combining a general emotion regulation factor and five additional domain-specific facet-factors had superior model fit. As expected, difficulties in emotion regulation correlated positively with symptoms of depression and anxiety, and negatively with psychological health and well-being. Associations were generally of moderate strength. We can thus conclude that the DERS-16 demonstrates excellent psychometric properties when used in samples with older adults and may safely be employed in studies of emotion regulation difficulties in the older segment of our population.

Psychoanalytic Psychology, 2014

ABSTRACT Concepts of mentalization, affect consciousness, and mindfulness have been increasingly ... more ABSTRACT Concepts of mentalization, affect consciousness, and mindfulness have been increasingly emphasized as crucial in psychotherapy of diverse orientations. Different measures have been developed that purportedly measure these concepts, but little is known about their interrelationships. We discuss conceptual overlaps and distinctions between these three concepts, and present results from a preliminary empirical study comparing their measures. To study the relationships between these concepts, data from a group of psychotherapy students (N = 46) was used. Mentalization operationalized as Reflective Functioning (RF) was rated on transcripts of a brief version of the Adult Attachment Interview; the Five Facet Mindfulness Questionnaire (FFMQ) was used to measure mindfulness; and the Affect Consciousness Interview-Self/Other version (ACI-S/O) to measure affect consciousness. There was a small but statistically significant relationship between RF and FFMQ, but surprisingly no relationship between AC-S/O and RF or FFMQ. A post hoc analysis showed a relationship between consciousness of others’ affects and a reduced version of the RF scale. Results confirm that mentalization and mindfulness share some common variance, but contrary to expectations, affect consciousness seems to be more different from RF and mindfulness than expected. A possible explanation for the counterintuitive finding of no relationship between RF and affect consciousness is that the high end of the affect consciousness scale measures a mature capacity for mentalized affectivity, while RF is largely a buffer against trauma and adversity. Low or absent findings for the FFMQ are explained more in terms of different methods variance. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

Journal of Consulting and Clinical Psychology, Apr 1, 2022

OBJECTIVE The aim of this naturalistic process study was to investigate the relationship between ... more OBJECTIVE The aim of this naturalistic process study was to investigate the relationship between emotional clarity and tolerance of emotional distress and depressive symptoms over the course of short-term psychodynamic psychotherapy for chronically depressed patients. METHOD Weekly self-reports of emotional clarity, tolerance of emotional distress, and depressive symptoms (PHQ-9) were provided by 252 patients with chronic depression who were admitted to a 13-week inpatient treatment program. Latent curve modeling with structured residuals (LCM-SR) was applied to investigate the between- and within-person effects of week-to-week change in emotional clarity and tolerance of emotional distress as predictors of subsequent depression. The relationship between emotional clarity and tolerance of emotional distress was also investigated. RESULTS At the within-person level, higher level of emotional clarity and tolerance of emotional distress predicted subsequent lower level of depression. A reciprocal relationship was found for tolerance of emotional distress (lower level of depression predicted subsequent level of tolerance emotional distress) but not for emotional clarity. No within-person effect between emotional clarity and tolerance of emotional distress was found. DISCUSSION The results indicate that emotional clarity and tolerance of emotional distress may be mechanisms of change in short-term psychodynamic psychotherapy for chronic depression. The results are consistent with previous findings of the importance of emotional clarity and tolerance of emotional distress in psychotherapy. This study demonstrated the utility of LCM-SR as a method to identity mechanisms of change in psychotherapy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychotherapy Research, Jan 27, 2023

BMC Health Services Research, Dec 20, 2022

Background: Norway has prioritized health services according to the principle of "severity of con... more Background: Norway has prioritized health services according to the principle of "severity of conditions", where waiting time reflects patients' medical urgency. We aim to investigate if the "severity-of-condition" principle performs well in the priority setting of waiting time, between and within groups of patients using community mental health services. We also aim to investigate the association between patients' diagnoses and symptom severity at the start of treatment and the corresponding waiting time. Methods: The study analyzed routine data from Lovisenberg electronic Patient-Reported Outcome Measurement (LOVePROM) at Lovisenberg Diaconal Hospital in Norway. We estimated patient-reported severity by using Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), together with patients' diagnoses to identify patients' needs in general. To assess the performance of current prioritization, we compared waiting times for patients with major depressive disorder and their maximum recommended waiting time. Multivariate regression models were used to assess the association between patient-reported severity, their diagnosis, and waiting times. Results: Of the 6108 mental health disorder patients, patients with moderate to severe conditions waited seven weeks, while patients with mild conditions or below clinical cutoff waited 8 weeks. Included in the sample, 1583 were diagnosed with depression. Results indicated that patients with moderate and severe depression had a slightly shorter wait-time than patients with mild depression. However, 32.4% patients with moderate depression and 83.3% patients with severe depression, waited longer than their maximum recommended waiting time. CORE-OM identified depressive patients with risk-to-self harm, who had a 0.84 weeks shorter wait-time. These results were also applied to patients with other common mental health disorders. Conclusion: Overall, patients waited in accordance with the "severity of condition" principle, but the trend was not strong. Therefore, we advocate that there is substantial room for quality improvements in priority setting on waiting time. We suggest further research should investigate if routine collection of PROM and assessment of referral letters, can better inform specialists when deciding on waiting time.

Journal of Consulting and Clinical Psychology, Sep 1, 2023

Patient Preference and Adherence, Jul 1, 2021

Purpose: Medication has been a central part of treatment for severe mental disorders in Western m... more Purpose: Medication has been a central part of treatment for severe mental disorders in Western medicine since the 1950s. In 2015, Norwegian Health Authorities decided that Norwegian health regions must have treatment units devoted to medication-free mental health treatment to enhance service users' freedom of choice. The need for these units has been controversial. The aim of this study was to examine why service users choose medication-free services. This article examines what purpose these units serve in terms of the users' reasons for choosing this service, what is important for them to receive during the treatment, and what factors lay behind their concerns in terms of medication-related views and experiences. Methods: Questionnaires were answered by 46 participants and 5 participants were interviewed in a mixed-method design integrated with a concurrent triangulation strategy applying thematic analysis and descriptive statistics. Results: Negative effects of medications and unavailable alternatives to medication in ordinary health care were important reasons for wanting medication-free treatment. Medication use may conflict with personal values, attitudes, and beliefs. Conclusion: This study broadens the understanding of why the demand for separate medication-free units has arisen. The findings may contribute to making medication-free treatment an option in mental health care in general. To this end, clinicians are advised to communicate all treatment alternatives to service users and to be mindful of the effect of power imbalances in their interactions with them.

Journal of Couple & Relationship Therapy

Journal of Medical Internet Research

Background Text mining methods such as topic modeling can offer valuable information on how and t... more Background Text mining methods such as topic modeling can offer valuable information on how and to whom internet-delivered cognitive behavioral therapies (iCBT) work. Although iCBT treatments provide convenient data for topic modeling, it has rarely been used in this context. Objective Our aims were to apply topic modeling to written assignment texts from iCBT for generalized anxiety disorder and explore the resulting topics’ associations with treatment response. As predetermining the number of topics presents a considerable challenge in topic modeling, we also aimed to explore a novel method for topic number selection. Methods We defined 2 latent Dirichlet allocation (LDA) topic models using a novel data-driven and a more commonly used interpretability-based topic number selection approaches. We used multilevel models to associate the topics with continuous-valued treatment response, defined as the rate of per-session change in GAD-7 sum scores throughout the treatment. Results Our...

Journal of Marital and Family Therapy

In a Norwegian study of 73 couples attending a residential couple therapy program lasting between... more In a Norwegian study of 73 couples attending a residential couple therapy program lasting between 6 and 12 weeks, weekly self‐report data on therapy alliance and couple satisfaction were collected using routine outcome monitoring (ROM). The aim was to show how dyadic analyses could be applied to examine the predictive association between alliances and couple satisfaction. Results showed that improved alliance between dyad members and their couple therapist predicted their spouses' couple satisfaction. Furthermore, improved couple satisfaction predicted improvement in spouse's alliance. The clinical implication of these findings should heighten awareness to the importance of establishing and maintaining the alliance of male partners in couple therapy, something that predicts their spouses' couple satisfaction. These findings help nuance the already existing literature on the working alliance. Furthermore, we propose that dyadic analyses should be widely used in any psycho...

International journal of psychology and psychological therapy, 2021

Affect integration, denoting the capacity to utilize the motivational-and signal properties of af... more Affect integration, denoting the capacity to utilize the motivational-and signal properties of affects, is essential to adaptive psychological functioning. Affect integration is commonly operationalized and assessed with the self-rated Affect Integration Inventory (AII). This study tested the concurrent and construct validity of a short-form version (AII-SF-42) against the long-form version in a nonclinical reference sample comprising 157 Norwegian respondents. We conducted analyses of reliability, standardized mean differences and associations between short-and long-forms, assessment of internal structure by confirmatory factor analyses, and assessment of external validity by tests of associations with emotion regulation, alexithymia, psychiatric symptoms, and interpersonal problems. Results demonstrated high reliability and validity for the AII-SF-42, including high internal consistency and correspondence with long-form scores, a theoretically consistent factor structure organized according to discrete affects, and theoretically consistent patterns of convergent and discriminant associations with external criteria, including distinct sinusoidal patterns of relationships between AII-SF-42 affect scores and specific interpersonal problem types. Overall, findings indicate that the AII-SF-42 is a viable alternative to the AII in conditions where completion of longer instruments might be unfeasible.

Integrative Cancer Therapies, 2021

Background Preoperative hypnosis has shown promising effects in controlling side effects from bre... more Background Preoperative hypnosis has shown promising effects in controlling side effects from breast cancer surgery, but the feasibility and effects are largely unknown outside the US. Methods A mixed-methods approach was applied involving a large-scale population survey and a small-scale pilot study. The survey assessed attitudes toward hypnosis in a representative sample from the general population (n = 1049), while the pilot study involved interviews with 5 women who received hypnosis prior to mastectomy/lumpectomy. Results In the survey, 8% reported to have previous experience with hypnosis, and 67% reported willingness to accept hypnosis in a medical setting. Increasing age was associated with more skepticism, while previous experience was associated with less skepticism. In the pilot study, 4 themes were identified: (1) caretaking, (2) experiences related to hypnosis, (3) thoughts and feelings related to diagnosis, and (4) surgery. All participants reported positive experience...

International journal of psychology and psychological therapy, 2018

The essential role of affect and emotion in human behavior, motivation, cognition, and interperso... more The essential role of affect and emotion in human behavior, motivation, cognition, and interpersonal interaction is emphasized in various efforts to understand how children develop. However, various theoretical traditions have focused on different features. In this article we focus on the views in attachment theory and the affect consciousness (AC) model/related affect integration perspectives. The attachment theory and the AC perspective/related affect integration perspectives are widely recognized approaches that explicitly focus on the role of affect, cognition, and behavior in the context of others as the main areas in both children’s developmental processes and psychotherapeutic processes. However, these traditions represent both overlapping and contrasting views. On this background we discuss the following questions: 1. How does attachment theory describe the view on affect/emotion, motivation, cognition, and interpersonal interaction, and how do the AC perspective/related aff...

Journal of Personality Assessment, 2013

Interpersonal problems among psychiatric outpatients. A study of interpersonal problems and their... more Interpersonal problems among psychiatric outpatients. A study of interpersonal problems and their association s with symptoms and forms of self-relatedness. Espen Bjerke "The unique contribution of psychoanalysis is the demonstration of the power and persistence of the intrapsychic determinants. But these determinants become only artificial abstractions if they are dealt with in isolation from the interpersonal context in which they find expression" (Merton Gill, 1982, p. 92)

Background Norwegian health authorities have implemented treatment units devoted to medication-fr... more Background Norwegian health authorities have implemented treatment units devoted to medication-free mental health treatment in all health regions to improve people’s freedom of choice. This article examines how medication-free treatment differs from treatment as usual across various central dimensions. Methods We used a mixed-methods design that included questionnaire data obtained from a medication-free unit and two comparison units (n 59 + 124), as well as interviews with patients (n 5) and staff (n 8) in the medication-free unit. Participants compared their experiences with the unit to other relevant experiences with mental health care. Results Medication-free treatment involved less reliance on medications to become well and more extensive psychosocial treatment that involved a culture of openness, expression of feelings, and focus on individual responsibility and intensive work. The extent of formal examination and overall ratings of help with medications was similar to that in...

Journal of Consulting and Clinical Psychology