Psychological treatment: internet and exposure – Brjánn Ljótsson's research group

The project aims to facilitate the treatment of children with type 1 diabetes by providing parents with tools to better support their children in self-management and reduce conflicts around treatment. Parents of children aged 9–14, a period when children gradually take on more responsibility for their care but still require substantial support, participate in a six-week course based on established parenting strategies adapted to life with diabetes. Through interviews and feasibility studies, the project examines how the intervention works in practice and how it can be improved. The initial results show that the course is feasible, well received by parents, and leads to fewer conflicts and improved cooperation between children and parents. The next step is to develop a digital version to increase accessibility. The goal is for the intervention to become an important complement to medical diabetes care and, in the long term, to be adaptable to other conditions that require self-management.

Collaborators:

Charlotte Nylander, Senior Consultant in Paediatrics and Adolescent Medicine, PhD

Anna Bengtsson Strandqvist, Licensed Psychologist, PhD

Maria Lalouni, Licensed Psychologist, Associate Professor

Linda Holmström, Physiotherapist, Associate Professor

Ongoing studies:

“Challenges and facilitators in self-management routines reported by parents of children with type 1 diabetes and ADHD,” “Feasibility study of a CBT-based parent intervention to support and improve pediatric type 1 diabetes management.”

Completed projects:

None yet

Funding:

The Swedish Child Diabetes Foundation, the Swedish Diabetes Association Research Fund, the Diabetes Foundation, and ALF funding.

The project investigates the treatment of cardiac anxiety in patients who have experienced a myocardial infarction or unstable angina. Following such an event, persistent fear of physical symptoms, hypervigilance, and avoidance behaviours are common, which can lead to activity limitations, reduced functioning, and poorer quality of life.

The intervention consists of eight weeks of internet-based, exposure-based cognitive behavioural therapy (CBT), combining interoceptive exposure (deliberately inducing harmless physical sensations) with situational exposure (gradually approaching activities that have been avoided). The treatment is delivered through structured online modules and asynchronous contact with a psychologist.

The aim of the project is to investigate whether exposure-based CBT can reduce cardiac anxiety and avoidance behaviours and improve quality of life following myocardial infarction or unstable angina. The project comprises two randomised controlled trials (RCTs). The first RCT compared the treatment with usual care and showed reduced cardiac anxiety, fewer physical limitations, and improved quality of life. The ongoing study is a second RCT in which outcomes are assessed at baseline, after treatment, and at a six-month follow-up using standardised self-report measures.

Ongoing studies:

Digital cognitive behavioural therapy for cardiac anxiety following acute coronary syndrome: a randomised controlled trial comparing CBT to a digital lifestyle intervention. (Recruitment completed)

Completed projects:

Online Cognitive Behavioral Therapy Targeting Cardiac Anxiety: A randomized controlled trial

The project investigates CBT treatment for symptom preoccupation (including cardiac-related fear, hypervigilance, and avoidance behaviours) in patients with atrial fibrillation and ventricular extrasystoles. Despite adequate medical treatment, persistent symptoms and increased attention to bodily signals are common, which can lead to activity limitations, reduced functioning, and impaired quality of life.

The project comprises several pilot studies as well as two randomised controlled trials (RCTs). The intervention consists of ten weeks of internet-based cognitive behavioural therapy (CBT), combining psychoeducation, strategies for managing worry, and behavioural exercises aimed at reducing avoidance and symptom-focused attention. The treatment is intended to improve quality of life and is delivered through structured online modules with ongoing therapist support.

The results indicate that symptom preoccupation is a key factor contributing to reduced quality of life in patients with atrial fibrillation and is likely to be an important mechanism underlying treatment effects. The overall goal is to develop evidence-based and scalable psychological treatments and to facilitate their implementation within cardiac care.

Collaborators:

Professor Brjánn Ljótsson

Dr Josefin Särnholm

Professor Frieder Braunschweig

PhD students:

Björn Liliequist

Former PhD students:

Helga Skúladóttir

Ongoing studies:

Mediation analysis of treatment effects in AF-CBT – Examines whether changes in symptom preoccupation mediate improvements in atrial fibrillation-specific quality of life.

Exposure-based CBT vs. stress management for symptomatic paroxysmal atrial fibrillation – A randomised controlled trial of patients with atrial fibrillation and elevated symptom preoccupation.

Completed projects:

Symptom preoccupation in atrial fibrillation: a cross-sectional study

CBT for symptom preoccupation in premature ventricular contractions (PVCs): a pilot study

Funding:

Swedish Research Council

Swedish Heart-Lung Foundation

Region Stockholm (ALF)

Research and Development (R&D) funding, Karolinska University Hospital

Nyckelfonden