{"id":6348,"date":"2026-10-19T09:48:48","date_gmt":"2026-10-19T09:48:48","guid":{"rendered":"https:\/\/phd.hi.is\/doktorsvorn\/doktorsvorn-i-heilbrigdisvisindum-magnus-blondahl-sighvatsson\/"},"modified":"2026-10-19T09:48:48","modified_gmt":"2026-10-19T09:48:48","slug":"doktorsvorn-i-heilbrigdisvisindum-magnus-blondahl-sighvatsson","status":"publish","type":"phd_defence","link":"https:\/\/phd.hi.is\/en\/doktorsvorn\/doktorsvorn-i-heilbrigdisvisindum-magnus-blondahl-sighvatsson\/","title":{"rendered":"Doktorsv\u00f6rn \u00ed heilbrig\u00f0isv\u00edsindum – Magn\u00fas Bl\u00f6ndahl Sighvatsson"},"content":{"rendered":"
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M\u00e1nudaginn 22. ma\u00ed 2023 ver Magn\u00fas Bl\u00f6ndahl Sighvatsson s\u00e1lfr\u00e6\u00f0ingur doktorsritger\u00f0 s\u00edna \u00ed heilbrig\u00f0isv\u00edsindum vi\u00f0 L\u00e6knadeild H\u00e1sk\u00f3la \u00cdslands. Ritger\u00f0in ber heiti\u00f0: Virkir \u00fe\u00e6ttir \u00ed \u00f3s\u00e9rt\u00e6kri hugr\u00e6nni atferlisme\u00f0fer\u00f0 vi\u00f0 kv\u00ed\u00f0a og \u00feunglyndi. Mechanisms of change in transdiagnostic cognitive behaviour therapy for anxiety and depression.<\/strong><\/p>\n

Andm\u00e6lendur eru dr. Robert DeRubeis, pr\u00f3fessor og forst\u00f6\u00f0uma\u00f0ur kl\u00edn\u00edskrar \u00fej\u00e1lfunar vi\u00f0 H\u00e1sk\u00f3lann \u00ed Pennsylvania \u00ed Bandar\u00edkjunum, og dr. Glenn Waller, pr\u00f3fessor vi\u00f0 H\u00e1sk\u00f3lann \u00ed Sheffield \u00ed Englandi.<\/p>\n

Umsj\u00f3narkennari og lei\u00f0beinandi var dr. J\u00f3n Fri\u00f0rik Sigur\u00f0sson, pr\u00f3fessor emeritus vi\u00f0 L\u00e6knadeild H\u00e1sk\u00f3la \u00cdslands og S\u00e1lfr\u00e6\u00f0ideild H\u00e1sk\u00f3lans \u00ed Reykjav\u00edk. Me\u00f0lei\u00f0beinandi var dr. Paul M. Salkovskis, pr\u00f3fessor vi\u00f0 Oxford-h\u00e1sk\u00f3la. Auk \u00feeirra s\u00e1tu \u00ed doktorsnefnd Engilbert Sigur\u00f0sson, Fanney \u00de\u00f3risd\u00f3ttir og Hei\u00f0d\u00eds B. Valdimarsd\u00f3ttir.<\/p>\n

Dr. \u00de\u00f3rarinn Gu\u00f0j\u00f3nsson, pr\u00f3fessor og deildarforseti L\u00e6knadeildar, stj\u00f3rnar ath\u00f6fninni sem fer fram \u00ed H\u00e1t\u00ed\u00f0asal H\u00e1sk\u00f3la \u00cdslands og hefst kl. 13.00.<\/p>\n

\u00c1grip<\/strong><\/p>\n

Bakgrunnur: <\/strong>Virkir \u00fe\u00e6ttir \u00ed \u00f3s\u00e9rt\u00e6kri hugr\u00e6nni atferlisme\u00f0fer\u00f0 (\u00d3HAM) eru l\u00edti\u00f0 rannsaka\u00f0ir. \u00der\u00e1tt fyrir \u00feetta er \u00d3HAM gagnreynd me\u00f0fer\u00f0 vi\u00f0 algengum tilfinningavanda og \u00ed sumum tilfellum jafn gagnleg og s\u00e9rt\u00e6k HAM. Spurningar hafa \u00fev\u00ed vakna\u00f0 um virka \u00fe\u00e6tti \u00feessara \u00f3l\u00edku me\u00f0fer\u00f0a. Salkovskis (1996) kom me\u00f0 \u00fe\u00e1 tilg\u00e1tu a\u00f0 virkur \u00fe\u00e1ttur \u00ed \u00d3HAM s\u00e9 a\u00f0 kenna skj\u00f3lst\u00e6\u00f0ingi a\u00f0ra l\u00edklegri, sveigjanlegri og raunh\u00e6fari sk\u00fdringu \u00e1 tilfinningavanda vi\u00f0komandi (\u201ckenning B\u201d) en \u00fe\u00e1 neikv\u00e6\u00f0u, \u00f3hj\u00e1lplegu og \u00f3sveigjanlegu sk\u00fdringu sem skj\u00f3lst\u00e6\u00f0ingur hefur \u00feegar hann kemur til me\u00f0fer\u00f0ar (\u201ckenning A\u201d). Salkovskis nefndi \u00feennan feril sem breytingu \u00e1 tiltr\u00fa fr\u00e1 \u201ckenningu A\u201d til \u201ckenningu B\u201d. Markmi\u00f0 \u00feessa doktorsverkefnis var a\u00f0 kanna tilg\u00e1tu Salkovskis og nota \u00ferj\u00e1r \u00f3l\u00edkar ranns\u00f3knara\u00f0fer\u00f0ir til \u00feess.<\/p>\n

A\u00f0fer\u00f0: <\/strong>\u00cd ranns\u00f3kn I voru 24 \u00fe\u00e1tttakendur me\u00f0 kv\u00ed\u00f0a og\/e\u00f0a \u00feunglyndi \u00far n\u00fdlegri \u00e1rangursranns\u00f3kn. \u00deeim var skipt \u00ed tvo h\u00f3pa eftir \u00fev\u00ed hvort me\u00f0fer\u00f0in var \u00e1rangursr\u00edk e\u00f0a ekki, til a\u00f0 meta hvort mismunandi skilningur tengdist \u00e1rangri. \u00de\u00e1tttakendur voru teknir \u00ed vi\u00f0tal og \u00deema-rammagreining notu\u00f0 til a\u00f0 greina vi\u00f0t\u00f6lin. \u00cd ranns\u00f3kn II var margf\u00f6ldu grunnl\u00ednusni\u00f0i beitt til a\u00f0 meta \u00e1rangur frum\u00fatg\u00e1fu \u00d3HAM (bygg\u00f0a \u00e1 kenningu Salkovskis) hj\u00e1 \u00ferett\u00e1n einstaklingum me\u00f0 fj\u00f6l\u00fe\u00e6ttan tilfinningavanda. \u00cd ranns\u00f3kn III voru tv\u00e6r \u00fatg\u00e1fur sj\u00e1lfsmatskvar\u00f0a \u00fer\u00f3a\u00f0ar til a\u00f0 meta hversu nau\u00f0synleg og mikilv\u00e6g me\u00f0fer\u00f0ara\u00f0ilar t\u00f6ldu mismunandi inngrip vera \u00ed \u00e1rangri s\u00e1lfr\u00e6\u00f0ilegrar me\u00f0fer\u00f0ar. Sv\u00f6rum 233 me\u00f0fer\u00f0ara\u00f0ila var safna\u00f0.<\/p>\n

Ni\u00f0urst\u00f6\u00f0ur: <\/strong>\u00cd ranns\u00f3kn I greindust fj\u00f6gur yfir\u00feemu og \u00e1tj\u00e1n undir\u00feemu sem tengdust \u00e1rangri me\u00f0fer\u00f0ar en fj\u00f6gur af \u00e1tj\u00e1n undir\u00feemum voru \u00f3l\u00edk milli h\u00f3panna. \u00cd ranns\u00f3kn II var \u00d3HAM gagnleg fyrir \u00e1tta \u00fe\u00e1tttakendur. Ni\u00f0urst\u00f6\u00f0ur voru \u00fe\u00f3 breytilegar eftir \u00fev\u00ed hva\u00f0a \u00e1reiti var meti\u00f0 neikv\u00e6tt e\u00f0a \u00f3gnv\u00e6nlegt. Stig og stefna \u00ed mati \u00e1 tiltr\u00fa \u00e1 \u201ckenningu A\u201d fylgdu stigi og stefnu einkennam\u00e6linga mun meira heldur en \u00f6fug stig og stefna \u00ed mati \u00e1 tiltr\u00fa \u00e1 \u201ckenningu B\u201d. \u00cd ranns\u00f3kn III voru pr\u00f3ffr\u00e6\u00f0ilegir eiginleikar listanna tveggja g\u00f3\u00f0ir. Inngrip sem eru s\u00e9rt\u00e6k fyrir HAM voru metin mikilv\u00e6gari og nau\u00f0synlegri samanbori\u00f0 vi\u00f0 \u00f6nnur inngrip.<\/p>\n

\u00c1lyktanir: <\/strong>\u00a0\u00dea\u00f0 \u00feema sem helst greindi \u00e1 milli h\u00f3panna \u00ed ranns\u00f3kn I var hugr\u00e6nn sveigjanleiki og s\u00e9rstaklega \u00fear sem me\u00f0fer\u00f0in var \u00e1rangursr\u00edk. Ni\u00f0urst\u00f6\u00f0ur ranns\u00f3knar II benda til a\u00f0 \u00d3HAM sem bygg\u00f0 er \u00e1 virkum \u00fe\u00e6tti \u00fear sem einstaklingum er kennt s\u00e9rstaklega a\u00f0 breyta um tiltr\u00fa fr\u00e1 \u201ckenningu A\u201d a\u00f0 \u201ckenningu B\u201d s\u00e9 \u00e1rangursr\u00edk. \u00cd ranns\u00f3kn III voru inngrip sem metin voru HAM s\u00e9rt\u00e6k einkennandi fyrir \u00e1rangursr\u00edka me\u00f0fer\u00f0. Ni\u00f0urst\u00f6\u00f0ur \u00feessa doktorsverkefnis benda til a\u00f0 virkur \u00fe\u00e1ttur \u00ed \u00d3HAM s\u00e9 f\u00f3lginn \u00ed \u00fev\u00ed a\u00f0 kenna skj\u00f3lst\u00e6\u00f0ingi a\u00f0ra l\u00edklegri, sveigjanlegri og raunh\u00e6fari sk\u00fdringu \u00e1 tilfinningavanda vi\u00f0komandi en \u00fe\u00e1 neikv\u00e6\u00f0u, \u00f3hj\u00e1lplegu og \u00f3sveigjanlegu sk\u00fdringu sem skj\u00f3lst\u00e6\u00f0ingur hefur \u00feegar hann kemur til me\u00f0fer\u00f0ar. Mikilv\u00e6gt er a\u00f0 \u201ckenning B\u201d s\u00e9 bygg\u00f0 \u00e1 vinnugreiningu um tilfinningavandam\u00e1l skj\u00f3lst\u00e6\u00f0ings sem og sameiginlegum skilningi skj\u00f3lst\u00e6\u00f0ings og me\u00f0fer\u00f0ara\u00f0ila.<\/p>\n

English abstract<\/strong><\/p>\n

Background:<\/strong> Transdiagnostic mechanisms of change (txMOC) in cognitive behaviour therapy (CBT) are seldom studied. Despite this omission, transdiagnostic CBT (txCBT) is established as effective for prevalent mental health problems and equally effective as disorder specific CBT. Therefore, questions have been raised as to what mechanisms might be responsible for the treatment change. Salkovskis (1996) proposed a txMOC which involves the shift from inflexibly held negative or threat-based beliefs towards alternative, less negative and flexible understanding of their problems, referred to as the belief shifting from \u201ctheory A\u201d to \u201ctheory B\u201d. Aims of this thesis was to evaluate Salkovskis\u2019 proposed mechanism with three different research strategies.<\/p>\n

Method: <\/strong>In study I, a sample of 24 participants suffering from anxiety and\/or depression was divided into two groups according to treatment efficacy, to evaluate whether different understandings were associated with the efficacy of treatment. Participants were interviewed and Thematic Framework Analysis used to analyse the data. In study II a non-concurrent multiple baseline design was used to evaluate the effectiveness of an adapted txCBT based on Salkovskis hypothesis, with thirteen participants suffering from diverse mental health problems. In study III two versions of a self-report questionnaire were developed to assess how necessary and how important therapists evaluated different interventions were in bringing about treatment change. In total, 233 therapists were recruited.<\/p>\n

Results: <\/strong>In study I, four overarching themes and eighteen subthemes associated with treatments\u2019 efficacy were identified but four of the eighteen subthemes were different between the groups. In study II the txCBT was clearly effective for eight participants. The results varied dependent on the stimuli evaluated as negative or threatening. Level and trend of the ratings of belief in \u201ctheory A\u201d followed the level and trend of symptom measures to a greater extent than the (inverse) level and trend of belief in \u201ctheory B\u201d. In study III psychometric properties of the instruments were evaluated as sufficient. Interventions summarized on sub-scales as CBT specific were evaluated more highly relative to other interventions on both versions of the measure.<\/p>\n

Conclusions: <\/strong>In study I, the most important between group difference, was cognitive flexibility. In study II the data indicate that effective treatment involves the txMOC where individuals with common mental health are taught to shift beliefs from a prior fixed negative view of their environment and experiences to a less negative psychologically focused alternative. Study III interventions characterized as CBT-specific were more strongly endorsed relative to other interventions. The results of this thesis indicate that treatment change may be facilitated by txMOC involving the shift from fixed negative or threatening views of situations to alternative, more flexible and less negative view.\u00a0 Such an alternative can be based on formulation and shared understanding of the person\u2019s mental health problems (\u201ctheory B\u201d).<\/p>\n

Um doktorsefni\u00f0<\/strong><\/p>\n

Magn\u00fas Bl\u00f6ndahl Sighvatsson er f\u00e6ddur \u00e1ri\u00f0 1977 \u00ed Reykjav\u00edk. Hann lauk st\u00fadentspr\u00f3fi af n\u00e1tt\u00farufr\u00e6\u00f0ibraut Menntask\u00f3lans \u00ed Reykjav\u00edk \u00e1ri\u00f0 1997. Hann lauk BA-pr\u00f3fi \u00ed s\u00e1lfr\u00e6\u00f0i fr\u00e1 H\u00e1sk\u00f3la \u00cdslands \u00e1ri\u00f0 2001 og MA-pr\u00f3fi \u00ed s\u00e1lfr\u00e6\u00f0i fr\u00e1 sama sk\u00f3la \u00e1ri\u00f0 2006. \u00c1rin 2006-2016 starfa\u00f0i Magn\u00fas sem s\u00e1lfr\u00e6\u00f0ingur \u00e1 Landsp\u00edtala, b\u00e6\u00f0i \u00e1 innlagnadeild og \u00e1 g\u00f6ngudeild. Fr\u00e1 \u00e1rinu 2007 hefur Magn\u00fas starfa\u00f0 sem sj\u00e1lfst\u00e6tt starfandi s\u00e1lfr\u00e6\u00f0ingur og reki\u00f0 eigin s\u00e1lfr\u00e6\u00f0istofu. Fr\u00e1 \u00e1rinu 2007 hefur Magn\u00fas veri\u00f0 stundakennari vi\u00f0 H\u00e1sk\u00f3la \u00cdslands og fr\u00e1 \u00e1rinu 2013 vi\u00f0 H\u00e1sk\u00f3lann \u00ed Reykjav\u00edk. Magn\u00fas var skipa\u00f0ur kl\u00edn\u00edskur lektor vi\u00f0 S\u00e1lfr\u00e6\u00f0ideild H\u00e1sk\u00f3la \u00cdslands \u00e1ri\u00f0 2017. Foreldrar Magn\u00fasar eru Sighvatur Bl\u00f6ndahl og S\u00f3lveig A\u00f0alsteinsd\u00f3ttir. Magn\u00fas er giftur Au\u00f0i Eir\u00edksd\u00f3ttur s\u00e1lfr\u00e6\u00f0ingi og doktorsnema og eiga \u00feau tv\u00e6r d\u00e6tur, B\u00e1ru og S\u00f3lveigu.<\/p>\n<\/div><\/div>","protected":false},"featured_media":5651,"template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_phd_date_start":"2023-05-22T13:00:00+00:00","_phd_date_end":"2023-05-22T16:00:00+00:00","_phd_location":"A\u00f0albygging H\u00e1t\u00ed\u00f0asalur","_phd_admission":"A\u00f0gangur \u00f3keypis","_phd_thesis_title":"Virkir \u00fe\u00e6ttir \u00ed \u00f3s\u00e9rt\u00e6kri hugr\u00e6nni atferlisme\u00f0fer\u00f0 vi\u00f0 kv\u00ed\u00f0a og \u00feunglyndi. 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