Karl Yngvar Dale

• Nobakht, Habib Niyaraq & Dale, Karl Yngvar (2019). The mediational roles of sleep disorders and nightmares in the relationship between trauma and dissociation. Dreaming (New York, N.Y.).  ISSN 1053-0797.  29(1), s 79- 90 . doi: 10.1037/drm0000095 Vis sammendrag

  The aim of this study was to test the validity of the “sleep-dissociation” perspective. In addition, and to gain a more comprehensive overview of the trauma–sleep– dissociation complex, we aimed to test in which manner and to what degree trauma sleep disorders and nightmares are related to dissociation. A total of 100 male and 100 female university students with mean age of 24 completed and returned a 160-item questionnaire designed to detect the extent of dissociation, childhood and recent trauma history, sleep disorders, and nightmares. Correlation analyses showed that sleep disorders and nightmares correlated significantly with history of childhood and recent trauma and dissociation. Findings from bootstrap- ping procedures showed that nightmares and sleep disorders, separately from each other, mediated the relationship between trauma and dissociation. However, when nightmares and sleep disorders were analyzed together in one data set, the only significant mediator was nightmares, which explained a substantial proportion of the total effect of childhood trauma on dissociation. These observations support the “sleep-dissociation” perspective on the relationship between trauma and dissociation, meaning that traumatic events might engender both sleep disturbances and nightmares, which in turn might play a pivotal role in the genesis of dissociative symptoms. The results of this study imply that trauma survivors, routinely, should be assessed and monitored with regard to sleep disorders and nightmares. Treating nightmares and, consequently, securing trauma survivors a consistent sleeping pattern and quality may play an important role in preventing the potential occurrence of dissociative symptoms. Keywords: trauma, sleep disorders, nightmares, dissociation

• Nobakht, Habib Niyaraq; Ojagh, Faeze Sadat & Dale, Karl Yngvar (2019). Risk factors of post-traumatic stress among survivors of the 2017 Iran earthquake : the importance of peritraumatic dissociation. Psychiatry Research.  ISSN 0165-1781.  271(January), s 702- 707 . doi: 10.1016/j.psychres.2018.12.057 Vis sammendrag

  The aim of this study was to explore the roles of pre-earthquake characteristics (age, gender, years of education, history of childhood and recent trauma and trait dissociation), during-the-earthquake state (peritraumatic dissociation) and post-earthquake difficulties (severity of exposure to earthquake) in post-traumatic stress among survivors of the 2017 Iran earthquake. A total number of 127 individuals in Kermanshah and 103 individuals in Sarpol-e Zahab completed and returned a 105-item questionnaire. Among these, 32 (25.2%) participants in the Kermanshah sample and 80 (77.7%) participants in the Sarpol-e Zahab sample scored equal to, or more than, the cut-off score of 33 on the Impact of Event Scale – Revised and, thus, were considered as having high likelihood of having PTSD. A three-model hierarchical linear regression analysis showed that pre-earthquake characteristics, during-the-earthquake state and post-earthquake difficulties each explained a unique variance of 11.3%, 34.4% and 14.7%, respectively, and together explained a total variance of 60.4% in post-traumatic stress. Earthquake victims who report higher degrees of peritraumatic dissociation during and immediately after the earthquake are more vulnerable to develop PTSD and should be prioritized in terms of receiving psychological interventions. Keywords: earthquake, trauma, post-traumatic stress, peritraumatic dissociation, trait dissociation

• Nobakht, Habib Niyaraq & Dale, Karl Yngvar (2018). An exploration of the roles of trauma and dissociation in mystical experiences and near-death experiences. The Journal of Spirituality in Mental Health.  ISSN 1934-9637.  20(4), s 321- 332 . doi: 10.1080/19349637.2018.1439796 Vis sammendrag

  The study aimed to corroborate the notion that mystical experiences and near-death experiences (NDE) are associated with trauma and dissociation and to test whether the prevalence of NDE is congruent across cultures. Among 100 university students who completed a 99-item questionnaire, 20 scored 7 or above on the NDE Scale. Furthermore, group comparisons showed that participants with either mystical experiences or NDE scored significantly higher than those without such experiences on all dissociative measures, but not on the trauma-related measures and absorption. The results support earlier findings implying that dissociation is a common feature in NDE and mystical experiences. Keywords: Trauma, dissociation, mystical experiences, near-death experiences, absorption

• Nobakht, Habib Niyaraq & Dale, Karl Yngvar (2018). The Importance of Religious/Ritual Abuse as a Traumatic Predictor of Dissociation. Journal of Interpersonal Violence.  ISSN 0886-2605.  33(23), s 3575- 3588 . doi: 10.1177/0886260517723747 Vis sammendrag

  This study aimed to ascertain the prevalence of different types of Religious/Ritual Abuse (RA) among Iranian young adults and to investigate the relationships between RA, childhood and recent trauma, and different patterns of dissociativity. A total of 100 male and 100 female university students completed and returned a 51-item questionnaire designed to detect the extent of dissociation, childhood and recent trauma history, and RA; 12.5% of participants reported history of RA. Pearson correlation analysis showed that RA strongly correlated with dissociativity. The most notable finding of this study is that RA and being victim of violence within the last 3 years are the most important traumatic predictors of dissociativity. More research on the nature of the relationship between RA and dissociation is suggested. Keywords: trauma, dissociation, religious abuse, ritual abuse

• Nobakht, Habib Niyaraq & Dale, Karl Yngvar (2017). The prevalence of deliberate self-harm and its relationships to trauma and dissociation among Iranian young adults. Journal of Trauma & Dissociation.  ISSN 1529-9732.  18(4), s 610- 623 . doi: 10.1080/15299732.2016.1246397 Vis sammendrag

  This study aims to investigate the prevalence of deliberate self-harm and its relationships to childhood and recent trauma and different patterns of dissociative features. A total of 100 male and 100 female college students were administered a 58-item questionnaire designed to detect the extent of dissociation, deliberate self-harm, and trauma history. Participants with deliberate self-harm behaviors reported more traumatic experiences and dissociative features than participants without such behaviors. Furthermore, the prevalence of deliberate self-harm (i.e., 40.5%) was similar to previous studies on college student populations. However, and contrary to earlier research, deliberate self-harm was significantly more prevalent among men (48%) than women (33%). The findings support the notion that trauma, pathological dissociation, and depersonalization/derealization play important functional roles in self-harm behaviors. From this perspective, it is feasible to understand individuals who engage in self-harm as either escaping from uncomfortable dissociative states or experiencing an infra-psychological conflict in which one dissociative part of the self is being abusive toward another. Keywords: deliberate self-harm, depersonalization/derealization, dissociation, trauma

• Ormbostad, Helga A.K.; Dale, Karl Yngvar; Gjengedal, Eva & Stallvik, Marianne (2017). Faktorer som virker inn ved frafall i døgnbehandling for pasienter med ruslidelser : en case-studie med vekt på både pasient- og behandlerperspektivet. Nordisk tidsskrift for helseforskning.  ISSN 1504-3614.  13(1) . doi: 10.7557/14.4076 Vis sammendrag

  Factors affecting dropout from residential treatment for patients with substance use disorders. A case study with emphasis on both patient and clinician perspectives

• Orvik, Sissel Telnes & Dale, Karl Yngvar (2017). Faglig frihet og uklare rammer : kommunale fagansattes erfaringer med psykisk helsearbeid. Tidsskrift for psykisk helsearbeid.  ISSN 1503-6707.  14(3), s 221- 231 . doi: 10.18261/issn.1504-3010-2017-03-03 Vis sammendrag

  Siden begynnelsen av 1990-tallet har flere lovendringer ført til stadig nye oppgaver for kommunalt fagansatte som arbeider med psykisk helse- og rusarbeid. Hensikten med denne studien var å undersøke hvordan slike fagpersoner erfarer sin arbeidshverdag. Det ble gjennomført semi-strukturerte intervju av syv ansatte. Tre hovedfunn skilte seg ut: 1) De fagansatte beskriver et behov for å synliggjøre og dokumentere egen identitet og praksiskompetanse, 2) de erfarer en følelse av stress og bekymring for fremtiden og med tanke på daglige oppgaver, og 3) de erfarer en stor grad av faglig frihet, glede og motivasjon i sin arbeidshverdag. Nøkkelord: psykisk helsearbeider, psykiatrisk sykepleier, kommunal, lokal, opplevelse, erfaring, samhandlingsreformen

• Eines, Trude Fløystad & Dale, Karl Yngvar (2015). Challenges in the standardization of nursing education in Europe: A literature study focusing on the implementation of qualification frameworks. Nordic journal of nursing research.  ISSN 2057-1585.  35(4), s 235- 240 . doi: 10.1177/0107408315592768 Vis sammendrag

  Two European qualification frameworks for higher education have been developed over the past decades. One of the goals of these are to promote common descriptions of learning outcomes at various levels within higher education. This article describes a) how national qualification frameworks have been perceived within bachelor nursing education, and b) the correspondence between learning outcomes and assessment methods. Evidently, a key factor for success is that the governing entities create a climate for good cooperation within and between the education institutions. However, our findings suggest that the communication between the experts and the educational institutions, who worked with the development and implementation of the national qualifications frameworks, has been far from good enough. Furthermore, there is a need to develop valid criteria for nursing competence, which in turn, could be integrated into the QFs and the NQFs. In this manner, on might secure that nursing education will uphold and meet the highest standards in all educational systems across Europe. Keywords: assessment methods, higher education, learning outcomes, nursing students, qualification frameworks

• Ulvund, Ingeborg; Dale, Karl Yngvar & Ødegård, Atle (2015). Skal – skal ikke : jordmødre og psykiatriske sykepleieres erfaringer med varsling av avvik. Nordisk tidsskrift for helseforskning.  ISSN 1504-3614.  11(2), s 86- 96 . doi: 10.7557/14.3714 Vis sammendrag

  Midwives and mental health nurses experiences with reporting adverse events

• Dale, Karl Yngvar; Ødegård, Atle; Nesje, Svanhild Villa; Iversen, Hans Petter & Bjørkly, Stål (2011). Bygge ned og bygge annerledes : endringer i psykisk helsetilbud for voksne i Nordmøre og Romsdal i lys av reduserte døgntilbud og opptrappingsplanen. Tidsskrift for psykisk helsearbeid.  ISSN 1503-6707.  8(3), s 227- 236 Vis sammendrag

  Det gis en presentasjon av seks ulike tiltak innen psykisk helsearbeid som har blitt utviklet i Nordmøre og Romsdal i den perioden Opptrappingsplanen har virket. Opptrappingsplanen la føringer for hvordan man skulle organisere tilbudene lokalt for personer med psykiske lidelser. Parallelt med denne planen har det foregått en radikal nedbygging av antall døgnplasser innen spesialisthelsetjenesten i Nordmøre og Roms- dal. Utvalget er på ingen måte fullstendig, men det utgjør eksempler på utviklingstrender innen psykisk helsearbeid som har vokst frem i brytningsfeltet mellom Opptrappingsplanens føringer, faglig nyorien- tering og organisasjonsendringer ved sentralinstitusjonen. Eksemplene omfatter kompensatoriske tiltak, tilbakefallsforebygging, profesjonalisert brukermedvirkning og interkommunalt samarbeid. Økt fokus på brukermedvirkning og mer effektivt samarbeid trekkes frem som de mest sentrale løsningene i denne overgangsperioden. Endringene synes også å representere et brudd med den etablerte sykdomsmodellen når det gjelder både hjelperelasjon og organisering av tilbud.

• Dale, Karl Yngvar; Ødegård, Atle; Tschudi, Finn; Cromwell, Rue L; Saunders, Buddy; Elden, Åke & Holte, Arne (2010). Cognitive complexity and dissociative identity disorder. Journal of constructivist psychology.  ISSN 1072-0537.  23(2), s 158- 165 . doi: 10.1080/10720530903563264 Vis sammendrag

  Thirteen patients with dissociative identity disorder (DID), 13 with other mental disorders, and 10 nondiagnosed comparison participants were given individual grids. Results showed that displaying alternate personalities did not portend a more multidimensional level of thinking. Instead, the nonclinical comparison group had the greater degree of complexity in comparison to both clinical groups. A notable clinical observation was that DID patients, as compared to non-DID participants, had a greater understanding and speed in completing the grid. Findings are discussed in terms of the advantages of personal construct theory for conceptualizing the construct of dissociation.

• Dale, Karl Yngvar; Berg, Renate; Elden, Åke; Ødegård, Atle & Holte, A (2009). Testing the diagnosis of dissociative identity disorder through measures of dissociation, absorption, hypnotizability and PTSD : a Norwegian pilot study. Journal of Trauma & Dissociation.  ISSN 1529-9732.  10(1), s 102- 112 . doi: 10.1080/15299730802488478 Vis sammendrag

  A total of 14 women meeting criteria for dissociative identity disorder (DID) based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]) were compared to a group of women (n = 10) with other dissociative diagnoses and a group of normal controls (n = 14) with regard to dissociativity, absorption, trauma related symptoms and hypnotizability. Both of the clinical groups reported histories of childhood trauma and attained high PTSD scores. The DID group differed significantly from the group with other dissociative diagnoses and the non-diagnosed comparison group with regard to hypnotizability, the variety of dissociative symptomatology, and the magnitude of dissociative symptomatology. However, no significant differences between the two clinical groups were detected with regard to absorption, general dissociative level, or symptoms related to traumatic stress. Results support the notion that DID can be regarded as a clinical entity which is separable from other dissociative disorders. Results also indicated that hypnotizability is the most important clinical feature of DID.

• Dale, Karl Yngvar; Flaten, Magne Arve; Elden, Åke & Holte, Arne (2008). Dissociative identity disorder and prepulse inhibition of the acoustic startle reflex. Neuropsychiatric Disease and Treatment.  ISSN 1176-6328.  4(3), s 653- 662 . doi: 10.2147/NDT.S3006 Fulltekst i vitenarkiv.
• Dale, Karl Yngvar (1996). Dissosiativ identitetsforstyrrelse : presentasjon av et behandlingsopplegg ved en voksenpsykiatrisk poliklinikk i Finnmark. Tidsskrift for Norsk Psykologforening.  ISSN 0332-6470.  33(11), s 1043- 1049 Vis sammendrag

  Dissociative identity disorder – a presentation of a treatment program at a psychiatric clinic in Finnmark

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• Hogset, Heidi; Berge, Dag Magne & Dale, Karl Yngvar (red.) (2018). Det regionale i det internasjonale : fjordantologien 2018. Universitetsforlaget.  ISBN 9788215031217.  401 s.

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• Dale, Karl Yngvar (2019). In case of life-limiting illness : what is most important for the public in Norway?.
• Hogset, Heidi; Berge, Dag Magne & Dale, Karl Yngvar (2018). I spenningsfeltet mellom det regionale og det internasjonale, I: Heidi Hogset; Dag Magne Berge & Karl Yngvar Dale (red.),  Det regionale i det internasjonale : fjordantologien 2018.  Universitetsforlaget.  ISBN 9788215031217.  Kapittel 1.  s 15 - 28 Vis sammendrag

  «Globalisering» er definert som ein prosess som fører til auka integrering på tvers av landegrensar. Artiklane i denne antologien tematiserar korleis denne prosessen påverkar lokale og regionale tilhøve i Norge. Prosessen kan karakteriserast med omgrepet «glokalisering», som femnar at globalisering er ein prosess som skjer i interaksjon mellom globale og lokale prosessar. Bidraga representerar eit breitt fagleg mangfald. Nøkkelord: internasjonalisering, glokalisering, kommunikasjon, integrering, outsourcing

• Karlsen, Lillian; Driller, Bardo; Dale, Karl Yngvar; Brenne, Anne-Tove & Knudsen, Anne Kari (2018). Where would you prefer to die? : answers from general public and advanced cancer patients in Mid-Norway.
• Rønning, Solrun Brenk; Hoemsnes, Helene; Solheim, Inger Helen; Orøy, Aud Jorun & Dale, Karl Yngvar (2018). Kan økt kompetanse imøtekomme behov i regionen?. Åndalsnes Avis.  s 12
• Rønning, Solrun Brenk; Hoemsnes, Helene; Solheim, Inger Helen; Orøy, Aud Jorun & Dale, Karl Yngvar (2018). Kan økt kompetanse imøtekomme behov i regionen?. Tidens Krav.  s 22
• Rønning, Solrun Brenk; Hoemsnes, Helene; Solheim, Inger Helen; Orøy, Aud Jorun & Dale, Karl Yngvar (2018). Kan økt kompetanse imøtekomme behov i regionen? : nasjonale føringer for kompetanse innen helse- sosial og velferdstjenester er tydelige. Romsdals Budstikke..  ISSN 0806-5160.  s 40
• Fluttert, Frans A. J.; Eidhammer, Gunnar; Friestad, Christine; Dale, Karl Yngvar; Bjørkly, Stål & Rustad, Åse-Bente L (2015). The Early Recognition Method used to identify precursors of aggression in prisoner.
• Fluttert, Frans A. J.; Eidhammer, Gunnar; Friestad, Christine; Dale, Karl Yngvar; Bjørkly, Stål & Rustad, Åse-Bente L (2015). The Early Recognition Method used to identify precursors of aggression in prisoner, In Patrick Callaghan; Nico Oud; Johan Håkon Bjørngaard; Henk Nijman; Tom Palmstierna & Joy Duxbury (ed.),  Violence in Clinical Psychiatry : Proceedings of the 9th European Congress on Violence in Clinical Psychiatry, 22 – 24 October 2015 Crowne Plaza Copenhagen Towers.  Kavanah, Dwingeloo & Oud Consultancy.  ISBN 978-90-574-0144-2.  Konferanseabstract i rapport.  s 313 - 314
• Dale, Karl Yngvar (2014). Traumatic stress, personality and psychobiological health : conceptualizations and research findings. Arbeidsnotat (Høgskolen i Molde - Vitenskapelig høgskole i logistikk). 2014:6.
• Dale, Karl Yngvar & Ødegård, Atle (2014). Examining the Construct of Dissociation within the Framework of G-theory. Arbeidsnotat (Høgskolen i Molde - Vitenskapelig høgskole i logistikk). 2014:4.
• Dale, Karl Yngvar (2013). Ambulante team i Møre og Romsdal innen psykisk helse-feltet : en kvalitativ studie med fokus på praktiske og kliniske tilpasninger, innovative løsninger og samarbeidsrelasjoner : foreløpig prosjektrapport. Arbeidsnotat (Høgskolen i Molde). 2013:9.
• Dale, Karl Yngvar; Driller, Bardo; Jørgensen, Else; Nygård, Linda Kornstad & Strømskag, Kjell Erik (2013). Integrasjon av praksis, undervisning og forskning : hvordan kan man sikre høyest mulig kvalitet innen omsorg og behandling av alvorlig syke og døende på kommunalt nivå?. Arbeidsnotat (Høgskolen i Molde). 2013:8. Vis sammendrag

  Det sentrale spørsmålet vi stiller er: Hvordan kan praksis, undervisning og forskning samarbeide for å legge til rette for ”best practice” innen det palliative feltet. “Best practice” er beskrevet gjennom nasjonale retningslinjer og faglige ”gullstandarder”. Her vil vi fremholde at mye avhenger dels av et godt tilrettelagt utdanningssystem, dels et godt faglig samarbeid mellom helseforetak, det kommunale praksisfeltet og utdanningsinstitusjon, og sist men ikke minst: At alle disse instanser kan inngå i et tett og gjensidig utviklende forskningssamarbeid. Vi vil argumentere for at dette gir den beste muligheten for å sikre høyest mulig kvalitet i det palliative feltet, herunder at man evner å etablere en forskningsbasert praksis som også er i tråd med nasjonale retningslinjer. I artikkelen belyses dette gjennom et case.

• Dale, Karl Yngvar (2011). Videreutdanning i psykisk helsearbeid.
• Sun, Hao; Berg, Jens Petter & Dale, Karl Yngvar (2011). Balansering av undervisning og egenlæring, I: Gerd Bjørke; André Alfredsen; Trond Ålvik & Anne Skumsnes (red.),  Blikk inn i høgskolepedagogisk virksomhet : utdrag fra rapporter fra miniprosjekter ved "Program for pedagogisk basiskompetanse", Grunnmodulen, 2008-2010.  Høgskolen i Oslo.  ISBN 978-82-579-4758-3.  Kapittel.  s 26 - 31 Vis sammendrag

  Kapittelet er delvis skrevet på engelsk

• Dale, Karl Yngvar (2008). Out of mind - out of sight : studies on clinical and psychophysiological characteristics of dissociative identity disorder. Vis sammendrag

  Dissociative identity disorder (DID; APA, 1994), previously labeled Multiple personality (APA, 1980) and Multiple Personality Disorder (APA, 1987), has good diagnostic validity (Gleaves, May, & Cardeña, 2001) and is supported by taxometric research, whereby two types of dissociation have been identified: Pathological dissociation, whose features are consistent with DID, and nonpathological dissociation (Waller, Putnam, & Carlson, 1996). On these grounds, we aimed to contribute to a further validation of the construct of DID by (1) testing to which extent DID may be separated from other dissociative disorders on a series of clinical and psychophysiological measures, and (2) exploring the characteristics of DID within the framework of Personal construct theory. 14 persons with DID were compared with persons with other dissociative disorders, and non‐clinical comparison participants with regard to severity of PTSD related features, dissociative functioning, hypnotizability (Paper I), and prepulse inhibition (PPI) of the acoustic startle eye‐blink reflex (Paper II). Persons with DID had reduced habituation of startle reflexes and increased PPI, compared to non‐DID participants. These data suggest the operation of an aberrant voluntary attentional processes in the face of unpleasant and threatening stimuli, and this may be a defining characteristic in DID. This finding supports the notion that DID is a separate clinical and nosological entity (Gleaves et al., 2001; Waller et al., 1996). Results also showed that persons with DID differed significantly from persons with other dissociative disorders with regard to the complexity and magnitude of dissociative symptomatology, and with regard to hypnotizability. These results are also indicative of DID being a separate clinical entity, qualitatively different from other dissociative disorders (Gleaves et al., 2001; Waller et al., 1996). As expected, histories of childhood sexual and physical assault were reported among persons with DID and persons with other dissociative disorders and both these groups attained high PTSD scores. Although the clinical groups did not differ significantly with regard to scores of current and lifetime PTSD, some differences were observable with regard to the type and occurrence of abuse, with, e.g., a higher percentage of the DID group having experienced sexual assault by a close relative during childhood compared to the group with other dissociative disorders. This is consistent with findings that DID is linked to the nature of the assault and to the relationship between the victim and the perpetrator (Boon & Drajer, 1993). In a design involving test technology developed within the framework of Personal construct theory (Kelly, 1955), 13 persons with DID were compared to persons with other clinical conditions and non‐diagnosed comparison participants with regard to cognitive complexity (Paper III). Contrary to expectations, results showed that displaying alternate personalities does not imply a more multidimensional level of thinking. However, persons with DID seemed to have a more advanced social skill in role thinking and role conceptualization, in comparison with non‐dissociative persons. The results have important implications for the identification, treatment, and understanding of DID.

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