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Gustafsson, Per E
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Publications (9 of 9) Show all publications
Allansson, E., Gustafsson, P. E., Gustafsson, P. & Nelson, N. (2014). Overweight and obese children have lower cortisol levels than normal weight children. Acta Paediatrica, 103(3), 295-299
Open this publication in new window or tab >>Overweight and obese children have lower cortisol levels than normal weight children
2014 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 3, p. 295-299Article in journal (Refereed) Published
Abstract [en]

AimThe stress hormone cortisol is vital to survival, and a disturbed circadian rhythm can be deleterious to health. However, little is known about cortisol levels in healthy children. The aim of this study was to examine cortisol levels in relation to body mass index (BMI), age and sex. MethodsSalivary samples were collected in early morning, late morning and evening, on four consecutive days, from 342 children aged 6-12years using Salivette((R)) tubes. Samples were analysed using a commercial enzyme immunoassay (EIA). School nurses measured the childrens height and weight, and these measurements were used to calculate their BMI. ResultsThe children displayed a circadian rhythm in cortisol secretion, with morning zeniths and evening nadirs. Average cortisol levels in early morning, late morning and evening were significantly lower in overweight and obese children than in their normal weight counterparts. Cortisol levels did not vary significantly with age or sex. ConclusionOur findings may suggest cortisol suppression in overweight and obese children. We found no evidence that sex or age influences cortisol levels. These findings highlight the need for further research on the relationship between stress and obesity in children.

Place, publisher, year, edition, pages
Wiley, 2014
Keywords
Body mass index; child; circadian rhythm; cortisol; obesity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-105742 (URN)10.1111/apa.12499 (DOI)000331270000024 ()
Available from: 2014-04-07 Created: 2014-04-04 Last updated: 2017-12-05
Nilsson, D., Gustafsson, P. E. & Svedin, C. G. (2012). The psychometric properties of the Trauma Symptom Checklist for Young Children in a sample of Swedish children. European Journal of Psychotraumatology, 3, Article ID 18505.
Open this publication in new window or tab >>The psychometric properties of the Trauma Symptom Checklist for Young Children in a sample of Swedish children
2012 (English)In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 3, article id 18505Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate the psychometric properties of the Swedish version of Trauma Symptom Checklist for Young Children (TSCYC).

Method: The study was composed of a total of 629 children - 296 girls and 333 boys - aged 311, from a nonclinical population who were rated by their caretakers (26 of whom performed a re-test after 2 weeks) in addition to 59 children from a clinical population with known experience of sexual and/or physical abuse. The caretakers from the normal population completed the TSCYC and Lifetime Incidence of Traumatic Events Scale-parent scale (LITE-P) and the clinical-sample caretakers completed TSCYC. The psychometric properties of the TSCYC were examined, including reliability and validity.

Results: The reliability (Cronbach’s alpha) of the TSCYC, total scale, was α=0.93 (normative group) and α=0.96 (clinical group). For the clinical scales, this ranged between α=0.550.88 and 0.770.93, respectively. Test-retest for the total scale was r0.77. Regarding criterion-related validity, the clinical groups scored significantly higher than the normative group, and within the normative group significant relationships were found between exposure to traumatic events and TSCYC scores. Confirmatory factor analysis testing of the construction of the TSCYC indicated significant loadings on the original scales.

Conclusion: The Swedish version of TSCYC appears to be a screening instrument with satisfactory psychometric qualities for identifying symptoms after trauma in young children. The instrument can also be recommended to clinicians for screening purposes in a European context.

Abstract [sv]

Syftet med studien har varit att utvärdera och undersöka de psykometriska egenskaperna av den svenska versionen av Trauma Symptom Checklist for Young Children (TSCYC). TSCYC är ett formulär utvecklat av John Briere (2001,2005), det är ett formulär för föräldrar och vårdnadshavare som avser att identifiera mindre barns symptom som de kan uppvisa efter en eller flera potentiellt traumatisk a händelser. TSCYC består av 90 frågor och tar ca 15-20 minuter att fylla i. Formuläret består av åtta kliniska skalor vilka avser att mäta ångest, depression, ilska, posttraumatisk stress-undvikande, posttraumatisk stress- överspändhet, posttraumatisk stress- inträngande, dissociation samt sexuell upptagenhet. Dessutom en sammanlagd skala av de tre ptsd-skalorna samt två validitets skalor som mäter svarsnivå samt atypiska svar. De två sistnämnda för att få se om individen eventuellt underrapporterar respektive överrapporterar. TSCYC är ett brett instrument som inte bara mäter ptsd symptom då man vet att barn även kan uppvisa andra symptom efter traumatiska händelser. Således ett formulär som identifierar flera möjliga symptom vilket underlättar för både den som fyller i och för klinikern. För att klinikern ska kunna rätt värdera de skattningar föräldern till det traumatiserade barnet ger är det nödvändigt att det även finns data från normativa grupper att jämföra med.

Metod: I studien deltog totalt 629 barn- 296 flickor och 333 pojkar i åldern 3-11, från en icke-klinisk population. Barnens skattades av sina föräldrar/vårdnadsgivare (varav 26 utförde en re-test efter 2 veckor), dessutom deltog 59 barn från en klinisk population med tidigare erfarenhet av att ha blivit sexuellt utnyttjade och/ eller fysiskt misshandlade. Vårdnadshavarna från normalpopulationen fick fylla i TSCYC och Life Incidence of Traumatic Events Scale-föräldraversion (LITE-P) och den kliniska populationen fick fylla i TSCYC. De psykometriska egenskaperna, såsom reliabilitet och validitet, undersöktes.

Resultat: Reliabiliteten (Cronbach’s alpha) av totalskalan på TSCYC varα= 0.93 (normativa gruppen) och α=0.96 (kliniska gruppen). För de kliniska skalorna varieradeα mellan 0.55-0.88 respektive 0.77-0.93 för de två grupperna. Test-retest för total skalan var r=0.77. När det gäller kriterierelaterad validitet, så skattades den kliniska gruppen signifikant högre än den normativa gruppen på samtliga delskalor och totalt och inom den normativa gruppen fanns ett signifikant samband mellan erfarenhet av potentiellt traumatiska händelser och högre TSCYC poäng. En konfirmatorisk faktoranalys genomfördes för att ytterligare testa konstruktionen bakom TSCYC; denna analys gav signifikanta laddningar på de olika kliniska skalorna som ingår i TSCYC.

Konklusion: Den svenska versionen av TSCYC verkar vara ett screeninginstrument med tillfredställande psykometriska kvaliterer för att kunna identifiera symptom efter traumatiska händelser hos mindre barn. Instrumentet kan rekommenderas för forskning och klinisk screening även i ett Europeiskt sammanhang.

Place, publisher, year, edition, pages
Järfälla, Sweden: Co-Action Publishing, 2012
Keywords
post-traumatic stress, young children, assessment, trauma, TSCYC
National Category
Psychiatry
Identifiers
urn:nbn:se:liu:diva-79852 (URN)10.3402/ejpt.v3i0.18505 (DOI)000208868400023 ()
Available from: 2012-08-14 Created: 2012-08-14 Last updated: 2017-12-07Bibliographically approved
Gustafsson, P. E., Nelson, N. & Gustafsson, P. A. (2010). Diurnal cortisol levels, psychiatric symptoms and sense of coherence in abused adolescents. Nordic Journal of Psychiatry, 64(1), 27-31
Open this publication in new window or tab >>Diurnal cortisol levels, psychiatric symptoms and sense of coherence in abused adolescents
2010 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 64, no 1, p. 27-31Article in journal (Refereed) Published
Abstract [en]

Background. The role of the HPA axis in psychiatric disorders following trauma is poorly studied and most studies have been done on adults. Aims. To investigate the association of mental well-being and diurnal cortisol in abused adolescents. Methods. The present crosssectional study examined diurnal salivary cortisol (measured three times a day during three days) in relation to psychiatric symptoms (Trauma Symptoms Checklist for Children) and the salutogenic construct “Sense of coherence”, in fifteen adolescents exposed to childhood abuse. Results. Significant positive correlations were found between symptoms and sense of coherence versus early and late morning cortisol concentrations. The correlations were most consistent for internalizing and externalizing symptoms, and somewhat less for post-traumatic symptoms and sense of coherence. In contrast, evening cortisol did not correlate with any of the psychological measures. Conclusion. These results extend previous research findings by pointing towards a relation between symptoms and higher morning cortisol and accentuated diurnal cortisol variation in abused adolescent as opposed to lower basal cortisol and a flattening of the cortisol rhythm repeatedly observed in traumatized adults.

Keywords
Adolescents, Childhood Abuse, Cortisol, Psychiatric Symptoms, Sense of Coherence
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-15683 (URN)10.3109/08039480903265314 (DOI)000273780200005 ()
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2017-12-14
Nilsson, D., Gustafsson, P. E. & Goran Svedin, C. (2010). Self-reported potentially traumatic life events and symptoms of post-traumatic stress and dissociation. NORDIC JOURNAL OF PSYCHIATRY, 64(1), 19-26
Open this publication in new window or tab >>Self-reported potentially traumatic life events and symptoms of post-traumatic stress and dissociation
2010 (English)In: NORDIC JOURNAL OF PSYCHIATRY, ISSN 0803-9488, Vol. 64, no 1, p. 19-26Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate single potentially traumatic events and cumulative effects of these events based on the reported symptoms of post-traumatic stress and dissociation. An additional goal was to evaluate the psychometric properties of Life Incidence of Traumatic Events-Student scale (LITE-S). Methods: 400 adolescents from the normative population answered the questionnaire Life Incidence of Traumatic Experiences (LITE-S) together with Trauma Symptom Checklist for Children (TSCC), Dissociation-Questionnaire-Sweden (Dis-Q-Sweden) and Adolescent-Dissociative Experience Scale (A-DES). The single self-reported traumas, and the cumulative self-reported traumas and their effects on post-traumatic stress disorder and dissociative symptoms scales were examined. The psychometric properties of LITE-S were first investigated through calculating, test-retest reliability by Pearson correlation for the total scale and by Cohens kappa item per item. Results: Self-reported symptoms were related to both the cumulative traumas and exposure to some single traumas, such as seeing somebody get hurt, having parents destroy things or hurting each other, being whipped or hit, or even being made to carry out some kind of sexual act. Interpersonal events were consistently more strongly related to symptoms across the TSCC clinical scales. Finally, test-retest reliability as found to be for the total scale r = 0.76 and kappa item per item ranging between k = 0.33 and 0.86. Conclusion: The cumulative effects of potentially traumatic events on adolescents are significant, and interpersonal traumas results in more self-reported symptoms of post-traumatic stress and dissociation than non-interpersonal. LITE has satisfactory psychometric properties concerning reliability. Clinical implications: The results underline the importance in clinical practice of taking into consideration how many potentially traumatic events an adolescent has experienced before, seeking help on specific occasion. This knowledge can help the clinician to understand better the breadth of feelings their client is experiencing and thus can help the clinician better to be able to suggest appropriate treatment.

Keywords
Adolescents, Dissociation, Post-traumatic stress, Traumatic life events
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-53815 (URN)10.3109/08039480903264846 (DOI)000273780200004 ()
Available from: 2010-02-05 Created: 2010-02-05 Last updated: 2010-02-05
Gustafsson, P. E., Nilsson, D. & Svedin, C. G. (2009). Polytraumatization and Psychological Symptoms in Children and Adolescents. European Child and Adolescent Psychiatry, 18(5), 274-283
Open this publication in new window or tab >>Polytraumatization and Psychological Symptoms in Children and Adolescents
2009 (English)In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 18, no 5, p. 274-283Article in journal (Refereed) Published
Abstract [en]

Previous research on the impact of traumatic experiences in children and adolescents has focused almost entirely on the effect of single trauma. Research on cumulative traumas been lacking, but Finkelhor (2007) has recently directed the attention to the concept of polyvictimization. As an extension of this concept, this study examined the impact of polytraumatization, operationalized as the number of different potentially traumatic events. The study population comprised two cross-sectional samples of school-aged children (n = 270) and adolescents (n = 400). Information of life-time incidence of traumatic events was collected by the Life Incidence of Traumatic Events (LITE), and psychological symptoms by the parent version of the Strengths and Difficulties Questionnaire (SDQ) for the school children and the self-report Trauma Symptom Checklist for Children (TSCC) for the adolescents. We found that exposure to at least one traumatic event was common in both the samples (63% of the children and 89.5% of the adolescents). The number of different traumatic events, polytraumatization, was highly predictive of symptoms in both samples, and with a few exceptions surpassed the impact of specific events in exploratory analyses. We furthermore replicated previous findings of the important impact of interpersonal over noninterpersonal events on symptoms in both samples, and found an indication that this effect differed by gender in different manners in the two samples. This study emphasizes the significance of both the quantity of traumatic events, polytraumatization, as well as the quality, interpersonal events.

Keywords
child traumatization, symptomatology, multiple traumatization, gender differences
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-15685 (URN)10.1007/s00787-008-0728-2 (DOI)
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2017-12-14
Gustafsson, P. E., Larsson, I., Nelson, N. & Gustafsson, P. A. (2009). Sociocultural Disadvantage, Traumatic Life Events, and Psychiatric Symptoms in Preadolescent Children. American Journal of Orthopsychiatry, 79(3), 387-397
Open this publication in new window or tab >>Sociocultural Disadvantage, Traumatic Life Events, and Psychiatric Symptoms in Preadolescent Children
2009 (English)In: American Journal of Orthopsychiatry, ISSN 0002-9432, E-ISSN 1939-0025, Vol. 79, no 3, p. 387-397Article in journal (Refereed) Published
Abstract [en]

Previous research has demonstrated impact of psychosocial adversity on the mental health of children. This cross-sectional study examined the differential relationships between life-time exposure to interpersonal and non-interpersonal traumatic life events as well as sociocultural factors (family social class and immigrant family), and the level of externalizing versus internalizing symptoms. Participants included 258 children aged 6 to 12 years from two Swedish elementary schools. Information was obtained from their parents by means of questionnaires (a demographic form including information about parental occupation and country of origin, the Strengths and Difficulties Questionnaire and the Life Incidence of Traumatic Events checklist). While controlling for gender, age and the other symptom dimension, the sociocultural factors were associated to internalizing but not to externalizing symptoms. In contrast, traumatic life events and especially interpersonal traumas related to externalizing symptoms but not to internalizing symptoms. These findings provide some support for specificity of psychosocial adversities and for the importance of interpersonal traumas, in the impact on child mental health.

 

Keywords
stressor-outcome specificity, traumatic life events, sociocultural disadvantage, mental health, children
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-15684 (URN)10.1037/a0016559 (DOI)
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2017-12-14
Gustafsson, P. E., Gustafsson, P. A., Ivarsson, T. & Nelson, N. (2008). Diurnal Cortisol Levels and Cortisol Response in Youths with Obsessive-Compulsive Disorder. Neuropsychobiology, 57(1-2), 14-21
Open this publication in new window or tab >>Diurnal Cortisol Levels and Cortisol Response in Youths with Obsessive-Compulsive Disorder
2008 (English)In: Neuropsychobiology, ISSN 0302-282X, E-ISSN 1423-0224, Vol. 57, no 1-2, p. 14-21Article in journal (Refereed) Published
Abstract [en]

Background/Aims: Recent results indicate a role of the hypothalamic-pituitary-adrenal (HPA) axis in the pathophysiology of obsessive-compulsive disorder (OCD). Although childhood onset is common, the HPA axis has scarcely been studied in young OCD subjects. Therefore, the present study aimed at examining basal and response levels of salivary cortisol in a sample of young OCD subjects.

Methods: Twenty-three children and adolescents with DSM-IV OCD were compared to a reference group of school children (n = 240-336). The basal cortisol rhythm was measured through saliva samples 3 times/day. The cortisol response to a psychological stressor (exposure therapy in the OCD group and a fire alarm in the reference group) was also examined.

Results: Compared to the reference group, OCD subjects displayed higher early-morning cortisol values (p = 0.005) with no difference between the late-morning and evening values. The cortisol levels in the OCD group diminished in response to the psychological stressor, compared to a positive response in the reference group (p < 0.001). No relation was found between cortisol and clinical parameters.

Conclusion: These results support the idea that HPA hyperactivity, commonly found in adult OCD patients, is also present at an earlier stage of development, with specificity for the early-morning peak.

Place, publisher, year, edition, pages
S. Karger, 2008
Keywords
Cortisol, Stress response, Obsessive-compulsive disorder, children
National Category
Neurosciences
Identifiers
urn:nbn:se:liu:diva-15681 (URN)10.1159/000123117 (DOI)000257134900005 ()
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2018-01-13Bibliographically approved
Gustafsson, P. E. (2008). Psychosocial Stress, Mental Health and Salivary Cortisol in Children and Adolescents. (Doctoral dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Psychosocial Stress, Mental Health and Salivary Cortisol in Children and Adolescents
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Stressful experiences and conditions in childhood influence the health and well-being of the growing individual, and can also confer a long-lasting impact into adult life. Delineating the social, mental and biological aspects of stress in children and adolescents is therefore of great concern for human beings. Despite these notions, much knowledge is lacking regarding stress in childhood.

This thesis aimed at examining diverse aspects of stress in children and adolescents: associations between social conditions, traumatic life events, mental health, and salivary cortisol as a measure of the activity of a major physiological stress system. Cross-sectional samples included two non-clinical samples of school-aged children (N=240-336) and adolescents (N =400), and two clinical samples of children with obsessive-compulsive disorder (OCD) (N =23) and adolescents who had experienced childhood abuse (N =15). Main measures were salivary cortisol sampled three times a day, and questionnaires to teachers, parents and children with questions about each child’s mental health, traumatic life events and about the socioeconomic situation of the parents.

The main findings include observation of 1) higher cortisol levels in children with a moderate level of psychosocial burden (low socioeconomic status, immigrant family, social impairment of mental health problems), 2) higher cortisol levels in children with OCD who also displayed a tendency to decreasing cortisol in the face of an acute stressor, and 3) cortisol was positively related to mental health problems in abused adolescents. Furthermore, the deleterious effect of 4) traumatic events involving a social dimension, interpersonal traumas, and 5) cumulative traumatic events, polytraumatization, on the mental health of children and adolescents was indicated.

The findings are discussed with respect to the complex interactions between social, mental and biological aspects of children and adolescents. The consequences of adverse experiences in childhood may represent pathways to future health problems. Consideration of the social circumstances in childhood might in the future guide public health policies and the identification of target groups for preventive interventions as well as leading to improvements in treatment for children exposed to severe stress.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2008. p. 138
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1084
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-15686 (URN)978-91-7393-776-4 (ISBN)
Public defence
2008-12-03, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2009-08-21Bibliographically approved
Gustafsson, P. E., Gustafsson, P. A. & Nelson, N. (2006). Cortisol levels and psychosocial factors in preadolescent children. Stress and Health, 22(1), 3-9
Open this publication in new window or tab >>Cortisol levels and psychosocial factors in preadolescent children
2006 (English)In: Stress and Health, ISSN 1532-3005, E-ISSN 1532-2998, Vol. 22, no 1, p. 3-9Article in journal (Refereed) Published
Abstract [en]

Regarding the relationship between psychosocial factors and health, one model of explanation states that psychosocial stress constitutes a principal mediator connecting psychosocial factors to health outcome, affecting the body through psychobiological mechanisms. This relationship has scarcely been studied in children. In the present study the relation between diurnal cortisol secretion and psychosocial factors [socio-economic status (SES), immigrant status and impact of psychiatric symptoms] was investigated in a normal population of 6-12 year old children (n = 273). Salivary cortisol levels were measured in the early morning, late morning and in the evening during three consecutive days. Parents answered demographic questionnaires and teachers answered psychiatric questionnaires concerning the children. Children exposed to one or more of the factors of psychosocial load (n = 117) had significantly higher morning (p < 0.001) and evening (p = 0.029) cortisol levels as well as total daily cortisol secretion [measured by the area under the curve (AUC), p = 0.003] compared to the group of children with none of the factors (n = 156). Different psychosocial stressors seemed to influence different parts of the diurnal cortisol curve. In conclusion, this study indicates that even children exposed to a moderate degree of psychosocial load differ in their cortisol levels compared to non-exposed children.

Keywords
Psychiatric symptoms, child, cortisol, socio-economic factors, stress
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-15680 (URN)10.1002/smi.1074 (DOI)
Available from: 2008-11-26 Created: 2008-11-26 Last updated: 2017-12-14
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