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  • 1.
    Adeback, Petra
    et al.
    Karolinska Institute, Sweden.
    Schulman, Abbe
    Karolinska Institute, Sweden.
    Nilsson, Doris
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Karolinska Institute, Sweden.
    Children exposed to a natural disaster: psychological consequences eight years after 2004 tsunami2018In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 72, no 1, p. 75-81Article, review/survey (Refereed)
    Abstract [en]

    Background: There is a need for studies that follow up children and adolescents for many years post disaster since earlier studies have shown that exposure during natural disasters constitutes a risk factor for poor psychological health.Aims: The main aim was to examine whether there was an association between severity of exposures during a natural disaster experienced in childhood or adolescence and posttraumatic stress symptoms, psychological distress, self-rated health, diagnosis of depression, anxiety or worry, thoughts about or attempted suicide, physical symptoms or daily functioning eight years later in young adulthood. A second aim was to compare psychological distress and self-rated health of exposed young adults with a matched population-based sample.Method: Young adults, who experienced the 2004 tsunami as children between 10 and 15 years of age, responded to a questionnaire eight years post disaster. The results were compared to a matched population sample.Results: The results showed that the likelihood for negative psychological outcomes was higher for those who had been exposed to several types of exposures during this natural disaster.Conclusions: The negative psychological impact on children and adolescents can still be present eight years post-disaster and seems to have association with the type of exposure; loss, physical presence and subjective experience. It is important for clinicians, who meet young adults seeking help, to be conscious about the impact as long as eight years post disaster and to be aware of possible clinical implications associated with severity of exposures.

  • 2.
    Agnafors, Sara
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Mental health in young mothers, single mothers and their children2019In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 19, article id 112Article in journal (Refereed)
    Abstract [en]

    Background: Parenthood is a life transition that can be especially demanding for vulnerable individuals. Young maternal age and maternal single status have been reported to increase the risk for adverse outcomes for both mother and child. The aim of this study was to investigate the effect of young maternal age and maternal single status on maternal and child mental health and child development at age 3. Methods: A birth-cohort of 1723 mothers and their children were followed from birth to age 3. Sixty-one mothers (3.5%) were age 20 or younger, and 65 (4.0%) reported single status at childbirth. The mothers filled out standardized instruments and medical information was retrieved from the standardized clinical assessment of the children at Child Welfare Centers, (CWC). Results: Young maternal age was associated with symptoms of postpartum depression whereas single status was not. Young mothers were more prone to report internalizing and externalizing problems in their children, while there was no association between single status and child behavioral problems. No differences were seen on child development (CWC scores). School drop-out was, however, a more influential factor on depressive symptoms postpartum than maternal age. Conclusion: Young mothers are at increased risk for symptoms of postpartum depression which indicates the need for attention in pre- and postnatal health care programs. Single mothers and their children were not found to be at increased risk for adverse outcomes. The importance of schooling was demonstrated, indicating the need for societal support to encourage adolescents to remain in school.

  • 3.
    Agnafors, Sara
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Oreland, Lars
    Uppsala University, Sweden.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Comasco, Erika
    Uppsala University, Sweden.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    A Biopsychosocial Approach to Risk and Resilience on Behavior in Children Followed from Birth to Age 122017In: Child Psychiatry and Human Development, ISSN 0009-398X, E-ISSN 1573-3327, Vol. 48, no 4, p. 584-596Article in journal (Refereed)
    Abstract [en]

    An increasing prevalence of mental health problems calls for more knowledge into factors associated with resilience. The present study used multiple statistical methodologies to examine a biopsychosocial model of risk and resilience on preadolescence behavior. Data from 889 children and mothers from a birth cohort were used. An adversity score was created by combining maternal symptoms of depression, psychosocial risk and childrens experiences of life events. The proposed resilience factors investigated were candidate genetic polymorphisms, child temperament, social functioning, and maternal sense of coherence. The l/ l genotype of the serotonin transporter linked polymorphic region was associated with lower internalizing scores, but not mainly related to the level of adversity. An easy temperament was associated with resilience for children exposed to high adversity. Social functioning was found to be promotive independent of the risk level. The results support a multiple-level model of resilience indicating effects, though small, of both biological and psychosocial factors.

  • 4.
    Agnafors, Sara
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Oreland, Lars
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Comasco, Erika
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    A biopsychosocial approach to risk and resilience on behavior in children followed from birth to age twelve2016Manuscript (preprint) (Other academic)
    Abstract [en]

    An increasing prevalence of mental health problems calls for more knowledge into factors associated with resilience in the context of child behavior. Biological factors are seldom considered in psychosocial models of resilience. The present study used multiple statistical methodologies to examine a biopsychosocial model of risk and resilience on behavior at preadolescence. Data from 889 children and their mothers were used. A cumulative adversity score was created by combining maternal symptoms of depression, psychosocial risk and children’s experiences of life events. The proposed resilience factors investigated were candidate genetic polymorphisms, child temperament and social functioning, and maternal sense of coherence. Results show that the l/l genotype of the serotonin transporter linked polymorphic region (5-HTTLPR) was associated with lower internalizing scores, especially for children exposed to low adversity. An easy temperament was associated with resilient outcomes for children exposed to high adversity. Child social functioning was found to be more of a general resource variable buffering risk in both high and low adversity groups. The results support a multiple level model of resilience indicating effects, though small, of both biological and psychosocial factors. The present findings call for both preventive actions and further studies on biopsychosocial models in resilience research.

  • 5.
    Agnafors, Sara
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Comasco, Erika
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Oreland, Lars
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Early predictors of behavioural problems in pre-schoolers: a longitudinal study of constitutional and environmental main and interaction effects2016In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 16Article in journal (Refereed)
    Abstract [en]

    Background: The early environment is important for child development and wellbeing. Gene-by-environment studies investigating the impact of the serotonin transporter genelinked polymorphic region (5-HTTLPR) and the Brain Derived Neurotrophic Factor (BDNF) Val66Met polymorphisms by life events on mental health and behaviour problems have been inconclusive. Methodological differences regarding sample sizes, study population, definitions of adversities and measures of mental health problems obstacle their comparability. Furthermore, very few studies included children. The aim of this study was to examine the associations between a broad range of risk factors covering pregnancy and birth, genetic polymorphism, experience of multiple life events and psychosocial environment, and child behaviour at age three, using a comparably large, representative, population-based sample.

    Methods: A total of 1,106 children, and their mothers, were followed from pregnancy to age three. Information on pregnancy and birth-related factors was retrieved from the Medical Birth Register. Questionnaires on depressive symptoms, child behaviour and child experiences of life events were filled in by the mothers. Child saliva samples were used for genotyping the 5-HTTLPR and BDNF Val66Met polymorphisms. Multiple logistic regression was used to investigate the association between psychological scales and genetic polymorphisms.

    Results: Symptoms of postpartum depression increased the risk of both internalizing and externalizing problems. Experience of multiple life events was also a predictor of behavioural problems across the scales. No gene-by-environment or gene-bygene-by-environment interactions were found. Children of immigrants had an increased risk of internalizing problems and parental unemployment was significantly associated with both internalizing and externalizing type of problems.

    Conclusion: This study shows the importance of the psychosocial environment for psychosocial health in preschool children, and adds to  the literature of null-findings of gene-by-environment effects of 5-HTTLPR and BDNF in children

  • 6.
    Aho, Nikolas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Gren Landell, Malin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Linköping University, Center for Social and Affective Neuroscience (CSAN).
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    The Prevalence of Potentially Victimizing Events, Poly-Victimization, and Its Association to Sociodemographic Factors: A Swedish Youth Survey2016In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 31, no 4, p. 620-651Article in journal (Refereed)
    Abstract [en]

    Studying the extent to which children are exposed to victimizing events is important to fully understand the effect of such exposure in shaping them as adults. The aim of this study was to use self-report by adolescents to measure the prevalence of victimizing events and of poly-victimization. A representative sample of 5,960 students (aged 17) from high schools in Sweden was given the self-administrated version of the Juvenile Victimization Questionnaire (JVQ) along with questions concerning gender, birthplace, parents birthplace and employment, residence, educational program, and municipality size. The results show that 84.1% (83.0% young men and 85.2% young women) of the students had experienced victimization during their lifetime, and 10.3% were categorized as poly-victims (8.1% young men and 12.5% young women; OR = 1.62, 95% confidence interval [CI] = [1.35, 1.94]). Adolescents living with both parents were at lower risk of any form of victimization for both genders, while females were at higher risk of maltreatment, peer victimization, and, most significantly, sexual victimization. In conclusion, the vast majority of young people have been victimized during their lifetime. A greater awareness of the impact of these victimizing events on children and adolescents is important as a basis for providing a safer milieu and establishing better interventions, especially for those that have been victimized on multiple occasions. The high-exposure group was determined by using 10 events as a cutoff. Findings on this group corresponded with findings in other international studies regarding distribution, elevated risk for females, and the possibility of limiting the effects of victimization by modifying living conditions.

  • 7.
    Aho, Nikolas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Proczkowska Björklund, Marie
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress in high school students2017In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 8, no 1, article id 1380998Article in journal (Refereed)
    Abstract [en]

    Background: Exposure to traumatic events is clearly associated with a diversity of subsequent mental health problems, with posttraumatic stress disorder (PTSD) as the most prevalent disorder. Epidemiologically, trauma exposure rates are more prevalent than PTSD, indicating that most trauma victims do not develop PTSD. More knowledge is needed to understand the development of the different posttraumatic pathways including the significance of pretraumatic, peritraumatic and posttraumatic risk factors. Objective: To study peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress and to enhance our understanding of peritraumatic reactions as mediators between trauma and later symptomatology. Method: The study was composed of a representative community sample of 5332 second year high school students (mean age 17.3 years) who completed the Juvenile Victimization Questionnaire (SAQ/JVQ), Trauma Symptom Checklist for Children (TSCC) and answered questions about peritraumatic reactions. Mediation effects of peritraumatic reactions on the trauma exposure relationship to symptoms was tested using the PROCESS macro for SPSS. Results: Traumatic events are common (84.1%) and are accompanied in three-quarters of the students with at least one form of peritraumatic reaction. Peritraumatic reactions, especially peritraumatic dissociative reactions, mediate the relationship between trauma exposure and symptoms, and gender moderates the effect of peritraumatic dissociation. This moderating effect was found to be larger for boys than for girls, indicating gender differences in response to trauma. Conclusions: The results indicate the need to screen for peritraumatic reactions as early as possible after a traumatic event in order to identify those at risk for PTSD.

  • 8.
    Aho, Nikolas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Proczkowska-Björklund, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Victimization, polyvictimization , and health in Swedish adolescents2016In: Adolescent Health, Medicine and Therapeutics, ISSN 1179-318X, Vol. 7, p. 89-99Article in journal (Refereed)
    Abstract [en]

    The main objective of this article was to study the relationship between the different areas of victimization (eg, sexual victimization) and psychological symptoms, taking into account the full range of victimization domains. The final aim was to contribute further evidence regarding the bias that studies that focus on just one area of victimization may be introduced into our psychological knowledge. The sample included 5,960 second-year high school students in Sweden with a mean age of 17.3 years (range =16–20 years, standard deviation =0.652), of which 49.6% were females and 50.4% males. The Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children were used to assess victimization and psychological problems separately. The results show that a majority of adolescents have been victimized, females reported more total events and more sexual victimization and childhood maltreatment, and males were more often victims of conventional crime. The majority of victimization domains as well as the sheer number of events (polyvictimization [PV]) proved to be harmful to adolescent health, affecting females more than males. PV explained part of the health effect and had an impact on its own and in relation to each domain. This suggests the possibility that PV to a large degree explains trauma symptoms. In order to understand the psychological effects of trauma, clinicians and researchers should take into account the whole range of possible types of victimization.

  • 9.
    Anagnostopoulos, Dimitris C.
    et al.
    University of Athens, Greece.
    Heberbrand, Johannes
    University of Duisburg Essen, Germany.
    Eliez, Stephan
    University of Geneva, Switzerland.
    Doyle, Maeve B.
    St Davnets Hospital, Ireland.
    Klasen, Henrikje
    Leiden University, Netherlands.
    Crommen, Sofie
    Flemish Assoc Child and Adolescent Psychiat, Belgium.
    Cetin Cuhadaroglu, Fusun
    Hacettepe University, Turkey.
    Pejovic-Milovancevic, Milica
    University of Belgrade, Serbia.
    Herreros, Oscar
    Hospital University of Virgen de las Nieves, Spain.
    Minderaa, Ruud
    European Soc Child and Adolescent Psychiat, Belgium.
    Karwautz, Andreas
    Medical University of Vienna, Austria.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Raynaud, Jean Philippe
    Centre Hospital University of Toulouse, France.
    Editorial Material: European Society of Child and Adolescent Psychiatry: position statement on mental health of child and adolescent refugees in EUROPEAN CHILD and ADOLESCENT PSYCHIATRY, vol 25, issue 7, pp 673-6762016In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 25, no 7, p. 673-676Article in journal (Other academic)
    Abstract [en]

    n/a

  • 10.
    Andersson, Yvonne
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Holmqvist, Rolf
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Nilsson, Doris
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Child Evacuations During World War II: This ShouldNot Happen Again2019In: Journal of Loss and Trauma, ISSN 1532-5024Article in journal (Refereed)
    Abstract [en]

    There is little research about the long-term effects on childrenthat were separated from their parents and moved fromFinland to Sweden during World War II. The aim of this studywas to capture these now-lifelong reflections, and so questionnaireswere sent to 14 potential participants. Ten personsaged 7381 responded. The themes that emerged concernedpride over professional achievements, the pain of separation,and feelings of alienation and loneliness. The informantsemphasized the importance of sibling relationships. The conclusionwas that the participants, despite the hardships connectedwith the migration, had successfully lived a good lifein Sweden.ARTICLE HISTORYReceived 16 July 2018Accepted 11 May 2018KEYWORDSFinnish war children; childseparations; childevacuation; importance ofsibling relationsAt

  • 11.
    Annerbäck, Eva-Maria
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Centre for Clinical Research in Sörmland, Sörmland County Council, Uppsala University, Eskilstuna, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Child physical abuse: factors influencing the associations between self-reported exposure and self-reported health problems: a cross-sectional study2018In: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, E-ISSN 1753-2000, Vol. 12, article id 38Article in journal (Refereed)
    Abstract [en]

    Background

    Child physical abuse (CPA) is an extensive public health problem because of its associations with poor health outcomes. The aim of this study was to examine which of the background factors of CPA committed by a parent or other caregiver relates to self-reported poor health among girls and boys (13; 15 and 17 years old): perpetrator, last year exposure; severity and frequency; socioeconomic load and foreign background.

    Methods

    In a cross-sectional study in a Swedish county (n = 8024) a path analysis was performed to evaluate a model where all background variables were put as predictors of three health-status variables: mental; physical and general health problems. In a second step a log linear analysis was performed to examine how the distribution over the health-status categories was different for different combinations of background factors.

    Results

    Children exposed to CPA reported poor health to a much higher extent than those who were not exposed. In the path analysis it was found that frequency and severity of abuse (boys only) and having experienced CPA during the last year, was significantly associated with poor health as well as socioeconomic load in the families. Foreign background was significantly negatively associated with all three health indicators especially for girls. Neither mother nor father as perpetrator remained significant in the path analysis, while the results from the log linear analyses showed that mother-abuse did in fact relate to poor general health and mental as well as physical health problems among boys and girls. Father-abuse was associated with poor mental health if severe abuse was reported. Poor mental health was also associated with mild father-abuse if exposure during the last year was reported.

    Conclusion

    Despite the limitations that cross-sectional studies imply, this study provides new knowledge about factors associated with poor health among physically abused children. It describes details of CPA that have significant associations to different aspects of poor health and thus what needs to be addressed by professionals within mental health providers and social services. Understanding how different factors may contribute to different health outcomes for exposed children is important in future research and needs further studies.

  • 12.
    Arnison, Tor
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Menon, JA
    Department of Psychology, University of Zambia, Lusaka, Zambia.
    Malambo, C
    Department of Psychology, University of Zambia, Lusaka, Zambia.
    Nilsson, Doris
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Posttraumatic Stress among women with HIV in Zambia2017In: The Medical Journal of Zambia, ISSN 0047-651X, Vol. 44, no 2, p. 100-105Article in journal (Refereed)
    Abstract [en]

    Objective: To examine whether HIV-positive women in Lusaka District, Zambia, displays a higher degree of PTSD-symptoms than a HIV-negative control group.

    Method: The study targeted 50 HIV-positive women from four ART-clinics and 42 HIV-negative women from corresponding VCT-units. All sites were located in Lusaka District, Zambia. The HIV-positive women were compared with the control group in regard for PTSD, PTSD-symptoms, dissociative symptoms and history of traumatic experiences. The instruments used were PCL-C, DES-T and LYLES-A. Prior to the main study, the validity of the instruments were assessed with a pilot-sample.

    Results: Three participants in the HIV-positive group fulfilled the criteria for clinical PTSD (10.7 %), as compared to none in the control group. The HIV-positive group also displayed a significantly higher degree of PTSD-symptoms and previous traumatic experiences, with strong effect sizes, but not for dissociative symptoms. The significant difference in PTSD-symptoms remained while trauma-history was controlled for.

    Conclusions: The results of this study clearly indicates that women with HIV are vulnerable to PTSD and that contracting HIV in itself can constitute a psychological trauma in itself. Since PTSD among persons with HIV has been associated with transmission risk behaviours, reduced treatment adherence and a faster disease progression, these findings are important to consider in actions against HIV and AIDS. 

  • 13.
    Bergström, Malin
    et al.
    Stockholm University, Sweden.
    Fransson, Emma
    Stockholm University, Sweden.
    Modin, Bitte
    Stockholm University, Sweden.
    Berlin, Marie
    National Board Health and Welf, Sweden; Stockholm University, Sweden.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Hjern, Anders
    Stockholm University, Sweden; Karolinska Institute, Sweden.
    Fifty moves a year: is there an association between joint physical custody and psychosomatic problems in children?2015In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 69, no 8, p. 769-774Article in journal (Refereed)
    Abstract [en]

    Background In many Western countries, an increasing number of children with separated parents have joint physical custody, that is, live equally much in their parents respective homes. In Sweden, joint physical custody is particularly common and concerns between 30% and 40% of the children with separated parents. It has been hypothesised that the frequent moves and lack of stability in parenting may be stressful for these children. Methods We used data from a national classroom survey of all sixth and ninth grade students in Sweden (N=147839) to investigate the association between childrens psychosomatic problems and living arrangements. Children in joint physical custody were compared with those living only or mostly with one parent and in nuclear families. We conducted sex-specific linear regression analyses for z-transformed sum scores of psychosomatic problems and adjusted for age, country of origin as well as childrens satisfaction with material resources and relationships to parents. Clustering by school was accounted for by using a two-level random intercept model. Results Children in joint physical custody suffered from less psychosomatic problems than those living mostly or only with one parent but reported more symptoms than those in nuclear families. Satisfaction with their material resources and parent-child relationships was associated with childrens psychosomatic health but could not explain the differences between children in the different living arrangements. Conclusions Children with non-cohabitant parents experience more psychosomatic problems than those in nuclear families. Those in joint physical custody do however report better psychosomatic health than children living mostly or only with one parent. Longitudinal studies with information on family factors before and after the separation are needed to inform policy of childrens postseparation living arrangements.

  • 14.
    Bergström, Malin
    et al.
    Stockholm University, Sweden.
    Modin, Bitte
    Stockholm University, Sweden.
    Fransson, Emma
    Stockholm University, Sweden.
    Rajmil, Luis
    Catalan Agency Health Informat Assessment and Qual, Spain.
    Berlin, Marie
    National Board Health and Welf, Sweden.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Hjern, Anders
    Stockholm University, Sweden.
    Living in two homes-a Swedish national survey of wellbeing in 12 and 15 year olds with joint physical custody2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13Article in journal (Refereed)
    Abstract [en]

    Background

    The practice of joint physical custody, where children spend equal time in each parent’s home after they separate, is increasing in many countries. It is particularly common in Sweden, where this custody arrangement applies to 30 per cent of children with separated parents. The aim of this study was to examine children’s health-related quality of life after parental separation, by comparing children living with both parents in nuclear families to those living in joint physical custody and other forms of domestic arrangements.

    Methods

    Data from a national Swedish classroom study of 164,580 children aged 12 and 15-years-old were analysed by two-level linear regression modelling. Z-scores were used to equalise scales for ten dimensions of wellbeing from the KIDSCREEN-52 and the KIDSCREEN-10 Index and analysed for children in joint physical custody in comparison with children living in nuclear families and mostly or only with one parent.

    Results

    Living in a nuclear family was positively associated with almost all aspects of wellbeing in comparison to children with separated parents. Children in joint physical custody experienced more positive outcomes, in terms of subjective wellbeing, family life and peer relations, than children living mostly or only with one parent. For the 12-year-olds, beta coefficients for moods and emotions ranged from −0.20 to −0.33 and peer relations from −0.11 to −0.20 for children in joint physical custody and living mostly or only with one parent. The corresponding estimates for the 15-year-olds varied from −0.08 to −0.28 and from −0.03 to −0.13 on these subscales. The 15-year-olds in joint physical custody were more likely than the 12-year-olds to report similar wellbeing levels on most outcomes to the children in nuclear families.

    Conclusions

    Children who spent equal time living with both parents after a separation reported better wellbeing than children in predominantly single parent care. This was particularly true for the 15-year-olds, while the reported wellbeing of 12-years-olds was less satisfactory. There is a need for further studies that can account for the pre and post separation context of individual families and the wellbeing of younger age groups in joint physical custody.

  • 15.
    Briere, John
    Keck School of Medicine, University of Southern California, USA.
    Svedin, Carl Göran (Translator, Contributor)
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    TSCC, Trauma Symptom Checklist for Children: Manual Supplement, svensk version2010Other (Other academic)
    Abstract [sv]

    TSCC är ett självrapporteringsformulär som mäter posttraumatisk stress och relaterade symptom. Instrumentet är avsett att användas för barn och ungdomar som har upplevt traumatiska händelser såsom fysiska eller sexuella övergrepp, dödsfall av närstående, naturkatastrofer eller bevittnat hot och våld. TSCC mäter ett brett spektrum av traumatiska symptom och lämpar sig framförallt för screening men kan också användas för att utvärdera effekter av psykoterapeutiska interventioner.

  • 16.
    Briere, John
    Keck School of Medicine, University of Southern California, USA.
    Svedin, Carl Göran (Translator, Contributor)
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    TSCYC, Trauma Symptom Checklist for Young Children: Manual, Svensk version2012Other (Other academic)
    Abstract [sv]

    TSCYC är ett frågeformulär som används för att mäta ett brett spektrum av akuta eller kroniska posttraumatiska symptom hos barn som har upplevt traumatiska händelser såsom övergrepp eller misshandel eller har bevittnat våld i hemmet eller i sin närmiljö. Den svenska versionen av TSCYC har översatts av docent Doris Nilsson och professor Carl-Göran Svedin som även har översatt, normerat och standardiserat den svenska versionen av traumainstrumentet TSCC för äldre barn och ungdomar.

    Den svenska standardiseringen och normeringen av TSCYC har gjorts i en grupp om 629 barn ur normalpopulation och en klinisk grupp om 59 barn i åldrarna 3–11 år. Normerna är uppdelade utifrån ålder och kön.

    TSCYC-formuläret innehåller 90 frågor och handlar om olika typer av traumasymptom som barnet kan uppvisa. Frågorna besvaras av barnets förälder eller vårdnadshavare. TSCYC ger en detaljerad utvärdering av posttraumatiska symptom på åtta kliniska skalor. En summaskala ger värdefull information om akuta och kroniska symptom samt andra vanligt förekommande symptom hos traumatiserade barn. PTSD-diagnosbladet, som ingår i svarsblanketten, kan användas som stöd i evalueringen av möjlig PTSD-diagnos.

  • 17.
    Chermá, Maria D.
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology. Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
    Josefsson, Martin
    Linköping University, Department of Physics, Chemistry and Biology, Chemistry. Linköping University, Faculty of Science & Engineering. Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden.
    Rydberg, Irene
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences.
    Woxler, Per
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Dependency in Linköping.
    Trygg, Tomas
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Dependency in Linköping.
    Hollertz, Olle
    Department of General Psychiatry, Västervik Hospital, Västervik, Sweden.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Methylphenidate for Treating ADHD: A Naturalistic Clinical Study of Methylphenidate Blood Concentrations in Children and Adults With Optimized Dosage.2017In: European journal of drug metabolism and pharmacokinetics, ISSN 0378-7966, E-ISSN 2107-0180, Vol. 42, no 2, p. 295-307Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Methylphenidate (MPH), along with behavioral and psychosocial interventions, is the first-line medication to treat attention-deficit hyperactivity disorder (ADHD) in Sweden. The dose of MPH for good symptom control differs between patients. However, studies of MPH concentration measurement in ADHD treatment are limited.

    OBJECTIVE: To describe blood and oral fluid (OF) concentrations of MPH after administration of medication in patients with well-adjusted MPH treatment for ADHD, and to identify the most suitable matrix for accurate MPH concentration during treatment.

    METHODS: Patients were recruited from Child and Adolescent Psychiatry (CAP), General Psychiatry (GP), and the Department of Dependency (DD). Blood and OF samples were collected in the morning before MPH administration as well as 1 and 6 h after administration of the prescribed morning dose of MPH.

    RESULTS: Fifty-nine patients aged between 9 and 69 years, 76 % males. The daily dose of MPH varied from 18 to 180 mg, but the median daily dose per body weight was similar, approximately 1.0 mg/kg body weight. The median MPH concentration in blood 1 and 6 h after the morning dose was 5.4 and 9.3 ng/mL, respectively. Highly variable OF-to-blood ratios for MPH were found at all time points for all three groups.

    CONCLUSIONS: Weight is a reliable clinical parameter for optimal dose titration. Otherwise, MPH blood concentration might be used for individual dose optimization and for monitoring of the prescribed dose. Relying only on the outcome in OF cannot be recommended for evaluation of accurate MPH concentrations for treatment monitoring.

  • 18.
    Comasco, Erika
    et al.
    Uppsala University, Sweden.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Agnafors, Sara
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Aho, Nikolas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Psychiatric symptoms in adolescents: FKBP5 genotype-early life adversity interaction effects2015In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 24, no 12, p. 1473-1483Article in journal (Refereed)
    Abstract [en]

    Psychiatric disorders are multi-factorial and their symptoms overlap. Constitutional and environmental factors influence each other, and this contributes to risk and resilience in mental ill-health. We investigated functional genetic variation of stress responsiveness, assessed as FKBP5 genotype, in relation to early life adversity and mental health in two samples of adolescents. One population-based sample of 909 12-year-old adolescents was assessed using the Life Incidence of Traumatic Events scale and the Strengths and Difficulties Questionnaire. One sample of 398 17-year-old adolescents, enriched for poly-victimized individuals (USSS), was assessed using the Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children (TSCC). The FKBP5 rs1360780 and rs3800373 polymorphisms were genotyped using a fluorescence-based competitive allele-specific PCR. Most prominently among poly-victimized older male adolescents, the least common alleles of the polymorphisms, in interaction with adverse life events, were associated with psychiatric symptoms, after controlling for ethno-socio-economic factors. The interaction effect between rs3800373 and adverse life events on the TSCC sub-scales-anxiety, depression, anger, and dissociation-and with the rs1360780 on dissociation in the USSS cohort remained significant after Bonferroni correction. This pattern of association is in line with the findings of clinical and neuroimaging studies, and implies interactive effects of FKBP5 polymorphisms and early life environment on several psychiatric symptoms. These correlates add up to provide constructs that are relevant to several psychiatric symptoms, and to identify early predictors of mental ill-health.

  • 19.
    Cooper, Karen
    et al.
    University of Edinburgh, Scotland.
    Quayle, Ethel
    University of Edinburgh, Scotland.
    Jonsson, Linda
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Adolescents and self-taken sexual images: A review of the literature2016In: Computers in human behavior, ISSN 0747-5632, E-ISSN 1873-7692, Vol. 55, no part B, p. 706-716Article, review/survey (Refereed)
    Abstract [en]

    Despite increasing public interest and concern about young peoples involvement in the self-production of sexual images (or sexting), there remains a dearth of research into their reasons for making and sending images, the processes involved, and the consequences arising from their experiences. This article reviews the motivational, lifestyle and personality factors influencing adolescent sexting practices and explores the research evidence within the wider context of debates around contemporary social and visual media cultures and gender. A systematic search of databases was conducted and eighty-eight records were identified for inclusion in the review. The findings reveal that sexting is remarkably varied in terms of context, meaning and intention, with the potential for consensual and non-consensual aspects of the activity. Whilst sexting can be a means of flirting or enhancing a sexual relationship, it can highlight potential vulnerabilities to victimisation or to participation in risky sexual practices. Sexting is also inextricably linked to social expectations of gendered sexual behaviours, with females often deriving less satisfaction from their experiences and being perceived more negatively by their peers. Further research linking adolescent motivations, well-being, relationships and lifestyles with the broader socio-cultural and media landscape will ultimately help drive understanding about the subject forward. (C) 2015 Elsevier Ltd. All rights reserved.

  • 20.
    Eckhardt, Anna
    et al.
    Institute of Tropical Medicine and International Health, Charité Universitätsmedizin, Berlin, Germany.
    Aguilar Zambrano, Enrique
    Universidad Central del Ecuador, Instituto de Investigación y Postgrado, Facultad de Sciencias Médicas, Quito, Ecuador.
    Nilsson, Doris
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Traumatic experiences and dissociation in a non-clinical group of university students in Ecuador: a cross-sectional study2018In: Journal of Child and Adolescent Mental Health, ISSN 1728-0583, E-ISSN 1728-0591, Vol. 30, no 3, p. 191-202Article in journal (Refereed)
    Abstract [en]

    Background: In Ecuador, as in most Latin American countries, scientific research on trauma and dissociation is scarce. The aim of this study was to examine the prevalence of potentially traumatic experiences and dissociative symptoms in adolescents and young adults who were students at the Central University in Quito, Ecuador.

    Methods: A cross-sectional study in which 144 students completed a self-administrated questionnaire consisting of Linköping Youth Life Experience Scale (LYLES), Adolescent-Dissociation Experience Scale (A-DES ) and background variables. Data collection was conducted in autumn 2012. Standard multiple regression analysis was used to analyse the data.

    Results: All students reported a history of a minimum of five potentially traumatic experiences with a mean of 14.8. Eight participants (5.6%) scored above 3.7 on the Adolescent-Dissociation Experience Scale, which is considered clinically significant dissociation. No correlation was found between high scores on LYLES and A-DES.

    Conclusions: The prevalence of potentially traumatic experiences in the study population is very high compared to studies conducted in high-income settings. The low prevalence of dissociation suggests high resilience in the study population but more research on morbidity is needed to draw conclusions about mental health outcomes. Further research should include study populations in less advantageous contexts.

  • 21.
    Emilsson, Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Department of Health Science, Section of Nursing Graduate Level, University West, Trollhättan, Sweden.
    Gustafsson, Per A
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Öhnström, Gisela
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Marteinsdottir, Ina
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Beliefs regarding medication and side effects influence treatment adherence in adolescents with attention deficit hyperactivity disorder2017In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 26, no 5, p. 559-571Article in journal (Refereed)
    Abstract [en]

    Adherence to attention deficit hyperactivity disorder (ADHD) treatment is important because, when untreated, it may have serious consequences with lifelong effects. In the case of adolescents on long-term medicine prescription, more knowledge is needed regarding adherence and factors influencing adherence, which was the purpose of this study. Adolescents (n = 101) on ADHD medication ≥6 months were administrated questionnaires at a monitoring appointment: Medication Adherence Report Scale (MARS), beliefs about medicines (BMQ) and the Brief Illness Perception Questionnaire (B-IPQ). Adherence was high, the mean value was 88% of the maximum MARS score, and correlated positively with the “BMQ-necessity-concerns differential” but negatively with “BMQ-concerns” and “BMQ-side effects”. Adolescents with more belief in the necessity of the medication, less concerns and less experience of side effects tended to be more adherent to medication prescription (“intentional non-adherence”), while “unintentional non-adherence” (forgetfulness) was associated with how much they perceived that their ADHD affected their lives. In a multiple regression model, the variance of MARS total (R2 = 0.21) and “intentional non-adherence” (R2 = 0.24) was explained by the “BMQ-necessity–concern differential” and “BMQ-experienced side effects”. The variance of “unintentional non-adherence” (R2 = 0.12) was explained by the “BMQ-necessity–concern differential” and “B-IPQ-consequences of ADHD”. In conclusion, adolescents on long-term medication reported good adherence, mainly influenced by more beliefs in the necessity versus concerns of the medications, less experienced side effects and more perceived consequences of ADHD. BMQ could be useful to identify risks of low adherence, which should be counteracted by partially gender-specific interventions.

  • 22.
    Fredlund, Cecilia
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Jonsson, Linda
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Pribe, Gisela
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Lund Univ, Sweden.
    Adolescents motives for selling sex in a welfare state - A Swedish national study2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 81, p. 286-295Article in journal (Refereed)
    Abstract [en]

    In addition to money or other compensation, other motives for selling sex may be important in a welfare country such as Sweden. The aim of this study was to carry out an exploratory investigation of adolescents motives for selling sex in a population-based survey in Sweden. A total of 5839 adolescents from the third year of Swedish high school, mean age 18.0 years, participated in the study. The response rate was 59.7% and 51 students (0.9%) reported having sold sex. Exploratory factor analysis and hierarchical cluster analysis were used to identify groups of adolescents according to underlying motives for selling sex. Further analyses were carried out for characteristics of selling sex and risk factors. Three groups of adolescents were categorized according to their motives for selling sex: Adolescents reporting; 1) Emotional reasons, being at a greater risk of sexual abuse, using sex as a means of self-injury and having a non-heterosexual orientation. 2) Material but no Emotional reasons, who more often receive money as compensation and selling sex to a person over 25 years of age, and 3) Pleasure or no underlying motive for selling sex reported, who were mostly heterosexual males selling sex to a person under 25 years of age, the buyer was not known from the Internet, the reward was seldom money and this group was less exposed to penetrative sexual abuse or using sex as a means of self-injury. In conclusion, adolescents selling sex are a heterogeneous group in regard to underlying motives.

    The full text will be freely available from 2021-05-05 00:01
  • 23.
    Fredlund, Cecilia
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Svedin, Carl Göran
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences.
    Pribe, Gisela
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences.
    Jonsson, Linda
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Self-reported frequency of sex as self-injury (SASI) in a national study of Swedish adolescents and association to sociodemographic factors, sexual behaviors, abuse and mental health2017In: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, E-ISSN 1753-2000, Vol. 11, no 1Article in journal (Refereed)
    Abstract [en]

    Sex as self-injury has become a concept in Swedish society; however it is a largely unexplored area of research, not yet conceptualized and far from accepted in the research field. The use of sex as a way of affect regulation is known in the literature and has, in interviews with young women who sell sex, been compared to direct self-injury, such as cutting or burning the skin. The aim of this study was to investigate the self-reported frequency of sex as self-injury and the association to sociodemographic factors, sexual orientation, voluntary sexual experiences, sexual risk-taking behaviors, sexual, physical and mental abuse, trauma symptoms, healthcare for psychiatric disorders and non-suicidal self-injury.

  • 24.
    Gren Landell, Malin
    et al.
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Ekerfelt Allvin, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Bradely, Maria
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
    Teachers' views on risk factors for problematic school absenteeism in Swedish primary school students2015In: Educational Psychology in Practice, ISSN 0266-7363, E-ISSN 1469-5839, Vol. 31, no 4, p. 412-423Article in journal (Refereed)
    Abstract [en]

    In the present online survey, 158 teachers in regular and special education teaching in grades six to nine were asked to rate the importance of probable reasons for problematic school absenteeism. On average, the teachers estimated that among their students, 19 students had presented with problematic school absenteeism over the last five years. Teachers viewed school absenteeism as a multifactorial problem. Family factors were considered to contribute most and low mood or depression were rated as one of the five most contributing factors. Teachers in special education viewed school factors as more influential than teachers in mainstream education did (t156 = −3.94, p < 0.05). The current findings stress the importance of collaboration between the school, parents and the student to be able to address all factors that may lead to problematic school absenteeism.

  • 25.
    Gustafsson, Berit M.
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Danielsson, Henrik
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Granlund, Mats
    CHILD research environment, SIDR, Jönköping University, Sweden and Department of Special Education, Oslo University, Norway.
    Gustafsson, Per A
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Proczkowska, Marie
    Psychiatric Clinic, Hospital of Jönköping, Division of Psychiatrics and Rehabilitation/Jönköping County, Sweden..
    Hyperactivity precedes conduct problems in preschool children: a longitudinal study.2018In: BJPsych Open, E-ISSN 2056-4724, Vol. 4, no 4, p. 186-191Article in journal (Refereed)
    Abstract [en]

    Background: Externalising problems are among the most common symptoms of mental health problems in preschool children.

    Aims: To investigate the development of externalising problems in preschool children over time, and the way in which conduct problems are linked to hyperactivity problems.

    Method: In this longitudinal study, 195 preschool children were included. Latent growth modelling of conduct problems was carried out, with gender and hyperactivity at year 1 as time-invariant predictors.

    Results: Hyperactivity was a significant predictor for the intercept and slope of conduct problems. Children with more hyperactivity at year 1 had more conduct problems and a slower reduction in conduct problems. Gender was a significant predictor for the slope of conduct problems.

    Conclusions: Children with more initial hyperactivity have less of a reduction in conduct problems over time. It is important to consider the role of hyperactivity in studies of the development of conduct problems.

    Declaration of interest: None.

  • 26.
    Gustafsson, Berit M.
    et al.
    Linköping University, Center for Social and Affective Neuroscience (CSAN). Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Högland Hospital, Sweden; Jönköping University, Sweden.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Proczkowska, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Hospital Jönköping, Sweden.
    The Strengths and Difficulties Questionnaire (SDQ) for preschool childrena Swedish validation2016In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, no 8, p. 567-574Article in journal (Refereed)
    Abstract [en]

    Background: In Sweden, 80-90% of children aged 1-5 years attend preschool, and that environment is well suited to identify behaviours that may be signs of mental health problems. The Strengths and Difficulties Questionnaire (SDQ) is a well-known short and structured instrument measuring child behaviours that indicate mental health problems well suited for preschool use.Aim: To investigate whether SDQ is a reliable and valid instrument for identifying behavioural problems in children aged 1-3 years and 4-5 years in a Swedish population, as rated by preschool teachers.Methods: Preschools situated in different sized municipalities in Sweden participated. The preschool teacher rated each individual child. Concurrent validity was tested using the Child-Teacher Report Form (C-TRF) and Child Engagement Questionnaire (CEQ). Exploratory factor analysis was conducted for age groups, 1-3 years and 4-5 years.Results: The preschool teachers considered most of the SDQ items relevant and possible to rate. For the children aged 1-3 years, the subscales Hyperactivity (Cronbach alpha=0.84, split half=0.73) and Conduct (Cronbach alpha=0.76, split half=0.80) were considered to be valid. For the age group 4-5 years, the whole original SDQ scale, 4-factor solution was used and showed reasonable validity (Cronbach alpha=0.83, split half=0.87).Conclusion: SDQ can be used in a preschool setting by preschool teachers as a valid instrument for identifying externalizing behavioural problems (hyperactivity and conduct problems) in young children.Clinical implications: SDQ could be used to identify preschool children at high-risk for mental health problems later in life.

  • 27.
    Gustafsson, Berit
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Högland Hospital, Sweden; Jonköping University, Sweden; Hogland Hospital, Sweden.
    Proczkowska-Björklund, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Hospital Jonköping, Sweden.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Emotional and behavioural problems in Swedish preschool children rated by preschool teachers with the Strengths and Difficulties Questionnaire (SDQ)2017In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 17, no 110Article in journal (Refereed)
    Abstract [en]

    Background: There is a high risk that young children who show early signs of mental health problems develop symptoms in the same or overlapping areas some years later. The Strengths and Difficulties Questionnaire (SDQ) is widely used to screen externalizing and internalizing problems early in life. In Sweden 80-90% of all children aged 1-5 years go to preschool and preschool is thus an appropriate context for finding early signs of mental health problems among children. Methods: This study is part of a longitudinal project too investigate the frequency of emotional and behavioural problems for children between 1 and 5 years of age in Sweden. The SDQ including the impairment supplement questions were rated by preschool teachers too establish Swedish norms for SDQ in preschool children. Results: The sample involved 815 children with a mean age of 42 months (SD = 16, range 13-71 months). 195 children were followed longitudinally for three years. There were significant differences between boys and girls on all subscales except for the Emotional subscale. The prevalence of behavioural problems was similar to other that in European countries, except for Prosocial behaviour, which was rated lower, and Conduct problems, rated higher. Swedish children were estimated to have more problems in the preschool setting, scored by preschool teachers. The development of behaviour over time differed for the different subscales of SDQ. Conclusions: The teacher version of the SDQ, for 2-4 year-olds, can be used as a screening instrument to identify early signs of emotional distress/behavioural problems in young children. Preschool teachers seem to be able to identify children with problematic behaviour with the use of SDQ at an early age. The development of behaviour over time differs for the different subscales of SDQ. The Swedish norms for SDQ are to a large extent, similar to findings from other European countries.

  • 28.
    Holmqvist Larsson, Kristina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Stern, Helene
    Psykologhalsan, Linkoping, Sweden.
    Zetterqvist, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Emotion regulation group skills training for adolescents and parents: A pilot study of an add-on treatment in a clinical setting2019In: Clinical Child Psychology and Psychiatry, ISSN 1359-1045, E-ISSN 1461-7021, article id UNSP 1359104519869782Article in journal (Refereed)
    Abstract [en]

    Difficulties with emotion regulation have been identified as an underlying mechanism in mental health. This pilot study aimed at examining whether group skills training in emotion regulation for adolescents and parents as an add-on intervention was feasible in an outpatient child and adolescent psychiatric clinic. We also investigated if the treatment increased knowledge and awareness of emotions and their functions, increased emotion regulation skills and decreased self-reported symptoms of anxiety and depression. Six skills training groups were piloted with a total of 20 adolescents and 21 adults. The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired-samples t test was used to compare differences between before-and-after measures for adolescents and parents separately. The primary outcome measure, Difficulties in Emotion Regulation Scale, showed significant improvement after treatment for both adolescents and parents. For adolescents, measures of alexithymia were significantly reduced. Also, emotional awareness was significantly increased. Measures of depression and anxiety did not change. In conclusion, group skills training as an add-on treatment can be feasible and effective but further studies are needed.

  • 29.
    Jonsson, Linda
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Fredlund, Cecilia
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Priebe, Gisela
    Lund Univ, Sweden.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Online sexual abuse of adolescents by a perpetrator met online: a cross-sectional study2019In: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, E-ISSN 1753-2000, Vol. 13, no 1, article id 32Article in journal (Refereed)
    Abstract [en]

    Background

    The current study aimed at exploring adolescents’ experiences of online sexual contacts leading to online sexual abuse by a perpetrator whom the victim had first met online. Associations with socio demographic background, experience of abuse, relation to parents, health and risk behaviors were studied.

    Methods

    The participants were a representative national sample of 5175 students in the third year of the Swedish high school Swedish (M age = 17.97). Analyses included bivariate statistics and stepwise multiple logistic regression models.

    Results

    In total 330 (5.8%) adolescents had gotten to know someone during the preceding 12 months for the purpose of engaging in some kind of sexual activity online. Thirty-two (9.7%) of those, the index group, had felt that they had been persuaded, pressed or coerced on at least one occasion. Sexual interaction under pressure was seen as constituting sexual abuse. These adolescent victims of online sexual abuse, the index group, did not differ with respect to socio-demographic background from the adolescents without this experience, the reference group. The index group had significantly more prior experiences of different kind of abuse, indicating that they belong to a polyvictimized group. More frequent risk behavior, poorer psychological health, poorer relationships with parents and lower self-esteem also characterized the index group. Online sexual abuse, without experiences of offline abuse, was associated with a poorer psychological health, at least at the same level as offline sexual abuse only.

    Conclusions

    The study made clear the importance of viewing online sexual abuse as a serious form of sexual abuse. Professionals meeting these children need to focus not only on their psychological health such as symptoms of trauma and depression but also need to screen them for online behavior, online abuse and other forms of previous abuse.

  • 30.
    Jonsson, Linda
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Barn utsatta för sexuella övergrepp på nätet2017Report (Other academic)
    Abstract [sv]

    Denna fördjupningsrapport fokuserar på barns erfarenheter av sexuella övergrepp på nätet. Rapporten baseras på den tredje epidemiologiska undersökningen om ungdomars sexuella beteenden och erfarenheter på Internet. Unga sex och Internet – i en föränderlig värld är en enkätstudie från 2014 där 5 839 elever i gymnasiets tredje år deltog. Deltagarna tillfrågades om erfarenheter av olika övergrepp av sexuell karaktär på nätet såsom nätgrooming, sexuella övergrepp och sexuella övergreppsbilder.

    Resultaten i denna rapport är nya och unika. De ska tolkas med försiktighet då det behövs mer studier inom området. Dock visar resultaten tydliga mönster, som vi till viss del känner igen från både nationell och internationell forskning samt kliniska erfarenheter vi fått ta del av.

    Såväl de ungdomar som blivit nätgroomade (23,2 %) som de som blivit utsatta för sexuella övergrepp över nätet senaste året (32 ungdomar av de 330 ungdomar som hade haft sex på nätet) uppvisade en tämligen likartad bild av utsatthet för andra sexuella övergrepp, känslomässig och fysisk misshandel, känslomässig och fysisk mobbning samt olika former av självskadebeteenden. Till detta kommer att de rapporterade en sämre känslomässig relation till sina föräldrar under uppväxten även om de sociodemografiskt inte skiljde sig från andra ungdomar med få undantag.

    Ett viktigt resultat från studien är att vi har kunnat konstatera att dokumentation i form av fotografering och filmning av sexuella övergrepp påverkar den psykiska hälsan negativt. Även osäkerheten om det skett eller inte är förknippad med en ytterligare försämrad psykisk ohälsa jämfört med när övergrepp inte dokumenterats. För de barn/ungdomar vars bilder spritts ökar den psykiska ohälsan ytterligare.

    Bilden som målas upp är att denna grupp av ungdomar har en komplex bild av traumatiska erfarenheter och ohälsa och närmast är att betrakta som polytraumatiserade.

    Forskningens uppgift är att på ett vetenskapligt sätt belysa olika fenomen i samhället och att utifrån genererade data dra slutsatser och ge rekommendationer för att som i detta fall bidra till en bättre hjälp som i detta fall till en utsatt och belastad grupp barn- och ungdomar.

    Vi kan se att dessa ungdomar behöver såväl förebyggande som rehabiliterande insatser.

    På det förebyggande planet behövs bättre kunskap om våld och andra former av övergrepp bland alla som arbetar med barn. Utan denna kunskap och professionell utveckling kommer de barn som riskerar att utsättas eller redan blivit utsatta riskera att inte upptäckas i tid, och att inte heller kunna erbjudas adekvata insatser. Detta gäller sannolikt än mer de mest utsatta, bl.a. de grupper som denna fördjupningsrapport fokuserat på.

    Barn och unga måste tidigt få kunskap om vad ett sexuellt övergrepp är, vilka rättigheter man har och vad man kan göra om man blir drabbad. Skolan är en utmärkt plats att genomföra denna typ av utbildning. Vi kan se ett behov av en förändrad, moderniserad, sexualundervisning med fokus på relationer, ömsesidighet och respekt för att stärka barn och ungdomars sexuella integritet.

    Kunskap om våld och andra övergrepp mot barn behöver integreras i samtliga utbildningar som riktar sig till personer som kommer att arbeta med barn och ungdomar. Detta sker lämpligast genom att ämnet införs i respektive examinationsordningar. Det är också angeläget att fortbilda redan anställd personal inom rättsväsende, socialt arbete, hälso- och sjukvård och skola om våld och sexuella övergrepp mot barn.

    Utsatta barn/och ungdomar vänder sig oftast till kompisar och andra jämnåriga för att prata om övergreppen och för att få ett initialt stöd (Svedin et al., 2015; Landberg et al., 2015). Därför måste det till stora satsningar vad gäller kunskap om kompisstöd, vad man t.ex. ska göra om en kompis utsatts. Redan idag finns bra framtaget material (se www.dagsattprataom.se) som behöver spridas vidare till bland annat ungdomsmottagningar och skolan.

    Erfarenheterna från intervjuer med ungdomar i EU-projektet SPIRTO (Jonsson et al, 2015c) visar att främsta anledningen till att unga undviker att prata med sina föräldrar om vad de gör på nätet är för att de upplever att föräldrarna kan för lite. Unga efterlyser kunskapsspridning till föräldrar och lärare och andra som arbetar med barn om nätet. Hur nätet fungerar som källa till information och glädje såväl som till de risker som finns på nätet.

    Förövarna behöver hjälp och behandling för att minska risken att de utsätter nya barn. Därför är det ytterst viktigt med behandlingsenheter spridda i landet som alla har möjlighet att kontakta.

    Resultaten gällande det markant allvarliga hälsoläget för de barn som drabbats av övergrepp på nätet av sexuell karaktär ställer krav på skola, hälso- och sjukvård samt rättsväsende. De drabbade barnen måste prioriteras genom att få snabba utredningar från både polis och socialtjänst följt av möjlighet till bra stöd och behandling. Precis som i huvudrapporten från 2015 (Svedin et al., 2015), finns det anledning att understryka att om barn och ungdomars psykosociala ohälsa är så nedsatt som här framkommer, måste samhället säkerställa att de erbjuds professionellt stöd och hjälp. Många kan behöva högspecialiserad vård. Detta gäller en stor del av de barn och unga som utsatts för våld eller andra övergrepp och är extra angeläget för en polyviktimiserad grupp som den som denna rapport fokuserar på.

    I framtiden behövs fler studier med olika metodik för att få en bättre bild och en djupare förståelse för hur övergrepp på nätet av sexuell karaktär påverkar de drabbade barnen.

  • 31.
    Jonsson, Linda
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Pribe, Gisela
    Department of Psychology, IKV, Lund University, Lund, Sweden.
    Fredlund, Cecilia
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Zetterqvist, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Similarities and differences in the functions of nonsuicidal self-injury (NSSI) and sex as self-injury (SASI)2019In: Journal of Suicide and Life-threatening Behaviour, ISSN 0363-0234, E-ISSN 1943-278X, no 1, p. 120-136Article in journal (Refereed)
    Abstract [en]

    Differences and similarities were studied in the functions of two different self-injurious behaviors (SIB): nonsuicidal self-injury (NSSI) and sex as self-injury (SASI). Based on type of SIB reported, adolescents were classified in one of three groups: NSSI only (n = 910), SASI only (n = 41), and both NSSI and SASI (n = 76). There was support for functional equivalence in the two forms of SIB, with automatic functions being most commonly endorsed in all three groups. There were also functional differences, with adolescents in the SASI only group reporting more social influence functions than those with NSSI only. Adolescents reporting both NSSI and SASI endorsed the highest number of functions for both behaviors. Clinical implications are discussed, emphasizing the need for emotion regulation skills.

    The full text will be freely available from 2019-10-26 15:38
  • 32.
    Kastbom, Åsa A.
    et al.
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Larsson, I.
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Svedin, Carl Göran
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Parents?: Observations and Reports on the Sexual Behaviour of 7 to 13 Years Old Children2012In: Reproductive System & Sexual Disorders, ISSN 2161-038X, Vol. 1, no 2, p. 2-7Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate sexual behaviours, types and frequencies, among Swedish children in the age group of 7-13 years, as observed and reported by their parents and to give professionals in different areas a greater knowledge of sexual behaviour among younger school children.

    Methods: The parents of 418 children answered questionnaires about their child's behaviour, both general and sexual, and about their own attitudes.

    Results: We found that most sexual behaviours we asked about were reported by the parents as common, and are in part related to, or vary with, age and gender. A small number of sexual behaviours often referred to as problematic behaviour were found to be very unusual in this normative group of Swedish children.

    Conclusion: Behaviours usually referred to as sexualized and problematic were rare in this normative sample of children at 7-13 years of age. The results are of importance for clinicians' evaluation of sexual behaviours reported by parents.

  • 33.
    Kastbom, Åsa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping. Department of Psychology, Linnaeus University, Växjö, Sweden.
    Priebe, Gisela
    Department of Psychology, Lund University, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Comparing quality of life between Swedish adolescents and young adults from sexual minorities and heterosexual groups2015Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: To investigate the relationship between sexual identity and socio- demographics, sexual experience, health, experience of child abuse, sexual exploitation and present behavior among Swedish adolescents and young adults.

    Methods: A cross-sectional survey with 3,503 adolescents completing a  survey  about their sexuality, health and abuse at a mean age of 18.3 years. In addition, 362 members of the Swedish Federation for Lesbian, Gay, Bisexual and Transgender Rights completed the same survey at a mean age of 21.4 years.

    Results: Sexual minority respondents were more likely to say that their parental relationship was based on low care and high overprotection and they used alcohol and other drugs to a significantly higher extent than their heterosexual peers. Multivariate analysis showed a positive correlation between sexual minority and  low  self-esteem, poor mental health and experience of sexual abuse, physical abuse and sexual exploitation.

    Conclusion: The sexual minority group had a lower quality of life than their heterosexual peers and professionals need to be more aware that they are more vulnerable in a number of respects, including an increased risk of having experienced child abuse, and offer them different forms of support.

  • 34.
    Kastbom, Åsa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping. Department of Psychology, Linnaeus University, Växjö, Sweden.
    Priebe, Gisela
    Department of Psychology, Linnæus University, Växjö, Sweden; Department of Child and Adolescent Psychiatry, Lund University, Lund, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Differences in sexual behavior, health, and history of child abuse among school students who had and had not engaged in sexual activity by the age of 18 years: a cross-sectional study2016In: Adolescent Health, Medicine and Therapeutics, ISSN 1179-318X, Vol. 7, p. 1-11Article in journal (Refereed)
    Abstract [en]

    Background: Empirical research about late sexual debut and its consequences is limited, and further research is needed.

    Objective: To explore how students who had not had intercourse by the age of 18 years differed in terms of sociodemographic factors, physical and psychological health, sexual behavior, and history of sexual abuse from those who had.

    Materials and methods: This is a cross-sectional survey involving 3,380 Swedish 18-year-olds. Descriptive analyses were used to investigate different types of sexual behavior. Ordinal data concerning alcohol consumption, self-esteem, sexual and physical abuse, parental relationships, sense of coherence, and health were analyzed, and multiple regression was carried out to identify the most important factors associated with no sexual debut.

    Results: Just under a quarter of the adolescents had not had oral, anal, or vaginal sex by the age of 18 years, and they comprised the index group. They were characterized by being more likely to have caring fathers, parents born outside Europe, lower pornography consumption, lower alcohol and tobacco consumption, less antisocial behavior, and above all lower sexual desire (sometimes, adjusted odds ratio [aOR] 3.8; never/seldom, aOR 13.3) and fewer experiences of sexual abuse (aOR 25.5). Family structure and culture matters when it comes to the age of sexual debut.

    Conclusion: Adolescents with no sexual debut at 18 years of age seemed to live a more stable and cautious life than more sexual experienced peers, exemplified by fewer antisocial acts, less smoking and alcohol/drug consumption, less sexual desire, and less experience of sexual abuse.

  • 35.
    Kastbom, Åsa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Priebe, Gisela
    Lund University, Sweden; Linnaeus University, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Sexual debut before the age of 14 leads to poorer psychosocial health and risky behaviour in later life2015In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 1, p. 91-100Article in journal (Refereed)
    Abstract [en]

    Aim: This study investigated the relationship between sexual debut before 14 years of age and socio-demographics, sexual experience, health, experience of child abuse and behaviour at 18 years of age.

    Methods: A sample of 3432 Swedish high school seniors completed a survey about sexuality, health and abuse at the age of 18.

    Results: Early debut was positively correlated with risky behaviours, such as the number of partners, experience of oral and anal sex, health behaviours, such as smoking, drug and alcohol use, and antisocial behaviour, such as being violent, lying, stealing and running away from home. Girls with an early sexual debut had significantly more experience of sexual abuse. Boys with an early sexual debut were more likely to have a weak sense of coherence, low self-esteem and poor mental health, together with experience of sexual abuse, selling sex and physical abuse. A multiple logistic regression model showed that a number of antisocial acts and health behaviours remained significant, but early sexual debut did not increase the risk of psychiatric symptoms, low self-esteem or low sense of coherence at 18 years of age.

    Conclusion: Early sexual debut was associated with problematic behaviours during later adolescence, and this vulnerability requires attention from parents and healthcare providers.

  • 36.
    Kjellgren, Ceclia
    et al.
    Linnéuniversitetet, Sweden.
    Nilsson, Doris
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Thulin, Johanna
    Linnéuniversitetet, Sweden.
    Implementering av en strukuterad behandlingsmetod vid barnmisshandel-ett tioårsperspektiv2017In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 4, p. 457-476Article in journal (Refereed)
    Abstract [en]

    Ten years ago an evidence based treatment model for families where phy-sical abuse had occurred (CPC-CBT, Combined Parent Child-Cognitive Be-havioral Therapy) was introduced in Sweden. The project was a bottom-up project initiated by social workers. Four teams were initially trained and pro-mising results by treatment follow-up were identified in a pilot study. Further implementation started and so far additional hundred therapists has been trained in the model. More than thousand families have completed treat-ment. Ongoing research examines treatment effects as well as experiences among children who have received treatment. Experiences of referring so-cial workers as well as the process of implementation are reported in this pa-per. Findings are discussed, obstacles as well as supportive factors during the implementation process

  • 37.
    Kloppen, Kathrine
    et al.
    University of Bergen, Norway.
    Haugland, Siren
    Uni Research Heatlh, Norway.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Maehle, Magne
    Sogn og Fjordane University of Coll, Norway.
    Breivik, Kyrre
    Uni Research Heatlh, Norway.
    Prevalence of Child Sexual Abuse in the Nordic Countries: A Literature Review2016In: Journal of Child Sexual Abuse, ISSN 1053-8712, E-ISSN 1547-0679, Vol. 25, no 1, p. 37-55Article in journal (Refereed)
    Abstract [en]

    This review examined child sexual abuse in the Nordic countries focusing on prevalence rates and victims age and relationship to the perpetrator. The results show a prevalence of child sexual abuse (broadly defined) between 3-23% for boys and 11-36% for girls. The prevalence rates for contact abuse were 1-12% for boys and 6-30% for girls, while 0.3-6.8% of the boys and 1.1-13.5% of the girls reported penetrating abuse. The findings suggest an increased risk of abuse from early adolescence. In adolescence, peers may constitute the largest group of perpetrators. The results highlight the need for preventive efforts also targeting peer abuse. Future research should include cross-national and repeated studies using comparable methodology.

  • 38.
    Kvist, T.
    et al.
    Karolinska Inst, Sweden.
    Annerbäck, Eva-Maria
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Uppsala Univ, Sweden.
    Dahllöf, G.
    Karolinska Inst, Sweden.
    Oral health in children investigated by Social services on suspicion of child abuse and neglect2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 76, p. 515-523Article in journal (Refereed)
    Abstract [en]

    Child abuse and neglect (CAN) are likely to have negative consequences on health; however, for oral health, studies on associated outcomes are sparse. The purpose of this study was to assess oral health and oral health behaviors in relation to suspected CAN among children being investigated by the Swedish Social Services. The material comprised data from the Social Services and dental records; the sample, 86 children and 172 matched controls. The children in the study group had a higher prevalence of dental caries than the control group; in addition, levels of non-attendance and dental avoidance were high, as was parental failure to promote good oral health. We found four factors that, taken together, indicated a high probability of being investigated because of suspected CAN: prevalence of dental caries in primary teeth, fillings in permanent teeth, dental health service avoidance, and referral to specialist pediatric dentistry clinics. If all four factors were present, the cumulative probability of being investigated was 0.918. In conclusion, there is a high prevalence of dental caries, irregular attendance, and a need for referral a pediatric dental clinic among Swedish children under investigation due to suspected CAN. Social context is an important factor in assessing the risk of developing dental caries, the inclination to follow treatment plans, and the prerequisites for cooperation during treatment. Routinely requesting dental records during an investigation would provide important information for social workers on parental skills and abilities to fulfill the basic needs of children.

  • 39.
    Landberg, Åsa
    et al.
    Stiftelsen Allmänna Barnhuset, Stockholm.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Priebe, Gisela
    Lunds universitet.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Jonsson, Linda
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Fredlund, Cecilia
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Det gäller en av fem: fakta om barn, sexuella övergrepp och sexuell exploatering i Sverige 20142014Report (Other academic)
    Abstract [sv]

    Det här är den tredje stora undersökningen som gjorts om av samma forskargrupp. De tidigare undersökningarna genomfördes 2004 och 2009. Det gör att vi kan jämföra svaren och se utveckling över tid. Undersökningen har genomförts av forskare från Linköpings och Lunds universitet på uppdrag av Stiftelsen Allmänna Barnhuset och har finansierats av regeringen. Den här skriften sammanfattar delar av undersökningen från 2014. Den som är intresserad av att läsa mer om resultaten eller om hur undersökningen är upplagd, kan ta del av den fullständiga rapporten, Unga, sex och internet - i en föränderlig värld, via Stiftelsen Allmänna Barnhusets hemsida www.allmannabarnhuset.se eller via Linköpings universitet www.barnafrid.se.

    Statistiska Centralbyrån har gjort ett urval av skolor som är representativt. Några av de utvalda skolorna föll bort för att de lagt ned, inte ville delta eller inte svarade. Det var frivilligt att delta, och det fanns elever som valde att avstå, eller helt enkelt inte var i skolan den dag som undersökningen genomfördes.

    Sammanlagt medverkade 5 873 elever från 171 skolor. Eleverna besvarade enkäten under lektionstid, med en av skolan utvald, ansvarig person i klassrummet. Elever, ansvariga lärare och rektor fick information om studien i form av ett informationsbrev. Där fanns också uppgifter om vart eleverna kunde vända sig för att få stöd och hjälp.

    Vi ställde frågor på en rad olika områden. Det gör att vi vet mycket om de elever som svarade. Frågorna handlade om sociodemografi (bakgrundsfaktorer som till exempel ålder, kön, födelseland, ekonomi eller föräldrarnas utbildningsnivå), sport/idrottsutövande, sexualitet, erfarenhet av frivilligt sex, alkohol och droganvändning, antisocialt beteende, fysiska, psykiska och sexuella övergrepp, erfarenheter av vård för psykiatriska besvär, självskadebeteende, självskada genom sex, sälja sex, människohandel, kontakt med socialtjänsten, mobbning samt användande av internet, mobiler och pornografi.

    Enkäten innefattade även ett antal standardiserade mätinstrument som mäter hur eleverna uppfattar relationen till sina föräldrar, deras självkänsla, symtom på posttraumatisk stress och självskadebeteende. De ungdomar som svarat gick tredje året på gymnasiet 2014. Åldern varierade mellan 16 och 23 år med en medelålder på knappt 18 år. Något fler tjejer än killar deltog och en grupp på 0,9 procent tyckte inte att indelningen kille/tjej passade dem. Vad den grupp som inte tycker att könsindelningen passar dem har svarat på frågorna redovisas på några områden.

  • 40.
    Lindgren, Britt-Marie
    et al.
    Umea Univ, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Werko, Sophie
    Swedish Agcy Hlth Technol Assessment and Assessment, Sweden; Karolinska Inst, Sweden.
    A Systematic Literature Review of Experiences of Professional Care and Support Among People Who Self-Harm2018In: Archives of Suicide Research, ISSN 1381-1118, E-ISSN 1573-8159, Vol. 22, no 2, p. 173-192Article, review/survey (Refereed)
    Abstract [en]

    Self-harm is an increasing phenomenon among young people, with potentially fatal outcomes. Patients perceptions of treatment and support are poorly documented. The aim was to synthesise the experiences of those who self-harm, with special reference to professional care and support by family, friends, and the school system. A systematic review of the literature was conducted. Following retrieval of 1,623 abstracts, 14 studies were included in the final analysis, 11 of which are reported here. Two quantitative studies as well as 1 mixed method study on self-care could not be reported on here due to word limitations. Adult people who self-harm described the importance of quality in the caring relationship and a tailored care designed for each individual. There is a need for more studies into adolescents who self-harm but of importance is the adolescents need for support from the adult world. A positive relationship between patient and healthcare professional can be crucial in motivating continued treatment of people who self-harm. A major priority is radical improvement in the attitudes of healthcare personnel.

  • 41.
    Michel, Per-Olof
    Michel Mentor AB, Karlstad.
    Bergh Johannesson, Kerstin (Contributor)
    Uppsala Psykoterapimottagning.
    Nilsson, Doris (Contributor)
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Arnberg, Filip (Contributor)
    Kunskapscentrum för katastrofpsykiatri, Uppsala universitet.
    Psykotraumatologi2018 (ed. 3)Book (Other academic)
    Abstract [sv]

    Människosläktet har genom årtusenden exponerats för olyckor och naturkatastrofer. Transportolyckor och andra tekniska katastrofer, krig och flyktingtrauman, terrorhändelser liksom interpersonellt våld och traumatiska övergrepp under uppväxten kan utgöra påfrestningar under människors liv samt leda till svåra hälsoeffekter.

    Denna tredje upplaga av Psykotraumatologi riktar sitt fokus mot den utveckling som skett under senaste decenniet när det gäller forskningen inom området. Sålunda beskrivs hur människor reagerar på hot och på faktorer som både kan öka risken för och motverka utvecklingen av traumatisk stress. Komplicerade sorgereaktioner och traumarelaterade tillstånd beskrivs ingående både när det gäller barn och vuxna. Vidare är avsnitten om neurobiologi, krisstöd i akutfas och behandling uppdaterade.

    Syftet med Psykotraumatologi är att utgöra en samlad kunskapskälla för den som behöver det i sin utbildning och fortbildning. På så sätt kan alla som i sin profession kommer i kontakt med potentiellt traumatiserade individer, till exempel inom hälso- och sjukvården, skolväsendet samt inom kommunernas socialtjänst ha nytta av boken.

  • 42.
    Modin, Bitte
    et al.
    Stockholm Univ, Sweden.
    Plenty, Stephanie
    Inst Futures Studies IFFS, Sweden; Swedish Inst Social Res, Sweden.
    Laftman, Sara B.
    Stockholm Univ, Sweden.
    Bergstrom, Malin
    Stockholm Univ, Sweden.
    Berlin, Marie
    Natl Board Hlth and Welf, Sweden; Stockholm Univ, Sweden.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Hjern, Anders
    Stockholm Univ, Sweden.
    School Contextual Features of Social Disorder and Mental Health ComplaintsA Multilevel Analysis of Swedish Sixth-Grade Students2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 1, article id 156Article in journal (Refereed)
    Abstract [en]

    This study addressed school-contextual features of social disorder in relation to sixth-grade students experiences of bullying victimization and mental health complaints. It investigated, firstly, whether the schools concentrations of behavioural problems were associated with individual students likelihood of being bullied, and secondly, whether the schools concentrations of behavioural problems and bullying victimization predicted students emotional and psychosomatic health complaints. The data were derived from the Swedish National Survey of Mental Health among Children and Young People, carried out among sixth-grade students (approximately 12-13 years old) in Sweden in 2009. The analyses were based on information from 59,510 students distributed across 1999 schools. The statistical method used was multilevel modelling. While students own behavioural problems were associated with an elevated risk of being bullied, attending a school with a higher concentration of students with behavioural problems also increased the likelihood of being bullied. Attending a school with higher levels of bullying victimization and behavioural problems predicted more emotional and psychosomatic complaints, even when adjusting for their individual level analogues. The findings indicate that school-level features of social disorder influence bullying victimization and mental health complaints among students.

  • 43.
    Mörelius, Evalotte
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Nelson, Nina
    Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Norrköping. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Neonatal Intensive Care and Child Psychiatry Inpatient Care: Do Different Working Conditions Influence Stress Levels?2013In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2013Article in journal (Refereed)
    Abstract [en]

    Introduction. Nurses often experience work-related stress. High stress can negatively affect job satisfaction and lead to emotional exhaustion with risk of burnout.

    Aim. To analyse possible differences in biological stress markers, psychosocial working conditions,health, and well-being between nurses working in two different departments.

    Methods. Stress was evaluated in nurses working in a neonatal intensive care unit (NICU) (𝑛 = 33) and nursesworking in a child and adolescent psychiatry inpatient ward (CAP) (𝑛 = 14) using salivary cortisol and HbA1c. Salivary cortisol was measured three times a day on two consecutive days during two one-week periods, seven weeks apart (= 12 samples/person). Psychosocial working conditions, health, and well-being were measured once.

    Results. NICU nurses had better social support and more self-determination. CAP nurses had a lower salivary cortisol quotient,poorer general health, and higher client-related burnout scores.

    Conclusion.When comparing these nurses with existing normdata for Sweden, as a group their scores reflect less work-related stress than Swedes overall. However, the comparison between NICU and CAP nurses indicates a less healthy work situation for CAP nurses.

    Relevance to Clinical Practice. Healthcare managers need to acknowledge the less healthy work situation CAP nurses experience in order to provide optimal support and promote good health.

  • 44.
    Mörelius, Evalotte
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Ivars, Katrin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Nelson Follin, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Karolinska University Hospital, Sweden.
    Salivary cortisol circadian rhythm in infants at psychosocial risk showed more variations than previous studies of healthy full-term infants2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 12, p. 2060-2061Article in journal (Refereed)
    Abstract [en]

    n/a

  • 45.
    Nilsson, Doris
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences.
    Bergh Johannesson, Kerstin
    National centre for disaster psychiatry, department of neuroscience, Uppsala university, Uppsala, Sweden.
    Evaluation of the Swedish Trauma Symptom Inventory -2 in a clinical and a studnet population2018In: European Journal of Trauma and Dissociation, ISSN 2468-7499, Vol. 2, no 2, p. 71-82Article in journal (Refereed)
    Abstract [en]

    Introduction. – The Trauma Symptom Inventory-2 (TSI-2) is a broad-spectrum assessment instrumentdesigned to identify symptoms that can appear in the aftermath of potentially traumatic experiences.

    Objective. – This study aimed to evaluate the external and internal validity of this newly reconstructedinstrument.Method. – In total, 696 individuals participated in the study, including 83 psychiatric outpatients. Participants answered the TSI-2, together with a trauma history questionnaire, and other questionnairesassumed to correlate with the different scales included in the TSI-2.

    Results. – Validity was evaluated by correlations between the TSI-2 and the other instruments and bythe differences between clinical and non-clinical populations. Reliability was calculated by testinginternal consistency and test-re-test reliability. A confirmatory factor analysis (CFA) was computed totest the postulated four-factor structure. Cronbach’s alpha was found to be good and ranged froma = .77 to .91 and test-retest reliability was strong. Strong to satisfactory correlations were foundbetween the TSI-2 and the other instruments. The student sample scored significantly lower than theclinical group on all clinical scales. Sensitivity and specificity were calculated with different cut-offscores.

    Conclusion. – Despite the CFA demonstrating a questionably good model of fit, most of the scales provedto be sound and the TSI-2 could be recommended as a broad-spectrum assessment instrument.

  • 46.
    Nilsson, Doris
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Bergh Johannesson, Kerstin
    Uppsala Psykoterapimottagning, Smedsgränd.
    Trauma Symptom Inventory™ -2 TSI-2: Svensk Version2015Book (Other academic)
    Abstract [sv]

    TSI-2 är ett självrapporteringsformulär som mäter posttraumatisk stress och relaterade symptom och beteenden. TSI-2 syftar till att identifiera symptom som kvarstår hos individen efter en eller flera svåra livshändelser. Mer specifikt är instrumentet avsett att användas för vuxna som har upplevt traumatiska händelser i livet såsom exempelvis fysiska eller sexuella övergrepp, olyckor, katastrofhändelser, traumatiska förluster, dödsfall av närstående, medicinska trauman eller bevittnat hot och våld. TSI-2 mäter ett brett spektrum av traumatiska symptom och lämpar sig framförallt för screening men kan också användas för att utvärdera effekter av psykoterapeutiska interventioner.

    TSI-2 består av 136 påståenden som ger resultat på:

    Två validitetsskalor

    Underrapportering eller förnekande av symptom, samt en skala gällande överrapportering av traumarelaterade symptom.

    Fyra faktorer

    Självförvirring, Posttraumatisk stress, Externalisering och Somatisering.

    Tolv kliniska skalor

    Ångestfylld spändhet, Depression, Ilska, Invaderande återupplevande, Undvikande, Dissociation, Somatisk upptagenhet, Sexuella svårigheter, Självmordsbenägenhet, Osäker anknytning, Skadad självkänsla, Spänningsreducerande beteende.

    Den svenska versionen av TSI-2 är standardiserad och normerad vid Linköpings universitet och Uppsala universitet under åren 2012-2014. Normgruppen består av sammanlagt 693 individer i åldrarna 18-65 år. En klinisk grupp med 83 individer ingår också i valideringen av den svenska versionen av TSI-2. Utvecklingsarbetet och den svenska versionens psykometriska egenskaper beskrivs i manualen, som även innehåller anvisningar för administrering, poängsättning och tolkning samt köns- och åldersspecifika normtabeller.

  • 47.
    Nilsson, Doris
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Green, Sara
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Psychoform and somatoform dissociation among children and adolescents: An evaluation of a new short screening instrument for dissociation, DSQ-122019In: European journal of trauma and dissociation, ISSN 2468-7499, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Introduction

    Today's assessment instruments for dissociation among adolescents are either relatively extensive or are specifically designed to identify either psychoform or somatoform dissociation.

    Objective

    A questionnaire that is shorter than any of the existing questionnaires and is concerned with both forms of dissociation would be helpful for both clinicians and researchers.

    Method

    Existing data from 462 adolescents who had answered Dis-Q Sweden and SDQ-20 were used to create a new questionnaire consisting of 12 items. A pilot study with 42 participants 15-19 years old, was carried out to test this new instrument, Dissociation Screening Questionnaire 12 (DSQ-12). DSQ-12 was then tested on 451 adolescents 10 to 20 years old. A matched clinical group of 25 adolescents in the same age range was used, in order to test the classification performance of DSQ-12.

    Results

    Results showed good reliability, convergent and construct validity was satisfactory, and dissociation differed between age groups as well as between genders.

    Conclusions

    Conclusions are that the developed DSQ-12 performed well psychometrically, was reliable and valid. DSQ-12 is easy to answer and is suitable for clinical screening purposes and future research.

  • 48.
    Nilsson, Doris
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Johansson, Erika
    Linköping University, Department of Behavioural Sciences and Learning.
    Larsson, Katarina
    Linköping University, Department of Behavioural Sciences and Learning.
    Näslund, Johan
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    The experience of internal and external supporting objects from the perspective of six young women who have lost a parent to cancer: An interpretative phenomenological analyisis2017In: Annals of Psychiatry and Treatment, Vol. 2, no (2), p. 24-32Article in journal (Refereed)
    Abstract [en]

    Background: Adolescents losing a parent are a risk group for future complications in their ongoing live such as higher rate of mortality, self- harm and other mental health problems. There is a lack of knowledge in what, how and when to offer help as well as no concluding theoretical model to understand the whole process of losing a parent. The objective of this study was to examine how the relationships of some young people are affected by the loss of a parent to cancer during their teenage years.

    Method: Six women aged between 18 and 25 participated in the study. An Interpretative Phenomenological Analysis (IPA) method was used.

    Result: The theme of loneliness was cemented with the two main themes, into loneliness and out of loneliness and sub-themes such as, cancer comes along, silence, hold on to and miss, those closest, the supporters, independence, closeness and distance.

    Conclusion: The parent who has died lives on as an inner object and the support from the remaining parent is viewed very important. The process to be back on track seems diverse and continues for a long time and outside help needs to tune in with this.

  • 49.
    Nilsson, Doris
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Lejonclou, Annika
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Jonsson, Mattias
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Holmqvist, Rolf
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Somatoform dissociation among Swedish adolescents and young adults: The psychometric properties of the Swedish versions of the SDQ-20 and SDQ-52015In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 69, no 2, p. 152-160Article in journal (Refereed)
    Abstract [en]

    Background: Somatoform dissociation is supposed to be a vital aspect of the general concept of dissociation. The Somatoform Dissociation Questionnaire-20 (SDQ-20) and the brief version SDQ-5 are self-report instruments constructed to identify somatic dissociation. Aim: In the present study, the psychometric qualities of the Swedish version of the SDQ-20 and its brief version, the SDQ-5, were examined among adolescents and young adults. Reliability and concurrent validity were investigated. Methods: A total of 512 adolescents and young adults participated in the study: 461 adolescents from a non-clinical sample and 50 adolescents and young adults from a clinical eating disorder outpatient unit. They completed the self-report instruments the SDQ-20, the SDQ-5 (part of SDQ-20), the Linköping Youth Life Experience Scale (LYLES, a trauma history scale) and the Dissociation Questionnaire-Sweden (Dis-Q-Sweden). Results: Both internal consistency and test-retest reliability of the Swedish version of SDQ-20 were good in both the non-clinical (α = 0.83) and the clinical groups (α = 0.84); the reliability for the SDQ-5 was, however, lower (non-clinical α = 0.50, clinical α = 0.64). Significant differences were found between the clinical and non-clinical groups on both somatoform and psychoform dissociation. Correlations between the Dis-Q-Sweden, SDQ-20 and SDQ-5 were generally high. The criterion and convergent validity was acceptable for both scales but somewhat better for SDQ-20 than for SDQ-5. Conclusion: The advantage with both the SDQ-20 and the SDQ-5 is that they are short questionnaires, but the results suggests that SDQ-20 is preferable based on the higher-quality psychometric properties of the SDQ-20.

  • 50.
    Nilsson, Doris
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Lejoonclou, Annika
    Region Östergötland.
    Holmqvist, Rolf
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Psychoform and somatoform dissociation amongindividuals with eating disorders2019In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Objective: This study analyzed the prevalence of psychoform and somatoform dissociation among individuals with the whole spectrum of eating disorder diagnoses and compared it with ratings from a non-clinical group. The relationship between dissociation and severity of eating disturbance was examined as well as differences between the eating disorder diagnosis groups in extent of dissociation. The validity of a new structural dissociation interview suitable for eating disorder patients was analyzed.

    Method: Sixty individuals with eating disorder completed three self-report questionnaires: Dissociation Questionnaire Sweden, Somatoform Dissociation Questionnaire and Eating Disorder Examination Questionnaire. The ratings were compared with the scores in a female non-clinical group (N = 245). Twenty patients with eating disorder diagnoses were interviewed with the Interview for Dissociative Disorders and Trauma Related Symptoms. The validity of the interview was tested by comparing the ratings on the interview subscales with the scores on the Dissociation questionnaires and the Somatoform Dissociation Questionnaire.

    Results: Participants with eating disorders reported a higher extent of both psychoform and somatoform dissociation compared with the non-clinical individuals. Analyses also showed a correlation between degree of dissociation and severity of eating disorder symptoms. No differences in dissociation were found between the ED subgroups. Participants reporting more dissociation got higher ratings on the interview, indicating convergent validity.

    Discussion: Eating disorders seem to be associated with presence and severity of dissociative symptoms. The extent of dissociation needs to be assessed for these individuals as treatment may benefit from a focus on such symptoms in order to increase its effect.

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