liu.seSearch for publications in DiVA
Change search
Refine search result
12 1 - 50 of 84
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Allansson, Elin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per E
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Nelson, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Overweight and obese children have lower cortisol levels than normal weight children2014In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 3, p. 295-299Article in journal (Refereed)
    Abstract [en]

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

  • 2.
    Annerbäck, Eva-Maria
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Lindell, Charlotta
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Severe child abuse: A study of cases reported to the police2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 12, p. 1760-1764Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate the characteristics of severe abuse of children and possible differences in comparison with less severe abuse. Method: Cases of abuse reported to the police within a single police district (n = 142) in Sweden were studied. The severe cases were compared to all the remaining cases. Results: Severe abuse constituted 14% of the total cases and was reported by agencies to a greater degree than minor cases. The suspected perpetrators were socially disadvantaged people in both groups. Half of the most serious cases led to conviction in the courts, compared to 8% in the reference group. The children who had been subjected to abuse were often already known to social services and reports of child abuse had frequently been made. Conclusion: In comparison between cases of severe and minor child abuse reported to the police, the results did not show any crucial differences except the pattern of reporting and a higher occurrence of prosecution/conviction in the severe cases. This finding places a responsibility on agencies outside of the justice system to consider all cases of reported abuse as serious warning signals and to make independent evaluations to identify risks and the possible need for child protection. © 2007 The Author(s).

  • 3.
    Annerbäck, Eva-Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Sahlqvist, L.
    Research and Development Centre, Sörmlands County Council, S-631 88 Eskilstuna, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Work and Environmental Science. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Child Physical Abuse and concurrence of other types of Child Abuse: associations with health and risk behaviors2012In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 36, no 7-8, p. 585-595Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the associations between child physical abuse and health problems/risk-taking behaviors among teen-agers. Further to evaluate concurrence of other types of abuse and how these alone and in addition to child physical abuse were associated with bad health status and risk-taking behaviors.

    Methods: A population-based survey was carried out in 2008 among all the pupils in two different grades (15 respectively 17 years old) in Södermanland County, Sweden (N=7 262). The response rate was 81.8 %. The pupils were asked among other things about their exposure to child physical abuse, exposure to parental intimate violence, bullying and exposure to being forced to engage in sexual acts. Adjusted analyses were conducted to estimate associations between exposure and illhealth/risk-taking behaviors.

    Results: Child physical abuse was associated with poor health and risk-taking behaviors with adjusted Odds Ratios (OR) ranging from 1.6 to 6.2. The associations were stronger when the pupils reported repeated abuse with OR ranging from 2.0 to 13.2. Also experiencing parental intimate partner violence, bullying and being forced to engage in sexual acts was associated with poor health and risk-taking behaviors with the same graded relationship to repeated abuse. Finally there was a cumulative effect of multiple abuse in the form of being exposed to child physical abuse plus other types of abuse and the associations increase with the number of concurrent abuse.

    Conclusions: This study provides strong indications that child abuse is a serious public health problem based on the clear links seen between abuse and poor health and behavioral problems. Consistent with other studies showing a graded relationship between experiences of abuse and poor health/risk-taking behaviors our study shows poorer outcomes for repeated and multiple abuse. Thus, our study calls for improvement of methods of comprehensive assessments, interventions and treatment in all settings where professionals meet young people.

  • 4.
    Annerbäck, Eva-Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Characteristic Features of Severe Child Physical Abuse-A Multi-informant Approach2010In: Journal of family Violence, ISSN 0885-7482, E-ISSN 1573-2851, Vol. 25, no 2, p. 165-172Article in journal (Refereed)
    Abstract [en]

    Minor child physical abuse has decreased in Sweden since 1979, when a law banning corporal punishment of children was passed, but more serious forms have not decreased. The aim of this study was to examine risk and background factors in cases of severe child abuse reported to the police. Files from different agencies (e.g., Social services, Adult and Child psychiatry and Pediatric clinic) for 20 children and 34 caretakers were studied. An accumulation of risk factors was found. It is concluded that when the following four factors are present, there is a risk for severe child abuse: 1) a person with a tendency to use violence in conflict situations; 2) a strong level of stress on the perpetrator and the family; 3) an insufficient social network that does not manage to protect the child; 4) a child that does not manage to protect him or herself. Thus, multiple sources of information must be used when investigating child abuse.

  • 5.
    Annerbäck, Eva-Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine . Linköping University, Faculty of Health Sciences.
    Göran Svedin, Carl
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Prevalence and characteristics of child physical abuse in Sweden - findings from a population-based youth survey2010In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 8, p. 1229-1236Article in journal (Refereed)
    Abstract [en]

    Aim: To examine prevalence rates of child physical abuse perpetrated by a parent/caretaker, abuse characteristics and the extent of disclosures. Methods: A population-based survey was carried out in 2008 amongst all the pupils in three different grades (n = 8494) in schools in Sodermanland County, Sweden. The pupils were asked about their exposure to violence and their experiences of parental intimate-partner violence. Data were analysed with bi- and multivariate models and a comparison between means of accumulating risk factors between three groups were performed. Results: A total of 15.2% of the children reported that they had been hit. There were strong associations between abuse and risk factors and there was a dose-response relationship between risks and reported abuse. It was shown that children who reported parental intimate-partner violence were at a considerably higher risk for abuse than other children and that only 7% of the children exposed to violence had disclosed this to authorities. Conclusion: Even though child abuse in Sweden has decreased markedly during the last 40 years, violence against children is still a considerable problem. It is a challenge to develop methods of assessment and interventions that will ensure that the violence and its underlying causes are directly addressed.

  • 6.
    Back, Christina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    How do children overcome difficulties talking about sexual abuseManuscript (preprint) (Other academic)
    Abstract [en]

    Aim of this study was to identify and describe the obstacles that can prevent children from talking about sexual abuse in a police interview. Data consisted of 28 investigative interviews with children and 12 police interrogations with non-offending parents. The children in these situations were between 8 and 15 years of age when they were interviewed. Data interpretation and analysis were based on content analysis. The following categories were identified: not being believed/telling the truth, need of support and dependence on adults, guilt and shame, fear, and spatial- and time-oriented.

  • 7.
    Back, Christina
    et al.
    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.
    Gustafsson, Per A.
    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.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Parental opinions of their child's experience in the legal process: an interpretative analysis2014In: Journal of Child Sexual Abuse, ISSN 1053-8712, E-ISSN 1547-0679, Vol. 23, no 3, p. 290-303Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to demonstrate how parents of children who are victims of sexual assault experience the legal process from the children’s and parents’ perspective. Nine parents, identified in the records of three public prosecution offices in three cities in Sweden, were interviewed. The parents described feelings of shame and guilt over what their children had experienced. They felt stigmatized and had difficulty fulfilling their parental role, perceived a lack of information and support from the professionals involved, and experienced a sense of withdrawal from their role as parents, though they felt the professionals who worked with their children were helpful and influential.

  • 8.
    Back, Christina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Parents’ opinions – view of their child´s experiences in the legal process: An interpretative analysis of parents’ opinionsManuscript (preprint) (Other academic)
    Abstract [en]

    The aim of this study was to demonstrate how parents of children, who are victims of sexual assault, experience the legal process, seen from the child’s, as well as the parents’ perspective. Nine parents identified in the records of three public prosecution offices in three cities in Sweden, were interviewed. The parents described feelings of shame and guilt over what their children had experienced. They felt stigmatized and had difficulty fulfilling their parental role; perceived a lack of information and support from the professionals involved; experienced a sense of withdrawal from their role as parents, even though they felt the professionals who worked with their children were helpful and influential.

  • 9.
    Back, Christina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Sexually Abused Children – Prosecutors' Experiences of their Participation in the Legal Process in Sweden2013In: Psychiatry, Psychology and Law, ISSN 1321-8719, E-ISSN 1934-1687, Vol. 20, no 2, p. 273-283Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to interview prosecutors, based on their experiences working with children who have been sexually abused. The informants were seven prosecutors identified from the records of three public prosecution offices in three cities in Sweden. The informants' experiences were elicited via individual in-depth semi-structured interviews. The interviews were carried out and analysed using interpretative phenomenological analysis (IPA). Three themes emerged: (1) difficulties with evidence of criminal conduct, (2) children's special needs, and (3) children's dependence on adults. Informants' descriptions of how they perceived the children in the legal process were associated with their experience of the difficulty of finding proof of the crime. Informants were found to experience difficulties when they encounter children in the legal process. As prosecutors they often face difficulties proving that the child has been exposed to crime.

  • 10.
    Bernfort, Lars
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment.
    Nordfeldt, Sam
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    AD/HD i ett samhällsekonomiskt perspektiv2005Report (Other academic)
  • 11.
    Bernfort, Lars
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Nordfeldt, Sam
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry. Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics.
    Persson, Jan
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    ADHD from a socio-economic perspective2008In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 2, p. 239-245Article, review/survey (Refereed)
    Abstract [en]

    Aim: Attention deficit hyperactivity disorder (ADHD) and related disorders affect children's ability to function in school and other environments. Awareness has increased in recent years that the same problems often persist in adulthood. Based on previous studies, we aimed to outline and discuss a descriptive model for calculation of the societal costs associated with ADHD and related disorders. Methods: Following a literature review including childhood and adult studies, long-term outcomes of ADHD and associated societal costs were outlined in a simple model. Results: The literature concerning long-term consequences of ADHD and related disorders is scarce. There is some evidence regarding educational level, psychosocial problems, substance abuse, psychiatric problems and risky behaviour. The problems are likely to affect employment status, healthcare consumption, traffic and other accidents and criminality. A proposed model structure includes persisting problems in adulthood, possible undesirable outcomes (and their probabilities) and (lifetime) costs associated with these outcomes. Conclusions: Existing literature supports the conclusion that ADHD and related disorders are associated with a considerable societal burden. To estimate that burden with any accuracy, more detailed long-term data are needed. © 2007 The Author(s).

  • 12.
    Birberg Thornberg, Ulrika
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Silfverdal, Sven-Arne
    Division of Paediatrics, Department of Clinical Sciences, Umeå University.
    Duchén, Karel
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    A Placebo controlled, randomized study of PUFA (Poly Unsaturated Fatty Acids) as treatment for neurodevelopmental problems in 7-year-old children and cognitive performance in relation to an age-matched control groupManuscript (preprint) (Other academic)
    Abstract [en]

    OBJECTIVE: The goal of the present randomized placebo controlled double-blind study was to investigate the potential effect of PUFA supplementation on cognitive and behavioural performance in children with neurodevelopmental problems at 7 years of age (n = 28) and to compare findings with an age matched healthy control group (n = 20).

    METHODS: Children were screened with parent and teacher rating scales (Conner’s and SNAP-IV), and were included if they showed a range of neurodevelopmental problems that reached ADHD criteria. The group with neurodevelopmental difficulties was randomized to treatment with an EPA rich formula (n = 13) or to placebo (n = 15). Cognitive performance was determined at baseline and after 15 weeks of supplementation with a cognitive test battery including executive function and theory of mind tasks.

    RESULTS: Children with neurodevelopmental problems differed from the control group regarding working memory, inhibition and language ability, but not on an advanced theory of mind task. Regarding the treatment with EPA supplement there were no significant advantages in the active treatment group compared to placebo in any of the cognitive measures or in parents or teacher rating scales.

    CONCLUSION: The significant differences in cognitive performance and rating scales between the group with neurodevelopmental problems and the healthy control group at baseline indicate problems at a clinical level and suitability for treatment. However we found no significant effects of PUFA supplementation. The study is small and limited by a number of drop-outs.

  • 13.
    Birberg Thornberg, Ulrika
    et al.
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Karlsson, Thomas
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Gustafsson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Duchén, Karel
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Nutrition and theory of mind: The role of polyunsaturated fatty acids (PUFA) in the development of theory of mind2006In: Prostaglandins, Leukotrienes and Essential Fatty Acids, ISSN 0952-3278, E-ISSN 1532-2823, Vol. 75, no 1, p. 33-41Article in journal (Refereed)
    Abstract [en]

    Breast-milk provides nutrients required for the development of the brain. n-6 and n-3 long-chain polyunsaturated fatty acids (LCPUFAs) have been suggested to be particularly involved. In this study levels of fatty acids in breast-milk were examined in relation to theory of mind (ToM) (n=13) and WISC-III (n=22) in six-year-old children. ToM tasks comprised four illustrated stories with questions about emotional (sad) events. Single polyunsaturated fatty acids (PUFA) were estimated as well as ratios between different fatty acids in order to describe putative associations between PUFA and psychological measures. Results show correlations between both ToM and WISC-III with single n-6 PUFA and the ratios DHA/AA and DHA/DPA. The correlations remained when socio-demographic factors were statistically controlled for. The positive findings related to the n-6 and n-3 LCPUFAs corroborate previous findings related to child cognitive development. © 2006 Elsevier Ltd. All rights reserved.

  • 14.
    Cocozza, Madeleine
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Who suspects and report child maltreatment to Social Services in Sweden?: Is there a reliable mandatory reporting process?2007In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 10, no 2, p. 209-223Article in journal (Refereed)
    Abstract [en]

    This article deals with the mandatory report process in Sweden. The components that are analysed are who makes the reports, what is reported and the outcome for the reports. Data were collected in a Swedish county in the year 2000 by means of locating every report made to the Social Services during one year (1998). The net sample consisted of 1,570 reports regarding 1,051 children. A follow-up study was carried out in 2003 of all the children for whom a report in 1998 did not lead to an investigation being initiated. We found in these study indicators that the process might not be secure. The professionals reported 1% of the children in the municipality; 22% of the reports from professionals were not investigated. The five-year follow-up study shows that 53% of the children that these reports concerned had been the subject of an investigation. This could be an indicator that children continue to be maltreated after being reported since the assessments are not accurate. In this study, 67% of 'crime reports' were 'not indicating' child maltreatment. There should be a questioning of 'crime reports' automatically entering the mandated report process as, if registered nationally, this could lead to a deflation of mandatory reports. Administration needs to change introducing a national form for filing reports.

  • 15.
    D Cherma, Maria
    et al.
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Ahlner, Johan
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Bengtsson, Finn
    Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Antidepressant Drugs in Children and Adolescents Analytical and Demographic Data in a Naturalistic, Clinical Study2011In: JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, ISSN 0271-0749, Vol. 31, no 1, p. 98-102Article in journal (Refereed)
    Abstract [en]

    Pharmacokinetics of antidepressant drugs (ATDs), in terms of steady-state and trough values, in patients from Child and Adolescent Psychiatry centers in the midsouth-eastern part of Sweden, were evaluated, and the use of ATDs in this population were described. Patients to be prescribed an ATD were studied between 2002 and 2004. Two hundred eleven children, 64% girls and 36% boys (ages 8-20 years) were evaluated. The primary indication for the antidepressant treatment was depression in 69% of subjects. The median body mass index was 20.2 kg/m(2) (range, 12.4-38.6 kg/m(2)). Suspected adverse drug reactions were spontaneously reported in 31% (no serious). Monotherapy was indicated in 49% of request forms. The most common drug combination with the ATD was oral contraceptives. The concentrations of drugs in the patient evaluated population to referenced data for adults from the dose administered were as expected in 63%, higher than expected in 26% and lower than expected in 11%. The most prescribed ATD was sertraline (SERT). Dose-concentration relationships for SERT and metabolite desmethylsertraline (DSERT) were seen, r(s) = 0.48 and r(s) = 0.5, respectively. No relationship was found between dose and ratio DSERT/SERT. The median daily dose was 50 mg (range, 12.5-150 mg), SERT concentration 16 ng/mL (range, 3-88 ng/mL), and DSERT 33 ng/mL (range, 0-253 ng/mL). CYP2D6*4 was the most common poor metabolizer allele. Therapeutic drug monitoring may provide support to prescribing physicians to individual dose optimizing and to assess drug compliance, above all when ATDs are not well studied in pediatric patients before approval for general prescription.

  • 16.
    Dahlström, Örjan
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Lundh, Lars-Gunnar
    Department of Psychology, Lund University, Lund, Sweden..
    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.
    Functions of Nonsuicidal Self-Injury: Exploratory and Confirmatory Factor Analyses in a Large Community Sample of Adolescents2015In: Psychological Assessment, ISSN 1040-3590, E-ISSN 1939-134X, Vol. 27, no 1, p. 302-313Article in journal (Refereed)
    Abstract [en]

    Given that nonsuicidal self-injury (NSSI) is prevalent in adolescents, structured assessment is an essential tool to guide treatment interventions. The Functional Assessment of Self-Mutilation (FASM) is a self-report scale that assesses frequency, methods, and functions of NSSI. FASM was administered to 3,097 Swedish adolescents in a community sample. With the aim of examining the underlying factor structure of the functions of FASM in this sample, the adolescents with NSSI who completed all function items (n = 836) were randomly divided into 2 subsamples for cross-validation purposes. An exploratory factor analysis (EFA) was followed by a confirmatory factor analysis (CFA) using the mean and variance adjusted weighted least squares (WLSMV) estimator in the Mplus statistical modeling program. The results of the EFA suggested a 3-factor model (social influence, automatic functions, and nonconformist peer identification), which was supported by a good fit in the CFA. Factors differentiated between social/interpersonal and automatic/intrapersonal functions. Based on learning theory and the specific concepts of negative and positive reinforcement, the nonconformist peer identification factor was then split into 2 factors (peer identification and avoiding demands). The resulting 4-factor model showed an excellent fit. Dividing social functions into separate factors (social influence, peer identification, and avoiding demands) can be helpful in clinical practice, where the assessment of NSSI functions is an important tool with direct implications for treatment.

  • 17.
    deKeyser, Linda
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health 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.
    Agnafors, Sara
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Multi-informant reports of mental health in Swedish-born children of immigrants and children born to non-immigrants - the SESBiC-study2014In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 14, p. 95-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The European literature on mental health of the children of immigrants is limited. Therefore this study aims to investigate gender-specific mental health reported by teachers, parents and the children themselves in 12-year old children of immigrants and non-immigrants and also to study the level of agreement between the different informants.

    METHODS:

    This cross-sectional study is a part of the longitudinal South East Sweden Birth Cohort-study (the SESBiC-study) on children's health. All children born in town in the south of Sweden 1995-1996 were invited to take part. The mothers of 1723 children (88%) consented. In this part 87 Swedish-born 12-year old children of immigrants and 687 12-year old children of non-immigrants were investigated regarding gender-specific differences in mental health as reported by teachers (Teacher-report form), parents (Child behavior checklist), and children (Strengths and Difficulties Questionnaire) and the agreement reached between the informants.

    RESULTS:

    Parental immigrant status was not associated with mental health in any of the groups, but living arrangements and parental educational level were mainly found to have an effect on the health status of boys (TRF-Internalizing β = .77 95% CI = .02-1.52; TRF-Externalizing.β = 2.31 95% CI = .63-3.99; TRF-Total β = 6.22 95% CI = 2.27-10.18) The agreement between different informants was generally low, except for externalizing problems among boys (Boys of immigrant parents: Parent and teacher correlation ρ = .422 and Child teacher correlation ρ = .524, p-value < .05, respectively). The correlation between teachers and parents were lower in the index group compared to the reference group. In the index group, the correlations between teacher's and children's assessments were fairly high for boys but not for girls (ρ Total = .400, ρ Internalizing = .240 and ρ Externalizing = .524, p-value < .05 for Total and Externalizing).

    CONCLUSION:

    This study confirms previous findings that the mental health of children of immigrants is similar to that of children of non-immigrants. We found that family factors have a greater impact on the reported mental health than immigrant status does. This might be of clinical importance for healthcare workers to recognize when investigating and treating children from other cultures.

  • 18.
    Ekberg, Joakim
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ericson, Leni
    Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces. Linköping University, The Institute of Technology.
    Timpka, Toomas
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Public Health Sciences.
    Eriksson, Henrik
    Linköping University, Department of Computer and Information Science, MDALAB - Human Computer Interfaces. Linköping University, The Institute of Technology.
    Nordfeldt, Sam
    Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Hanberger, Lena
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Ludvigsson, Johnny
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Web 2.0 Systems Supporting Childhood Chronic Disease Management: Design Guidelines Based on Information Behaviour and Social Learning Theories2010In: JOURNAL OF MEDICAL SYSTEMS, ISSN 0148-5598, Vol. 34, no 2, p. 107-117Article in journal (Refereed)
    Abstract [en]

    Self-directed learning denotes that the individual is in command of what should be learned and why it is important. In this study, guidelines for the design of Web 2.0 systems for supporting diabetic adolescents every day learning needs are examined in light of theories about information behaviour and social learning. A Web 2.0 system was developed to support a community of practice and social learning structures were created to support building of relations between members on several levels in the community. The features of the system included access to participation in the culture of diabetes management practice, entry to information about the community and about what needs to be learned to be a full practitioner or respected member in the community, and free sharing of information, narratives and experience-based knowledge. After integration with the key elements derived from theories of information behaviour, a preliminary design guideline document was formulated.

  • 19.
    Gren Landell, Malin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Aho, Nikolas
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Carlsson, Elisabeth
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Jones, Annica
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Posttraumatic stress symptoms and mental health services utilization in adolescents with social anxiety disorder and experiences of victimization2013In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 22, no 3, p. 177-184Article in journal (Refereed)
    Abstract [en]

    Recent findings from studies on adults show similarities between social anxiety disorder (SAD) and posttraumatic stress in the form of recurrent memories and intrusive and distressing images of earlier aversive events. Further, treatment models for SAD in adults have been successfully developed by using transdiagnostic knowledge on posttraumatic stress symptoms (PTSS). Studies on adolescents are though missing. The present study aimed at exploring the association between PTSS and SAD in Swedish adolescents. A second aim was to study mental health services utilization in relation to these conditions. A total of 5,960 high-school students participated and reported on SAD, life time victimization, PTSS and mental health service utilization. Socially anxious adolescents reported significantly higher levels of PTSS than adolescents not reporting SAD and this difference was seen in victimized as well as non-victimized subjects. Contact with a school counselor was the most common mental health service utilization in subjects with SAD and those with elevated PTSS. In the prediction of contact with a CAP-clinic, significant odds ratios were found for a condition of SAD and elevated PTSS (OR = 4.88, 95 % CI = 3.53–6.73) but not for SAD only. Screening of PTSS in adolescents with SAD is recommended. The service of school counselors is important in detecting and helping young people with SAD and elevated PTSS. Clinical studies on SAD and PTSS in adolescents could aid in modifying treatment models for SAD.

  • 20.
    Gustafsson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Don't blame it on the parents - Make them your allies: A family/systems approach to paediatric illness2005In: Clinical Child Psychology and Psychiatry, ISSN 1359-1045, E-ISSN 1461-7021, Vol. 10, no 1, p. 23-31Article in journal (Refereed)
    Abstract [en]

    A family/systems approach allows us to see the individual in context. The family and the informal social network constitute the most important environment for a child. A basic assumption is that changes in family interaction patterns will have an impact on somatic as well as psychiatric symptoms in the child. In modern paediatric practice parents are routinely instructed to give their sick child the prescribed treatment and to implement preventive measures, they are recruited as part of the medical team. A family/systems approach helps families to identify their strengths and needs. The approach described here with a session transcript illustrates how understanding the ways in which family relatioinships interact with the course of illness and treatment can influence quality of life.

  • 21.
    Gustafsson, Per
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Birberg Thornberg, Ulrika
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Duchén, Karel
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Landgren, Magnus
    Department of Pediatrics, Mariestad, Sweden .
    Malmberg, Kerstin
    Karolinska Institutet, Stockholm.
    Pelling, Henrik
    Uppsala University.
    Strandvik, Birgitta
    Gothenburg University, Sweden.
    Karlsson, Thomas
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    EPA supplementation improves teacher-rated behaviour and oppositional symptoms in children with ADHD2010In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 99, no 10, p. 1540-1549Article in journal (Refereed)
    Abstract [en]

    Aim: Measure efficacy of eicosapentaenoic acid (EPA) in children with attention deficit hyperactivity disorder (ADHD). Methods: Randomized controlled trial (RCT) of 0.5 g EPA or placebo (15 weeks) in 92 children (7-12 years) with ADHD. Efficacy measure was Conners Parent/Teacher Rating Scales (CPRS/CTRS). Fatty acids were analysed in serum phospholipids and red blood cell membranes (RBC) at baseline and endpoint with gas chromatography. Results: EPA improved CTRS inattention/cognitive subscale (p = 0.04), but not Conners total score. In oppositional children (n = 48), CTRS total score improved andgt;= 25% in 48% of the children receiving EPA vs. 9% for placebo [effect size (ES) 0.63, p = 0.01]. In less hyperactive/impulsive children (n = 44), andgt;= 25% improvement was seen in 36% vs. 18% (ES 0.41, n.s.), and with both these types of symptoms 8/13 with EPA vs. 1/9 for placebo improved andgt;= 25% (p = 0.03). Children responding to treatment had lower EPA concentrations (p = 0.02), higher AA/EPA (p = 0.005) and higher AA/DHA ratios (p = 0.03) in serum at baseline. Similarly, AA/EPA (p = 0.01), AA/DHA (p = 0.038) and total omega-6/omega-3 ratios (p = 0.028) were higher in RBC, probably because of higher AA (p = 0.011). Conclusion: Two ADHD subgroups (oppositional and less hyperactive/impulsive children) improved after 15-week EPA treatment. Increasing EPA and decreasing omega-6 fatty acid concentrations in phospholipids were related to clinical improvement.

  • 22.
    Gustafsson, Per
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Duchén, Karel
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Birberg, Ulrika
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Karlsson, Thomas
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Breastfeeding, very long polyunsaturated fatty acids (PUFA) and IQ at 6 1/2 years of age2004In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 93, no 10, p. 1280-1287Article in journal (Refereed)
    Abstract [en]

    Aim: Breastfeeding seems to be favorable for cognitive development. Could levels of polyunsaturated fatty acids (PUFA) explain this? Methods: Pregnant mothers were recruited consecutively at maternity care centres. PUFA were analysed in colostrum and breast milk at 1 and 3 mo. The product-precursor ratios of n-6+n-3 PUFA were examined as measures of activity in respective steps in the fatty acid metabolic chain. Also, the quotient between DHA and AA was analysed. The children were tested with the full WISC-III at 6.5 y. Results: First, the influence of length of breastfeeding was analysed by multiple regression together with relevant cofactors (except for PUFA). In the best models, 46% of the variation in total IQ was explained. Length of breastfeeding contributed significantly to total IQ (beta = 0.228, p = 0.021), verbal IQ (beta = 0.204, p = 0.040) and performance IQ (beta = 0.210, p = 0.056). There were no significant single correlations between PUFA and measures of cognitive development. However, in multiple regression analysis of colostrum, significant beta-coefficients were found for steps 4+5 in the fatty acid metabolic chain (beta = 0.559, p = 0.002). If length of breastfeeding and gestation week were added to steps 4+5, this three-factor model could explain 67% of the variation of total IQ. Introducing length of breastfeeding and gestation week together with the quotient DHA/AA (beta = 0.510, p < 0.001) yielded a three-factor model, which explained 76% of the variation in total IQ. Conclusion: Our findings could be interpreted as supporting the importance of high levels of PUFA for cognitive development. However, the sample is small and the results must be interpreted with caution.

  • 23.
    Gustafsson, Per E
    et al.
    Dept. of Public Health and Clinical Medicine, Family Medicine, Umeå University.
    Anckarsäter, Henrik
    Dept. of Neuroscience and Physiology, Forensic Psychiatry, Gothenburg University.
    Lichtenstein, Paul
    Dept. of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm.
    Nelson, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology 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. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Does quantity have a quality all its own?: Cumulative adversity and up- and down-regulation of circadian salivary cortisol levels in healthy children2010In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 35, no 9, p. 1410-1415Article in journal (Refereed)
    Abstract [en]

    Findings have been divergent regarding the direction of basal cortisol dysregulations resulting from stressor exposure, and seem to differ between young people and adults. Accumulated stress exposure has been suggested to be a risk factor for the development of hypocortisolism. This cross-sectional study aims to examine the impact of cumulative adversity, i.e., the number of adversities, on diurnal salivary cortisol levels, including the cortisol awakening response (CAR), in children without psychiatric disorder. The sample consisted of 130 children (mean age 12.8 years), representing one in each twin pair included in the population-based Child and Adolescent Twin Study in Sweden (CATSS). Information about socioeconomic disadvantage, negative life events and potentially traumatic life events were collected by telephone interview and questionnaires, with parents as informants. Salivary cortisol sampling was performed in the home during two school days: at awakening, +30 min post-awakening, and at bedtime. Results showed that the number of adversities was related to the CAR, diurnal decline and +30 min post-awakening cortisol levels. Children with a moderate amount of cumulative adversity displayed high cortisol measures, while those with a high amount (3 or more) of adversities instead showed levels similar to the non-exposed group, yielding an inverse U-pattern of the association between cortisol and adversity. These results indicate that the accumulation of adversity might be an explanation of patterns of basal cortisol up-regulation in children and that those most severely exposed can exhibit an early stage of down-regulation, an issue which should be further examined in longitudinal studies.

  • 24.
    Gustafsson, Per E.
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Ivarsson, Tord
    Department of Child and Adolescent Psychiatry, Göteborg University, Göteborg, Sweden; The Regional Center for Child and Adolescent Psychiatry (R. BUP), Oslo, Norway.
    Nelson, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Diurnal Cortisol Levels and Cortisol Response in Youths with Obsessive-Compulsive Disorder2008In: Neuropsychobiology, ISSN 0302-282X, E-ISSN 1423-0224, Vol. 57, no 1-2, p. 14-21Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 25.
    Gustafsson, Per E.
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Nelson, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. 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. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Diurnal cortisol levels, psychiatric symptoms and sense of coherence in abused adolescents2010In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 64, no 1, p. 27-31Article in journal (Refereed)
    Abstract [en]

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

  • 26.
    Gustafsson, Per E
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Nilsson, Doris
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Polytraumatization and Psychological Symptoms in Children and Adolescents2009In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 18, no 5, p. 274-283Article in journal (Refereed)
    Abstract [en]

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

  • 27.
    Gustafsson, Per E
    et al.
    Folkhälsa och Klinisk Medicin/Socialmedicin, Umeå University.
    Szczepanski, Anders
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Department of Culture and Communication, Arts, Crafts and Design. Linköping University, Faculty of Arts and Sciences.
    Nelson, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. 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. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Effects of an outdoor education intervention on the mental health of schoolchildren2012In: Journal of Adventure Education and Outdoor Learning, ISSN 1472-9679, E-ISSN 1754-0402, Vol. 12, no 1, p. 63-79Article in journal (Refereed)
    Abstract [en]

    This study aimed at examining the effects of an outdoor educational intervention on the mental health of schoolchildren. Two elementary schools participated (N = 230); one experimental school where the intervention was implemented, and the other a reference school. Demographic questions and the Strengths and Difficulties Questionnaire were completed by the parents. An outdoor educational intervention was implemented at the experimental school, and the data collection was repeated after one year. The results point towards a small but non-significant improvement in mental health at the experimental school while adjusting for demographics. However, this effect was significantly moderated by gender: boys generally fared better than girls at the intervention school, relative to the reference school. The results indicate that it may be important to address gender issues when educational programmes are implemented in schools.

  • 28.
    Gustafsson, Per
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Gustafsson, Per E
    Umeå University.
    Anckarsater, Henrik
    Gothenburg University.
    Lichtenstein, Paul
    Karolinska Institute.
    Ljung, Therese
    Karolinska Institute.
    Nelson, Nina
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Larsson, Henrik
    Karolinska Institute.
    Heritability of Cortisol Regulation in Children2011In: Twin Research and Human Genetics, ISSN 1832-4274, E-ISSN 1839-2628, Vol. 14, no 6, p. 553-561Article in journal (Refereed)
    Abstract [en]

    Background: The normal development of cortisol regulation during childhood is thought to be influenced by a complex interplay between environmental and genetic factors. Method: The aim of this study was to estimate genetic and environmental influences on basal cortisol levels in a sample of 151 twin pairs aged 9-16 years. Salivary cortisol was collected on two consecutive days when the children attended school immediately after awakening, 30 min post-awakening and at bedtime. Results: Heritability was highest (60%) for cortisol levels about 30 min after awakening. For samples taken immediately at awakening heritability was less pronounced (28%) and in the evening low (8%). Conclusion: The limited genetic influence on evening levels, moderate on cortisol at awakening and high on awakening response, might imply two genetic regulation patterns, one specifically for awakening response and one for the circadian rhythm proper. These findings could explain divergent results in previous studies and highlight the importance of taking the circadian rhythm into account in studies of cortisol levels in children.

  • 29.
    Hanberger, Lena
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Ludvigsson, Johnny
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Nordfeldt, Sam
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Center for Medical Technology Assessment. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Quality of care from the patient's perspective in pediatric diabetes care2006In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 72, no 2, p. 197-205Article in journal (Refereed)
    Abstract [en]

    This study aimed to investigate perceived quality of diabetes care. A geographic population of 400 type 1 diabetes patients <20 years received the validated questionnaire quality of care from the patient's perspective (QPP) including additional context-specific items. Primary endpoints were perceived reality of care by specific items and factors and their subjective importance, respectively. Relations to severe hypoglycemia, HbA1c, insulin dose, BMI, age, duration and sociodemographic factors were also studied. On average, a high perceived quality of care was reported from both parents and adolescents (response rate 285/400 (71%) and 155/237 (65%), respectively), highest regarding possibility to talk to nurse/doctor in privacy, respect, general atmosphere, continuity in patient-physician relationship and patient participation. Lower perceived reality with higher subjective importance was seen for information about results from medical examinations and treatments and information about self-care, access to care and waiting time. While parents' and their adolescents' mean ratings correlated well for reality r = 0.95 (p < 0.001) and importance r = 0.53 (p = 0.023), parents rated reality level higher (p = 0.012) and importance even higher (p < 0.001). The QPP instrument used with additional context-specific items can provide specific information to be used in quality of care development. In our setting, improvements are needed regarding patient information, access to care and waiting time. © 2005 Elsevier Ireland Ltd. All rights reserved.

  • 30.
    Hanberger, Lena
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Ludvigsson, Johnny
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Nordfeldt, Sam
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Use of a Web 2.0 Portal to Improve Education and Communication in Young Patients With Families: Randomized Controlled Trial2013In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 15, no 8Article in journal (Refereed)
    Abstract [en]

    Background: Diabetes requires extensive self-care and comprehensive knowledge, making patient education central to diabetes self-management. Web 2.0 systems have great potential to enhance health information and open new ways for patients and practitioners to communicate. less thanbrgreater than less thanbrgreater thanObjective: To develop a Web portal designed to facilitate self-management, including diabetes-related information and social networking functions, and to study its use and effects in pediatric patients with diabetes. less thanbrgreater than less thanbrgreater thanMethods: A Web 2.0 portal was developed in collaboration with patients, parents, and practitioners. It offered communication with local practitioners, interaction with peers, and access to relevant information and services. Children and adolescents with diabetes in a geographic population of two pediatric clinics in Sweden were randomized to a group receiving passwords for access to the portal or a control group with no access (n=230) for 1 year. All subjects had access during a second study year. Users activity was logged by site and page visits. Health-related quality of life (HRQOL), empowerment (DES), and quality of information (QPP) questionnaires were given at baseline and after 1 and 2 study years. Clinical data came from the Swedish pediatric diabetes quality registry SWEDIABKIDS. less thanbrgreater than less thanbrgreater thanResults: There was a continuous flow of site visits, decreasing in summer and Christmas periods. In 119/233 families (51%), someone visited the portal the first study year and 169/484 (35%) the second study year. The outcome variables did not differ between intervention and control group. No adverse treatment or self-care effects were identified. A higher proportion of mothers compared to fathers visited once or more the first year (Pandlt;.001) and the second year (Pandlt;.001). The patients who had someone in the family visiting the portal 5 times or more, had shorter diabetes duration (P=.006), were younger (P=.008), had lower HbA1c after 1 year of access (P=.010), and were more often girls (Pandlt;.001). Peer interaction seems to be a valued aspect. less thanbrgreater than less thanbrgreater thanConclusions: The Web 2.0 portal may be useful as a complement to traditional care for this target group. Widespread use of a portal would need integration in routine care and promotion by diabetes team members.

  • 31.
    Jarkman Björn, Gunilla
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Bodén, Christina
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, 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, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Gustafsson, Per A.
    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.
    Brief Family Therapy for Refugee Children2013In: The Family Journal, ISSN 1066-4807, E-ISSN 1552-3950, Vol. 21, no 3, p. 272-278Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare refugee children’s psychological well-being before and after brief family therapy. Families from Bosnia-Herzegovina with one child aged 5–12 years received three family therapy sessions. Psychological assessments using the Erica play-diagnostic method and parental interviews were made before and after the intervention. The main finding was that more children built normal sandboxes (showing no pathological findings)after the intervention than before, indicating that the rather short intervention had a positive effect on the children’s psychological well-being. To conclude, it might be valuable to offer refugee families a few family therapy sessions even if the children do not have psychiatric symptoms with the aim of helping them adapt to a new system of society.

  • 32.
    Jarkman Björn, Gunilla
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, 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, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Family therapy sessions with regugee families: a qualitative study2013In: Conflict and Health, ISSN 1752-1505, E-ISSN 1752-1505, Vol. 7, article id 7Article in journal (Refereed)
    Abstract [en]

    Background

    Due to the armed conflicts in the Balkans in the 1990s many families escaped to other countries. The main goal of this study was to explore in more detail the complexity of various family members’ experiences and perceptions from their life before the war, during the war and the escape, and during their new life in Sweden. There is insufficient knowledge of refugee families’ perceptions, experiences and needs, and especially of the complexity of family perspectives and family systems. This study focused on three families from Bosnia and Herzegovina who came to Sweden and were granted permanent residence permits. The families had at least one child between 5 and 12 years old.

    Method

    Family therapy sessions were videotaped and verbatim transcriptions were made. Nine family therapy sessions were analysed using a qualitative method with directed content analysis.

    Results

    Three main categories and ten subcategories were found - 1. Everyday life at home, with two subcategories: The family, Work and School/preschool; 2. The influence of war on everyday life, with three subcategories: The war, The escape, Reflections; 3. The new life, with five subcategories: Employment, Health, Relatives and friends, Limited future, Transition to the new life.

    Conclusions

    Health care and social welfare professionals need to find out what kind of lives refugee families have lived before coming to a new country, in order to determine individual needs of support. In this study the families had lived ordinary lives in their country of origin, and after experiencing a war situation they escaped to a new country and started a new life. They had thoughts of a limited future but also hopes of getting jobs and taking care of themselves and their families. When analysing each person’s point of view one must seek an all-embracing picture of a family and its complexity to tie together the family narrative. To offer refugee families meetings with family-oriented professionals to provide the opportunity to create a family narrative is recommended for the health and social welfare sector. Using this knowledge by emphasizing the salutogenic perspectives facilitates support to refugee families and individuals. This kind of support can help refugee families to adapt to a new system of society and recapture a sense of coherence, including all three components that lead to coherence: comprehensibility, manageability and meaningfulness. More studies are needed to further investigate the thoughts, experiences and needs of various refugee families and how refugee receiving societies can give the most effective support.

  • 33.
    Jarkman-Björn, Gunilla
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Ethics and interpreting in psychotherapy with refugee children and families2005In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 59, no 6, p. 516-521Article in journal (Refereed)
    Abstract [en]

    Basic ethical principles like autonomy, non-maleficence, beneficence and justice should be taken into consideration step by step when treating refugee children and their families. These principles may be considered from the point of view of each of the actors involved - patient, therapist and interpreter. This paper is focused on the role of the interpreter and on different aspects to be considered by the therapist when working with interpreters in psychotherapeutic treatment of refugee children and families. Elements of case histories are used to illustrate situations faced in working with an interpreter. An ethical analysis of a case where a teenage refugee received therapeutic treatment using an interpreter is made. © 2005 Taylor & Francis.

  • 34.
    Jarkman-Björn, Gunilla
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Bodén, Christina
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Gustafsson, Per A
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Psychological evaluation of refugee children: contrasting results from play diagnosis and parental interviews2011In: Clinical Child Psychology and Psychiatry, ISSN 1359-1045, E-ISSN 1461-7021, Vol. 16, no 4, p. 517-34Article in journal (Refereed)
    Abstract [en]

    Many refugee families from Bosnia and Herzegovina arrived in Sweden during the Balkan conflict in the 1990s. We studied 14 of these families to compare psychological evaluation of the children using two different methods. We first carried out a semi-structured interview of a parent or parents in each family. The symptoms of each of the children, who ranged in age from 5 to 12 years, were evaluated based on these interview results. Then a second method, the Erica play-diagnosis method, was used to study the inner thoughts and feelings of the children. Results from the Erica play-diagnosis method were compared with results from Erica play- diagnosis from a normal group. According to results from the parental interviews all but one child in this study had a low level of psychological symptoms. In contrast, results from Erica play-diagnosis of these children showed that there were higher frequencies of not-normal play in these children compared with those in the normal group, which is an indication of deficiencies in the psychological well-being of these children. The results emphasise the importance of getting diagnostic information from the child in order to understand each child's psychological condition.

  • 35.
    Jonsson, Linda
    et al.
    Östergötlands Läns Landsting, 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 Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Priebe, Gisela
    Department of Psychology, Linnæus University, Växjö, Sweden.
    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.
    Online sexual behaviours among Swedish youth: associations to background factors, behaviours and abuse2015In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 24, no 10, p. 1245-1260Article in journal (Refereed)
    Abstract [en]

    Sexual activity online may result in positive experiences for young people, or lead them to engage in risky behaviours possibly resulting in sexual assault or abuse. The aim of our study was to investigate associations between online sexual behaviours among Swedish youth and background factors as well as aspects of well-being. The behaviours investigated were: having sex online with a contact met online, having sex with an online contact offline, posting sexual pictures online, and selling sex online. We used data from a representative sample of 3,432 Swedish youth who were asked about their lifetime experiences as well as their experiences within the previous year. We hypothesized that more advanced online sexual behaviours were associated with more problematic background factors, worse psychosocial well-being and riskier behaviours in general. Bivariate relationships were evaluated followed by a multiple logistic regression model. Our data suggested that most Swedish youth do not perform any of the assessed online sexual behaviours. Young people who reported online sexual behaviour showed a more problematic background, rated their health as poorer, had a more sexualized life and had experienced more sexual or physical abuse. Professionals who work with young people need to help them better evaluate potential risks online and offer support when needed. Youths who sell sex online are especially at risk and need extra attention, as they might be in greater need of protection and therapeutic support.

  • 36.
    Jonsson, Linda
    et al.
    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.
    Priebe, Gisela
    Lund University, Sweden .
    Bladh, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynecology and Obstetrics UHL.
    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.
    Voluntary sexual exposure online among Swedish youth - social background, Internet behavior and psychosocial health2014In: Computers in human behavior, ISSN 0747-5632, E-ISSN 1873-7692, Vol. 30, p. 181-190Article in journal (Refereed)
    Abstract [en]

    Studies have described the phenomenon of voluntary sexual exposure among youth online but only a few focus on the typical young person who has this experience. The purpose of this study was to investigate Swedish youth with experience of voluntary sexual exposure online, with regard to Internet behavior, social background, and psychosocial health including parent-child relationships. A representative sample of 3503 Swedish youths in their third year of high school completed a survey about Internet behavior, Internet-related sexual harassment, sexuality, health, and sexual abuse. Out of those taking part in the survey, 20.9% (19.2% boys and 22.3% girls) reported experiences of voluntary sexual exposure online. Multivariate analysis showed a significant association between voluntary sexual exposure online and a number of different forms of harassment online. Neither poorer psychosocial health nor problematic relationships with parents remained significant in the final model. The results underlined the fact that voluntary sexual exposure online is associated with vulnerability on the Internet among both boys and girls and that there is a need for parents and professionals to better understand what young people do on the Internet and the risks they may incur.

  • 37.
    Jonsson, Linda S.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Online Sexual Behaviours Among Swedish Youth: Characteristics, Associations and Consequences2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Online sexual behaviours refer to sexual activities where the Internet and/or mobile phone are used. The aims of this thesis were to investigate young people and their experiences of different online sexual behaviours with regard to characteristics, associations and consequences, by using data from a representative sample of 3,503 Swedish youth (m= 18.3 years). In addition 16 interviews were made with young women who had sold sex online before the age of 18. Focus in these interviews were in which ways contacts between buyer and seller were established and the motivational factors for selling sex online.

    In study I (n= 3,288), 20.9% (19.2% boys and 22.3% girls) reported experiences of voluntary online sexual exposure: flashing in webcam/mobile; posted partially undressed pictures or films; masturbated on webcam; had sex on webcam. Multivariate analysis showed a significant association between voluntary online sexual exposure and a number of different forms of harassments online. Neither poorer psychological health nor problematic relations with parents remained significant in the final model predicting voluntary online sexual exposure. In study II (n= 3,432) four online sexual behaviours were studied: meeting a person online for sex online; meeting a person online for sex offline; posted sexual pictures online; selling sex online. These were investigated in relation to socio-demographic factors, psychosocial wellbeing and risk behaviours. Bivariate logistic regressions were followed by multiple logistic regressions. The data suggested that most Swedish youth do not perform any of the assessed online sexual behaviours, but those who did (15.2%) reported a more problematic background, rated their health as poorer, had a more sexualised life and had experienced more sexual or physical abuse. This was especially prevalent among those who had sold sex online. In study III, young women with experiences of selling sex online before the age of 18 were interviewed. The interviews focused on the role Internet and mobile phone play and the methods of contacts and characteristics of the communication between buyer and seller. Two main themes were identified: Internet use - part of daily life for good and bad, depending on mood; Patterns of contacts - innocent/curious, dating, advertising. In the fourth study the interviews with the young women who had sold sex online before the age of 18 were analysed focusing on the women’s perceptions of the reasons why they started, continued and stopped selling sex. Three themes and eight sub-themes were identified in relation to different stages in their lives in the sex trade, each with its own storyline: Entering, adverse life experiences - traumatic events, feeling different and being excluded; Immersion, using the body as a regulating tool - being seen, being touched, being in control, affect regulation and self-harming; Exiting, change or die - living close to death, the process of quitting.

    In conclusion, the results from this thesis showed that most young people use Internet and mobile phones for non-sexual activities. Sexual behaviours online were associated with a more problematic background and poorer wellbeing. More research, attention and support are needed, especially related to young people selling sex online.

    List of papers
    1. Voluntary sexual exposure online among Swedish youth - social background, Internet behavior and psychosocial health
    Open this publication in new window or tab >>Voluntary sexual exposure online among Swedish youth - social background, Internet behavior and psychosocial health
    2014 (English)In: Computers in human behavior, ISSN 0747-5632, E-ISSN 1873-7692, Vol. 30, p. 181-190Article in journal (Refereed) Published
    Abstract [en]

    Studies have described the phenomenon of voluntary sexual exposure among youth online but only a few focus on the typical young person who has this experience. The purpose of this study was to investigate Swedish youth with experience of voluntary sexual exposure online, with regard to Internet behavior, social background, and psychosocial health including parent-child relationships. A representative sample of 3503 Swedish youths in their third year of high school completed a survey about Internet behavior, Internet-related sexual harassment, sexuality, health, and sexual abuse. Out of those taking part in the survey, 20.9% (19.2% boys and 22.3% girls) reported experiences of voluntary sexual exposure online. Multivariate analysis showed a significant association between voluntary sexual exposure online and a number of different forms of harassment online. Neither poorer psychosocial health nor problematic relationships with parents remained significant in the final model. The results underlined the fact that voluntary sexual exposure online is associated with vulnerability on the Internet among both boys and girls and that there is a need for parents and professionals to better understand what young people do on the Internet and the risks they may incur.

    Place, publisher, year, edition, pages
    Elsevier, 2014
    Keywords
    Youth; Internet; Technology; Sexual exposure; Sexting
    National Category
    Clinical Medicine Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-104645 (URN)10.1016/j.chb.2013.08.005 (DOI)000330090900020 ()
    Available from: 2014-02-20 Created: 2014-02-20 Last updated: 2017-12-06
    2. Online sexual behaviours among Swedish youth: associations to background factors, behaviours and abuse
    Open this publication in new window or tab >>Online sexual behaviours among Swedish youth: associations to background factors, behaviours and abuse
    2015 (English)In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 24, no 10, p. 1245-1260Article in journal (Refereed) Published
    Abstract [en]

    Sexual activity online may result in positive experiences for young people, or lead them to engage in risky behaviours possibly resulting in sexual assault or abuse. The aim of our study was to investigate associations between online sexual behaviours among Swedish youth and background factors as well as aspects of well-being. The behaviours investigated were: having sex online with a contact met online, having sex with an online contact offline, posting sexual pictures online, and selling sex online. We used data from a representative sample of 3,432 Swedish youth who were asked about their lifetime experiences as well as their experiences within the previous year. We hypothesized that more advanced online sexual behaviours were associated with more problematic background factors, worse psychosocial well-being and riskier behaviours in general. Bivariate relationships were evaluated followed by a multiple logistic regression model. Our data suggested that most Swedish youth do not perform any of the assessed online sexual behaviours. Young people who reported online sexual behaviour showed a more problematic background, rated their health as poorer, had a more sexualized life and had experienced more sexual or physical abuse. Professionals who work with young people need to help them better evaluate potential risks online and offer support when needed. Youths who sell sex online are especially at risk and need extra attention, as they might be in greater need of protection and therapeutic support.

    Keywords
    Sexual risk taking; Online sexual behaviour; Sexting; Selling sex; Youth; Adolescent; Internet
    National Category
    Psychiatry Social Sciences Interdisciplinary
    Identifiers
    urn:nbn:se:liu:diva-114538 (URN)10.1007/s00787-015-0673-9 (DOI)000362331400009 ()25589438 (PubMedID)
    Available from: 2015-02-26 Created: 2015-02-26 Last updated: 2018-01-11Bibliographically approved
    3. "Without the Internet, I never would have sold sex": Young Women Selling Sex Online
    Open this publication in new window or tab >>"Without the Internet, I never would have sold sex": Young Women Selling Sex Online
    2014 (English)In: Cyberpsychology : Journal of Psychosocial Research on Cyberspace, ISSN 1802-7962, E-ISSN 1802-7962, Vol. 8, no 1Article in journal (Refereed) Published
    Abstract [en]

    Among Swedish youth with experience of selling sex, the Internet is the most common means of contact between buyer and seller. There are few descriptions of how these contacts are established, but studies have indicated that young people under the age of 18 seldom engage in open prostitution online. This study aimed to examine what role the Internet and the use of smartphones play in young women selling sex online, focusing on the method of contact and the characteristics of the communication online between buyer and seller. The study included 15 young women between the ages of 15 and 25 (M=18.9) who had sold sex online before the age of 18. Thematic analysis was used to identify similarities and differences in the narratives.

    Two main themes were identified: (I) Internet use—Part of daily life, for good and bad, and Depending on mood. The young women described using the Internet on a daily basis. During periods of poorer psychological health they were more active on sites focusing on self-destructiveness and sex. During these periods, they also sold sex more frequently. (II) Patterns of contacts—Innocent/curious, Dating, and Advertising. The narratives about communication prior to a sexual encounter detailed differences ranging from being lured to direct negotiations. The results indicate that there is a group of young women who sell sex online that is not in the open prostitution. Police and other authorities working with young women selling sex need to better understand the coded sexual communication behind some of these sexual encounters and how different communication strategies might affect the young women

    Keywords
    young women; prostitution; selling sex; online; Internet
    National Category
    Psychology
    Identifiers
    urn:nbn:se:liu:diva-107658 (URN)10.5817/CP2014-1-4 (DOI)
    Available from: 2014-06-18 Created: 2014-06-18 Last updated: 2017-12-05
    4. Young women selling sex online: narratives on regulating
    Open this publication in new window or tab >>Young women selling sex online: narratives on regulating
    2015 (English)In: Adolescent Health, Medicine and Therapeutics, ISSN 1179-318X, Vol. 6, p. 17-27Article in journal (Refereed) Published
    Abstract [en]

    The current study concerns young women’s life stories of their experiences selling sex online before the age of 18. The aim was to gain an understanding of young women’s perceptions of the reasons they started, continued, and stopped selling sex. The study included interviews with 15 young women between the ages of 15 and 25 (M=18.9). Thematic analysis was used to identify similarities and differences in the narratives. Three themes and eight sub-themes were identified in relation to different stages in their lives in the sex trade. The themes were organized into three parts, each with its own storyline: “Entering – adverse life experiences”; traumatic events: feeling different and being excluded. “Immersion – using the body as a tool for regulating feelings”; being seen: being touched: being in control: affect regulation and self-harming. “Exiting – change or die”; living close to death: the process of quitting. The informants all had stable social lives in the sense that they had roofs over their heads, food to eat, and no substance-abuse issues. None had a third party who arranged the sexual contacts and none were currently trafficked. They described how their experiences of traumatic events and of feeling different and excluded had led them into the sex trade. Selling sex functioned as a way to be seen, to handle traumatic events, and to regulate feelings. Professionals working with young people who sell sex online need to understand the complex web of mixed feelings and emotional needs that can play a role in selling sex. Young people selling sex might need guidance in relationship building as well as help processing traumatic experiences and ending self-harming behavior. Further studies are needed on the functions of online sex selling and on the exit process for young people, in order to prevent entrance and facilitate exiting.

    Place, publisher, year, edition, pages
    Dovepress, 2015
    Keywords
    Adolescent, women, affect regulation, selling sex, prostitution, online
    National Category
    Psychology
    Identifiers
    urn:nbn:se:liu:diva-114541 (URN)10.2147/AHMT.S77324 (DOI)
    Available from: 2015-02-26 Created: 2015-02-26 Last updated: 2017-12-04Bibliographically approved
  • 38.
    Jonsson, Linda
    et al.
    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.
    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.
    Hydén, Margareta
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences.
    "Without the Internet, I never would have sold sex": Young Women Selling Sex Online2014In: Cyberpsychology : Journal of Psychosocial Research on Cyberspace, ISSN 1802-7962, E-ISSN 1802-7962, Vol. 8, no 1Article in journal (Refereed)
    Abstract [en]

    Among Swedish youth with experience of selling sex, the Internet is the most common means of contact between buyer and seller. There are few descriptions of how these contacts are established, but studies have indicated that young people under the age of 18 seldom engage in open prostitution online. This study aimed to examine what role the Internet and the use of smartphones play in young women selling sex online, focusing on the method of contact and the characteristics of the communication online between buyer and seller. The study included 15 young women between the ages of 15 and 25 (M=18.9) who had sold sex online before the age of 18. Thematic analysis was used to identify similarities and differences in the narratives.

    Two main themes were identified: (I) Internet use—Part of daily life, for good and bad, and Depending on mood. The young women described using the Internet on a daily basis. During periods of poorer psychological health they were more active on sites focusing on self-destructiveness and sex. During these periods, they also sold sex more frequently. (II) Patterns of contacts—Innocent/curious, Dating, and Advertising. The narratives about communication prior to a sexual encounter detailed differences ranging from being lured to direct negotiations. The results indicate that there is a group of young women who sell sex online that is not in the open prostitution. Police and other authorities working with young women selling sex need to better understand the coded sexual communication behind some of these sexual encounters and how different communication strategies might affect the young women

  • 39.
    Jonsson, Linda
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, 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, 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.
    Hydén, Margareta
    Linköping University, Department of Social and Welfare Studies, Social Work. Linköping University, Faculty of Arts and Sciences.
    Young women selling sex online: narratives on regulating2015In: Adolescent Health, Medicine and Therapeutics, ISSN 1179-318X, Vol. 6, p. 17-27Article in journal (Refereed)
    Abstract [en]

    The current study concerns young women’s life stories of their experiences selling sex online before the age of 18. The aim was to gain an understanding of young women’s perceptions of the reasons they started, continued, and stopped selling sex. The study included interviews with 15 young women between the ages of 15 and 25 (M=18.9). Thematic analysis was used to identify similarities and differences in the narratives. Three themes and eight sub-themes were identified in relation to different stages in their lives in the sex trade. The themes were organized into three parts, each with its own storyline: “Entering – adverse life experiences”; traumatic events: feeling different and being excluded. “Immersion – using the body as a tool for regulating feelings”; being seen: being touched: being in control: affect regulation and self-harming. “Exiting – change or die”; living close to death: the process of quitting. The informants all had stable social lives in the sense that they had roofs over their heads, food to eat, and no substance-abuse issues. None had a third party who arranged the sexual contacts and none were currently trafficked. They described how their experiences of traumatic events and of feeling different and excluded had led them into the sex trade. Selling sex functioned as a way to be seen, to handle traumatic events, and to regulate feelings. Professionals working with young people who sell sex online need to understand the complex web of mixed feelings and emotional needs that can play a role in selling sex. Young people selling sex might need guidance in relationship building as well as help processing traumatic experiences and ending self-harming behavior. Further studies are needed on the functions of online sex selling and on the exit process for young people, in order to prevent entrance and facilitate exiting.

  • 40.
    Kjellgren, Cecilia
    et al.
    Linné Universitetet.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Nilsson, Doris
    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.
    Child Physical Abuse—Experiences of Combined Treatment for Children and their Parents: A Pilot Study2013In: Child Care in Practice, ISSN 1357-5279, E-ISSN 1476-489X, Vol. 19, no 3, p. 275-290Article, review/survey (Refereed)
    Abstract [en]

    This paper reports on the results of treatment for families where child physical abuse has occurred. The Combined Parent–Child Cognitive–Behavioral Therapy for Families at Risk for Child Physical Abuse (CPC-CBT) model includes parent and child interventions. Four teams (within child protection and child and adolescent psychiatry services, based in Sweden) were trained to run the treatment. CPC-CBT is a 16-session programme where children and parents receive treatment in parallel groups and joint family sessions. A pilot study, with pre and post measures for both children and parents, was carried out to evaluate the treatment effects (18 families, 26 adults and 25 children). Significantly decreased symptoms of depression among parents, less use of violent parenting strategies and less inconsistent parenting were reported after treatment. Children initially reported high levels of traumatic experiences and symptoms of post-traumatic stress disorder. After treatment, trauma symptoms and depression among children were significantly reduced. Children also reported that parents used significantly less violence and increased positive parenting strategies after completion of the treatment. The implications of the findings are discussed.

  • 41. Klingberg, Torkel
    et al.
    Fernell, Elisabeth
    Olesen, Pernille
    Johnson, Mats
    Gustafsson, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Child and Adolescent Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Dahlström, Kerstin
    Gillberg, Christopher
    Forssberg, Hans
    Westerberg, Helena
    Computerized training of working memory in children with ADHD - A randomized, controlled trial2005In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 44, no 2, p. 177-186Article in journal (Refereed)
    Abstract [en]

    Objective: Deficits in executive functioning, including working memory (WM) deficits, have been suggested to be important in attention-deficit/ hyperactivity disorder (ADHD). During 2002 to 2003, the authors conducted a multicenter, randomized, controlled, double-blind trial to investigate the effect of improving WM by computerized, systematic practice of WM tasks. Method: Included in the trial were 53 children with ADHD (9 girls, 15 of 53 inattentive subtype), aged 7 to 12 years, without stimulant medication. The compliance criterion (>20 days of training) was met by 44 subjects, 42 of whom were also evaluated at follow-up 3 months later. Participants were randomly assigned to use either the treatment computer program for training WM or a comparison program. The main outcome measure was the span-board task, a visuospatial WM task that was not part of the training program. Results: For the span-board task, there was a significant treatment effect both post-intervention and at follow-up. In addition, there were significant effects for secondary outcome tasks measuring verbal WM, response inhibition, and complex reasoning. Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity, both post-intervention and at follow-up. Conclusions: This study shows that WM can be improved by training in children with ADHD. This training also improved response inhibition and reasoning and resulted in a reduction of the parent-rated inattentive symptoms of ADHD.

  • 42.
    Lejoonclou, Annika
    et al.
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Nilsson, Doris
    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.
    Holmqvist, Rolf
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Variants of Potentially Traumatizing Life Events in Eating Disorder patients2014In: Psychological Trauma, ISSN 1942-9681, E-ISSN 1942-969X, Vol. 6, no 6, p. 661-667Article in journal (Refereed)
    Abstract [en]

    Although many studies have found associations between trauma and eating disorders, it is important to study associations between the whole spectrum of potentially traumatic experiences and eating disorders. This study examined to what extent noninterpersonal traumas, interpersonal traumas, and adverse childhood circumstances were reported in a sample of patients with eating disorders, comparing this with ratings in a nonclinical group. Differences in trauma experiences between the different eating disorder diagnosis groups were assessed, and associations between trauma experiences and the reported severity of eating disturbance were analyzed. Fifty patients with eating disorders and a group of adolescent girls and young women (N = 245) without known psychological problems completed a self-report trauma-history questionnaire: the Linköping Youth Life Experience Scale. The eating disorder group also answered the Eating Disorder Examination Questionnaire. For several specific traumas, the eating disorder group had experienced a significantly larger number of potentially traumatizing events. With regard to the number of different traumas, the results were more equivocal; more experiences of adverse childhood circumstances and repeated traumas were reported in the eating disorder group, but more noninterpersonal traumas were reported in the nonclinical group. The number of adverse childhood experiences and repeated traumas was associated with the presence of eating disorders in outpatient adolescents and young women. The frequency and type of potentially traumatizing events need to be clearly assessed for these patients, placing particular focus on repeated traumas. Treatment may be improved through a focus on traumatic experiences in order to resolve the eating problems.

  • 43.
    Mauritzson, Margareta
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Bergendahl Odby, Elisabeth
    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. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    The Fog Is Lifting; Veils of Mist Come and Go: An Interpretative Phenomenological Analysis of the Experiences of Six Women Recovering From Pathological Dissociation2015In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 30, no 1, p. 45-61Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to illuminate experiences of the process of recovering from pathological dissociation. The study used data from interviews with six female participants diagnosed with pathological dissociative disturbances. All the women had a history of having been sexually abused. Data were analyzed using Interpretative Phenomenological Analysis (IPA). Two main themes emerged in the analysis: social and relational change and self in movement. The themes mirror the interplay in the recovery process that took place both intrapsychically and with regard to the relational interplay between self and other significant people. The recovery process was dependent on an incipient sense of security in relational interaction, and this process was hindered by insecurity and ambivalence in relationships. Each patient’s relationship with her therapist also played a crucial role for the participants.

  • 44.
    Michel, Per-Olof
    Nasjonalt kunnskapssenter om vold og traumatisk stress, Oslo universitet.
    Nilsson, Doris (Contributor)
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social 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.
    Bergh Johannesson, Kersin (Contributor)
    Uppsala Psykoterapimottagning.
    Lundin, Tom (Contributor)
    Institutionen för neurovetenskap, Ekselius: Psykiatri, Akademiska sjukhuset, Uppsala.
    Psykotraumatologi: bedömning, bemötande och behandling av stresstillstånd2010Collection (editor) (Other academic)
    Abstract [sv]

    Nya allvarliga händelser drabbar kontinuerligt människor runt om i världen och även i vårt land. Det gör att ämnet psykotraumatologi ständigt är aktuellt och som följd av att kunskapsmängden inom området har ökat under senare år har det blivit nödvändigt att sammanfatta det psykotraumatologiska fältet på nytt.I denna omarbetade och utökade upplaga har författarna behållit utgångspunkten med det psykiska traumat sett ur ett historiskt och socialt sammanhang, grundat på ett holistiskt synsätt. Vi beskriver hur den normala och den traumatiska stressen påverkar människan. Faktorer som kan verka skyddande och sådana som kan bidra till att utveckla psykiska störningar skildras även. Vi beskriver ingående krisstöd i akutfas och riktlinjer för modern traumafokuserad behandling.Syftet med boken är att utgöra en samlad kunskapskälla på svenska språket för den som behöver det i sin utbildning och fortbildning. De som på så sätt kan ha nytta av boken är personal i hälso- och sjukvården, kuratorer, läkare, psykologer, skötare inom vuxen-, barn- och ungdomspsykiatrin, primärvården och företagshälsovården samt även befattningshavare inom kommunernas krisstödsorganisation. Andra som kan ha nytta av boken är alla som i sin profession kommer i kontakt med traumatiserade individer.Boken kan med fördel användas både som lärobok och uppslagsbok.

  • 45.
    Nilsson, Doris
    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.
    Bedömningsinstrument2013In: Vad har du varit med om?: PTSD och dissociation hos barn och unga : förekomst, diagnostik och behandling / [ed] Anna Gerge, Vaxholm: Insidan , 2013, p. 527-Chapter in book (Other academic)
    Abstract [sv]

    Den här boken vänder sig till alla som i sitt yrke kommer i kontakt med traumatiserade barn och unga, oberoende av vilka diagnoser de eventuellt fått tidigare. Anna Gerge och medförfattare redogör för hur komplex psykisk traumatisering och dissociation kan ta sig uttryck hos barn och unga samt visar hur framgångsrik behandling kan se ut.Sambandet mellan anknytningsskador, inklusive svektraumatisering, och senare traumatiska händelser tydliggörs. Därefter beskrivs diagnostik, generella principer, även riktlinjer, för bedömningssamtal och behandling samt metoderna klinisk hypnos, EMDR och symboldrama.En stor del av boken utgörs av kliniska vinjetter skrivna av psykologer, socionomer och psykoterapeuter. Dessa belyser vikten av ett traumaperspektiv i barn- och ungdomspsykiatrin, liksom inom socialtjänsten och elevhälsan. Flera vinjetter visar att enkel PTSD ofta läker ut snabbt om patienterna erbjuds t ex EMDR-behandling. Vid behandlingsarbete med komplext traumatiserade barn och unga kan - och behöver - olika terapimetoder anpassas. Metoder som bygger på ett tydligt traumaperspektiv, med förståelse för betydelsen av fasspecifikt arbete på relationell grund, kan bidra till en initial stabilisering och reglering. Då kan kvarstående symptom efter försummelse och övergrepp i barndomen, liksom traumatiska upplevelser, som t ex flykt, svår mobbing och våldtäkter, bearbetas och läka ut.Vissa symptom, som t ex nedstämdhet, aggressivitet, koncentrationssvårigheter, självskadebeteende eller missbruk, kan tidigare ha diagnostiserats som något annat än traumarelaterade

  • 46.
    Nilsson, Doris
    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.
    Symbolhantering via symboldrama, psykoterapi och lekterapi med barn och ungdomar med symptom av posttraumatisk stress och dissociation2013In: Vad har du varit med om?: PTSD och dissociation hos barn och unga : förekomst, diagnostik och behandling / [ed] Anna Gerge, Vaxholm: Insidan , 2013, p. 527-Chapter in book (Other academic)
    Abstract [sv]

    Den här boken vänder sig till alla som i sitt yrke kommer i kontakt med traumatiserade barn och unga, oberoende av vilka diagnoser de eventuellt fått tidigare. Anna Gerge och medförfattare redogör för hur komplex psykisk traumatisering och dissociation kan ta sig uttryck hos barn och unga samt visar hur framgångsrik behandling kan se ut.Sambandet mellan anknytningsskador, inklusive svektraumatisering, och senare traumatiska händelser tydliggörs. Därefter beskrivs diagnostik, generella principer, även riktlinjer, för bedömningssamtal och behandling samt metoderna klinisk hypnos, EMDR och symboldrama.En stor del av boken utgörs av kliniska vinjetter skrivna av psykologer, socionomer och psykoterapeuter. Dessa belyser vikten av ett traumaperspektiv i barn- och ungdomspsykiatrin, liksom inom socialtjänsten och elevhälsan. Flera vinjetter visar att enkel PTSD ofta läker ut snabbt om patienterna erbjuds t ex EMDR-behandling. Vid behandlingsarbete med komplext traumatiserade barn och unga kan - och behöver - olika terapimetoder anpassas. Metoder som bygger på ett tydligt traumaperspektiv, med förståelse för betydelsen av fasspecifikt arbete på relationell grund, kan bidra till en initial stabilisering och reglering. Då kan kvarstående symptom efter försummelse och övergrepp i barndomen, liksom traumatiska upplevelser, som t ex flykt, svår mobbing och våldtäkter, bearbetas och läka ut.Vissa symptom, som t ex nedstämdhet, aggressivitet, koncentrationssvårigheter, självskadebeteende eller missbruk, kan tidigare ha diagnostiserats som något annat än traumarelaterade

  • 47.
    Nilsson, Doris
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Trauma, Posttraumatic Stress and Dissociation Among Swedish Adolescents: Evaluation of Questionnaires2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The main aim of this thesis has been to investigate trauma and dissociation among Swedish adolescents and to evaluate the psychometric properties such as reliability and various kinds of validity of three screening instruments for assessment of dissociation and other symptoms of post traumatic stress. The three instruments in question have been Dis-Q-Sweden, A-DES and TSCC, the symptoms measured by these instruments are neither easy to capture nor easy for the adolescent to talk about. Therefore these self report scales are essential. A second aim has been to compare the results with results from other countries and to develop preliminary Swedish norms for the clinician to use. Age and gender differences have been looked upon as well as assessed symptoms connected to known experienced trauma/sexual and/or physical abuse and self-reported trauma in normal and clinical populations.

    The populations, in this thesis have been children and adolescents age 10 -19 years old from the general population; the clinical groups have had the same age range. All children and adolescents in the clinical groups have been sexually and/or physically abused. Participants have answered the questionnaires Dis-Q-Sweden, A-DES and/or TSCC and their answers have been statistically analysed.

    All three instruments have been shown to have good reliability, such as internal consistency and test-retest. Validity has been established through factor analyses, concurrent, and criterion related validity. Clinical groups with known experienced trauma/sexual abuse and/or physical abuse gave significantly higher scores on all the instruments compared to normative groups. Also self-reported trauma in a normative group gave significantly higher scores even if the significances are not as high as between the normative and clinical groups. Girls scored significantly higher than boys in both the clinical and normative groups. Girls in the age range 14-15 years old gave the significantly highest scores on both Dis-Q-Sweden and ADES. Swedish adolescents gave lower mean scores on all three instruments than have been reported from other studies in other countries. The scores from the clinical groups gave about the same mean as have been reported elsewhere.

    The conclusion from this thesis is that all the three questionnaires Dis-Q-Sweden, A-DES and TSCC have shown satisfactory psychometrics properties and can very well be used by Swedish clinicians in Child and Adolescents Psychiatry.

    List of papers
    1. Traumatic experiences and dissociative symptoms among Swedish adolescents: A pilot study using Dis-Q-Sweden
    Open this publication in new window or tab >>Traumatic experiences and dissociative symptoms among Swedish adolescents: A pilot study using Dis-Q-Sweden
    2004 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, Vol. 58, no 5, p. 349-355Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was to explore the occurrence of dissociative symptoms in relation to reported traumatic experiences among adolescents. A normative sample of 216 adolescents and a clinical sample of 30 cases with a history of traumatization were given the Swedish translation of Dissociation Questionnaire, DIS-Q. The results showed that 8.8% of the adolescents reported scores above the cut-off score of 2.5 on the Dis-Q-Sweden, with a female-male ratio of 2.6:1. In the normative sample, 53 (24.5%) of the adolescents reported one or more trauma experiences. The adolescents who self-reported trauma experiences in the normative sample scored higher on the total Dis-Q-Sweden scores and on three of the four subscales compared to the adolescents with no such experiences. The clinical group exhibited significantly higher Dis-Q-Sweden scores than the normative sample on every scale, with 60% above the cut-off score. The study confirms the results from earlier studies that adolescents with a history of trauma exhibit more dissociative symptoms in this study according to Dis-Q-Sweden. The impact of trauma qualities and background factors on the development of dissociative symptoms need to be studied further.

    Keywords
    Adolescents, DIS-Q, Dissociation, Measurement, Trauma
    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:liu:diva-14266 (URN)10.1080/08039480410005891 (DOI)
    Available from: 2007-01-31 Created: 2007-01-31 Last updated: 2013-09-16
    2. Evaluation of the Swedish version of Dissociation Questionnaire (DIS-Q), Dis-Q-Sweden, Among Adolescents
    Open this publication in new window or tab >>Evaluation of the Swedish version of Dissociation Questionnaire (DIS-Q), Dis-Q-Sweden, Among Adolescents
    2006 (English)In: Journal of Trauma & Dissociation, ISSN 1529-9732, Vol. 7, no 3, p. 65-89Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was to investigate the psychometric properties of the Swedish version of the Dissociation Questionnaire in a normative adolescent population and also to investigate dissociative symptoms associated with trauma including sexual and physical abuse. A normative sample of 449 adolescents between the ages of 12 and 19 and a clinical group of 74 adolescents with known experiences of trauma, sexual and/or physical abuse was given Dis-Q-Sweden. A mixed group of 22 abused and non-abused adolescents who answered Dis-Q-Sweden was also interviewed by using the Structural Clinical Interview for DSM-IV Dissociative Disorders (SCID-D). A test-retest procedure was conducted with 90 subjects from the normative group. The results showed good reliability concerning both internal consistency and test-retest stability. Validity was tested in several ways (criterion, predictive, construct and concurrent) and found to be satisfactory. Significant differences for the total sum scores of Dis-Q-Sweden were found between the normative group and the clinical group with known sexual abuse (p < 0.001). The prevalence of dissociative symptoms (cut-off score > 2.5) was 2.3% in the normative group and 50% in the clinical group. Dis-Q-Sweden has proven to be a screening instrument with good psychometric properties and has proven to be able to capture dissociative symptoms in adolescents with self-reported trauma and known trauma (sexual abuse).

    Keywords
    Dis-Q-Sweden; method; dissociation; adolescents; trauma
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-14267 (URN)10.1300/J229v07n03_05 (DOI)
    Available from: 2007-01-31 Created: 2007-01-31
    3. Dissociation among Swedish Adolescents and the connection to trauma: An Evaluation of the Swedish version of Adolescent Dissociative Experience Scale
    Open this publication in new window or tab >>Dissociation among Swedish Adolescents and the connection to trauma: An Evaluation of the Swedish version of Adolescent Dissociative Experience Scale
    2006 (English)In: Journal of Nervous and Mental Disease, ISSN 0022-3018, Vol. 194, no 9, p. 684-689Article in journal (Refereed) Published
    Abstract [en]

    The purpose of this study was to investigate the psychometric properties of the Swedish version of Adolescent Dissociative Experience Scale (A-DES), dissociative symptoms among Swedish adolescents, and dissociative symptoms connected to trauma and sexual and physical abuse. A normative group of 400 adolescents aged 12 to 19 years and a clinical group of 20 adolescents with known experienced trauma were given A-DES. A test-retest procedure was conducted with 90 subjects from the normative group. The results showed good reliability, internal consistency and test-retest. Factor analysis in the normative sample (N = 400) resulted in a one factor solution. Correlation between A-DES and other measures of dissociation was high (r = .86). Significant differences for the total sum of A-DES were found in the normative group between adolescents with and without self-reported trauma and between the normative group and the clinical group with known experienced trauma. The Swedish version of A-DES was shown to be a screening instrument with satisfactory psychometric qualities and the capability of capturing dissociative symptoms in adolescents with self-reported trauma as well as clinical cases with identified trauma.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-14268 (URN)10.1097/01.nmd.0000235774.08690.dc (DOI)
    Available from: 2007-01-31 Created: 2007-01-31
    4. The psychometric properties of the Trauma Symptom Checklist For Children (TSCC) in a sample of Swedish children
    Open this publication in new window or tab >>The psychometric properties of the Trauma Symptom Checklist For Children (TSCC) in a sample of Swedish children
    2008 (English)In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 32, no 6, p. 627-636Article in journal (Refereed) Published
    Abstract [en]

    Objective: To evaluate the psychometric properties of the Swedish version of the Trauma Symptom Checklist for Children (TSCC) and to study traumatic symptoms in a normative group of Swedish children and adolescents. Method: A normative group of 728 children and adolescents age 10-17 and a clinical group of 91 children and adolescents known to have experienced sexual abuse participated in the study. A test-retest procedure was conducted with 79 participants from the normative group. Results: Good reliability such as internal consistency (Cronbach's alpha) for the total scale .94 (ranging in the clinical scales .78-.83) and test-retest for the total scale r = .81 (ranging in the clinical scales .67-.81) were found. The confirmatory 6-factor analysis explained 50.7% of the variance. Other validity measures such as concurrent validity and criterion related validity were also shown to be satisfactory. The normative sample of Swedish children and adolescents showed lower means on the subscales than has been reported in previous studies from a number of other countries. Conclusion: The Swedish version of TSCC has been shown to be a screening instrument with satisfactory psychometric qualities that is capable to identify trauma symptoms among children and adolescents who have themselves self-reported experiencing trauma or for whom clinicians have identified traumatic experiences. © 2008 Elsevier Ltd. All rights reserved.

    Keywords
    TSCC, method, children, adolescents, trauma, sexual abuse
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-42956 (URN)10.1016/j.chiabu.2007.09.009 (DOI)70185 (Local ID)70185 (Archive number)70185 (OAI)
    Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2019-01-17
  • 48.
    Nilsson, Doris
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping. Linköping University, Faculty of Arts and Sciences.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Pribe, Gisela
    Linnaeus Univ, Dept Psychol, SE-35195 Vaxjo, Sweden.
    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.
    Polytraumatization in an adult national sample and its association with psychological distress and self-esteem2015In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 5, no 1, p. 62-74Article in journal (Refereed)
    Abstract [en]

    AbstractObjective

    The objective of this study was to examine the prevalence of self-reported experiences of potential childhood traumas and polytraumatization, and to find cut-off values for different kinds of potential traumatic events in a national representative sample of adults in Sweden. In addition, to analyse the association between polytraumatization and both psychological distress and global self-esteem.

    Method

    A web-based survey - containing SCL-25 and Rosenberg Self-Esteem Scale, and Linköping Difficult Life Events Scale - Adult - was sent out to a nationally reprative sample and 5062 people chose to participate in the study.

    Results

    Results showed that almost everyone (97%) has experienced at least one potential traumatic event and that polytraumatization (the 10% of the participants with most reported traumas) was significantly (Z = 12.57, P < 0.001, r = 0.18) associated with psychological distress and global self-esteem. Gender differences were significant (Z = 8.44, P < 0.001, r = 0.12), in that men experience more noninterpersonal traumas but women report more symptoms. The effect sizes regarding the impact of potential trauma on self-esteem were largest for women with experience of polytraumatization in the age group 18–25 (r = 0.48). There was almost linear increase in psychological distress and linear decrease in self-esteem with increasing number of traumatic events experienced.

    Conclusion

    Experience of polytrauma can be considered an important factor to take into account in psychiatric settings as well.

  • 49.
    Nilsson, Doris
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Gustafsson, Per E
    Lund University.
    Goran Svedin, Carl
    Lund University.
    Self-reported potentially traumatic life events and symptoms of post-traumatic stress and dissociation2010In: NORDIC JOURNAL OF PSYCHIATRY, ISSN 0803-9488, Vol. 64, no 1, p. 19-26Article in journal (Refereed)
    Abstract [en]

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

  • 50.
    Nilsson, Doris
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry.
    Gustafsson, Per. E
    Hälsa och familje medicin Umeå.
    Larsson, Jessica
    Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Child and Adolescent Habilitation.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Evaluation of the Linköping Youth Life experience Scale2010In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 198, no 10, p. 768-774Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate the psychometric properties of a newly developed instrument for potentially traumatic life events, the Linköping Youth Life Experience Scale (LYLES), and determine the benefits of including adverse childhood circumstances (ACCs) as factors in the evaluation. In addition, we wanted to investigate the difference between interpersonal and noninterpersonal traumatic events, the impact of ACCs, and the cumulative effects of these events on self-reported symptoms of dissociation, depression, and anxiety. Adolescents from the normative population (n = 188) answered the questionnaire LYLES and also the Dissociation-Questionnaire-Sweden and Hospital Anxiety and Depression Scale. The results showed that LYLES was stable, with test-retest r = 0.79 and kappa item per item ranging between k = 0.44 and 1.0. ACCs contributed independently to the explanation of symptoms explaining them better than potentially traumatic events alone, particularly for boys where the impact of ACCs exceeded the impact of events. The conclusions are that LYLES displayed satisfactory psychometric properties and that ACCs seem to be a valuable addition to an instrument to evaluate potentially traumatic events.

12 1 - 50 of 84
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf