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  • 101.
    Proczkowska-Björklund, Marie
    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.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Children's play after anaesthesia and surgery: background factors and associations to behaviour during anaesthetic induction2010In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 14, no 2, p. 170-178Article in journal (Refereed)
    Abstract [en]

    Children can experience anaesthetic induction as fearful and frightening and this can lead to postoperative behaviour changes and symptoms of high anxiety. A fearful experience can also lead to avoidant reactions due to raised negative emotions in situations similar to that, which evoked the fear. To analyse children’s reactions after anaesthesia to anaesthetic play equipment, 49 children (three—six years old) were video-filmed during play with anaesthetic equipment 14 days after anaesthesia and surgery. The risk that the child avoided playing with anaesthetic equipment was increased if the child took the premedication unwillingly and if the child was younger. The risk for not telling about the experience was increased if the child took the premedication unwillingly and if the child showed signs of shyness. The risk for telling mostly unspecific memories increased if the child was younger and if the child showed signs of shyness. Avoidant reactions could bee seen in 50 percent of the children. It is important to be aware of the characteristics of a vulnerable child (age, shyness) and to meet the child without raising negative emotions in any part of the anaesthetic process, in order to avoid negative reactions in future encounters.

  • 102.
    Proczkowska-Björklund, Marie
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry.
    Runeson, I.
    Department of Health and Behaviour Sciences, University of Kalmar, Kalmar, Sweden.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Svedin, Carl Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry.
    Decision making about pre-medication to children.2008In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 34, no 6, p. 713-720Article in journal (Refereed)
    Abstract [en]

    Background: Inviting the child to participate in medical decisions regarding common medical procedures might influence the child's behaviour during the procedures. We wanted to study nurse decision-making communication regarding pre-medication before ear, nose and throat (ENT) surgery.

    Method: In total, 102 children (3-6 years) signed for ENT surgery were video-filmed during the pre-medication process. The nurse decision-making communication was identified, transcribed and grouped in six main categories dependent on the level of participation (self-determination, compromise, negotiation, questioning, information, lack of communication). Associations between child factors (age, gender, verbal communication and non-verbal communication) and different nurse decision-making communication were studied. Associations between the decision-making communication and verbal hesitation and/or the child's compliance in taking pre-medication were also studied.

    Results: Totally, information was the most frequently used category of decision making communication followed by negotiation and questioning. To the children showing signs of shyness, the nurse used more negotiation, questions and self-determination communication and less information. The nurse used more compromise, negotiation and gave less information to children with less compliance. No specific type of nurse decision-making communication was associated with verbal hesitation. The most important predictors for verbal hesitation were none or hesitant eye contact with nurse (OR = 4.5) and placement nearby or in parent's lap (OR = 4.7). Predictors for less compliance in taking pre-medication were verbal hesitation from the child (OR = 22.7) and children who did not give any verbal answer to nurse initial questions (OR = 5.5).

    Conclusion: Decision-making communication could not predict the child's compliance during pre-medication. Although negotiation, questioning and self-determination communication were associated with more unwillingness to take pre-medication. More knowledge is needed about communication to children in medical settings and how it influences the child's behaviours.

  • 103.
    Proczkowska-Björklund, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Runeson, Ingrid
    Department of Health and Behaviour Sciences, University of Kalmar, Kalmar, Sweden.
    Gustafsson, Per A
    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.
    Communication and child behaviour associated with unwillingness to take premedication.2008In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 97, no 9, p. 1238-1242Article in journal (Refereed)
    Abstract [en]

    Aim: To see how dominance in adult communication and child behaviour during premedication affects the child's unwillingness to take premedication.

    Method: Ninety-five children scheduled for ENT surgery were video-filmed during premedication. All communication was translated verbatim and the communication was grouped according to; if the parent or nurse directed their communication towards the child or not, or; if they talked about nonprocedural matters or procedural matters.

    Results: Unwillingness to take premedication was associated with more parent communication and less anaesthetic nurse communication compared to willingness to take premedication. There was a heighten risk that the child took their premedication unwillingly if their parent talked more directly to the child (OR = 4.9, p < or = 0.01), the child gave hesitant eye contact with the anaesthetic nurse (OR = 4.5, p < or = 0.05), the child had experienced an earlier traumatic medical procedure (OR = 4.1. p < or = 0.001) or if the child placed her/himself nearby their parent (OR = 4.0, p < or = 0.001).

    Conclusion: Together with behaviour that could be signs of shyness and earlier medical traumatic experience, parents that are actively communicating with their child before premedication may heighten the risk that the child will take the premedication unwillingly.

  • 104.
    Proczkowska-Björklund, Marie
    et al.
    Linköping University, Department of Medicine and Health Sciences, Anesthesiology . 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.
    Child related background factors affecting compliance with induction of anaesthesia.2004In: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 14, no 3, p. 225-234Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Factors such as age, sex, behaviour problems, fears, earlier traumatic hospital events and reactions to vaccination were assessed together with behaviour observed before premedication in order to evaluate their importance in predicting response to the anaesthetic process. The anaesthetic process was divided into four endpoints; compliance when given premedication, sedation, compliance during needle insertion or when an anaesthetic mask was put in place and behaviour when put to sleep.

    METHODS: A total of 102 children who were undergoing day-stay surgery and overnight stay surgery were video-filmed during premedication and anaesthetic induction. Before premedication the children and parents answered questionnaires about behaviour [Preschool Behaviour Check List (PBCL)] and fears [Fears Survey Schedule for Children-Revised (FSSC-R)]. The films were analysed to assess behaviour before and after premedication and during induction of anaesthesia. A semistructured interview was conducted with the parents during the time the children were asleep. '

    RESULTS: There was a significantly higher odds ratio for noncompliant behaviour during premedication if the child placed itself in the parent's lap or near the parent or had previously experienced traumatic hospital events. The odds ratio for not being sedated by premedication was higher if compliance was low when premedication was given or the child had experienced a traumatic hospital event in the past. A high odds ratio for noncompliant behaviour during venous access or placement of an anaesthetic mask was seen if the child was not sedated or the child had had a negative reaction when vaccinated. The odds ratio for falling asleep in an anxious or upset state was higher if the child had shown noncompliant behaviour during premedication, had not been sedated or had shown noncompliant behaviour during venous access or facemask placement.

    CONCLUSIONS: The overall most important factor that predicts noncompliant behaviour and a distressed state in the child during the anaesthetic process was the experience of earlier traumatic hospital events including negative reaction to vaccination. All elements of the process are important in determining what will happen and all steps will influence how the child reacts when put to sleep.

  • 105.
    Runeson, Ingrid
    et al.
    Linnaeus University.
    Björklund, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Idvall, Ewa
    Malmo University.
    Ethical dilemmas before and during anaesthetic induction of young children, as described by nurse anaesthetists2010In: JOURNAL OF CHILD HEALTH CARE, ISSN 1367-4935, Vol. 14, no 4, p. 345-354Article in journal (Refereed)
    Abstract [en]

    Research on physicians, nurses and enrolled nurses experiences of ethical dilemmas have been conducted in many healthcare fields. The aim of this study was to elucidate ethical dilemmas before and during the induction of anaesthesia of children aged three to six years as described by nurse anaesthetists (NAs). Two group interviews with NAs were conducted where they were asked to describe ethically problematic situations. Three situations were chosen from a total of 15: administration of anaesthesia to an already sleeping child, lack of information given to a child, and a child is anaesthetized against his/her will. Conceivable and reasonable alternative options were identified and consequences of the different actions were presented. Finally the conflicts of value were discussed and commented on. The cases describe when a childs rights are given less weight and the child has little opportunity to participate in the decision making. However, parents and NAs acted in the best interest of the child. Analysing and reflecting on situations involving ethical dilemmas would enhance NAs critical thinking and guide NAs in their decision making when providing anaesthesia care.

  • 106.
    Seto, MC
    et al.
    Royal Ottawa Hlth Care Grp, Integrated Forens Program, Brockville, ON Canada.
    Kjellgren, C
    Lund Univ, Dept Child & Adolescent Psychiat, S-22100 Lund, Sweden.
    Priebe, G
    Lund Univ, Dept Child & Adolescent Psychiat, S-22100 Lund, Sweden.
    Mossige, S
    Norwegian Social Res, Oslo, Norway.
    Svedin, Carl-Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Långström, N
    Karolinska Inst, Ctr Violence Prevent, Stockholm, Sweden.
    Sexual Coercion Experience and Sexually Coercive Behavior:: A Population Study of Swedish and Norwegian Male Youth2010In: Child Maltreatment, ISSN 1077-5595, E-ISSN 1552-6119, Vol. 15, no 3, p. 219-228Article in journal (Refereed)
    Abstract [en]

    The authors tested the hypothesis that experiencing sexual coercion and engaging in sexually coercive behavior are positively associated in a representative sample totaling almost 4,000 Swedish or Norwegian male high school students (estimated response rate 80%). In both surveys, youths who had experienced sexual coercion were approximately three times more likely to engage in sexually coercive behavior than those without such experience (10%-12% vs. 4%). The association between sexual coercion experience and sexually coercive behavior was attenuated but remained significant and moderately strong in both surveys when controlling for nonsexual antisocial behavior, substance use, and noncoercive sexual behavior in multivariate logistic regression models. The population attributable fraction (proportion of sexually coercive behavior that can be explained by sexual coercion experience) was 18%-25%. The findings support a robust link between having been sexually coerced and engaging in coercive sexual behavior in the general population

  • 107.
    Svanborg, Paer
    et al.
    Eli Lilly Sweden AB.
    Thernlund, Gunilla
    Lund University.
    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.
    Hagglof, Bruno
    Umeå University.
    Poole, Lynne
    Eli Lilly & Co.
    Kadesjoe, Bjoern
    University of Gothenburg.
    Efficacy and safety of atomoxetine as add-on to psychoeducation in the treatment of attention deficit/hyperactivity disorder A randomized, double-blind, placebo-controlled study in stimulant-naive Swedish children and adolescents2009In: EUROPEAN CHILD and ADOLESCENT PSYCHIATRY, ISSN 1018-8827, Vol. 18, no 4, p. 240-249Article in journal (Refereed)
    Abstract [en]

    Objective The primary objective of this study was to assess the impact of atomoxetine in combination with psychoeducation, compared with placebo and psychoeducation, on health-related quality of life (HRQL) in Swedish stimulant-naive pediatric patients with attention deficit/hyperactivity disorder (ADHD). HRQL results will be presented elsewhere. Here, psychoeducation as well as efficacy and safety of the treatment are described. Patients and methods A total of 99 pediatric ADHD patients were randomized to a 10-week double-blind treatment with atomoxetine (49 patients) or placebo (50 patients). Parents of all patients received four sessions of psychoeducation. Atomoxetine was dosed up to approximately 1.2 mg/kg day (<= 70 kg) or 80 mg/day (>70 kg). Improvement of ADHD symptoms was evaluated using the ADHD rating scale (ADHD-RS) and clinical global impression (CGI) rating scales. Safety was assessed based on adverse events (AEs). Results The study population was predominantly male (80.8%) and diagnosed with the combined ADHD subtype (77.8%). The least square mean (lsmean) change from baseline to endpoint in total ADHD-RS score was -19.0 for atomoxetine patients and -6.3 for placebo patients, resulting in an effect size (ES) of 1.3 at endpoint. Treatment response (reduction in ADHD-RS score of >= 25 or >= 40%) was achieved in 71.4 or 63.3% of atomoxetine patients and 28.6 or 14.3% of placebo patients. The lsmean change from baseline to endpoint in CGI-Severity group compared with -0.3 in the placebo group. The difference between treatments in CGI-Improvement at endpoint was -1.4 in favor of atomoxetine. No serious AEs occurred. The safety profile of atomoxetine was in line with the current label. Conclusions Atomoxetine combined with psychoeducation was superior to placebo and psychoeducation in ADHD core symptoms improvement. The large ES might be a result of including stimulant-naive patients only, but also may indicate a positive interaction between atomoxetine treatment and psychoeducation, possibly by increased compliance.

  • 108.
    Svanborg, Par
    et al.
    Eli Lilly Sweden AB.
    Thernlund, Gunilla
    Lund University.
    Gustafsson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Hagglof, Bruno
    Umeå University.
    Schacht, Alexander
    Lilly Deutschland GmbH.
    Kadesjo, Bjorn
    University of Gothenburg.
    Atomoxetine improves patient and family coping in attention deficit/hyperactivity disorder: a randomized, double-blind, placebo-controlled study in Swedish children and adolescents2009In: EUROPEAN CHILD and ADOLESCENT PSYCHIATRY, ISSN 1018-8827, Vol. 18, no 12, p. 725-735Article in journal (Refereed)
    Abstract [en]

    This 10-week study assessed the efficacy of atomoxetine in combination with psychoeducation compared to placebo and psychoeducation in the improvement of Quality of Life in Swedish stimulant-naive children and adolescents with attention deficit/hyperactivity disorder. A total of 99 patients were treated with atomoxetine (49 patients) or placebo (50 patients) for 10 weeks and assessed regarding broader areas of functioning using the Quality of Life measures Child Health and Illness Profile-Child Edition (CHIP-CE), Family Strain Index [FSI; equivalent to the Family Burden of Illness Module used in the study], Appraisal of Stress in Child-Rearing (ASCR), Five to fifteen (FTF), "I think I am" ("Jag tycker jag ar"), and Childrens Depression Rating Scale-Revised (CDRS-R) before and after the active treatment phase. Simultaneously, the patients parents participated in a 4-session psychoeducation program. A statistically significant difference in favor of atomoxetine was seen in the improvement from baseline to study endpoint for the CHIP-CE domains "Achievement" and "Risk avoidance", for the FSI total score, for the ASCR section (I) domain "Child as a burden", for all FTF domains except for "Language and Speech", and for the CDRS-R total score. No difference between treatment groups was observed in the patient-assessed evaluation of self-esteem using the "I think I am" scale. Atomoxetine combined with psychoeducation had a positive effect on various everyday coping abilities of the patients as well as their families during 10 weeks of treatment, whereas the patients self-image and the parents image of the climate in the family were not significantly improved.

  • 109.
    Svedin, Carl Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry .
    Lost childhoods. The plight of the parentified child2000In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 24, no 2, p. 306-306Article, book review (Other academic)
  • 110.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Unga sex och internet2009In: Se mig - Unga om sex och internet, Ungdomsstyrelsen , 2009, p. 32-147Chapter in book (Other (popular science, discussion, etc.))
  • 111.
    Svedin, Carl Göran
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Jonsson, Linda
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Kjellgren, Cecilia
    Barn- och ungdomspsykiatri, Lunds universitet.
    Priebe, Gisela
    Barn- och ungdomspsykiatri, Lunds universitet.
    Åkerman, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Prostitution i Sverige. Huvudrapport: Kartläggning och utvärdering av prostitutionsgruppernas insatser samt erfarenheter och attityder i befolkningen2012Report (Other academic)
    Abstract [sv]

    Denna rapport är huvudrapporten ”Prostitution i Sverige – Kartläggning och utvärdering av prostitutionsgruppernas insatser samt erfarenheter och attityder i befolkningen” och den kan läsas separat som en sammanfattning. Vill man ha mer detaljerad information hänvisas till respektive delrapport. I den första delrapporten ”Sälja och köpa sex i Sverige 2011. Förekomst, hälsa och attityder” redovisas en webbaserad epidemiologisk undersökning vars avsikt var att kartlägga erfarenheter av att köpa och sälja sex i befolkningen 18-65 år. I rapporten läggs en bakgrund till det kontext i vilket prostitutionsgruppernas arbete bedrivs. I del 2-4 beskrivs prostitutionsgruppernas organisation och arbetssätt ”Kartläggning av insatser mot prostitutionen i Stockholm, Göteborg och Malmö” (delrapport 2) samt de klienter verksamheterna mött under ett år inom programmen för Försäljare av Sexuella Tjänster (FAST) ”Ett års kontakter med prostitutionsenheterna och beskrivning av insatser till personer med prostitutionserfarenhet (FAST)”(delrapport 3) och Köpare av Sexuella Tjänster (KAST) ”Ett års kontakter med prostitutionsenheterna. En beskrivning av insatser till personer med erfarenhet av att köpa sex/problematiskt sexuellt beteende (KAST)” (delrapport 4). Det centrala fokus för regeringens och Socialstyrelsens uppdrag har varit att göra en utvärdering av det behandlingsarbete som bedrivs av prostitutionsgrupperna för stöd och hjälp till försäljare av sexuella tjänster och köpare av sexuella tjänster. Dessa studier ”Utvärdering av samtalsbehandling med försäljare av sexuella tjänster (FAST)” och ”Utvärdering av samtalsbehandling med köpare av sexuella tjänster (KAST)” kompletteras med en kvalitativ studie om tidigare klienters erfarenhet av given behandling ”Intervjuer med personer som tidigare fått behandling vid FAST”.  Rapporten avslutas med en intervjustudie med 11 unga kvinnor som sålt sex via Internet, ”Online är jag någon annan…….Unga kvinnor med erfarenhet av att sälja sexuella tjänster online”.

    Rapporten inleds med en övergripande sammanfattning av de olika delrapporterna därefter ett antal övergripande tema samt avslutningsvis forskargruppens rekommendationer. För mer detaljerad information hänvisas till delrapport, 1-8. Dessa kan laddas ned från Linköpings universitets hemsida:

    Delrapport 1: http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75340

    Delrapport 2: http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75362

    Delrapport 3: http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75366

    Delrapport 4: http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75369

    Delrapport 5: http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75371

    Delrapport 6: http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75377

    Delrapport 7: http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75378

    Delrapport 8: http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-75380

    Download full text (pdf)
    Prostitution i Sverige. Huvudrapport: Kartläggning och utvärdering av prostitutionsgruppernas insatser samt erfarenheter och attityder i befolkningen
  • 112.
    Svedin, Carl Göran
    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 in Linköping.
    Lindell, Charlotta
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Traumatic experiences and dissociative symptoms among Swedish adolescents: A pilot study using Dis-Q-Sweden2004In: Nordic Journal of Psychiatry, ISSN 0803-9488, Vol. 58, no 5, p. 349-355Article in journal (Refereed)
    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.

  • 113.
    Svedin, Carl Göran
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry .
    Priebe, Gisela
    Barn och Ungdomspsykiatri Lunds Universitet.
    The strengths and difficulties questionnaire as a screening instrument in a community sample of high school seniors in Sweden2008In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 62, no 3, p. 225-232Article in journal (Refereed)
    Abstract [en]

    The Strengths and Difficulties Questionnaire (SDQ) has been used among Swedish children since 1996, usually the parent or the teacher version. The self-report version was originally developed for children aged 11-16 years. The aim of this study was to investigate the application of the Swedish self-report version to a representative sample of 1015 senior high school students aged 17-19 years. Girls reported more emotional symptoms and scored higher on prosocial items than boys. Boys on the other hand scored higher on both conduct and peer problems. The means were similar to means in two Nordic studies that have included subjects of this age group. A confirmatory five-factor analyses explained 44.5% of the variance with a good fit for all subjects and boys but somewhat weaker for girls. The item-subscale correlation (ISC) ranged from moderate to high (r = 0.47-0.76) and the Cronbach's alpha was 0.74 (ranging in the five subscales 0.50-0.70). The SDQ seems to be useful even in this older age group. The psychometric qualities were acceptable but can probably be improved by changing the oppositely worded questions and by considering development of different questionnaires for boys and girls at least in late adolescence.

  • 114.
    Svedin, Carl Göran
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Åkerman, Ingrid
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry.
    Priebe, Gisela
    Department of Child and Adolescent Psychiatry, Lund University, Lund.
    Frequent users of pornography. A population based epidemiological study of Swedish male adolescents2011In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 34, no 4, p. 779-788Article in journal (Refereed)
    Abstract [en]

    Frequent use of pornography has not been sufficiently studied before. In a Swedish survey 2015 male students aged 18 years participated. A group of frequent users of pornography (N = 200, 10.5%) were studied with respect to background and psychosocial correlates. The frequent users had a more positive attitude to pornography, were more often "turned on" viewing pornography and viewed more often advanced forms of pornography. Frequent use was also associated with many problem behaviours. A multiple logistic regression analysis showed that frequent users of pornography were more likely to be living in a large city, consuming alcohol more often, having greater sexual desire and had more often sold sex than other boys of the same age. less thanbrgreater than less thanbrgreater thanHigh frequent viewing of pornography may be seen as a problematic behaviour that needs more attention from both parents and teachers and also to be addressed in clinical interviews.

  • 115.
    Svensson, Frida
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Fredlund, Cecilia
    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.
    Priebe, Gisela
    Lunds universitet.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Adolescents selling sex: Exposure to abuse, mental health, self-harm behaviour and the need for help and support - a study of a Swedish national sample2013In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 67, no 2, p. 81-88Article in journal (Refereed)
    Abstract [en]

    Selling sex is not uncommon among adolescents and we need to increase our knowledge of how this affects them. The aim of this study was to investigate adolescents who sell sex regarding sexual, mental and physical abuse, mental health as estimated by using the Hopkins Symptom Check List-25 (HSCL-25), self-harm behaviour and the adolescents' experience of receiving help and support. The study was carried out on a national representative sample of adolescents (mean age 18.3 years) in Swedish high schools in the final year of their 3-year programme. The study had 3498 participants and a response rate of 60.4%. Of the adolescents, 1.5% stated that they had sold sexual services. The selling of sex was associated with a history of sexual, mental and physical abuse. Poorer mental health and a higher degree of self-harm behaviour were reported among the adolescents who had sold sex. Help and support was sought to a greater extent by adolescents who had sold sex but these adolescents were not as satisfied with this help and support as the other adolescents. Adolescents that sell sex are a group especially exposed to sexual, mental and physical abuse. They have poorer metnal health and engage in more self-harm behaviour than other adolescents. They are in need of more help and support than other adolescents ant it is reasonable to assert that more resources, research and attention should be directed to this group to provide better help and support in the future.

  • 116.
    Sydsjö, Gunilla
    et al.
    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.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Sydsjö, Adam
    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.
    Ekholm Selling, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Relationship and parenthood in IVF couples with twin and singleton pregnancies compared with pontaneous singleton primiparous couples—a prospective 5-year follow-up study2008In: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 89, no 3, p. 578-585Article in journal (Refereed)
    Abstract [en]

    Objective: To analyze relationship and parenthood in IVF twin couples, IVF singleton couples, and spontaneously pregnant primiparous couples.

    Setting: Southeast region of Sweden.

    Design: Prospective case-control study.

    Patient(s): In total, 24 women and men who became pregnant with twins, consecutively, and expected their first child in 1997–98 were studied. A control IVF group of 94 singleton primiparous IVF couples were used. A group of spontaneous primiparous pregnant women were selected out of the total pregnant population as a control group.

    Main Outcome Measure(s): Relationship and parenthood measured by questionnaires and interviews.

    Result(s): The IVF singleton couples were most stable in their relationship during the whole study period, and the IVF twin parents also seemed more stable and satisfied compared with the control group of spontaneous conception couples. In the control group, 88% had a second child during the study period. In the singleton IVF group the corresponding number was 9%, and none of the twin parents had another child during the study period.

    Conclusion(s): We conclude that the stresses associated with IVF treatment and becoming first-time parents of twins did not have a negative impact on the couples' appreciation of their relationship and parenthood as stated by both men and women.

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  • 117.
    Tingskull, Sylvia
    et al.
    Child and Adolescent Psychiatry Clinic, Karlskrona, Sweden.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Agnafors, Sara
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. 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.
    deKeyser, Linda
    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.
    Parent and Child Agreement on Experience of Potential Traumatic Events2013In: Child Abuse Review, ISSN 0952-9136, E-ISSN 1099-0852, Vol. 24, no 3, p. 170-181Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate the agreement between parent and child report of potential traumas experienced, to look at the agreement by interpersonal versus non-interpersonal traumas and by gender. A birth cohort of 1723 children and their parents was followed from three months until 12 years after birth (South East Sweden Birth Cohort (SESBiC) study). At 12-year follow-up, 1174 children, 875 mothers and 601 fathers completed the Life Incidence of Traumatic Events (LITE) questionnaire. Cohen's kappa was used to assess the agreement between parent and child reports of traumas experienced by the child. The group was split by gender and kappa statistics were computed to determine the level of agreement between the different informants. The sample was also analysed according to the nature of the traumatic event: interpersonal or non-interpersonal. Agreement was low across most types of traumas reported between parents and children and moderate between mothers and fathers. Agreement was lower when the trauma was interpersonal. No significant discrepancies in general were found on gender. The study highlights the importance of from whom the researcher collects information. In future research, it is important to study the significance the choice of information source might have on reported symptoms and behavioural problems.

  • 118.
    Van Vliet, Jolanda S
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Rasanen, Leena
    Department of Food and Environmental Sciences, Division of Nutrition, University of Helsinki, Finland..
    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.
    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 perception among adolescent girls in relation to appearance of female characteristics2014In: Paediatrics and Health, ISSN 2052-935X, Vol. 2, no 1, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Background: Overweight perception has been shown to be important for health related adolescent behavior, particularly in girls. Body perception may be affected by bodily changes, especially changes visible for others. Female pubertal development is characterized by many physical changes, such as accelerated growth and altered body fat distribution. This study examined the role of appearance of female characteristics in the risk for overweight perception among healthy adolescent girls.

    Methods: 220 girls, aged 11–16, provided self-reports on body perception and pubertal maturation before anthropometric measurements of height, weight, hip and waist circumference (WC). Logistic regression modeling was used to study the appearance of pubertal characteristics in relation to body perception.

    Results: Of the 76 girls (35%) perceiving themselves as overweight, only 14 and 36 girls were overweight according to body mass index and waist circumference respectively. Girls reporting breast development and acne (n=144) were more likely to perceive themselves as overweight than girls who did not report this appearance (n=76). These findings persist after adjusting for overweight according to WC. Non-overweight (n=170) rather than overweight girls reporting characteristics (n=50) were at risk of perceiving themselves overweight.

    Conclusions: Girls may confuse natural changes occurring during adolescent development with being overweight. It is therefore important to improve the understanding about the physical changes that normally occur during puberty along with the girls' own perception of these bodily changes among girls themselves, their parents, at schools, and other healthcare services.

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  • 119.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Can early intervention have an impact on future life? A study of life events, social interaction, and child behavior among mothers at psychosocial risk and their children eight years after interaction treatment2012In: Journal of Family Social Work, ISSN 1052-2158, E-ISSN 1540-4072, Vol. 15, no 1, p. 78-95Article in journal (Refereed)
    Abstract [en]

    Forty-six mothers at psychosocial risk who had undergone interaction treatment when their children were babies were studied with respect to experienced negative life events, social network, and behavior problems in children. One reference group comprising 45 nontreated mothers at psychosocial risk and one comprising 56 mothers without psychosocial problems was used. Children in the study group had experienced more life events than the children of nonrisk mothers but fewer than the children of untreated psychosocial risk mothers. They had a poorer social network than nonrisk mothers, and the children had fewer acting-out behavior than the children of nontreated risk mothers.

  • 120.
    Wadsby, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Arvidsson, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Eight years after - a follow-up study of mothers and children at psychosocial risk who received early treatment: does early intervention leave its mark?2010In: CHILD and FAMILY SOCIAL WORK, ISSN 1356-7500, Vol. 15, no 4, p. 452-460Article in journal (Refereed)
    Abstract [en]

    One-hundred forty-five mothers at psychosocial risk who, with their babies, had been given treatment at a parent-baby clinic during a 2-year period starting in 1999, treatment designed to strengthen the mother-child relationship, were followed up 8 years later. Both the mothers who had agreed to take part in the treatment programme (n = 73) and those who had declined (n = 72) were searched for in the records of the Social Welfare office to determine if the treated mothers had been focused on to a lesser degree in the following 8 years than those who had declined treatment, a hypothesis that was initially put forward. The behaviour of the children whose mothers had undergone treatment (n = 46) was studied. The initial hypothesis had to be rejected; support and intervention from the social authorities had been equally common in both groups. However, the children of treated mothers had fewer externalizing behaviour than children of untreated mothers at psychosocial risk.

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  • 121.
    Wadsby, Marie
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry .
    Sydsjö, Gunilla
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    From pregnancy to parenthood: A study of couples' relationship.2001In: Nordisk Psykologi: teori, forskning, praksis, ISSN 0029-1463, Vol. 53, no 4, p. 275-288Article in journal (Refereed)
    Abstract [en]

    The relationship between 60 first time parents-to-be were studied during pregnancy and when the child was 1 year old in order to find out if, and then in what way the relationship changes during transition to parenthood. Although the relationship was rated as highly harmonious by both women and men during the pregnancy, a significant decline in marital satisfaction was noted when the child was 1 year old. The men experienced an impairment what concerned financial matters, leisure activities, and relations to family and friends. Both women and men experienced an impairment what concerned closeness and sexuality, and a change in opinion about children and parenthood. The women scored, in opposite to the men, higher on conception of life at both study occasions, although they scored lower at the follow-up, The lowest agreement among the couples concerned leisure activities, and it was in this area together with opinion about children and parenthood and conception of life that the agreement had decreased most at the second study occasion.The family climate had changed in direction towards an increased experience of distance according to both women and men, and the men also experienced a decrease in closeness, If the decision to have a baby not had been a joint decision, or if one of the spouses ealier had thought of a separation, there was a lower marital satisfaction at both study occasions.

  • 122.
    Wijma, Klaas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Saita, E
    Department of Psychology, Università Cattolica S. Cuore, Milan, Italy.
    Fenaroli, V
    Department of Psychology, Università Cattolica S. Cuore, Milan, Italy.
    Post traumatic stress disorder (PTSD) following childbirth2010In: Close relationships and community psychology: an international perspective / [ed] V. Cigoli, M. Gennari, Milan:: Franco Angeli , 2010, p. 83-100Chapter in book (Other academic)
  • 123.
    Zetterqvist, Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Lundh, Lars-Gunnar
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Dahlström, Örjan
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Prevalence and Function of Non-Suicidal Self-Injury (NSSI) in a Community Sample of Adolescents, Using Suggested DSM-5 Criteria for a Potential NSSI Disorder2013In: Journal of Abnormal Child Psychology, ISSN 0091-0627, E-ISSN 1573-2835, Vol. 41, no 5, p. 759-773Article in journal (Refereed)
    Abstract [en]

    Previous prevalence rates of non-suicidal self-injury (NSSI) in adolescents have varied considerably. In the present cross-sectional study, prevalence rates, characteristics and functions of NSSI were assessed in a large randomized community sample consisting of 3,060 (50.5 % female) Swedish adolescents aged 15-17 years. The suggested criteria for NSSI disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, (DSM-5) were used to assess prevalence rates with the aim of arriving at a more precise estimate. Out of the whole sample, 1,088 (35.6 %) adolescents (56.2 % female) reported at least one episode of NSSI during the last year, of which 205 (6.7 %) met suggested DSM-5 criteria for a potential NSSI disorder diagnosis. The NSSI disorder diagnosis was significantly more common in girls (11.1 % vs. 2.3 %, χ (2) (1, N = 3046) = 94.08, p < 0.001, cOR = 5.43, 95 % CI [3.73, 7.90]). The NSSI disorder group consisted of significantly more smokers and drug users compared to adolescents with NSSI that did not meet DSM-5 criteria for NSSI disorder, and also differed concerning demographic variables. A confirmatory factor analysis (CFA) was conducted on reported functions of NSSI, with the aim of validating Nock and Prinstein's (Journal of Consulting and Clinical Psychology 72:885-890, 2004, Journal of Abnormal Psychology 114:140-146, 2005) four-factor model on a Swedish community sample, resulting in a close to acceptable fit. A two-factor model (social and automatic reinforcement) resulted in a slightly better fit. The most frequently reported factors were positive and negative automatic reinforcement. A majority of functions were significantly more often reported by girls than boys. The implications of the suggested DSM-5 criteria and reported functions are discussed.

  • 124.
    Zetterqvist, Maria
    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.
    Lundh, Lars-Gunnar
    Lund University, Sweden .
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    A Comparison of Adolescents Engaging in Self-Injurious Behaviors With and Without Suicidal Intent: Self-Reported Experiences of Adverse Life Events and Trauma Symptoms2013In: Journal of Youth and Adolescence, ISSN 0047-2891, E-ISSN 1573-6601, Vol. 42, no 8, p. 1257-1272Article in journal (Refereed)
    Abstract [en]

    Research comparing adolescents engaging in suicidal and non-suicidal self-injury (NSSI), both separately and in combination, is still at an early stage. The purpose of the present study was to examine overlapping and distinguishable features in groups with different types of self-injurious behaviors, using a large community sample of 2,964 (50.6 % female) Swedish adolescents aged 15-17 years. Adolescents were grouped into six categories based on self-reported lifetime prevalence of self-injurious behaviors. Of the total sample, 1,651 (55.7 %) adolescents reported no self-injurious behavior, 630 (21.2 %) reported NSSI 1-4 times, 177 (6.0 %) reported NSSI 5-10 times, 311 (10.5 %) reported NSSI a parts per thousand yen 11 times, 26 (0.9 %) reported lifetime prevalence of suicide attempt and 169 (5.7 %) adolescents reported both NSSI and suicide attempt. After controlling for gender, parental occupation and living conditions, there were significant differences between groups. Pairwise comparisons showed that adolescents with both NSSI and suicide attempt reported significantly more adverse life events and trauma symptoms than adolescents with only NSSI, regardless of NSSI frequency. The largest differences (effect sizes) were found for interpersonal negative events and for symptoms of depression and posttraumatic stress. Adolescents with frequent NSSI reported more adversities and trauma symptoms than those with less frequent NSSI. There were also significant differences between all the NSSI groups and adolescents without any self-injurious behavior. These findings draw attention to the importance of considering the cumulative exposure of different types of adversities and trauma symptoms when describing self-injurious behaviors, with and without suicidal intent.

  • 125. Order onlineBuy this publication >>
    Ängarne-Lindberg, Teresia
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Grown-up children of divorce: Experiences and health2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The comprehensive purpose of the thesis was to study the health and experiences, with a main focus on mental health, of a group of grown-up children of divorced parents in comparison to a group of persons without this experience. Mental health, experienced life events, narratives of divorce related experiences and personal resources were therefore examined in a group of young adults (age 22-33 years) whose parents divorced 15 years before the start of the first three studies. In addition to this, the presence of a child/adolescent and/or an adult psychiatric record and ten years of diagnosed physical health visits in the same but extended group (age 21-38 years) was examined 20 years after parental divorce. The outcomes of these examinations were compared with the outcomes of a group with married parents still living together, matched with the divorce group on age gender and living area. The results showed no major differences in mental health between the divorce and the non-divorce group, with the exception of women age 22-27 showing poorer mental health than the others in the study. Personal resources in this case SOC (Sense of Coherence) followed the same pattern, with no significant differences between the divorce and the non-divorce group, but with women age 22-27 showing lower SOC. The experiences/narratives told by the divorce group fell into one of two categories: one disappointment, the other contentment, with the first indicating non-optimal chances for adjustment to parental divorce and the other good. The run-through of psychiatric records showed no significant differences between the number of persons in need of adult psychiatric care in the divorce and the non-divorce group. A significant difference was present, however, in child- and adolescent psychiatric care pointing to a larger need for psychiatric care in the divorce group, a need most pronounced among girls. As concerned the number of diagnosed physical health care visits, only small differences between the groups were found. The main conclusion of the study was that experience of parental divorce in childhood is not found for a majority to be an experience determining poorer mental or somatic health in young adulthood.

    List of papers
    1. Fifteen years after parental divorce: mental health and experienced life-events
    Open this publication in new window or tab >>Fifteen years after parental divorce: mental health and experienced life-events
    2009 (English)In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, no 1, p. 32-43Article in journal (Refereed) Published
    Abstract [en]

    The children who experienced their parents divorce when the divorce rate in Sweden had begun to grow to higher levels than in preceding decades are today adults. The aim of this study was to investigate if adults who had experienced parental divorce 15 years before the time of our study, differed in mental health from those with continuously married parents, taking into account life events other than the divorce. Instruments used were the Symptom Checklist (SCL-90) measuring mental health and the Life Event questionnaire capturing the number and experience of occurred events. Forty-eight persons, who were 7-18 years old when their parents divorced, constituted the divorce group, and 48 persons matched on age, sex and growth environment formed the study groups. The SCL-90 showed a limited difference between the groups, but not concerning total mental health. A main finding was a difference with regard to sex and age; women aged 22-27 in the divorce group displayed poorer mental health than other participants in both groups. The results from the Life Event questionnaire showed that the divorce group had experienced a significantly larger number of events, and more life events were described as negative with difficult adjustment. A regression analysis showed a significant relation between the SCL-90, Global Severity Index and life events experienced as negative with difficult adjustment, divorce events excluded, but not with the divorce itself. It seems highly desirable to pay more attention than has thus far been paid to girls with experience of childhood divorce at age 7-12.

    Keywords
    Age differences, Gender differences, Life-events, Mental well-being, Parental divorce
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-16725 (URN)10.1080/08039480802098386 (DOI)
    Note
    This is an electronic version of an article published in: Teresia Ängarne-Lindberg and Marie Wadsby, Fifteen years after parental divorce: mental health and experienced life-events, 2009, NORDIC JOURNAL OF PSYCHIATRY, (63), 1, 32-43. NORDIC JOURNAL OF PSYCHIATRY is available online at informaworldTM: http://dx.doi.org/10.1080/08039480802098386 Copyright: Taylor & Francis http://www.tandf.co.uk/journals/default.asp Available from: 2009-02-26 Created: 2009-02-13 Last updated: 2017-12-14Bibliographically approved
    2. Sense of coherence in young adults with and without childhood experience of parental divorce
    Open this publication in new window or tab >>Sense of coherence in young adults with and without childhood experience of parental divorce
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Aim: A number of studies show variability in children’s response to parental divorce. The intent of the present study was to look at personal resources as one possible factor explaining differences in mental health among young adults with childhood experience of parental divorce. This factor is examined by also taking into account the effect of traumatic experiences other than the possibly traumatic parental divorce. Method:  A group of persons with childhood experience of parental divorce (divorce group) was compared to a group without this experience, a non-divorce group consisting of persons of the same gender and age and living in the same locations as those in the divorce group. Personal resources were defined in this study as “Sense of Coherence” (SOC) measured with SOC-29, and mental health was assessed by the SCL-90 index General Severity Index (GSI). Traumatic life events were accounted for by using Life Incidence of Traumatic Events (LITE). Results: The results showed a significant connection between a strong SOC-29 and good mental health SCL-90/GSI, but no significant connection between SOC-29 and LITE, and the same pattern was seen in both the divorce and the non-divorce group. Conclusion: Personal resources measured as strong sense of coherence seem to be important in retaining a good mental health and the capacity to deal with life incidences such as parental divorce.

    .                                                                                                                           

    Keywords
    Parental divorce, personal resourses, mental health, traumatic life events
    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:liu:diva-54626 (URN)
    Projects
    Grown-up children of divorce: Experiences and health
    Available from: 2010-03-26 Created: 2010-03-26 Last updated: 2010-03-26
    3. Young adults with childhood experience of parental divorce: Disappointment and contentment
    Open this publication in new window or tab >>Young adults with childhood experience of parental divorce: Disappointment and contentment
    2009 (English)In: Journal of Divorce and Remarriage, ISSN 1050-2556, E-ISSN 1540-4811, Vol. 50, no 3, p. 172-184Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study was to use in-depth interviews to identify and describe experiences of parental divorce among adult children whose parents divorced 15 years earlier. Ten out of 76 interviews were recorded and transcribed verbatim, and data were analyzed using qualitative content analysis. Two categories of experiences were identified: disappointment and contentment. Two subcategories of disappointment were distinguished: disappointment toward mother, father, or both, and disappointment with relatives and other surrounding persons. Four subcategories of contentment were distinguished: contentment in the belief that the members of the original family received a good or even better life after the divorce, contentment with how the divorce was handled by the parents, contentment and inner strength as a part of the child's own personality, and contentment with receiving adequate help during and after the parental divorce.

    Place, publisher, year, edition, pages
    Routledge, 2009
    Keywords
    Parental divorce, qualitative content analysis, disappointment, contentment
    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:liu:diva-54627 (URN)10.1080/10502550902717749 (DOI)
    Projects
    Grown-up children of divorce: Expereinces and health
    Available from: 2010-03-26 Created: 2010-03-26 Last updated: 2017-12-12Bibliographically approved
    4. Psychiatric and somatic health in relation to expereince of parental divorce in childhood
    Open this publication in new window or tab >>Psychiatric and somatic health in relation to expereince of parental divorce in childhood
    2012 (English)In: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 58, no 1, p. 16-25Article in journal (Refereed) Published
    Abstract [en]

    Background: The outcome of studies about experience of parental divorce and effects on mental and physical health differs in result possibly caused by the use of different questionnaires and instruments, varying length of time since the divorce and divergent drop-off of participants.

    Aims: To study the presence of psychiatric records and number of diagnosed somatic and mental health care visits in a group of young adults with childhood experience of parental divorce in comparison to a group without this experience.

    Methods: The presence of a record at the public psychiatric clinics and ten years of administrative health care data (somatic and mental) was checked for both groups.

    Results: Significantly more persons from the divorce group occurred in child and adolescent psychiatric care, most pronounced women. However, no significant difference between the groups in number of persons seeking adult psychiatry, or in number of psychiatric consultations was present. Experience of parental divorce was not either found to be an indicator of larger somatic health problems.

    Conclusion: Experience of parental divorce in childhood is not an indicator of adult psychiatric or somatic need of care.

    Place, publisher, year, edition, pages
    Sage Publications, 2012
    Keywords
    Somatic health, parental divorce, psychiatric records
    National Category
    Psychiatry
    Identifiers
    urn:nbn:se:liu:diva-54628 (URN)10.1177/0020764010382372 (DOI)000297867400002 ()
    Projects
    Grown-up children of divorce: Expereinces and health
    Available from: 2010-03-26 Created: 2010-03-26 Last updated: 2017-12-12
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    Grown-up children of divorce : Experiences and health
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  • 126.
    Ängarne-Lindberg, Teresia
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Wadsby , Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry . Linköping University, Faculty of Health Sciences.
    Fifteen years after parental divorce: mental health and experienced life-events2009In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 63, no 1, p. 32-43Article in journal (Refereed)
    Abstract [en]

    The children who experienced their parents divorce when the divorce rate in Sweden had begun to grow to higher levels than in preceding decades are today adults. The aim of this study was to investigate if adults who had experienced parental divorce 15 years before the time of our study, differed in mental health from those with continuously married parents, taking into account life events other than the divorce. Instruments used were the Symptom Checklist (SCL-90) measuring mental health and the Life Event questionnaire capturing the number and experience of occurred events. Forty-eight persons, who were 7-18 years old when their parents divorced, constituted the divorce group, and 48 persons matched on age, sex and growth environment formed the study groups. The SCL-90 showed a limited difference between the groups, but not concerning total mental health. A main finding was a difference with regard to sex and age; women aged 22-27 in the divorce group displayed poorer mental health than other participants in both groups. The results from the Life Event questionnaire showed that the divorce group had experienced a significantly larger number of events, and more life events were described as negative with difficult adjustment. A regression analysis showed a significant relation between the SCL-90, Global Severity Index and life events experienced as negative with difficult adjustment, divorce events excluded, but not with the divorce itself. It seems highly desirable to pay more attention than has thus far been paid to girls with experience of childhood divorce at age 7-12.

    Download full text (pdf)
    FULLTEXT01
  • 127.
    Ängarne-Lindberg, Teresia
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Psychiatric and somatic health in relation to expereince of parental divorce in childhood2012In: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 58, no 1, p. 16-25Article in journal (Refereed)
    Abstract [en]

    Background: The outcome of studies about experience of parental divorce and effects on mental and physical health differs in result possibly caused by the use of different questionnaires and instruments, varying length of time since the divorce and divergent drop-off of participants.

    Aims: To study the presence of psychiatric records and number of diagnosed somatic and mental health care visits in a group of young adults with childhood experience of parental divorce in comparison to a group without this experience.

    Methods: The presence of a record at the public psychiatric clinics and ten years of administrative health care data (somatic and mental) was checked for both groups.

    Results: Significantly more persons from the divorce group occurred in child and adolescent psychiatric care, most pronounced women. However, no significant difference between the groups in number of persons seeking adult psychiatry, or in number of psychiatric consultations was present. Experience of parental divorce was not either found to be an indicator of larger somatic health problems.

    Conclusion: Experience of parental divorce in childhood is not an indicator of adult psychiatric or somatic need of care.

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  • 128.
    Ängarne-Lindberg, Teresia
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Psychosocial risk-mothers and their babies: Opinions about interaction treatment2013In: Child Care in Practice, ISSN 1357-5279, E-ISSN 1476-489X, Vol. 19, no 1, p. 49-60Article in journal (Refereed)
    Abstract [en]

    Studies focusing on mothers' own reports of their experience with intervention programmes are rare, so very little has been known about their evaluations of the programmes and what they have learned. The aim of the present study was to use interviews to evaluate these aspects of an intervention programme. The interviews were designed to capture the mothers' memories and thoughts about their experiences and to learn about the knowledge they acquired in a short-term intervention programme. Forty-six mothers identified as being at psychosocial risk were interviewed. The interview materials were analysed using qualitative content analysis. Two categories were identified: emotional context, and knowledge. The material assigned to the second category was further divided into three sub-categories. The study results point to the equal importance of actual knowledge and to the emotional dimension.

  • 129.
    Ängarne-Lindberg, Teresia
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry .
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry .
    Sense of coherence in young adults with and without childhood experience of parental divorceManuscript (preprint) (Other academic)
    Abstract [en]

    Aim: A number of studies show variability in children’s response to parental divorce. The intent of the present study was to look at personal resources as one possible factor explaining differences in mental health among young adults with childhood experience of parental divorce. This factor is examined by also taking into account the effect of traumatic experiences other than the possibly traumatic parental divorce. Method:  A group of persons with childhood experience of parental divorce (divorce group) was compared to a group without this experience, a non-divorce group consisting of persons of the same gender and age and living in the same locations as those in the divorce group. Personal resources were defined in this study as “Sense of Coherence” (SOC) measured with SOC-29, and mental health was assessed by the SCL-90 index General Severity Index (GSI). Traumatic life events were accounted for by using Life Incidence of Traumatic Events (LITE). Results: The results showed a significant connection between a strong SOC-29 and good mental health SCL-90/GSI, but no significant connection between SOC-29 and LITE, and the same pattern was seen in both the divorce and the non-divorce group. Conclusion: Personal resources measured as strong sense of coherence seem to be important in retaining a good mental health and the capacity to deal with life incidences such as parental divorce.

    .                                                                                                                           

  • 130.
    Ängarne-Lindberg, Teresia
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Sense of Coherence in Young Adults With and Without Experience of Parental Divorce in Childhood2011In: Journal of Divorce and Remarriage, ISSN 1050-2556, E-ISSN 1540-4811, Vol. 52, no 5, p. 309-321Article in journal (Refereed)
    Abstract [en]

    The intent of this study was to look at personal resources, defined in this study as sense of coherence (SOC), as one possible factor explaining equalities and differences in mental health between individuals with and without experience of parental divorce, when traumatic experiences, other than a possibly traumatic parental divorce, were also considered. The results showed a significant connection between a strong SOC-29 and good mental health (Symptom Checklist-90/Global Severity Index), but no significant connection between SOC-29 and Life Incidence of Traumatic Events. Personal resources measured as strong sense of coherence seem to be important in retaining good mental health and for the capacity to deal with life incidences.

  • 131.
    Ängarne-Lindberg, Teresia
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Wadsby, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Young adults with childhood experience of parental divorce: Disappointment and contentment2009In: Journal of Divorce and Remarriage, ISSN 1050-2556, E-ISSN 1540-4811, Vol. 50, no 3, p. 172-184Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to use in-depth interviews to identify and describe experiences of parental divorce among adult children whose parents divorced 15 years earlier. Ten out of 76 interviews were recorded and transcribed verbatim, and data were analyzed using qualitative content analysis. Two categories of experiences were identified: disappointment and contentment. Two subcategories of disappointment were distinguished: disappointment toward mother, father, or both, and disappointment with relatives and other surrounding persons. Four subcategories of contentment were distinguished: contentment in the belief that the members of the original family received a good or even better life after the divorce, contentment with how the divorce was handled by the parents, contentment and inner strength as a part of the child's own personality, and contentment with receiving adequate help during and after the parental divorce.

  • 132.
    Åkerman, Ingrid
    et al.
    Lunds universitet.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Ett års kontakter med prostitutionsenheterna (FAST) – En beskrivning av insatser till personer med prostitutionserfarenhet (Försäljare av Sexuella Tjänster, FAST): Delrapport 3 ur Prostitution i Sverige – Kartläggning och utvärdering av prostitutionsgruppernas insatser samt erfarenheter och attityder i befolkningen2012Report (Other academic)
    Abstract [sv]

    Syftet med kartläggningarna av ett års verksamhet vid de enheter som vänder sig till Försäljare Av Sexuella Tjänster (FAST) var att få en enhetlig och samlad bild av hur många försäljare av sexuella tjänster som prostitutionsgrupperna kommer i kontakt med under ett år och att samtidigt göra en grundläggande kartläggning av prostitutionsenheternas arbete utifrån antalet kontakter som tas under en viss tid, kontakternas karaktär och vad dessa leder till för klienten.

    Specifika frågeställningar som har valts att belysas:

    • Hur många personer arbetar FAST-grupperna med under ett år?
    • Hur fördelar sig de olika insatser som görs?
    • Hur blir man aktuell för behandling?
    • Hur många av dem inleder en samtals-/psykoterapeutisk behandling?

    Metod. En beskrivning av prostitutionsgruppernas målgrupper har möjliggjorts genom att varje handläggare på ett likartat sätt vid varje grupp (Göteborg, Malmö och Stockholm) som vänder sig till Försäljare Av Sexuella Tjänster (FAST) upprättat ett anonymt rapportblad på varje person de mött i sitt arbete under tidperioden 1/10 2009 – 30/9 2010, i texten kallad utredningsåret. De har sedan på rapportbladet registrerat varje kontakt/insats som de under perioden haft med denna person.

    Resultat FAST. FAST-enheterna hade under rapportåret kontakt med 326 unika personer med prostitutionserfarenhet varav 237 personer (73 %) var nya under året. Av de 326 var 317 kvinnor varav nio minderåriga (< 18 år), 31 procent var att betrakta som barn eller unga vuxna, dvs. ålder 15 – 25 år och majoriteten (57 %) var i åldern 15-35 år. Trettio procent var av utländsk härkomst där kvinnor från Östeuropa dominerade. Av de totala insatserna riktade mot säljare av sexuella tjänster gjordes 2945 insatser motsvarande 9 insatser per person under året. Dessa fördelade sig på 88 personer (27 % av samtliga) vars kontakt slutligen rubricerades som kontaktförsök dessa hade sammanlagt 157 kontakter (1,8 insatser per person) motsvarande 5,3 procent av samtliga kontakter. Etthundrafyrtio personers kontakter (43 % av samtliga) rubricerades som råd och stöd och dessa hade 1 801 kontakter (12,9 insatser per person) motsvarande 61,2 procent av samtliga kontakter. Sextio personer (18 % av samtliga) rubricerades som behandling och dessa hade i sin tur 905 kontakter (15,1 insatser per person) motsvarande 31 procent av samtliga kontakter. Hälften av de 60 behandlingsärendena startade under rapportåret som behandling antingen som pågående behandling (18 %) eller som nya behandlingar under året (32 %). Andra kom via tidigare bedömningssamtal och samtal (18 %) eller som nya bedömningssamtal och samtal under året (20 %). Detta innebär inte att man inte kan ha haft kortare eller längre kontakter via det uppsökande arbetet eller motiverande samtal längre tillbaka i tiden.

    Rekommendationer. Med utgångspunkt i resultaten från denna delstudie vill vi lyfta följande frågor av betydelse för det framtida arbetet med att förebygga och reducera säljande av sexuella tjänster.

    • Att det är en specialiserad och mångfacetterad verksamhet där delar som uppsökande verksamhet, råd och stöds och behandling har betydelse för att nå målgruppen.
    • Att verksamheterna i verksamhetsplanerna riktar sig till alla som säljer sexuella tjänster men att FAST i huvudsak har kontakt med vuxna kvinnor, få minderåriga och få män.
    • Att de individinriktade insatserna i form av behandling och samtalsterapi kommer 18 procent av ett års besökande personer tillgodo inom FAST och att dessa konsumerade 31 procent av samtliga insatser.
    • Att de som kommer till behandling och samtalsterapi oftast redan från början kommer för detta direkt eller via bedömningssamtal och introduktionssamtal.
    • Att det inte finns någon liknande verksamhet som riktar sig till minderåriga i samma situation.
    • Att uppmärksamma att kvinnor med utländsk nationalitet utgör 30 procent av samtliga personer under året och att dessa till allra största delen säljer sex på gatan i Stockholm och Göteborg. Att handläggarna i många fall misstänker att dessa kvinnor är offer för människohandel eller människohandelsliknande brott som t.ex. koppleri. Flera kvinnor i rapportbladen behöver stora insatser t.ex. nio utländska kvinnor i Malmö behöver 90 procent av Malmös alla råd och stöd insatser.
    • Att specialiserad verksamhet mot personer som säljer sexuella tjänster bara finns i de tre storstäderna. Att liknande verksamheter borde finnas på andra orter eller att de verksamheter som finns idag får möjlighet att arbeta som dels kunskapscentrariktad mot andra kommuner och ges möjlighet att ta emot personer för råd och stöd och behandling även från andra delar i landet.
    Download full text (pdf)
    Ett års kontakter med prostitutionsenheterna (FAST) – En beskrivning av insatser till personer med prostitutionserfarenhet (Försäljare av Sexuella Tjänster, FAST): Delrapport 3 ur Prostitution i Sverige – Kartläggning och utvärdering av prostitutionsgruppernas insatser samt erfarenheter och attityder i befolkningen
  • 133.
    Åkerman, Ingrid
    et al.
    Lunds universitet.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Ett års kontakter med prostitutionsenheterna (KAST) – En beskrivning av insatser till personer med erfarenhet av Köp av Sexuella Tjänster/problematiskt sexuellt beteende (KAST): Delrapport 4 ur Prostitution i Sverige – Kartläggning och utvärdering av prostitutionsgruppernas insatser samt erfarenheter och attityder i befolkningen2012Report (Other academic)
    Abstract [sv]

    Syftet med kartläggningarna av ett års verksamhet vid de enheter som vänder sig till Köpare Av Sexuella Tjänster (KAST) var att få en enhetlig och samlad bild av hur många köpare som prostitutionsgrupperna kommer i kontakt med under ett år och att samtidigt göra en grundläggande kartläggning av prostitutionsenheternas arbete utifrån antalet kontakter som tas under en viss tid, kontakternas karaktär och vad dessa leder till för klienten.

    • Specifika frågeställningar som valts att belysas:
    • Hur många personer arbetar KAST-grupperna med under ett år?
    • Hur fördelar sig de olika insatser som görs?
    • Hur blir man aktuell för behandling?
    • Hur många av dem inleder en samtals-/psykoterapeutisk behandling?

    Metod. En beskrivning av prostitutionsgruppernas målgrupper har möjliggjorts genom att varje handläggare på ett likartat sätt vid varje grupp (Göteborg, Malmö och Stockholm) som vänder sig till Köpare Av Sexuella Tjänster (KAST) upprättat ett anonymt rapportblad på varje person de mött i sitt arbete under tidperioden 1/10 2009 – 30/9 2010, i texten kallad utredningsåret. De har sedan på rapportbladet registrerat varje kontakt/insats som de under perioden haft med denna person.

    Resultat: KAST-enheterna hade under rapportåret kontakt med 209 unika personer som antingen var köpare av sexuella tjänster (54 %) eller personer med ett problematiskt sexuellt beteende/sexmissbruk (42 %). Av de 209 personerna var 173 (83 %) nya under året och 199 var män varav två minderåriga. Trettiosex av de 209 personerna (17 %) var kända före den 1 oktober 2009 medan 173 (83 %) kom som nya under utredningsåret.

    Av de totala insatserna riktade mot köpare av sexuella tjänster och personer med sexmissbruk gjordes 1391 insatser motsvarande 6,7 insatser per person under året. Dessa fördelade sig på 105 personer (50 % av samtliga) vars kontakt slutligen rubricerades som kontaktförsök dessa hade sammanlagt 153 kontakter (1,5 insatser per person) motsvarande 11 procent av samtliga kontakter. Sjutton personers kontakter rubricerades som råd och stöd (8 % av samtliga) dessa hade sammanlagt 101 kontakter (4,8 kontakter per person) motsvarande 7,2 procent av samtliga kontakter. Fyrtiosex personers kontakter (22 % av samtliga) rubricerades som samtalskontakt och dessa hade 299 kontakter (6,9 insatser per person) motsvarande 21,5 procent av samtliga kontakter. Fyrtioen personer (20 % av samtliga) rubricerades som behandling och dessa hade i sin tur 838 kontakter (20,4 insatser per person) motsvarande 60 procent av samtliga kontakter. De 41 behandlingsärendena kom till stor utsträckning direkt till behandling (54 %) eller via introduktionssamtal (41 %).

    Rekommendationer. Med utgångspunkt i resultaten från denna delstudie vill vi lyfta följande frågor av betydelse för det framtida arbetet med att förebygga och reducera köpandet av sexuella tjänster.

    • Att det är en specialiserad och mångfacetterad verksamhet där delar som uppsökande verksamhet, råd och stöds och behandling har betydelse för att nå målgruppen.
    • Att verksamheterna i verksamhetsplanerna riktar sig till alla som köper sexuella tjänster men att KAST i huvudsak har kontakt med vuxna män och få minderåriga och få kvinnor.
    • Att de individinriktade insatserna i form av behandling och samtalsterapi kommer 20 procent av ett års besökande personer tillgodo inom KAST och att dessa konsumerade 60 procent av samtliga insatser.
    • Att de som kommer till behandling och samtalsterapi oftast redan från början kommer för detta direkt eller via bedömningssamtal och introduktionssamtal.
    • Att det inte finns någon liknande verksamhet som riktar sig till minderåriga i samma situation.
    • Att specialiserad verksamhet mot personer som köper sexuella tjänster bara finns i de tre storstäderna. Att liknande verksamheter borde finnas på andra orter eller att de verksamheter som finns idag får möjlighet att arbeta kunskapscentrariktad mot andra kommuner och därmed ges möjlighet att ta emot personer får råd och stöd och behandling även från andra delar i landet.
    Download full text (pdf)
    Ett års kontakter med prostitutionsenheterna (KAST) – En beskrivning av insatser till personer med erfarenhet av Köp av Sexuella Tjänster/problematiskt sexuellt beteende (KAST): Delrapport 4 ur Prostitution i Sverige – Kartläggning och utvärdering av prostitutionsgruppernas insatser samt erfarenheter och attityder i befolkningen
  • 134.
    Åkerman, Ingrid
    et al.
    Lunds universitet.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences.
    Kartläggning av insatser mot prostitutionen i Stockholm, Göteborg och Malmö: Delrapport 2 ur Prostitution i Sverige – Kartläggning och utvärdering av prostitutionsgruppernas insatser samt erfarenheter och attityder i befolkningen2012Report (Other academic)
    Abstract [sv]

    Syftet med undersökningen är att kartlägga de tre stora kommunernas verksamheter riktade mot mot prostitutionen och till personer som försäljer sexuella tjänster (FAST) eller köper sexuella tjänster (KAST). Rapporten beskriver i huvudsak de kommunala verksamheternas organisation, inriktning, resurser och arbetssätt. Detta för att bättre förstå förutsättningarna för de totala insatser som görs mot målgrupperna (delrapport 3-4) och de behandlingar som erbjuds målgrupperna och som senare beskrivs i tre andra delrapporter (delrapport 5-7).

    Metod. Som underlag för rapporten har personalen vid varje enhet intervjuats vid personliga besök på enheterna och verksamhetsbeskrivningar, årsredovisningar, projektdokumentation och informationsmaterial har samlats in. Intervjucitat från intervjuer med personal är i texten markerade med kursiv stil. Det är således verksamheternas egna beskrivningar och inte våra värderingar eller bedömningar som utgör underlaget för denna rapport. Kartläggningen har gjorts vid projektets början 2009 samt kontinuerligt fram till december 2011 då rapporten stämdes av med personalen vid de tre prostitutionsgrupperna.

    Resultat. Det finns tre offentligt finansierade verksamheter som har som uppgift att arbeta mot prostitutionen i Sverige och dessa finns i de tre storstäderna Stockholm, Göteborg och Malmö.  Samtliga verksamheter har enheter riktade till Försäljare av Sexuella Tjänster (FAST) och Köpare av Sexuella Tjänster (KAST).

    Samtliga enheter lyder organisatoriskt under socialtjänsten i respektive kommun.      På personalsidan (heltidstjänster) hade under hösten 2011 Stockholm sammanlagt 10.25 tjänster + chef, Göteborg 5,0 tjänster + chef, Malmö 6,0 tjänster + chef.

    De tre enheternas likheter är betydande då det gäller de grundläggande målsättningarna. Dessa är att:

    • arbeta för att minska prostitutionen. Verksamheten ska ha kunskap om prostitutionens omfattning i sitt upptagningsområde och kontinuerligt följa prostitutionens förändringar på gatan, hotell och barer och nätet.
    • ansvara för utveckling och samarbete med andra myndigheter och frivilliga organisationer i traffickingfrågor. En första kontakt och stödinsats för vissa traffickingoffer i sitt upptagningsområde i samarbete med aktuell stadsdelsförvaltning/kommun.
    • erbjuda och ge kvinnor och män i prostitution eller prostitutionsliknande verksamhet på olika sätt stöd och hjälp för att kunna hitta andra alternativ (råd och stöd och behandling).
    • bedriva ett uppsökande arbete i första hand riktat mot gatuprostitutionen, men även andra miljöer och Internet
    • erbjuda och ge köpare av sexuella tjänster råd och stöd och behandling.
    • kunna erbjuda personal inom kommunen och andra samarbetspartners information och stöd i frågor som rör området.

    De tre enheterna skiljer sig åt på en del områden som i huvudsak har med tradition och prioriteringar i arbetet:

    • I Stockholm erbjuds klienter gynekologiska undersökningar av enhetens barnmorska/gynekologer, Spiralprojektet. Vid behov kontakt med psykiatriker och leg.läkare i samarbete med landstinget. Vare sig Göteborg eller Malmö har motsvarande verksamhet.
    • Göteborg är den enhet (KAST) som tidigast och mest konsekvent utvecklat ett arbete att erbjuda samtal och behandling till sexköpare och sexmissbrukare.
    • Malmö är den enhet som tidigast och mest konsekvent arbetar med skadereducerande insatser (harm reduction) genom att dela ut ett s.k. preventionspaket – en liten väska med en säkerhetsguide, personlarm, kondomer, glidmedel, tandborste, våtservetter mm.
    • Malmö är den enhet som först utvecklat ett uppsökande arbete över Internet. Detta har sedan i mindre skala anammats av enheterna i Stockholm och Göteborg. Malmö har också utvecklat gruppverksamhet för anhöriga till köpare av sexuella tjänster samt gruppsamtal med kvinnor som både har en missbruksproblematik och sålt sexuella tjänster.
    • De teoretiska modellerna i kontakterna med klienterna men fr.a. i behandlingsarbetet skiljer också mellan enheterna

    Under perioden som uppdraget pågått 2009-2011 har det vid varje enhet skett omorganiseringar och t.ex. har samtliga enheter bytt enhetschef, personalsituationen har varit osäker liksom de ekonomiska förutsättningarna för att bedriva verksamheterna. Detta har enligt såväl intervjuare som utredare haft en negativ påverkan (osäkerhet, erfarenhets- och kapacitetstapp, omprioriteringar) på verksamheterna.

    Verksamheterna har enligt ovan tämligen breda arbetsuppgifter men de målgrupper man arbetar med är inom FAST i första hand kvinnor och män som befinner sig i prostitution eller prostitutionsliknande verksamhet men även preventivt för att förhindra unga människor att börja sälja sex samt stöd och behandling till kvinnor och män när de lämnat prostitutionen. Inom KAST är den officiella målgruppen män och kvinnor som köper sex men i verkligheten så är det nästen lika många som har ett sexmissbruk som söker sig till enheterna. Detta motiveras med att det inom ramen för ett sexmissbruk är stor risk att individen även köper sex.

    Av materialet och intervjuerna framkommer att på de flesta enheterna kommer majoriteten av behandlingsärendena i FAST via tidigare kontakter, rekommendationer av andra inklusive tidigare klienter vid enheterna samt information från hemsidor.

    Rekommendationer. Det är viktigt att inledningsvis kommentera att det utifrån ett föränderligt samhälle så förändras även prostitutionens förutsättningar. Dessa förändringar har dels att göra med tillkomsten av Internet dels av människors rörlighet i samhället men även internationellt. Utifrån dessa successivt förändrade villkor är det inte tillfredställande att var man bor i Sverige blir avgörande för vilken hjälp man kan få som säljare eller köpare av sexuella tjänster.

    Den statliga styrningen har syftet att ge kommuner och landsting förutsättningar att kunna erbjuda befolkningen vård på lika villkor, samt att säkerställa att verksamheterna upprätthåller en säker och god vård enligt vetenskap och beprövad erfarenhet (SOU 1999:66). Människor ska således utifrån sina behov erbjudas råd och stöd samt behandling oavsett var de bor i landet.

    • vi rekommenderar en översyn över hur individer utanför de tre storstäderna kan tillförsäkras samma service som dessa kommuners invånare. Frågan är inte helt okomplicerad då målgruppernas klienter till stor utsträckning behöver mötas lokalt med uppsökande verksamhet, råd och stöd samt samtalsbehandling. Detta kan för en del klienter, som bor strax utanför de tre storstadsområdena, lösas genom att dessa enkelt får tillgång till någon av de tre prostitutionsenheterna. För andra kan behovet av dessa insatser kanske lösas genom att ett nationellt nätverk av på prostitutionsområdet kunniga personer etableras i landet.
    • köp och försäljning av sexuella tjänster över Internet blir allt vanligare såväl bland unga (< 18 år) som äldre. Den Internetrelaterade prostitutionen är betydligt osynligare än t.ex. gatuprostitutionen. En ökad aktivitet genom information och uppsökande verksamhet på Internet behöver stödjas och utvecklas. Erfarenheter som uppnåtts vid prostitutionsverksamheten i Malmö bör tas till vara och uppgiften bör vara ett nationellt ansvar.

    Samtliga verksamheter bedriver råd och stöd, samtal och samtalsbehandling samtidigt som det saknas övergripande regler för journalskrivning annat än för Spiralprojektets medicinska del. Detta är högst otillfredsställande då majoriteten av klienterna framför allt inom FAST programmen ofta har en påtaglig psykisk ohälsa och allvarliga sociala problem. Anonymitetsaspekten har haft företräde före rättssäkerhetsaspekten

    • vi föreslår en översyn av journalföringsreglerna för verksamheternas direkta klientarbete

    I kartläggningen av enheternas arbete framkommer en traditionell bild av kvinnor som säljer sex till män, d.v.s. en traditionell vuxen bild av prostitutionen. Tidigare undersökningar av ungdomar och denna undersöknings delrapport 1 visar dock att det är vanligare att pojkar och män säljer sex än att flickor och kvinnor gör det. Till detta kommer att unga människor med homo-, bi- eller transsexuell läggning (HBT) oftare har erfarenheter att sälja sex.

    • vi föreslår att extra ansträngningar görs för bättre nå ut med information och service till män som säljare av sexuella tjänster liksom personer med homo-, bi-, eller transexuell läggning.
    Download full text (pdf)
    Kartläggning av insatser mot prostitutionen i Stockholm, Göteborg och Malmö: Delrapport 2 ur Prostitution i Sverige – Kartläggning och utvärdering av prostitutionsgruppernas insatser samt erfarenheter och attityder i befolkning
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