Rising rates of mental health problems and nonsuicidal self-injury (NSSI) among adolescents highlight the need for preventive interventions and the lack of evidence regarding such measures. To date, few studies have investigated school-based prevention programs targeting NSSI. In this study, a whole-school preventive intervention was carried out at Swedish lower secondary schools and evaluated in a cluster-randomized controlled trial. The whole-school intervention included classroom-based modules focusing on mental health and NSSI directed at students, psychoeducational webinars on NSSI directed at parents and teachers, and a two-day workshop on NSSI and suicidality for school health staff. Data were collected from students (N = 183, age M = 14.17, SD = 0.55, 58% female) at baseline and three- and six-month post-intervention follow-ups. Analyses revealed a significant decrease in three-month NSSI frequency and a significant difference in mental health-related stigma awareness in the intervention group compared to controls. Regarding other outcomes (NSSI onset, attitudes toward help-seeking, perceived social support, health-related quality of life, emotion regulation and self-criticism), no significant effects were found. Effects moderated by gender and history of NSSI were found, underscoring that the outcomes of universal prevention are not always uniformly distributed. Main conclusions were that whole-school prevention can be effective in reducing NSSI frequency as well as affecting the awareness of mental health-related stigma.

Background Elite athletes are role models for young sportspersons regarding social media use. Self-objectification, including self-sexualizing, contributes to body dissatisfaction and body shame, especially in young females. For efficient prevention of self-objectification, knowledge is needed about elite athletes’ self-presentation on social media.

Objective To compare social media postings indicative of self-objectification among female elite athletes in an aesthetic and a non-aesthetic individual sport and by age.

Design Cross-sectional quantitative visual content analysis study.

Setting Instagram on October 1st, 2021.

Participants All Swedish elite female athletes aged 16 years or older with open Instagram accounts in figure skaters (n=26) and athletics (track and field) athletes (n=40).

Assessment of Risk Factors The 30 most recently posted images were identified from each athlete’s Instagram account (Figure). Following exclusion of non-topical images, a panel (4 women/4 men) individually scored factors indicative of self-objectification in the remaining images. The scores were analyzed quantitatively by sport (figure skating/athletics) and age group (age-cut at 21 years).

Main Outcome Measurements Proportion of sexually suggestive images in Instagram postings.

Results In total, 1,869 images were analyzed; 669 posted by figure skaters and 1200 by athletics athletes. Seventy-four images (4%) were classified as containing sexually suggestive content. Figure skaters posted more images with sexually suggestive content (p=0.032) than athletics athletes (especially images with sexual posing (p=0.005) and sexualized body parts in focus (chest (p=0.049); hip-region (p=0.001)). Younger athletes published more images interpreted to contain sexual suggestion than older athletes (p<0.001) (especially images focusing on the chest (p=0.008)). 

Conclusions Prevention of self-objectification in young female sportspersons should include moderation of self-presentation practices on social media among female elite athletes in aesthetic sports and young elite athletes in their upper teens. Further research on the role of social media in the etiology of mental unhealth in sportspersons is warranted. 

Background Programs for mental health promotion and prevention of nonsuicidal self-injury (NSSI) in schools have gained increased focus during the last decades, but less is known about adolescents’ experiences of such interventions.

Methods A whole-school preventive intervention targeting mental health and NSSI was delivered to six secondary schools. Adolescents participated in the Youth Aware of Mental Health program combined with an NSSI-focused psychoeducation module. Caregivers and teachers were given online psychoeducation on NSSI, and school health care staff were given a workshop on self-injury. Eleven group interviews (n = 65 participants) were conducted with adolescents (ages 13–15 years, 65% females) exploring participant experiences. Interviews were analyzed using thematic analysis and interpreted in light of a biopsychosocial understanding of adolescence.

Results The analysis generated two main themes. The first theme, Mental health in the context of adolescence, centered around adolescents’ conception of mental health, after having taken part in the intervention, framed in a context of coping with external stressors. The dilemma of autonomy versus help-seeking was also identified as part of the first main theme. The second theme, The who, when, what, and how of the intervention, described adolescents’ experiences of the intervention. This theme included increased awareness and knowledge of mental ill-health. The participants generally agreed that the topics included are important to adolescents and emphasized that the content needs to be relatable. Several factors that influence how a school-based program is received by adolescents were identified, such as who should be targeted and when. Adolescents also identified challenges and gave recommendations for future similar projects.

Conclusions Adolescents generally perceived addressing mental health and NSSI in schools as important. Help-seeking initiatives need to be balanced against adolescents’ need for autonomy when planning mental health prevention and intervention.

BackgroundNonsuicidal self-injury (NSSI) is highly prevalent in adolescents. In survey and interview studies assessing NSSI, methods of assessment have been shown to influence prevalence estimates. However, knowledge of which groups of adolescents that are identified with different measurement methods is lacking, and the characteristics of identified groups are yet to be investigated. Further, only a handful of studies have been carried out using exploratory methods to identify subgroups among adolescents with NSSI.MethodsThe performance of two prevalence measures (single-item vs. behavioral checklist) in the same cross-sectional community sample (n = 266, age M = 14.21, 58.3% female) of adolescents was compared regarding prevalence estimates and also characterization of the identified groups with lifetime NSSI prevalence. A cluster analysis was carried out in the same sample. Identified clusters were compared to the two groups defined using the prevalence measures.ResultsA total of 118 (44.4%) participants acknowledged having engaged in NSSI at least once. Of these, a group of 55 (20.7%) adolescents confirmed NSSI on a single item and 63 (23.7%) adolescents confirmed NSSI only on a behavioral checklist, while denying NSSI on the single item. Groups differed significantly, with the single-item group being more severely affected and having higher mean scores on difficulties in emotion regulation, self-criticism, number of methods, higher frequency of NSSI, higher rates of suicidal ideation and suicidal behavior and lower mean score on health-related quality of life. All cases with higher severity were not identified by the single-item question. Cluster analysis identified three clusters, two of which fit well with the groups identified by single-item and behavioral checklist measures.ConclusionsWhen investigating NSSI prevalence in adolescents, findings are influenced by the researchers' choice of measures. The present study provides some directions toward what kind of influence to expect given the type of measure used, both with regards to the size of the identified group and its composition. Implications for future research as well as clinical and preventive work are discussed.

The relation between religiosity and well-being is one of the most researched topics in the psychology of religion, yet the directionality and robustness of the effect remains debated. Here, we adopted a many-analysts approach to assess the robustness of this relation based on a new cross-cultural dataset (N = 10, 535 participants from 24 countries). We recruited 120 analysis teams to investigate (1) whether religious people self-report higher well-being, and (2) whether the relation between religiosity and self-reported well-being depends on perceived cultural norms of religion (i.e., whether it is considered normal and desirable to be religious in a given country). In a two-stage procedure, the teams first created an analysis plan and then executed their planned analysis on the data. For the first research question, all but 3 teams reported positive effect sizes with credible/confidence intervals excluding zero (median reported beta = 0.120). For the second research question, this was the case for 65% of the teams (median reported beta = 0.039). While most teams applied (multilevel) linear regression models, there was considerable variability in the choice of items used to construct the independent variables, the dependent variable, and the included covariates.

Few studies have examined which acoustic features of speech can be used to distinguish between different emotions, and how combinations of acoustic parameters contribute to identification of emotions. The aim of the present study was to investigate which acoustic parameters in Swedish speech are most important for differentiation between, and identification of, the emotions anger, fear, happiness, sadness, and surprise in Swedish sentences. One-way ANOVAs were used to compare acoustic parameters between the emotions and both simple and multiple logistic regression models were used to examine the contribution of different acoustic parameters to differentiation between emotions. Results showed differences between emotions for several acoustic parameters in Swedish speech: surprise was the most distinct emotion, with significant differences compared to the other emotions across a range of acoustic parameters, while anger and happiness did not differ from each other on any parameter. The logistic regression models showed that fear was the best-predicted emotion while happiness was most difficult to predict. Frequency- and spectral-balance-related parameters were best at predicting fear. Amplitude- and temporal-related parameters were most important for surprise, while a combination of frequency-, amplitude- and spectral balance-related parameters are important for sadness. Assuming that there are similarities between acoustic models and how listeners infer emotions in speech, results suggest that individuals with hearing loss, who lack abilities of frequency detection, may compared to normal hearing individuals have difficulties in identifying fear in Swedish speech. Since happiness and fear relied primarily on amplitude- and spectral-balance-related parameters, detection of them are probably facilitated more by hearing aid use.

IntroductionThe interest in the health of Para athletes continues to increase. Still, there are few studies that have evaluated health parameters beyond injury and illness in this athlete population. ObjectiveTo assess (1) the weekly proportion of elite Para athletes reporting anxiety/depression, low sleep levels (&lt;= 7 hours), and pain over 52 weeks; (2) and to explore whether these health parameters are associated with the risk for a sports injury or illness. DesignA 52-week prospective study, part of the Sports-related Injury and Illness in Paralympic Sport Study (SRIIPSS). SettingA total of 107 Swedish elite Para athletes with physical, visual, and intellectual impairment participated. Main outcome measuresData on self-reported anxiety/depression, sleep levels, pain, and injuries/illnesses were collected weekly. Comparisons of these parameters preceding an injury/illness were made using Friedmans analysis of variance (ANOVA). ResultsThe proportion of athletes reporting weekly anxiety/depression was 34.1%; 60.9% of athletes reported sleeping &lt;= 7 hours and 49.9% reported pain. In exploratory analyses, there were no significant differences between weeks before an injury for any of the variables. There were significant differences in levels of sleep over the weeks, where sleep levels were significantly higher (&gt;10 hours) 4 weeks prior to an illness (p = .016). ConclusionThis cohort of elite Para athletes reported relatively high levels of anxiety/depression, low sleep levels, and pain, which is a concern. High sleep levels and the risk for illness might be an indication of overtraining, which commonly leads to persistent fatigue and an increased susceptibility to infections. Monitoring of the health of elite Para athletes is recommended to be able to improve performance and health in this population.

Objectives To examine whether universal prevention via a digital health platform can reduce the injury incidence in athletics athletes aged 12-15 years and if club size had an influence on the effect of the intervention. Methods This was a cluster randomised trial where young athletics athletes were randomised through their club following stratification by club size into intervention (11 clubs; 56 athletes) and control (10 clubs; 79 athletes) groups. The primary endpoint was time from baseline to the first self-reported injury. Intervention group parents and coaches were given access to a website with health information adapted to adolescent athletes and were encouraged to log in and explore its content during 16 weeks. The control group continued training as normal. Training exposure and injury data were self-reported by youths/parents every second week, that is, eight times. The primary endpoint data were analysed using the log-rank test. Cox proportional hazards regression was used to analyse the second study aim with intervention status and club size included in the explanatory models. Results The proportion of completed training reports was 85% (n=382) in the intervention group and 86% (n=545) in the control group. The injury incidence was significantly lower (HR=0.62; chi(2)=3.865; p=0.049) in the intervention group. The median time to first injury was 16 weeks in the intervention group and 8 weeks in the control group. An interaction effect between the intervention and stratification factor was observed with a difference in injury risk between athletes in the large clubs in the intervention group versus their peers in the control group (HR 0.491 (95% CI 0.242 to 0.998); p=0.049). Conclusions A protective effect against injury through universal access to health information adapted for adolescent athletes was observed in youth athletics athletes. The efficacy of the intervention was stronger in large clubs.

Previous research has shown deficits in vocal emotion recognition in sub-populations of individuals with hearing loss, making this a high priority research topic. However, previousresearch has only examined vocal emotion recognition using verbal material, in which emotions are expressed through emotional prosody. There is evidence that older individualswith hearing loss suffer from deficits in general prosody recognition, not specific to emotionalprosody. No study has examined the recognition of non-verbal vocalization, which constitutes another important source for the vocal communication of emotions. It might be thecase that individuals with hearing loss have specific difficulties in recognizing emotionsexpressed through prosody in speech, but not non-verbal vocalizations. We aim to examinewhether vocal emotion recognition difficulties in middle- aged-to older individuals with sensorineural mild-moderate hearing loss are better explained by deficits in vocal emotion recognition specifically, or deficits in prosody recognition generally by including both sentencesand non-verbal expressions. Furthermore a, some of the studies which have concluded thatindividuals with mild-moderate hearing loss have deficits in vocal emotion recognition abilityhave also found that the use of hearing aids does not improve recognition accuracy in thisgroup. We aim to examine the effects of linear amplification and audibility on the recognitionof different emotions expressed both verbally and non-verbally. Besides examining accuracy for different emotions we will also look at patterns of confusion (which specific emotionsare mistaken for other specific emotion and at which rates) during both amplified and nonamplified listening, and we will analyze all material acoustically and relate the acoustic content to performance. Together these analyses will provide clues to effects of amplification onthe perception of different emotions. For these purposes, a total of 70 middle-aged-olderindividuals, half with mild-moderate hearing loss and half with normal hearing will perform acomputerized forced-choice vocal emotion recognition task with and without amplification

The purpose of this study was to explore young women's experiences of pornography and how they believe pornography has affected both themselves and other adolescents in terms of sexuality and sexual experiences. Seven young women aged 17-18 years were interviewed and their narratives were analyzed through thematic analysis. The results show that the participants' pornography consumption has at times evoked feelings of shame in relation to their official feminist stance. Moreover, they all report experiences of being pressured to adopt a "supporting role" in sex and to perform in line with a narrow pornographic script, thus compromising their wish to enjoy sex and enact sexual agency. It is also evident how the participants have struggled to navigate through the conflicting positions that are available within a postfeminist culture, for instance in relation to feminism, heterosexual gender norms, and the strong ideal of being an "agent" in sex. In the pursuit of young women's healthy sexual development, the results highlight the need for safe female venues, a relational understanding of agency, cultural change rather than individualized responsibility, porn literacy training, and the advancement of broader sexual scripts.