Background: Participatory approaches in child maltreatment (CM) research increasingly focus on involving children, youth, and adults as co-researchers. However, little is known about their use in Europe. Objective: To review the European literature on participatory approaches in CM research. Methods: The study was undertaken by members of the Euro-CAN (COST Action 19,106) representing 35 countries in the European region. Focusing on the European research literature, we searched eight databases for studies investigating CM and using a participatory approach. The review followed scoping review guidelines and PRISMA-ScR, with thematic analysis for data synthesis. Results: We identified 4927 potentially relevant articles, of which 307 were fully assessed for eligibility, and eight were ultimately included. The included studies addressed all types of CM; however, only two studies involved child and youth survivors of CM, while six involved children and youth from the community. Notably, no studies involving adult survivors were found. The findings indicate that children, youth, and adults can be involved in all stages of the research process, but the level of participation remains low. Eighteen different participatory methods were identified, and the ethical procedures and safeguarding of co-investigators varied significantly. Several barriers and challenges were identified, including issues related to adult gatekeeping behaviors, parental consent, confidentiality, and practical difficulties. Conclusions: The involvement of children, youth, and adults as co-researchers in CM research across Europe remains limited, with considerable variation in methods and procedures. These findings inform an ongoing e-Delphi study aimed at building consensus recommendations for participatory CM research. © 2024 The Authors

Although previous studies have suggested an association between digital media use and health, detailed knowledge about how different types of digital media impact adolescent health is limited. This cross-sectional population-based study explored the relationship between time spent on various digital media and adolescents’ self-rated general and mental health. The study included 3566 Swedish high school students aged 16–17 years. Associations between time spent on digital media (social media, gaming, watching movies/series/video clips etc. and digital schoolwork) and self-rated health outcomes (general health, self-esteem, symptoms of worry/anxiety and low mood/depression, trust in other people, head/neck/shoulder pain and sleep quality) was assessed. Statistical analyses employed logistic regression models adjusted for covariates (sociodemographic variables and health behaviours). In the adjusted models, spending very high amounts of time (≥ 6 h/day) on any digital media, except schoolwork, was associated with poor self-esteem, symptoms of low mood/depression and poor sleep (ORs 1.35–2.93, p< 0.05). Spending six hours or more on digital media was also associated with worry/anxiety (for social media and gaming), head/neck/shoulder pain (for social media, watching movies/series/video clips and schoolwork), poor general health (for gaming and watching movies/series/video clips) and low trust (for gaming) (ORs 1.39–3.18, p< 0.05). High amounts of time (4–5 h/day) of watching movies/series/video clips was associated with daily symptoms of low mood/depression, neck/shoulder pain, and low trust in other people (ORs 1.46, 1.41, and 1.32, p< 0.05). This study indicates a dose-response relationship between digital media use and adverse health outcomes in adolescents, where adverse associations start to appear after 4–5 h, particularly for watching movies/series/video clips. However, further longitudinal studies, randomized controlled trials and public health interventions focused on healthy and balanced use of digital media are warranted.

Background:

Child maltreatment (CM) is a major public health issue. Data collection, analysis, andreporting are widely recognized as key components in developing policies and programs aimed atpreventing child maltreatment. Unfortunately, CM is significantly under-coded by healthcareprofessionals (HCPs) in hospitals. Due to a lack of studies, causes of this under-coding are not fullyunderstood.

Objective:

The aim was to identify and understand challenging factors leading to under-coding ofCM in hospitals in Germany and Sweden.Participants and setting: The sample includes 28 HCPs from different professional groups involvedin coding-process: pediatricians (n = 14), child psychiatrists (n = 6), pediatric surgeons (n = 4),medical coding professionals (n = 3), and child protection coordinators (n = 1). Nineteen identified as female and 9 as male; age ranged from 24 to 65.

Methods:

The transcripts of the semi-structured interviews have been coded and analyzed usingthe thematic analysis approach of Braun & Clarke.

Results:

In this study, four major themes were identified influencing child maltreatment codingpractices on multiple levels. (1) The Impact of Systemic Frameworks, describing systemic factors,such as legal requirements and lack of mandatory education; (2) The Role of Organizational Cultureand Structures, describing attitude of the clinic, transparency, and shortcomings in quality control;(3) Interpersonal Dynamics of Multidisciplinary Cooperation and Communication; and (4) Intrapersonal Barriers: Knowledge, Uncertainty, and Emotional Burdens.

I sin debattartikel i Läkartidningen (7 jan 2025) argumenterar Anna Melin och Lykke Tamm för att relativ energibrist inom idrott (REDs) är ett allvarligt och vanligt problem som bör tas på allvar.

Vi instämmer i att nutrition är en av flera grundläggande förutsättningar för idrottslig utveckling, prestation samt fysisk och psykisk hälsa. Det är självklart att träningsbelastning och energiintag måste anpassas och balanseras på alla nivåer av idrottsutövande. Däremot ifrågasätter vi författarnas framställande av REDs som ett väletablerat »syndrom«, särskilt i Läkartidningen, som riktar sig till den svenska hälso- och sjukvården.

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.

ObjectiveChildren and young adults comprise a significant proportion of the world´s refugee population and are disproportionately negatively affected by the social determinants of health. This heterogeneous group faces high rates of poor mental health, yet research investigating within-group inequalities in mental health remains limited. We performed a latent profile analysis to explore classes of mental health based on posttraumatic stress symptoms (PTSS), general functioning, and well-being. This study aimed to improve the understanding of mental health differences, thereby providing better guidance for assessment and tailored interventions.MethodThis study involved 131 children and 127 young adults with refugee backgrounds (mean age 18.21 years, 44.6% female, 23.6% unaccompanied) recruited nationwide in Sweden (2019-2022). To examine classes and their predictors, latent profile analysis was conducted, followed by multinomial logistic regression analysis.ResultsLatent profile analysis identified four distinct classes: Good Mental Health (58.1%; low PTSS, good functioning and well-being), Severe Mental Distress (13.6%; high PTSS, low functioning and well-being), Moderate Mental Strain (12.4%; low PTSS, moderate functioning, low well-being), and Resilient (15.9%, high PTSS, good functioning, moderate well-being). Social determinants of health, such as being unaccompanied, asylum status, exposure to multiple types of violence, sexual victimization, and child maltreatment, distinguished the classes.ConclusionChildren and young adults with refugee backgrounds can be categorized into classes based on clinically relevant mental health indicators. Focusing solely on those at the highest risk for poor mental health may overlook many who are mentally healthy and those who need more targeted support. Future research should aim to replicate findings and evaluate additional predictive factors at the family and societal levels.

Background: Currently, approximately 100 million people are displaced worldwide, including children and young adults. Previous studies showed exposure to violence and posttraumatic stress disorder (PTSD) are common in this sub-population. However, we still lack comprehensive data on well-being, mental health, and the ability to function. Methods: This study included 291 adolescent (aged 12-17 years) and young adult (18-25 years) refugees recruited nationwide in Sweden between 2019 and 2022. Sociodemographic, mental health and well-beingrelated data (well-being, post-traumatic stress symptoms, psychiatric diagnoses, and functional ability) were collected using semi-structured interviews with structured components. Associations between accompanied status and well-being/depression/suicidal thoughts, generalized anxiety disorder/panic disorder/PTSD symptoms, and functional ability were analyzed using linear and logistic regression, adjusted for age, gender, parental education, asylum status, and region of origin. Findings: Most study participants (mean age 17.9 years) originated from the Middle East and North Africa (70.6 %) or Sub-Saharan Africa (27.0 %). 16.1 % of adolescents and 32.3 % of young adults were unaccompanied. Nearly the entire study sample had experienced violence (92.8 %). However, the sample had a low prevalence of psychiatric diagnoses. For example, only 5.9 % fulfilled the criteria for clinical depression. Self-reported wellbeing (WHO-5, 71.09 (23.91)) and observer-rated functional ability (GAS/GAF, 81.76 (14.15)) were high. There were no significant differences in diagnosis prevalence by gender. However, significant differences existed between accompanied versus unaccompanied groups. Being an unaccompanied refugee individual was associated with a higher risk of suicidal thoughts, adjusted odds ratio, aOR 5.66 (95 % CI 2.15-14.88), higher rates of posttraumatic stress disorder symptoms /3 = 0.72 (0.39-1.05), lower mental well-being /3 = -10.86 95 % CI (- 18.23- -3.48) and lower functional ability /3 = -9.38 (- 13.84- -4.92). There were no differences in outcomes by gender except for worse well-being in males (/3 = 6.83 (1.01-12.66)). Interpretation: In this sample, we found lower prevalence rates for all psychiatric diagnoses compared to earlier published studies. Being an unaccompanied refugee individual was a risk factor for all adverse outcomes. Future studies need to confirm the relatively low rates of psychiatric diagnoses. Regardless, the results highlight the heterogeneous needs among newly arrived refugees.

Research on complex posttraumatic stress disorder (CPTSD) among individuals with refugee backgrounds is limited, and its validity within this group remains underexplored. This study aimed to assess the prevalence and discriminant validity of posttraumatic stress disorder (PTSD) and CPTSD, as well as the risk factors for CPTSD, in a community sample of adolescents with refugee backgrounds residing in Sweden. This study involved 296 adolescents. Probable diagnoses were evaluated according to DSM-5 and ICD-11 criteria. Latent class analysis was employed to examine the discriminant validity of PTSD and CPTSD, while logistic regression analysis was used to explore risk factors for CPTSD. The findings indicated that 24.1% had a probable diagnosis of PTSD according to the DSM-5. For ICD-11, the equivalent proportions were 7.1% for PTSD and 10.8% for CPTSD. Latent class analysis identified three distinct classes: Low symptoms (46.9%), PTSD (29.6%), and CPTSD (23.6%). Compared to the PTSD class, membership in the CPTSD class was predicted by exposure to more types of violence and child maltreatment. It was also associated with higher posttraumatic stress symptoms, worse general functioning, poorer mental well-being, increased suicidal thoughts, more treatment-seeking behavior, and greater comorbidity. This study found a high prevalence of PTSD and CPTSD among adolescents with refugee backgrounds living in Sweden. Distinct classes aligned with the ICD-11 formulation of PTSD and CPTSD were identified, with exposure to violence and child maltreatment emerging as key risk factors for CPTSD. Results underscore the importance of identifying and addressing posttraumatic stress in adolescents with refugee backgrounds. Future research should aim to further validate the CPTSD diagnosis in larger samples of adolescents with refugee backgrounds.