The purpose of this study was to investigate the association between students’ perceptions of staff efforts to counteract bullying and students’ self-reported psychosomatic problems. Using an ecological framework, the associations were investigated in the light of contextual factors related to the students’ family, school, and peer group, as well as their personal characteristics. We used cross-sectional questionnaire data collected in 2009 and 2010 among 2 582 Swedish students aged between 13 and 15 years. Our main finding was that students’ perception of efforts by school staff to counteract bullying is an important factor in relation to their self-reported psychosomatic problems. Multinomial logistic regression analysis showed that the odds of having a higher degree of psychosomatic problems compared to lower degree of psychosomatic problems were about 2.5 times higher among students who reported that school staff members do little to counteract bullying. Analysis of interaction effects revealed that the strength of the association between students’ perception of staff efforts to counteract bullying and the students’ psychosomatic problems was not affected by different types of bullying experienced, nor was the strength of the association modified by the students’ personal characteristics or contextual situation. We conclude that social support from school staff is important in relation to students’ self-reported psychosomatic problems, irrespective of the students’ own experience of bullying. The results underline the importance of promoting a school climate and school culture that support staff members’ opportunities, abilities, and willingness to prevent bullying.

The purpose was to investigate the association between disability, and psychosomatic problems among adolescents at compulsory regular school also taking into account parental and student achievement expectations and student self-efficacy. We analysed cross-sectional questionnaire data collected in 2010, from 2004 Swedish adolescents. The results showed that the degree of psychosomatic problems and self-efficacy varied with regard to whether the adolescent reported having a disability or not. The distribution of parents’ and adolescents’ own achievement expectations did not differ significantly with regard to having a disability. Neither achievement expectations nor self-efficacy did moderate the association between disability and psychosomatic problems.

Objectives: An increasing number of children and adolescents divide their time between their separated parents' homes. Although marital conflict is disadvantageous for children's sleep, little is known about how children of separated parents sleep. The objective was to investigate the association between children's cus-tody arrangements and sleep habits and sleep initiation difficulties. Design: Cross sectional nationally representative samples of adolescents from the WHO study Health Behav-iour in School-aged Children (HBSC) (n = 11,802). Setting: Sweden in 2013/2014 and 2017/2018. Participants: Adolescents in grades 5, 7, and 9 from Swedish compulsory comprehensive school. Measurements: The survey included questions on sleep behaviors including bedtime, wake-up time and fre-quency of sleep onset problems. The analysis methods used were ordinary least squares and logistic regression. Results: The results show differences by custody arrangement, but they are not uniform across the dependent variables. Children and adolescents in sole maternal custody were less likely to sleep as much as recommended (P < .001), more likely to have late bedtimes (P < .001), report sleep initiation difficulties (P < .01) and to report social jetlag between school mornings and weekends (P < .05) compared to those in 2-parent families. Shared physical custody was associated with a higher likelihood of late bedtimes (P < .05) and sleep initiation difficulties (P < .05) compared to those in 2-parent families, but not of sleeping less than recommended or reporting social jetlag. Less-than-equal sharing was generally associated with worse sleep than in 2-parent families. Conclusions: As custody arrangements seem to be associated with sleep, it is important to understand the mechanisms behind the findings.

To examine whether a public health project to reduce problem behavior in schools and improve the classroom climate, undertaken among eight secondary schools in a municipality in Sweden, was accompanied by favorable changes in the school environment over time. Data were collected from ninth grade students (aged 15-16years) at three different time points: the year before the project began (2005), during the project (2008) and when the project finished (2011). Changes in the school environment, measured as damage, littering, noise and classroom disorder, were compared between the project municipality and a comparison group of other municipalities in the same county, using multinomial logistic regression analysis. Descriptive comparisons were made between the schools within the project municipality. The school environment improved significantly from 2005 to 2011 in the project municipality compared with the other municipalities. The school environment was improved in all schools within the project municipality. The biggest improvements took place in two schools which systematically worked with one program incorporated into the school schedule. This study demonstrates that it may be possible to improve the school environment by implementing health programs. Further studies based on experimental designs are required in order to confirm the potential and efficiency of school health programs.

Improving school effectiveness is a priority for many countries. The Swedish instrument Pedagogical and Social Climate in School (PESOC) has been widely used for measurement of school improvement. Since pedagogical leadership is an important component of school effectiveness, this study aimed to describe the psychometric properties of the PESOC subscale of pedagogical leadership (PESOC-PLP). Participants were 344 teachers from 30 schools in Karlstad, Sweden. Rasch analysis indicated two subdimensions of the scale, corresponding to academic and social objectives. Analysis showed that the instrument worked invariantly across different sub groups and that the response categories functioned as intended. Small, if any, within-school response dependence was noted. PESOC-PLP may be a useful tool for school leaders when evaluating their success in fulfilling academic and social objectives. Given the global demand for measurement of school leadership, also researchers and educators outside Sweden may have interest in translating and adapting the PESOC-PLP scale. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

The purpose of this study was to investigate the associations between self-reported schoolwork pressure and family factors with psychosomatic problems, and to investigate possible moderators of these associations. We examined self-efficacy as a personal resource that may be directly associated with psychosomatic problems, as well as serve as a moderator between stress exposure and psychosomatic problems. Furthermore, we examined sex as a possible moderator. The data were collected in 2010 among 2,004 pupils, aged between 13 and 15 years, in all schools in the municipality of Karlstad, Sweden. Multinomial logistic regression analysis showed that self-efficacy did not moderate the relationships between any of the school- and family-related factors and psychosomatic problems. However, self-efficacy had a direct effect on psychosomatic problems. Based on the results from the study, we concluded that health promoting and preventive work by the school health team should focus on strengthening pupils' self-efficacy and target schoolwork pressure. Special attention needs to be given to girls and adolescents living with a single parent or no parents.

Aims To characterize changes in patterns of adolescent substance use in Sweden between 1988 and 2011, and to assess whether sex and psychosomatic problems were associated with substance use and whether these associations changed over time. Design Secondary analysis of repeated cross-sectional survey data. Survey data were collected eight times and analyzed as four cohorts (1988-91, 1995-98, 2002-05 and 2008-11). Setting and participants The sample included all 15-16-year-olds in Varmland County, Sweden (n = 20 057). Measurements Binary-coded substance use measures included life-time use of alcohol and tobacco, getting drunk and past school year use of inhalants. An eight-item scale was used to assess psychosomatic problems. Findings A three-class model fitted the data best (i.e. non/low use, mainly alcohol use and polysubstance use). The patterns of substance use were different among cohorts; most notably, adolescents in the last cohort had lower odds of being included in the alcohol and polysubstance use classes rather than the non/low use class than in the earlier cohorts (all Ps < 0.001). Males had higher odds than females of being in the polysubstance use class rather than the non/low use class among the first three cohorts (all Ps < 0.001) but not the last. Sex was not associated with inclusion in the alcohol use class rather than the non/low use class. Adolescents who reported more psychosomatic problems had higher odds of being included in the alcohol and polysubstance use classes rather than the non/low use class (all Ps < 0.001). The associations of sex and psychosomatic problems with class inclusion did not change during the study period. Conclusions Between 1988 and 2011, patterns of substance use among adolescents in Sweden shifted away from polysubstance use and alcohol use to non-use or low use. Associations between patterns of substance use and sex and psychosomatic problems remained largely consistent across the study period.

BACKGROUND Internalizing problems have increased among Swedish adolescents. We examined whether classroom disorder was associated with internalizing problems and whether it explained the trends in internalizing problems. Furthermore, we examined whether school contextual factors were associated with internalizing problems and whether they moderated the association between classroom disorder and internalizing problems. METHODS We used repeated cross-sectional survey data (1988-2011) among all 15- to 16-year-old students in Varmland, Sweden (N = 9491 boys, N = 9313 girls). School-level factors were the proportions of students with a low/average socioeconomic or an immigration background. RESULTS Results from mixed effects models showed that classroom disorder was associated with internalizing problems across the years of investigation but did not explain the trends in internalizing problems. This association was moderated by the school-level proportion of students with a low/average socioeconomic background but not the school-level proportion of students with an immigration background. CONCLUSIONS Students who perceived their classroom to be disorderly more often also reported more internalizing problems. Future studies are necessary to investigate other potential school factors that may explain the trends in internalizing problems.

Increasing levels of psychosomatic symptoms, and other mental health problems, among adolescents, and especially among girls, have been reported across various countries. The "educational stressors hypothesis" states that this trend can be explained by an increasing amount of stressors in the school environment. This study tests this hypothesis, using repeated cross-sectional data, between the years 1993-2017, from the Health Behaviours of School-aged Children (HBSC) survey. Regression and decomposition techniques are used to investigate the role of school stress for trends in psychosomatic symptoms, and for gender differences in symptoms. Results show that the effects of school stress on psychosomatic symptoms have become stronger over time, but that they can only account for a small share of the overall increase in symptoms since 1993. However, school stress has increased more among girls than among boys, and it explains about half of the growth of the gender gap in symptoms. Thus, school stress accounts for a substantial portion of the increase in symptoms for girls, but only a minor share of the increase for boys. In sum, we found weak evidence for the educational stressors hypothesis in regard to the overall trend in symptoms, but strong evidence for it in explaining the growing gender gap.