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  • 1.
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Traditional Bullying and Cyberbullying among Swedish Adolescents: Gender differences and associations with mental health2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis is to study the differences between traditional bullying and cyberbullying among adolescents, focusing on gender, psychosomatic problems, and disability, and to gain insight into health staff’s experience of bullying in schools.

    The four studies in this thesis were based on surveys undertaken among 3,800 adolescents in Grades 7, 8 and 9 in Sweden, as well as focus groups of 16 people consisting of school social workers and school nurses.

    While almost no gender differences were found among traditional victims, Study I showed that girls were more likely than boys to be cybervictims. Boys were more likely than girls to be traditional bullies, while girls were equally as likely as boys to be cyberbullies. Study II showed that psychosomatic problems were associated with being a victim, a bully or a bully-victim. Cyberbullying showed no stronger association with psychosomatic problems than traditional bullying. Study III: Three main categories emerged from school health staff’s experience: 1) “Anti-bullying team”; 2) “Working style”; and 3) “Perspectives on bullying”. The last two each comprised two sub-categories: “Team member”/“Single worker”; and “Contextual perspective”/“Individual-oriented perspective”. Study IV showed that, regardless of gender and grade, students with a disability were more likely to be bully-victims and, more particularly, bully-victims involved in both traditional bullying and cyberbullying. No differences between disabled adolescents and others were found with respect to the association between bullying and psychosomatic health.

    The results show that some adolescents are more likely to experience higher levels of psychosomatic health problems than others. They also show that some adolescents are more likely to be involved in bullying, either as victims, bullies or bully-victims. This thesis also discusses contextual and individual approaches adopted by schools in preventing bullying.

    Download full text (pdf)
    Traditional Bullying and Cyberbullying among Swedish Adolescents
  • 2.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Hur mår barn och ungdomar i Sverige?: Analys av den officiella bilden, mediebilden och bilden från forskningen2010Report (Other (popular science, discussion, etc.))
    Abstract [en]

    During the past two decades, ”Alarming reports” on young people’s mental health have frequently been published in newspapers.  . These questions have gained great attention in the public debate, both in media and on the political agenda. In the 2008 Public Health government bill, it is pointed out that children and adolescents is one of the most important target groups and that mental health is one of the most prioritized areas within public health politics.

     

    This report takes its beginning from an apparently general opinion, saying that children’s and young people’s mental health tends to deteriorate. In this report, the mediated picture of children’s and young people’s mental health over time is presented. Three operators in society are analyzed from their standpoints of children’s and adolescent’s mental health with respect to trends, socio demographic and regional differences, and also which sources are used in their argumentations. The three operators are the Government, authorities working with these questions, daily press and scientific research.

     

    The material for the media analysis is a systematic review of articles in newspapers during the period 1988-2008 via two electronic databases. The official standpoint has been described using government documents. The material from the research area consists of peer- reviewed published articles, epidemiological studies, and so called ”grey literature”.

     

    The result shows that the standpoint of the three different operators is remarkably consistent, but far from identical. The sources used are frequently quoted and tend to circulate among the operators. The result also shows that the groups experiencing the worst health are girls and young women. However, neither ethnicity nor regional differences are described. Also, the epidemiological data is very insufficient. As a whole, Swedish adolescent seem however experiencing a vital mental health, but stress and mental ill- health has become more frequent, especially among girls and young women. It is crucial to reflect over terms and expressions used in measurements which are being compared over a 20- year perspective. To which extent are they reflecting the same values and terms as two decades ago?

     

    Neither the media nor the official actors can be accused of fabricating constructions, since their reports are more or less based on published research reports. Inversely, the official standpoint and the picture from media can also be assumed to be mirroring the things not being published.

    Download full text (pdf)
    FULLTEXT03
  • 3.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Views of Bullying and Antibullying Working Styles Among School Nurses and School Social Workers in Sweden2016In: Journal of School Violence, ISSN 1538-8220, E-ISSN 1538-8239, Vol. 15, no 4, p. 438-459Article in journal (Refereed)
  • 4.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health. Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Hellström, Lisa
    Karlstad University, Faculty of Social and Life Sciences.
    Discrepant gender patterns for cyberbullying and traditional bullying - An analysis of Swedish adolescent data (vol 29, pg 1896, 2013)2014In: Computers in human behavior, ISSN 0747-5632, E-ISSN 1873-7692, Vol. 34, p. 353-353Article in journal (Refereed)
  • 5.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Hellström, Lisa
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Discrepant gender patterns for cyberbullying and traditional bullying: An analysis of Swedish adolescent data2013In: Computers in human behavior, ISSN 0747-5632, E-ISSN 1873-7692, Vol. 29, no 5, p. 1896-1903Article in journal (Refereed)
    Abstract [en]

    In the wake of the rapid development of modern IT technology, cyberspace bullying has emerged among adolescents. The aim of the present study was to examine gender differences among adolescents involved in traditional bullying and cyberbullying. Cross-sectional data from 2989 Swedish students aged 13–15 were analyzed using logistic regression analysis. The results show discrepant gender patterns of involvement in traditional bullying and cyberbullying. First, although there were only minimal gender differences among traditional victims, girls are more likely than boys to be cybervictims when occasional cyberbullying is used as a cut-off point. Second, whereas boys are more likely to be traditional bullies, girls are as likely as boys to be cyberbullies. In conclusion, compared to traditional bullying, girls are generally more involved in cyberbullying relative to boys. We discuss these results in the light of adolescents’ usage of computerized devices.

  • 6.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Hellström, Lisa
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Does the association with psychosomatic health problems differ between cyberbullying and traditional bullying?2012In: Emotional and Behavioural Difficulties, ISSN 1363-2752, E-ISSN 1741-2692, Vol. 17, no 3-4, p. 421-434Article in journal (Refereed)
    Abstract [en]

    The association between mental health problems and traditional bullying is well known,whereas the strength of the association in cyberbullying is less known. This study aimedto compare the association between mutually exclusive groups of bullying involvementand psychosomatic problems as measured by the PsychoSomatic Problems scale. Thesample comprised 3820 students (13–16 years old) in Sweden. The results indicate anassociation between bullying and psychosomatic problems, regardless of type of bullyinginvolvement. No statistically significant differences in psychosomatic problemswere found between cyberbullying and traditional bullying, either for victims or forbullies. The results do not confirm the hypothesis that the association between bullyingand mental health is stronger for cyberbullying than for traditional bullying. Anotherimportant finding is that cyberbullies seem as likely as cybervictims to be at risk formental health problems.

  • 7.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Hellström, Lisa
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Traditional bullying and cyberbullying2011Conference paper (Other academic)
  • 8.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Hellström, Lisa
    Department of School Development and Leadership, Malmö University, Malmö, Sweden.
    von Kobyletzki, Laura Beate
    Lund University, Skåne University Hospital, Department of Dermatology, Malmö, Sweden.
    Cyber bullying among children with neurodevelopmental disorders: A systematic review2019In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 61, no 1, p. 54-67Article in journal (Refereed)
    Abstract [en]

    Children and young adults with neurodevelopmental disorders (ND) are at increased risk of bullying compared to typically developing peers. It is still unclear to what extent they are involved in cyber bullying. This systematic review aimed at studying the prevalence of cyber bullying as perpetrators, victims, or both (“bully-victims”) among students with ND in a school setting and in need of special education. The Web of Science, Scopus, ERIC, PsycINFO, PubMED, and Cochrane databases were searched including a manual search of reference lists, until February 24, 2018. Eight studies conducted in Europe, North America, the Middle East, and Australia were included reporting a prevalence of cyber-victimization among students with ND of 0%–41%, a prevalence of cyber-perpetration of 0%–16.7%, and a prevalence of bully-victims of 6.7%. Three out of five studies using control groups showed that students with ND might be more involved in cyber bullying overall compared to typically developing students. Students in segregated school settings report slightly higher prevalence rates of cyber bullying compared to students with ND in inclusive school settings, especially among girls. When comparing prevalence rates among studies using the same definition, we found similar prevalence rates. There was a tendency towards students with ND being more involved in cyber bullying compared to typically developing students, but this needs to be confirmed in future studies that should include control groups with typically developing students as well as validated and standardized measurements of cyber bullying and ND diagnoses. © 2019 Scandinavian Psychological Associations and John Wiley & Sons Ltd

  • 9.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    von Kobyletzki, Laura B.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lund Univ, Skne Univ Hosp, Dept Dermatol, Inst Clin Res Malmo, Malmo, Sweden.;Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Associations between neurodevelopmental disorders and factors related to school, health, and social interaction in schoolchildren: Results from a Swedish population-based survey2016In: Disability and Health Journal, ISSN 1936-6574, E-ISSN 1876-7583, Vol. 9, no 4, p. 663-672Article in journal (Refereed)
    Abstract [en]

    Background: Children and adolescents with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) are more likely to be surrounded by different risk factors. In order to work preventively with decreasing ADHD and ASD symptoms, there is a need of more knowledge concerning risk factors. Objective: This study aimed to investigate school, health, lifestyle and social interactions association with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) among schoolchildren aged 6-17 years. Methods: Data for 18,416 children and adolescents aged 6-17 years in the county of Varmland, Sweden, from the school year 2012/2013 and 2013/2014 were obtained from the Student Health Database, which includes information on health examinations by school nurses and self-reported information of mental and physical health, social relations, physical activity, and school conditions. Results: Of all participants, 2.4% reported only ADHD and 1.6% reported only ASD. The results confirmed that ADHD or ASD was significantly associated with worse school experiences, lower socioeconomic status, less physical activity, more substance use, weaker social network and more impairments than those without ADHD or ASD. Conclusions: Knowledge of risk or protective factors during school years is needed to develop interventions to reduce symptoms of neurodevelopmental disorders in children and adolescents.

  • 10.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
    von Kobyletzki, Laura B.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lund University, Skåne University Hospital, Department of Dermatology, Malmö, Sweden.
    Corrigendum to “Associations between neurodevelopmental disorders and factors related to school, health, and social interaction in schoolchildren Results from a Swedish population-based survey” [Disabil Health J 9(4) (2016) 663–672](S1936657416300723)(10.1016/j.dhjo.2016.05.002)2018Other (Refereed)
    Abstract [en]

    In the article ‘‘Associations between neurodevelopmental disorders and factors related to school, health, and social interaction in schoolchildren: Results from a Swedish population-based survey’’ Disability and Health Journal 2016; 9(4):663–672 by Linda Beckman, Staffan Janson, and Laura von Kobyletzki on page 2 the ethical considerations under section “Questionnaires, interviews, and health examinations”, the following sentence “The ELSA project has been approved by the regional ethical research committee in Uppsala, Sweden (reg. no: 2013/160).”should read as “The study has been reviewed by the local ethical research committee in Karlstad, Sweden (reg. no: C2015/65).”

  • 11.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Stenbeck, Magnus
    Karolinska institutet.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Disability in Relation to Different Peer-Victimization Groups and Psychosomatic Problems2016In: Children & Schools, ISSN 1532-8759, E-ISSN 1545-682X, Vol. 38, no 3, p. 153-161Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to examine the associations between disability, victims, perpetrators, and so-called "bully-victims" (someone reporting being both a victim and a perpetrator) of traditional, cyber, or combined victimization or perpetration and psychosomatic health among adolescents. Authors analyzed cross-sectional data from 3,820 Swedish students (ages 13 through 15) using linear and multinomial regression. The results show that students with a disability were more likely to be bully-victims and, more particularly, involved in both traditional and cyber victimization. Authors did not find any differences between adolescents with a disability and others with respect to the association between peer victimization and psychosomatic health. When developing intervention programs, schools may take a comprehensive approach due to the relatively large overlap between traditional and cyber victimization. Targeting groups with known disadvantages may also help reach out to bully-victims.

  • 12.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Svensson, Mikael
    Örebro universitet; Göteborgs universitet.
    The Cost-effectiveness of the Olweus Bullying Prevention Program: Results from a Modelling Study2015In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 45, p. 127-137Article in journal (Refereed)
    Abstract [en]

    Exposure to bullying affects around 3–5 percent of adolescents in secondary school and is related to various mental health problems. Many different anti-bullying programmes are currently available, but economic evaluations are lacking. The aim of this study is to identify the cost effectiveness of the Olweus Bullying Prevention Program (OBPP). We constructed a decision-tree model for a Swedish secondary school, using a public payer perspective, and retrieved data on costs and effects from the published literature. Probabilistic sensitivity analysis to reflect the uncertainty in the model was conducted. The base-case analysis showed that using the OBPP to reduce the number of victims of bullying costs 131 250 Swedish kronor (€14 470) per victim spared. Compared to a relevant threshold of the societal value of bullying reduction, this indicates that the programme is cost-effective. Using a relevant willingness-to-pay threshold shows that the OBPP is a cost-effective intervention.

  • 13.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Svensson, Mikael
    Göteborgs universitet.
    Frisén, Ann
    Göteborgs universitet.
    Preference-based health-related quality of life among victims of bullying2016In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, no 2, p. 303-309Article in journal (Refereed)
    Abstract [en]

    Abstract Purpose No previous study has estimated the association between bullying and preference-based health-related quality of life (HRQoL) (‘‘utility’’), knowledge of which may be used for cost-effectiveness studies of interventions designed to prevent bullying. Therefore, the aim of the study was to estimate preference-based HRQoL among victims of bullying compared to non-victims. Methods A cross-sectional survey data collection among Swedish adolescents aged 15–17 years in the first year of upper secondary school was conducted in the city of Gothenburg in Sweden (N = 758). Preference-based HRQoL was estimated with the SF-6D. Regression analyses were conducted to adjust for some individual-level background variable. Results Mean preference-based health-related quality of life scores were 0.77 and 0.71 for non-victims and victims of bullying, respectively. The difference of 0.06 points was statistically significant (p\0.05) and robust to inclusion of gender, age, and parental immigrant status. Conclusions The preference-based HRQoL estimates in this study may be used as an upper bound in economic evaluations of bullying prevention interventions, facilitating a comparison between costs and quality-adjusted lifeyears.

  • 14.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Univ Orebro, Sch Hlth Sci, Fac Med Hlth, S-70182 Orebro, Sweden.;Karlstad Univ, Dept Publ Hlth, Univ Gaten 2, S-65188 Karlstad, Sweden..
    Svensson, Mikael
    Univ Gothenburg, Sahlgrenska Acad, Hlth Metr, Medicinaregatan 18G, S-41390 Gothenburg, Sweden..
    Geidne, Susanna
    Univ Orebro, Sch Hlth Sci, Fac Med Hlth, S-70182 Orebro, Sweden..
    Eriksson, Charli
    Univ Orebro, Sch Hlth Sci, Fac Med Hlth, S-70182 Orebro, Sweden..
    Effects on alcohol use of a Swedish school-based prevention program for early adolescents: a longitudinal study2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, article id 2Article in journal (Refereed)
    Abstract [en]

    Background: The aim of the study was to address the lack of evaluations of school-based substance use prevention programs and to conduct a quasi-experimental evaluation of the alcohol use part of the Triad intervention. Methods: Eleven Swedish intervention schools (285 pupils) and three control schools (159 pupils) participated in the evaluation. Baseline measurements were conducted in 2011 before the alcohol part in the prevention program was implemented in the intervention schools (school year 6, ages 12-13). We estimated an Intention-To-Treat (ITT) Difference-in-Difference (DD) model to analyze the effectiveness of the intervention on subsequent alcohol use measured in grades 7, 8 and 9. Results: The main results show no effect on the likelihood of drinking alcohol or drinking to intoxication. Conclusions: The lack of positive effects highlights the need for policy-makers and public health officials need to carefully consider and evaluate prevention programs in order to ensure that they are worthwhile from school, health, and societal perspectives.

  • 15.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    von Kobyletzki, Laura B.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Economic Costs of Antidepressant Use: A Population-Based Study in Sweden2019In: Journal of Mental Health Policy and Economics, ISSN 1091-4358, E-ISSN 1099-176X, Vol. 22, no 4, p. 125-130Article in journal (Refereed)
    Abstract [en]

    Background: Prescription of antidepressant drugs (ADs) has increased in recent decades, with rising costs for patients as well as for the health care system. There is sparse evidence of which factors explain the high economic costs and financial burden for the general population. Aims of the Study: The aim was to assess individual-level determinants of out-of-pocket and total health care costs of AD use in the Swedish general population. Methods: We randomly sampled 400,000 individuals aged 18+ from Statistics Sweden's population register from 2010 to 2013. Two-part regression models were used for our two primary outcome variables: (i) total health care costs for AD use per year and individual, and (ii) total out-of-pocket costs of AD use per year and individual. Results: Women, the unemployed, unmarried people and residents of big cities have both higher use of ADs and higher associated total health care and out-of-pocket costs. Today, ADs are relatively inexpensive and average cost differences among all groups are therefore minor. The elderly have higher use of ADs, but are more commonly low-volume users and do not have higher total health care or out-of-pocket costs. Discussion and Limitations: Groups with relatively low socioeconomic status are at risk of higher costs for antidepressant use. However, given the Swedish system of drug subsidies, differences in financial burden for individuals are minor. The limitations of this study included that we lacked data on diagnosis and could therefore not categorize the reasons for AD consumption. Furthermore, our results may not be generalized to other countries with a lower AD prevalence then Sweden's, since our estimates are dependent on the point prevalence of antidepressant use in the population. Implications for Health Care Provision and Use: Groups with higher AD consumption and economic costs may suffer from more severe depression owing to more risk factors and less social support in their surroundings, and may be in greater need of additional treatment and support than other groups. Implications for Health Policies and Further Research: Our results offer insight at an aggregate level, and more information on the underlying causes of higher costs is needed to discern the policy implications.

  • 16.
    Beckman, Linda
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    von Kobyletzki, Laura B.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lund Univ, Skane Univ Hosp, Dept Dermatol, Jan Waldenstroms Gatan 16, S-21428 Malmo, Sweden.
    Svensson, Mikael
    Sahlgrenska Univ, Hlth Metr Unit, Box 414, S-40530 Gothenburg, Sweden..
    Determinants of Antidepressants Use and Economic Costs: A Population Based Study2017In: Journal of Mental Health Policy and Economics, Vol. 20, no Suppl.1, p. S2-S2Article in journal (Other academic)
  • 17.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Jernbro, Carolina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Injury risks in schoolchildren with attention-deficit/hyperactivity or autismspectrumdisorder: Results from two school-based health surveys of 6- to 17-year-old children in Sweden2016In: Journal of Safety Research, ISSN 0022-4375, E-ISSN 1879-1247, Vol. 58, p. 49-56Article in journal (Refereed)
    Abstract [en]

    Introduction: Injuries are one of the leading causes of death and disability among children in Sweden and attention-deficit/hyperactivity disorder (ADHD) has previously been associated with an increased risk of injury in pediatric populations elsewhere in the world. Current evidence regarding the possible link between autism spectrum disorder (ASD) and injury risk appears limited, even though some potentially risk-increasing symptoms overlap. The purpose of this study was thus to study the association between both ADHD and ASD concerning the risk of injury among Swedish schoolchildren. Methods: Two samples were used: a population based register study containing data from 18,416 children ranging from the ages of 6-17 years collected by school nurses during 2012/2014 (Survey A), and a national cross-sectional study of 3202 ninth-grade children (similar to 15 years old) collected from 92 schools in 2011 (Survey B). The data were analyzed using chi(2)-tests and log binomial generalized linear models to obtain risk ratios (RR), comparing cases reportedly affected by ADHD or ASD to unaffected controls. Results: After adjusting for confounders, ADHD was associated with a 65% increased risk of injury (RR 1.65 [95% CI: 132-2.05] in Survey A, and a 57% increased risk of injury (RR 1.57 [95% CI: 1.27-1.95]) in Survey B. ASD was not significantly associated with any differences in injury risk (RR 0.81 [95% CI: 0.57-1.14]). Conclusions: The results indicate that there is an elevated injury risk among Swedish schoolchildren with ADHD but not for children with ASD. Future studies should focus on causal mechanisms mediating the association between ADHD and injuries in order to facilitate injury prevention strategies. Practical applications: Parents and teachers of schoolchildren with ADHD should be made aware of the elevated injury risks associated with the diagnosis. Safety experts and injury control professionals should consider the development of specialized prevention strategies in order to reduce these risks.

  • 18.
    Geidne, Susanna
    et al.
    Örebro Universitet.
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Edvardsson, Ingrid
    Örebro universitet.
    Hulldin, Johanna
    Örebro universitet.
    Prevalence and Risk factors of Electronic Cigarette Use among Adolescents: Data from Four Swedish Municipalities Nordic Studies on Alcohol and Drugs2016In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 33, no 3, p. 225-240Article in journal (Refereed)
    Abstract [en]

    Aims

    To assess the prevalence rates and risk factors of electronic cigarette (e-cigarette) use, with special focus on e-cigarettes containing nicotine, among grade 9 students (aged 15–16 years) in four different municipalities in Sweden.

    Methods

    A cross-sectional sample of 665 adolescents was collected in April 2014. The data was analysed using binary logistic regression analysis.

    Results

    The results show that 26% of adolescents in this study have smoked e-cigarettes (have ever used), while 19% have smoked e-cigarettes with nicotine or do not know whether or not they contained nicotine. The strongest risk factor for ever having used e-cigarettes (any type or with nicotine) was smoking conventional cigarettes. Having tried cigarettes and having tried snus, as well as using or having used alcohol and having smoked a water pipe were also statistically significant risk factors for ever use of any type of e-cigarettes but not for use of e-cigarettes with nicotine. There was no gender difference.

    Conclusions

    Our result show that the use of e-cigarettes tends to cluster with the use of other substances, such as other tobacco products and alcohol. As a relatively large share of the participating adolescents, more than a fourth, had smoked e-cigarettes, this rather new phenomenon requires monitoring as a part of the tobacco control.

    Download full text (pdf)
    Geidne2016
  • 19.
    Hagquist, Curt
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Beckman, Linda
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Bergh, Daniel
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Hellström, Lisa
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Skolmiljö, psykisk hälsa och skolprestationer: En komparativ kommunstudie 2005-2011 med fokus på Karlstad och projektet Skolan förebygger2012Report (Other academic)
  • 20.
    Hagquist, Curt
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Beckman, Linda
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Bergh, Daniel
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Hellström, Lisa
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Persson, Louise
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Främjande av psykisk hälsa och förebyggande av mobbning bland barn och unga, samverkansprojekt mellan Karlstads kommun och Karlstads universitet2012Report (Refereed)
  • 21.
    Hellström, Lisa
    et al.
    Malmö University.
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Adolescents’ perception of gender differences in bullying2019In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 61, no 1, p. 90-96Article in journal (Refereed)
    Abstract [en]

    Gender norms are normative societal expectations regarding the behaviors of girls and boys that can guide bullying behavior. As early adolescence is a time when peer relations become increasingly important, it is critical to understand the peer relationships of adolescents and what is considered gender non-confirming behavior. Therefore, the aim of this study is to analyze Swedish girls’ and boys’ perception of gender differences in bullying. Twenty-one Swedish adolescents (8 girls and 13 boys) took part in four focus group discussions separated by boys and girls. Data analysis was conducted using qualitative content analysis. “Expectations and needs to fit the norm” emerged as the main category as all categories emerging from the analysis related to boys’ and girls’ understandings of how expectations, strategies, expressions relating to bullying and the need to belong vary depending on gender. Further, girls and boys expressed admiration for each other's ways of coping with bullying indicating that also coping strategies are associated with expectations based on gender. For schools and adults to be better equipped to meet the needs of girls and boys and understand how these needs are expressed, adolescents voices regarding gender related bullying can be seen as helpful tools to develop strategies to work with gender norms and gender expectations. In light of the results of our study, schools may have work to do when it comes to the awareness of norms and attitudes and how they are expressed as these may be a foundation for bullying, among both staff and students.

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  • 22.
    Hellström, Lisa
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Beckman, Linda
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Does the Strength of the Association Between Peer Victimization and Psychosomatic Health Problems Depend on Whether Bullying or Peer Aggression is Measured?2017In: Child Indicators Research, ISSN 1874-897X, E-ISSN 1874-8988, Vol. 10, no 2, p. 447-459Article in journal (Refereed)
    Abstract [en]

    This study aimed to analyze to what extent the strength of the previously established association between peer victimization and psychosomatic problems depends on which of two measures is being used, a measure of bullying and a measure of peer aggression. The study included 2568 Swedish adolescents aged 13–15 years. An Ordinary Least Square regression showed that all regressors representing bullying and peer aggression revealed significant effects on psychosomatic health using no peer victimization as the reference category. An ANOVA showed no significant differences in mean values on the Psychosomatic Problems Scale captured by the two measures. Given that both measures of peer victimization show strong associations with psychosomatic health, using only one of the two measures is therefore likely not just to underestimate the overall prevalence of peer victimization but also the number of children experiencing psychosomatic problems in relation with peer victimization.

  • 23.
    Hellström, Lisa
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Beckman, Linda
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Self-reported peer victimization: Concordance and discordance between measures of bullying and peer aggresion among Swedish adolescents2013In: Journal of School Violence, ISSN 1538-8220, E-ISSN 1538-8239, Vol. 12, no 4, p. 395-413Article in journal (Refereed)
    Abstract [en]

    The current study examined concordance and discordance

    between a measure of bullying and measures of peer aggression

    with respect to the number of students identified as victims.

    Swedish adolescents (N

    = 1,760) completed a web-based questionnaire.

    A measure of bullying and measures of peer aggression

    were compared in order to elucidate the unique contribution of

    each measure as well as the overlap: 13% of students who experienced

    peer victimization reported only bullying, 44% reported only

    repeated peer aggression, and 43% reported both. Concordance

    was further elucidated by phi-square coefficient tests revealing that

    18% of the variance in either measure was accounted for by the

    other measure. Given recent research showing similar associations

    with mental health for bullying and peer aggression victimization,

    it is suggested that questions about peer aggression as well

    as bullying should be used simultaneously in order to capture the

    prevalence and full magnitude of peer victimization.

  • 24.
    Howells, L.
    et al.
    University of Nottingham, UK.
    Thomas, K.S.
    University of Nottingham, UK.
    Sears, A.V.
    St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust, UK; King’s College London, UK.
    Nasr, I.
    Gloucester, UK.
    Wollenberg, A.
    Ludwig Maximilian University, Germany; Klinik Thalkirchner Straße, Germany.
    Schuttelaar, M.L.A.
    University of Groningen, The Netherlands.
    Romeijn, G.L.E.
    University of Groningen, The Netherlands.
    Paller, A.S.
    Northwestern University Feinberg School of Medicine, USA.
    Mueller, K.
    Northwestern University Feinberg School of Medicine, USA.
    Doytcheva, K.
    Northwestern University Feinberg School of Medicine, USA.
    Kataoka, Y.
    Osaka Habikino Medical Center, Japan.
    Daguze, J.
    CHU Nantes, France.
    Barbarot, S.
    CHU Nantes, Nantes, France.
    von Kobyletzki, Laura B.
    Lunds universitet.
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Ratib, S.
    niversity of Nottingham, UK.
    Cowdell, F.
    Birmingham City University, UK.
    Santer, M.
    University of Southampton, UK.
    Chalmers, J.R.
    University of Nottingham, UK.
    Defining and measuring 'eczema control': an international qualitative study to explore the views of those living with and treating atopic eczema2019In: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 33, no 6, p. 1124-1132Article in journal (Refereed)
    Abstract [en]

    Background Atopic eczema (also known as eczema) is a chronic, inflammatory skin condition that often afflicts patients' health and well-being. The Harmonising Outcome Measures for Eczema (HOME) initiative recommends that 'long-term control of eczema' is measured in all clinical trials 3 months or longer in duration. However, little has been published on what eczema control means to those living with or treating atopic eczema. Objectives To (i) develop understanding of what eczema control means to patients, carers and clinicians and (ii) explore the feasibility and acceptability of different ways of measuring eczema control in the long term. Methods Online focus groups explored patients/carers experiences in the UK, the United States, the Netherlands, France, Sweden and Japan, and an international online survey gathered views of clinicians. The framework method was used to analyse the focus groups, and thematic analysis was used to analyse survey data. All findings were integrated into a theoretical framework to create overarching themes that cut across these diverse groups. Results Eight focus groups with patients (16 years+) and eight groups with carers of children took place (N = 97). Sixty-two people took part in the survey. Eczema control was described as a multifaceted construct involving changes in disease activity, the treatment and management of the condition and psychological, social and physical functioning. Patient/carer measurement allows personal accounts and frequent measurement, whilst clinician measurement was deemed less subjective. The burden on patients/carers and issues for analysing and interpreting data should be considered. Conclusions This study formed the basis of judging the content validity and feasibility of measurement instruments/methods to assess control of eczema in clinical trials. This online approach to an international qualitative study is an example of how core outcome set developers with limited resources can engage with multiple stakeholder groups on an international basis to inform consensus meeting discussions.

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  • 25.
    Jernbro, Carolina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Bonander, Carl
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013). Göteborgs universitet.
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    The association between disability and unintentional injuries among adolescents in a general education setting: Evidence from a Swedish population-based school survey2019In: Disability and Health Journal, ISSN 1936-6574, E-ISSN 1876-7583, Vol. 13, p. 1-7, article id 100841Article in journal (Refereed)
    Abstract [en]

    Background: Unintentional injuries are the leading cause of death among adolescents. Adolescents with disabilities may be particularly vulnerable with an increased risk of unintentional injuries. Objective: To study the association between a set of disabilities and unintentional injury risks among adolescents, accounting for comorbidity, subjective disability severity and sex. Method: Cross-sectional data from a Swedish national school survey including 4,741 students (15 and 17-year olds) conducted in 2016 was analyzed using log-binomial generalized linear models. Results: We found a 33% increased risk of injury the last 12 months and a 53% increased risk of injury leading to hospitalization for adolescents with any disability compared to their peers with no disability. The differences in injury risk were greater for girls than boys. There was a dose-response relationship between disability severity and injury risk. In analyses adjusted for sociodemographic factors and comorbidity, attention-deficit/hyperactivity disorder (ADHD) and epilepsy were associated with an increased risk of injury the last 12 months, risk ratios [RR] were 1.41 (95% Confidence Interval [CI] 1.08–2.97) and 1.79 (95% CI 1.10–1.81) respectively. Autism spectrum disorder was associated with a decreased injury risk the last 12 months (RR = 0.43, CI 0.2–0.92). ADHD, mobility impairment and visual impairment were associated with hospitalization due to injury during lifetime. Conclusions: There was an increased risk of unintentional injuries for adolescents with disabilities compared to their non-disabled peers, specifically for individuals with ADHD, epilepsy, visual impairment and mobility impairment. Injury prevention strategies may include adapting the physical environment and medical treatment.

  • 26. Milerad, Josef
    et al.
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Att förebygga olycksfall, mobbning och våld2017In: Evidensbaserad elevhälsa / [ed] Josef Milerad och Carl Lindgren, Stockholm: Studentlitteratur AB, 2017, 2Chapter in book (Refereed)
  • 27.
    Persson, Mattias
    et al.
    School of Business, Örebro University, Sweden.
    Wennberg, Linn
    Department of Public Health & Community Medicine, University of Gothenburg, Sweden.
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Salmivalli, Christina
    Department of Psychology, University of Turku, Finland.
    Svensson, Mikael
    Health Metrics, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    The Cost-Effectiveness of the Kiva Antibullying Program: Results from a Decision-Analytic Model2018In: Prevention Science, ISSN 1389-4986, E-ISSN 1573-6695, Vol. 19, no 6, p. 728-737Article in journal (Refereed)
    Abstract [en]

    Bullying causes substantial suffering for children and adolescents. A number of bullying prevention programs have been advocated as effective methods for counteracting school bullying. However, there is a lack of economic evaluations of bullying prevention programs assessing the “value for money.” The aim of this study was to assess the cost-effectiveness of the Finnish bullying prevention program KiVa in comparison to “status quo” (treatment as usual) in a Swedish elementary school setting (grades 1 to 9). The cost-effectiveness analysis was carried out using a payer perspective based on a Markov cohort model. The costs of the program were measured in Swedish kronor and Euros, and the benefits were measured using two different metrics: (1) the number of victim-free years and (2) the number of quality adjusted life years (QALYs). Data on costs, probability transitions, and health-related quality of life measures were retrieved from published literature. Deterministic and probabilistic sensitivity analyses were carried out to establish the uncertainty of the cost-effectiveness results. The base-case analysis indicated that KiVa leads to an increased cost of €829 for a gain of 0.47 victim-free years per student. In terms of the cost per gained QALY, the results indicated a base-case estimate of €13,823, which may be seen as cost-effective given that it is lower than the typically accepted threshold value in Swedish health policy of around €50,000. Further research is needed to confirm the conclusions of this study, especially regarding the treatment effects of KiVa in different school contexts

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  • 28.
    von Kobyletzki, Laura B.
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lunds universitet.
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Smeeth, Liam
    London Sch Hyg & Trop Med, London, England.
    McKee, Martin
    London Sch Hyg & Trop Med, London, England; .
    Quint, Jennifer K.
    Imperial Coll London, Resp Epidemiol Occupat Med & Publ Hlth, London.
    Abuabara, Katrina
    Univ Calif San Francisco, Dept Dermatol, Program Clin Res, San Francisco.
    Langan, Sinead
    London Sch Hyg & Trop Med, London, England; St Johns Inst Dermatol, Dept Dermatol, London, England.
    Association between childhood allergic diseases, educational attainment and occupational status in later life: systematic review protocol2017In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 10, article id e017245Article in journal (Refereed)
    Abstract [en]

    Introduction Childhood allergic diseases may prevent affected children from achieving their academic potential. Potential mechanisms include absence from school due to illness and medical appointments. Experience of symptoms in classes or leisure time, and stigma associated with visible signs and symptoms, including skin disease, requirements for medication during school time or the need for specific diets, may also contribute to reduced educational attainment. Studies have investigated the association between specific allergic diseases and educational attainment. The aim of this study is to systematically review the literature on allergic diseases, educational attainment and occupational status, and if possible, calculate meta-analytic summary estimates for the associations. Methods Systematic electronic searches in Medline, EMBASE, Cochrane, Cumulative Index to Nursing & Allied Health Literature (CINAHL), PsycINFO and education Resources Information Center (ERIC); hand search in reference lists of included papers and conference reports; search for unpublished studies in clinical trial registers and the New York Academy of Medicine Grey Literature Report; data extraction; and study quality assessment (Newcastle-Ottawa Scale) will be performed. Analysis Data will be summarised descriptively, and meta-analysis including meta-regression to explore sources of heterogeneities will be performed if possible. Ethics and dissemination Dissemination in a peer-reviewed, open-access, international scientific journal is planned.

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    vonKobyletzki2017
  • 29.
    von Kobyletzki, Laura B.
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lund Univ, Skne Univ Hosp, Dept Dermatol, Inst Clin Res Malmo, Malmo, Sweden.;Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Smirnova, J
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Smeeth, L
    London School of Hygiene and Tropical Medicine.
    Williams, H C
    Centre of Evidence Based Dermatology, University of Nottingham.
    McKee, M
    London School of Hygiene and Tropical Medicine.
    Abuabara, K
    University of California, San Francisco, USA.
    Langan, S M
    London School of Hygiene and Tropical Medicine, UK.
    Eczema and educational attainment: A systematic review2017In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 177, no 3, p. e47-e49Article, review/survey (Refereed)
    Abstract [en]

    Eczema (syn. atopic dermatitis or atopic eczema) accounts for the largest global burden of disability due to skin disease (1) . Eczema affects up to 20% of children (1) , and is associated with impaired quality of life (QoL) of a similar magnitude to cancer and epilepsy. Yet, although eczema is common in children, little is known about long-term outcomes such as educational attainment (EA) of those affected. This article is protected by copyright. All rights reserved.

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