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  • 101.
    Nilsson, Karina
    et al.
    Umea Univ, Dept Sociol, SE-90187 Umea, Sweden..
    Hammarström, Anne
    Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Strandh, Mattias
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Umea Univ, Dept Social Work, Umea, Sweden.;Karlstad Univ, Ctr Res Child & Adolescent Mental Hlth, Karlstad, Sweden..
    The relationship between work and family preferences and behaviors: A longitudinal study of gender differences in Sweden2017In: Acta Sociologica, ISSN 0001-6993, E-ISSN 1502-3869, Vol. 60, no 2, p. 120-133Article in journal (Refereed)
    Abstract [en]

    Proposed theories to explain gender inequality in the labor market and family, such as gender specialization within families and gender segregation in the labor markets, lack consideration for individual preferences. Preference theory accounts for individual choice and gendered preferences but has been substantially criticized, indicating a need for further research. This study uses Swedish longitudinal data to explore how preferences for work and family relate to behavior. We explore three critical issues raised in previous research: gender differences in preferences; the relationship between work and family changes and subsequent preferences; how preferences relate to work and family behaviors. Our results showed small general gender differences in preferences, although women had a stronger preference for both children and work than men. Changes in work status were further related to changes in work preferences, while changes in family status were related to changes in family preferences. Moreover, preferences had poor predictive power in relation to work and family behaviors. Our results indicate that preferences do not explain gender inequality in Sweden. The relationship between preferences and behaviors seems bidirectional and preferences and behavior within the family sphere has little to do with preferences and behavior within the work sphere.

  • 102.
    Nordgren, Kenneth
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Political, Historical, Religious and Cultural Studies (from 2013).
    Kristiansson, Martin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for the Studies of Social Sciences Didactics (from 2013).
    Liljekvist, Yvonne
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Mathematics and Computer Science (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Educational Studies (from 2013).
    Bergh, Daniel
    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 Arts and Social Sciences (starting 2013), Department of Political, Historical, Religious and Cultural Studies (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Lärares planering och efterarbete av lektioner: Infrastrukturer för kollegialt samarbete och forskningssamverkan2019Report (Refereed)
    Abstract [sv]

    I denna rapport beskrivs de huvudsakliga resultaten från en enkätstudie om hur lärare i svensk skola uppfattar sina förutsättningar att planeraoch efterarbeta sina lektioner. Studien visar för det första att de flesta lärare inte har organiserad tid för kollegialt samarbete runt planering och efterarbete av lektioner. För det andra visar studien att när det finns organiserat samarbete så är lärarna betydligt mer positiva till sin arbetsmiljö och sina möjligheter att planera och efterarbeta sina lektioner. För det tredje visar studien att skolor i liten utsträckning arbetar med formativ undervisning. Detta även på skolor med tid för organiserat samarbete. Sammantaget tyder resultaten på att vissa grundläggande förutsättningar för en skola på vetenskaplig grund saknas.

  • 103.
    Nordgren, Kenneth
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Centre for the Studies of Social Sciences Didactics. Karlstad University, Faculty of Arts and Social Sciences (starting 2013).
    Liljekvist, Yvonne
    Karlstad University, Faculty of Technology and Science, Department of Mathematics. Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Mathematics and Computer Science (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Educational Studies (from 2013).
    Kristiansson, Martin
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for the Studies of Social Sciences Didactics (from 2013).
    Bergh, Daniel
    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 Arts and Social Sciences (starting 2013), Department of Political, Historical, Religious and Cultural Studies (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Reformer verkningslösa om lärare inte får tid att planera2018In: Dagens nyheterArticle, book review (Other (popular science, discussion, etc.))
  • 104.
    Norell-Clarke, Annika
    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).
    Adolescent sleep duration in relation to psychosomatic complaints: development between 1985 and 2013 in Sweden2016In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, no SI, p. 139-139Article in journal (Refereed)
  • 105.
    Norell-Clarke, Annika
    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).
    Changes in sleep habits between 1985 and 2013 among children and adolescents in Sweden2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 8, p. 869-877Article in journal (Refereed)
    Abstract [en]

    Aims: The aim was to investigate changes in child and adolescent sleep habits in Sweden over time. This had not been done previously. Methods: Cross-sectional questionnaire data over three decades of investigations of the Health Behaviours of School Children study (1985/1986, 2005/2006 and 2013/2014) were used. The sample included 18,682 children and adolescents, aged 11, 13 and 15. Empirically based age-specific sleep duration recommendations were used to operationalise sleep duration. Results: The results showed that, over time, fewer go to bed early and more go to bed late. Regarding sleep duration, there have been decreases in the proportion of children and adolescents that sleep as much as is recommended for their age. Sleep onset difficulties have increased for all ages and increase the odds of sleeping less than recommended as well as having late bedtimes. Boys were more likely than girls to have later bedtimes and to sleep less than recommended. A vocational educational track, not planning to study further or being unsure of which track to choose increased the odds for 15 year olds to have late bedtimes and to sleep less than recommended compared with a college preparatory track. Conclusions: The results indicate that over time, fewer children and adolescents attain sufficient sleep duration. This may have implications for study results, mental health and cognitive abilities.

  • 106.
    Norell-Clarke, Annika
    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).
    Child and adolescent sleep duration recommendations in relation to psychological and somatic complaints based on data between 1985 and 2013 from 11 to 15 year-olds2018In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 68, p. 12-21Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the association between sleep duration, sleep initiation difficulties and psychological and somatic complaints. Methods: We used three cohorts of cross-sectional Swedish questionnaire data, from the Health Behaviours of School aged Children (1985/1986, 2005/2006, 2013/2014, n=>18 000, aged 11–15). Specific complaints (e.g. pain) and total complaint load were used as outcomes of sleep duration, sleep initiation difficulties and the combination of them both. Results: Sleeping less than recommended and sleep initiation difficulties were associated with increased odds of specific complaints and belonging to the group with the greatest complaint load. The combination of short sleep duration and sleep initiation difficulties were associated with higher odds than either sleep issue alone. No interaction effects between time and sleep variables were found regarding complaints. Conclusions: The findings support recent sleep duration recommendations. Further, sleep issues warrant a broad health assessment as they indicate a high likelihood of other complaints.

  • 107.
    Norell-Clarke, Annika
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health. Örebro University, School of Law, Psychology and Social Work.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Psychosomatic problems in relation to alcohol use and physical exercise: A study between 1988 and 2011 among adolescents in Sweden2016In: Journal of Public Health, ISSN 2198-1833, E-ISSN 1613-2238, Vol. 24, no 4, p. 325-333Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to investigate the association between psychosomatic problems and lifestyle patterns of alcohol use and physical exercise in adolescence. Subject and Methods: Cross-sectional questionnaire data from 8 years of investigations (1988–2011) were used. The sample included over 20,000 adolescents (50 % girls), aged 15–16. Adolescents were divided into three groups depending on psychosomatic problem load: 10th, 11th–89th and 90th percentiles on the psychosomatic problems scale (PSP). A composite measure of alcohol use (frequent/rarely/never) and physical exercise (regular/little/never) was created, resulting in nine combinations of health-related behaviours, and used as dependent variable. Results: Multinomial regression analysis showed that those over the 90th percentile of the PSP had nearly 12 times higher odds of regular alcohol use combined with no exercise compared with those who had the least symptoms. The former subgroup also had higher odds of belonging to all suboptimal lifestyle categories. Those in the 11th–89th percentiles had increased, albeit smaller, odds of belonging to all lifestyle categories. Descriptive data analysis indicated gender differences and changes over time in the strength of the association between psychosomatic problems and health-related behaviours but the regression analysis did not show any statistically significant interactions. The proportion of adolescents engaging in the unhealthiest lifestyle had decreased over time while reports of psychosomatic problems had increased. Conclusion: Adolescents with the greatest psychosomatic symptom load were the most likely to engage in unhealthy lifestyles. This may mean multiplied risks of future psychopathology and warrants longitudinal investigations

  • 108.
    Norell-Clarke, Annika
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Jansson-Fröjmark, Markus
    Örebro universitet.
    Tillfors, Maria
    Göteborgs universitet.
    Holländare, Fredrik
    Örebro universitet.
    Engström, Ingemar
    Örebro universitet.
    Group cognitive behavioural therapy for insomnia: Effects on sleep and depressive symptomatology in a sample with comorbidity2015In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 74, p. 80-93Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate the effects of group CBT for insomnia (CBT-I) on insomnia and depressive symptomatology in a comorbid sample through a randomised controlled trial with a 6 month follow-up.

    METHODS: 64 participants were recruited through advertisements and randomised to receive CBT-I or an active control (relaxation training: RT) during four group sessions. Insomnia Severity Index and BDI-II were the primary outcome measures, assessed pre-treatment, post-treatment and at 6 month follow-up. Insomnia and depressive diagnoses, and functional impairment were assessed before and after treatment, whereas sleep diary data was gathered continuously from one week before treatment until after treatment.

    RESULTS: CBT-I was more efficient than RT in reducing insomnia severity and equally effective in reducing depressive symptoms, although CBT-I was associated with a higher proportion of remitted persons than RT, regarding both insomnia and depression diagnoses. Also, CBT-I was associated with less functional impairment, shorter sleep onset latency and wake after sleep onset but both treatments had equal improvements of sleep quality, early morning awakenings and total sleep time.

    CONCLUSION: Group CBT-I is an efficient form of insomnia-treatment for people with insomnia comorbid with depressive symptomatology. The mixed results regarding depression outcomes warrants replication and further studies into treatment mechanisms.

  • 109.
    Norell-Clarke, Annika
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Tillfors, Maria
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Jansson-Froejmark, Markus
    Karolinska institutet.
    Hollaendare, Fredrik
    Örebro University.
    Engstroem, Ingemar
    Örebro University.
    Does Mid-Treatment Insomnia Severity Mediate between Cognitive Behavioural Therapy for Insomnia and Post-Treatment Depression?: An Investigation in a Sample with Comorbid Insomnia and Depressive Symptomatology2018In: Behavioural and Cognitive Psychotherapy, ISSN 1352-4658, E-ISSN 1469-1833, Vol. 46, no 6, p. 726-737Article in journal (Refereed)
    Abstract [en]

    Background: Recent treatment studies with cognitive behavioural therapy for insomnia (CBT-I) have demonstrated effects on both sleep problems and depression. Two previous studies have indicated that the beneficial effect from CBT-I on depression may come through improved sleep, although insomnia severity during treatment had not previously been investigated as a mediator. Aims: Our aim was to investigate if insomnia severity during treatment mediated between CBT-I and depression severity after treatment, in a sample with co-morbid insomnia and depressive symptomology. We also examined whether depressive severity during treatment mediated between CBT-I and insomnia after treatment. Method: The participants were recruited from advertisements and fulfilled criteria for insomnia diagnosis, and had depressive symptomatology (Beck Depression Inventory-second edition: BDI-II > 13). Two-thirds of the participants were diagnosed with major depressive disorder. The participants received four biweekly group sessions of CBT-I or relaxation training (active control). Insomnia severity (Insomnia Severity Index) and depressive severity (BDI-II) were measured at baseline, mid-treatment, post-treatment and 6-month follow-up. The mid-treatment measures were used as mediators. Results: Mediational analyses demonstrated a significant reciprocal relationship between insomnia severity and depressive severity throughout CBT-I, although mid-treatment insomnia had a stronger effect on depression than mid-treatment depression had on insomnia. The results were similar for both post-treatment and follow-up. Discussion: Some improvement in depressive severity after CBT-I is explained by improved sleep. The findings emphasize the importance of making comorbid insomnia a treatment focus in its own right.

  • 110.
    Norell-Clarke, Annika
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Tillfors, Maria
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Jansson-Fröjmark, Markus
    Karolinska institutet, Stockholm.
    Holländare, Fredrik
    Örebro universitet.
    Engstrom, Ingemar
    Örebro universitet.
    How does cognitive behavioral therapy for insomnia work?: An investigation of cognitive processes and time in bed as outcomes and mediators in a sample with insomnia and depressive symptomatology2017In: International Journal of Cognitive Therapy, ISSN 1937-1209, E-ISSN 1937-1217, Vol. 10, no 4, p. 304-329Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to gain a greater understanding of the five cognitive processes from the cognitive model of insomnia, negative automatic thoughts, and time in bed as outcomes and potential mediators of cognitive behavioral therapy for insomnia (CBT-I), in a sample with insomnia and depressive symptomatology. Sixty-four participants were randomized to receive either CBT-I or an active control (relaxation training: RT) in groups during four biweekly sessions. Insomnia, depressive severity, and the potential processes of change were measured pre-, mid-, and post-treatment. CBT-I was associated with greater reductions of dysfunctional beliefs about sleep, sleep-related safety behaviors, and time in bed compared to RT. Mid-treatment dysfunctional beliefs about sleep was the only process that mediated between CBT-I and outcomes on insomnia and depressive severity, respectively. The relationships were reciprocal. Dysfunctional beliefs about sleep may be a transdiagnostic process of both insomnia and depression.

  • 111.
    Norell-Clarke, Annika
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Tillfors, Maria
    Örebro University.
    Wilmenius, Lina
    Örebro University.
    Jansson Fröjmark, Markus
    Stockholms universitet, Klinisk psykologi.
    Holländare, Fredrik
    Örebro University.
    Engström, Ingemar
    Örebro University.
    Insomnia severity mediates between cognitive behavioural therapy for insomnia and depression in a sample with insomnia and depression: New possibilities for treatments of comorbid patients2016In: EABCT 2016 Abstract Book: Total Awareness, The European Association for Behavioural and Cognitive Therapies , 2016, p. 544-544Conference paper (Other (popular science, discussion, etc.))
    Abstract [en]

    Clinical trials have shown that cognitive behavioural therapy for insomnia (CBT-I) may have an effect on both insomnia and depression in comorbid samples, but there is a gap in the knowledge on why CBT-I has an impact on depression. Neuropsychological theories suggest that disturbed sleep may work as a transdiagnostic process that maintains psychopathology. The aim was to test whether CBT-I impacts depressive symptoms through improved sleep, in a sample with insomnia comorbid with major depression and subthreshold depressive symptoms. 64 participants were recruited through advertisements and randomised to receive either CBT-I or an active control (relaxation training: RT) in groups during four bi-weekly sessions. Insomnia (ISI) and depressive severity (BDI-II) were measured pre-, mid- and post-treatment. Mediational analyses were conducted. Insomnia and depressive severity lowered over the course of treatments. CBT-I was superior in reducing insomnia. The main treatment outcomes have been published elsewhere (Norell-Clarke et al, 2015). The relationship between CBT-I and post-treatment depressive severity was mediated by mid-treatment insomnia severity, which indicates that the effect of CBT-I on depression goes through improved sleep (b = -4.87, BCa CI = -9.21, -1.97). The results were maintained when pre-treatment insomnia and depressive severity were controlled for (b = -3.36, BCa CI = -8.86, -0.45). Testing for reciprocity, we found that mid-treatment depressive severity did not mediate between CBT-I and post-treatment insomnia severity. The results support the perpetuating role of insomnia in depression. This may have implications for other psychiatric patient groups with comorbid insomnia. Also, the results indicate that CBT for comorbid patient groups may need to target sleep specifically.

  • 112.
    Nygren, Karina
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Umeå universitet.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Self-reported school demands and psychosomatic problems among adolescents: Changes in the association between 1988 and 2011?2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, no 2, p. 174-181Article in journal (Refereed)
    Abstract [en]

    Aims: the aim of the present study was to examine changes over time in the relationship between self-reported school demands and psychosomatic problems, also considering the impact of student influence and teacher support. Methods: Data from a cross-sectional study (young in Värmland) including eight data collections (1988–2011) among Swedish students aged 15–16 were used (n = 20,115). Analyses with multinomial logistic regression and descriptive statistics were applied. Results: Between 1988 and 2011, the proportions of students with a higher degree of psychosomatic problems increased, as did the proportion of students experiencing school demands that were too high. Finer-level analyses based on stratification of student groups did not show any associations at the aggregated level between increases of school demands and psychosomatic problems. Similarly, individual level analyses showed that the strength of the association between school demands and psychosomatic problems was not affected by year of investigation. Conclusions:Changes in school demands over time could not explain the increasing trend in psychosomatic problems among adolescents. Since the relationship between school demands and psychosomatic problems is strong across time, there is, however, a continued need for school-based interventions. More studies are required to gain further understanding of adolescent mental health from a trend perspective.

  • 113.
    Olsson, Ann
    et al.
    Primärvårdens FoU-enhet.
    Hasselgren, Mikael
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Janson, Staffan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    The association between medical conditions and gender, well-being, psychosomatic complaints as well as school adaptability2013In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, no 5, p. 550-555Article in journal (Refereed)
    Abstract [en]

    Aim:

    The aim was to assess the association between medical conditions and gender,

    well-being, psychosomatic complaints and school adaptability. The second aim was

    to determine whether self-reported medical conditions should be included in class-room

    questionnaires that deal with well-being and risk behaviour.

    Methods:

    A cross-sectional class-room questionnaire was given to all 15- to 16-year-olds

    within a Swedish county. The questionnaire included background factors, subjective health,

    well-being, psychosomatic complaints, self image, drug use and also several themes

    from the school context. In addition, there were 13 medical conditions/problems to tick

    (yes or no) and an open alternative for other problems/medical conditions.

    Results:

    3108 questionnaires (response rate 84%) were analysed. The majority of the girls

    and the boys reported no medical conditions; however, 49% of the girls and 39% of the

    boys reported at least one medical condition. The medical conditions were associated with

    gender, well-being, psychosomatic complaints and school adaptability. The association was

    stronger for girls than for boys.

    Conclusion:

    Medical conditions among these teenagers were associated with gender, wellbeing,

    psychosomatic complaints and school adaptability, particularly for girls. Our results

    suggest that medical conditions could preferably be included in regular classroom

    questionnaires.

  • 114.
    Persson, Louise
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Haraldsson, Katarina
    Department of Research and Development, Region Halland.
    Health promotion in Swedish schools: School managers' views2017In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 32, no 2, p. 231-240Article in journal (Refereed)
    Abstract [en]

    Schools are recognized worldwide as settings for health promotion, and leadership has a bearing on schools’ ability to be health promoting. School managers have a great influence on what is prioritized in school, which in turn affects students’ school performance and health. There is lack of research into school managers’ views on health promotion, and what they consider to be central to health promotion. The aim was therefore to examine school managers’ views about what health promotion in schools include. An explorative design, qualitative content analysis, was performed. In-depth interviews were conducted with all 13 school managers of a middle-sized municipality in central Sweden. The analysis had both manifest and latent content and three categories: ‘Organization and Collaboration’, ‘Optimize the arena’ and ‘Strengthen the individual’, and 10 subcategories emerged. The theme, ‘Opportunities for learning and a good life’, describes the latent content of these categories. Taking into account the views of school managers are important because these views help form a more complete picture of how school managers work with health promotion and what is needed to enhance health promotion to improve students’ opportunities for learning and a good life. The Ottawa Charter for Health promotion is thereby transformed into practice.

  • 115.
    Persson, Louise
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Haraldsson, Katarina
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    School satisfaction and social relations: Swedish schoolchildren's improvement suggestions2016In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 61, no 1, p. 83-90Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim was to explore schoolchildren’sviews on how to increase school satisfaction and improvesocial relations among peers at school.

    Method: Improvement suggestions were collected fromschool children aged 10–12 years with the help of a feed-back model developed for the purpose. Qualitative contentanalysis was used.

    Results: Two categories emerged from the analysis:‘psychosocial climate’, which included the subcategories‘adults’ roles and responsibilities’ and ‘classmates’ normsand values’; ‘influence’, which included the subcategories‘changes in the physical environment’ and ‘flexible learn-ing’. The categories are seen as important to increaseschool satisfaction and improve social relations amongpeers at school.

    Conclusion: Examining children’s opinions is requestedand promoted by the UN convention on the Rights of theChild. The findings contribute to the field by showing howschool satisfaction and social relations might be improved,if the child perspective is considered in the planning ofhealth promotion activities in school

  • 116.
    Persson, Louise
    et al.
    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.
    Svensson, Mikael
    Department of Health Metrics, Gothenburg, University Gothenburg, Sweden.
    Classmate characteristic’s, class composition and children’s perceived classroom climate2017In: Journal of Public Health, ISSN 2198-1833, E-ISSN 1613-2238, Vol. 25, no 5, p. 473-480Article in journal (Refereed)
    Abstract [en]

    AIM:

    A beneficial classroom climate is vital for school achievements, health, well-being, and school satisfaction. However, there is little knowledge as to how the classmate characteristics and class composition are related to the level of a perceived messy and disorderly classroom climate and whether the estimated relationships vary between different groups of children. The aim of the study was to explore the relationship between classmate characteristics as well as class composition and children's perceived classroom climate.

    METHOD:

    Data from a cross-sectional survey administrated in 71 classes including 1,247 children in a mid-sized Swedish city were used. The analyses were conducted using multilevel models.

    RESULTS:

    A class with a higher proportion of girls was associated with a lower likelihood of perceiving the classroom climate as messy and disorderly. Moreover, a higher proportion of immigrant children in a class was associated with a perception of a messier and disorderly classroom climate among non-immigrant children, but not among immigrant children themselves.

    CONCLUSION:

    Classmate characteristics and class composition deserve more research attention and can be important considerations when aiming to improve the classroom climate and children's well-being in general.

  • 117.
    Persson, Stefan
    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).
    Michelson, Daniel
    King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience and University of Oxford, Centre for Evidence-Based Intervention, Department of Social Policy and Intervention.
    Young voices in mental health care: Exploring children's and adolescents' service experiences and preferences2017In: Clinical Child Psychology and Psychiatry, ISSN 1359-1045, E-ISSN 1461-7021, Vol. 22, no 1, p. 140-151Article in journal (Refereed)
    Abstract [en]

    The development of ‘youth-friendly’ services has become a priority across a wide range of health-care contexts. However, relatively few studies have specifically examined users’ experiences of, and preferences for, child and adolescent mental health care. The current study investigated young service users’ views of outpatient and community mental health clinics in Sweden, based on two data sources. First, focus group interviews were conducted with seven children and adolescents (aged 10–18 years) to explore both positive and negative experiences of mental health care. Second, written suggestions about specific service improvements were obtained from 106 children and adolescents.

    Qualitative content analysis revealed three overarching themes: ‘Accessibility’, ‘Being heard and seen’ and ‘Usefulness of sessions’. Young people’s recommendations for improving practice included more convenient appointment times, offered in welcoming settings; opportunities to communicate more openly with clinical staff, enabling sensitive discussion of mental health and wider personal issues; and more structured treatments that offer greater credibility and relevance to young people’s mental health and developmental needs. Young people also discussed being compelled by parents and school professionals to engage in treatment. Attending to young people’s preferences must be a priority in order to overcome ambivalence about session attendance, and enhance treatment participation and outcomes.

  • 118.
    Rantakeisu, Ulla
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Olsson, Eva
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Janson, Staffan
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Berger, Sune
    Starrin, Bengt
    Karlstad University, Faculty of Social and Life Sciences, Department of Social Studies.
    Trött på den ekonomiska krisen?2009In: Värmlands Folkblad, Vol. 20, no oktoberArticle in journal (Other (popular science, discussion, etc.))
  • 119.
    Ruppanner, Leah
    et al.
    University of Melbourne, Australia.
    Branden, Maria
    Stockholm University Demography Unit (SUDA), Sweden; Linköping University, Sweden.
    Turunen, Jani
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Stockholm University Demography Unit (SUDA).
    Does Unequal Housework Lead to Divorce?: Evidence from Sweden2018In: Sociology, ISSN 0038-0385, E-ISSN 1469-8684, Vol. 52, no 1, p. 75-94Article in journal (Refereed)
    Abstract [en]

    The lack of couple-level data hinders direct exploration of how inconsistencies in couples' housework reports structure their relationship quality. We address this limitation by applying Swedish data from the 2009 Young Adult Panel Study (N = 1057 couples) matched with Swedish register data (2009-2014) to extend equity theory by estimating mismatch in couples' housework reports on relationship satisfaction and stability. We find women who report performing more housework are less likely to be satisfied with their relationships, and are more likely to consider breaking up. These unions are also more likely to dissolve. Using both partners' housework reports, we document discrediting women's housework contribution, or reporting she does less than she reports, is associated with lower relationship satisfaction. Women in these partnerships also consider breaking up, and the unions are more likely to dissolve. Our results identify the gendered impact of housework inequality on relationship stability.

  • 120. Stattin, Håkan
    et al.
    Kim, Yunhwan
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Both parents and adolescents project their own values when perceiving each other’s values2018In: International Journal of Behavioral Development, ISSN 0165-0254, E-ISSN 1464-0651, Vol. 42, no 1, p. 106-115Article in journal (Refereed)
    Abstract [en]

    How parents and adolescents perceive each other’s life values is a key to understanding successful value transmission. In the value socializations literature, it has been proposed that parents’ values become internalized when children correctly perceive their parents’ values and decide to adopt them as their own. In the current study, we propose that interpersonal value perception of broader life values is characterized by a perceptual bias—projection—which propels adolescents to perceive their parents’ values to be similar to their own, and propels parents to perceive their adolescents’ values to be similar to theirs. This cross-sectional study examined 518 dyads of adolescents and their parents. Adolescents rated how important different humanistic, environmental, and achievement values were to them, and how important these values were to their parents. Parents similarly rated how important these values were to them and to their adolescents. Using structural equation modeling, an interpersonal value perception model was constructed that estimated how much parents and adolescents projected their own values when perceiving each other’s values. The results supported the idea that both parents and adolescents substantially project their own values when perceiving the others’ values, and that they perceive the others’ values with low accuracy. We discuss our findings in light of value socialization in both research and practice.

  • 121.
    Steigen, Anne Mari
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). Inland Norway University of Applied Sciences.
    Bergh, Daniel
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    The Social Provisions Scale: psychometric properties of the SPS-10 among participants in nature-based services2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 14, p. 1690-1698Article in journal (Refereed)
    Abstract [en]

    Purpose:This article analyses the psychometric properties of the Social Provisions Scale 10-items version.Methods:The Social Provisions Scale was analysed by means of the polytomous Rasch model, applied todata on 93 young adults (16–30 years) out of school or work, participating in different nature-based serv-ices, due to mental or drug-related problems.Results:The psychometric analysis concludes that the original scale has difficulties related to targetingand construct validity. In order to improve the psychometric properties, the scale was modified to includeeight items measuring functional support. The modification was based on theoretical and statisticalconsiderations.Conclusion:After modifications the scale showed not only satisfying psychometric properties, but it alsoclarified uncertainties regarding construct validity of the measure. However, further analysis on larger sam-ples are required

  • 122.
    Steigen, Anne Mari
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Eriksson, Bengt G
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), FoU Välfärd Värmland (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Kogstad, Ragnfrid Eline
    Bergh, Daniel
    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 Arts and Social Sciences (starting 2013), Department of Political, Historical, Religious and Cultural Studies (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Social support in Nature-based services.Manuscript (preprint) (Other academic)
  • 123.
    Steigen, Anne Mari
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Eriksson, Bengt G
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), FoU Välfärd Värmland (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Kogstad, Ragnfrid Eline
    Toft, Helge
    Bergh, Daniel
    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 Arts and Social Sciences (starting 2013), Department of Political, Historical, Religious and Cultural Studies (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Young adults in Nature-based servicesManuscript (preprint) (Other academic)
  • 124.
    Steigen, Anne Mari
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013). Inland University of Applied Sciences, Faculty of Health and Social Sciences.
    Eriksson, Bengt G
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Kogstad, Ragnfrid Eline
    Inland University of Applied Sciences, Faculty of Health and Social Sciences.
    Toft, Helge Prytz
    Noregian National Advisory Unit on Concurrent Substance Abuse and Mental health Disorders, Innlandet Hospital Trust.
    Bergh, Daniel
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Young Adults in Nature-Based Services in Norway: In-Group and Between-Group Variations Related to Mental Health Problems2018In: Nordic Journal of Social Research, ISSN 1892-2783, E-ISSN 1892-2783, Vol. 9, p. 110-133Article in journal (Refereed)
    Abstract [en]

    Young adults with mental health problems who do not attend school or work constitute a significant welfare challenge in Norway. The welfare services available to these individuals include nature-based services, which are primarily located on farms and integrate the natural and agricultural environment into their daily activities. The aim of this study is to examine young adults (16–30 years old) not attending school or work who participated in nature-based services in Norway. In particular, the study analyses mental health problems among the participants and in-group variations regarding their symptoms of mental health problems using the Hopkins Symptoms Checklist (HSCL-10). This paper compares symptoms of mental health problems among participants in nature-based services with those of a sample from the general population and a sample of those receiving clinical in-patient mental healthcare. A questionnaire was developed for the study and was completed by 93 participants in nature-based services. The majority of these participants were recruited from the Norwegian Labour and Welfare Administration (NAV), local mental health services, and school authorities. Results indicate that just more than half of the respondents exhibited symptoms of mental health problems based on their HSCL-10 scores. In general, they reported fewer symptoms than the clinical in-patient sample (18–30 years old) and more symptoms than the general population sample (18–19 years old). Among the participants in nature-based services, those recruited through NAV and local mental health services exhibited no differences in symptoms. Half of the participants older than 23 years in nature-based services had not completed upper secondary school. The participants, including those with symptoms of mental health problems and low expectations at the outset of their participation, generally expressed high satisfaction with the services.

  • 125.
    Strandh, Mattias
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Nilsson, Karina
    Umeå universitet.
    Nordlund, Madelene
    Umeå universietet.
    Hammarström, Anne
    Umeå universitet.
    Do open youth unemployment and youth programs leave the same mental health scars: Evidence from a Swedish 27-year cohort study2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, no 1, article id 1151Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Recent findings suggest that the mental health costs of unemployment are related to both short- and long-term mental health scars. The main policy tools for dealing with young people at risk of labor market exclusion are Active Labor Market Policy programs for youths (youth programs). There has been little research on the potential effects of participation in youth programs on mental health and even less on whether participation in such programs alleviates the long-term mental health scarring caused by unemployment. This study compares exposure to open youth unemployment and exposure to youth program participation between ages 18 and 21 in relation to adult internalized mental health immediately after the end of the exposure period at age 21 and two decades later at age 43.

    METHODS:

    The study uses a five wave Swedish 27-year prospective cohort study consisting of all graduates from compulsory school in an industrial town in Sweden initiated in 1981. Of the original 1083 participants 94.3 % of those alive were still participating at the 27-year follow up. Exposure to open unemployment and youth programs were measured between ages 18-21. Mental health, indicated through an ordinal level three item composite index of internalized mental health symptoms (IMHS), was measured pre-exposure at age 16 and post exposure at ages 21 and 42. Ordinal regressions of internalized mental health at ages 21 and 43 were performed using the Polytomous Universal Model (PLUM). Models were controlled for pre-exposure internalized mental health as well as other available confounders.

    RESULTS:

    Results show strong and significant relationships between exposure to open youth unemployment and IMHS at age 21 (OR = 2.48, CI = 1.57-3.60) as well as at age 43 (OR = 1.71, CI = 1.20-2.43). No such significant relationship is observed for exposure to youth programs at age 21 (OR = 0.95, CI = 0.72-1.26) or at age 43 (OR = 1.23, CI = 0.93-1.63).

    CONCLUSIONS:

    A considered and consistent active labor market policy directed at youths could potentially reduce the short- and long-term mental health costs of youth unemployment.

  • 126.
    Tillfors, Maria
    et al.
    Univ Orebro, Sch Law Psychol & Social Work, Örebro, Sweden.
    Persson, Stefan
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Willén, Maria
    Univ Orebro, Sch Law Psychol & Social Work, Örebro, Sweden.
    Burk, William J
    Radboud Univ Nijmegen, Inst Behav Sci, Nijmegen, Netherland.
    Prospective links between social anxiety and adolescent peer relations2012In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 35, no 5, p. 1255-1263Article in journal (Refereed)
    Abstract [en]

    This study examines bi-directional links between social anxiety and multiple aspects of peer relations (peer acceptance, peer victimization, and relationship quality) in a longitudinal sample of 1528 adolescents assessed twice with one year between (754 females and 774 males; M = 14.7 years of age). Lower levels of peer acceptance predicted increases in social anxiety. Social anxiety predicted decreases in relationship support for males and increases in peer victimization for females. Collectively our findings suggest that peers seem to play a significant role for adolescent mental health and social anxiety seems to interfere with healthy peer relations. Importantly, developmental pathways for social anxiety seem to differ for adolescent females and males.

  • 127.
    Turunen, Jani
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Stockholms universitet.
    Shared Physical Custody and Children’s Experience of Stress2017In: Journal of Divorce and Remarriage, ISSN 1050-2556, E-ISSN 1540-4811, Vol. 58, no 5, p. 371-392Article in journal (Refereed)
    Abstract [en]

    This article studies shared physical custody in Sweden, the country in the world where the phenomenon is most prevalent. We ask whether children in sharedphysical custody settings are more likely to report high levels of stress compared to children living in sole custody. The analysis is based on data with combined information fromparents, children, and administrative registers. Themodels are controlled control for interparental as well as parent–child relationship quality and parents' income. The results show that children sharing residence equally have lower likelihood of experiencing high levels of stress. The results can be interpreted as evidence for a positive effect of continuing everyday-like parental relationships after a family dissolution.

  • 128.
    Turunen, Jani
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Fransson, E
    Karolinska institutet.
    Bergström, M
    Karolinska institutet.
    Self-esteem in children in joint physical custody and other living arrangements.2017In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 149, p. 106-112, article id S0033-3506(17)30146-4Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Parental support has been shown to be important for children's self-esteem, which in turn is related to later important life outcomes. Today, an increasing number of children in the Western world spend time in both the parents' respective households after a separation. Children who live with both parents report more parental support than children who live only with one parent after a divorce. We took the opportunity of the commonness of children sharing their time between their parents' homes in Sweden to investigate children's self-esteem in relation to family type.

    STUDY DESIGN AND METHODS: With nationally representative survey data (ULF) collected from both parents and children, we analyze differences in children's self-esteem among 4823 10-18 year olds in nuclear families, joint physical custody and those living mostly or only with one parent after a separation using ordinary least squares regression, adjusting for demographic and socioeconomic characteristics.

    RESULTS: We found no significant difference in self-esteem between children who lived equally much with both parents, mostly with one parent and those in nuclear families, whereas children in single care showed lower self-esteem compared with children in the other living arrangements. The difference was not explained by socioeconomic factors.

    CONCLUSION: The self-esteem of children who share their time between their parent's respective homes after a separation does not deviate from that in their peers in nuclear families. Instead, those in single care reported lower self-esteem than those in the other living arrangements. These differences were not explained by socioeconomic factors. Longitudinal studies are needed to establish pre- and post-separation family characteristics that influence self-esteem and well-being in young people.

  • 129.
    van Geelen, Stefan
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health. Wilhelmina Children’s Hospital of the University Medical Center Utrecht, The Netherlands.
    Franssen, Gaston
    University of Amsterdam.
    Management of the self: An interdisciplinary approach toself-management in psychiatry and psychosomatic medicine2017In: Philosophy, Psychiatry, and Psychology, ISSN 1071-6076, E-ISSN 1086-3303, Vol. 24, no 2, p. 109-113Article in journal (Refereed)
  • 130.
    van Geelen, Stefan M.
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health. Univ Med Ctr Utrecht, Div Pediat, Utrecht, Netherlands..
    Fuchs, Coralie E.
    Vrije University Amsterdam, Amsterdam, Netherlands..
    van Geel, Rolf
    Open University Nijmegen, Netherlands.
    Luyten, Patrick
    University Leuven, England.
    van de Putte, Elise M.
    University Medical Centre Utrecht, Netherlands.
    The Self beyond Somatic Symptoms: A Narrative Approach to Self-Experience in Adolescent Chronic Fatigue Syndrome2015In: Psychopathology, ISSN 0254-4962, E-ISSN 1423-033X, Vol. 48, no 5, p. 278-286Article in journal (Refereed)
    Abstract [en]

    Background: The self and self-experience are often assumed to play an important role in adolescent patients presenting with severe somatic symptoms and bodily distress. Nonetheless, most empirical work on this subject is confined to studies of personality and patients' experience of negative emotionality. This study aims to move beyond mere descriptions of symptoms, traits and distress, and consequently adopts a narrative approach to self-experience in adolescent chronic fatigue syndrome (CFS). Sampling and Methods: The self-confrontation method (SCM) is a well-validated instrument to systematically analyze narrative self-experience. The SCM was used to study 42 adolescents with CFS, compared to 36 adolescents with juvenile idiopathic arthritis (JIA) and 25 matched healthy controls. The Child Health Questionnaire (CHQ-CF87) was used to assess mental health, self-esteem, and physical and psychosocial functioning. Results: Both patient groups reported significantly less positive self-experience of autonomy and success compared to healthy controls. Furthermore, patients with CFS described significantly more negative self-experience of powerlessness, isolation and unfulfilled longing. In the CHQ-CF87, both patient groups scored significantly lower on physical functioning than controls. Adolescents with CFS also scored significantly lower on mental health and self-esteem. Conclusions: Adolescent CFS entails a serious threat to the self, which might be inherent to the condition. Not only are patients more impaired in mental health, self-esteem, and physical and psychosocial functioning than patients with JIA, they also suffer from a distinct combination of high negative and low positive self-experience. These findings stress the need for strategies that empower patients towards a 'management of the self'. (C) 2015 S. Karger AG, Basel

  • 131.
    van Geelen, Stefan M.
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Univ Med Ctr Utrecht, Div Pediat, Lundlaan 6, NL-3584 EA Utrecht, Netherlands..
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Are the time trends in adolescent psychosomatic problems related to functional impairment in daily life?: A 23-year study among 20,000 15-16 year olds in Sweden2016In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 87, p. 50-56Article in journal (Refereed)
    Abstract [en]

    Objective: Worldwide there are frequent reports on increasing psychosomatic problems, anxiety, emotional distress, conduct problems, and depression among adolescents. Recently, it was contended that secular studies on such aspects of adolescent mental health can only be evaluated adequately when data on symptom prevalence are analyzed together with data on functional impairment Still, this has not yet been done in epidemiological time-trend studies on any aspect of adolescent mental health. Therefore, this study aims to investigate if, and to what extent, changes in adolescents' symptoms of psychosomatic problems are affected when data on functional impairment are taken into account simultaneously. Methods: A repeated cross-sectional population study relating self-reported symptoms of psychosomatic problems to functional impairment; covering the time-period 1988-2011 and including 19.823 adolescents 15-16 years old in eight cohorts in one geographically defined population (Varmland, Sweden). Results: The proportion of adolescents with psychosomatic problems had increased significantly from 1988 to 2005/2008. In all cohorts the proportion of girls with psychosomatic problems was significantly higher than the proportion of boys reporting symptoms. Over the same period, there was a corresponding significant increase of the proportion of participants with symptoms of psychosomatic problems in combination with functional impairment Adding functional impairment to the measure of psychosomatic problems decreased the prevalence rates, while the shapes of the trend-curves stayed congruent in form. Conclusion: The long-term pattern of increasing psychosomatic problems among adolescents remains evident, even when taking functional impairment data into account. Previously observed trends of a deteriorating adolescent mental health are thus consistent with this study. 

  • 132.
    Van Geelen, Stefan
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Rydelius, Per-Anders
    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.
    Somatic symptoms and psychological concerns in a general adolescent population: Exploring the relevance of DSM-5 Somatic Symptom Disorder2015In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 79, no 4, p. 251-258Article in journal (Refereed)
    Abstract [en]

    Objective: DSM-5 somatic symptom disorder (SSD) constitutes a major change for psychosomaticmedicine and psychiatry, as well as for epidemiological research in these fields. This studyinvestigates somatic symptoms and psychological concerns among adolescents in order tosystematically explore the relevance of SSD for general adolescent populations.

    Methods: A crosssectionalpopulation-based design, with a symptoms-based strategy and a symptom-andpsychological-concerns-based strategy, was used to estimate the prevalence of somatic symptomsand psychological concerns in a general adolescent population (n=2476, mean age=16 years, 49%boys, 51% girls). Somatic symptoms and psychological concerns in relation to gender, and selfreportedmedical and psychiatric conditions were investigated. The association between somaticsymptoms, psychological concerns, and functional impairment in school-, family-, peer- and physicalactivities was studied.

    Results: Reporting 3+ persistent distressing somatic symptoms wassignificantly more common than reporting one or more persistent distressing somatic symptom(s)combined with serious psychological concern. The prevalence of such complaints was significantlyhigher in girls. The proportion of medical and psychiatric conditions was highest in the groupreporting 3+ persistent distressing somatic symptoms combined with serious psychological concern.Belonging to this group most significantly increased odds ratios for functional impairment.

    Conclusion: For large-scale studies on SSD, results suggest the use of measures based on multiplesomatic items in combination with psychological concerns, and a methodologically soundstandardized measure of functional impairment. To further enhance clinical decision-making, therelation of symptoms to functional impairment, and the substantial overlap of SSD with medical andpsychiatric conditions during adolescence should be addressed.

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