Introduction: Violence in a broad sense among youth is common and there is some evidence that there are groups of youth who are victims of more than one form of violence. More knowledge is needed in terms of patterning of subgroups of poly-victimization. The aim was to explore if there are distinct subgroups of youth with particular patterns of violence victimization.

Method: Survey data from a Swedish sample (n = 1,569) of 14-16-year-olds were used (females 48.4%). Measures were physical violence, threat of physical violence, bullying, sexual harassment, and cyber bullying and harassment in the past six months as well as lifetime physical violence. Latent Class Analysis (LCA) was used to identify subgroups of youth with particular violence victimization patterns. Model fit assessment was based on model parsimony, theoretical justification and fit indices criteria (the Akaike information criterion and the Bayesian information criterion).

Result: A three-latent-class model was selected: 1. Poly-victims with high probabilities of being victimized by a multitude of different types of violence (girls 47.6%). 2. Overall low probabilities of violence victimization (girls 47.5%). 3. High probabilities of victimization of sexual harassment off- and online as well as bullying online (girls 65.6%).

Discussion: Three distinct subgroups of violence victimization in youth was evident in the data. There was a greater representation of girls in the purely sexualized violence sub-group. Further research and preventive programs should acknowledge that young people who are victims of one type of violence are likely also to be victims of other types of violence.

Violence among youth is common and has been linked to poor mental health outcomes. There is some evidence that there are groups of youth who are victims of more than one form of violence but more knowledge is needed in terms of patterning of subgroups of multiple violence victimization. Aim: To explore if there are distinct subgroups of youth with particular patterns of violence victimization. Method: Survey data from a Swedish sample (n = 1,569) of youth 14-16 years old were used (females 48.4%). Using a broad definition of violence, respondents indicated if they had experienced physical violence, threat of physical violence, bullying, sexual harassment, cyber bullying, online sexual victimization, and other adverse sexual experience in the past six months as well as lifetime physical violence victimization. Distinct subgroups of youth within the data set with particular patterns of violence victimization were identified using Latent Class Analysis (LCA). Model fit was assessed using the Akaike information criterion (AIC) and the Bayesian information criterion (BIC), with smaller values indicating better model fit. Results: Preliminary results show three distinct subgroups: 1. Sexualized violence off- and online (girls 66.6%), 2. Bullying only (girls 47.5%) and 3. Multi-victimization including threat of physical violence, violence in the past six months and lifetime, sexual harassment on- and offline, bullying on- and offline as well as other adverse sexual experience (girls 47.6%). Conclusions: Three distinct subgroups of violence victimization in a sample of 14-16 year old youth was evident in the data. There was a greater representation of girls in the sexualized violence sub-group. Further research as well as preventive programs should acknowledge that many young people are victims of several types of violence. Future research should also investigate the implications of multi-victimization on mental health outcomes.

The aim of this study was to investigate the effectiveness of the DISA-programme in preventing depressive symptoms (DS) in adolescent girls, as implemented in a real-world school setting, accounting for baseline socioeconomic and psychosocial factors, and to investigate whether the effects of these baseline variables on DS differed between intervention participants and non-participants. In this non-randomised pragmatic trial, an electronic questionnaire was disseminated in 2011 (baseline) and 2012 (follow-up) in schools in one municipality in northern Sweden. Pupils (total n=275; intervention participants identified in the questionnaire: n=53; non-partici-pants: n=222) were 14–15 years old at baseline. The groups were compared by means of SEM. DISA could not predict differences in DS at follow-up in this real-life setting. In the overall sample, sexual harassment victimisation (SH) at baseline was associated with DS at follow-up and the estimate for SH increased in the DISA-participants compared to the overall sample.

Background. Adolescents are a vulnerable group when it comes to the risk of developing depression. Preventing the onset of depressive episodes in this group is therefore a major public health priority. In the last decades, school-based cognitive-behavioural interventions have been a common primary prevention approach. However, evidence on what girls actually are allocated to such interventions when no researchers are involved is scarce.

Objective. To explore how a selective cognitive-behavioural program (Depression In Swedish Adolescents) developed to prevent depression in adolescents, was implemented in a naturalistic setting in schools in northern part of Sweden. The focus was on characteristics of participants allocated to the intervention.

Design. Cross-sectional baseline data on depressive symptoms, school environment and socio-economic factors were collected in 2011 by means of questionnaires in schools in a municipality in the northern part of Sweden. Intervention participants were identified in a follow-up questionnaire in 2012. Students (n=288) included in the analyses were in the ages of 14–15.

Results. Sixty-six girls and no boys were identified as intervention participants. They reported higher levels of depressive symptoms, lower personal relative affluence, more sexual harassment victimization and less peer support compared to female non-participants (n=222). Intervention participants were more likely to attend schools with a higher proportion of low parental education levels and a lower proportion of students graduating with a diploma.

Conclusions. The developers of the intervention originally intended the program to be universal or selective, but it was implemented as targeted in these schools. It is important for school administrations to adhere to program fidelity when it comes to what students it is aimed for. Implications for effectivenss trials of cognitive-behavioural interventions in the school setting is discussed.

Depressive symptoms in adolescents are an in-creasing public health issue in Sweden and in most Western countries. Aim: To explore how individual, psychosocial, and structural deter-minants are associated with depressive symp-toms in Swedish adolescents. Methods: A web- based questionnaire was answered by 1193 13- to 16-year-old boys (n = 566) and girls (n = 627). Stepwise logistic regressions were employed to analyse the association between depressive sym- ptoms and various determinants at the individ-ual level (self-efficacy), the psychosocial level (parental, peer, and teacher support, school de-mands, sexual harassment, and bullying) and the structural level (family affluence, having less money than friends, and parental foreign back-ground). Results: Determinants at the individual, psychosocial, and structural levels were inde-pendently associated with high levels of depres-sive symptoms in both boys and girls. The full model explained a high proportion of the vari-ance in depressive symptoms in both genders; 34.1% in boys and 36.8% in girls. The psycho-social level contributed the most to explaining the variance in depressive symptoms in boys. In girls, when harassment variables were separated from psychosocial variables, the harassment var- iables contributed as much to the full model as the rest of the psychosocial variables combined. Conclusions: Addressing psychosocial determi-nants provides the greatest benefits for prevent-ing depressive symptoms in adolescents. Ac-knowledging the association between sexual harassment and depressive symptoms for girls and having less money than their friends for boys and girls are particularly important.

Despite increasing concerns about stress levels in adolescents, knowledge is scarce about what boys and girls from different social backgrounds find stressful. This cross-sectional study explored gender and class patterning of perceived stress and reported stressors in a sample of 1,663 17-year-old Swedish students. The students, especially girls, were highly stressed. No class difference (indicated by educational programme) was found. Performance-related stressors (e.g. school work) and stress due to pressure on looks was mainly patterned by gender (girls), whilst relational stressors were patterned by class (vocational programme students). There was a complex gender and class patterning of stress due to school work and lack of money. The interplay of gender and class inequalities should be acknowledged in identifying determinants of stress in young people. Challenging normative ideals and implementing policies aiming at reducing gender and class inequalities are central components for stress-reducing interventions in, for example, schools.

Background: Deliberate self-harm (DSH) in young people is an important public health issue. To prevent DSH, more knowledge is needed about its prevalence and associated contextual factors in community samples of adolescents. Aims: To determine the prevalence of deliberate self-harm in 17-year-old Swedish students and to explore the association of demographic variables, psychological distress, experiences of violence, and school-related factors with DSH. Methods: Data were derived from a cross-sectional study in which 17-year-old students completed questionnaires during school hours (n=1,663; 78.3%). The variables used in this analysis are as follows: deliberate self-harm, demographic variables, psychological distress, experiences of violence, and school-related factors. Data were analysed using chi-squared statistics and logistic regression. Results: The lifetime prevalence of DSH was 17%, and it was more common among girls (23.3%) than boys (10.5%). There were considerable socioeconomic differences in reports of DSH. Psychological distress was strongly associated with DSH in both boys and girls, as were experiences of bullying, sexual harassment, physical violence and sexual assault. Social support, safety and academic factors in school were related to reports of DSH in both girls and boys. There were some gender differences with respect to which factors were associated with DSH. Conclusions: Deliberate self-harm is common and more frequently reported by girls than boys. Psychological distress, experiences of different types of violence, and school-related factors (academic, social and safety-related), should be considered risk factors for DSH in young people. Findings can be applied to health-promotion policy and interventions in various contexts, for example schools.

Purpose: To explore the psychological distress associations of experiences of several types of violence and the victim-perpetrator relationship of physical violence, a gender analysis was applied. Methods: Data were derived from a cross-sectional questionnaire study among 17-year-old upper secondary school students (N = 1,663). Variables in focus were: self-reported psychological distress, experiences of physical violence, sexual assault, bullying and sexual harassment. Logistic regressions were used to examine associations. Results: Experiences of physical violence, sexual assault, bullying and sexual harassment were associated with psychological distress in boys and girls. The perpetrators of physical violence were predominately males. Whether the perpetrator was unknown or known to the victim seem to be linked to psychological distress. Victimisation by a boyfriend was strongly related to psychological distress among girls. Conclusions: Experiences of several types of violence should be highlighted as factors associated with mental health problems in adolescents. The victim-perpetrator relationships of violence are gendered and likely influence the psychological distress association. Gendered hierarchies and norms likely influence the extent to which adolescents experience violence and how they respond to it in terms of psychological distress.

Despite a well-documented gender pattern in adolescent mental health, research investigating possible explanatory factors from a gender-theoretical approach is scarce. This paper reports a grounded theory study based on 29 focus groups. The aim was to explore 16- to 19-year-old students' perceptions of what is significant for mental health, and to apply a gender analysis to the findings in order to advance understanding of the gender pattern in adolescent mental health. Significant factors were identified in three social processes categories, including both positive and negative aspects: (1) social interactions, (2) performance and (3) responsibility. Girls more often experienced negative aspects of these processes, placing them at greater risk for mental health problems. Boys' more positive mental health appeared to be associated with their low degree of responsibility-taking and beneficial positions relative to girls. Negotiating cultural norms of femininity and masculinity seemed to be more strenuous for girls, which could place them at a disadvantage with regard to mental health. Social factors and processes (particularly responsibility), gendered power relations and constructions of masculinities and femininities should be acknowledged as important for adolescent mental health.