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| 2. |
- Airaksinen, Jaakko, et al.
(författare)
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The effect of smoking cessation on work disability risk : a longitudinal study analysing observational data as non-randomized nested pseudo-trials
- 2019
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 48:2, s. 415-422
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSmoking increases disability risk, but the extent to which smoking cessation reduces the risk of work disability is unclear. We used non-randomized nested pseudo-trials to estimate the benefits of smoking cessation for preventing work disability.MethodsWe analysed longitudinal data on smoking status and work disability [long-term sickness absence (≥90 days) or disability pension] from two independent prospective cohort studies—the Finnish Public Sector study (FPS) (n = 7393) and the Health and Social Support study (HeSSup) (n = 2701)—as ‘nested pseudo-trials’. All the 10 094 participants were smokers at Time 1 and free of long-term work disability at Time 2. We compared the work disability risk after Time 2 of the participants who smoked at Time 1 and Time 2 with that of those who quit smoking between these times.ResultsOf the participants in pseudo-trials, 2964 quit smoking between Times 1 and 2. During the mean follow-up of 4.8 to 8.6 years after Time 2, there were 2197 incident cases of work disability across the trials. Quitting smoking was associated with a reduced risk of any work disability [summary hazard ratio = 0.89, 95% confidence interval (CI) 0.81–0.98]. The hazard ratio for the association between quitting smoking and permanent disability pension (928 cases) was of similar magnitude, but less precisely estimated (0.91, 95% CI 0.81–1.02). Among the participants with high scores on the work disability risk score (top third), smoking cessation reduced the risk of disability pension by three percentage points. Among those with a low risk score (bottom third), smoking cessation reduced the risk by half a percentage point.ConclusionsOur results suggest an approximately 10% hazard reduction of work disability as a result of quitting smoking.
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| 3. |
- Blomberg, Helena, et al.
(författare)
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Socialklass och attityderna till nedskärningar i välfärdssystemet i Finland
- 1996
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Ingår i: Sociologisk forskning. - : Sveriges Sociologförbund. - 0038-0342 .- 2002-066X. ; 33:4, s. 57-78
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Tidskriftsartikel (refereegranskat)abstract
- Social class and attitude towards cuts in the welfare system in FinlandIn various earlier studies focusing on the expansion of the welfare state social class has proven to be of great significance in explaining attitudinal cleavages among citizens. This study focuses mainly on how social class influences attitudes towards cuts in three main types of welfare programmes in Finland, namely eamings-related and universal cash benefits and also universal social services and, further, to look for possible attitude differences within the classes. In addition to class, explanatory variables both mainly related to the individual's self-interest and to socialisation were included in the analysis. The study is based on data concerning respondents active in working life (N=1178) included in a Finnish nationwide survey. Results show that the attitudinal differences between social classes vary depending on the type of benefit. The greatest differences between social classes are to be found in the case of eamings-related benefits and the smallest in the case of universal cash benefits. Attitudes within the social classes vary the most among lower white-collar employees, whose attitudes are differentiated by many different explanatory variables. When it comes to variables mainly related to socialisation, the social class of the father is most important in explaining variations in attitudes; respondents with blue-collar worker fathers more often resist cuts than do respondents of the same class whose fathers are farmers or whitecollar employees. These differences are greatest among higher professionals. This finding suggests that analyses of welfare attitudes might gain from including other than only the traditional, mainly self-interest based explanatory variables. Comparing with the results from previous studies, gender seems to be of greater importance when explaining attitudes towards cuts in the welfare system; women more often resist cuts than men do. Hence, the study shows that attitudes towards cuts in the welfare system might be partially influenced by different factors than attitudes towards an expansion of the welfare system.
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| 4. |
- Carlén, Kristina, et al.
(författare)
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Parental distress rating at the child’s age of 15 years predicts probable mental diagnosis : a three‑year follow‑up
- 2022
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Ingår i: BMC Pediatrics. - : BioMed Central. - 1471-2431 .- 1471-2431. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mental health in adolescence is an increasing global public health concern. Over half of all mental disorders debut by 14 years of age and remain largely untreated up to adulthood, underlining the significance of early detection. The study aimed to investigate whether parental distress rating at the child's age of 15 predicts a probable mental diagnosis in a three-year follow-up.Methods: All data was derived from the Finnish Family Competence (FFC) Study. The analysis focused on whether parental CBCL (Child Behavior Checklist) rating (n = 441) at the child's age of 15 years predicted the outcome of the child's standardised DAWBA (Development and Well-Being Assessment) interview at offspring's 18 years.Results: Multivariable analysis showed that a one-unit increase in the total CBCL scores increased the relative risk of a DAWBA-based diagnosis by 3% (RR [95% CI] 1.03 [1.02-1.04], p < 0.001).Conclusions: Parental CBCL rating in a community sample at the adolescent's age of 15 contributes to early identification of adolescents potentially at risk and thus benefitting from early interventions.
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| 5. |
- Carlén, Kristina
(författare)
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Predictors of mental health in adolescents - with a salutogenic perspective
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Mental health in adolescence is an increasing public health concern. Over half of all mental disorders debut by 14 years of age and remain largely untreated up to adulthood, which underlines the importance of early detection. Mental health is a complex concept that consists of both mental well-being and mental ill-health (including mental health problems and mental disorders). However, the development of mental health during the transition period from childhood to adulthood is dependent on the coping strategies used to meet everyday stressors. Therefore, the framework is salutogenic, looking at the world from a resource perspective to promote mental well-being. However, finding predictors also include identifying risk factors of mental ill-health.The overall aim of the thesis was to investigate predictors of mental health in adolescents from a longitudinal perspective. The Finnish Family Competence (FFC) study was used with adolescents at 15 years of age and their parents, with a follow-up at 18 years of age. Also, Swedish data material was used, The Longitudinal Research on Development In Adolescence (LoRDIA) with adolescents at 12-13 years and a follow-up at 17 years. In sub-studies I, II, and III the outcome was a probable mental health diagnosis determined by a standardised Development and Well-being Assessment (DAWBA) interview. In sub-study IV the outcome was perceived mental health status (MHS).The results showed that a strong sense of coherence was associated with a decreased risk for subsequent mental disorders (sub-study I) and that self-esteem was negatively associated with future mental well-being (sub[1]study IV). Further, low levels of mental health problems reported by the adolescents (sub-study II) or by their parents (sub-study III) were related to a decreased risk for subsequent mental disorders. There was a gender aspect that affected the results and which showed girls as having more internal mental health problems or mental disorders. Other factors indicating an increased risk of mental ill-health were parental low age at childbirth and socioeconomic factors such as the mother’s low educational level, father’s blue-collar profession, and a poor economic situation in the family.The results from this thesis underline the importance of having a salutogenic approach when dealing with mental health in adolescence to identify coping resources for stressors in Antonovsky’s ‘River of Life’. The school might be an arena for creating interventions with a resource perspective for strengthening a sense of coherence and self-esteem, and for alleviating perceived mental health problems.
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| 6. |
- Carlén, Kristina, et al.
(författare)
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Sense of coherence predicts adolescent mental health
- 2020
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Ingår i: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 274, s. 1206-1210
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Tidskriftsartikel (refereegranskat)abstract
- Background: Strong sense of coherence (SOC) has been shown to predict good mental health among adults whereas its predictive value in adolescence is unclear. This life-course oriented prospective study explores whether SOC predicts mental health in a three-year follow-up. Methods: The data is part of the ongoing ‘Finnish Family Competence Study’ launched in 1986 in southwestern Finland (baseline n = 1287). The outcome variable was adolescent's mental health at 18 years of age, measured on the Development and Well-Being Assessment (DAWBA) scale. The main predictor was Antonovsky's SOC score (1987) measured at the age of 15. A total of 498 adolescents were included in the present analyses. Poisson regression was used by univariate and multivariable models using the parents’ age and socioeconomic status and adolescents’ gender as covariates. Results: Multivariable analysis showed that a one-unit increase in SOC decreased the relative risk of a DAWBA-based diagnosis by 4 % (RR [95% CI] 0.96 [0.94–0.98], p < 0.001). Limitations: Typical of very long follow-up, as in our study of nearly two decades, a substantial proportion of the original population-based cohort was lost to follow-up weakening the representability of our cohort. Conclusions: Sense of coherence is a useful and clinically sensitive tool to predict mental health in adolescence. The easily administered, coping-oriented SOC questionnaire is an appropriate instrument in screening for adolescents who would benefit from supportive measures to strengthen their mental well-being.
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| 7. |
- Carlén, Kristina, et al.
(författare)
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Teenagers’ mental health problems predict probable mental diagnosis 3 years later among girls, but what about the boys?
- 2022
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 16:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background: The prevalence of mental disorders is increasing, and there seems to be a gender difference in prevalence, with girls reporting more mental health problems than boys, especially regarding internalizing problems. Most mental disorders debut early but often remain untreated into adulthood. Early detection of mental disorders is essential for successful treatment, which is not always happening. The study aimed to estimate to what extent teenagers’ self-reports predict probable mental diagnosis as they enter adulthood, particularly regarding gender differences. Methods: Self-reported mental health problems, Youth Self-Report (YSR) at 15 years (range 3–110, n = 504) from the ongoing Finnish family competence study (FFC) using modified multivariable Poisson regression analysis for prediction of DAWBA (Development and Wellbeing Assessment) interview outcomes 3 years later. Results: One unit’s increase in YSR was estimated to correspond to an increase in the relative risk of a probable DAWBA-based diagnosis by 3.3% [RR (95% CI) 1.03 (1.03–1.04), p < 0.001]. In gender-specific analysis, the findings applied, particularly to girls. Conclusions: Youth Self-Report (YSR) scores at pubertal age predicted the risk of a probable mental diagnosis at the onset of adulthood, particularly in girls. Further research is needed to explain the lower sensitivity of YSR among boys.
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| 8. |
- Carlén, Kristina, et al.
(författare)
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Teenagers’ mental health problems predict probable mental diagnosis among girls, but what about the boys?
- 2023
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Ingår i: Population Medicine. - : European Publishing. - 2654-1459 .- 2654-1459. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives: Adolescents’ mental health is a public health concern. The prevalence of mental disorders is increasing, and there seems to be a gender difference, with girls reporting more mental health problems than boys, especially regarding internalizing problems. Most mental disorders debut early but often remain untreated into adulthood. Therefore, early detection of mental disorders is essential. The study aimed to estimate to what extent teenagers’ self-reports of mental health problems predict probable mental diagnoses as they enter adulthood, particularly regarding gender differences. Methods: Self-reported mental health problems, Youth Self-Report (YSR) at 15 years (n = 504) from the ongoing Finnish family competence study (FFC) using modified multivariable Poisson regression analysis for prediction of DAWBA (Development and Wellbeing Assessment) interview outcomes 3 years later. Results: Recently published Results (Carlén et al., 2022) showed that one unit’s increase in YSR was estimated to correspond to an increase in the relative risk of a probable DAWBA-based diagnosis by 3.3% [RR (95% CI) 1.03 (1.03–1.04), p < 0.001]. In gender-specific analysis, the Findings applied, particularly to girls. Conclusions: Youth Self-Report (YSR) scores at pubertal age predicted the risk of a probable mental diagnosis at the onset of adulthood, particularly for girls. Further research is needed to explain the lower sensitivity of YSR among boys.
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| 9. |
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| 10. |
- Carlén, Kristina, et al.
(författare)
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The association between adolescents’ self-esteem and perceived mental well-being in Sweden in four years of follow-up
- 2023
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Ingår i: BMC Psychology. - : BioMed Central (BMC). - 2050-7283. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The situation concerning adolescent mental health is a global public health concern, and the concept includes the ability to cope with problems of everyday life. A person’s approach and attitude towards themselves, i.e., their self-esteem, affects mental health. The study aimed to appraise and deepen the scientific understanding of adolescents’ self-reported self-esteem at age 12−13 from a resource perspective and test its ability to predict subsequent perceived mental well-being at age 17.Methods: Data from the Longitudinal Research on Development in Adolescence (LoRDIA) prospective follow-up study of adolescents aged 12−13, and 17 (n = 654) were analysed using ANCOVA. The outcome variable, perceived mental well-being (MWB), covers the aspects of mental well-being inspired by the “Mental Health Continuum,” representing positive mental health. Covariates were self-esteem (SE) and reported initially perceived MWB at age 12−13. Other independent explanatory variables were gender, the family’s economy, and the mother’s educational level.Results: Self-esteem appeared relatively stable from 12−13 to 17 years (M = 20.7 SD = 5.8 vs. M = 20.5 SD = 1.7). There was a significant but inverted U – shaped association between SE at age 12–13 and perceived MWB at age 17 [F (1, 646) = 19.02, β-0.057; CI -0.08−-0.03, Eta = 0.03, p =.000]. Intermediate but not strong SE predicted significantly good MWB. When conducting the ANCOVA for boys and girls separately, only the mother’s educational level was significantly positively associated with perceived MWB of girls.Conclusions: Good self-esteem in early adolescence increases the likelihood of an unchanged favourable development of self-esteem and the probability of good perceived mental well-being. SE explained 18 per cent of the variation of MWB, and even more among girls. However, normal SE rather than high SE at 12 and 13 years is predictive of later mental well-being. Girls reported low self-esteem more often. Therefore, supporting self-esteem early in life can promote mental well-being in adolescence.
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