| 31. |
- Britt-Marie, Ljungström, et al.
(författare)
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Bottom-up and top-down approaches to understanding oppositional defiant disorder symptoms during early childhood: a mixed method study
- 2020
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : Springer Science and Business Media LLC. - 1753-2000. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Children with clinical levels of conduct problems are at high risk of developing mental health problems such as persistent antisocial behavior or emotional problems in adolescence. Serious conduct problems in childhood also predict poor functioning across other areas of life in early adulthood such as overweight, heavy drinking, social isolation and not in employment or education. It is important to capture those children who are most at risk, early in their development. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is commonly used in clinical settings, to identify children with conduct problems such as oppositional defiant disorder (ODD).This paper presents a cross-sectional study in a clinical setting, and describes behaviors in 3- to 8-year-olds with ODD. Our aim was to investigate whether there were problematic behaviors that were not captured by the diagnosis of ODD, using two different methods: a clinical approach (bottom-up) and the nosology for the diagnosis of ODD (top-down). Method Fifty-seven children with clinical levels of ODD participated in the study. The mothers were interviewed with both open questions and with a semi-structured diagnostic interview K-SADS. The data was analyzed using a mixed method, convergent, parallel qualitative/quantitative (QUAL + QUAN) design. For QUAL analysis qualitative content analysis was used, and for QUAN analysis associations between the two data sets, and ages-groups and gender were compared using Chi-square test. Results In the top-down approach, the ODD criteria helped to identify and separate commonly occurring oppositional behavior from conduct problems, but in the bottom-up approach, the accepted diagnostic criteria did not capture the entire range of problematic behaviors-especially those behaviors that constitute a risk for antisocial behavior. Conclusions The present study shows a gap between the diagnoses of ODD and conduct disorder (CD) in younger children. Antisocial behaviors manifest in preschool and early school years are not always sufficiently alarming to meet the diagnosis of CD, nor are they caught in their entirety by the ODD diagnostic tool. One way to verify suspicion of early antisocial behavior in preschool children would be to specify in the ODD diagnosis if there also is subclinical CD.
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| 32. |
- 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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| 33. |
- Danielson, M., et al.
(författare)
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Clinicians' attitudes toward standardized assessment and diagnosis within child and adolescent psychiatry
- 2019
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : Springer Science and Business Media LLC. - 1753-2000. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a strong call for clinically useful standardized assessment tools in everyday child and adolescent psychiatric practice. The attitudes of clinicians have been raised as a key-facilitating factor when implementing new methods. An explorative study was conducted aimed to investigate the clinicians' attitudes regarding standardized assessments and usefulness of diagnoses in treatment planning.Methods: 411 mental health service personnel working with outpatient and inpatient assessment and treatment within the specialist child and adolescent mental health services, Stockholm County Council were asked to participate in the study, of which 345 (84%) agreed answer a questionnaire. The questionnaire included questions regarding Attitudes toward Standardized Assessment and Utility of Diagnosis. Descriptive analyses were performed and four subscales were compared with information from a similar study in US using the same instruments. The demographic and professional characteristics (age, working years, gender, education, profession, management position, involvement in assessment, level of service) in terms of prediction of attitudes were studied by univariate and multivariate linear regressions.Results: Overall, the clinicians had quite positive attitudes and were more positive compared to a similar study conducted in the US earlier. There were differences in attitudes due to several characteristics but the only characteristic predicting all subscales was type of profession (counselor, nurse, psychiatrist, psychologist, other), with counselors being less positive than other groups.Conclusion: The overall positive attitudes toward standard assessment are of importance in the development of evidence-based practice and our study implies that clinicians in general value and are willing to use standardized assessment. Nevertheless, there are specific issues such as adequate training and available translated assessment instrument that need to be addressed. When implementing new methods in practice, there are general as well as specific resistances that need to be overcome. Studies in different cultural settings are of importance to further extend the knowledge of what is general and what is specific barriers.
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| 34. |
- Elwin, Marie, 1953-, et al.
(författare)
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Symptoms and level of functioning related to comorbidity in children and adolescents with ADHD : a cross-sectional registry study
- 2020
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is well known that a wide range of psychiatric disorders co-occur with attention deficit hyperactivity disorder. In this study we aimed to examine the associations of psychiatric comorbidity in ADHD with symptom severity and level of functioning.Methods: We used data from the Swedish National Quality Registry for ADHD Treatment Follow-up and identified comorbid diagnoses in a sample of 3246 Swedish children and adolescents with ADHD. We investigated the association of comorbidity with symptom severity and level of function by multiple linear regressions.Results: Autism spectrum disorder, anxiety and affective disorders, oppositional defiant disorder or conduct disorder, learning disorders, and multiple comorbid disorders associate to lower levels of functioning compared to ADHD only. Multiple comorbidity, autism spectrum disorder, oppositional defiant or conduct disorders and tic disorders relate to ADHD symptom severity.Conclusions: Comorbidity subgroups with ADHD differ in functional impairment and ADHD symptoms severity. Information on comorbidity profiles could be used for treatment planning more adapted to the individual. Especially those who have autism spectrum disorders and multiple comorbid disorders are at risk of severe ADHD symptoms and low level of functioning.
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| 35. |
- Fredlund, Cecilia, 1984-, et al.
(författare)
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Self-reported frequency of sex as self-injury (SASI) in a national study of Swedish adolescents and association to sociodemographic factors, sexual behaviors, abuse and mental health
- 2017
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sex as self-injury has become a concept in Swedish society; however it is a largely unexplored area of research, not yet conceptualized and far from accepted in the research field. The use of sex as a way of affect regulation is known in the literature and has, in interviews with young women who sell sex, been compared to direct selfinjury, such as cutting or burning the skin. The aim of this study was to investigate the self-reported frequency of sex as self-injury and the association to sociodemographic factors, sexual orientation, voluntary sexual experiences, sexual risk-taking behaviors, sexual, physical and mental abuse, trauma symptoms, healthcare for psychiatric disorders and non-suicidal self-injury. Methods: A representative national sample of 5750 students in the 3rd year of Swedish high school, with a mean age of 18 years was included in the study. The study was questionnaire-based and the response rate was 59.7%. Mostly descriptive statistics were used and a final logistic regression model was made. Results: Sex as self-injury was reported by 100 (3.2%) of the girls and 20 (. 8%) of the boys. Few correlations to sociodemographic factors were noted, but the group was burdened with more experiences of sexual, physical and emotional abuse. Non-heterosexual orientation, trauma symptoms, non-suicidal self-injury and healthcare for suicide attempts, depression and eating disorders were common. Conclusions: Sex used as self-injury seems to be highly associated with earlier traumas such as sexual abuse and poor mental health. It is a behavior that needs to be conceptualized in order to provide proper help and support to a highly vulnerable group of adolescents.
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| 36. |
- Gilsbach, Susanne, et al.
(författare)
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Increase in admission rates and symptom severity of childhood and adolescent anorexia nervosa in Europe during the COVID-19 pandemic: data from specialized eating disorder units in different European countries
- 2022
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : Springer Science and Business Media LLC. - 1753-2000. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background The COVID-19 pandemic, associated with confinement and social isolation, seems to have impacted the course of many mental disorders in children and adolescents. An increase in hospital admission rates for juvenile anorexia nervosa (AN) has been documented in many regions of the world. However, data from Europe are scarce. Methods We asked clinicians in specialized eating disorder units in hospitals of maximum care in France, Germany, Italy, Spain, Sweden, and the Netherlands to report on (i) overall (inpatient and outpatient) and (ii) inpatient admission rates for adolescents with AN during 2019 and 2020. Additionally, a modified version of the COVID Isolation Eating Scale (CIES) was used to assess the child and adolescent psychiatrists’ estimations of a possible increase in symptom severity in children and adolescents with AN during the COVID-19 pandemic and to (iii) inquire about the contributing factors perceived by the caring professionals. Results Four out of six representatives of European hospitals described a higher rate of overall admissions during the pandemic. Three hospitals out of six reported an increase in inpatient admissions, and two centres had constant high numbers of admissions of both outpatients and inpatients. The clinicians perceived a higher symptom severity in 2020 than in 2019, especially involving more frequent use of social media, longer duration of exercising, and more restrictive eating. They supposed an increase in social media consumption, a perceived “loss of control”, and a lack of in-person assessments and weight controls as the main contributing factors for the deterioration in AN numbers and symptomatology. Conclusions The COVID-19 pandemic seems to have had a deep impact on symptom severity in AN, which is mirrored by a large increase in admission rates across Europe. An increase in exercise, social media consumption, a perceived “loss of control”, and a lack of face-to-face health care seem to have contributed to this development. Further investigation is required to identify which factors may lead to the increase in incidence and deterioration of childhood and adolescent AN. Possible preventive means for the future could include educating paediatricians and health care workers about AN, regular weight assessment, and home-based treatments.
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| 37. |
- Hatfield, Megan, et al.
(författare)
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Effectiveness of the BOOST-A (TM) online transition planning program for adolescents on the autism spectrum: a quasi-randomized controlled trial
- 2017
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : BIOMED CENTRAL LTD. - 1753-2000. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: The majority of existing transition planning programs are focused on people with a disability in general and may not meet the specific need of adolescents on the autism spectrum. In addition, these interventions focus on specific skills (e.g. job readiness or self-determination) rather than the overall transition planning process and there are methodological limitations to many of the studies determining their effectiveness. The Better OutcOmes amp; Successful Transitions for Autism (BOOST-A (TM)) is an online program that supports adolescents on the autism spectrum to prepare for leaving school. This study aimed to determine the effectiveness of the BOOST-A T in enhancing self-determination. Methods: A quasi-randomized controlled trial was conducted with adolescents on the autism spectrum enrolled in years 8 to 11 in Australian schools (N = 94). Participants had to have basic computer skills and the ability to write at a year 5 reading level. Participants were allocated to a control (n = 45) or intervention (n = 49) group and participants were blinded to the trial hypothesis. The intervention group used the BOOST-A T for 12 months, while the control group participated in regular practice. Outcomes included self-determination, career planning and exploration, quality of life, environmental support and domain specific self-determination. Data were collected from parents and adolescents. Results: There were no significant differences in overall self-determination between groups. Results indicated significant differences in favor of the intervention group in three areas: opportunity for self-determination at home as reported by parents; career exploration as reported by parents and adolescents; and transition-specific self-determination as reported by parents. Conclusions: Results provide preliminary evidence that the BOOST-A T can enhance some career-readiness outcomes. Lack of significant outcomes related to self-determination at school and career planning may be due to the lack of face-to-face training and parents being the primary contacts in the study. Further research is needed to determine effectiveness of the BOOST-A T related to post-secondary education and employment.
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| 38. |
- Hatfield, Megan, et al.
(författare)
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Evaluation of the effectiveness of an online transition planning program for adolescents on the autism spectrum: trial protocol
- 2016
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : BIOMED CENTRAL LTD. - 1753-2000. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: The transition from high school to post-secondary education and work is difficult for adolescents on the autism spectrum. Transition planning can be an effective way of supporting adolescents on the autism spectrum to prepare for leaving school and to succeed in obtaining employment; however, there is a need for an autism-specific transition planning program with proven effectiveness. This paper describes a trial protocol for evaluating the Better OutcOmes amp; Successful Transitions for Autism (BOOST-A (TM)); an online interactive program that empowers adolescents on the autism spectrum to plan their transition from school to further study, training, or employment. Methods: The trial will involve adolescents on the autism spectrum in high school and their parents, who will be alternately assigned to a control group (regular practice) or an intervention group (using the BOOST-A (TM)). The BOOST-A (TM) was developed using the PRECEDE-PROCEED model, and is based on the self-determination model, and the strengths-and technology-based approaches. It involves participants completing a series of online modules. The primary outcome will be self-determination, because high self-determination has been linked to successful transition to employment among adolescents on the autism spectrum. Secondary outcomes will include domain-specific self-determination, career planning and exploration, quality of life, and environmental support. Data will be obtained from questionnaires completed by the adolescent on the autism spectrum and their parent/s. Data collection will take place at baseline (Time point 1) and 12 months later (Time point 2). Discussion and conclusions: This trial will provide evidence of the effectiveness of the BOOST-A T to assist adolescents on the autism spectrum to successfully transition from school.
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| 39. |
- Isaksson, Johan, et al.
(författare)
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Risky sexual behaviour among Russian adolescents : association with internalizing and externalizing symptoms
- 2021
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Risky sexual behaviour (RSB) is regarded as a major health problem during adolescence. Russia has one of the highest rates of teenage pregnancy, abortion and newly diagnosed HIV infections in the world, but research on RSB in Russian youth has been limited. To address this deficit, this study examined the role of several factors, including internalizing and externalizing symptoms, in RSB among Russian adolescents. Methods: Self-reported data were collected from 2573 Russian adolescents aged 13–17 years old (59.4 % girls; Mean age = 14.89) regarding RSB (unprotected sex, early pregnancy, multiple sexual partners and substance use during sexual encounters). Information was also obtained on externalizing (conduct problems and delinquent behaviour) and internalizing (depression, anxiety and posttraumatic stress) symptoms, as well as interpersonal risk and protective factors (affiliation with delinquent peers, parental involvement and teacher support). Hierarchical multiple binary logistic regression analysis was used to examine the associations between these variables and RSB. Results: Boys reported engaging in more RSB than girls. Externalizing symptoms and affiliation with delinquent peers were most strongly associated with RSB, whereas symptoms of anxiety were negatively associated with RSB. There was an interaction effect for sex and affiliation with delinquent peers on RSB with boys reporting RSB when having more delinquent peers. Neither parental involvement nor teacher support were protective against RSB. Conclusions: Early detection of and interventions for RSB and associated externalizing symptoms may be important for adolescent physical and mental wellbeing. Affiliation with delinquent peers should, especially among boys, be regarded as a risk marker for RSB.
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| 40. |
- Jonsson, Linda, 1975-, et al.
(författare)
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Online sexual abuse of adolescents by a perpetrator met online : a cross-sectional study
- 2019
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 13:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background The current study aimed at exploring adolescents' experiences of online sexual contacts leading to online sexual abuse by a perpetrator whom the victim had first met online. Associations with socio demographic background, experience of abuse, relation to parents, health and risk behaviors were studied. Methods The participants were a representative national sample of 5175 students in the third year of the Swedish high school Swedish (M age = 17.97). Analyses included bivariate statistics and stepwise multiple logistic regression models. Results In total 330 (5.8%) adolescents had gotten to know someone during the preceding 12 months for the purpose of engaging in some kind of sexual activity online. Thirty-two (9.7%) of those, the index group, had felt that they had been persuaded, pressed or coerced on at least one occasion. Sexual interaction under pressure was seen as constituting sexual abuse. These adolescent victims of online sexual abuse, the index group, did not differ with respect to socio-demographic background from the adolescents without this experience, the reference group. The index group had significantly more prior experiences of different kind of abuse, indicating that they belong to a polyvictimized group. More frequent risk behavior, poorer psychological health, poorer relationships with parents and lower self-esteem also characterized the index group. Online sexual abuse, without experiences of offline abuse, was associated with a poorer psychological health, at least at the same level as offline sexual abuse only. Conclusions The study made clear the importance of viewing online sexual abuse as a serious form of sexual abuse. Professionals meeting these children need to focus not only on their psychological health such as symptoms of trauma and depression but also need to screen them for online behavior, online abuse and other forms of previous abuse.
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