| 1. |
- Höglund, Per, 1969-
(författare)
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Stress, sleep disturbance, and related ill-health : from prevalence and risk-factors to indicated interventions
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- With focus on stress-related ill-health and insomnia/sleep disturbance, the overall aim of this thesis was to determine severity and prevalence, risk factors and effectiveness of low-intensity group sessions. This was accomplished by taking epidemiological and quasi-experimental approaches. With the aim of examining symptom severity and prevalence of insomnia, burnout, anxiety, depression, and somatization across different age groups and sexes, Study I used cross-sectional data (n=3406) from the baseline data collection of the Västerbotten Environmental Health Study (VEHS). In comparison to men, women in most age groups exhibited higher levels of symptom severity and prevalence of caseness in various mental health conditions. Insomnia (28.6%) and burnout (17.3%) were common in the population.With focus on risk factors for insomnia and burnout, Study II used a longitudinal design and VEHS data (n=1702–1972) to compare a range of mental and somatic conditions in a general population. The results showed that all examined health conditions were risk factors for cases of insomnia and burnout. For example, insomnia can increase the risk of developing burnout (odds ratio: 2.67), and burnout increase the risk of developing insomnia (odds ratio: 2.73), underscoring the importance of early detection and prevention. The aim of Study III was to examine the effectiveness of four low-intensity group sessions for stress (n=274) and sleep disturbance (n=106) conducted by psychology students. A non-randomized controlled trial design was used in primary care with naturally occurring groups. A control group (n=221) was recruited via social media. Whereas effects were small at post-treatment, a substantial proportion of the patients showed a reliable improvement or recovery at 3-month follow-up. This thesis provides support for the assumption that severity and prevalence of insomnia, burnout, anxiety, depression, and somatization are common in the population. Burnout and insomnia are mutual risk factors and underscore the importance of indicated prevention in primary care. Low-intensity group interventions facilitated by non-experts can be effective and scalable for patients with stress and sleep disturbance.
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| 2. |
- Ahlborg, Tone, 1950, et al.
(författare)
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Sensual and sexual marital contentment in parents of small children--a follow-up study when the first child is four years old.
- 2008
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Ingår i: Journal of sex research. - : Informa UK Limited. - 0022-4499 .- 1559-8519. ; 45:3, s. 295-304
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Tidskriftsartikel (refereegranskat)abstract
- This follow-up study explored parents' (N=452) intimate relationships when their firstborn child was 6 months old and then 4 years later. The measurement used was a modified version of the Dyadic Adjustment Scale, DAS. The present results show that most parents responding were content sensually at 6 months postpartum in 2002 and 4 years later, in 2006. More parents had changed from being sensually content in 2002 to discontent in 2006, than the contrary, however, and the sexual contentment remained low. The average sexual frequency was low both at 6 months and at 4 years for both parents with and without additional children. Experiencing tiredness as a hindrance to having sex was perceived as a greater problem among those parents without additional children. Prospective regression analyses indicated that sexuality was significantly related to both sensual and sexual contentment 4 years later. Sexuality was also one of the most significant covariates in the cross-sectional regression analysis for sensual contentment. Since sexuality plays a central role in partner well-being, it may be an important target for helping parents with small children.
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| 3. |
- Arnberg, Filip K, 1981-, et al.
(författare)
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Internet-delivered psychological treatments for mood and anxiety disorders : a systematic review of their efficacy, safety, and cost-effectiveness
- 2014
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:5, s. e98118-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Greater access to evidence-based psychological treatments is needed. This review aimed to evaluate whether internet-delivered psychological treatments for mood and anxiety disorders are efficacious, noninferior to established treatments, safe, and cost-effective for children, adolescents and adults.METHODS: We searched the literature for studies published until March 2013. Randomized controlled trials (RCTs) were considered for the assessment of short-term efficacy and safety and were pooled in meta-analyses. Other designs were also considered for long-term effect and cost-effectiveness. Comparisons against established treatments were evaluated for noninferiority. Two reviewers independently assessed the relevant studies for risk of bias. The quality of the evidence was graded using an international grading system.RESULTS: A total of 52 relevant RCTs were identified whereof 12 were excluded due to high risk of bias. Five cost-effectiveness studies were identified and three were excluded due to high risk of bias. The included trials mainly evaluated internet-delivered cognitive behavioral therapy (I-CBT) against a waiting list in adult volunteers and 88% were conducted in Sweden or Australia. One trial involved children. For adults, the quality of evidence was graded as moderate for the short-term efficacy of I-CBT vs. waiting list for mild/moderate depression (d = 0.83; 95% CI 0.59, 1.07) and social phobia (d = 0.85; 95% CI 0.66, 1.05), and moderate for no efficacy of internet-delivered attention bias modification vs. sham treatment for social phobia (d = -0.04; 95% CI -0.24, 0.35). The quality of evidence was graded as low/very low for other disorders, interventions, children/adolescents, noninferiority, adverse events, and cost-effectiveness.CONCLUSIONS: I-CBT is a viable treatment option for adults with depression and some anxiety disorders who request this treatment modality. Important questions remain before broad implementation can be supported. Future research would benefit from prioritizing adapting treatments to children/adolescents and using noninferiority designs with established forms of treatment.
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| 4. |
- Askeland, Kristin Gärtner, et al.
(författare)
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Association of Depressive Symptoms in Late Adolescence and School Dropout
- 2022
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Ingår i: School Mental Health. - : Springer. - 1866-2625 .- 1866-2633. ; 14:4, s. 1044-1056
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Tidskriftsartikel (refereegranskat)abstract
- The present study investigated the association between symptoms of depression in late adolescence and completion of upper secondary school, taking symptoms of ADHD and conduct disorder, and parental education into account. The study is based on the youth@hordaland-survey, conducted in Western Norway in 2012. A total of 9157 adolescents (aged 16-19 years, 53% girls) consented to participation and registry linkage and comprised the sample of the present study. Symptoms of depression, ADHD, and conduct disorder were based on adolescent self-report. Information on parental education, grade point average (GPA), and upper secondary school completion was retrieved from the National Education Database. In the sample, 14.8% had not completed upper secondary education within 5 years. Symptoms of depression were associated with higher odds of failure to graduate within 5 years (adjusted odds ratio (AOR) = 1.50). The association was attenuated but remained significant when adjusting for symptoms of ADHD, conduct disorder, and parental education. Adolescents reporting high levels of both depression and conduct disorder had the highest odds of dropout (AOR = 4.15). GPA partially mediated the association between symptoms of depression and dropout. The results show a consistent, but small association between symptoms of depression in late adolescence and failure to complete upper secondary education within five years. Given the high rate of depressive symptoms in the adolescent population, it is important to identify protective factors that promote school functioning and graduation for adolescents experiencing such symptoms.
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| 5. |
- Bauducco, Serena, 1988-
(författare)
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Adolescents' sleep in a 24/7 society : Epidemiology and prevention
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Sleep undergoes important changes during adolescence and many teenagers experience problems sleeping. These in turn affect adolescents´ academic, physical and psychosocial functioning. Moreover, there are some indications that sleep problems in this age group may be increasing, possibly as a consequence of societal changes, e.g., internet availability. Research on adolescents´ sleep is growing, but more epidemiological studies are needed to clarify the prevalence of poor sleep, long and short-term outcomes associated with it, and potential risk and protective factors to target in preventive interventions. The aim of this dissertation was to contribute to each of these goals; Study I investigated the longitudinal association between sleep problems, defined as symptoms of insomnia, and school absenteeism; Study II explored the prevalence of poor sleep, defined as sleep deficit, in an adolescent population and psychosocial and contextual factors associated with it, including emotional and behavioral problems, stress, sleep hygiene and technology use; finally, Study III evaluated the short-term effects of a novel universal school-based intervention to improve adolescents´ sleep health.The findings show that poor sleep was strongly related to adolescents´ functioning, including emotional and behavioral problems and school attendance, and that sleep deficit was prevalent in adolescents. This supports the need for prevention. Moreover, sleep deficit was associated with stress, technology use and arousal at bedtime, which may represent important barriers to sleep. A preventive intervention targeting these barriers to promote adolescents´ sleep health was successful with the individuals most at risk. However, it remains to be seen whether these changes will be maintained after the intervention and whether incidence of sleep problems will be lower relative to a control group. Implications for theory and practice are discussed.
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| 6. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Making room for sleep : A classroom based prevention program for adolescents
- 2016
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Ingår i: EABCT2016 Abstract Book. ; , s. 546-546
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Sleep patterns go through important changes during adolescence and sleep deprivation is extremely common, with severe consequences for adolescents´ daily functioning (Owens et al., 2014).Previous school-based interventions attempting to prevent sleep problems and their consequences have shown an increase in adolescents´ sleep knowledge but no behavioral changes. These programs usually include sleep education, cognitive and behavioral strategies, and a motivational framework (Cassoff, Knäuper, Michaelsen, & Gruber, 2013). Although the importance of motivation and engagement is unquestionable, previous attempts at enhancing adolescents´ motivation to change sleep behaviors might have been too shallow. We developed a new program that specifically targets barriers adolescents may encounter when trying to change their sleep behaviors, such as use of information and communication technology (ICT) late in the evening, stress due to schoolwork, and extracurricular activities. So, the intervention did not only focus on sleep education but also on improving students’ time management skills and encouraging them to monitor their ICT use. We also developed an interactive app for the intervention to increase engagement and to take advantage of the opportunities of ICT.The aim of this study was to evaluate the effectiveness of this classroom delivered universal sleep intervention. More specifically, we wanted to investigate whether changes in technology usage and perceived stress preceded changes in adolescents´ sleep duration. The intervention consisted of 5x45 min sessions over 6-7 weeks. Students (N = 292) completed weekly questionnaires through the app including a sleep diary for school-week and weekend sleep (bedtime, wake time, sleep onset latency, and wake after sleep onset), mobile usage, and motivation to change. They also completed pre- and post-intervention assessments, including self-reported sleep hygiene, perceived stress, and mood. At the end of the intervention students provided a qualitative evaluation of the sleep program.The intervention is still ongoing and will be completed by the end of the school year (June 2016). So far, the intervention has shown good feasibility in the school context. Preliminary results will be presented on possible changes in sleep duration and sleep hygiene and the role of ICT use and stress.This study will give us important information on adolescents´ sleep and its barriers in our 24/7 society. The discussion will focus on the possibilities of using this kind of preventive school-based interventions, as well as how modern technology (i.e. an interactive app) may be used for promoting engagement in this age group.
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| 7. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Prevalence, Incidence and Risk Factors for Sleep Deprivation in Adolescence : The Role of Technology and Stress
- 2016
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The first aim of this study was to describe the prevalence and incidence of poor sleep duration (<7 hours) over a one year period in a large sample of adolescents. The second aim was to inform prevention about the influence of adolescents´ social context on sleep duration. Therefore, we wanted to describe the longitudinal association between the use of Information and Communication Technology (ICT) at bedtime and daily stressors (e.g. school performance, family and peer issues) and poor sleep duration.Method: Participants were high school students in the 7th and 8th grade (N = 2505; age range: 12-15 years, at baseline) from 17 public schools in three communities in middle Sweden. Students filled out questionnaires in school during the spring, 2014 and one year later (85% retention rate). Sleep measures included bed time (BT), wake up time (WUT), and sleep onset latency (SOL). Total sleep time was calculated as, BT + WUT - SOL.We calculated prevalence, incidence, and chronicity of poor sleep duration. Moreover, the effect of ICT and daily stressors on future sleep duration was estimated with odds ratios, controlling for gender.Results: Prevalence (18.6%), incidence (12.8%) and chronicity (50%) rates indicate that poor sleep duration was persistent and increased one year later. Moreover, adolescents who often used ICT at bedtime (OR = 1.21, p < .001) and reported more school stress (OR = 1.16, p = .02), were more likely to report poor sleep duration one year later.Conclusion: Because poor sleep duration is common and persists over time, it is crucial to intervene early to prevent chronic sleep deprivation. Sleep interventions with younger adolescence, before chronicity occurs, should focus on barriers to change, such as stress and use of technology. The results from this study have been used to develop an early school-based intervention.
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| 8. |
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| 9. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Preventing sleep deficit in adolescents : Long-term effects of a quasi-experimental school-based intervention study
- 2020
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Ingår i: Journal of Sleep Research. - : Wiley-Blackwell. - 0962-1105 .- 1365-2869. ; 29:1
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Tidskriftsartikel (refereegranskat)abstract
- Adolescents are at risk of sleep deficit, which has serious consequences for their daytime functioning. However, school-based interventions to improve sleep have shown limited success. This might be due to the content of the programmes (e.g., not targeting central factors such as daytime stress and technology use) or because changes have not been captured due to a lack of long-term follow-ups. Hence, the aim of this study was to evaluate the long-term effects of a school-based sleep education curriculum including time-management training. The study used a quasi-experimental design. Participants were 3,622 adolescents (mean age 13.7, 48% girls); 286 were in the intervention group and 3,336 were followed as a natural control group. Data were collected before the intervention and at a 1-year follow-up. We divided participants into three groups according to baseline sleep duration (calculated from self-reported bed- and wake times, minus sleep onset latency): insufficient (<7 hr), borderline (7-8 hr) and adequate (>8 hr). Adolescents in the intervention group were ~2 times less likely to report insufficient sleep at follow-up as compared to controls. Sleep knowledge improved significantly in the intervention group but there were no changes in emotional sleep hygiene (e.g., bedtime worry) and perceived stress. Surprisingly, technology use increased and behavioural sleep hygiene worsened in the intervention group. Although the mechanisms of change need further investigation, the results of this study point to potential long-term benefits of school-based sleep programmes.
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| 10. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Sleep duration and patterns in adolescents : Correlates and the role of daily stressors
- 2016
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Ingår i: Sleep Health. - : Elsevier. - 2352-7218 .- 2352-7226. ; 2:3, s. 211-218
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The first aim of this study was to assess the prevalence of sleep deficit in a large sample of adolescents. Second, the study aimed to assess whether short sleep duration in the sample was associated with emotional and behavioral problems. Lastly, the study aimed to investigate the association between daily stressors-bedtime activities and sleep duration.Design: Cross-sectional survey.Setting: The questionnaires were completed during school hours in 17 municipal junior high schools in Sweden.Participants: A total of 2767 adolescents aged 12 to 16 years, 48% girls.Measurements and Results: Sleep measures included total sleep time (TST) for schooldays and weekends, obtained as combined measures of self-reported bed-time, wake-time, and sleep onset latency. We used the new National Sleep Foundation's guidelines to operationalize sleep duration. Overall 12% of younger adolescents (age 12-13 years) and 18% of older adolescents (14-16 years) slept less than recommended (TST < 7 hours). Adolescents reporting nonrecommended TST also reported more behavioral (ie, norm-breaking behaviors) and emotional problems (ie, depression, anxiety, and anger), with effects in the small-medium range. Finally, adolescents reporting bedtime arousal and use of information and communication technology in bed were more likely to report TST < 7 hours. Stress at home (for younger adolescents) and stress of school performance (for older adolescents) were also associated with TST less than 7 hours.Conclusions: The new National Sleep Foundation's recommendations were informative in this context. Future sleep interventions need to target barriers to good sleep practices, such as use of information and communication technology, stress, and worry that may contribute to arousal at bedtime.
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