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1.	Sonmark, Kristina, et al. (author) Individual and contextual expressions of school demands and their relation to psychosomatic health : a comparative study of students in France and Sweden 2016 In: Child Indicators Research. - 1874-897X .- 1874-8988. ; 9:1, s. 93-109 Journal article (peer-reviewed)abstract This study explores the health-related implications of both individual students’ and class-level concentrations of perceived demands in terms of pressuring, difficult and tiring schoolwork in France and Sweden, two countries with substantial differences in their educational systems and recent notable differences in PISA-results. Data come from Health Behaviour in School-aged Children (2001/02, 2005/06 and 2009/10) and comprise a total of 33,243 students aged 11, 13 and 15. Findings show that feeling under pressure from schoolwork is less prevalent in Sweden than in France among 11 and 13-year olds, but almost twice as common among 15-year olds. Yet its correlation with 15-year olds’ psychosomatic complaints is stronger in France than in Sweden. Feeling tired by schoolwork is equally common for 11- and 13-year olds in the two countries, but more frequent among 15-year olds in Sweden. It is also a stronger predictor of psychosomatic complaints in Sweden than in France across all age-groups. While it is more common at all ages to perceive the schoolwork as difficult in France, its relationship with psychosomatic complaints is stronger among students in Sweden. The proportion of classmates reporting high school demands is also linked to poorer student health, but these effects were largely confined to girls in both countries.
2.	Almquist, Ylva B., 1983-, et al. (author) Peer acceptance in the school class and subjective health complaints : a multilevel approach 2013 In: Journal of School Health. - : Wiley. - 0022-4391 .- 1746-1561. ; 83:10, s. 690-696 Journal article (peer-reviewed)abstract BACKGROUND: Feeling accepted by peers is important for young people's health but few studies have examined the overall degree of acceptance in school and its health consequences. The purpose of the study was to investigate whether health complaints among Swedish students can be attributed to the acceptance climate in their school class even when the health effects of their own (individual) acceptance score have been taken into account. METHODS: The data used were from the Health Behaviour in School-aged Children (HBSC) study for the years 2001 to 2002, 2005 to 2006, and 2009 to 2010, consisting of 13,902 5th-, 7th-, and 9th-grade Swedish students nested into 742 school classes. The statistical analyses were performed by means of linear regression multilevel analysis. RESULTS: The results indicated that the variation in subjective health complaints could be ascribed partly to the school-class level (boys: 5.0%; girls: 13.5%). Peer acceptance at the individual level demonstrated a clear association with health: the lower the acceptance, the higher the complaint scores. For girls, but not for boys, the overall degree of peer acceptance in the school class demonstrated a contextual effect on health, net of acceptance at the student level. Interaction analyses also revealed an increasingly favorable health among poorly accepted girls as the acceptance climate in the school class declined. CONCLUSIONS: A lower overall degree of peer acceptance in the school class is associated with poorer health among girls. However, girls who
3.	Arnarsson, Arsaell, et al. (author) Cyberbullying and traditional bullying among Nordic adolescents and their impact on life satisfaction 2020 In: Scandinavian Journal of Public Health. - London : SAGE Publications. - 1403-4948 .- 1651-1905. ; 48:5, s. 502-510 Journal article (peer-reviewed)abstract © Author(s) 2019. Aims: The aim of this study was to investigate the prevalence of cybervictimization in the six Nordic countries and to assess its overlap with traditional bullying. A further aim was to examine potential associations between life satisfaction, on the one hand, and traditional bullying and cyberbullying on the other. Methods: Analyses were based on data from the 2013⁄2014 Health Behaviour in School-aged Children study. It included 32,210 boys and girls, aged 11, 13, and 15, living in the six Nordic countries. Results: The prevalence of cyberbullying by both pictures and by messages was around 2% in all the Nordic countries except Greenland. There it was considerably higher. The prevalence of being bullied in a traditional manner varied widely by country. For boys, this type of bullying was most frequent in the youngest age group and then decreased steadily in the older age groups. Girls were on average more likely to be cyberbullied. Cyberbullying was more common among 13- and 15-year-olds than 11-year-olds. Higher family affluence was unrelated to the risk of cyberbullying. However, it was related to traditional bullying and combined forms of bullying. Compared with intact families, cybervictimization was commoner among single-parent families and stepfamilies. Adjusting for age, gender, family affluence, and family structure, those subjected to cyberbullying had lower life satisfaction than those who were not bullied. Conclusions: We found relatively little overlap between cyberbullying and traditional bullying, indicating that the two may be separate phenomena stemming from different mechanisms, at least in the Nordic context.
4.	Augustine, Lilly, 1979-, et al. (author) Bullying and its relationship with mental health in school children – with a special focus on children with disabilities 2021 In: Abstract book. ; , s. 109-110 Conference paper (peer-reviewed)
5.	Augustine, Lilly, 1979-, et al. (author) How is disability and bullying victimization related to psychosomatic complaints? A crosssectional study on Swedish children 2020 In: 12th Excellence in Pediatrics Conference – 2020. - : Taylor & Francis. ; , s. 18-19 Conference paper (peer-reviewed)
6.	Augustine, Lilly (author) I skärlinjen mellan funktionsnedsättning och mobbning och dessa barns psykiska hälsa 2021 In: Barnsliga sammanhang. - Kristianstad : Kristianstad University Press. - 9789187973727 ; , s. 81-93 Book chapter (other academic/artistic)abstract Vi är sociala individer, relationer med andra är drivkraften, det centrala i mänsklig anpassning och också grunden till lycka, vi som människor behöver känna tillhörighet och uppskattning (Rudolph, Lansford och Rodkin, 2016). Att inte få vara med är smärtsamt, att känna att man inte duger kan leda till en maladaptiv utveckling och sämre psykisk hälsa. Att få uppleva att man aktivt exkluderas, att man knuffas, eller kallas namn, sådant gör ont och kan skapa långvariga sår i själen. Om detta dessutom sker ofta, att det sker av personer som är mer gillade i den kontext man är i, eller att de är flera skapar också en känsla av maktlöshet. Att detta är fallet och att det är något många bearbetar länge kan nog också ses i den mängd med böcker och filmer där offer och förövare på olika sätt porträtteras. Sverige har länge stoltserat med att vi har låga nivåer av mobbning i skolan, lägre än i andra länder. På sistone har andelen individer som upplever att de blir mobbade i svenska skolan ökat (Bjereld, Augustine och Thornberg, 2020). Detta kan bero på flera saker, medvetenhet, hur man mäter, men sannolikt så visar det på en verklig förändring som skett. Detta då svenska studier över lag, användande olika studier och olika definitioner alla pekar på en uppgång de senaste 10 åren (Bjereld med fler, 2020), även om ökning är från låga nivåer och Sverige fortfarande ses som ett föredöme rörande frågor rörande mobbning (UNESCO, 2019).
7.	Augustine, Lilly, 1979- (author) I skärlinjen mellan funktionsnedsättning och mobbning och dessa barns psykiska hälsa 2021 In: Barnsliga sammanhang. - Kristianstad : Kristianstad University Press. - 9789187973727 ; , s. 81-93 Book chapter (other academic/artistic)abstract Vi är sociala individer, relationer med andra är drivkraften, det centrala i mänsklig anpassning och också grunden till lycka, vi som människor behöver känna tillhörighet och uppskattning (Rudolph, Lansford och Rodkin, 2016). Att inte få vara med är smärtsamt, att känna att man inte duger kan leda till en maladaptiv utveckling och sämre psykisk hälsa. Att få uppleva att man aktivt exkluderas, att man knuffas, eller kallas namn, sådant gör ont och kan skapa långvariga sår i själen. Om detta dessutom sker ofta, att det sker av personer som är mer gillade i den kontext man är i, eller att de är flera skapar också en känsla av maktlöshet. Att detta är fallet och att det är något många bearbetar länge kan nog också ses i den mängd med böcker och filmer där offer och förövare på olika sätt porträtteras. Sverige har länge stoltserat med att vi har låga nivåer av mobbning i skolan, lägre än i andra länder. På sistone har andelen individer som upplever att de blir mobbade i svenska skolan ökat (Bjereld, Augustine och Thornberg, 2020). Detta kan bero på flera saker, medvetenhet, hur man mäter, men sannolikt så visar det på en verklig förändring som skett. Detta då svenska studier över lag, användande olika studier och olika definitioner alla pekar på en uppgång de senaste 10 åren (Bjereld med fler, 2020), även om ökning är från låga nivåer och Sverige fortfarande ses som ett föredöme rörande frågor rörande mobbning (UNESCO, 2019).
8.	Augustine, Lilly, 1979-, et al. (author) Linking youths’ mental, psychosocial, and emotional functioning to ICF-CY : Lessons learned 2018 In: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 40:19, s. 2293-2299 Journal article (peer-reviewed)abstract Purpose: Linking ready-made questionnaires to codes within the International Classification of Functioning, Disability and Health, Children and Youth Version with the intention of using the information statistically for studying mental health problems can pose several challenges. Many of the constructs measured are latent, and therefore, difficult to describe in single codes. The aim of this study was to describe and discuss challenges encountered in this coding process.Materials and methods: A questionnaire from a Swedish research programme was linked to the International Classification of Functioning, Disability and Health, Children and Youth Version and the agreement was assessed.Results: Including the original aim of the questionnaire into the coding process was found to be very important for managing the coding of the latent constructs of the items. Items from the International Classification of Functioning, Disability and Health, Children and Youth Version chapters with narrow definitions for example mental functions, were more easily translated to meaningful concepts to code, while broadly defined chapters, such as interactions and relationships, were more difficult.Conclusion: This study stresses the importance of a clear, predefined coding scheme as well as the importance of not relying too heavily on common linking rules, especially in cases when it is not possible to use multiple codes for a single item.Implications for rehabilitationThe International Classification of Functioning, Disability and Health, Children and Youth Version, is a useful tool for merging assessment data from several sources when documenting adolescents’ mental functioning in different life domains.Measures of mental health are often based on latent constructs, often revealed in the description of the rationale/aim of a measure. The latent construct should be the primary focus in linking information.By mapping latent constructs to the International Classification of Functioning, Disability and Health, Children and Youth Version, users of the classification can capture a broad range of areas relevant to everyday functioning in adolescents with mental health problems.The subjective experience of participation, i.e., the level of subjective involvement, is not possible to code into the International Classification of Functioning, Disability and Health, Children and Youth Version. However, when linking mental health constructs to the International Classification of Functioning, Disability and Health, Children and Youth Version codes, the two dimensions of participation (the being there, and the level of involvement) need to be separated in the linking process. This can be performed by assigning codes focusing on being there as separate from items focusing on the subjective experience of involvement while being there.
9.	Augustine, Lilly, 1979-, et al. (author) The Role of Disability in the Relationship Between Mental Health and Bullying: A Focused, Systematic Review of Longitudinal Studies 2022 In: Child Psychiatry & Human Development. - : Springer Science and Business Media LLC. - 0009-398X .- 1573-3327. Research review (peer-reviewed)abstract Having both a disability and being bullied increases the risk of later mental health issues. Children with disabilities are at greater risk of being bullied and therefore at greater risk of adverse mental health outcomes. We conducted a limited systematic review of longitudinal studies focusing on the role of disability in relation to bullying and mental health problems. Twelve studies with an initial measure of mental health or disorder, measured no later than 10 years of age, were found. Ten of these twelve studies suggested that having a disability before victimisation increased the impact of mental health problems measured after bullying experiences. The conclusion is that children with a disability, such as behavioural problems, have an increased risk of later mental health problems through bullying victimization. Children with two risk factors had significantly worse mental health outcomes. These additional mental health problems may be alleviated through reduced bullying victimisation.
10.	Augustine, Lilly, 1979-, et al. (author) The utility of the International Classification of Functioning construct as a statistical tool – operationalizing mental health as an indicator of adolescent participation 2022 In: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 44:16, s. 4220-4226 Journal article (peer-reviewed)abstract Background The ICF provides a common scientific language for the study of health and functioning. Adolescent mental health, operationalized as engagement in life situations, is one aspect of functioning. Engagement as mental health has a bi-directional relation with environmental factors.Aim To test the statistical utility of the International Classification of Functioning (ICF) classification in coding adolescent mental health and mental health problems.Methods Using data measuring mental health in a representative Swedish sample of 12-13-year-olds linking responses to the classification codes. The internal structure of the classification system constructs was tested using factor analysis.Results A factorial solution could be found for most chapters indicating that the ICF framework and coding system could be used; however, the variance explained was quite low. Linking worked better at code-level, rather than chapter level. Items measuring risk behavior or risk factors are loaded in separate constructs.Conclusions When coding items for statistical purposes, code-level rather than chapter level is to be preferred. Also, participation in risk behavior loads in separate factors indicating that these behaviors are separate from other types of participation.Implications for rehabilitation Considering some challenges with varying level of detail in the ICF-CY's chapters, the framework can be used to identify the content of mental health questionnaires to be used in rehabilitation. To provide more detailed information in rehabilitation addressing mental health, a code-level solution is more appropriate than a chapter level solution. Despite the use of same ICF-CY codes, negative participation, i.e., risk behavior, measures a different dimension than positive participation, is especially relevant in rehabilitation addressing mental health.
11.	Augustine, Lilly, 1979-, et al. (author) Trajectories of participation, mental health, and mental health problems in adolescents with self-reported neurodevelopmental disorders 2022 In: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 44:9, s. 1595-1608 Journal article (peer-reviewed)abstract PURPOSE: Having a neurodevelopmental disorder (NDD) increases the risk of mental health problems and lower participation. We investigated the trajectories of mental health problems and participation in adolescents with NDD and compared these with trajectories for peers without NDD. In addition, the relationship between participation, mental health (well-being), and mental health problems were investigated.MATERIALS AND METHODS: Data from a Swedish longitudinal survey study (LoRDIA) was used and adolescents with and without self-reported NDD were followed from 12/13 to 17 years, in three waves. Mental health problems were measured using the Strength and Difficulties Questionnaire, and well-being was measured with the Mental Health Continuum short form.RESULTS: Adolescents with NDD experience more mental health problems than adolescents without NDD. Hyperactivity, a key feature of NDD, remains stable, while emotional problems and psychosomatic complaints, increase over time for girls, independent of NDD. Participation is stable over time but is more related to well-being than to NDD or mental health problems.CONCLUSIONS: Gender is an important factor with girls exhibiting more problems. Mental health explains more of the variation in participation than mental health problems and NDD. Probably participation intervention can enhance mental health which may protect from mental health problems.Implications for rehabilitationMental health, i.e., emotional-, social-, and psychological well-being is more strongly related to participation and to reduced levels of mental health problems than having an NDD or not, thus assessing mental health separately from measuring NDD is important.Interventions focusing on participation may lead to higher mental health and having high mental health (flourishing) may facilitate participation.Girls with self-reported NDD seem to have a higher burden of mental health problems, especially if they also are languishing, i.e., having low mental health, therefore a strong focus on this group is needed both in research and clinical practice.Half of all adolescents are flourishing, independently of NDD or not, even if they are experiencing some symptoms of mental health problems, adolescents with NDD who are also languishing, have much higher ratings of mental health problems.
12.	Augustine, Lilly, 1979-, et al. (author) Är depression en klassfråga? En systematisk litteraturöversikt över kopplingen mellan social klass och depression 2008 Reports (other academic/artistic)
13.	Bertills, Karin (author) Different is cool! Self-efficacy and participation of students with and without disabilities in school-based Physical Education 2019 Doctoral thesis (other academic/artistic)abstract Background: Self-efficacy predicts school achievement. Participation is important for life outcomes. Functioning affects to what degree you can participate in everyday life situations. Participation-related constructs such as self-efficacy and functioning work both as a means of participation and as an end outcome. Learning takes place in this interrelationship. How relationships between participation and these constructs vary, depending on whether impacted by disability or not, how they develop over time and outcomes of these processes need to be explored.Method: In this three-year longitudinal study developmental processes of student self-efficacy (PE specific and general), aptitude to participate and functioning were explored. The context is school-based Physical Education (PE) in mainstream inclusive secondary school in Sweden. Data was collected from student and teacher questionnaires and observations of PE lessons. Students self-rated their perceived self-efficacy, aptitude to participate and functioning in school years seven and nine. Teachers self-rated their teaching skills. Student engagement, teaching behaviors, interactions and activities in Swedish school-based PE were observed in year eight. Relationships between the constructs and how they develop over time were studied in a total sample of 450 students (aged 12,5-15,5). Specifically focusing on three student groups, students with diagnosed disabilities (n=30), students with low grades in PE (n=36), and students with high grades (n=53) in PE.Results: Adapted instruments to measure self-efficacy (PE specific and general), aptitude to participate in PE, and functional skills (physical and socio-cognitive were developed and validated. PE specific self-efficacy is closely related to the aptitude to participate and has effects on student engagement and general self-efficacy. Over time PE specific self-efficacy increase in adolescents, but students with disabilities initially responded negatively if their PE teachers rated their teaching skills high. They were also more sensitive to the social environment, which was associated with PE grades over time. During this time the relationship between perceived physical functional skills and PE specific self-efficacy accelerated for students with disabilities. They were observed to be equally highly engaged in PE lessons as their peers. However, students with disabilities were observed to be closer to their teacher and tended to be less social and alone than their peers. Observed teaching skills as measured by level of alignment with syllabus, and affective tone when giving instructions showed differences in complexity and efficiency. Students in the study sample were more engaged in high-level teaching and were more frequently in communicative proximity to their teacher. In conditions of high-level teaching, teachers gave more instructions and used more materials for teaching purposes. Lessons were more often structured into whole group activities and lessons were more focused.Conclusion: PE specific self-efficacy measures students’ perceived knowledge and skills in PE and is related to students’ aptitude to participate, general self-efficacy and functioning. The overall findings imply that the developmental processes of perceived self-efficacy (PE specific and general), aptitude to participate and functioning differ between the student groups. PE specific self-efficacy and socio-cognitive functioning improve over time in all groups. Stronger associations of PE specific self-efficacy with aptitude to participate and functional skills, and weaker with general self-efficacy were found in students with disabilities compared to their typically functioning peers. Individual factors are vital to learning, but students with disabilities seem to be more sensitive to environmental factors than their peers. The aptitude to participate declines in students with disabilities, probably due to their experience of having physical restrictions. However, while participating in PE, they were similarly relatively highly engaged as their typically functioning peers. Instructions in PE indicate differences in complexity and efficiency of PE teaching. More complex lesson content requires more instructions and more purposeful materials. Time was used more efficiently in high-level teaching conditions. Lessons were more focused and had more flow, leaving students with less time to socialize. Space was also used more efficiently, and teachers were closer to their students. Indicating that more individual support, feed-back and feedforward was provided. Students with disabilities were more frequently close to their teacher than their typically functioning peers. The use of more whole group formats indicate that teaching is more differentiated in high-level teaching. When activating students physically, teachers may choose simpler self-sustaining activities, i.e. sports games. Small group formats may be used for individual development of motor skills or drills.
14.	Bertills, Karin, et al. (author) Inclusive teaching skills and student engagement in physical education 2019 In: Frontiers in Education. - : Frontiers Media S.A.. - 2504-284X. ; 4 Journal article (peer-reviewed)abstract Including students with disabilities in school-based Physical Education (PE) is common practice. However, little is known about students’ engagement and interaction in this environment and how it is related to PE teaching skills. Student engagement and interaction patterns were therefore observed. A multiple time-sampling method was used to perform observations of individual, contextual and environmental aspects of student engagement in school-based PE lessons. Three groups of students, aged 14 (n = 94), with: (1) Disabilities (n = 23), (2) Low grades (n = 27), and (3) High grades (n = 44) were compared. Students, independent of group, showed relatively high engagement in PE. The observed frequency of linking lesson content to PE syllabus in combination with using a vibrant affective tone when instructing was used as an indicator of high-/low-level teaching skills. Higher student engagement was observed in environments with high-level PE teaching skills, which included more whole group teaching, a higher frequency of student-teacher communicative proximity and more instructions. Students with disabilities and with low grades were more often observed in whole group activities, students with high grades in small group activities. The primary type of support provided to students with disabilities in PE seemed to consist of communicative proximity to the teacher. They were more often observed to be close to the teacher. Our results suggest that proximity to the teacher may serve as an indicator of inclusive teaching. In high-level teaching environments, teachers were more frequently in communicative proximity to all students, which facilitates learning. Lessons were also more focused (physically and academically) and technical devices and music were used for teaching purposes. More complex lesson content requires more instructions and our results show that, despite more instructions, all student groups were more on-task. Implied from our observations is that lesson complexity, the structuring of whole/small group formats, teacher proximity, and student engagement are aspects to consider when studying school-based PE. More instructions, closer communicative proximity and higher student engagement in high-level teaching provide students with more learning opportunities and facilitate feed-back and feed-forward, and individual support to students with disabilities.
15.	Bertills, Karin, et al. (author) Measuring self-efficacy, aptitude to participate and functioning in students with and without impairments 2018 In: European Journal of Special Needs Education. - : Taylor & Francis. - 0885-6257 .- 1469-591X. ; 33:4, s. 572-583 Journal article (peer-reviewed)abstract Including vulnerable groups of students such as students with learning disabilities in mainstream school research, require ethical considerations and questionnaire adaptation. These students are often excluded, due to low understanding or methodologies generating inadequate data. Students with disability need be studied as a separate group and provided accessible questionnaires. This pilot study aims at developing and evaluating student self-reported measures, rating aspects of student experiences of school-based Physical Education (PE). Instrument design, reliability and validity were examined in Swedish secondary school students (n = 47) including students, aged 13, with intellectual disability (n = 5) and without impairment and test–retested on 28 of these students. Psychometric results from the small pilot-study sample were confirmed in analyses based on replies from the first wave of data collection in the main study (n = 450). Results show adequate internal consistency, factor structure and relations between measures. In conclusion, reliability and validity were satisfactory in scales to measure self-efficacy in general, in PE, and aptitude to participate. Adapting proxy ratings for functioning into self-reports indicated problems. Adequacy of adjustments made were confirmed and a dichotomous scale for typical/atypical function is suggested for further analyses.
16.	Bertills, Karin, et al. (author) Measuring self-efficacy, aptitude to participate and functioning in students with and without impairments 2018 In: European Journal of Special Needs Education. - : Taylor & Francis. - 0885-6257 .- 1469-591X. ; 33:4, s. 572-583 Journal article (peer-reviewed)abstract Including vulnerable groups of students such as students with learning disabilities in mainstream school research, require ethical considerations and questionnaire adaptation. These students are often excluded, due to low understanding or methodologies generating inadequate data. Students with disability need be studied as a separate group and provided accessible questionnaires. This pilot study aims at developing and evaluating student self-reported measures, rating aspects of student experiences of school-based Physical Education (PE). Instrument design, reliability and validity were examined in Swedish secondary school students (n = 47) including students, aged 13, with intellectual disability (n = 5) and without impairment and test–retested on 28 of these students. Psychometric results from the small pilot-study sample were confirmed in analyses based on replies from the first wave of data collection in the main study (n = 450). Results show adequate internal consistency, factor structure and relations between measures. In conclusion, reliability and validity were satisfactory in scales to measure self-efficacy in general, in PE, and aptitude to participate. Adapting proxy ratings for functioning into self-reports indicated problems. Adequacy of adjustments made were confirmed and a dichotomous scale for typical/atypical function is suggested for further analyses.
17.	Bertills, Karin, et al. (author) Quality teaching and student perceived self-efficacy, function and aptitude to participate in PE 2017 Conference paper (other academic/artistic)abstract Background: Students with disability show a trajectory of higher incidence of school failure. High quality teaching and proper support may foster high self-efficacy, as protective factors for successful school outcomes. Physical Education (PE) can provide students with a context in which self-efficacy is promoted. At transition into high school with higher cognitive stakes, developmental changes and individual social identification coinciding, a disability may add to the challenge of success. Investigating self-efficacy as a predictor of achievement operationalized as grade points, student perceived self-efficacy, function and aptitude to participate in PE, and teacher rated teaching quality are examined.Method: Three groups were studied, students with 1. Diagnosed disability, 2. Low grades and 3. High grades in PE in year 6. Questionnaires were completed by students in 26 classes including classmates (n=450, 228 boys) and their PE-teachers (n=25). Correlations were analyzed, differentiating groups of students.Results: Students with disabilities experience lower general self-efficacy and in PE, and are less apt to participate in PE. Their PE self-efficacy is higher if the classroom climate is good. PE-teachers systematic work with grading has positive effects on academic and movement self-efficacy for students with low grades and on health self-efficacy for students with high grades. Highest effect of perceived socio-cognitive function is displayed in students with low grades, the correlation is stronger in general self-efficacy than in self-efficacy in PE. Students with high grades have higher self-efficacy in general and in PE.Conclusions: Student perceived socio-cognitive function is of major importance to students experience of self-efficacy. Most impact is seen on subscales measuring academic and movement self-efficacy.
18.	Bertills, Karin, et al. (author) Quality teaching and student perceived self-efficacy, function and aptitude to participate in Physical Education 2017 Conference paper (other academic/artistic)
19.	Bertills, Karin, et al. (author) Relationships between physical education (PE) teaching and student self-efficacy, aptitude to participate in PE and functional skills : with a special focus on students with disabilities 2018 In: Physical Education and Sport Pedagogy. - : Taylor & Francis. - 1740-8989 .- 1742-5786. ; 23:4, s. 387-401 Journal article (peer-reviewed)abstract Background: Students with disability show an increasing incidence of school failure. Quality teaching and appropriate support may foster high self-efficacy, a predictive factor for successful school outcomes. Physical Education (PE) can provide students with a context in which self-efficacy and participation are promoted leading to improved academic achievement. The transition into secondary school can be challenging for many students with increased educational demands, developmental changes and individual social identification coinciding. A disability may add to the challenge of success.Methods: Three groups of students, aged 13 years and enrolled in Swedish mainstream schools were targeted (n = 439). Groups included students with 1. A diagnosed disability, 2. Low grades in PE (D–F) and 3. High grades (A–C) in PE. Questionnaires were collected and analyzed from 30/439 students with a diagnosed disability (physical, neuro-developmental and intellectual) from 26 classes, their classmates and their PE-teachers (n = 25). Relationships between student self-reports and PE-teachers’ self-ratings were investigated. Also examined was the potential to which students’ functional skills could predict elevated general school self-efficacy, PE specific self-efficacy and aptitude to participate in PE. Results were compared with the total sample and between the three target groups (n = 121).Results: For students with disabilities, better self-rated teaching skills were related to lower student perceived general school self-efficacy, PE specific self-efficacy and aptitude to participate in PE. The impact of classroom climate in PE was more obvious among students with disabilities. Perceived functional skills were associated with elevated general school self-efficacy, PE specific self-efficacy and aptitude to participate in PE. Better socio-cognitive functional skills had an overall positive effect on all outcomes. Students with disabilities reported results similar to the total sample, the D–F group scored lower and the A–C group higher than the total sample and the disability group. Elevated self-efficacy in PE is six times less probable in students with disabilities, compared to the A–C group.Conclusions: Our findings that better teacher planning and grading skills, are detrimental to students disadvantaged by disability is contradictive. Improving the establishment and communication of adapted learning standards at the transition to secondary school is a crucial and a predictive factor for promoting positive school experiences for students with disability. Students with disabilities need to be assured that the intended learning outcomes can be reached by doing activities differently than their typically functioning peers. Consideration of class composition is suggested as a means of promoting a positive learning climate, which would particularly benefit students with disabilities. Allocation of resources to support student socio-cognitive skills would improve experiences for the D–F group and likely promote a positive learning environment.
20.	Bertills, Karin, et al. (author) Student engagement and high quality teaching in PE 2018 Conference paper (peer-reviewed)
21.	Bertills, Karin, et al. (author) Student Self-Efficacy and Aptitude to Participate in Relation to Perceived Functioning and Achievement in Students in Secondary School With and Without Disabilities 2021 In: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 12 Journal article (peer-reviewed)abstract School-based Physical Education (PE) is important, especially to students with disabilities whose participation in physical activities out of school is limited. The development over time of participation-related constructs in relation to students' perceived functioning and achievement is explored. Students in mainstream inclusive secondary school self-rated their PE-specific self-efficacy, general school self-efficacy, aptitude to participate in PE, and perceived physical and socio-cognitive functional skills at two timepoints, year 7 and year 9. Results were compared between three groups of students with: disabilities (n = 28), high grades (n = 47), or low grades (n = 30) in PE. Over time, perceived physical skills of students with disabilities became strongly associated with self-efficacy and aptitude to participate. Perceived socio-cognitive skills in the study sample improved and had a positive effect on PE-specific self-efficacy. Efforts should be made to limit the accelerated negative impact of perceived restricted functioning of students with disabilities. Grading criteria need to be developed to comply with standards adapted to fit abilities of students with disabilities. Meaningful learning experiences appear to be created when participation is promoted and capacity beliefs (PE-specific self-efficacy) are boosted. Allocating resources to support the development of students' socio-cognitive skills seem to have potential for overall positive school outcome.
22.	Bjereld, Ylva, 1984-, et al. (author) Measuring the prevalence of peer bullying victimization : Review of studies from Sweden during 1993–2017 2020 In: Children and youth services review. - : Elsevier. - 0190-7409 .- 1873-7765. ; 119 Research review (peer-reviewed)abstract Research into the prevalence of bullying is important to enable the correct allocation of resources to prevent and end bullying. One problem when gathering knowledge in how prevalent bullying is, is the considerable variation in percentage points in research studies. The aim of this study was to analyze how the estimated prevalence in Swedish national population-based studies of peer bullying victimization is related to how it is defined and measured.The analysis focused on national population-based studies in Sweden, in order to ensure that the sampling and cultural aspects of data collection were similar throughout the period. Data came from three sources: 1) a scoping review of peer bullying victimization in Sweden, 2) reports from Swedish government agencies and non-government organizations that were not included in the scoping review, and 3) data from the Health Behaviour in School-aged Children (HBSC) Sweden 1993–2017 study.The results showed that although the estimated levels of bullying victimization depend on the measurement method, they all followed a similar pattern over time with a higher prevalence of bullying in recent years. The study raised conceptual inconsistencies between bullying, peer aggression, and peer victimization, which are further discussed in relation to prevalence and measurement.
23.	Bjereld, Ylva, 1984, et al. (author) The association between self-reported psychosomatic complaints and bullying victimisation and disability among adolescents in Finland and Sweden 2023 In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 51:8, s. 1136-1143 Journal article (peer-reviewed)abstract Aim: To analyse the associations between bullying victimisation, disability, and self-reported psychosomatic complaints in adolescents, and to investigate the role of support from parents and teachers in such associations. Methods: The study was based on Finnish and Swedish data from two waves (2013/2014 and 2017/2018) of the Health Behaviour in School-aged Children survey (n=16,057). Descriptive statistics were produced for four groups of adolescents: (a) bullied with disabilities; (b) not bullied with disabilities; (c) bullied without disabilities; and (d) not bullied without disabilities (reference group). Two multilevel multinomial logistic regression models were performed for the Finnish and Swedish samples separately. The first model analysed associations between psychosomatic complaints and bullying victimisation, controlling for a range of confounders. The second model analysed associations between psychosomatic complaints and social support from parents and teachers. Results: Across both countries, bullied adolescents with disabilities were more likely to self-report psychosomatic complaints than the reference group, even after adjusting for other potential confounders. Teacher support was identified as a potential protective factor as the odds ratio for psychosomatic complaints decreased when including teacher support as a factor in the model. The association with parent support showed mixed findings in Finland and Sweden. Conclusions: Disability in combination with bullying victimisation generated the highest levels of self-reported psychosomatic complaints compared to adolescents that were not bullied nor had disabilities. High teacher support may be a protective factor against psychosomatic complaints for bullied and/or disabled adolescents.
24.	Björck-Åkesson, Eva, 1952-, et al. (author) The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention - feasibility and usefulness as a common language and frame of reference for practice 2010 In: Disability and Rehabilitation. - London : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 32:S1, s. S125-S138 Journal article (peer-reviewed)abstract Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project.
25.	Bonin, Maria, et al. (author) Beyond silence : A scoping review of provided support for grieving children with intellectual disabilities or autism spectrum disorder 2024 In: Omega. - : Sage Publications. - 0030-2228 .- 1541-3764. Research review (peer-reviewed)abstract Children with intellectual disabilities (ID) or autism spectrum disorder (ASD) are considered unable to grieve or understand the concept of death and might not receive grief support after the death of a beloved person; hence, they are at risk of developing complicated grief. This scoping review identified existing grief support for children with ID or ASD. Searching seven databases yielded 514 records; six studies met the predefined inclusion criteria. The six studies identified grief support, including discussions, participation in death rituals, family support, stories, and professional interventions. The support could be organized into three levels, micro, meso, and exo, overlooking the macro level completely, indicating that grief support for these children tends to be irregular and inconsistent.
26.	Carlén, Kristina, et al. (author) Parental distress rating at the child’s age of 15 years predicts probable mental diagnosis : a three‑year follow‑up 2022 In: BMC Pediatrics. - : BioMed Central. - 1471-2431. ; 22:1 Journal article (peer-reviewed)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.
27.	Carlén, Kristina (author) Predictors of mental health in adolescents - with a salutogenic perspective 2022 Doctoral thesis (other academic/artistic)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.
28.	Carlén, Kristina, et al. (author) Teenagers’ mental health problems predict probable mental diagnosis 3 years later among girls, but what about the boys? 2022 In: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 16:1, s. 1-10 Journal article (peer-reviewed)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.
29.	Carlén, Kristina, et al. (author) Teenagers’ mental health problems predict probable mental diagnosis among girls, but what about the boys? 2023 In: Population Medicine. - : European Publishing. - 2654-1459 .- 2654-1459. ; 5 Journal article (peer-reviewed)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.
30.	Carlén, Kristina, et al. (author) The association between adolescents’ self-esteem and perceived mental health status in Sweden in four years of follow-up 2022 Other publication (other academic/artistic)
31.	Carlén, Kristina, et al. (author) The association between adolescents’ self-esteem and perceived mental well-being in Sweden in four years of follow-up 2023 In: BMC Psychology. - : BioMed Central (BMC). - 2050-7283. ; 11:1 Journal article (peer-reviewed)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.
32.	Carney, J., et al. (author) Development of the International Spinal Cord Injury/Dysfunction Education Basic Data Set 2019 In: Spinal cord series and cases. - : Nature Publishing Group. - 2058-6124. ; 5 Journal article (peer-reviewed)abstract Study design:Consensus among international experts.Objectives: The objective of this project was to develop the International Spinal Cord Injury/Dysfunction (SCI/D) Education Basic Data Set. Setting: International expert working group.Methods: The published guidelines for developing the International SCI Basic Data Sets were used to develop the International SCI/D Education Basic Data Set. Existing measures and literature on education and disability were reviewed to develop a preliminary draft of the basic education data set through iterative modifications via biweekly conference calls and email communication. The draft was disseminated to the larger International Workgroup for Development of Pediatric SCI/D Basic Data Sets and then to the members of the International Spinal Cord Society (ISCoS), American Spinal Injury Association (ASIA), and relevant expert groups and interested individuals for comments. All feedback received was taken into consideration before the final data set was approved by ISCoS and ASIA.Results: The finalized version of the International SCI/D Education Basic Data Set Version 1.0 contains 16 items divided into three domains: school setting/therapeutic services, school participation/academic success, and barriers/attitudes. Most of the variables have been adapted from established measures. This data set is intended for children and youth up to and including high school, but not for emerging adults in higher education or postsecondary vocational training or trade schools.Conclusion: The International SCI/D Education Basic Data Set has been developed for collection of a minimal amount of highly relevant information on the education experience in children and youth with SCI/D. Further validation work is needed.Sponsorship: This project was funded by the Rick Hansen Institute, Research Award #G2015-27 (Mulcahey, PI).
33.	Clausson, Eva K., et al. (author) Barnsliga sammanhang : forskning om barns och ungdomars hälsa och välmående 2022 Conference paper (peer-reviewed)
34.	Cosma, Alina, et al. (author) Gender Differences in Bullying Reflect Societal Gender Inequality : A Multilevel Study With Adolescents in 46 Countries 2022 In: Journal of Adolescent Health. - : Elsevier. - 1054-139X .- 1879-1972. ; 71:5, s. 601-608 Journal article (peer-reviewed)abstract Purpose: Social patterns in bullying show consistent gender differences in adolescent perpetration and victimization with large cross-national variations. Previous research shows associations between societal gender inequality and gender differences in some violent behaviors in adolescents. Therefore, there is a need to go beyond individual associations and use a more social ecological perspective when examining gender differences in bullying behaviors. The aim of the present study was twofold: (1) to explore cross-national gender differences in bullying behaviors and (2) to examine whether national-level gender inequality relates to gender differences in adolescent bullying behaviors.Methods: Traditional bullying and cyberbullying were measured in 11-year-olds to 15-year-olds in the 2017/18 Health Behaviour in School-aged Children study (n = 200,423). We linked individual data to national gender inequality (Gender Inequality Index, 2018) in 46 countries and tested their association using mixed-effects (multilevel) logistic regression models.Results: Large cross-national variations were observed in gender differences in bullying. Boys had higher odds of perpetrating both traditional and cyberbullying and victimization by traditional bullying than girls. Greater gender inequality at country level was associated with heightened gender differences in traditional bullying. In contrast, lower gender inequality was associated with larger gender differences for cyber victimization.Discussion: Societal gender inequality relates to adolescents' involvement in bullying and gendered patterns in bullying. Public health policy should target societal factors that have an impact on young people's behavior.
35.	Danielsson, Henrik, et al. (author) A Systematic Review of Longitudinal Trajectories of Mental Health Problems in Children with Neurodevelopmental Disabilities 2024 In: Journal of Developmental and Physical Disabilities. - : Springer. - 1056-263X .- 1573-3580. ; 36, s. 203-242 Research review (peer-reviewed)abstract To review the longitudinal trajectories - and the factors influencing their development - of mental health problems in children with neurodevelopmental disabilities. Systematic review methods were employed. Searches of six databases used keywords and MeSH terms related to children with neurodevelopmental disabilities, mental health problems, and longitudinal research. After the removal of duplicates, reviewers independently screened records for inclusion, extracted data (outcomes and influencing factors), and evaluated the risk of bias. Findings were tabulated and synthesized using graphs and a narrative. Searches identified 94,662 unique records, from which 49 publications were included. The median publication year was 2015. Children with attention deficit hyperactivity disorder were the most commonly included population in retrieved studies. In almost 50% of studies, trajectories of mental health problems changed by < 10% between the first and last time point. Despite multiple studies reporting longitudinal trajectories of mental health problems, greater conceptual clarity and consideration of the measures included in research is needed, along with the inclusion of a more diverse range of populations of children with neurodevelopmental disabilities.
36.	Dierckens, M., et al. (author) National-Level Wealth Inequality and Socioeconomic Inequality in Adolescent Mental Well-Being : A Time Series Analysis of 17 Countries 2020 In: Journal of Adolescent Health. - : Elsevier. - 1054-139X .- 1879-1972. ; 66:6, s. 21-28 Journal article (peer-reviewed)abstract Purpose: Although previous research has established a positive association between national income inequality and socioeconomic inequalities in adolescent health, very little is known about the extent to which national-level wealth inequalities (i.e., accumulated financial resources) are associated with these inequalities in health. Therefore, this study examined the association between national wealth inequality and income inequality and socioeconomic inequality in adolescents' mental well-being at the aggregated level. Methods: Data were from 17 countries participating in three consecutive waves (2010, 2014, and 2018) of the cross-sectional Health Behaviour in School-aged Children study. We aggregated data on adolescents' life satisfaction, psychological and somatic symptoms, and socioeconomic status (SES) to produce a country-level slope index of inequality and combined it with country-level data on income inequality and wealth inequality (n = 244,771). Time series analyses were performed on a pooled sample of 48 country-year groups. Results: Higher levels of national wealth inequality were associated with fewer average psychological and somatic symptoms, while higher levels of national income inequality were associated with more psychological and somatic symptoms. No associations between either national wealth inequality or income inequality and life satisfaction were found. Smaller differences in somatic symptoms between higher and lower SES groups were found in countries with higher levels of national wealth inequality. In contrast, larger differences in psychological symptoms and life satisfaction (but not somatic symptoms) between higher and lower SES groups were found in countries with higher levels of national income inequality. Conclusions: Although both national wealth and income inequality are associated with socioeconomic inequalities in adolescent mental well-being at the aggregated level, associations are in opposite directions. Social policies aimed at a redistribution of income resources at the national level could decrease socioeconomic inequalities in adolescent mental well-being while further research is warranted to gain a better understanding of the role of national wealth inequality in socioeconomic inequalities in adolescent health.
37.	Dierckens, M., et al. (author) National level wealth inequality and socioeconomic inequality in adolescent mental wellbeing 2020 In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 30:Supplement 5 Journal article (peer-reviewed)abstract BackgroundPrevious research established a positive association between national income inequality and socioeconomic inequalities in adolescent health, but little is known about the extent to which national level inequalities in accumulated financial resources (i.e. wealth) are associated with these health inequalities. Therefore, we examined the association between national wealth inequality and income inequality and socioeconomic inequalities in adolescent mental wellbeing.MethodsData were from 17 countries participating in three successive waves (2010, 2014 and 2018) of the cross-sectional Health Behaviour in School-aged Children (HBSC) study. We combined individual-level data on adolescents' life satisfaction, psychological and somatic symptoms and socioeconomic status (SES) with country-level data on income and wealth inequality (n = 244771). We performed time-series analysis on a pooled sample of 48 country/year groups.ResultsHigher levels of national wealth inequality were associated with fewer average psychological and somatic symptoms, while higher levels of national income inequality were associated with more psychological and somatic symptoms. No associations between either national wealth inequality or income inequality and life satisfaction were found. Smaller differences in somatic symptoms between higher and lower SES groups were found in countries with higher levels of national wealth inequality. In contrast, larger differences in psychological symptoms and life satisfaction (but not somatic symptoms) between higher and lower SES groups were found in countries with higher levels of national income inequality.ConclusionsAlthough both national wealth and income inequality are associated with (socioeconomic inequalities in) adolescent mental wellbeing, associations are in opposite directions. Further research is warranted to gain better understanding in the role of national wealth inequality on (socioeconomic inequalities in) adolescent health.Key MessagesThis is one of the first studies to examine if socioeconomic inequalities in adolescent mental wellbeing are associated with national wealth inequality independently from national income inequality.Opposing effects of national wealth inequality and income inequality on socioeconomic inequalities in adolescents’ mental wellbeing warrant further research before policy recommendations can be made.
38.	Fismen, Anne-Siri, et al. (author) Trends in food habits and their relation to socioeconomic status among Nordic adolescents 2001/2002-2009/2010 2016 In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 11:2 Journal article (peer-reviewed)abstract BackgroundIn the Nordic countries, substantial policy and intervention efforts have been made to increase adolescents' consumption of fruit and vegetables and to reduce their intake of sweets and soft drinks. Some initiatives have been formulated in a Nordic collaboration and implemented at national level. In recent years, social inequalities in food habits have been attracted particular governmental interest and several initiatives addressing the socioeconomic gradient in food habits have been highlighted. However, few internationally published studies have evaluated how trends in adolescents' food habits develop in the context of Nordic nutrition policy, or have compared differences between the Nordic countries.MethodsThe study was based on Danish, Finnish, Norwegian and Swedish cross-sectional data from the international Health Behaviour in School-Aged Children (HBSC) study, collected via three nationally representative and comparable questionnaire surveys in 2001/2002, 2005/2006 and 2009/2010. Food habits were identified by students' consumption of fruit, vegetables, sweets and sugar sweetened soft drink. Socioeconomic status (SES) was measured with the Family Affluence Scale (FAS). Multilevel logistic regression was used to analyze the data.ResultsTrends in fruit consumption developed differently across countries, characterized by an increase in Denmark and Norway and more stable trends in Sweden and Finland. Vegetable consumption increased particularly in Denmark and to a lesser extent in Norway, whereas Sweden and Finland displayed stable trends. Decreased trends were observed for sweet and soft drink consumption and were similar in Norway, Sweden and Finland. Sweet consumption decreased across all survey years, whereas soft drink consumption decreased between 2001/2002–2005/2006 and was stable thereafter. Denmark displayed an increase between 2001/2002–2005/2006 followed by a similar decrease between 2005/2006–2009/2010 for both sweet and soft drink consumption. Socioeconomic inequalities in fruit and vegetable consumption were observed in all countries, with no cross-country differences, and no changes over time. Small but not significant cross-country variation was identified for SES inequalities in sweet consumption. Reduced SES inequalities were observed in Sweden between 2005/2006 and 2009/2010. SES was not associated with soft drink consumption in this study population, with the exception of Denmark for the survey year 2009/2010.ConclusionDifferent trends resulted in increased country differences in food habits during the time of observations. In survey year 2009/2010, Danish students reported a higher intake of fruit and vegetable consumption than their counterparts in the other Nordic countries. Finnish students reported the lowest frequency of sweets and soft drink consumption. Despite the positive dietary trends documented in the present study, the majority of Nordic adolescents are far from meeting national dietary recommendations. Our findings underline the need for more comprehensive initiatives targeting young people's food habits as well as a more deliberate and focused action to close gaps in social inequalities that affect food choices.
39.	Fismen, Anne-Siri, et al. (author) Trends in food habits and their relation to socioeconomic status among Nordic adolescents 2001/2002-2009/2010 2016 In: PLoS ONE. - : Public Library of Science. - 1932-6203. ; 11:2 Journal article (peer-reviewed)abstract Background In the Nordic countries, substantial policy and intervention efforts have been made to increase adolescents' consumption of fruit and vegetables and to reduce their intake of sweets and soft drinks. Some initiatives have been formulated in a Nordic collaboration and implemented at national level. In recent years, social inequalities in food habits have been attracted particular governmental interest and several initiatives addressing the socioeconomic gradient in food habits have been highlighted. However, few internationally published studies have evaluated how trends in adolescents' food habits develop in the context of Nordic nutrition policy, or have compared differences between the Nordic countries. Methods The study was based on Danish, Finnish, Norwegian and Swedish cross-sectional data from the international Health Behaviour in School-Aged Children (HBSC) study, collected via three nationally representative and comparable questionnaire surveys in 2001/2002, 2005/2006 and 2009/2010. Food habits were identified by students' consumption of fruit, vegetables, sweets and sugar sweetened soft drink. Socioeconomic status (SES) was measured with the Family Affluence Scale (FAS). Multilevel logistic regression was used to analyze the data. Results Trends in fruit consumption developed differently across countries, characterized by an increase in Denmark and Norway and more stable trends in Sweden and Finland. Vegetable consumption increased particularly in Denmark and to a lesser extent in Norway, whereas Sweden and Finland displayed stable trends. Decreased trends were observed for sweet and soft drink consumption and were similar in Norway, Sweden and Finland. Sweet consumption decreased across all survey years, whereas soft drink consumption decreased between 2001/2002–2005/2006 and was stable thereafter. Denmark displayed an increase between 2001/2002–2005/2006 followed by a similar decrease between 2005/2006–2009/2010 for both sweet and soft drink consumption. Socioeconomic inequalities in fruit and vegetable consumption were observed in all countries, with no cross-country differences, and no changes over time. Small but not significant cross-country variation was identified for SES inequalities in sweet consumption. Reduced SES inequalities were observed in Sweden between 2005/2006 and 2009/2010. SES was not associated with soft drink consumption in this study population, with the exception of Denmark for the survey year 2009/2010. Conclusion Different trends resulted in increased country differences in food habits during the time of observations. In survey year 2009/2010, Danish students reported a higher intake of fruit and vegetable consumption than their counterparts in the other Nordic countries. Finnish students reported the lowest frequency of sweets and soft drink consumption. Despite the positive dietary trends documented in the present study, the majority of Nordic adolescents are far from meeting national dietary recommendations. Our findings underline the need for more comprehensive initiatives targeting young people's food habits as well as a more deliberate and focused action to close gaps in social inequalities that affect food choices.
40.	Granlund, Mats, 1954-, et al. (author) Definitions and operationalization of mental health problems, wellbeing and participation constructs in children with ndd : Distinctions and clarifications 2021 In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:4, s. 1-19 Journal article (peer-reviewed)abstract Children with impairments are known to experience more restricted participation than other children. It also appears that low levels of participation are related to a higher prevalence of mental health problems in children with neurodevelopmental disorders (NDD). The purpose of this conceptual paper is to describe and define the constructs mental health problems, mental health, and participation to ensure that future research investigating participation as a means to mental health in children and adolescents with NDD is founded on conceptual clarity. We first discuss the difference between two aspects of mental health problems, namely mental disorder and mental illness. This discussion serves to highlight three areas of conceptual difficulty and their consequences for understanding the mental health of children with NDD that we then consider in the article: (1) how to define mental health problems, (2) how to define and assess mental health problems and mental health, i.e., wellbeing as separate constructs, and (3) how to describe the relationship between participation and wellbeing. We then discuss the implications of our propositions for measurement and the use of participation interventions as a means to enhance mental health (defined as wellbeing). Conclusions: Mental disorders include both diagnoses related to impairments in the developmental period, i.e., NDD and diagnoses related to mental illness. These two types of mental disorders must be separated. Children with NDD, just like other people, may exhibit aspects of both mental health problems and wellbeing simultaneously. Measures of wellbeing defined as a continuum from flourishing to languishing for children with NDD need to be designed and evaluated. Wellbeing can lead to further participation and act to protect from mental health problems.
41.	Granlund, Mats, et al. (author) Differentiating activity and participation of children and youth with disability in Sweden : a third qualifier in the International Classification of Functioning, Disability, and Health for Children and Youth? 2012 In: American Journal of Physical Medicine & Rehabilitation. - 0894-9115 .- 1537-7385. ; 91:13:S1, s. S84-S96 Journal article (peer-reviewed)abstract OBJECTIVE:This article discusses the use of a third qualifier, subjective experience of involvement, as a supplement to the qualifiers of capacity and performance, to anchor activity and participation as separate endpoints on a continuum of actions.DESIGN:Empirical data from correlational studies were used for secondary analyses. The analyses were focused on the conceptual roots of the participation construct as indicated by the focus of policy documents, the support for a third qualifier as indicated by correlational data, differences between self-ratings and ratings by others in measuring subjective experience of involvement, and the empirical support for a split between activity and participation in different domains of the activity and participation component.RESULTS:Participation seems to have two conceptual roots, one sociologic and one psychologic. The correlational pattern between the qualifiers of capacity, performance, and subjective experience of involvement indicates a possible split between activity and participation. Self-ratings of participation provide information not obtained through ratings by others, and later domains in the activities and participation component fit better with measures of experienced involvement than earlier domains did.CONCLUSIONS:The results from secondary analyses provide preliminary support for the use of a third qualifier measuring subjective experience of involvement to facilitate the split between activity and participation in the International Classification of Functioning, Disability and Health, Children and Youth version, activity and participation domain.
42.	Green, Dido, et al. (author) Participatory profiles of children and adolescents with cerebral palsy : With and without mental health issues 2019 Conference paper (peer-reviewed)
43.	Gudmundsson, Julius, et al. (author) Common sequence variants on 2p15 and Xp11.22 confer susceptibility to prostate cancer. 2008 In: Nat Genet. - : Springer Science and Business Media LLC. - 1546-1718 .- 1061-4036. ; 40:3, s. 281-3 Journal article (peer-reviewed)
44.	Holmberg, Jorunn, et al. (author) Expatriate Adolescents’ Resilience : Risk and Protective Factors inthe Third Culture Context 2022 In: Xenophobiavs. Patriotism: Where is my Home?. - : International Association for Cross-Cultural Psychology. Conference paper (peer-reviewed)abstract Expatriate children and adolescents typically spend several of their formative years moving from country to country, frequently having to adapt to new cultures, making new friends, and fit into new school systems. It has been established in literature that such frequent changes may cause increased and prolonged risk of developing internalizing behavior problems such as depression and anxiety. However, little is still known regarding which protective factors serve as buffer towards the increased risk within the expatriate demographic. This study examined risk and protective factors among a group of expatriates, adolescents, and their parents, originating from 21 countries on five continents. Adolescent resilience was established through measuring risk and protective factors within three domains (i) individual, (ii) family, and (iii) school/community. In particular, the results indicated that adolescents’ sense of coherence, positive family climate, and satisfaction with school and friends, each predicted resilience significantly above other demographic factors. Interestingly, higher number of international moves did not predict adolescents’ resilience. The results imply that a coherent identity, high self-esteem, sense of “Third Cultural” group belonging, paired with a robust family environment, would promote resilience in the expatriate population. This may in turn serve as a buffer towards the negative effects caused by a stressful, transient upbringing.
45.	Huus, Karina, et al. (author) Perceived needs among parents of children with a mild intellectual disability in Sweden 2017 In: Scandinavian Journal of Disability Research. - : Taylor & Francis. - 1501-7419 .- 1745-3011. ; 19:4, s. 307-317 Journal article (peer-reviewed)abstract Parents of children with a mild intellectual disability experience more distress and require more support than other parents. The aim was to investigate the perceived family needs of parents of children with an MID and to investigate the relationship between parents’ perceived self-efficacy in their parental role and in collaborating with professionals as well as with their perceived needs for support. Interviews were based on questionnaires to the parents of 38 children. The results revealed that parents perceived need for information, respite, and venues in which to meet other parents in similar situations. The informational needs were related to parental self-efficacy and obtaining support. A lower need for information was related to higher perceived control over services. In conclusion, it appears that professionals need to work to strengthen parents’ ability to ask for support and to express the needs. Well-informed parents will develop stronger parental self-efficacy and perceived control over services.
46.	Huus, Karina, 1968-, et al. (author) Perceived needs among parents of children with a mild intellectual disability in Sweden 2017 In: Scandinavian Journal of Disability Research. - : Taylor & Francis. - 1501-7419 .- 1745-3011. ; 19:4, s. 307-317 Journal article (peer-reviewed)abstract Parents of children with a mild intellectual disability experience more distress and require more support than other parents. The aim was to investigate the perceived family needs of parents of children with an MID and to investigate the relationship between parents’ perceived self-efficacy in their parental role and in collaborating with professionals as well as with their perceived needs for support. Interviews were based on questionnaires to the parents of 38 children. The results revealed that parents perceived need for information, respite, and venues in which to meet other parents in similar situations. The informational needs were related to parental self-efficacy and obtaining support. A lower need for information was related to higher perceived control over services. In conclusion, it appears that professionals need to work to strengthen parents’ ability to ask for support and to express the needs. Well-informed parents will develop stronger parental self-efficacy and perceived control over services.
47.	Kim, S. S., et al. (author) Bullying, Mental Health, and the Moderating Role of Supportive Adults : A Cross-National Analysis of Adolescents in 45 Countries 2022 In: International Journal of Public Health. - : Frontiers Media S.A.. - 1661-8556 .- 1661-8564. ; 67 Journal article (peer-reviewed)abstract Objectives: Relationships with supportive adults during adolescence may be a protective factor that lowers the risks associated with bullying. The current study aimed to examine the moderating role of supportive adults in the associations between bullying involvement (in-person and cyber) and mental health problems (psychological symptoms and low life satisfaction). Methods: Data from 45 countries and regions taking part in the 2017/18 Health Behaviour in School-Aged Children study (N = 230,757) were used. Multivariable Poisson regression models were used to estimate relative risks of bullying on mental health. Effect estimates were compared across the number of supportive adults to examine a possible cumulative protective effect of relationships with supportive adults. Results: Bullying involvement was consistently associated with poor mental health across the 45 countries. Risk of mental health problems associated with bullying involvement was greatest among students reporting relationships with multiple supportive adults. This was true for all indicators of bullying involvement. Conclusion: Bullying remains a prevalent and harmful experience for youth worldwide. Merely having supportive adults is not sufficient in protecting youth from experiencing the mental health risks associated with bullying.
48.	Lygnegård, Frida, et al. (author) Factors associated with participation and change over time in domestic life, peer relations and school for adolescents with and without self-reported neurodevelopmental disorders : a follow-up prospective study 2018 In: Frontiers in Education Conference, Conference Proceedings. - : Frontiers Media S.A.. - 1539-4565. ; 3, s. 1-13 Journal article (peer-reviewed)abstract Even though participation in everyday events is a vital part in the fulfilment of human rights, adolescents with neurodevelopmental disorders often face participation restrictions in every-day activities. Few studies have investigated the predictors for participation in different contexts, over time and in relation to the same outcome variables. The objective of the current study was therefore to investigate predictors of change in participation operationalized as frequency of attendance and perceived importance in domestic life activities, peer related activities, and school activities as experienced by adolescents with and without self-reported neurodevelopmental disorders. Method: Associations with participation, both in terms of frequency and perceived importance, in domestic life, peer relations, and the school setting were investigated using six independent variables measuring experience of time and self, sex, age, stress, support from siblings, and atmosphere in family at two-time (with approximately 2 years in between). The sample consisted of adolescents with and without self-reported neurodevelopmental disorders (n= 916). Adolescents with self-reported neurodevelopmental disorders were n=154 and adolescents without self-reported neurodevelopmental disorders was n= 762. Data was collected via self-reported questionnaires administered in schools. Results: Three key findings are presented. 1) more factors were associated with participation outcomes at time1 for adolescents without NDD than for adolescents with NDD, but this difference in the number of factors decreases with time; 2) few associations were related to time for both adolescents with and without NDD; and 3) patterns of predicting variables were different for adolescents with and without NDD. Conclusion: The findings indicate that the factors related to participation in and outside school differs between groups, when the impairment or disability is not considered as a predictor for participation. This study supports the need for using a multidimensional developmental and contextual perspective in addressing enhanced participation for adolescents with neurodevelopmental disorders.
49.	Lygnegård, Frida, et al. (author) Factors associated with participation and change over time in domestic life, peer relations and school for adolescents with and without self-reported neurodevelopmental disorders : a follow-up prospective study 2018 In: Frontiers in Education Conference, Conference Proceedings. - : Institute of Electrical and Electronics Engineers Inc.. - 1539-4565. ; 3 Journal article (peer-reviewed)abstract Even though participation in everyday events is a vital part in the fulfilment of human rights, adolescents with neurodevelopmental disorders often face participation restrictions in every-day activities. Few studies have investigated the predictors for participation in different contexts, over time and in relation to the same outcome variables. The objective of the current study was therefore to investigate predictors of change in participation operationalized as frequency of attendance and perceived importance in domestic life activities, peer related activities, and school activities as experienced by adolescents with and without self-reported neurodevelopmental disorders. Method: Associations with participation, both in terms of frequency and perceived importance, in domestic life, peer relations, and the school setting were investigated using six independent variables measuring experience of time and self, sex, age, stress, support from siblings, and atmosphere in family at two-time (with approximately 2years in between). The sample consisted of adolescents with and without self-reported neurodevelopmental disorders (n= 916). Adolescents with self-reported neurodevelopmental disorders were n=154 and adolescents without self-reported neurodevelopmental disorders was n= 762. Data was collected via self-reported questionnaires administered in schools. Results: Three key findings are presented. 1) more factors were associated with participation outcomes at time1 for adolescents without NDD than for adolescents with NDD, but this difference in the number of factors decreases with time; 2) few associations were related to time for both adolescents with and without NDD; and 3) patterns of predicting variables were different for adolescents with and without NDD. Conclusion: The findings indicate that the factors related to participation in and outside school differs between groups, when the impairment or disability is not considered as a predictor for participation. This study supports the need for using a multidimensional developmental and contextual perspective in addressing enhanced participation for adolescents with neurodevelopmental disorders.
50.	Lygnegård, Frida (author) Participation in and outside school : Self-ratings by Swedish adolescents with and without impairments and long-term health conditions 2018 Doctoral thesis (other academic/artistic)abstract This thesis concerns the short-term state of and changes in self-rated participation in domestic life, peer relations and, to some extent, school. Participants were adolescents with and without self-reported impairments and long-term health conditions. It is a thesis in disability research and a functional perspective on the participation of adolescents in everyday activities is applied. The thesis is one of several sub-studies in the Swedish research program LoRDIA (Longitudinal Research on Development in Adolescence).Aim: The aim was to study the relationships between individual and environmental factors and participation in a two-time point longitudinal study within the frame of the health classification system ICF-CY. The aim was also to study the impact of environmental and individual factors on self-reported participation in adolescents with and without impairments and long-term health conditions.Methods: The study designs in the four studies are cross-sectional (studies I and II), and prospective longitudinal (studies III & IV). A combination of person-based (such as cluster analysis in studies II and IV) and variable-based methods (such as ANOVA, multiple regressions, logistic regressions (studies I, II, III and IV)) were used.Results: When linking items from a questionnaire aiming to measure mental health in adolescents to codes in the International Classification of Functioning, Disability and Health, Children and Youth version, latent coding is preferable to manifest coding. The focus should be on the underlying meaning of the item and the primary aim of the scale from which the item originated should be taken into consideration. Concerning the self-rated experience of participation, it was stable over time when investigated from a two-time point longitudinal perspective. Results revealed that type of impairment cannot be considered the sole predictor of the experience of participation at home, with peers and in school. Factors in the microsystem, e.g. sibling support, and perceived communication within the family, are of greater importance for the level of both participation attendance and the perceived importance of participating in domestic life and peer relations.Conclusion: Everyday functioning in adolescents with self-reported neurodevelopmental impairments is partially affected by the same factors as for children without self-reported neurodevelopmental impairments. The effect of the neurodevelopmental impairment seems more evident in school and decreases in importance with age. Factors in the environment such as the experience of sibling support and communication patterns in the family must be taken into consideration when investigating influences on participation. When measuring participation both the frequency of attendance dimension as well as the perceived importance of the activity should be included as they seem to be related to partly differing influences.

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