| 1. |
- Kvillemo, Pia, et al.
(author)
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Effects of an automated digital brief prevention intervention targeting adolescents and young adults with risky alcohol and other substance use : study protocol for a randomised controlled trial
- 2020
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In: BMJ Open. - : BMJ. - 2044-6055. ; 10:5
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Journal article (peer-reviewed)abstract
- Adolescence and young adulthood is a period in life when individuals may be especially vulnerable to harmful substance use. Several critical developmental processes are occurring in the brain, and substance use poses both short-term and long-term risks with regard to mental health and social development. From a public health perspective, it is important to prevent or delay substance use to reduce individual risk and societal costs. Given the scarcity of effective interventions targeting substance use among adolescents and young adults, cost-effective and easily disseminated interventions are warranted. The current study will test the effectiveness of a fully automated digital brief intervention aimed at reducing alcohol and other substance use in adolescents and young adults aged 15 to 25 years. Methods and analysis A two-arm, double-blind, randomised controlled trial design is applied to assess the effectiveness of the intervention. Baseline assessment, as well as 3-month and 6-month follow-up, will be carried out. The aim is to include 800 participants with risky substance use based on the screening tool CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble). Recruitment, informed consent, randomisation, intervention and follow-up will be implemented online. The primary outcome is reduction in alcohol use, measured by Alcohol Use Disorders Identification Test total score. Secondary outcomes concern binge drinking, frequency of alcohol consumption, amount of alcohol consumed a typical day when alcohol is consumed, average daily drinks per typical week, other substance use, mental health, sexual risk behaviours and perceived peer pressure. Moreover, the study involves analyses of potential moderators including perfectionism, openness to parents, help-seeking and background variables. Ethics and dissemination The study was approved by the Swedish Ethical Review Authority (no. 2019-03249). The trial is expected to expand the knowledge on digital preventive interventions for substance using adolescents and young adults. Results will be disseminated in research journals, at conferences and via the media.
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| 2. |
- Källmén, Håkan, et al.
(author)
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Alcohol habits in Sweden during 1997-2018 : a repeated cross-sectional study
- 2019
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 73:8, s. 522-526
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Journal article (peer-reviewed)abstract
- Aims: This study describes changes in alcohol habits in age and gender strata among the Swedish general population during the 21-year period following the Swedish EU membership in 1995.Methods: The Alcohol Use Disorders Identification Test (AUDIT) was distributed as a postal questionnaire to randomly selected cross-sectional samples every fourth year, starting in 1997.Results: Six samples were included in this study. A comparison between 2014 and 2018 showed a tendency to decreasing average total AUDIT scores, particularly among men and in the youngest age group (Cohen’s d = 0.28).Conclusion: The results should be understood in the context of declining response rates in this type of survey.
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| 3. |
- Källmén, Håkan, et al.
(author)
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Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) in relation to Alcohol Use Disorder (AUD) severity levels according to the brief DSM-5 AUD diagnostic assessment screener
- 2019
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 73:7, s. 397-400
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Journal article (peer-reviewed)abstract
- Aims: The Alcohol Use Disorders Identification Test (AUDIT) is a well-established and widely used screening instrument. It has been shown that AUDIT has good criterion validity in relation to alcohol abuse and dependence according to DSM-IV, but it has not yet been validated following the introduction of the DSM-5 diagnostic system. The aim of this study was to evaluate concurrent validity for the AUDIT in relation to self-reported DSM-5 severity levels for Alcohol Use Disorder (AUD) in a Swedish general population sample.Methods: A postal questionnaire, containing the AUDIT and the 13-item brief DSM-5 AUD diagnostic assessment screener, was sent to a random sample of 1,500 persons drawn from the Swedish population, aged between 17 and 80 years and having a public residence address in Sweden. To evaluate the concurrent validity of AUDIT in relation to DSM-5 severity criteria for AUD, a Receiver Operating Characteristics (ROC) curve analysis was conducted.Results: Area under the curve (AUROC) showed excellent differentiation between AUD or not, mild (.93), moderate (.92) and severe (.99). Higher individual AUDIT scores were associated with more severe levels of AUD according to the DSM-5 screener. The optimal cutoff scores approximate earlier research on the DSM-IV and were identified as 5, 7 and 13 points, respectively, for mild, moderate and severe AUD.Conclusions: Our findings indicate that AUDIT is a valid screener for detecting concurrent AUD at three severity levels in the Swedish general population.
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| 4. |
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| 5. |
- Arnaud, Nicolas, et al.
(author)
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Moderators of outcome in a web-based substance use intervention for adolescents.
- 2015
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In: SUCHT. - : Hogrefe Publishing Group. - 0939-5911 .- 1664-2856. ; 61:6, s. 377-387
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Journal article (peer-reviewed)abstract
- Aims: In this article we explore the moderators of effectiveness of WISEteens (Web-based brief Intervention for SubstancE using teens), a fully automated web-based brief motivational intervention targeting risky substance use among adolescents. Based on previous studies, we examined the differential effects on drinking of sex, readiness to change, self-efficacy, alcohol risk status, and parental monitoring as hypothesized moderators. Methods: We analyzed completers data from a two-armed RCT study with follow-up assessment after 3 months, including N = 211 self-enrolled adolescents (16 – 18 years) who screened positive for at-risk substance use in Sweden, Belgium, the Czech Republic, and Germany. The trial compared a single-session brief motivational intervention to an assessment-only control group with AUDIT-C scores for drinking frequency, quantity, and frequency of binge drinking in the past month as study outcome. Results: The analyses revealed a statistically significant moderation effect for sex on drinking in the previous month, with a stronger effect for males. In contrast, readiness to change, self-efficacy, alcohol risk status, and parental monitoring did not moderate the effects. Conclusions: Although the trial was limited by large dropout, our findings imply that web-based interventions can be particularly effective for male adolescents, although the effects of WISEteens were largely independent of other individual characteristics. Web-based brief intervention should integrate gender-specific components to raise effectiveness for females.
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| 6. |
- Baldus, Christiane, et al.
(author)
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Risky Sexual Behaviour and Sexual Victimization among Young People with Risky Substance Use in Europe-Perspectives from Belgium, Sweden, the Czech Republic, and Germany
- 2023
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In: International Journal of Environmental Research and Public Health. - 1660-4601. ; 20:21
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Journal article (peer-reviewed)abstract
- BACKGROUND: Research indicates that among the risks associated with young people's alcohol and illicit drug use are sexual risks. However, insights into co-occurrence of substance use and sexual risks in adolescent samples and possible differences across countries are limited. METHODS: A sample of 1449 adolescents from Belgium, Sweden, the Czech Republic, and Germany screened positive for risky alcohol/illicit drug use in a web-based intervention against alcohol and illicit drug use. They also reported incidents of sex while being drunk and/or high on drugs, condomless sex on these occasions, and sexualized touching and sexual victimization while being drunk or high on drugs. RESULTS: In the sample, 21.5% of the participants reported sexualized touching, 9.9% being victim to sexual assault, and 49.8% having had sex while being drunk and/or high on drugs; of the latter, 48.3% had condomless sex. Reports on having had sex while being drunk and/or high on drugs were associated with higher levels of past 30-day binge drinking. Being a victim of sexual assault was associated with past 30-day binge drinking only in young men. CONCLUSION: When devising preventive interventions against risky substance use in adolescents, an additional focus should be set on integrating steps against sexual risks.
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| 7. |
- Elgán, Tobias H., et al.
(author)
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A web-based group course intervention for 15-25-year-olds whose parents have substance use problems or mental illness : Study protocol for a randomized controlled trial
- 2016
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 16:1
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Journal article (peer-reviewed)abstract
- Background: Depending on the definitions used, between 5 and 20 % of all Swedish children grow up with at least one parent suffering from alcohol problems, while 6 % have at least one parent who has received inpatient psychiatric care, conditions that may affect the children negatively. Nine out of ten Swedish municipalities therefore provide support resources, but less than 2 % of these children are reached by such support. Delivering intervention programs via the Internet is a promising strategy. However, web-based programs targeting this at-risk group of children are scarce. We have previously developed a 1.5-h-long web-based self-help program, Alcohol & Coping, which appears to be effective with regards to adolescents' own alcohol consumption. However, there is a need for a more intense program, and therefore we adapted Kopstoring, a comprehensive Dutch web-based psycho-educative prevention program, to fit the Swedish context. The purpose of the program, which in Swedish has been called Grubbel, is to strengthen protective factors, such as coping skills and psychological well-being, prevent the development of psychological disorders, and reduce alcohol consumption. Methods/design: The aim of the current study is to evaluate the effectiveness of Grubbel, which targets 15-25-year-olds whose parents have substance use problems and/or mental illness. Specific research questions relate to the participants' own coping strategies, mental health status and substance use. The study was initiated in the spring of 2016 and uses a two-armed RCT design. Participants will be recruited via social media and also through existing agencies that provide support to this target group. The assessment will consist of a baseline measurement (t0) and three follow-ups after six (t1), 12 (t2), and 24 months (t3). Measures include YSR, CES-DC, Ladder of Life, Brief COPE, AUDIT-C, and WHOQOL-BREF. Discussion: Studies have revealed that the majority of children whose parents have substance use or mental health problems are not reached by the existing support. Thus, there is an urgent need to develop, implement, and evaluate novel intervention programs and disseminate successful programs to a broader audience. This study, investigating the effects of a web-based intervention, therefore makes an important contribution to this field of research. Trial registration: ISRCTN10099247. Retrospectively registered on August 31, 2016.
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| 8. |
- Elgan, Tobias H., et al.
(author)
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Design of a Web-based individual coping and alcohol-intervention program (web-ICAIP) for children of parents with alcohol problems: study protocol for a randomized controlled trial
- 2012
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12
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Journal article (peer-reviewed)abstract
- Background: It has been estimated that approximately 20% of all Swedish children grow up with parents having alcohol problems, which may result in negative outcomes among these children. Therefore, most Swedish municipalities provide resources for support, but at the same time figures reveal that not even 2% receive support, mainly due to difficulties in identifying and recruiting these children into support programs. Delivering intervention programs to children and adolescents via the Internet seems a promising strategy, but to date, the number of web-based interventions aimed at this target group is very scarce. We have therefore developed a novel internet-delivered therapist assisted self-management intervention called the web-ICAIP (Individual Coping and Alcohol Intervention Program) for adolescents having parents with alcohol problems. The purpose of the program is to strengthen adolescents' coping behavior, improve their mental health, and postponing the onset or decreasing risky alcohol consumption. This paper describes the web-ICAIP and the design of a randomized controlled trial (RCT) to measure the efficacy of this intervention. Methods/Design: The RCT will include at least 183 adolescents (15-19 year old) who will be randomly allocated to two conditions where one group has access to the web-ICAIP and the other is a waiting list control group. Participants will be recruited from websites containing information and facts for adolescents about alcohol and other drugs. Possible participants will be screened using the short version of the Children of Alcoholics Screening Test (CAST-6). The assessment consists of a baseline and two follow-up measurements taking place after two and six months, respectively. The primary outcomes include the Center for Epidemiological Studies Depression Scale (CES-DC), a coping behavior scale, and also the short version of the Alcohol Use Disorders Identification Test (AUDIT-C). Additional outcomes include the "Ladder of life" which measures overall life satisfaction and questions concerning program adherence. Discussion: There is an urgent need for developing and evaluating web-based intervention programs which target children having parents with alcohol problems. This study will therefore make an important contribution to this novel field of research.
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| 9. |
- Elgán, Tobias H., et al.
(author)
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Determinants of activity in glutaredoxins : An in vitro evolved Grx1-like variant of Escherichia coli Grx3
- 2010
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In: Biochemical Journal. - 0264-6021 .- 1470-8728. ; 430:3, s. 487-495
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Journal article (peer-reviewed)abstract
- The Escherichia coli glutaredoxins 1 and 3 (Grx1 and Grx3) are structurally similar (37% sequence identity), yet have different activities in vivo. Unlike Grx3, Grx1 efficiently reduces protein disulfides in proteins such as RR (ribonucleotide reductase), whereas it is poor at reducing S-glutathionylated proteins. An E. coli strain lacking genes encoding thioredoxins 1 and 2 and Grx1 is not viable on either rich or minimal medium; however, a M43V mutation in Grx3 restores growth under these conditions and results in a Grx1-like protein [Ortenberg, Gon, Porat and Beckwith (2004) Proc. Natl. Acad. Sci. U.S.A. 101, 7439-7944]. To uncover the structural basis of this change in activity, we have compared wild-type and mutant Grx3 using CD and NMR spectroscopy. Ligand-induced stability measurements demonstrate that the Grx3(M43V/C65Y) mutant has acquired affinity for RR. Far-UV CD spectra reveal no significant differences, but differences are observed in the near-UV region indicative of tertiary structural changes. NMR 1H- 15N HSQC (heteronuclear single quantum coherence) spectra show that approximately half of the 82 residues experience significant (Δδ > 0.03 p.p.m.) chemical shift deviations in the mutant, including nine residues experiencing extensive (Δδ ≥ 0.15 p.p.m.) deviations. To test whether the M43V mutation alters dynamic properties of Grx3, H/D (hydrogen/deuterium) exchange experiments were performed demonstrating that the rate at which backbone amides exchange protons with the solvent is dramatically enhanced in the mutant, particularly in the core of the protein. These data suggest that the Grx1-like activity of the Grx3(M43V/C65Y) mutant may be explained by enhanced intrinsic motion allowing for increased specificity towards larger substrates such as RR.
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