| 1. |
- Afzelius, Maria, et al.
(author)
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Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry
- 2018
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 72:1, s. 31-38
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Journal article (peer-reviewed)abstract
- Background: A parental mental illness affects all family members and should warrant a need for support.Aim: To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration.Methods: Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients' main diagnoses, comorbidity, children below the age of 18, and child-focused interventions.Results: Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care.Conclusions: Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.
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| 2. |
- Agardh, A., et al.
(author)
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Sexual harassment among employees and students at a large Swedish university : who are exposed, to what, by whom and where – a cross-sectional prevalence study
- 2022
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In: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 22:1
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Journal article (peer-reviewed)abstract
- Background: Sexual harassment (SH) in the workplace is prevalent and associated with poor health. Universities are large workplaces with complex formal and informal power relations, which may influence the prevalence of SH. Although employees and students share the university context, few studies on SH have included both groups. The overall aim of the study was to investigate SH among employees and students at a large Swedish public university regarding types of harassment, prevalence in different groups, characteristics of the perpetrators, and the circumstances in which it occurs. Methods: A cross-sectional analysis was performed, based on a web-based survey with 120 items that was sent out to all staff, including PhD students (N = 8,238) and students (N = 30,244) in November 2019. The response rate was 33% for staff and 32% for students. Exposure to SH was defined as having experienced at least one of ten defined SH behaviors during their work or studies. Results: Among women, 24.5% of staff and 26.8% of students reported having been exposed to SH. The corresponding figures were 7.0% and 11.3% for male staff and students and 33.3% and 29.4% for non-binary individuals among staff and students. Unwelcome comments, suggestive looks or gestures, and ‘inadvertent’ brushing or touching were the three most common forms of reported harassment, both among staff and students. Attempted or completed rape had been experienced by 2.1% of female and 0.6% of male students. Male and female perpetrators were reported by about 80% and 15%, respectively, of exposed participants. Among staff most reported events occurred during the everyday operation of the university, while among students the majority of the events took place during social events linked to student life. When exposed to a perpetrator from the same group (staff or students), women reported more often being in a subordinate power position in relation to the perpetrator. Conclusions: The results indicate that sexual harassment is common in the university context, and interventions and case management routines of events should consider power relations between victim and perpetrator, as well as the various contexts within which sexual harassment takes place.
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| 3. |
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| 4. |
- Axberg, Ulf, 1961, et al.
(author)
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Barn till föräldrar som har kontakt med vuxenpsykiatrin – hur har de det? Rapport från en nationell studie
- 2020
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Reports (other academic/artistic)abstract
- Psykisk ohälsa hos vuxna som depression, ångest eller bipolär sjukdom är idag ett be-tydande folkhälsoproblem. Många av de drabbade är föräldrar till minderåriga barn. Psykisk ohälsa hos föräldern påverkar barnens utveckling och välmående, men sam-bandet medieras av föräldraförmågan och relationen mellan barnet och föräldern. Sammantaget finns på gruppnivå en ökad risk att barnen också utvecklar psykiska problem, även om det inte behöver vara så i varje enskilt fall. Barns behov av information, råd och stöd ska enligt Hälso- och sjukvårdslagen beak-tas när en förälder lider av psykisk ohälsa. Det finns idag ett flertal interventioner som kan användas för att tillgodose detta behov. Samtidigt behöver man utvärdera hur dessa interventioner fungerar i Sverige. Denna rapport handlar om en kartläggning av hur barn vars föräldrar är patienter inom den specialiserade vuxenpsykiatrin har det med avseende på psykisk hälsa och generell familjesituation. Kartläggningen ingår i ett större forskningsprojekt vars syfte är att göra en utvärdering av interventioner (Beardslees familjeintervention, Föra barn på tal och reguljär behandling/övriga insatser) för stöd till barn i åldern 8 till 17 år med föräldrar med depression, dystymi, ångeststörning och/eller bipolär sjukdom. Totalt ingår föräldrar, både patienter och deras partners, till 88 barn i studien och 19 barn har gjort egna skattningar. De fick fylla i ett antal frågeformulär, där föräldrarna skattade barnens psykiska hälsa, sitt eget psykiska mående, sin generella livssituation, sin relation till eventuell nuvarande partner, sin upplevelse av att kunna hantera bar-nens beteende och olika aspekter av klimat och funktion i familjen. Barnen skattade sin egen psykiska hälsa samt vissa aspekter av klimat och funktion i familjen. Resultaten visar att föräldrar i vår studie rapporterar signifikant högre nivåer av psy-kisk ohälsa hos barnen än föräldrar i en normgrupp i den vanliga befolkningen. Barn rapporterar större symptombelastning än föräldrarna när det gäller emotionella pro-blem, hyperaktivitet/ouppmärksamhet och total problembelastning. De föräldrar som är patienter rapporterar som väntat lägre psykiskt välmående än sina partners, men även i partnergruppen finns det flera som uppger en egen psykisk problematik på klinisk nivå. Patienter och deras partner ger en samstämmig bedömning av sin re-lation; betydligt fler än i en normalgrupp anger bekymmersamt höga nivåer av stress i relationen. Insatser för barn som anhöriga ses ofta som indikerade preventioner i syfte att minska risken för psykisk ohälsa i vuxenåldern, men det finns utifrån studiens resultat mycket som talar för att det istället kan finnas behov av tidig behandling. Studien pekar på vikten av att man som professionell inom vuxenpsykiatrin i enlighet med lagstiftningen tar reda på om det finns barn i familjen, även ställer frågor om hur patienten upplever att barnet mår psykisk och fysiskt, vilka övriga personer som finns omkring barnet och hur tillgängliga de är som stöd för barnet, hur relationerna mellan olika familjemedlemmar är, samt hur föräldraskapet upplevs.
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| 5. |
- Axberg, Ulf, et al.
(author)
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Barn till föräldrar som har kontakt med vuxenpsykiatrin - hur har de det? : Rapport från en nationell studie
- 2020
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In: Nationellt kompetenscentrum anhöriga. - 9789187731631
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Book chapter (other academic/artistic)abstract
- Mental illness in adults such as depression, anxiety or bipolar disorder are nowadays a significant public health problem. Many of those with mental illness are parents of underage children. A parents’ mental illness affects children’s development and wellbeing, but this association is mediated by parental skills and the relation between child and parent. In summary, at a group level there is an increased risk that the children also develop mental illness, even if it does not need to be so in every individual case.Children’s need for information, advice and support has to be considered according to the Swedish Health Care Act if a parent is mentally ill. A number of different interventions are available that can be used in order to meet this need. At the same time, it has to be evaluated how these interventions work in a Swedish context.This report is about a study on how children with parents who are patients in adult psychiatry do with regard to mental health and general family situation. The study is part of a larger research project with the aim to evaluate interventions (Beardslee Family Intervention, Let’s talk about children and treatment as usual/other interventions) for support to children at 8 to 17 years of age who have parents with depression, dysthymia, anxiety and/or bipolar disease. In total, parents, both patients and their partners, of 88 children are included in the study and 19 children have also participated. They answered a number of questionnaires. Parents estimated their children’s mental health, their own psychological wellbeing, their life situation in general, their relation to their current partner, their experience of control of their child’s behavior and different aspects of family climate and function. Children reported their own mental health and some aspects of family climate and function.The results show that parents in our study report significantly higher levels of mental ill-health in their children than parents in a non-clinical norm group. Children report higher symptom load than parents concerning emotional problems, hyperactivity/inattention and total problem score. Those parents who are psychiatric patients report as expected lower psychological wellbeing than their partners, but also several partners indicate own psychological problems on a clinical level. Patients and their partners give a consistent estimation of their relation. Considerably more participants as compared to a normal group report concerning high stress levels in their relation.Interventions for children as next of kin are often regarded as indicated preventions that aim to decrease the risk for mental illness in adulthood, but the results of this study indicate that there may be need for early treatment instead.The study points out the importance that practitioners in adult psychiatry in agreement with the law find out if there are children in the family and even ask about how the patients perceive their child’s psychological and physical wellbeing, if there are other significant persons around the child and how available they are as a support for the child, how relations between other family members are and how parenthood is experienced.
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| 6. |
- Donevan, Meghan, Affilierad forskare, et al.
(author)
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Adolescents' Use of Pornography : Trends over a Ten-year Period in Sweden
- 2022
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In: Archives of Sexual Behavior. - : Springer Science and Business Media LLC. - 0004-0002 .- 1573-2800. ; 51, s. 1125-1140
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Journal article (peer-reviewed)abstract
- Using survey data from three nationally representative surveys in 2004, 2009, and 2014 among senior high school students in Sweden, this study investigates trends in adolescents' lifetime prevalence of pornography use, frequency of pornography use, and type of pornography used over time. While almost all boys and a considerable proportion of girls used pornography across the three waves, the lifetime prevalence of pornography use decreased overall for both girls and boys. The share of boys who use pornography frequently increased over the three survey cycles; those who reported using pornography daily increased from 11% in 2004 to 24% in 2014. In contrast, there was no change in girls who reported using pornography daily, while the proportion who never used pornography increased from 40% in 2004 to 51% in 2014. Adolescents appear to use a narrower range of different pornography types over the survey cycles. Multiple logistic regression models were generated to investigate factors associated with pornography use over the 10-year period. The results suggest that rule-breaking behavior, having higher economic status and higher academic achievement were related to boy's pornography use, while rule-breaking behavior, early sexual debut and victimization were associated with girls' pornography use.
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| 7. |
- Fredlund, Cecilia, et al.
(author)
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Adolescents' Lifetime Experience of Selling Sex : Development Over Five Years
- 2013
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In: Journal of Child Sexual Abuse. - : Routledge. - 1053-8712 .- 1547-0679. ; 22:3, s. 312-325
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Journal article (peer-reviewed)abstract
- Lifetime experience of selling sex among adolescents was investigated together with sociodemographic correlates, parentchild relationship, and the existence of people to confide in. Changes over time regarding the selling of sex were investigated through a comparison of data from 2004 and 2009. This study was carried out using 3,498 adolescents from a representative sample of Swedish high school students with a mean age 18.3 years. Of these adolescents, 1.5% stated that they had given sexual services for reimbursement and both male and female buyers existed. The adolescents who had sold sex had a poorer parentchild relationship during childhood and had fewer people to confide in about problems and worries. Changes over time were found especially regarding the Internet as a contact source and also immigrant background.
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| 8. |
- Fredlund, Cecilia, 1984-, et al.
(author)
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Adolescents' motives for selling sex in a welfare state - A Swedish national study
- 2018
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In: International Journal of Child Abuse & Neglect. - : Elsevier. - 0145-2134 .- 1873-7757. ; 81, s. 286-295
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Journal article (peer-reviewed)abstract
- In addition to money or other compensation, other motives for selling sex may be important in a welfare country such as Sweden. The aim of this study was to carry out an exploratory investigation of adolescents' motives for selling sex in a population-based survey in Sweden. A total of 5839 adolescents from the third year of Swedish high school, mean age 18.0 years, participated in the study. The response rate was 59.7% and 51 students (0.9%) reported having sold sex. Exploratory factor analysis and hierarchical cluster analysis were used to identify groups of adolescents according to underlying motives for selling sex. Further analyses were carried out for characteristics of selling sex and risk factors. Three groups of adolescents were categorized according to their motives for selling sex: Adolescents reporting; 1) Emotional reasons, being at a greater risk of sexual abuse, using sex as a means of self-injury and having a non-heterosexual orientation. 2) Material but no Emotional reasons, who more often receive money as compensation and selling sex to a person over 25 years of age, and 3) Pleasure or no underlying motive for selling sex reported, who were mostly heterosexual males selling sex to a person under 25 years of age, the buyer was not known from the Internet, the reward was seldom money and this group was less exposed to penetrative sexual abuse or using sex as a means of self-injury. In conclusion, adolescents selling sex are a heterogeneous group in regard to underlying motives.
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| 9. |
- Fredlund, Cecilia, 1984-, et al.
(author)
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Self-reported frequency of sex as self-injury (SASI) in a national study of Swedish adolescents and association to sociodemographic factors, sexual behaviors, abuse and mental health
- 2017
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In: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 11
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Journal article (peer-reviewed)abstract
- Background: Sex as self-injury has become a concept in Swedish society; however it is a largely unexplored area of research, not yet conceptualized and far from accepted in the research field. The use of sex as a way of affect regulation is known in the literature and has, in interviews with young women who sell sex, been compared to direct selfinjury, such as cutting or burning the skin. The aim of this study was to investigate the self-reported frequency of sex as self-injury and the association to sociodemographic factors, sexual orientation, voluntary sexual experiences, sexual risk-taking behaviors, sexual, physical and mental abuse, trauma symptoms, healthcare for psychiatric disorders and non-suicidal self-injury. Methods: A representative national sample of 5750 students in the 3rd year of Swedish high school, with a mean age of 18 years was included in the study. The study was questionnaire-based and the response rate was 59.7%. Mostly descriptive statistics were used and a final logistic regression model was made. Results: Sex as self-injury was reported by 100 (3.2%) of the girls and 20 (. 8%) of the boys. Few correlations to sociodemographic factors were noted, but the group was burdened with more experiences of sexual, physical and emotional abuse. Non-heterosexual orientation, trauma symptoms, non-suicidal self-injury and healthcare for suicide attempts, depression and eating disorders were common. Conclusions: Sex used as self-injury seems to be highly associated with earlier traumas such as sexual abuse and poor mental health. It is a behavior that needs to be conceptualized in order to provide proper help and support to a highly vulnerable group of adolescents.
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| 10. |
- Hammarström, Sofia, 1984-
(author)
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Identification of young people at risk of sexual ill health : implementing a new tool in youth clinics
- 2021
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Doctoral thesis (other academic/artistic)abstract
- Background: Young people are at increased risk of sexual ill health in terms of sexually transmitted infections, unintended pregnancy, and sexual violence. There is limited knowledge of evidence-based preventive practices for identification of young people at risk of sexual ill health when in contact with health care. Aims: The overall aim of this thesis was to generate new knowledge concerning how Swedish youth clinics can work systematically to identify young people at risk of sexual ill health or who have negative sexual experiences. Specific objectives were to develop a risk-assessment model for the identification of youth at risk of contracting chlamydia; to develop and pilot-implement an evidence-informed tool for identifying young people at risk of sexual ill health in terms of sexually transmitted infections, unintended pregnancies, and sexual violence at Swedish youth clinics; and to explore youth clinic visitors’ and staff’s experiences of using that tool. Methods: The thesis takes a mixed methods approach and includes four studies. First, data from a national sample of sexually active young people, aged 15–24 years (n=6544), were used to develop a risk-assessment model for chlamydia infection. Second, a risk-assessment tool (SEXual health Identification Tool; SEXIT) was developed and pilot-implemented at three youth clinics for 1 month. The tool includes three components: (1) staff training; (2) a questionnaire for youth clinic visitors; and (3) a written guide for staff to support the subsequent dialogue and risk assessment based on the questionnaire. Questionnaire data from visitors (n=268) and staff (n=18) were analysed. Third, youth clinic visitors’ experiences were explored in 20 interviews with visitors (15–24 years) from the participating youth clinics. Fourth, staff’s experiences of working with SEXIT were investigated in four focus group discussions (n=16). Quantitative and qualitative methods were used for data analyses. Results: The risk-assessment model demonstrated that the distribution of chlamydia is skewed; 38% of cases were estimated to occur among a tenth of the population. Women most at risk of chlamydia were best identified using the variables age, number of sexual partners in the past year, and experience of sex for reimbursement. The corresponding variables for men were age, number of sexual partners, and alcohol use. SEXIT was validated and pilot-implemented at three youth clinics (response rate 86%). Before implementation, all staff perceived a need for more systematic screening for sexual risk-taking and sexual ill health at youth clinics. Youth clinic visitors demonstrated between 0 and 7 parallel risk factors. Staff experienced that using SEXIT systematically increased the consistency and quality of the clinics’ work, and youth clinic visitors reported that the questions were important and not uncomfortable or difficult. The visitors explained that questions in a written format followed by a dialogue initiated by the youth clinic staff enabled disclosure of negative experiences. Conclusions: The risk-assessment model demonstrates that the number of partners during the past year is the most important risk factor for chlamydia regardless of gender. SEXIT is an acceptable, appropriate, and feasible tool from the perspective of youth clinic staff, youth clinic visitors, and from an implementation point of view. Using the tool systematically may help raise important questions on sexual risk-taking and sexual ill health with youth clinic visitors and identify visitors with multiple risk factors. Being asked the sensitive yet important questions in SEXIT, followed by a respectful and non-judgemental conversation led by the youth clinic staff, has the potential to open up a more in depth and broader dialogue about the visitors’ sexual health. The systematic procedure helps youths feel that they are taken seriously and instils a feeling of trust that enables disclosure of sensitive experiences. From the staff perspective, SEXIT facilitates identification of young people exposed to or at risk of sexual ill health by simplifying and ensuring consistency and quality in their work.
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