| 1. |
- Alm, Charlotta, et al.
(author)
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Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6 : Analysis of three-year follow-up data and predictive validity
- 2014
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In: Mental Health and Substance Use. - Abingdon : Routledge. - 1752-3281 .- 1752-3273. ; 7:4, s. 431-445
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Journal article (peer-reviewed)abstract
- Previous research is scarce on the problems and needs of the “triply troubled” – among offenders with mental health problems and problematic substance use. Classifying this population into clusters based on problem profiles may provide information about individual needs for treatment. In a previous study, we identified four clusters of triply troubled: less troubled, severely triply troubled, triply troubled with medical problems, and working triply troubled. The present study explored the stability and predictive validity of these clusters in a naturalistic design. In total, 125 triply troubled individuals included in any of the four clusters were followed for approximately three years with regard to their inpatient and outpatient treatment participation. They were also interviewed with the 6th version of the Addiction Severity Index, the Psychopathy Checklist–Revised, and the World Health Organization Quality of Life–Bref. The main finding of the study was that on average the participants of all four clusters exhibited substantial improvements over the course of time but that improvements were cluster-specific rather than sample-specific. Implications of the study are discussed.
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| 2. |
- Alm, Charlotte, et al.
(author)
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Gender differences in re-offending among psychiatrically examined Swedish offenders
- 2010
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In: CBMH. Criminal behaviour and mental health. - : Wiley. - 0957-9664 .- 1471-2857. ; 20:5, s. 323-334
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Journal article (peer-reviewed)abstract
- Background: The gender gap for violent offending is narrowing in the general population. Substance abuse and mental health problems are known risk factors for criminality. While substance abuse treatment has been associated with reduced risk of re-offending, women seem less likely to engage than men. People misusing substances tend to be high users of emergency room (ER) services. Such use may be an indicator both of treatment failure for substance misuse and offending. Little is known about gender differences in this respect. Aims: This study aims to test for gender differences in re-offending, use of substance abuse treatment, and hospital ER visits among offenders referred for forensic psychiatric assessment in Sweden. Method: The study used a longitudinal retrospective design. Data on all 31 women from a 2-year (2000–2001) cohort of serious offenders referred for forensic psychiatric assessment in Stockholm county, and 31 men from the same cohort, were extracted from forensic service and national records. Selection of the men was by initial random sampling followed by matching on age and substance misuse. The two resulting samples were compared on health service use and re-offending data between release and the census date (30 April 2004). Results: There were no gender differences for violent re-offending or for engagement in planned substance abuse treatment, in spite of longer time at risk for the men. Re-offending was reduced for women but not men who did not present in the ER with physical health problems. Conclusions: Our study is limited by sample size, although it included all women referred to the specialist forensic psychiatric service over 2 years, but it does indicate that differences between men and women in this situation are likely, and worthy of further study. The only way of achieving adequate sample sizes is likely to be through multi-centre collaboration.
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| 3. |
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| 4. |
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| 5. |
- Dahlin, Moa Kindstrom, et al.
(author)
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Mentally disordered criminal offenders : Legal and criminological perspectives
- 2009
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In: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 32:6, s. 377-382
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Journal article (peer-reviewed)abstract
- Legal research in Sweden has traditionally focused on a systematization of the legal rules and their practical application, while the task of studying the effects of the application of the laws has been handed over to other branches of the social sciences. In contrast, new legal theories focusing on proactive and therapeutic dimensions in law have gained increasing attention in the international arena. These approaches may be better suited for evaluating legislation governing compulsory psychiatric care. Theoretical discussions and studies of causal mechanisms underlying criminal behaviour, as well as the implementation and value of instruments for predicting behaviour, are relevant to contemporary criminological research. Criminal behaviour varies across different groups of perpetrators, and the causes can be sought in the interplay between the individual and social factors. Multi-disciplinary efforts, integrating research from forensic psychiatry, psychology, sociology, and criminology, would be beneficial in leading to a better understanding of the causes underlying criminal behaviour.
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| 6. |
- Donahue, Kelly L, et al.
(author)
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Childhood Behavior Problems and Adolescent Sexual Risk Behavior: Familial Confounding in the Child and Adolescent Twin Study in Sweden (CATSS).
- 2013
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In: The Journal of adolescent health : official publication of the Society for Adolescent Medicine. - : Elsevier BV. - 1879-1972. ; 52:5, s. 606-612
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Previous studies have found associations between childhood behavior problems and adolescent sexual risk behavior. Using a quasi-experimental approach, we examined the extent to which this association may be due to between-family differences (i.e., unmeasured familial confounds) not adequately explored in prior research. METHODS: We used data from a longitudinal, population-based cohort of young twins in Sweden (first assessment: age 9 or 12 years; second assessment: age 15; n= 2,388). We explored the nature of the association between symptom scores for attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) at age 9 or 12 and the likelihood of having had sexual intercourse and number of sexual partners by age 15. Two-level mixed-effects models were used to estimate the effect of symptom score on each outcome after controlling for potential unmeasured familial confounds. RESULTS: Higher ADHD, ODD, and CD scores were associated with significantly increased likelihood of sexual intercourse by age 15. Higher ADHD and ODD scores were also associated with increased number of sexual partners. After controlling for unmeasured familial confounds, however, behavior problems were no longer significantly associated with either outcome. CONCLUSION: The association between childhood behavior problems and sexual risk behaviors may be due to characteristics shared within families. Hence, prevention strategies aimed at reducing these behaviors might need to address broader risk factors that contribute to both behavior problems and a greater likelihood of sexual risk behavior.
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| 7. |
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| 8. |
- Durbeej, Natalie, et al.
(author)
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Perceptions of treatment among offenders with mental health problems and problematic substance use : the possible relevance of psychopathic personality traits
- 2014
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In: Open Journal of Psychiatry. - Irvine : Scientific Research Publishing. - 2161-7325 .- 2161-7333. ; 4:1, s. 79-90
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Journal article (peer-reviewed)abstract
- Substance abuse is related to reoffending, and substance abuse treatment may be effective in reducing criminal recidivism. Psychopathy, however, another factor that strongly correlates with reoffending, may be negatively associated with treatment utilization. This qualitative study explored perceptions of substance abuse treatment among offenders with mental health problems, problematic substance use, and various degrees of psychopathic personality traits. An Interpretative Phenomenological Analysis (IPA) revealed that some treatment perceptions may vary with degree of psychopathic traits. For instance, participants with low and high degrees of psychopathic personality traits had different views on treatment requirements imposed upon them. Many treatment perceptions were also similar between the two participant groups. Thus, treatment perceptions may not be explained by degree of psychopathic personality traits alone, but the presence of some particular psychopathic traits may be relevant in explaining certain treatment perceptions. The results highlight the complex relationship between the individual and the treatment system, and may give input to future studies on rehabilitation of offenders with multiple treatment needs.
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| 9. |
- Eriksson, Åsa, et al.
(author)
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Offenders with mental health problems and substance misuse : cluster analysis based on the Addiction Severity Index version 6 (ASI-6)
- 2013
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In: Mental Health and Substance Use. - : Informa UK Limited. - 1752-3281 .- 1752-3273. ; 6:1, s. 15-28
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Journal article (peer-reviewed)abstract
- There is an urgent need to improve assessment and treatment among offenders with mental health problems and substance misuse (the “triply troubled”). An examination of the usefulness of the recently published Addiction Severity Index version 6 (ASI-6; Cacciola, J.S., Alterman, A.I., Habing, B., & McLellan, A.T. (2011). Recent status scores for version 6 of the Addiction Severity Index (ASI-6). Addiction, 106, 1588–1602) in classifying offenders with mental health problems and substance misuse was undertaken. A total of 207 offenders with suspect mental disorder and substance misuse about to go through a forensic psychiatric evaluation in Sweden were interviewed with the ASI-6. Data were cluster analyzed. Four distinct clusters emerged: (1) “less troubled” (n=35), (2) “severely triply troubled” (nfl30), (3) “triply troubled with medical problems” (n=52) and (4) “working triply troubled” (n=87). The ASI-6 proved useful in the classification of offenders with mental health problems and substance misuse. The authors suggest that the ASI-6 be used in research on the classification of the triply troubled.
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| 10. |
- Gumpert, Clara Hellner
(author)
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Alleged child sexual abuse : the expert witness and the court
- 2001
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Doctoral thesis (other academic/artistic)abstract
- Background: During the past decades, the evaluation of alleged sexual abuse has manifested itself as a major challenge for professionals working within the field of child maltreatment. A new role for psychologists and psychiatrists has been to give expert opinions regarding the credibility and reliability of child witnesses in legal proceedings. Although some aspects of evaluating suspected sexual abuse cases are close to traditional clinical work, other aspects necessitate new kinds of empirical and theoretical knowledge. Consulted experts have sometimes been accused of not meeting the new and different demands connected to such assignments. Professional efforts to determine whether a child has been the victim of sexual abuse or not has been the focus of an ongoing and heated debate in popular as well as scientific media. The overall aim of this study was to systematically explore how expert witnesses consulted in legal cases concerning alleged child sexual abuse have performed their task and collaborated with the courts. Method: The study was based on reviews of court files and written expert testimony (mainly focusing psychological expert testimony). Data from 800 court cases of alleged child sexual abuse was included (all cases from Swedish district courts during four different years; 1985, 1989, 1992 and 1997). A combination of quantitative and qualitative methods were applied. Results: The participation of expert witnesses decreased during the study period, from 25% of the cases (1985 and 1989) to 15% (1992) and 6% (1997). Logistic regression analyses showed that psychological expert participation was significantly associated with cases with young victims (< 7 years of age), cases with intra-familial abuse, and cases in which the suspect denied the charges (Paper I). The findings of the second study indicated that there have been communicative difficulties between expert witnesses and the courts. It appeared as if certain basic prerequisites for reaching a level of meaningful communication were not always achieved. Such prerequisites included a legally relevant focus for the expert's evaluation, a mutual understanding of certain central concepts, and a thorough description of the expert's reasoning, which would allow the court to review and analyse the expert's conclusions. The concept of 'quality' with regard to written psychological expert testimony (formal structure and content) was systematically approached in the third study, through the development of a reliable 12-item assessment tool (Structured Quality assessment of eXpert witness testimony [SQX-121, Paper III). In the fourth study, this assessment tool was applied on 121 (all available) expert witness reports from four different years, focusing the credibility or reliability of the child witness. Although the quality assessments according to the SQX- 12 improved over the study period, the results indicated that testimony concerning alleged child sexual abuse failed to follow many of the recommended standards. Expert reports produced by professionals applying statement analysis usually scored higher on the SQX-12 than did those written by more clinically oriented professionals. Published guidelines appeared to have had limited influence on actual practice (Paper IV). Professionals applying statement analysis as an assessment tool varied with regard to what features of the child's statements were emphasised and how such characteristics were evaluated. Special difficulties were connected to the interpretation of 'low quality' statements (Paper V). Conclusions: The results of the study illustrates various complex aspects of the evaluation of alleged child sexual abuse in a legal context. Different interventions are discussed and suggestions are given for further development of collaboration between psychological experts and the courts. In addition to an apparent need for improved quality with regard to written psychological testimony, other major issues concern how experts can provide the courts with legally relevant information, and how courts can makeuse of complex expert knowledge and still uphold the integrity of the legal process.
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| 11. |
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| 12. |
- Kaldal, Anna, 1966-
(author)
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Parallella processer : En rättsvetenskaplig studie av riskbedömningar i vårdnads- och LVU-mål
- 2010
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Doctoral thesis (other academic/artistic)abstract
- Crimes against children are among the most complicated. One of the reasons is high demand on the evidence in a criminal case. As a consequence, many alleged crimes may be difficult to solve. In order to protect the child from future harm, further legal processes might become necessary. The thesis studies risk assessment in custody cases and child protection cases. One aim of the thesis concerns what evidential criteria relate to the definition of risk within each act and if the law gives any indication of what information that is required in order to assess such risk. Related to the second theme is the issue of what legal possibilities exist to involve the child in the process. The thesis also applies a behavioral science perspective, and provides an overview of the discussion within the research area of children and risk. Limitations in contact between a child and a parent based on the legal concept of risk constitute exceptions to the main principle that children and parents have a right to live together. This presumption characterizes the current procedural legal frameworks. For example, the party that claims that there is a risk for the child also carries the burden of proof. The level of risk must be at least probable. If this level of risk can not be proven, there is no risk from a legal point of view, and consequently no possibility to intervene against the parents will. A regulation with more options to act within a lower risk domain could be motivated from a child protection perspective (risk monitoring). The similarities between custody cases which involves accusations of abuse of a child and a child protection case, motivates that both types of cases are handled in the same way and by the same authorities. In order to supply the court with sufficient information, it is necessary to secure both the authority and the competence to carry out this responsibility in the best possible way. This motivates not only alignment of investigative procedures, but also that the investigative body is equipped with the same authority and competence.
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| 13. |
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| 14. |
- Kindström Dahlin, Moa, et al.
(author)
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Swedish Legal Scholarship Concerning Protection of Vulnerable Groups : Therapeutic and Proactive Dimensions
- 2010
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In: International Journal of Law and Psychiatry. - : Elsevier BV. - 0160-2527 .- 1873-6386. ; 33:5-6, s. 398-405
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Journal article (peer-reviewed)abstract
- This paper presents a brief overview of the legal theoretical problems that arise in connection with the societal ambition of protecting vulnerable groups. One of the central difficulties in legislation with proactive and therapeutic ambitions arises from the link between law and philosophy of science, i.e., the relationship between facts and norms. It is shown that Therapeutic Jurisprudence differs in several aspects from Swedish legal scholarship that follows Scandinavian Legal Realism. It is also demonstrated that Therapeutic Jurisprudence has several similarities with the so-called Proactive Approach. This paper suggests that Therapeutic Jurisprudence may serve as a useful legal theoretical perspective in Swedish legal scholarship, especially when studying complex and vague regulations with a future focus. Two examples from Swedish legislation are examined: (a) Laws regulating compulsory care of abused or neglected children, and (b) laws related to the mentally ill. This paper illustrates the complexity in these acts, and poses the question of whether the regulations serve their purpose of providing adequate care for and protection of those in need.
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| 15. |
- Kosidou, Kyriaki, et al.
(author)
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Immigration, Transition into Adult Life and Social Adversity in Relation to Psychological Distress and Suicide Attempts among Young Adults
- 2012
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 7:10, s. e46284-
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Journal article (peer-reviewed)abstract
- Background: The increasing incidence of mental health problems among young people is a major concern in many Western countries. The causal mechanisms underlying these trends are not well established, but factors influenced by current societal changes ought to be implicated. Such factors include immigration and social adversity as well as the timing of taking on adult social roles (e.g. gainful employment, parenthood and own housing tenure). We therefore examined relationships between these factors and the risks of psychological distress as well as suicide attempts in young adults, with a focus on gender differences. Methods: We conducted a population-based study including 10,081 individuals aged 18-29, recruited in 2002 and 2006 in Stockholm, Sweden. Data were collected by record linkage and questionnaires. Results: Non-European immigrants had an increased risk of distress, and female non-European immigrants had a markedly higher risk of suicide attempts. Both early parenthood (<= 24 years) and not being a parent, being a student and the lack of own housing tenure were associated with distress, but only in women. In both sexes, financial strain was associated with the increased risk of distress and suicide attempts, while unemployment was only associated with distress. Conclusions: Immigration from outside Europe and social adversity are associated with mental health problems in young adults, especially females. Postponed transition into adulthood is associated with poor mental health in young women. These factors are influenced by current societal changes, and may have contributed to the increasing incidence of mental health problems among young people in Western countries.
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| 16. |
- Larson, Tomas, et al.
(author)
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Predictive properties of the A-TAC inventory when screening for childhood-onset neurodevelopmental problems in a population-based sample
- 2013
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In: BMC Psychiatry. - 1471-244X. ; 13
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Journal article (peer-reviewed)abstract
- Background: Identifying children with childhood-onset neurodevelopmental problems (NDPs, defined here as autism spectrum disorders [ASDs], attention-deficit/hyperactivity disorder [AD/HD], tic disorders [TDs], learning disorders [LDs] and development coordination disorder), using easily administered screening instruments, is a prerequisite for epidemiological research. Such instruments are also clinically useful to prioritize children for comprehensive assessments, to screen risk groups, and to follow controls. Autism-Tics, ADHD, and other Co-morbidities inventory (A-TAC) was developed to meet these requirements; here the A-TAC's prospective and psychometric properties are examined, when used in a population-based, epidemiological setting. Methods: Since 2004, parents of all Swedish twins have been asked to take part in an ongoing, nation-wide twin study (The Child and Adolescent Twin Study in Sweden). The study includes the A-TAC, carried out as a telephone interview with parents of twins aged 9 or 12. In the present study, screen-positive twins from three birth year cohorts (1993-1995) were invited to a comprehensive clinical follow-up (blinded for previous screening results) together with their co-twins and randomly selected, healthy controls at age 15 (Total N = 452). Results: Sensitivity and specificity of A-TAC scores for predicting later clinical diagnoses were good to excellent overall, with values of the area under the receiver operating characteristics curves ranging from 0.77 (AD/HD) to 0.91 (ASDs). Among children who were screen-positive for an ASD, 48% received a clinical diagnosis of ASDs. For AD/HD, the corresponding figure was also 48%, for LDs 16%, and for TDs 60%. Between 4% and 35% of screen-positive children did not receive any diagnosis at the clinical follow-up three years later. Among screen-negative controls, prevalence of ASDs, AD/HD, LDs, and TDs was 0%, 7%, 4%, and 2%, respectively. Conclusions: The A-TAC appeared to be a valid instrument to assess NDPs in this population-based, longitudinal study. It has good-to-excellent psychometric properties, with an excellent ability to distinguish NDPs (mainly ASDs) from non-NDPs at least three years after the screening evaluations, although specific diagnoses did not correspond closely to actual clinical diagnoses.
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| 17. |
- Larson, Tomas, 1967, et al.
(author)
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Reliability of the Autism - Tics, ADHD and other Comorbidities inventory (A-TAC) in a test-retest design
- 2014
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In: Psychological Reports. - 0033-2941. ; 114, s. 93-103
-
Journal article (peer-reviewed)abstract
- Summary .— The Autism–Tics, AD/HD, and other Comorbidities (A-TAC) inventory is used in epidemiological research to assess neurodevelopmental problems and coexisting conditions. Although the A-TAC has been applied in various populations, data on retest reliability are limited. The objective of the present study was to present additional reliability data. The A-TAC was administered by lay assessors and was completed on two occasions by parents of 400 individual twins, with an average interval of 70 days between test sessions. Intra- and inter-rater reliability were analysed with intraclass correlations and Cohen's !. A-TAC showed excellent test-retest intraclass correlations for both autism spectrum disorder and attention-defcit hyperactivity disorder (each at .84). Most modules in the A-TAC had intra and inter-rater reliability intraclass correlation coeffcients of # .60. Cohen's k indicated acceptable reliability. The current study provides statistical evidence that the A-TAC yields good test-retest reliability in a population-based cohort of children.
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| 18. |
- Leviner, Pernilla, 1973-
(author)
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Rättsliga dilemman i socialtjänstens barnskyddsarbete
- 2011
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Doctoral thesis (other academic/artistic)abstract
- Avhandlingen behandlar socialtjänstens ansvar för att skydda barn från brott och missförhållanden i hemmen och tar sin utgångspunkt i Barnkonventionens krav på ett fungerande samhälleligt barnskydd. Ämnet aktualiserar komplexa rättsliga frågor om grundläggande rättigheter för både barn och föräldrar. Syftet är att granska om socialtjänsten har de rättsliga förutsättningarna att leva upp till det ålagda barnskyddsansvaret. I detta ingår dels att undersöka om regleringens konstruktion är ändamålsenlig i förhållande till Barnkonventionens krav eller om det finns rättsliga hinder som gör att barns rätt till skydd svårligen låter sig realiseras, dels att klarlägga regleringens funktion och effekt i den praktiska tillämpningen.Undersökningen visar att regleringen uppställer höga mål kring barns livsvillkor och krav på att barn ska skyddas från våld och utsatthet i sina hem, men att socialtjänsten inte ges tydliga verktyg och befogenheter att realisera dessa mål. Socialtjänsten lämnas med vaga och osäkra rättsliga verktyg och ett starkt betonande av att utredning och insatser ska genomföras i samförstånd med vårdnadshavare. Detta leder till en rättslig praktik där fokus snarare ligger på samförstånd med och motivation av föräldrar än på utredning rörande vilka barn som behöver stöd och skydd. Denna situation är otillfredsställande ur både barns och föräldrars perspektiv, inte minst med hänsyn till krav på rättssäkerhet.I avhandlingen föreslås en genomgripande översyn av barnskyddsregleringen, där komplexiteten innefattande barns och föräldrars potentiellt motstående intressen lyfts fram. För att stärka barns position och rättsliga ställning föreslås bl.a. att Barnkonventionen inkorporeras i svensk rätt, att ökade krav ställs på fullgoda beslutsunderlag samt en tydligare uppdelning mellan frivillighet och tvång, där barn ges ökade möjligheter att företrädas av oberoende företrädare under barnskyddsutredningen.
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| 19. |
- Magnusson, Kristoffer, et al.
(author)
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Internet-delivered cognitive-behavioural therapy for concerned significant others of people with problem gambling : Study protocol for a randomised wait-list controlled trial
- 2015
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In: BMJ Open. - : BMJ. - 2044-6055. ; 5
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Journal article (peer-reviewed)abstract
- Introduction: About 2.3% of the adult population in Sweden are considered to suffer from problem gambling, and it is estimated that only 5% of those seek treatment. Problem gambling can have devastating effects on the economy, health and relationship, both for the individual who gambles and their concerned significant other (CSO). No empirically supported treatment exists for the CSOs of people with problem gambling. Consequently, the aim of this study is to develop and evaluate a programme aimed at CSOs of treatment-refusing problem gamblers. The programme will be based on principles from cognitive behavioural therapy (CBT) and motivational interviewing. To benefit as many CSOs as possible, the programme will be delivered via the internet with therapist support via encrypted email and short weekly conversations via telephone.Methods and analysis: This will be a randomised wait-list controlled internet-delivered treatment trial. A CBT programme for the CSOs of people with problem gambling will be developed and evaluated. The participants will work through nine modules over 10 weeks in a secure online environment, and receive support via secure emails and over the telephone. A total of 150 CSOs over 18 years of age will be included. Measures will be taken at baseline and at 3, 6 and 12 months. Primary outcomes concern gambling-related harm. Secondary outcomes include the treatment entry of the individual who gambles, the CSO's levels of depression, anxiety, as well as relationship satisfaction and quality of life.Ethics and dissemination: The protocol has been approved by the regional ethics board of Stockholm, Sweden. This study will add to the body of knowledge on how to protect CSOs from gambling-related harm, and how to motivate treatment-refusing individuals to seek professional help for problem gambling.Trial registration number: NCT02250586.
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| 20. |
- Magnusson, Patrik K. E., et al.
(author)
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The Swedish Twin Registry : establishment of a biobank and other recent developments
- 2013
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In: Twin Research and Human Genetics. - Cambridge, United Kingdom : Cambridge University Press. - 1832-4274 .- 1839-2628. ; 16:1, s. 317-329
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Journal article (peer-reviewed)abstract
- The Swedish Twin Registry (STR) today contains more than 194,000 twins and more than 75,000 pairs have zygosity determined by an intra-pair similarity algorithm, DNA, or by being of opposite sex. Of these, approximately 20,000, 25,000, and 30,000 pairs are monozygotic, same-sex dizygotic, and opposite-sex dizygotic pairs, respectively. Since its establishment in the late 1950s, the STR has been an important epidemiological resource for the study of genetic and environmental influences on a multitude of traits, behaviors, and diseases. Following large investments in the collection of biological specimens in the past 10 years we have now established a Swedish twin biobank with DNA from 45,000 twins and blood serum from 15,000 twins, which effectively has also transformed the registry into a powerful resource for molecular studies. We here describe the main projects within which the new collections of both biological samples as well as phenotypic measures have been collected. Coverage by year of birth, zygosity determination, ethnic heterogeneity, and influences of in vitro fertilization are also described.
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| 21. |
- Martin, Cederlöf, 1980-, et al.
(author)
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The association between childhood autistic traits and adolescent psychotic experiences is explained by general neuropsychiatric problems.
- 2016
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In: American Journal of Medical Genetics Part B. - Hoboken, USA : Wiley-Blackwell. - 1552-4841 .- 1552-485X. ; 171:2, s. 153-159
-
Journal article (peer-reviewed)abstract
- Studies suggest associations between childhood autistic traits and adolescent psychotic experiences. However, recent research suggests that a general neuropsychiatric problems factor predicts adverse outcomes better than specific diagnostic entities. To examine if the alleged association between autistic traits and psychotic experiences could rather be explained by a general neuropsychiatric problems factor comprising symptoms of ADHD, tic disorder, developmental coordination disorder, and learning disorder, we conducted a prospective cohort study based on the Child and Adolescent Twin Study in Sweden. In addition, we examined the genetic and environmental influences on the associations. A total of 9,282 twins with data on childhood autistic traits and other neuropsychiatric problems, and follow-up data on psychotic experiences at ages 15 and/or 18 years were included. First, psychotic experiences were regressed on autistic traits and second, the general neuropsychiatric problems factor was added to the model. Auditory hallucinations were analyzed separately from the other psychotic experiences. Finally, twin analyses were employed to disentangle genetic from environmental influences in the observed associations. Replicating prior research, significant associations were found between autistic traits in childhood and auditory hallucinations at ages 15 and 18. However, after controlling for the general neuropsychiatric problems factor, the associations between autistic traits and auditory hallucinations disappeared, whereas the association between the general neuropsychiatric problems factor and auditory hallucinations persisted after controlling for autistic traits. Twin analyses revealed that the association between the general neuropsychiatric problems factor and auditory hallucinations was driven by shared genetic influences. .
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| 22. |
- Nilsson, Anders, et al.
(author)
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Effects of added involvement from concerned significant others in internet-delivered CBT treatments for problem gambling : Study protocol for a randomised controlled trial
- 2016
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In: BMJ Open. - : BMJ. - 2044-6055. ; 6:9
-
Journal article (peer-reviewed)abstract
- Introduction: Problem gambling is a public health concern affecting ∼2.3% of the Swedish population. Problem gambling also severely affects concerned significant others (CSOs). Several studies have investigated the effect of individual treatments based on cognitive–behavioural therapy (CBT), but less is known of the effect of involving CSOs in treatment. This study aims to compare an intervention based on behavioural couples therapy (BCT), involving a CSO, with an individual CBT treatment to determine their relative efficacy. BCT has shown promising results in working with substance abuse, but this is the first time it is used as an intervention for problem gambling. Both interventions will be internet-delivered, and participants will receive written support and telephone support.Methods and analysis: A sample of 120 couples will be randomised to either the BCT condition, involving the gambler and the CSO, or the CBT condition, involving the gambler alone. Measures will be conducted weekly and at 3, 6 and 12 months follow-up. The primary outcome measure is gambling behaviour, as measured by Timeline Followback for Gambling. This article describes the outline of the research methods, interventions and outcome measures used to evaluate gambling behaviour, mechanisms of change and relationship satisfaction. This study will be the first study on BCT for problem gambling.Ethics and dissemination: This study has been given ethical approval from the regional ethics board of Stockholm, Sweden. It will add to the body of knowledge as to how to treat problem gambling and how to involve CSOs in treatment. The findings of this study will be published in peer-reviewed journals and published at international and national conferences.
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| 23. |
- Nilsson, Anders, et al.
(author)
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The Development of an Internet-Based Treatment for Problem Gamblers and Concerned Significant Others : A Pilot Randomized Controlled Trial
- 2018
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In: Journal of Gambling Studies. - : Springer Science and Business Media LLC. - 1050-5350 .- 1573-3602. ; 34:2, s. 539-559
-
Journal article (peer-reviewed)abstract
- Problem gambling creates significant harm for the gambler and for concerned significant others (CSOs). While several studies have investigated the effects of individual cognitive behavioral therapy (CBT) for problem gambling, less is known about the effects of involving CSOs in treatment. Behavioral couples therapy (BCT) has shown promising results when working with substance use disorders by involving both the user and a CSO. This pilot study investigated BCT for problem gambling, as well as the feasibility of performing a larger scale randomized controlled trial. 36 participants, 18 gamblers and 18 CSOs, were randomized to either BCT or individual CBT for the gambler. Both interventions were Internet-delivered self-help interventions with therapist support. Both groups of gamblers improved on all outcome measures, but there were no differences between the groups. The CSOs in the BCT group lowered their scores on anxiety and depression more than the CSOs of those randomized to the individual CBT group did. The implications of the results and the feasibility of the trial are discussed.
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| 24. |
- Quinn, Patrick D., et al.
(author)
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Childhood attention-deficit/hyperactivity disorder symptoms and the development of adolescent alcohol problems : A prospective, population-based study of Swedish twins
- 2016
-
In: American Journal of Medical Genetics Part B. - Hoboken, USA : John Wiley & Sons. - 1552-4841 .- 1552-485X. ; 171:7, s. 958-970
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Journal article (peer-reviewed)abstract
- Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of problematic alcohol and other substance use in adolescence. This study used data from an ongoing, prospective, population-based twin study of Swedish children and adolescents to evaluate the extent to which the association between ADHD symptoms and alcohol problems reflects a unique source of genetic or environmental risk related to ADHD versus a broader predisposition to youth externalizing behavior. We used all available data from same-sex monozygotic (MZ) and dizygotic (DZ) twins on ADHD symptoms in childhood (age 9/12; N = 15,549) and alcohol problems in late adolescence (age 18; N = 2,564). Consistent with prior longitudinal studies, the phenotypic association between hyperactive/impulsive ADHD symptoms and alcohol problems was small in magnitude, whereas the association for inattentive symptoms was even weaker. Additive genetic influences explained 99.8% of the association between hyperactive/impulsive symptoms and alcohol problems. Furthermore, we found that the genetic risk specifically associated with hyperactive/impulsive symptoms was attenuated when estimated in the context of externalizing behavior liability during childhood, of which ADHD symptoms were specific expressions. In sensitivity analyses exploring hyperactivity in mid-adolescence, we found a similar pattern of genetic associations. These results are consistent with previous findings of genetically driven overlap in the etiology of ADHD and problematic alcohol use. At least some of this co-occurrence may result from a general predisposition to externalizing behaviors in youth. © 2015 Wiley Periodicals, Inc.
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| 25. |
- Sahlin, Hanna, et al.
(author)
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Emotion regulation group therapy for deliberate self-harm : A multi-site evaluation in routine care using an uncontrolled open trial design
- 2017
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In: BMJ Open. - : BMJ. - 2044-6055. ; 7:10
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Journal article (peer-reviewed)abstract
- Objective Emotion regulation group therapy (ERGT) has shown promising results in several efficacy trials. However, it has not been evaluated outside a research setting. In order to increase the availability of empirically supported treatments for individuals with borderline personality disorder and deliberate self-harm, an evaluation of ERGT in routine clinical care was conducted with therapists of different professional backgrounds who had received brief intensive training in ERGT prior to trial onset. Design Multi-site evaluation, using an uncontrolled open trial design with assessments at pretreatment, post-treatment and 6-month follow-up. Setting 14 adult outpatient psychiatric clinics across Sweden. Participants Ninety-five women (mean age=25.1 years) with borderline personality disorder (both threshold and subthreshold) and repeated self-harm were enrolled in the study. Ninety-three per cent of participants completed the post-treatment assessment and 88% completed the follow-up assessment. Primary and secondary outcome measures Primary outcome was self-harm frequency as measured with the Deliberate Self-Harm Inventory. Secondary outcomes included self-harm versatility, emotion dysregulation, other self-destructive behaviours, depression, anxiety, stress symptoms and interpersonal and vocational difficulties. Intervention ERGT is an adjunctive, 14-week, acceptance-based behavioural group treatment that directly targets both self-harm and its proposed underlying mechanism of emotion dysregulation. Results At post-treatment, intent-to-treat analyses revealed a significant improvement associated with a moderate effect size on the primary outcome of self-harm frequency (51%, reduction; Cohen's d=0.52, p<0.001) as well as significant improvements in the secondary outcomes of self-harm versatility, emotion dysregulation, other self-destructive behaviours and general psychiatric symptomatology. These results were either maintained or further improved on at 6-month follow-up. Conclusions ERGT appears to be a feasible, transportable and useful treatment for deliberate self-harm and other self-destructive behaviours, emotion dysregulation and psychiatric symptoms when delivered by clinicians in the community. Trial registration number NCT01986257; results.
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| 26. |
- Selenius, Heidi, 1976-
(author)
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Dyslexia and risk of future violence in forensic psychiatric patients
- 2011
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Doctoral thesis (other academic/artistic)abstract
- The thesis consists of three studies. The main aim was to increase knowledge about dyslexia in forensic psychiatric patients and about how dyslexia is related to risk of future violence. In Study I, the prevalence of dyslexia was assessed by using different criteria, and the results showed that 17-53% of the patients met discrepancy criteria for dyslexia, while 50% had poor phonological processing skills and met the phonological core criterion for dyslexia. Poor phonological processing skills are believed to be the underlying cause of dyslexia. The results from Study I suggest that the patients’ phonological processing skills are not related to disadvantageous background factors and reading habits. Previous research indicates that dyslexia may worsen aggressive behaviour tendencies, and offenders with dyslexia are reported to be more violent than offenders without dyslexia. Violent crimes are strongly predicted by psychopathy, and therefore Study II focused on the relationship between phonological processing skills and psychopathy in order to clarify whether patients with dyslexia are characterized by psychopathy and therefore act more aggressively than those without dyslexia. However, the results from Study II showed that the patients’ reading speed, word decoding, and phonological processing skills were not significantly related to the total score of psychopathy, but significantly related to affective and interpersonal traits of psychopathy. In Study III, the focus was on aggression and risk of future violence in patients with and without dyslexia. The results revealed that the patients with dyslexia self-reported more anger and hostility compared to the patients without dyslexia. There was only a marginally significant tendency for the patients with dyslexia to have higher risk of future violence compared to those without dyslexia. However, poor phonological processing skills were a significant predictor of anger, which in turn predicted risk of future violence. Overall, the results showed that reading and writing problems are prevalent in forensic patients and that dyslexia does not have a straightforward relationship with future violence. The risk factors for criminality in patients with dyslexia are probably cumulative, and found in biological factors, individual abilities and personality, family, peers, school, community, and society.
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| 27. |
- Selinus, Eva Norén, et al.
(author)
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Childhood Symptoms of ADHD Overrule Comorbidity in Relation to Psychosocial Outcome at Age 15: A Longitudinal Study
- 2015
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:9
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Journal article (peer-reviewed)abstract
- Objective Neurodevelopmental problems (NDPs) may influence the transition from childhood to adolescence. Our aim was to study long-term psychosocial outcomes of NDPs, focusing on ADHD. Method Data was collected through a telephone interview with parents of twins at ages 9 or 12 years. NDP screen-positive children were clinically assessed at age 15; N = 450. Psychosocial outcome concerning peers, school, internalizing problems, antisocial behavior, alcohol misuse, drug misuse, and impaired daily functioning was examined. Results Even after controlling for other NDP comorbidity, screen-positivity for ADHD doubled or tripled the odds of later psychosocial problems. When controlling for parental education level, the significant effect of ADHD remained only for antisocial behavior and impaired daily functioning. Conclusions Signs of NDPs as well as other psychiatric diagnoses at ages 9 or 12 years are associated with a more problematic adolescence. However, despite the presence of comorbidity, early ADHD symptoms stand out as the most important risk factor for later antisocial development and impaired daily functioning.
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| 28. |
- Törn, Peggy, et al.
(author)
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Childhood neurodevelopmental problems and adolescent bully victimization : population-based, prospective twin study in Sweden
- 2015
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In: European Child and Adolescent Psychiatry. - New York, USA : Springer. - 1018-8827 .- 1435-165X. ; 24:9, s. 1049-1059
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Journal article (peer-reviewed)abstract
- Bully victimization is a common problem among children with neurodevelopmental disorders, including attention deficit/hyperactivity disorder and autism spectrum disorder. Previous research was mostly cross-sectional and seldom accounted for co-morbid psychopathology, which makes it difficult to draw conclusions about causality and specificity of any association. Using a genetically informative prospective design, we investigated the association between various neurodevelopmental problems (NDPs) in childhood and bully victimization in adolescence, and the relative contributions of genetic and environmental factors to this association. We obtained parent-reports of NDPs at age 9/12 years and self-reported bully victimization at age 15 for 3,921 children participating in the The Child and Adolescent Twin Study in Sweden (CATSS). Structural equation modelling was used to control for NDP co-morbidity and bully victimization at baseline. Cholesky decomposition was used to analyse genetic and environmental contributions to observed associations. Because most of the NDPs were associated to later bully victimization, a common effect of all NDPs was summarized into a general NDP factor. Controlling for this general factor, only problems with social interaction and motor control uniquely predicted subsequent bully victimization in girls. General and unique associations were influenced by both genetic and unique environmental factors. NDPs in general and social interaction and motor problems in particular predicted later bully victimization. The longitudinal design and twin analyses indicated that these associations might be causal. Knowledge of these vulnerabilities may be important when designing risk assessment and prevention strategies.
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| 29. |
- Vadlin, Sofia, 1973-
(author)
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Problematic Gaming and Gambling among Adolescents
- 2016
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Doctoral thesis (other academic/artistic)abstract
- The overall aims of this thesis were to develop and evaluate a screening instrument designed to detect gaming addiction symptoms in adolescents, to study associations between problematic gaming and psychiatric symptoms, to investigate the stability of problematic gaming, and to examine possible associations between gaming at baseline (W1) with problem gambling three years later (W2).The study population consisted of adolescents from the Survey of Adolescent Life in Västmanland SALVe Cohort (adolescents in Västmanland born in 1997 and 1999, and their parents), in two waves (2012, n = 1887; 2015, n = 1576), and adolescents from child and adolescent psychiatric clinics in Västmanland (2014, n = 242).The development of the Gaming Addiction Identification Test (GAIT) was based upon the research literature on gaming, gambling, and addiction. An expert panel estimated the content validity of the GAIT and found it to be excellent. Additional psychometric evaluations of the GAIT and the parent version, GAIT-P, were conducted and it was found that both versions showed promising psychometric results, with high internal consistency, high concurrent validity, high concordance, unidimensionality, and high factor loadings, although poor model fit in exploratory factor analysis. Self- and parent-rated prevalence of gaming addiction symptoms were estimated at 1.3% with the GAIT and 2.4% with the GAIT-P in 13- and 15-year-olds.Self-rated problematic gaming above the cutoff had a boy to girl ratio of approximately 5:1 in both the SALVe Cohort and the clinical sample, whereas more girls than boys reported symptoms above the cutoff for ADHD, depression, anxiety, and psychotic-like-experiences. ADHD, depression, and anxiety symptoms were associated with odds ratios of 2.43, 2.47, and 2.06, respectively, in relation to coexisting problematic gaming. Furthermore, problematic gaming was stable over time, and problematic gaming at the first wave was associated with problem gambling three years later.It is important to screen for possible co-occurring symptoms among those who seek treatment and among those who appear to have symptoms of gaming, gambling, or psychiatric symptoms. Ongoing evaluation of adequate screening and diagnostic measurements, and the development and evaluation of treatments for problematic gaming, gaming addiction, and comorbid conditions are needed.
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