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- Hiltunen, Linda, 1979-, et al.
(author)
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Risky drinking cultures among affluent youth in Sweden
- 2022
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In: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 10
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Journal article (peer-reviewed)abstract
- There is a growing scientific interest in drinking behavior among young people in affluent areas, who report higher levels of alcohol consumption compared to youth in less privileged areas. This phenomenon has been observed in several Western countries. The research has been dominated by variable-oriented analyses and has presented interesting explanations, but there has been little research into these young people's own experiences of and attitudes toward alcohol consumption. To develop interventions targeting this group, we need to understand their lifeworld. This study aims to develop an in-depth understanding of the high alcohol consumption among young people in affluent areas and how they themselves experience it. In the spring of 2019, we conducted 20 in-depth interviews with adolescents in upper secondary school (aged 15–19) in one of the most affluent area in Sweden. The empirical material was analyzed thematically. Theoretically, the phenomenon is understood by relating to social identity processes and considering the group's material, social and cultural means through Bourdieu's metaphors of capital. We found that affluent youth link their social identities to alcohol consumption. Alcohol is a social beverage that opens social networks and contributes to a sense of community. The consumption of alcohol gives experience capital leading to status in this context, with clear norms and expectations governing alcohol consumption. Parties are arranged in protected spaces where young people are free to drink out of the adults' sight. Affluent youths also have considerable purchasing power which contributes to drinking, and they are socialized into a pre-existing adult alcohol culture characterized by a liberal view on alcohol. Finally, when alcohol consumption escalates, the youths perceive that it is difficult to get adequate help from the adult world. The findings are important for future preventive interventions for subgroups of adolescents at high risk for heavy drinking.
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| 2. |
- Kvillemo, Pia
(author)
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Coping and stress management training with special focus on women with breast cancer
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Background: People diagnosed with cancer are confronted with many stressors, such as worries about diagnosis and prognosis, demanding treatments, treatment decisions, and disruption of ordinary life functions and roles. Compared to other types of cancer, breast cancer affects relatively young women, half of them of working ages. Knowledge of effective strategies to cope with breast cancer, as well as development of interventions strengthening stress management skills among women with breast cancer, are important in order to decrease individual suffering and facilitate the transition back into everyday life, including work. Aims: The general aim of this thesis was to generate more knowledge regarding psychological and social aspects of being diagnosed with breast cancer. More specifically, the aims were to examine sickness absence and disability pension after diagnosis, how different ways of coping with breast cancer are linked to health outcomes, and ways to promote mental health after diagnosis. Methods: Study I: All 3547 women in Sweden aged 20-65 with a first breast cancer diagnosis in 2005 and a matched comparison group were followed by register linkage regarding annual levels of diagnosis-specific sickness absence and disability pension through 2010. Associations with disease-related and sociodemographic factors were estimated using logistic regression. Study II: 78 studies were included in a meta-analysis ofassociations between different strategies to cope with a breast cancer diagnosis and health outcomes. The influence ofpotential moderators was also studied. Study III: People with cancer (76% with breast cancer) were randomized to a mindfulness-based stress management training program (n=32) or a wait-list control condition (n=39). Effects on psychological processes and mental health outcomes after six months were analyzed. Study IV: University students participating in a feasibility study of an Internetbased version of the mindfulness-based stress management training program were randomized to the intervention (n=46) or an active control condition (n=44). Completion rate, participant experiences, and post-intervention effects on mental health were assessed. Results: Study I: Sickness absence, mainly due to breast cancer, increased markedly in the first year after breast cancer diagnosis, however, it approached the levels of breast cancer-free women five years later. Pre-diagnosis sickness absence and advanced cancer stage were associated with higher risk of sickness absence and disability pension, as were lower education and being born outside of Sweden. Study II: Adaptive coping, such as acceptance and positive reappraisal, was associated with better mental health in women with breast cancer. These associations were strongest among individuals under current treatment and women assessed soon after diagnosis. Study III: No significant effect of the mindfulness-based stress management training program on mental health outcomes was found at the six-month follow-up. However, a positive effect on self-reported mindfulness was observed. Study IV: The Internet-based mindfulness-based stress management training program was experienced as usable and acceptable and had potential for increasing psychological well-being for those completing it. However, only 39% of the participants completed the program. Conclusions: Among women diagnosed with breast cancer, levels of sickness absence were back to the same levels as before diagnosis in a few years. Adaptive coping was associated with better mental health among women with breast cancer, especially during treatment and in newly diagnosed women. Despite increase in mindfulness at six-month follow-up after a mindfulness-based stress management training program, no statistically significant improvement in mental health was found. More knowledge is needed on the underlying mechanisms and moderating factors for achieving long-term benefits ofthis kind oftraining. The Internet could be a promising way to disseminate programs and tools facilitating mindfulness training, but if retention and compliance is important, additional modification of the assessed Internet-based mindfulness-based stress management training program is needed.
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| 3. |
- 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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| 4. |
- Kvillemo, Pia, et al.
(author)
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How to prevent alcohol and illicit drug use among students in affluent areas : a qualitative study on motivation and attitudes towards prevention
- 2021
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In: Substance Abuse Treatment, Prevention, and Policy. - : BioMed Central. - 1747-597X. ; 16
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Journal article (peer-reviewed)abstract
- Background: The use of alcohol and illicit drugs during adolescence can lead to serious short- and long-term health related consequences. Despite a global trend of decreased substance use, in particular alcohol, among adolescents, evidence suggests excessive use of substances by young people in socioeconomically affluent areas. To prevent substance use-related harm, we need in-depth knowledge about the reasons for substance use in this group and how they perceive various prevention interventions. The aim of the current study was to explore motives for using or abstaining from using substances among students in affluent areas as well as their attitudes to, and suggestions for, substance use prevention. Methods: Twenty high school students (age 15-19 years) in a Swedish affluent municipality were recruited through purposive sampling to take part in semi-structured interviews. Qualitative content analysis of transcribed interviews was performed. Results: The most prominent motive for substance use appears to be a desire to feel a part of the social milieu and to have high social status within the peer group. Motives for abstaining included academic ambitions, activities requiring sobriety and parental influence. Students reported universal information-based prevention to be irrelevant and hesitation to use selective prevention interventions due to fear of being reported to authorities. Suggested universal prevention concerned reliable information from credible sources, stricter substance control measures for those providing substances, parental involvement, and social leisure activities without substance use. Suggested selective prevention included guaranteed confidentiality and non-judging encounters when seeking help. Conclusions: Future research on substance use prevention targeting students in affluent areas should take into account the social milieu and with advantage pay attention to students' suggestions on credible prevention information, stricter control measures for substance providers, parental involvement, substance-free leisure, and confidential ways to seek help with a non-judging approach from adults.
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| 5. |
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| 6. |
- Wall, Håkan, et al.
(author)
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Effectiveness of a Web-Based Individual Coping and Alcohol Intervention Program for Children of Parents With Alcohol Use Problems : Randomized Controlled Trial
- 2024
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In: Journal of Medical Internet Research. - 1438-8871. ; 26:1
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Journal article (peer-reviewed)abstract
- Background: Children whose parents have alcohol use problems are at an increased risk of several negative consequences, such as poor school performance, an earlier onset of substance use, and poor mental health. Many would benefit from support programs, but the figures reveal that only a small proportion is reached by existing support. Digital interventions can provide readily accessible support and potentially reach a large number of children. Research on digital interventions aimed at this target group is scarce. We have developed a novel digital therapist-assisted self-management intervention targeting adolescents whose parents had alcohol use problems. This program aims to strengthen coping behaviors, improve mental health, and decrease alcohol consumption in adolescents. Objective: This study aims to examine the effectiveness of a novel web-based therapist-assisted self-management intervention for adolescents whose parents have alcohol use problems. Methods: Participants were recruited on the internet from social media and websites containing health-related information about adolescents. Possible participants were screened using the short version of the Children of Alcoholics Screening Test-6. Eligible participants were randomly allocated to either the intervention group (n=101) or the waitlist control group (n=103), and they were unblinded to the condition. The assessments, all self-assessed, consisted of a baseline and 2 follow-ups after 2 and 6 months. The primary outcome was the Coping With Parents Abuse Questionnaire (CPAQ), and secondary outcomes were the Center for Epidemiological Studies Depression Scale, Alcohol Use Disorders Identification Test (AUDIT-C), and Ladder of Life (LoL). Results: For the primary outcome, CPAQ, a small but inconclusive treatment effect was observed (Cohen d=–0.05 at both follow-up time points). The intervention group scored 38% and 46% lower than the control group on the continuous part of the AUDIT-C at the 2- and 6-month follow-up, respectively. All other between-group comparisons were inconclusive at either follow-up time point. Adherence was low, as only 24% (24/101) of the participants in the intervention group completed the intervention. Conclusions: The findings were inconclusive for the primary outcome but demonstrate that a digital therapist-assisted self-management intervention may contribute to a reduction in alcohol consumption. These results highlight the potential for digital interventions to reach a vulnerable, hard-to-reach group of adolescents but underscore the need to develop more engaging support interventions to increase adherence.
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