| 1. |
- af Klinteberg, Britt, et al.
(författare)
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Family psychosocial characteristics influencing criminal behaviour and mortality - possible mediating factors : a longitudinal study of male and female subjects in the Stockholm Birth Cohort
- 2011
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11, s. 756-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Family psychosocial characteristics in childhood have been associated with children's development into criminal behaviour and mortality. This study explored these possible relationships and examined alcohol and/or drug use and mental problems as possible mediating factors, highlighting gender-specific patterns. Methods: Data from Swedish subjects born in 1953 (n = 14,294) from the Stockholm Birth Cohort study were examined. Several indicators of adverse family factors and individual problems were included in the present study. The information was derived from various data sources, covering different periods. Gender-specific associations with incidence of criminality (1966-1980) and mortality (1981-2009) were analysed using logistic regression. Furthermore, the population attributable fraction (PAF) was calculated for all variables in the fully adjusted models which were positively related to the outcome. Results: Overall incidence of criminality and mortality was (m/f 32.3/6.6) and (m/f 6.1/3.5), respectively. The results showed that all aspects of family psychosocial and individual problems studied were associated with criminality for both genders. Among males, individual problems seemed to partly mediate these relations, but the associations remained statistically significant. Interestingly, the PAF analysis revealed a reduction in criminality of 17.5% when individual problems with alcohol and/or drug use were considered. Among females, a significant impact of alcohol and/or drug use on the association between family psychosocial characteristics and subsequent criminality was obtained. Inclusion of father's occupational class only somewhat reduced the estimates for the genders. Concerning male mortality, father's alcohol abuse was significantly related to an increased risk. When individual criminality was accounted for, the association was substantially reduced but remained statistically significant. Among females, when adjusting for family psychosocial factors, only the association between parents' mental problems and females' mortality was significant. None of the individual problem variables managed to explain this association. Conclusions: Family psychosocial characteristics were associated with both subsequent criminal behaviour and mortality. These connections were partly explained by individual risk factors, especially by alcohol and/or drug use. The practical implications of the findings point to the importance of addressing the individual's alcohol and/or drug use in reducing criminal behaviour, which would also lower the mortality rates.
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| 2. |
- Ahlqvist, Göran, et al.
(författare)
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The Sävsjö school project : A follow-up at the end of junior- and senior-high school of students that participated in a universal intervention at school start
- 2021
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Ingår i: International Journal of Educational Research Open. - elsevier : Elsevier BV. - 2666-3740. ; 2-2, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- A follow-up to the Sävajö school project, a universal intervention, from 1998 to 2002 is presented in this paper. The project was a cluster-randomised trial aimed at improving the literacy of beginners from the perspective of factors like achivements, mental health, school satisfaction, and reading capacity at the end of grade 3, while using an alternative curriculum. Half of all the six-year-olds (n = 92, of whom 48 attended single-age classes and 44 attended mixed-age ones) starting kindergarten were assigned to the intervention group. The comparison group (n = 85) followed the regular curriculum. The follow-ups after grades 9 and 12 show that the improvements observed after grade 3 persisted at the end of grade 9 in the experimental group attending single-age classes, but were not sustained for those who had atteded mixed-age classes. The students who had attended the experimental single-age classes were more likely to have completed their studies at the end of grade 12.
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| 3. |
- Arnberg, Filip K, 1981-, et al.
(författare)
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A longitudinal follow-up of posttraumatic stress : from 9 months to 20 years after a major road traffic accident
- 2011
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - London : BioMed Central. - 1753-2000. ; 5:8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although road traffic accidents (RTA) are a major cause of injury and a cause of posttraumatic stress (PTS) in the aftermath, little is known about the long-term psychological effects of RTA.Methods: This prospective longitudinal study assessed long-term PTS, grief, and general mental health after a bus carrying 23 sixth-grade schoolchildren crashed on a school outing and 12 children died. Directly affected (i.e., children in the crash) and indirectly affected children (i.e., all pupils in the sixth grade who were not in the crash) were surveyed at 9 months (N = 102), 4 years (N = 51), and 20 years (N = 40) after the event. Psychological distresswas assessed by single items, including sadness, avoidance, intrusions, and guilt. After 20 years, PTS was assessed by the Impact of Event Scale–Revised.Results: Stress reactions were prevalent 9 months after the event, with sadness (69%) and avoidance (59%) being highly represented in both directly and indirectly affected groups, whereas, nightmares (60%) and feelings of guilt (50%) were only frequent in those directly affected. The frequency of sadness and avoidance decreased after 4 years in the indirectly exposed (ps < .05). After 20 years, the directly affected had a higher prevalence of PTS (p = .003), but not decreased general mental health (p = .14), than those indirectly affected.Conclusions: The limitations preclude assertive conclusions. Nonetheless, the findings corroborate previous studies reporting traumatic events are associated with long-term PTS, but not with decreased general mental health.
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| 4. |
- Arnberg, Filip K, 1981-, et al.
(författare)
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Prospective longitudinal long-term studies 14-20 years after three disasters
- 2011
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Ingår i: European Journal of Psychotraumatology. ; , s. 72-72
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Konferensbidrag (refereegranskat)abstract
- Although clinical experience and past research have shown that posttraumatic stress (PTS) can last for decades after a disaster, long-term follow-ups are scarce and little is known about predictors of chronic PTS. In this presentation, long-term consequences of disasters will be described by a summary of the findings from three surveys of man-made/technological disasters with 2-4 assessments during the first 34-4 years and with a long-term assessment of PTSD and general mental health after 14-20 years (Ns = 33-57). Similarities and dissimilarities in the course of PTS between the disasters will be presented. The influence of traumatic bereavement, psychological or pharmacological treatment, and additional negative life events on long-term PTS will be discussed, and experiences form conducting long-term studies will be communicated.
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| 5. |
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| 6. |
- Brikell, Isabell, et al.
(författare)
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Relative Immaturity in Childhood and Attention-Deficit/Hyperactivity Disorder Symptoms From Childhood to Early Adulthood : Exploring Genetic and Environmental Overlap Across Development
- 2016
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Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier. - 0890-8567 .- 1527-5418. ; 55:10, s. 886-895
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Attention-deficit/hyperactivity disorder (ADHD) has been linked to immaturity relative to peers in childhood, yet it is unclear how such immaturity is associated with ADHD across development. This longitudinal twin study examined the genetic and environmental contributions to the association between parents' perception of their child's immaturity relative to peers (RI) in childhood and ADHD symptoms across development.Method: 1,302 twin pairs from the Swedish Twin Study of Child and Adolescent Development were followed prospectively from childhood to early adulthood. Parent ratings of RI were collected at 8 to 9 years and parent and self-ratings of ADHD symptoms were collected at 8 to 9, 13 to 14, 16 to 17, and 19 to 20 years using the Child Behavior Checklist Attention Problems scale. In addition, ADHD symptoms corresponding to DSM criteria were used for sensitivity analysis. Analyses were conducted using longitudinal structural equation modeling with multiple raters.Results: RI-related etiologic factors, predominantly influenced by genes, explained 10-14% of the variance in ADHD symptoms from 8 to 9 up to 16 to 17 years. The influence of these RI-related factors on ADHD symptoms attenuated to 4% by 19 to 20 years of age. The remaining variance in ADHD symptoms was primarily explained by genetic factors independent of RI, which remained relatively stable across development, explaining 19% to 30% of the variance in ADHD symptoms from 13 to 14 up to 19 to 20 years.Conclusion: The results show that RI is significantly associated with ADHD symptoms, particularly during childhood and adolescence, and that the association is primarily explained by a shared genetic liability. Nevertheless, the magnitude of associations across development was modest, highlighting that RI is merely one aspect contributing to the complex etiology of ADHD symptoms.
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| 7. |
- Daud, Atia, et al.
(författare)
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Resilience and vulnerability among refugee children of traumatized and non-traumatized parents
- 2008
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : Springer Science and Business Media LLC. - 1753-2000. ; 2:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of the study was to explore resilience among refugee children whose parents had been traumatized and were suffering from Post-Traumatic Stress Disorder (PTSD).Methods: The study comprised 80 refugee children (40 boys and 40 girls, age range 6–17 yrs), divided into two groups. The test group consisted of 40 refugee children whose parents had been tortured in Iraq before coming to Sweden. In accordance with DSM-IV criteria, these children were further divided in two sub-groups, those who were assessed as having PTSD-related symptoms (n = 31) and those who did not have PTSD-related symptoms (n = 9). The comparison group consisted of 40 children from Egypt, Syria and Morocco whose parents had not been tortured. Wechsler Intelligence Scale for Children, 3rd edn. (WISC-III), Diagnostic Interview for Children and Adolescents- Revised (DICA-R), Post-Traumatic Stress Symptoms checklist (PTSS), "I Think I am" (ITIA) and Strengths and Difficulties Questionnaire (SDQ) were used to assess IQ; PTSD-related symptoms; self-esteem; possible resilience and vulnerability.Results: Children without PTSD/PTSS in the traumatized parents group had more favorable values (ITIA and SDQ) with respect to total scores, emotionality, relation to family, peer relations and prosocial behavior than the children in the same group with PTSD/PTSS and these values were similar to those the children in the comparison group (the non-traumatized parents group). The children in the non-traumatized parents group scored significantly higher on the IQ test than the children with traumatized parents, both the children with PTSD-related symptoms and those without PTSD-related symptoms.Conclusion: Adequate emotional expression, supportive family relations, good peer relations, and prosociality constituted the main indicators of resilience. Further investigation is needed to explore the possible effects of these factors and the effects of IQ. The findings of this study are useful for treatment design in a holistic perspective, especially in planning the treatment for refugee children, adolescents and their families.
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| 8. |
- Daud, Atia, et al.
(författare)
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Trauma, PTSD and personality : the relationship between prolonged traumatisation and personality impairment
- 2008
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:3, s. 331-340
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Chronic post-traumatic stress disorder (PTSD) has been associated with personality impairments involving externalized and internalized psychopathology. This study has explored the association between PTSD symptoms as consequences of prolonged torture experiences or early childhood trauma exposure and personality traits.Method: One hundred and sixty-one men were included: 36 Iraqi men refugees (mean age = 43.9, SD = 8.7) who had longstanding torture experiences as adults; 42 Swedish prisoners (mean age = 33.8, SD = 7), with early childhood trauma exposure; 31 Arab men refugees (mean age = 41.8, SD = 8.9) without self-reported torture or violence experiences; 52 non-traumatized Swedish males (mean age = 39.3, SD = 5.5). They were assessed for symptoms of PTSD or PTSD hypothetical clusters. Personality profile was assessed by the Karolinska Scales of Personality (KSP). Factor analysis with varimax rotation was conducted and yielded three factors: externalized, internalized and avoidance domains.Results: Individuals who suffered prolonged torture experiences or had early childhood trauma exposure showed impaired personality profiles in internalized and externalized domains. Individuals with or without PTSD showed significant differences p < 0.05 concerning: internalized, externalized and avoidance. anova and post-hoc analysis according to Scheffé showed that the prolonged torture group > early childhood trauma exposure > nontraumatized group.Conclusion: Prolonged torture experiences or early trauma exposure may impair personality formation by enhancing the effects of cognitive, affective and behavioural vulnerabilities.
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| 9. |
- Eklund, Jenny M., 1974-
(författare)
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Adolescents at risk of persistent antisocial behaviour and alcohol problems : The role of behaviour, personality and biological factors
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Antisocial behaviour and alcohol problems are areas of great concern to society, not only associated with personal and emotional costs for the affected individuals and their victims, but also with major societal financial costs. What makes some individuals more likely than others to develop these kinds of problems? The general aim of this thesis was to explore the role of individual characteristics in the development of antisocial behaviour and alcohol problems. More specifically, the research focused on aspects of hyperactive behaviour, personality traits and biological vulnerability indicators in relation to self-reported norm breaking and violent behaviour, registered general criminality and violent offending in particular, and further, on risky alcohol use and drinking offences. The studies were based on both a prospective longitudinal project in which a group of adolescent male lawbreakers and controls were followed from the 1960s into the 1990s, and on more recently collected data on a representative group of Swedish male and female adolescents.The results of the thesis supported that neuropsychological deficits, manifested in attention difficulties, and personality traits reflecting disinhibition and negative emotionality, influence the development of antisocial behaviour and risky alcohol use, which in turn increases the risk of subsequent alcohol problems. The findings indicated, furthermore, that these neuropsychological deficits may be associated with an underlying biological vulnerability to various forms of disinhibitory psychopathology. Although the thesis focuses on individual characteristics, the results also support the view that environmental risk factors such as the influence of family and peers and possible stress experiences, play an important role. It was emphasized that individual characteristics continuously interact with environmental conditions in shaping each individual’s developmental course. Results also revealed that adolescent females displaying violent behaviour and engaging in potentially harmful use of alcohol deviated more in personality traits than did the corresponding group of males. Further knowledge of the development of these problems in females is crucial, since most theories in this area have been developed primarily on male samples.
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| 10. |
- Engqvist, Ulf, et al.
(författare)
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Child and adolescent psychiatric patients and later criminality
- 2007
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 7:147, s. 221-
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Tidskriftsartikel (refereegranskat)abstract
- Background Sweden has an extensive child and adolescent psychiatric (CAP) research tradition in which longitudinal methods are used to study juvenile delinquency. Up to the 1980s, results from descriptions and follow-ups of cohorts of CAP patients showed that children´s behavioural disturbances or disorders and school problems, together with dysfunctional family situations, were the main reasons for families, children, and youth to seek help from CAP units. Such factors were also related to registered criminality and registered alcohol and drug abuse in former CAP patients as adults. This study investigated the risk for patients treated 1975-1990 to be registered as criminals until the end of 2003. Methods A regional sample of 1,400 former CAP patients, whose treatment occurred between 1975 and 1990, was followed to 2003, using database-record links to the Register of Persons Convicted of Offences at the National Council for Crime Prevention (NCCP). Results Every third CAP patient treated between 1975 and 1990 (every second man and every fifth woman) had entered the Register of Persons Convicted of Offences during the observation period, which is a significantly higher rate than the general population. Conclusions Results were compared to published results for CAP patients who were treated between 1953 and 1955 and followed over 20 years. Compared to the group of CAP patients from the 1950s, the results indicate that the risk for boys to enter the register for criminality has doubled and for girls, the risk seems to have increased sevenfold. The reasons for this change are discussed. Although hypothetical and perhaps speculative this higher risk of later criminality may be the result of lack of social control due to (1) rising consumption of alcohol, (2) changes in organisation of child social welfare work, (3) the school system, and (4) CAP methods that were implemented since 1970.
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| 11. |
- Engqvist, Ulf, et al.
(författare)
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Hur går det för barn- och ungdomspsykiatrins patienter? : Samverkan krävs mellan pediatrik, barn- och vuxenpsykiatri
- 2000
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Ingår i: Läkartidningen. - 0023-7205. ; 97:23, s. 2856-2861
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Tidskriftsartikel (refereegranskat)abstract
- Under 1990-talet har både den vuxenpsykiatriska och den barn- och ungdomspsykiatriska vården varit föremål för statliga utredningar. Psykiatrireformen som avsåg den vuxenpsykiatriska verksamheten medförde bl.a. ett ökat primärkommunalt ansvar för psykiskt sjuka. När motsvarande utredning kring den barn- och ungdomspsykiatriska vården presenterades 1998, betonades både behovet av förbättrat samarbete mellan vuxen- och barn- och ungdomspsykiatri samt mellan den barn- och ungdomspsykiatriska vården och kommunernas socialtjänst. I en studie vid Östersunds sjukhus genomförd inom ramen för forskarutbildningen vid Karolinska Institutet i Stockholm har barnpsykiatriska patienter beskrivits med särskild hänsyn tagen till samarbetet både med vuxenpsykiatrin och socialtjänsten. Här presenteras data om 1 420 tidigare barn- och ungdomspsykiatriska patienter och deras framtida situation. Observationstiderna varierar mellan 5-20 år och intresset har fokuserats på BUP-patienternas framtida behov av vuxenpsykiatriska hjälpinsatser, deras självmordsrisk och kriminalitetsutveckling. Nästan 2 % har avlidit under observationstiden, huvudsakligen på grund av självmord. Fler än var fjärde patient har sökt kontakt med vuxenpsykiatrin, medan drygt var tredje har kommit i kontakt med kriminalvården. Emellertid utgör de tidigare BUP patienterna bara en mindre del (8 procent) av de aktuella åldersgrupperna inom vuxenpsykiatrin. Resultaten aktualiserar därför frågan om barnpsykiatrins samarbete med barnsjukvården. Kanske måste detta utvidgas än mer, om målet är att tidigt identifiera barn som utvecklar egna psykiatriska besvär och om effektiva preventiva åtgärder ska kunna utvecklas.
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| 12. |
- Engqvist, Ulf, 1951-, et al.
(författare)
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The occurrence and nature of early signs of schizophrenia and psychotic mood disorders among former child and adolescent psychiatric patients followed into adulthood
- 2008
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - England : BioMed Central Ltd. - 1753-2000. ; 2:1, s. 30-
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Tidskriftsartikel (refereegranskat)abstract
- Background This investigation was designed to characterize psychotic disorders among patients originally treated as in- and outpatients by child and adolescent psychiatric services and subsequently followed-up into mid-adulthood. The age at the first onset on symptoms, possible changes in diagnoses, early signs noted prior to or upon admission to child and adolescent psychiatric care and possible differences between patients with early- and later- onset disorder were of particular interest.MethodsThe study population consisted of patients (285 in- and 1115 outpatients) born between 1957 and 1976 and admitted to and treated by child and adolescent psychiatric care units in Jämtland County, Sweden, between 1975 and 1990. The status of their mental health was monitored until 2003 using official registries and hospital records. Diagnoses based on the ICD-8 and -9 systems, which were used in Sweden from 1968-1997, converted to diagnoses according to ICD-10, which has been in use since 1997. The Comprehensive Assessment of at Risk Mental States was employed to assess the information concerning psychopathology provided by the hospital records.ResultsBy the end of the follow-up period 62 former child and adolescent psychiatric patients (36 females and 26 males), 4.4% of the entire study group, had received an ICD-10 diagnosis of "F20-29: Schizophrenia, schizotypal and delusional disorders" (48) and/or "F30-39: Psychotic mood disorders" (14). One-third (21) of these individuals were given their initial diagnosis of psychosis in connection with child and adolescent psychiatric care. Two of these 21 were not treated later for this disorder in general (adult) psychiatric care whereas the remaining 19 individuals were diagnosed for the same type of disorder as adults. The other 41 patients were diagnosed as psychotic only in connection with general (adult) psychiatric care. The mean age at the time of first onset of symptoms was 21.4 years (SD 6.4) and corresponding median age was 18. Behavioural changes and positive symptoms were the most frequent signs associated with a diagnosis of "F20-F29: Schizophrenia, schizotypal and delusional disorders" made during child and adolescent psychiatric care. In cases where a specific psychopathology developed later on the initial admission to child and adolescent psychiatry involved unspecified psychopathology.ConclusionsIn summary, it appears that psychotic disorders are relatively uncommon among patients admitted to child and adolescent psychiatric care in Sweden. However, individuals experiencing early onset of disorders categorized as "F20-29: Schizophrenia, schizotypal and delusional disorders" may already exhibit typical symptoms upon admission to child and adolescent psychiatric care of the age of 13-17; whereas late-onset disorders it appear not be associated with any obvious signs or symptoms years before the disorder has developed fully. Finally, certain cases of psychotic disorder during adolescence seem to have been episodic.
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| 13. |
- Hagquist, Curt, 1952-, et al.
(författare)
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Psykisk ohälsa och alkohol har en nära koppling
- 2013
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Ingår i: Läkartidningen. - : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 110:36, s. 1547-1550
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Tidskriftsartikel (refereegranskat)abstract
- The association between adolescents' alcohol consumption and mental ill-health on an aggregate level is complex, including self-reported mental ill-health as well as suicide, deliberate self-harm and other psychiatric problems. The self-reported mental ill-health among 15-16-year-old girls in Sweden increased considerably from the middle of the 1980s to the middle of the 2000s, while the increase in alcohol consumption was substantially smaller. Among 15-16-year-old boys the alcohol consumption trend curve turned downwards following the turn of the millennium, while the mental ill-health trend levelled out after the end of the 1990s. The gender differences in alcohol consumption have, over time, evened out, while the differences in self-reported mental ill-health remain. The association between alcohol consumption and mental ill-health is, on an individual level, very strong. A high-risk group among adolescents, particularly among boys, are those who do not experience any life satisfaction and who also binge drink alcohol.
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| 14. |
- Ivert, Anna-Karin, et al.
(författare)
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Criminality among Former Child and Adolescent Psychiatric Patients and Matched Controls
- 2016
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Ingår i: Open Journal of Medical Psychology. - : Scientific Research Publishing. - 2165-9370 .- 2165-9389. ; :6, s. 16-30
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Tidskriftsartikel (refereegranskat)abstract
- Background: Externalizing symptoms in children (aggression, oppositionality, prop- erty and status violations), and the Attention Deficit Hyperactivity Disorder (ADHD) triad of problems (inattention, hyperactivity, impulsivity) display a substantial co- morbidity. The “short temper” problem is common to these syndromes, which are predictive of a range of negative life outcomes including substance abuse and crimi- nality in adulthood. There is a gender gap for the syndromes (boys are more af- fected), for criminality (men are more criminal) and knowledge (we know less about girls’ criminal careers). Aims: The main aim was to compare crime rates and crime profiles among former Child and Adolescent Psychiatric (CAP) patients with cor- responding data for matched controls, focusing externalizing and internalizing psy- chiatric symptoms, sex and adverse social factors. Method: Data for 6055 former CAP-Stockholm outpatients were extracted from available treatment registers. For each CAP patient, two matched controls from the general population were randomly selected from the same area of residence, of the same sex and with the same year of birth (N approx. 12,000). Data on criminality for these individuals were obtained from a Swedish police register which also includes crimes committed prior to age 15. Results: Overall, twice as many former CAP patients were registered for crimes at a mean age of 21.4 compared to the controls. The over-representation was larger for crimes of violence. Females were registered for a much lower number of crimes, par- ticularly crimes of violence (gender gap). The gender gap among the CAP patients was smaller than among controls. Compared with controls, CAP patients character- ized by externalizing problems at referral had an odds ratio (OR) for crimes of 5 for males and 10 for females. Neglect was the only adverse social factor which was asso- ciated with a higher crime rate and affected boys more than girls. Compared to pre- vious Swedish CAP cohorts, the criminality of the current cohort was much higher. Conclusion: In-depth studies of female crime careers characterized by externalising problems are needed. Child psychiatric services must find new and more effective ways of identifying and treating children with such problems, regardless of sex. The findings can guide the choice of strategies which will reduce crime rate.
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| 15. |
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| 16. |
- Ivert, Anna-Karin, et al.
(författare)
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Pathways to child and adolescent psychiatric clinics : a multilevel study of the significance of ethnicity and neighbourhood social characteristics on source of referral
- 2011
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background In the Swedish society, as in many other societies, many children and adolescents with mental health problems do not receive the help they need. As the Swedish society becomes increasingly multicultural, and as ethnic and economic residential segregation become more pronounced, this study utilises ethnicity and neighbourhood context to examine referral pathways to child and adolescent psychiatric (CAP) clinics. Methods The analysis examines four different sources of referrals: family referrals, social/legal agency referrals, school referrals and health/mental health referrals. The referrals of 2054 children aged 11-19 from the Stockholm Child-Psychiatric Database were studied using multilevel logistic regression analyses. Results Results indicate that ethnicity played an important role in how children and adolescents were referred to CAP-clinics. Family referrals were more common among children and adolescents with a Swedish background than among those with an immigrant background. Referrals by social/legal agencies were more common among children and adolescents with African and Asian backgrounds. Children with Asian or South American backgrounds were more likely to have been referred by schools or by the health/mental health care sector. A significant neighbourhood effect was found in relation to family referrals. Children and adolescents from neighbourhoods with low levels of socioeconomic deprivation were more likely to be referred to psychiatric child and youth clinics by their families in comparison to children from other neighbourhoods. Such differences were not found in relation in relation to the other sources of referral. Conclusions This article reports findings that can be an important first step toward increasing knowledge on reasons behind differential referral rates and uptake of psychiatric care in an ethnically diverse Swedish sample. These findings have implications for the design and evaluation of community mental health outreach programs and should be considered when developing measures and strategies intended to reach and help children with mental health problems. This might involve providing information about the availability and accessibility of health care for children and adolescents with mental health problems to families in certain neighbourhoods and with different ethnic backgrounds.
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| 17. |
- Johansson, Barbro, 1957-
(författare)
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Tonårsflickor berättar om att vara eller inte vara i behov av särskilt stöd : En longitudinell fallstudie
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to describe teenage girls’ experiences and perceptions of participation and influence during learning processes. The UN Convention on the Rights of the Child and the view that children are social actors with their own agency were central to the study. The girls, who were 13 years old when the study began, and 16 when it ended, were interviewed once per semester for three years. Classroom observations formed the basis of the interviews, which provided insight into the learning environment and its working methods. These, in turn, were discussed during the interviews. Nine girls were selected through the IEPs that the school had established for them. They attended regular classes for most of the school day, but received at least one session of special education in smaller groups each week. Their special needs were due to reading and writing difficulties. All of them received special support in English, while seven of the girls also received special support in mathematics. The girls described current events in their life, regarding both school and their spare time, as well as their thoughts about the future, and how efforts to accommodate their special educational needs have affected their schooling. In addition to the girls’ narratives, the IEPs and grades provided the school’s narrative about the girls. The theoretical basis of the thesis comprises cultural-historical ideas of teaching and learning, and the importance of relationships to group-based learning. Descriptive qualitative analyses were based on the teenage girls’ narratives and resulted in five themes; a sixth theme discussed the school’s assessment of the girls through the IEPs and their grades from lower secondary school. Feeling included or not in the group was the overarching theme of all the stories, which involved the girls’ perceptions of how they were treated by the people around them. The results indicate that the girls needed to have instructions repeated to them. There was also a need for continuous encouragement and affirmation in order for them to dare to take on assignments. When it came to collaborative learning together with classmates, the girls preferred to hide their perceived weaknesses, which only made them more dependent on the teacher’s aid. In addition, the girls felt that the teachers were unhappy with the way they handled their school work, and felt overlooked rather than “seen”. In both the stories and the IEPs, concentration difficulties were highlighted as a consistent problem. The analyses show that it is not possible to speak of concentration difficulties without further specification. Since the girls also explained that they were able to maintain concentration, it is necessary to identify which conditions allow pupils to maintain their skills, and when these skills are lost. One finding was that experiences of playing sports created unexpected development opportunities for performing under pressure, even in test situations. According to the girls, visual strengths could compensate for difficulties remembering comprehensive information. The teaching provided opportunities to demonstrate an understanding of facts through visual expression, but creative elements were not included in graded assessments. The study shows that the girls’ leisure-time experiences created opportunities for generalisation regarding learning strategies in school situations.
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| 18. |
- Nisell, Margret, et al.
(författare)
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How a family is affected when a child is born with anorectal malformation : Interviews with three patients and their parents
- 2003
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Ingår i: Journal of Pediatric Nursing. - 0882-5963 .- 1532-8449. ; 18:6, s. 423-432
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Tidskriftsartikel (refereegranskat)abstract
- Increased knowledge about families with a malformed child affects nursing practice. This study illuminates the experiences and psychosocial situation of 3 patients with imperforate anus and their parents. A qualitative method has been used to analyze the data. We found that the parents’ experiences of suffering were overwhelming and that the 3 patients had been depressed during periods. The patients were not as open as their parents; we need to devise better tools to explore and understand children’s experiences. The children and their parents need special care and an opportunity to express their anxieties.
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| 19. |
- Nisell, Margret, et al.
(författare)
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Psychosocial Experiences of Parents of a Child With Imperforate Anus
- 2009
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Ingår i: Journal for Specialists in Pediatric Nursing. - Oxford : Wiley-Blackwell. - 1539-0136 .- 1744-6155. ; 14:4, s. 221-229
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE. This study aims to examine the psychosocial experiences of parents of children with imperforate anus (IA) and to describe their potential positive experiences.DESIGN AND METHODS. Parents of IA children and a comparison group answered a questionnaire, which was analyzed quantitatively and with manifest content analysis.RESULTS. Social relationships and respect for the child's will were more affected among IA mothers. Positive experiences were revealed in relation to the child, the parent, and the family.PRACTICE IMPLICATIONS. Support to parents in caring for a child with IA should be individualized and occasionally undertaken through collaboration with experts from child and adolescent psychiatry.
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| 20. |
- Nisell, Margret, et al.
(författare)
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Social Issues Among Children With High or Intermediate Imperforate Anus : A Proxy Perspective
- 2009
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Ingår i: Journal of Child and Adolescent Psychiatric Nursing. - Oxford : Wiley-Blackwell. - 1073-6077 .- 1744-6171. ; 22:3, s. 132-142
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Tidskriftsartikel (refereegranskat)abstract
- PROBLEM: Children with imperforate anus (IA) may be psychosocially affected.METHODS: Parents of children with IA and parents in two comparison groups rated their children using a study-specific questionnaire and the Competence Scales in the Child Behavior Checklist (CBCL). Teachers rated Academic and Adaptive Functioning Scales in the Teacher's Report Form (TRF).FINDINGS: School items were rated favorably by the fathers of children with IA, and mothers reported less expression of their children's will. Children with IA were socially competent according to CBCL, although they received lower ratings on the TRF.CONCLUSIONS: Psychosocial issues seem to be challenging for children with IA, and this needs attention in care management.
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| 21. |
- Nisell, Margret, et al.
(författare)
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The Imperforate Anus Psychosocial Questionnaire (IAPSQ) : its construction and psychometric properties.
- 2009
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - London : Springer Science and Business Media LLC. - 1753-2000. ; 3:1, s. article number: 15-
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Tidskriftsartikel (refereegranskat)abstract
- The origin of the present study was to develop the liaison work between the disciplines of child and adolescent psychiatry and paediatric surgery and nursing, so as to improve the quality of treatment and care of a group of children with imperforate anus (IA) and their families. Imperforate anus is a congenital disease involving a deformity of the anorectum. The early surgery and invasive follow-up treatment associated with IA may affect the child psychosocially, including the child-parent relationship. By developing and testing a questionnaire for children born with anorectal anomalies, a tool for measuring psychosocial functioning can be realized. METHODS: First, a literature review on "Imperforate Anus" was performed. Second, an exploratory interview study was conducted with patients/adolescents with IA and their parents. The findings from these interviews were the foundation for construction of the questionnaire. The Imperforate Anus Psychosocial Questionnaire (IAPSQ) was tested and revised three times before its completion. It contains 45 items on Likert scales. A total of 87 children completed the IAPSQ: 25 children with IA and two comparison groups. Face and content validity were considered. The Rasch approach, an item response theory model, was used to evaluate the psychometric properties of the IAPSQ, where item difficulty and person ability are concurrently approximated. RESULTS: The findings of the Rasch analysis revealed that the psychological dimension was reasonable, and that person reliability (0.83) was moderate and item reliability (0.95) was sufficient. The social dimension showed satisfactory item reliability (0.87). The person reliability (0.52) of the social dimension was weak. Content validity seemed to be established and construct validity was recognized on the psychological dimension. CONCLUSION: The IAPSQ provides a reasonably valid and reliable measure of psychosocial functioning for clinical use among children with IA, although some revisions are suggested for the next version of the IAPSQ. By using the Rasch model, we discovered that specific items should be discarded and other items should be reformulated to make the questionnaire more "on target". The social dimension has to be expanded with further items to reasonably capture a social dimension.
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| 22. |
- Nisell, Margret, et al.
(författare)
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Views on Psychosocial Functioning : Responses from Children with Imperforate Anus and Their Parents
- 2008
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Ingår i: Journal of Pediatric Health Care. - : Elsevier. - 0891-5245 .- 1532-656X. ; 22:3, s. 166-174
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionHigh and intermediate imperforate anus (IA) is a congenital malformation that may entail psychosocial consequences. The objective was to examine disagreement on psychosocial functioning in reports between children with high and intermediate IA and their mothers.MethodTwenty-five children with IA and their mothers participated, including two groups for comparison. The responses on 15 psychosocial variables were compared on pair-level, between the mothers and their child, within each group.ResultsStatistically significant differences were found on the psychological variables in all groups, for example, feelings of sadness. For responses related to the social variables, few statistical discrepancies were found, except for the items “bullied” and “teased.” Two specific discrepancies emerged in responses from children with IA and their mothers, the child's self-confidence and the mothers' thinking about their child's disability.DiscussionIt is vital to gather information from both the child and the parents in order to obtain a complete assessment of the child. The course of disagreement can give valuable information for future care, including where to exert extra effort.
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| 23. |
- Olsson, Gunilla Maria, et al.
(författare)
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The Adolescent Adjustment Profile (AAP) in comparisons of patients with obesity, phenylketonuria or neurobehavioural disorders
- 2008
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 62:1, s. 66-76
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Tidskriftsartikel (refereegranskat)abstract
- Psychosocial development in children with chronic disease is a key issue in paediatrics. This study investigated whether psychosocial adjustment could be reliably assessed with the 42-item Adolescent Adjustment Profile (AAP) instrument. The study mainly focused on adjustment-to-obesity measurement, although it compared three patient groups with chronic conditions. All phenylketonuria (PKU) patients in Sweden between ages 9 and 18 and their parents and teachers were invited to participate. Patients with neurobehavioural syndromes and obesity were age- and gender-matched with PKU patients. Healthy children constituted a reference group. Psychosocial adjustment was measured using the AAP, which is a multi-informant questionnaire that contains four domains. Information concerning parents' socio-economic and civil status was requested separately. Respondents to the three questionnaires judged the PKU patients to be normal in all four domains. Patients with neurobehavioural syndromes demonstrated less competence and the most problems compared with the other three groups. According to the self-rating, the parent rating and the teacher rating questionnaires, obese patients had internalizing problems. The parent rating and the teacher rating questionnaire scored obese patients as having a lower work capacity than the reference group. Compared with the reference group, not only families with obese children but also families with children with neurobehavioural syndromes had significantly higher divorce rates. Obese patients were also investigated with the Strength and Difficulties Questionnaire (SDQ), another instrument that enables comparison between two measures of adjustment. The AAP had good psychometric properties; it was judged a useful instrument in research on adolescents with chronic diseases.
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| 24. |
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| 25. |
- Salomonsson, Björn, et al.
(författare)
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Psykoanalytisk behandling vid störningar i mor–barnrelationen
- 2011
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Ingår i: Läkartidningen. - Stockholm : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 108:18, s. 984-987
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Tidskriftsartikel (refereegranskat)abstract
- I en studie som jämför resultaten av sedvanlig BVC-behandling med en kortare psykoanalytisk mor–spädbarnsbehandling har vi undersökt 80 mammor med spädbarn, där inklusionskriterierna var att mamman upplevde problem i fråga om barnets funktion, sitt eget psykiska tillstånd eller i kontakten med barnet. Behandlingen gav signifikanta effekter på självrapporterad depression, intervjuarbedömd mor–barnrelation och hos mamman i hennes samspel med barnet. Nästan signifikanta effekter erhölls på självrapporterad stress. Kvalitativa bedömningar gjorda före behandlingarna indikerade att analysbehandlingen mest tycktes hjälpa de mammor som anade sin roll i problemen, liksom de barn som var kliniskt påverkade av relationsproblemen. Resultaten publiceras i Infant Mental Health Journal våren 2011.
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| 26. |
- Törnblom, Annelie Werbart, et al.
(författare)
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Shame Behind the Masks : The Parents' Perspective on Their Sons' Suicide
- 2013
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Ingår i: Archives of Suicide Research. - : Informa UK Limited. - 1381-1118 .- 1543-6136. ; 17:3, s. 242-261
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Tidskriftsartikel (refereegranskat)abstract
- Suicides are more frequent among boys than girls. A tentative, conceptual model of processes behind suicide among boys and young men (aged 12-25), grounded in their parents' views, is presented. Extensive interviews with parents in 33 cases of suicide were analyzed using grounded-theory methodology. Family alliances, coalitions, and secrets interacted with the boy concealing problems and hiding behind a mask, while the professionals did not understand the emergency. Four interwoven paths to suicide were found: the boy was hunted and haunted, addicted, depressed, or psychotic. Different forms of shame were hidden behind the masks of the clown, the warrior, and the prince. Future preventive programs need to address barriers to communication among all parties involved.
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| 27. |
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| 28. |
- Van Geelen, Stefan, et al.
(författare)
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Somatic symptoms and psychological concerns in a general adolescent population: Exploring the relevance of DSM-5 Somatic Symptom Disorder
- 2015
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Ingår i: Journal of Psychosomatic Research. - : Pergamon/Elsevier. - 0022-3999 .- 1879-1360. ; 79:4, s. 251-258
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Tidskriftsartikel (refereegranskat)abstract
- Objective: DSM-5 somatic symptom disorder (SSD) constitutes a major change for psychosomaticmedicine and psychiatry, as well as for epidemiological research in these fields. This studyinvestigates somatic symptoms and psychological concerns among adolescents in order tosystematically explore the relevance of SSD for general adolescent populations.Methods: A crosssectionalpopulation-based design, with a symptoms-based strategy and a symptom-andpsychological-concerns-based strategy, was used to estimate the prevalence of somatic symptomsand psychological concerns in a general adolescent population (n=2476, mean age=16 years, 49%boys, 51% girls). Somatic symptoms and psychological concerns in relation to gender, and selfreportedmedical and psychiatric conditions were investigated. The association between somaticsymptoms, psychological concerns, and functional impairment in school-, family-, peer- and physicalactivities was studied.Results: Reporting 3+ persistent distressing somatic symptoms wassignificantly more common than reporting one or more persistent distressing somatic symptom(s)combined with serious psychological concern. The prevalence of such complaints was significantlyhigher in girls. The proportion of medical and psychiatric conditions was highest in the groupreporting 3+ persistent distressing somatic symptoms combined with serious psychological concern.Belonging to this group most significantly increased odds ratios for functional impairment.Conclusion: For large-scale studies on SSD, results suggest the use of measures based on multiplesomatic items in combination with psychological concerns, and a methodologically soundstandardized measure of functional impairment. To further enhance clinical decision-making, therelation of symptoms to functional impairment, and the substantial overlap of SSD with medical andpsychiatric conditions during adolescence should be addressed.
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| 29. |
- Wennberg, Peter, 1973-
(författare)
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Studies on alcohol habits : development and problems in a birth cohort of Swedish males
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This work addresses several aspects of alcohol habits and problems in a male birth cohort. The studies focus on the prevalence of problematic alcohol use, different drinking patterns and the longitudinal development towards problematic alcohol use. The analysis concerns the male half (n=122) of a longitudinal study of individuals born between 1955-58 and prospectively followed from birth to young middle age. The results can be summarized as follows. 1) A high proportion of the participants presented an alcohol problem both according to a broad operational definition (approximately 22 percent) and according to a tentative DSM-III classification of abuse or dependence (approximately 11 percent). 2) There was a positive but modest association between consumption habits in adolescence and young middle age. The continuity in consumption could be attributed to subjects who retained their binge drinking practices from adolescence until young middle age; the explanatory value of drinking habits in adolescence and early adulthood could be further enhanced by including the consideration of drinking patterns and by focusing on data from more than two points in time. 3) A temperament profile including extraversion at age 4 was positively correlated with alcohol consumption and alcohol problems as an adult, indicating that one pathway towards problematic alcohol use may have a very early onset. Further, psychosocial characteristics at age 10 could to some extent differentiate between future alcohol use pathways. The results are compared with other prevalence studies and discussed in relations to existing typologies and developmental theories.
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| 30. |
- Werbart Törnblom, Annelie, et al.
(författare)
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Shame and Gender Differences in Paths to Youth Suicide : Parents' Perspective
- 2015
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Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 25:8, s. 1099-1116
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Tidskriftsartikel (refereegranskat)abstract
- Risk factors, suicidal behavior, and help-seeking patterns differ between young women and men. We constructed a generic conceptual model of the processes underlying youth suicide, grounded in 78 interviews with parents in 52 consecutive cases of suicide (19 women, 33 men) identified at forensic medical autopsy and compared by sex. We found different forms of shame hidden behind gender-specific masks, as well as gender differences in their paths to suicide. Several interacting factors formed negative feedback loops. Finding no way out, the young persons looked for an emergency exit. Signs and preparations could be observed at different times but recognized only in retrospect. Typically, the young persons and their parents asked for professional help but did not receive the help they needed. We discuss parents' experiences from the theoretical perspective on gender identity and developmental breakdown. Giving voice to the parents' tacit knowledge can contribute to better prevention and treatment.
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| 31. |
- Westling Allodi, Mara, et al.
(författare)
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The needs of gifted children : A pilot study of teachers' knowledge and attitudes
- 2008
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Konferensbidrag (populärvet., debatt m.m.)abstract
- Gifted children risk to experience a mismatch between their needs and the characteristics of their learning environment: they can meet too low learning demands, peers with different interests, teachers with ambivalent attitudes that may be unwilling to adapt the learning environment to their needs. There are indications that such problematic interactions not uncommon within the regular educational setting in some specific cultural contexts can become a risk for gifted children's mental health, leading eventually to higher rates of anxiety and depression than for a normal population. This study investigated the attitudes of special-educators-in-training in a Swedish educational context, where the theme of giftedness is presently not included in teachers' training or in the official guidelines.A pilot study using an anonymous web survey among experienced Swedish teachers attending a special-needs programme was conducted to elicit their overall knowledge of and attitudes towards gifted children. Of 243 teachers asked to participate, 81 answered the web questionnaire. The questionnaire’s six scales were: Needs and support for special services, Objections to resistance, Social value, Rejection, Ability grouping and School acceleration.The non-response rate of 67% indicates low interest in this area. However, over 80% of the responders believed that the needs of gifted children were being ignored at school. While mean scores on the scales Social values, Rejection and School acceleration were low, those for Needs and support and Objections to resistance were rather high, showing that responders acknowledged the needs of gifted children and were able to resist stereotyped views. The results indicate a need for more information about gifted children and for discussion, in teacher and special-needs programmes, of educational policies for gifted students.
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| 32. |
- Öjmyr-Joelsson, Maria, et al.
(författare)
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A Gender Perspective on the Extent to which Mothers and Fathers Each Take Responsibility for Care of a Child with High and Intermediate Imperforate Anus
- 2009
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Ingår i: Journal of Pediatric Nursing. - : Elsevier. - 0882-5963 .- 1532-8449. ; 24:3, s. 207-215
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Tidskriftsartikel (refereegranskat)abstract
- Imperforate anus is a malformation of the child's anus. Parents' experiences of responsibility for care of the child may differ. The aim of this study was to evaluate a gender perspective on the extent to which mothers and fathers each take responsibility for the care of a child with high and intermediate imperforate anus. Parents of children with imperforate anus and two control groups of children and parents participated. Data collection with questionnaires focusing on responsibility was performed. In conclusion, our study revealed additional evidence of unevenly divided parental responsibility for care of a child with a chronic condition. The mothers in this study were shown to be the primary caregiver.
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| 33. |
- Öjmyr-Joelsson, Maria, et al.
(författare)
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Children with high and intermediate imperforate anus : their experiences of hospital care
- 2011
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Ingår i: Pediatric surgery international (Print). - : Springer Science and Business Media LLC. - 0179-0358 .- 1437-9813. ; 27:10, s. 1117-1122
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThe purpose of this study was to examine the experiences of children with high and intermediate imperforate anus (IA), and specifically their experiences of hospital care.MethodsTwenty-five children born with high and intermediate IA participated; 9 boys and 16 girls. The mean age was 10.5 years (range 8.0–13.6). Two control groups were involved in the study. A self-report questionnaire was used to gather the data concerning children’s experiences of hospital care. Items were scored on a 5-point Likert scale.ResultsThe children’s responses on hospital care items scored high. The children with IA reported being less satisfied with the information given, and understood less why they needed to visit the hospital than did the children in the two control groups.ConclusionThe children’s experiences of care seemed to be positive even though the children born with IA are subjected to invasive treatment. More research is called for in the unexplored area of information to the children, and particularly to the children born with a defect. Children’s views are important and should always be considered, as their answers most certainly reflect a genuine experience, contributing to the further development of their specific care.
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| 34. |
- Öjmyr-Joelsson, Maria, et al.
(författare)
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High and intermediate imperforate anus : psychosocial consequences among school-aged children
- 2006
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Ingår i: Journal of Pediatric Surgery. - : Elsevier. - 0022-3468 .- 1531-5037. ; 41:7, s. 1272-1278
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Tidskriftsartikel (refereegranskat)abstract
- Background/PurposeImperforate anus is an unusual malformation, which, even after surgical intervention, usually entails constipation and fecal incontinence. This study aimed to evaluate ongoing psychosocial effects of this birth defect in school-aged children.MethodsTwenty-five children born with high and intermediate imperforate anus participated in the study, along with their parents and classroom teachers. One group of healthy children and 1 group of children with juvenile chronic arthritis, along with their parents, served as controls. Children and parents individually answered a questionnaire devised for this study. Parents filled out the Child Behavior Checklist and the children's teacher filled out the Teacher's Report Form.ResultsAccording to test results, children with imperforate anus were happy and optimistic. They liked school better and reported better relationships with schoolmates than the other children. The index group reported statistically significantly more frequent constipation. According to parental responses, the imperforate-anus children suffered from fecal incontinence and odor, as well as constipation (P < .001). Index-group parents reported on the Child Behavior Checklist that their children had more emotional and behavioral problems. On the Teacher's Report Form, teachers reported few problems for the same children.ConclusionsPatients with imperforate anus did not experience psychosocial impairment despite significant functional problems.
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| 35. |
- Öjmyr-Joelsson, Maria, et al.
(författare)
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Parental Experiences : Care of Children With High and Intermediate Imperforate Anus
- 2006
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Ingår i: Clinical Nursing Research. - : Sage Publications. - 1054-7738 .- 1552-3799. ; 15:4, s. 290-305
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Tidskriftsartikel (refereegranskat)abstract
- In this study parental experiences of care of children with high and intermediate imperforate anus were evaluated. A group of 45 parents of children with high and intermediate imperforate anus and two control groups participated. Data collection with individual questionnaires concerning the child's hospital care, information to the parent and the child, and involvement in the care of the child were performed. Parents of children with imperforate anus reported being less satisfied with the care of their child, and they were less content with information about their child's treatment compared with the control groups. The parents had been extremely involved in the follow-up treatment. Constipation and fecal incontinence are common and involve suffering for the children and their parents. Parents have to be motivated and supportive and have a great deal of patience to be able to put up with caring for these children, and it seems as if health care professionals have underestimated their problems.
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