The number of stressful life events experienced as measured on the modified Swedish version of Co... more The number of stressful life events experienced as measured on the modified Swedish version of Coddington's questionnaire, and the presence of behaviour problems assessed by Achenbach's Child Behavior Check List (CBCL) were studied in 45 eight-year-old children of identified psychosocial risk-mothers. The mothers' social network was estimated using the Swedish version of Undén and Orth-Gomér's Interview Schedule for Social Interaction (ISSI). These mothers had been identified during early pregnancy. A control group of 57 children of the same age and their mothers without the presence of psychosocial risk-criteria was used as reference. The results indicated that the index children had experienced significantly more life events, and displayed significantly more behaviour problems than the reference children. The mothers in the index group had a significantly poorer social network than the mothers in the reference group. The study suggests that children of mothers, identified early on psychosocial risk criteria develop suboptimally. Therefore, early interventions are of great importance.
ABSTRACT Sixty-three children aged 7-18 years were interviewed individually 2 years after their P... more ABSTRACT Sixty-three children aged 7-18 years were interviewed individually 2 years after their Parents' divorce about their experiences of this event, and their feelings about it. Their residential parents were interviewed in parallel. The results indicated that thoughts about the divorce were more prevalent among the children than the parents realized. The boys and the younger children accepted the divorce to a lesser extent relative to what the parents thought. The children's knowledge about the divorce before the event and the extent to which the divorce had been discussed by the children and their parents crystallized to be of great importance for the children's ability to cope with and accept the divorce. Additional findings suggested that about one-third of the children wished for more frequent contact with their divorced parent. In conclusion, there was both a lack of information to the children and a lack in communication between children and parents about the divorce. It seems of importance to teach parents to discuss the divorce event repeatedly with their children.
In Europe, 10-20% of all women and 3-10% of all men have experienced sexual abuse before the age ... more In Europe, 10-20% of all women and 3-10% of all men have experienced sexual abuse before the age of 18, according to surveys. Psychosocial problems are often seen as both short- and long-term consequences of such abuse. Family dysfunction may be seen as both a risk factor for abuse and a result of the disclosure of abuse. The aim of this research was to study how adolescents and adults, sexually abused during their childhood, experienced their family life and family climate in their family of origin. A clinical sample of 18 adolescent girls and 20 adult women comprised the study group. The methods used were a semi-structured interview and the questionnaire Family Climate Test. The majority of the participants kept quiet about the abuse during their childhood. The abuse took place for an average of 2.5 years among the adolescents and 6 years in the adult group. Secrecy, isolation and family problems were typical attributes in the interviews. The majority of both adolescents and women described their relationships in the family of origin as deviant or interrupted, with a reversed (negative) pattern on the Family Climate Test. This meant a low level of closeness and a high level of distance in the families combined with a low level of spontaneity and a high level of chaos. The study, even if relatively small and based on clinical cases, gives support to earlier research, which shows that sexual abuse in general, but especially intra-familial sexual abuse, is associated with family dysfunction.
Journal of Reproductive and Infant Psychology, 2001
Mother-child interaction in a group of women with psychosocial risks, identified during pregnancy... more Mother-child interaction in a group of women with psychosocial risks, identified during pregnancy, was assessed at birth, when the infants were 6 months old, and again when they were 18 months old. Presence of behavioural disturbances in the children was assessed when they were 8 years of age. The at-risk index group was comprised of 45 mothers and their children,
The presence of behavioral disturbances and psychiatric symptoms (mental health); the reactions t... more The presence of behavioral disturbances and psychiatric symptoms (mental health); the reactions to the information about the divorce, and the self-image among 113 children were investigated 2-8 weeks after their parent's application for divorce. As a reference group for the mental health, 300 children from intact homes were used. No significant differences in behavioral disturbances/symptoms in total were found between the groups, between sexes, or between different age groups. However, 25% of the reported individual disturbances/symptoms had appeared or intensified at the time for the divorce, while 20% had disappeared or diminished. Strongest reactions to the information about the divorce were shown by children aged 7-13 years. The boys showed a more positive self-image compared to standardized norms. No significant diiference was found for the girls. In conclusion, the divorce per se did not seem to cause any shortterm mental health problems in the children.
Demographic variables, the reasons for the divorce, the changes as a consequence of the divorce a... more Demographic variables, the reasons for the divorce, the changes as a consequence of the divorce and the differences between the sexes were studied among 157 Swedish-speaking spouses through interviews and assessments on visual analogue scales. The results showed that various conflicts were the main reason for the divorce in half of the families. Compared to men, women came significantly more often from broken homes, were the initiators of the divorce in most cases, and felt that the marriage had been dissatisfying for a significantly longer time period. Self-employed men were significantly overrepresented. The changes as a consequence of the divorce were significantly different for men and women in several areas, in most cases in favour of the women.
Day schools have developed as an important psychoeducational resource in the Swedish school syste... more Day schools have developed as an important psychoeducational resource in the Swedish school system since the middle of the 1960's. Day schools provide a combination of special education and training in small groups, as well as supervised free time activities for pupils exhibiting very pronounced adjustment problems. In an earlier national study, 108 pupils in the first three grades were examined. The majority of the day school pupils exhibited symptoms and behavioural disturbances associated with poor prognosis. Their families exhibited a pattern usually associated with “at risk families”, which affects the development of children and their adjustment to society. In the follow-up study, four years later, 104 pupils (95 boys/9 girls) and their families were re-examined with semi-structured interviews. The study also included interviews with day school staff and teachers from the ordinary school. At the time of the follow-up, 88% of the pupils had been discharged to a regular school after spending an average of two years at the day school. The symptom interview showed that mental health had improved significantly, especially with regard to social and emotional out acting behaviour. Sixty percent were now symptom-free or had only mild symptoms. On the other hand, two thirds were still slow performers and in need of special education and the children were still more disturbed compared to normal children. The most common diagnoses, according to DSM-III-R, were oppositional defiant disorders (53%) and conduct disorders (21%). All diagnostic groups did improve, but the children with conduct disorders were the most disturbed on both occasions. The majority of the parents had a positive attitude towards the day school and wanted to recommend day school placement to other parents. The ability of the day schools to intervene early and treat (secondary prevention) children with adjustment disorders was found to be an important resource.
European child & adolescent psychiatry, Jan 30, 2015
Psychiatric disorders are multi-factorial and their symptoms overlap. Constitutional and environm... more Psychiatric disorders are multi-factorial and their symptoms overlap. Constitutional and environmental factors influence each other, and this contributes to risk and resilience in mental ill-health. We investigated functional genetic variation of stress responsiveness, assessed as FKBP5 genotype, in relation to early life adversity and mental health in two samples of adolescents. One population-based sample of 909 12-year-old adolescents was assessed using the Life Incidence of Traumatic Events scale and the Strengths and Difficulties Questionnaire. One sample of 398 17-year-old adolescents, enriched for poly-victimized individuals (USSS), was assessed using the Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children (TSCC). The FKBP5 rs1360780 and rs3800373 polymorphisms were genotyped using a fluorescence-based competitive allele-specific PCR. Most prominently among poly-victimized older male adolescents, the least common alleles of the polymorphisms, in...
European child & adolescent psychiatry, Jan 15, 2015
Sexual activity online may result in positive experiences for young people, or lead them to engag... more Sexual activity online may result in positive experiences for young people, or lead them to engage in risky behaviours possibly resulting in sexual assault or abuse. The aim of our study was to investigate associations between online sexual behaviours among Swedish youth and background factors as well as aspects of well-being. The behaviours investigated were: having sex online with a contact met online, having sex with an online contact offline, posting sexual pictures online, and selling sex online. We used data from a representative sample of 3,432 Swedish youth who were asked about their lifetime experiences as well as their experiences within the previous year. We hypothesized that more advanced online sexual behaviours were associated with more problematic background factors, worse psychosocial well-being and riskier behaviours in general. Bivariate relationships were evaluated followed by a multiple logistic regression model. Our data suggested that most Swedish youth do not ...
Child and adolescent psychiatry and mental health, 2014
This study has investigated the specific relationship between childhood adversities, individual t... more This study has investigated the specific relationship between childhood adversities, individual trauma symptoms and the functions of non-suicidal self-injury (NSSI). The aim was to examine whether different self-reported adverse experiences and trauma symptoms predict the need to engage in NSSI, either to regulate emotions or to communicate with and influence others. The participants were a community sample of 816 adolescents aged 15-17 years with NSSI. Hierarchical multiple regression was used, controlling for NSSI frequency and gender. The dependent variables were the automatic and social functions of NSSI, respectively. The predictors entered in the model were several different maltreatment and adversity experiences as well as individual trauma symptoms. Mediation analyses were also performed using the bootstrapping method with bias-corrected confidence estimates. Frequency of NSSI, gender (female), emotional abuse, prolonged illness or handicap during upbringing and symptoms of ...
Background: Rape is considered a stressful trauma and often with durable consequences. How the af... more Background: Rape is considered a stressful trauma and often with durable consequences. How the aftermath of rape is for young adolescents' girls considering acute stress is an overlooked field and remains to be studied. Aims: In this study, we wanted to investigate acute stress among adolescent victims of rape and the psychometric properties of the Acute Stress Checklist for Children (ASC-Kids). Methods: A clinical sample (n = 79) of raped girls, 13-17 years old who had turned to a special rape victim unit for treatment, answered the ASC-Kids. ASC-Kids was also given to a group of minor stressed, non-raped adolescents in the same age range (n = 154) together with the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index (UCLA PTSD RI), and the Sense of Coherence Scale 13 (SOC-13). Results: The scores from the groups were compared and showed significant differences in mean values on all the diagnostic criteria of acute stress disorder. In the clinical group, 36.7% obtained full ASD criteria. ASC-Kids could discriminate well between groups. Cronbach's alpha was found to be excellent, and the correlation between the UCLA PTSD RI and ASC-Kids found to be good; both ASC-Kids and UCLA PTSD RI had a good and moderate negative correlation with SOC-13. Conclusion: Adolescent female rape victims were shown to have a very high level of acute stress, and the ASC-Kids was found to have sound psychometrics and can be a valuable screening instrument to support clinicians in their assessments of an indication of adolescents after potentially stressful events such as rape.
To ensure health and well-being for their athletes, sports organizations must offer preventive me... more To ensure health and well-being for their athletes, sports organizations must offer preventive measures against sexual abuse. The aim of this study was to design and evaluate feasibility of a research protocol for cross-sectional epidemiological studies of sexual abuse in athletics. Examination of the requirements on the study of sexual abuse in athletics was followed by iterated drafting of protocol specifications and formative evaluations. The feasibility of the resulting protocol was evaluated in a national-level study among elite athletics athletes (n = 507) in Sweden. The definition of sexual abuse, the ethical soundness of the protocol, reference populations and study of co-morbidity, and the means for athlete-level data collection were identified as particularly complex issues in the requirements analyses. The web-based survey defined by the protocol facilitates anonymous athlete self-reporting of data on exposure to sexual abuse. 198 athletes (39%) fully completed the feasib...
The number of stressful life events experienced as measured on the modified Swedish version of Co... more The number of stressful life events experienced as measured on the modified Swedish version of Coddington's questionnaire, and the presence of behaviour problems assessed by Achenbach's Child Behavior Check List (CBCL) were studied in 45 eight-year-old children of identified psychosocial risk-mothers. The mothers' social network was estimated using the Swedish version of Undén and Orth-Gomér's Interview Schedule for Social Interaction (ISSI). These mothers had been identified during early pregnancy. A control group of 57 children of the same age and their mothers without the presence of psychosocial risk-criteria was used as reference. The results indicated that the index children had experienced significantly more life events, and displayed significantly more behaviour problems than the reference children. The mothers in the index group had a significantly poorer social network than the mothers in the reference group. The study suggests that children of mothers, identified early on psychosocial risk criteria develop suboptimally. Therefore, early interventions are of great importance.
ABSTRACT Sixty-three children aged 7-18 years were interviewed individually 2 years after their P... more ABSTRACT Sixty-three children aged 7-18 years were interviewed individually 2 years after their Parents' divorce about their experiences of this event, and their feelings about it. Their residential parents were interviewed in parallel. The results indicated that thoughts about the divorce were more prevalent among the children than the parents realized. The boys and the younger children accepted the divorce to a lesser extent relative to what the parents thought. The children's knowledge about the divorce before the event and the extent to which the divorce had been discussed by the children and their parents crystallized to be of great importance for the children's ability to cope with and accept the divorce. Additional findings suggested that about one-third of the children wished for more frequent contact with their divorced parent. In conclusion, there was both a lack of information to the children and a lack in communication between children and parents about the divorce. It seems of importance to teach parents to discuss the divorce event repeatedly with their children.
In Europe, 10-20% of all women and 3-10% of all men have experienced sexual abuse before the age ... more In Europe, 10-20% of all women and 3-10% of all men have experienced sexual abuse before the age of 18, according to surveys. Psychosocial problems are often seen as both short- and long-term consequences of such abuse. Family dysfunction may be seen as both a risk factor for abuse and a result of the disclosure of abuse. The aim of this research was to study how adolescents and adults, sexually abused during their childhood, experienced their family life and family climate in their family of origin. A clinical sample of 18 adolescent girls and 20 adult women comprised the study group. The methods used were a semi-structured interview and the questionnaire Family Climate Test. The majority of the participants kept quiet about the abuse during their childhood. The abuse took place for an average of 2.5 years among the adolescents and 6 years in the adult group. Secrecy, isolation and family problems were typical attributes in the interviews. The majority of both adolescents and women described their relationships in the family of origin as deviant or interrupted, with a reversed (negative) pattern on the Family Climate Test. This meant a low level of closeness and a high level of distance in the families combined with a low level of spontaneity and a high level of chaos. The study, even if relatively small and based on clinical cases, gives support to earlier research, which shows that sexual abuse in general, but especially intra-familial sexual abuse, is associated with family dysfunction.
Journal of Reproductive and Infant Psychology, 2001
Mother-child interaction in a group of women with psychosocial risks, identified during pregnancy... more Mother-child interaction in a group of women with psychosocial risks, identified during pregnancy, was assessed at birth, when the infants were 6 months old, and again when they were 18 months old. Presence of behavioural disturbances in the children was assessed when they were 8 years of age. The at-risk index group was comprised of 45 mothers and their children,
The presence of behavioral disturbances and psychiatric symptoms (mental health); the reactions t... more The presence of behavioral disturbances and psychiatric symptoms (mental health); the reactions to the information about the divorce, and the self-image among 113 children were investigated 2-8 weeks after their parent's application for divorce. As a reference group for the mental health, 300 children from intact homes were used. No significant differences in behavioral disturbances/symptoms in total were found between the groups, between sexes, or between different age groups. However, 25% of the reported individual disturbances/symptoms had appeared or intensified at the time for the divorce, while 20% had disappeared or diminished. Strongest reactions to the information about the divorce were shown by children aged 7-13 years. The boys showed a more positive self-image compared to standardized norms. No significant diiference was found for the girls. In conclusion, the divorce per se did not seem to cause any shortterm mental health problems in the children.
Demographic variables, the reasons for the divorce, the changes as a consequence of the divorce a... more Demographic variables, the reasons for the divorce, the changes as a consequence of the divorce and the differences between the sexes were studied among 157 Swedish-speaking spouses through interviews and assessments on visual analogue scales. The results showed that various conflicts were the main reason for the divorce in half of the families. Compared to men, women came significantly more often from broken homes, were the initiators of the divorce in most cases, and felt that the marriage had been dissatisfying for a significantly longer time period. Self-employed men were significantly overrepresented. The changes as a consequence of the divorce were significantly different for men and women in several areas, in most cases in favour of the women.
Day schools have developed as an important psychoeducational resource in the Swedish school syste... more Day schools have developed as an important psychoeducational resource in the Swedish school system since the middle of the 1960's. Day schools provide a combination of special education and training in small groups, as well as supervised free time activities for pupils exhibiting very pronounced adjustment problems. In an earlier national study, 108 pupils in the first three grades were examined. The majority of the day school pupils exhibited symptoms and behavioural disturbances associated with poor prognosis. Their families exhibited a pattern usually associated with “at risk families”, which affects the development of children and their adjustment to society. In the follow-up study, four years later, 104 pupils (95 boys/9 girls) and their families were re-examined with semi-structured interviews. The study also included interviews with day school staff and teachers from the ordinary school. At the time of the follow-up, 88% of the pupils had been discharged to a regular school after spending an average of two years at the day school. The symptom interview showed that mental health had improved significantly, especially with regard to social and emotional out acting behaviour. Sixty percent were now symptom-free or had only mild symptoms. On the other hand, two thirds were still slow performers and in need of special education and the children were still more disturbed compared to normal children. The most common diagnoses, according to DSM-III-R, were oppositional defiant disorders (53%) and conduct disorders (21%). All diagnostic groups did improve, but the children with conduct disorders were the most disturbed on both occasions. The majority of the parents had a positive attitude towards the day school and wanted to recommend day school placement to other parents. The ability of the day schools to intervene early and treat (secondary prevention) children with adjustment disorders was found to be an important resource.
European child & adolescent psychiatry, Jan 30, 2015
Psychiatric disorders are multi-factorial and their symptoms overlap. Constitutional and environm... more Psychiatric disorders are multi-factorial and their symptoms overlap. Constitutional and environmental factors influence each other, and this contributes to risk and resilience in mental ill-health. We investigated functional genetic variation of stress responsiveness, assessed as FKBP5 genotype, in relation to early life adversity and mental health in two samples of adolescents. One population-based sample of 909 12-year-old adolescents was assessed using the Life Incidence of Traumatic Events scale and the Strengths and Difficulties Questionnaire. One sample of 398 17-year-old adolescents, enriched for poly-victimized individuals (USSS), was assessed using the Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children (TSCC). The FKBP5 rs1360780 and rs3800373 polymorphisms were genotyped using a fluorescence-based competitive allele-specific PCR. Most prominently among poly-victimized older male adolescents, the least common alleles of the polymorphisms, in...
European child & adolescent psychiatry, Jan 15, 2015
Sexual activity online may result in positive experiences for young people, or lead them to engag... more Sexual activity online may result in positive experiences for young people, or lead them to engage in risky behaviours possibly resulting in sexual assault or abuse. The aim of our study was to investigate associations between online sexual behaviours among Swedish youth and background factors as well as aspects of well-being. The behaviours investigated were: having sex online with a contact met online, having sex with an online contact offline, posting sexual pictures online, and selling sex online. We used data from a representative sample of 3,432 Swedish youth who were asked about their lifetime experiences as well as their experiences within the previous year. We hypothesized that more advanced online sexual behaviours were associated with more problematic background factors, worse psychosocial well-being and riskier behaviours in general. Bivariate relationships were evaluated followed by a multiple logistic regression model. Our data suggested that most Swedish youth do not ...
Child and adolescent psychiatry and mental health, 2014
This study has investigated the specific relationship between childhood adversities, individual t... more This study has investigated the specific relationship between childhood adversities, individual trauma symptoms and the functions of non-suicidal self-injury (NSSI). The aim was to examine whether different self-reported adverse experiences and trauma symptoms predict the need to engage in NSSI, either to regulate emotions or to communicate with and influence others. The participants were a community sample of 816 adolescents aged 15-17 years with NSSI. Hierarchical multiple regression was used, controlling for NSSI frequency and gender. The dependent variables were the automatic and social functions of NSSI, respectively. The predictors entered in the model were several different maltreatment and adversity experiences as well as individual trauma symptoms. Mediation analyses were also performed using the bootstrapping method with bias-corrected confidence estimates. Frequency of NSSI, gender (female), emotional abuse, prolonged illness or handicap during upbringing and symptoms of ...
Background: Rape is considered a stressful trauma and often with durable consequences. How the af... more Background: Rape is considered a stressful trauma and often with durable consequences. How the aftermath of rape is for young adolescents' girls considering acute stress is an overlooked field and remains to be studied. Aims: In this study, we wanted to investigate acute stress among adolescent victims of rape and the psychometric properties of the Acute Stress Checklist for Children (ASC-Kids). Methods: A clinical sample (n = 79) of raped girls, 13-17 years old who had turned to a special rape victim unit for treatment, answered the ASC-Kids. ASC-Kids was also given to a group of minor stressed, non-raped adolescents in the same age range (n = 154) together with the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index (UCLA PTSD RI), and the Sense of Coherence Scale 13 (SOC-13). Results: The scores from the groups were compared and showed significant differences in mean values on all the diagnostic criteria of acute stress disorder. In the clinical group, 36.7% obtained full ASD criteria. ASC-Kids could discriminate well between groups. Cronbach's alpha was found to be excellent, and the correlation between the UCLA PTSD RI and ASC-Kids found to be good; both ASC-Kids and UCLA PTSD RI had a good and moderate negative correlation with SOC-13. Conclusion: Adolescent female rape victims were shown to have a very high level of acute stress, and the ASC-Kids was found to have sound psychometrics and can be a valuable screening instrument to support clinicians in their assessments of an indication of adolescents after potentially stressful events such as rape.
To ensure health and well-being for their athletes, sports organizations must offer preventive me... more To ensure health and well-being for their athletes, sports organizations must offer preventive measures against sexual abuse. The aim of this study was to design and evaluate feasibility of a research protocol for cross-sectional epidemiological studies of sexual abuse in athletics. Examination of the requirements on the study of sexual abuse in athletics was followed by iterated drafting of protocol specifications and formative evaluations. The feasibility of the resulting protocol was evaluated in a national-level study among elite athletics athletes (n = 507) in Sweden. The definition of sexual abuse, the ethical soundness of the protocol, reference populations and study of co-morbidity, and the means for athlete-level data collection were identified as particularly complex issues in the requirements analyses. The web-based survey defined by the protocol facilitates anonymous athlete self-reporting of data on exposure to sexual abuse. 198 athletes (39%) fully completed the feasib...
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