Allt fler upplever utmaningar med sin psykiska hälsa, negativa tankemönster, ångest och depressiva tillstånd. Studiens syfte var att belysa vilken inverkan tankar kan ha på individens psykiska välbefinnande samt vilka metoder som upplevs hjälpsamma för att förändra dysfunktionella tankemönster. Studien hade en kvalitativ induktiv ansats där semistrukturerade intervjuer genomfördes med åtta respondenter. Intervjuerna bearbetades med en tematisk analys som sedan sammanfattades genom fem teman. Resultatet visade att respondenterna upplevde att tankar har en stark inverkan på det psykiska välbefinnandet. Deltagarna beskrev att kognitiv beteendeterapi i form av att träna in funktionella tankemönster, skifte av fokus, hälsofrämjande beteenden, mer närvaro och släppa kontroll och stanna kvar upplevdes betydelsefulla för deras psykiska hälsa. Resultatet visade även att deltagarna upplevde det hjälpsamt att både förändra tanken i sig, att ändra hur individen förhåller sig till sina tankar samt att införa hälsobeteenden som minskade mängden negativa tankar.
Bakgrund Den vårdande relationen är kärnan i omvårdnaden. Patienterna beskriver att de behöver känna trygghet innan den vårdande relationen skapas. Psykiatrisjuksköterskan är skyldig att ansvara för att patienternas behov tillgodoses. Syfte Syftet är att synliggöra hur sjuksköterskor inom psykiatrisk vård beskriver den vårdande relationen. Vidare syftar studien till att synliggöra likheter och skillnader jämfört med hur den vårdande relationen gestaltas i den teoretiska referensramen. Den metod som ansågs vara mest lämplig för att besvara studien var en kvalitativ innehållsanalys. Med en deduktiv ansats, vilket beskrivs utifrån Elo och Kyngäs, (2008). Den teoretiska referensramen som valdes till studien utgår från Kaséns (2002) fyra aspekter av den vårdande relationen. I resultatet framkommer sjuksköterskors beskrivningar av den vårdande relationer och hur den kan gestaltas utifrån Kaséns fyra aspekter. Det framkom likheter och skillnader i resultatets analys del, vad sjuksköterskor beskrev som vårdande relationer. Slutsatser som kan tas utifrån studien är att den vårdande relationen har flera liknelser med patienternas beskrivning av den vårdande relationen. Även skillnader i deras beskrivningar av den vårdande relationen visades. Den vårdande relationen berörde sjuksköterskan lika väl som den berörde patienten. Nyckelord:
Objectives We test the effects of four policy scenarios on recruitment into organized crime. The policy scenarios target (i) organized crime leaders and (ii) facilitators for imprisonment, (iii) provide educational and welfare support to children and their mothers while separating them from organized-crime fathers, and (iv) increase educational and social support to at-risk schoolchildren. Methods We developed a novel agent-based model drawing on theories of peer effects (differential association, social learning), social embeddedness of organized crime, and the general theory of crime. Agents are simultaneously embedded in multiple social networks (household, kinship, school, work, friends, and co-offending) and possess heterogeneous individual attributes. Relational and individual attributes determine the probability of offending. Co-offending with organized crime members determines recruitment into the criminal group. All the main parameters are calibrated on data from Palermo or Sicily (Italy). We test the effect of the four policy scenarios against a baseline no-intervention scenario on the number of newly recruited and total organized crime members using Generalized Estimating Equations models. Results The simulations generate realistic outcomes, with relatively stable organized crime membership and crime rates. All simulated policy interventions reduce the total number of members, whereas all but primary socialization reduce newly recruited members. The intensity of the effects, however, varies across dependent variables and models. Conclusions Agent-based models effectively enable to develop theoretically driven and empirically calibrated simulations of organized crime. The simulations can fill the gaps in evaluation research in the field of organized crime and allow us to test different policies in different environmental contexts.
BACKGROUND: Despite an increase in mental health problems, with psychosomatic symptoms having been observed in new generations of Swedish youth, the extent to which these problems correspond to an increase in adult mental problems is unknown. The present study investigates whether Swedish adolescents with high levels of psychosomatic symptoms are at risk of developing depression and anxiety problems in adulthood and whether sex moderates any association. Moreover, we aim to understand whether different clusters of youth psychosomatic symptoms - somatic, psychological and musculoskeletal - have different impacts on adult mental health. METHODS: One thousand five hundred forty-five Swedish adolescents - aged 13 (49%) and 15 (51%) - completed surveys at baseline (T1) and 3 years later (T2); of them, 1174 (61% females) also participated after 6 years (T3). Multivariate logistic models were run. RESULTS: Youth with high levels of psychosomatic symptoms had higher odds of high levels of depressive symptoms at T2 and T3. Moreover, psychosomatic symptoms at T1 predicted a high level of anxiety symptoms and diagnoses of anxiety disorders at T3. When analyzed separately, musculoskeletal symptoms predicted higher odds of having high levels of depressive symptoms at T2 and T3 while somatic symptoms predicted high levels of anxiety symptoms at T2. Moreover, somatic symptoms at T1 predicted diagnoses of depression and anxiety disorders at T3. Sex did not moderate any of the relationships. CONCLUSIONS: The study supports the idea that an increase in mental health problems, such as psychosomatic symptoms, can seriously impact the psychological health of new generations of young adults.
Physical activity has a demonstrated positive effect on youth depressive symptoms. However, very few studies have explored the bi-directionality of the links between physical activity and depression. The present study aims at filling this gap and tests whether any associations are moderated by sex. Moreover, the role of subtype of depressive symptoms, vegetative (i.e., lack of energy, poor sleep) or non-vegetative (i.e., mood-related), is explored. Participants were 910 12–13 year-old Swedish adolescents (56% girls) who answered a three-wave survey at ages 12–13 (T1), 15–16 (T2), and 18–19 (T3). Using a cross-lagged structural model, depression predicted decreased frequency of vigorous physical activity (VPA) from T1 to T2 (β = −0.09, p <.05) and from T2 to T3 (β = −0.10, p <.01), while frequency of VPA at T2 decreased depression at T3 (β = −0.12, p <.05). Associations did not differ between boys and girls. Non-vegetative symptoms predicted decreased frequency of VPA from T1 to T2 (β = −0.10, p <.05), while frequency of VPA at T2 predicted decreased non-vegetative symptoms at T3 (β = −0.15, p <.05). Vegetative symptoms predicted decreased frequency of VPA from T1 to T2 (β = −0.09, p <.05), while have a reciprocal influence with VPA from T2 to T3. Overall, our results highlight an association across adolescence between VPA and depression. The association becomes stronger and reciprocal in middle adolescence, which suggests this period as an effective developmental time to plan physical-activity-based interventions to decrease youth depressive symptoms.
Adolescent gambling is becoming a public health problem. While comorbidities with other externalizing behaviours have been ascertained, few studies focus on adolescents with a multi-problem behaviour pattern, i.e., alcohol and tobacco use, in addition to antisocial behaviour, which includes problem gambling. The purpose of this study was to identify adolescents with multi-problem behaviours, i.e., alcohol abuse, daily smoking, antisocial behaviour, and problem gambling and to investigate the differences in relation to gender. Unlike most studies on this topic, we adopted a person-oriented approach to identify groups of adolescent boys and girls who reported multi-problem risk behaviours, i.e., alcohol abuse, daily smoking, antisocial behaviour, and problem gambling. More-over, we explored to what extent these adolescents exhibited mental health problems, i.e., depressive, psychosomatic, and ADHD symptoms, as well as sleep problems. The sample consisted of 1,526 adolescents from two age cohorts, 15-to 16-year-olds (n = 711, 47%) and 17-to 18-year-olds (n = 815, 53%). Latent Variable Mixture Modeling (LVMM) revealed one group with low rates of all risk behaviours and three groups with multi-problem behaviours. Among the latter three groups, two reported problem gambling and had higher levels of mental health problems. These results suggest that gambling can be added to the constellation of risk behaviours in adolescence and might be more associated with mental health problems than other externalizing behaviours.
Children with impairments are known to experience more restricted participation than other children. It also appears that low levels of participation are related to a higher prevalence of mental health problems in children with neurodevelopmental disorders (NDD). The purpose of this conceptual paper is to describe and define the constructs mental health problems, mental health, and participation to ensure that future research investigating participation as a means to mental health in children and adolescents with NDD is founded on conceptual clarity. We first discuss the difference between two aspects of mental health problems, namely mental disorder and mental illness. This discussion serves to highlight three areas of conceptual difficulty and their consequences for understanding the mental health of children with NDD that we then consider in the article: (1) how to define mental health problems, (2) how to define and assess mental health problems and mental health, i.e., wellbeing as separate constructs, and (3) how to describe the relationship between participation and wellbeing. We then discuss the implications of our propositions for measurement and the use of participation interventions as a means to enhance mental health (defined as wellbeing). Conclusions: Mental disorders include both diagnoses related to impairments in the developmental period, i.e., NDD and diagnoses related to mental illness. These two types of mental disorders must be separated. Children with NDD, just like other people, may exhibit aspects of both mental health problems and wellbeing simultaneously. Measures of wellbeing defined as a continuum from flourishing to languishing for children with NDD need to be designed and evaluated. Wellbeing can lead to further participation and act to protect from mental health problems.
Objective: The authors aimed to elucidate the links between traumatic brain injuries (TBIs) and criminal convictions in a sample of 724 Canadian males with and without criminal records followed up to age 24. Methods: Prospectively collected data were analyzed to determine whether prior TBIs predicted subsequent criminal convictions after taking account of family social status (FSS) and childhood disruptive behaviors. At age 24, diagnoses of TBIs were extracted from health records and convictions from official criminal records. In childhood, teachers rated disruptive behaviors and parents reported FSS. Results: Proportionately more individuals with offender status than nonoffender status sustained a TBI from age 18 to age 24 but not before age 18. Individuals with offender status who had sustained a TBI before and after their first conviction were similar in numbers, were raised in families of low social status, and presented high levels of disruptive behaviors from age 6 to age 12. When FSS and childhood disruptive behaviors were included in multivariable regression models, sustaining a prior TBI was not associated with an increased risk of juvenile convictions for any type of crime, for violent crimes, for convictions for any crime or violent crime from age 18 to age 24, or for a first crime or a first violent crime from age 18 to age 24. Conclusions: Among males, there was no evidence that prior TBIs were associated with an increased risk of subsequent criminal convictions from age 12 to age 24 when taking account of FSS and childhood disruptive behaviors, although these latter factors may be associated with an increased prevalence of TBIs among adult offenders.
Background: Science shows that we will see a continuing increase of children with mental health problems in the coming years. As a consequence of this nurses will be meeting a larger number of children suffering from depression. Studies regarding nurses’ experiences of caring for children suffering from depression are sparse. More knowledge is required and will be meaningful in the future care of this vulnerable patient group.
Aim: To describe nurses’ experiences of caring for children with depression within child and adolescent outpatient psychiatric care.
Method: This study has a qualitative design with an inductive approach. As a data collecting method, semi- structured interviews were used which were conducted with six nurses in child and adolescent psychiatric outpatient care. The result was analyzed with qualitative content analysis.
Results: The results show that; the nurse’s role is about being an intermediary, to take into account that the child always exists in a specific context, to create a relationship to the child and to manage one's own emotions.
Conclusions: The nurse's role and significance would need to be made more visible as it today can be considered unclear. Specialist nurses have significant competences that is not always used in the best way to promote the child's recovery from depression.
Background: Depression often emerges during early adolescence and is one of the most common mental health problems. The present study investigated the influence of parenting styles and parental depression on depressive symptoms during adolescence and young adulthood, using both a cross-sectional and a longitudinal approach. Methods: Data were obtained from the Survey of Adolescent Life in Västmanland Cohort study and comprised 1603 adolescents who completed questionnaires at two time points (ages 16–18 and ages 19–21). Results: In the cross-sectional approach, a positive parenting style (Warmth, Structure, Autonomy support) was associated with less depressive symptoms, and a negative parenting style (Rejection, Chaos, Coercion) and parental depression were associated with more depressive symptoms in 16–18-year-old adolescents. The effect of parental depression was stronger among adolescent females. In the longitudinal approach, a protective effect was found, where a positive parenting style at adolescent ages 16–18 was associated with less depressive symptoms at ages 19–21, even when controlling for initial depressive symptomatology. Conclusions: These findings may make an important contribution to treatment programmes and family-based prevention strategies related to adolescent depressive symptomatology, particularly regarding the potential long-term protective effects of positive parenting style in middle and late adolescence. © 2020
Forensic psychiatric care in Sweden constitutes a specific institutional environment in health care in terms of gender and power relationships. This context emphasizes safety and protection in an environment where men constitute a majority of the patients and staff. It involves relationships among men's health, constructions of masculinities, and issues regarding equality between women's and men's caring work. The aim of this theoretical article is to problematize men's health in relation to constructions of masculinities. Our analysis shows how the perception of health is involved in the construction of masculinities and how this plays out in daily interactions between caregivers and patients.
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.
Background: Research has shown correlation between high self-compassion and wellbeing as well as low self-compassion has been correlated with psychopathology. Little research of Self-compassion in nursing science has been done and the concept is still relative unknown. Aim: To describe how adults with adhd percived the concept of self-compassion and conversation with Self-Compassion Scale as starting point. How did adults with adhd perceive self-compassion and it´s meaning? Which challanges and profits did they describe in the use of Self-Compassion Scale? How was their self-compassion? Method: The study had a QUAL + quan, mixed method design. Four participants performed cognitive interviews in the qualitative part and in the quantitative part 23 participants performed Self-Compassion Scale. The interviews underwent content analysis and the assessment tools has been numerically analyzed. Result: The interviews present three categories; Self-compassion contains wellbeing and the relationship to oneself and others, Conversation leeds to self-awareness and To explore problems and solutions is rewarding and challenging. Persons rate a medium-level self-compassion of 2,6 in total (medium level = 2,6-3,5). Highest scores for the categories isolation and over-identified. Conclusion: To converse about self-compassion can be challenging and important for persons with adhd. For the nurse within psychiatric care to have knowledge of self-compassion can be valuable to patient’s health and recovery.
Background: In psychiatric inpatient care, nurses regularly give forced injections to patients. Forced injections fall under The Compulsory Psychiatric Care Act as it is a special type of care which includes that the patient no longer receives the care voluntarily. Previous research shows that patients often have bad experiences of having received a forced injection and often see it as a violation. Nurses have expressed that this causes experiences of ethical challenges and state that knowledge of forced injections in staff is lacking. Thus, this indicates an area of improvement in healthcare. Purpose: To describe nurses' experiences of giving patients forced injections in psychiatric inpatient care. Method: The study follows a qualitative design with an inductive approach. Data collection has been done through semi-structured interviews with four nurses. Results: The results indicate that the nurse sees that forced injections are a necessary evil and has difficulty processing situations with forced injections, but that the team can be helpful. The result resulted in four categories; to realize limitations, to be part of a team, to improve the experience for the patient and to feel that you are making a difference. Conclusion: Nurses want to see a development in competence and knowledge for situations with forced injections to ensure good care.
Background
The objective was to examine various aspects of narcissism in patients admitted to acute psychiatric wards and to compare their level of narcissism to that of an age- and gender-matched sample from the general population (NORM).
Methods
This cross-sectional study interviewed 186 eligible acute psychiatric patients with the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF). The patients filled in the Narcissistic Personality Inventory-21 item version (NPI-21), The Hospital Anxiety and Depression Scale (HADS) and the Rosenberg Self-Esteem Scale. High and low narcissism was defined by the median of the total NPI-21 score. An age- and gender-matched control sample from the general population also scored the NPI-21 (NORM).
Results
Being male, involuntary admitted, having diagnosis of schizophrenia, higher self-esteem, and severe violence were significantly associated with high narcissism, and so were also low levels of suicidality, depression, anxiety and GAF scores. Severe violence and high self-esteem were significantly associated with high narcissism in multivariable analyses. The NPI-21 and its subscales showed test-retest correlations ≥0.83, while the BPRS and the HADS showed lower correlations, confirming the trait character of the NPI-21. Depression and suicidality were negatively associated with the NPI-21 total score and all its subscales, while positive association was observed with grandiosity. No significant differences were observed between patients and NORM on the NPI-21 total score or any of the NPI subscales.
Conclusion
Narcissism in the psychiatric patients was significantly associated with violence, suicidality and other symptoms relevant for management and treatment planning. Due to its trait character, use of the NPI-21 in acute psychiatric patients can give important clinical information. The similar level of narcissism found in patients and NORM is in need of further examination.
The Narcissistic Personality Inventory (NPI) is commonly used in empirical studies of narcissism. Few population-based studies have been published. Our aim was to do a confirmatory factor analysis (CFA) of the NPI 29 item version with a four-factor structure, in two population-based samples and in a patient sample, and present normative population-based data. The NPI-29 was filled in by 324 respondents from the Norwegian population, 231 from the Swedish population and 167 Norwegian psychiatric patients. The four-factor structure of the NPI-29 with Leadership/Power, Exhibitionism/Self-admiration, Superiority/Arrogance and Uniqueness/Entitlement was reproduced in these samples. The CFA models showed good fit indices in all samples. Mean scores on the NPI-29 and four subscales hardly differed between the samples. For the NPI-29 total score and factors, few significant differences were observed. CFA of the samples supported the factor structure of the NPI-29 formerly identified by principal component analysis of the Swedish population sample.
Severe dissociative states involving the experience of being in parts, typically associated with diagnosis such as dissociative identity disorder and other specified dissociative disorders, continue to be a controversial and rarely studied area of research. However, because persons with severe dissociative states are at risk of being harmed instead of helped within psychiatric care, their experiences of living with such states warrant further examination, while innovative ways to include them in research remain necessary. Against that background, this study aimed to illuminate the meanings of living with severe dissociative states involving the experience of being in parts. This is a phenomenological hermeneutic study with data collected from three social media sources, one personal blog and two Instagram accounts, in February and March 2023. The results were illuminated in light of four themes; Striving to remain in the world, Balancing exposure and trust, Balancing belonging and loneliness and Owning oneselves. The interpretation of the themes suggests that living with severe dissociative states means being a human under inhuman conditions, striving for coherence and meaning in a world that is often unsupportive. This calls for a trauma-informed care to better support recovery for persons with severe dissociative states.
The prevalence of depressive symptoms in adolescents is 12–18% and is twice as frequent in females. Sleep problems and thoughts of death are depressive symptoms or co-occurrent phenomena. Family maltreatment is a risk factor for later depressive symptoms and the period circadian regulator (PER) has been studied in relation to neurotransmitters, adaptation to stress, and winter depression. The purpose of this work was to study the relation of the three-way interactions of sex, PER2 rs56013859, and family maltreatment in relation to core depressive symptoms, sleep complaints, and thoughts of death and suicide in self-reports from a cohort of Swedish adolescents in 2012, 2015, and 2018. Cross-sectional and longitudinal analyses with linear and logistic regressions were used to study the relationships to the three outcomes. The three-way interaction was related to core depressive symptoms at both baseline and six years later. In contrast, the model did not show any relation to the other dependent variables. At 13–15 years, a sex-related differential expression was observed: females with the minor allele C:C/C:T exposed to family maltreatment showed higher levels of core depressive symptoms. Six years later, the trend was inverted among carriers of minor alleles.