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Högberg B, Strandh M, Johansson K, Petersen S. Trends in adolescent psychosomatic complaints: a quantile regression analysis of Swedish HBSC data 1985-2017. Scand J Public Health 2023; 51:619-627. [PMID: 35531772 PMCID: PMC10265281 DOI: 10.1177/14034948221094497] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 03/18/2022] [Accepted: 03/25/2022] [Indexed: 09/19/2023]
Abstract
BACKGROUND AND AIMS According to recent criticism, survey-based measures of adolescent psychosomatic complaints have poor content validity insofar as they conflate trivial with severe complaints. It is argued that this means that estimates of prevalence and trends in complaints may reflect trivial complaints that are not indicators of health problems. In this study, two observable implications of this criticism were investigated: (a) that self-reported psychosomatic complaints should have a bimodal distribution; and (b) that the increase in complaints over time should be of approximately equal size throughout the distribution of complaints. METHODS Three decades (1985/1986-2017/2018) of repeated cross-sectional data from the Swedish Health Behaviour in School-aged Children survey were used. Psychosomatic complaints were measured using the screening instrument Health Behaviour in School-aged Children symptom checklist. Histograms, bar charts and quantile regression models were used for the analysis. RESULTS AND CONCLUSIONS With regard to the first implication, the results showed that the distribution of complaints was not bimodal and that there were no clusters of respondents. This suggests that binary categorisations of students can be reductive and conceal important variations across students. With regard to the second implication, the results showed that the increase in complaints was greatest among students who report frequent and co-occurring complaints. This suggests that reports of increasing complaints in adolescents cannot be explained as being primarily due to a greater inclination to report trivial complaints. It is concluded that any conflation of trivial and more severe complaints in surveys of psychosomatic complaints is not reflected in population-based estimates.
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Affiliation(s)
- Björn Högberg
- Department of Social Work, Umeå University, Umeå, Sweden
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
| | | | - Klara Johansson
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Solveig Petersen
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Hagquist C. Worry and Psychosomatic Problems Among Adolescents in Sweden in the Wake of the COVID-19 Pandemic: Unequal Patterns Among Sociodemographic Groups? J Adolesc Health 2023; 72:688-695. [PMID: 36781326 PMCID: PMC9918865 DOI: 10.1016/j.jadohealth.2022.12.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/02/2022] [Accepted: 12/15/2022] [Indexed: 02/13/2023]
Abstract
PURPOSE To analyze potential associations between sociodemographic factors and adolescents' worry about family finances and other types of worries during the COVID-19 pandemic and the potential associations between different worry themes and psychosomatic problems. METHODS From December 2020 to March 2021, 3,068 16-17 years old students in Sweden completed a questionnaire about the impact of the COVID-19 pandemic on their schooling and everyday life. From April to June 2020, 70% of these students also responded to questions about their psychosomatic health. Logistic regression was applied to analyze the associations between sociodemographic factors and different worry themes and estimate the association between worry and psychosomatic problems. RESULTS Across all 13 worry themes, girls reported worry to a higher degree than boys. In most of the cases, adolescents with a lower parental educational background or immigrant background reported more frequent worrying. This was most evident for worry about family finances. The differences between adolescents with a Swedish background and those with a foreign background were large except for worry about climate change. All worry themes were associated with the students' psychosomatic health. Those who often or always experienced worry were more likely to report psychosomatic problems. Worry about family finances showed the highest odds ratio and marginal effect. DISCUSSION Worry about family finances during the COVID-19 pandemic turns out to be a strong and socially structured stressor that may widen the health inequalities among young people. This underlines the need for preventive and promoting measures aimed at supporting socioeconomic disadvantaged groups.
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Affiliation(s)
- Curt Hagquist
- Department of Education and Special Education, University of Gothenburg, Gothenburg, Sweden.
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Student achievement goals and psychosomatic health complaints among Swedish adolescents: the role of sex. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01374-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Abstract
Aim
School related determinants (e.g. student motivation and goals) may be important for student achievement as well as their mental health. Therefore, the aim of this study was to analyse the links between two goal orientations (mastery and performance) and psychosomatic health problems by investigating the general patterns as well as the patterns for specific classifications of students, in particular by investigating the potential statistical interaction effects by gender.
Subject and methods
Swedish nationally representative data among 4573 school year 9 students (15–16 years old) responding to the Evaluation Through Follow-up (ETF) questionnaire, in 2014, were used. Linear regression analysis as well as multinomial logistic regression were applied in order to address the research questions.
Results
Both the mastery orientation and the performance orientation are independently associated with adolescent psychosomatic health problems. The links between these goal orientations and psychosomatic health show different patterns. The mastery goal orientation may be considered a protective factor as there is a negative link to psychosomatic problems; the performance orientation may be considered a risk factor due to the positive association with psychosomatic health problems. The effect of performance orientation on psychosomatic health complaints was significantly stronger for girls (OR = 4.28) compared to boys (OR = 2.04). In particular, low mastery/high performance students may be at risk for experiencing poor psychosomatic health.
Conclusion
Adolescent psychosomatic health may be improved by the encouragement of student goals related to adaptive and successful goal profiles such as mastery orientation.
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Wang A, Duan L, Huang H, Ma J, Zhang Y, Ma Q, Guo Y, Li Z, Cheng X, Zhu J, Zhou G, Ba Y. Association between fluoride exposure and behavioural outcomes of school-age children: a pilot study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:232-241. [PMID: 32281876 DOI: 10.1080/09603123.2020.1747601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
To assess the association between fluoride exposure and children's behavioural outcomes, we recruited 325 resident school-age children (7-13 years old) lived in Tongxu County of Henan Province in China. We measured urinary fluoride (UF) concentrations using the ion-selective electrode method. Children's behavioural outcomes were assessed by Conners' Parent Rating Scale-Revised, including conduct problems, learning problems, psychosomatic problems, impulsive-hyperactive, anxiety, and ADHD index. It turned out that each 1.0 mg/L increment in UF concentration corresponded with an elevation in the psychosomatic problem score of 4.01 (95% CI: 2.74, 5.28) and a 97% (OR = 1.97, 95% CI: 1.19, 3.27) increase in the prevalence of psychosomatic problems after adjusting for potential influencing factors. The sensitivity analysis results were consistent with those observed in our preliminary analysis. Our study suggests that fluoride exposure is positively related to the behavioural problem in school-age children, psychosomatic problem in particular.
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Affiliation(s)
- Anqi Wang
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Leizhen Duan
- Department of Medical Services, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Hui Huang
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Jun Ma
- Department of Endemic Disease, Kaifeng Center for Disease Control and Prevention, Kaifeng, Henan, P. R. China
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Qiang Ma
- Teaching and Research Office, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Yao Guo
- Nursing College of Henan University of Chinese Medicine, Zhengzhou, Henan, P. R. China
| | - Zhiyuan Li
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Xuemin Cheng
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Jingyuan Zhu
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Guoyu Zhou
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
| | - Yue Ba
- Department of Environment Health, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
- Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, P. R. China
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Brooks SJ, Feldman I, Schiöth HB, Titova OE. Important gender differences in psychosomatic and school-related complaints in relation to adolescent weight status. Sci Rep 2021; 11:14147. [PMID: 34239031 PMCID: PMC8266882 DOI: 10.1038/s41598-021-93761-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/30/2021] [Indexed: 12/17/2022] Open
Abstract
Underweight or overweight in adolescence is linked to several adverse health outcomes. Less evidence exists about the association between weight status and school-related psychosocial characteristics in high income countries. We sought to investigate the relationship between weight status and psychosomatic and school-related complaints with a focus on gender differences. The study is a cohort of 18,462 adolescents (12-19 years; 51% girls) conducted in Sweden. The associations between weight status and psychosomatic and school-related complaints were estimated by binary logistic regression adjusted for several potential confounders. After correction for multiple testing, being underweight or overweight/obese was adversely associated with several psychosomatic and school-related complaints with significant differences between boys and girls. Specifically, underweight boys had higher odds to have psychosomatic complaints than normal-weight boys, while no such associations were observed among underweight girls. Overweight/obese (vs. normal-weight) boys had higher odds to complain about headache, pain in the back/hips, and feeling low. Overweight/obese (vs. normal-weight) girls were more likely to complain about feeling low, anxious/worried and having difficulty in falling asleep (P ≤ 0.01). In relation to school-related complaints (e.g., being bullied at school and academic failure), greater associations were observed for overweight/obese girls and boys than for underweight adolescents compared with normal-weight peers.
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Affiliation(s)
- Samantha J Brooks
- Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool, SE3 3AF, UK.,Neuroscience Research Laboratory (NeuRL), Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Inna Feldman
- Uppsala County Council, Uppsala, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Olga E Titova
- Department of Neuroscience, Uppsala University, Uppsala, Sweden. .,Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Epihubben, Dag Hammarskjölds väg 14 B, 75185, Uppsala, Sweden.
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Hagquist C. Explaining differential item functioning focusing on the crucial role of external information - an example from the measurement of adolescent mental health. BMC Med Res Methodol 2019; 19:185. [PMID: 31488055 PMCID: PMC6729037 DOI: 10.1186/s12874-019-0828-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 08/26/2019] [Indexed: 11/17/2022] Open
Abstract
Background An overarching objective in research comparing different sample groups is to ensure that the reported differences in outcomes are not affected by differences between groups in the functioning of the measurement instruments, i.e. the items have to work in the same way for the different sample groups to be compared. Lack of invariance across sample groups are commonly called Differential Item Functioning (DIF). There is a sense in which the DIF of an item can be taken account of by resolving (splitting) the item into group specific items, rather than deleting the item. Resolving improves fit, retains the reliability and content provided by the item, and compensates for the DIF in estimation of person parameters on the scale of the instrument. However, it destroys invariance of the item’s parameter value among the groups. Whether or not a DIF item should be resolved depends on whether the source of the DIF is relevant or irrelevant for the content of the variable. The present paper shows how external information can be used to investigate if the gender DIF found in the item “Stomach ache” in a psychosomatic symptoms scale used among adolescents may reflect abdominal pain because of a biological factor, the girls’ menstrual periods. Methods Swedish data from the international Health Behaviour in School-aged Children study (HBSC) collected in 2005/06, 2009/10 and 2013/14 were used, comprising a total of 18,983 students in grades 5, 7 and 9. A composite measure of eight items of psychosomatic problems was analysed for DIF with respect to gender and menstrual periods using the Rasch model. Results The results support the hypothesis that the source of the gender DIF for the item “Stomach ache” is a gender specific biological factor. In that case the DIF should be resolved if the psychosomatic measure is not intended to tap information about abdominal pain caused by a gender specific biological factor. In contrast, if the measure is intended to tap such information, the DIF should not be resolved. Conclusions The conceptualisation of the measure governs whether the item showing DIF should be resolved or not.
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Affiliation(s)
- Curt Hagquist
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, SE-651 88, Karlstad, Sweden.
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Baceviciene M, Jankauskiene R, Emeljanovas A. Self-perception of physical activity and fitness is related to lower psychosomatic health symptoms in adolescents with unhealthy lifestyles. BMC Public Health 2019; 19:980. [PMID: 31337374 PMCID: PMC6647301 DOI: 10.1186/s12889-019-7311-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/12/2019] [Indexed: 12/14/2022] Open
Abstract
The general aim of the present study was to examine how physical activity, participation in sports, and beliefs about personal physical activity and physical fitness are associated with adolescents' psychosomatic health complaints (PHC) in relation to their lifestyles. METHODS A total of 3284 11-19-year-old adolescents (average age 14.9 ± 2.0; 48.6% male) participated in the population-based cross-sectional study. Self-administered questionnaires addressed lifestyle, sports participation, physical activity, physical fitness perception, and PHC. RESULTS Female gender (OR = 1.92; 95% CI = 1.57-2.35), smoking (OR = 1.31; 95%PI = 1.01-1.68), alcohol consumption (OR = 1.60; 95%PI = 1.30-1.97), unhealthy foods (OR = 1.14; 95%PI = 1.04-1.26), hours of internet use (OR = 1.14; 95%PI = 1.07-1.21), and poor personal fitness perception (OR = 1.60; 95% CI = 1.27-2.02) were associated with PHC in adolescents. Lower physical activity and self-perceived insufficient physical activity, perception of physical fitness as being poor, and not participating in sports were associated with greater somatic and psychological complaints controlling for age, gender, and BMI. Participation in sports and physical activity did not change PHC in adolescents involved in unhealthy behaviour. However, a positive perception of one's own physical activity and physical fitness decreased PHC in adolescents who reported an unhealthy lifestyle. CONCLUSIONS Adolescents demonstrating poorer health-related behavioural profiles showed higher PHC. Physical activity and sports participation were related to lower PHC. Positive physical activity and physical fitness perception changed the associations between PHC and unhealthy lifestyle: adolescents perceiving themselves as sufficiently physically active and those evaluating their physical fitness as good showed lower PHC, despite the presence of unhealthy habits (high screen time, drinking alcohol, smoking, and consuming unhealthy foods). It is important to study cognitive factors when exploring the associations between adolescent lifestyles and PHC. These results are important for health promotion and education programmes aimed at improving healthy lifestyle and psychosocial well-being in adolescents.
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Affiliation(s)
- Migle Baceviciene
- Department of Physical and Social Education, Lithuanian Sports University, Sporto str. 6, LT-44221 Kaunas, Lithuania
| | - Rasa Jankauskiene
- Institute of Sport Science and Innovation, Lithuanian Sports University, Sporto str. 6, LT44221, Kaunas, Lithuania
| | - Arunas Emeljanovas
- Department of Physical and Social Education, Lithuanian Sports University, Sporto str. 6, LT-44221 Kaunas, Lithuania
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van Geelen SM, Hagquist C. Are the time trends in adolescent psychosomatic problems related to functional impairment in daily life? A 23-year study among 20,000 15-16year olds in Sweden. J Psychosom Res 2016; 87:50-6. [PMID: 27411752 DOI: 10.1016/j.jpsychores.2016.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/26/2016] [Accepted: 06/04/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Worldwide there are frequent reports on increasing psychosomatic problems, anxiety, emotional distress, conduct problems, and depression among adolescents. Recently, it was contended that secular studies on such aspects of adolescent mental health can only be evaluated adequately when data on symptom prevalence are analyzed together with data on functional impairment. Still, this has not yet been done in epidemiological time-trend studies on any aspect of adolescent mental health. Therefore, this study aims to investigate if, and to what extent, changes in adolescents' symptoms of psychosomatic problems are affected when data on functional impairment are taken into account simultaneously. METHODS A repeated cross-sectional population study relating self-reported symptoms of psychosomatic problems to functional impairment; covering the time-period 1988-2011 and including 19.823 adolescents 15-16years old in eight cohorts in one geographically defined population (Värmland, Sweden). RESULTS The proportion of adolescents with psychosomatic problems had increased significantly from 1988 to 2005/2008. In all cohorts the proportion of girls with psychosomatic problems was significantly higher than the proportion of boys reporting symptoms. Over the same period, there was a corresponding significant increase of the proportion of participants with symptoms of psychosomatic problems in combination with functional impairment. Adding functional impairment to the measure of psychosomatic problems decreased the prevalence rates, while the shapes of the trend-curves stayed congruent in form. CONCLUSION The long-term pattern of increasing psychosomatic problems among adolescents remains evident, even when taking functional impairment data into account. Previously observed trends of a deteriorating adolescent mental health are thus consistent with this study.
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Affiliation(s)
- Stefan M van Geelen
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, 65188 Karlstad, Sweden; Division of Pediatrics, University Medical Center Utrecht, The Netherlands.
| | - Curt Hagquist
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Sweden
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Piko BF, Varga S, Mellor D. Are adolescents with high self-esteem protected from psychosomatic symptomatology? Eur J Pediatr 2016; 175:785-92. [PMID: 26895878 DOI: 10.1007/s00431-016-2709-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 02/07/2016] [Accepted: 02/09/2016] [Indexed: 10/22/2022]
Abstract
UNLABELLED This study investigated the role of self-esteem, social (need to belong, loneliness, competitiveness, and shyness), and health (smoking, drinking) behaviors in Hungarian adolescents' psychosomatic symptoms. Our sample of 490 students (ages 14-19 years) from Debrecen (Hungary) completed the questionnaires. Besides descriptive statistics, correlation and multiple regression analyses were applied to test interrelationships. Frequency analysis revealed that fatigue was the most commonly experienced psychosomatic symptom in this sample, followed by sleeping problems and (lower) back pain. Girls reported experiencing more symptoms. Multiple regression analyses suggested that (1) need to belong, shyness, and competitiveness may serve as social behavioral risk factors for adolescents' psychosomatic symptomatology, whereas (2) self-esteem may play a protective role. The role of social and health behaviors was modified when analyzed by gender: the psychosomatic index score was positively related to smoking and shyness among girls, and need to belong among boys. Self-esteem provided protection for both sexes. CONCLUSION We conclude that problems with social relationships (namely, unmet need to belong, competitiveness, and shyness) may lead to psychosomatic health complaints, whereas self-esteem may serve as a protection. Findings suggest that social skills training and strengthening self-esteem should be an important part of children's health promotion programs in schools to improve their psychosomatic health and well-being. WHAT IS KNOWN • Despite being free of serious physical illness, many adolescents often report subjective health complaints, such as psychosomatic symptoms • As children in this life stage develop independence and autonomy, new types of social relationships, and identity, their social needs and skills also change What is new: • Need to belong, shyness, and competitiveness may serve as social behavioral risk factors for adolescents' psychosomatic symptomatology, whereas self-esteem may play a protective role • The role of social and health behaviors may vary by gender.
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Affiliation(s)
- Bettina F Piko
- Department of Behavioral Sciences, University of Szeged, Szentharomsag str. 5, 6722, Szeged, Hungary.
| | - Szabolcs Varga
- Semmelweis University, Institute of Behavioral Sciences, Budapest, Hungary
| | - David Mellor
- School of Psychology, Deakin University, Geelong, Victoria, 3217, Australia
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Hagquist C. Family residency and psychosomatic problems among adolescents in Sweden: The impact of child-parent relations. Scand J Public Health 2015; 44:36-46. [PMID: 26487762 DOI: 10.1177/1403494815610664] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2015] [Indexed: 11/17/2022]
Abstract
AIMS Profound changes in family structure took place in many countries, during the second part of the previous century. The purpose of this paper is to analyse the association between the type of family residency and psychosomatic problems in younger and older adolescents, particularly focusing on alternate residency, and to examine the impact of child-parent relations. METHODS We used data collected in 2009 by Statistics Sweden among 172,298 Swedish students in Grade 6 and Grade 9 (approximate ages 12 and 15 years old); comprising 80% and 86%, respectively, of the entire population of students in those grades. We collected the data with a questionnaire, completed anonymously in school: We used the Psychosomatic Problems (PSP) scale as the outcome measure. RESULTS The type of family residency showed a weaker association with psychosomatic problems than the child-parent relationships did. Living in non-intact families increased the probability of adolescent psychosomatic problems by 0-0.05, compared to intact families. In Grade 9, there were no differences in psychosomatic problems between the students in alternate residency and those living with their two parents; and in Grade 6, these differences were relatively small. In comparison, a worse relationship with parents increased the probability of psychosomatic problems by 0.11-0.17, depending on the school grade and type of family residency. CONCLUSIONS The structure of the family, as well as the child-parent relationships needs to be taken into account, to properly estimate the magnitude of the family situation as a determinant of adolescent psychosomatic problems. Our results justify universal intervention at the policy level.
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Affiliation(s)
- Curt Hagquist
- Centre for Research on Child and Adolescent Mental Health, Karlstad University, Karlstad, Sweden
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