Margit Wångby-Lundh

Self-reported emotional and behavioral problems in Swedish 14 to 15-year-old adolescents: A study with the self-report version of the Strengths and Difficulties Questionnaire

The psychometric properties of the Swedish self-report version of the Strengths and Difficulties Questionnaire (SDQ-s), and the prevalence of emotional and behavioral problems as measured by the SDQ-s, were studied in 14 to 15-year-old adolescents. The psychometric properties were found to be similar to those found in other language versions, in terms of similar factor structure and acceptable test-retest stability, but low internal consistencies for some of the subscales. There was evidence of good convergent and discriminant validity. The results with regard to gender differences replicated previous findings in other countries, the girls reporting more emotional symptoms and more prosocial behavior, and the boys reporting more conduct problems and tending to report more peer problems. It is concluded that the results are in favor of using the Swedish SDQ-s as a screening instrument for adolescents, despite the low internal consistencies of some of its subscales.

Measuring Mindfulness: Pilot Studies with the Swedish Versions of the Mindful Attention Awareness Scale and the Kentucky Inventory of Mindfulness Skills

The present article describes data from pilot studies with the Swedish versions of the Mindful Attention Awareness Scale (MAAS) and the Kentucky Inventory of Mindfulness Skills (KIMS). The MAAS and two of the KIMS scales, Act with Awareness and Accept without Judgment, were found to correlate in the predicted direction with measures of well‐being and emotional distress. The KIMS scales Observe and Describe showed more ambiguous results, possibly because these two scales measure a mixture of two opposite kinds of processes: healthy self‐observation (“experiential self‐focus”) and unhealthy rumination (“analytical self‐focus”). The KIMS was also used in an uncontrolled study with participants in an educational programme for close relatives of persons with borderline personality disorder, Family Connections (FC), which includes components of mindfulness training. The FC participants were found to (a) score lower than a comparison group on Act with Awareness and Accept without Judgment before treatment and (b) show significantly increased scores on Accept without Judgment after treatment.

Deliberate self-harm and psychological problems in young adolescents: Evidence of a bidirectional relationship in girls

The purpose of this study was to test the hypotheses that there is a bidirectional prospective relationship between mental health and deliberate self-harm, in the sense that (1) psychological problems are a risk factor for the development of self-harm; (2) self-harm is a risk factor for the development of psychological problems; and (3) the relative absence of psychological problems is a protective factor against the continued use of self-harm in adolescents who have started to harm themselves. This was studied in a community sample of 879 young adolescents by means of a 2-wave longitudinal design with a one-year interval, with self-harm measured by a nine-item version of the Deliberate Self-Harm Inventory (DSHI-9r) and psychological problems by the self-report version of the Strengths and Difficulties Questionnaire (SDQ). The hypothesis of bidirectional relationship between psychological problems and self-harm was supported among girls, but not among boys - although there was evidence of psychological problems as a risk factor of self-harm in boys, the converse was not the case. The relative absence of psychological problems was found to be a protective factor against self-harm only among boys, but not among girls. The results are discussed in terms of self-harm having a different role in the development of psychopathology among girls than among boys.

Depressive Symptoms and Deliberate Self-Harm in a Community Sample of Adolescents: A Prospective Study

The associations between depressive symptoms and deliberate self-harm were studied by means of a 2-wave longitudinal design in a community sample of 1052 young adolescents, with longitudinal data for 83.6% of the sample. Evidence was found for a bidirectional relationship in girls, with depressive symptoms being a risk factor for increased self-harm one year later and self-harm a risk factor for increased depressive symptoms. Cluster analysis of profiles of depressive symptoms led to the identification of two clusters with clear depressive profiles (one severe, the other mild/moderate) which were both characterized by an overrepresentation of girls and elevated levels of self-harm. Clusters with more circumscribed problems were also identified; of these, significantly increased levels of self-harm were found in a cluster characterized by negative self-image and in a cluster characterized by dysphoric relations to parents. It is suggested that self-harm serves more to regulate negative self-related feelings than sadness.

Examining the Acceptability, Attractiveness, and Effects of a School-Based Validating Interview for Adolescents Who Self-Injure

Nonsuicidal self-injury (NSSI) in adolescents is a significant problem that needs to be addressed, and in some cases managed, in school settings. The current feasibility study uses screening questionnaires and follow up-interviews on NSSI in a community sample of adolescents (N = 1,052) in Sweden. Both adolescents reporting self-injury (n = 66) and a comparison group (n = 31) were interviewed, and information disclosed about self-injury, as well as the results from the interviewers assessments of the seriousness of these behaviors, were examined. Generally, adolescents reported positive feelings about being interviewed, and 52% of those who had reported self-injury in the questionnaire disclosed NSSI in the interviews. Further, a majority of these cases, 76%, were not assessed as very serious. When NSSI was reported in a questionnaire 1 year after the interview, there were no indications of iatrogenic effects from participating in the interview. The results support the feasibility of using NSSI screening questionnaires in combination with follow-up interviews in schools.

Reciprocal prospective associations between disordered eating and other psychological problems in a community sample of Swedish adolescent girls

Disordered eating and its associations with psychological difficulties and body satisfaction were prospectively studied in a community sample of 13-15 year old adolescent girls (N=428). General psychological difficulties (including hyperactivity-inattention) and lower levels of body satisfaction at T1 were found to predict disordered eating at follow-up one year later (T2). Furthermore, reciprocal associations were found between disordered eating and psychological difficulties (but not body dissatisfaction) so that disordered eating at T1 predicted general psychological difficulties (including hyperactivity-inattention) at T2. The results support the notion of a vicious interplay between disordered eating and other subclinical psychological problems, which may represent a potential mechanism for the development of clinically significant eating disorders. It is suggested that it could be important to identify these kinds of bidirectional processes at an early stage, in order to prevent further developments of clinical forms of psychopathology.

Direct and indirect aggression and victimization in adolescents - associations with the development of psychological difficulties

BackgroundPrevious research has established that direct and indirect forms of aggression differ in their association with gender and type of psychological difficulties. One purpose of the present study was to test if the same applies to direct and indirect victimization. A second purpose was to study these associations not only cross-sectionally (as in most previous research) but also longitudinally. A third purpose was to test the hypotheses that there are prospective bidirectional associations not only between victimization and psychological difficulties (which has been shown in previous research), but also between aggression and psychological difficulties, and that direct and indirect forms of aggression and victimization show different associations with different types of psychological difficulties.MethodsThe participants were a community sample of all students in two grades of regular school in a Swedish municipality who answered questionnaires as part of a two-wave longitudinal study with a one-year interval. The participants were 13–15 years old, and there were longitudinal data on 893 students, which represented 85% of all students. The cross-sectional associations were primarily tested by semi-partial correlations, and the longitudinal associations by hierarchical multiple regression.ResultsThe results corroborated the meaningfulness of differentiating not only between direct and indirect aggression but also between direct and indirect victimization. Boys reported being more victim to direct aggression, whereas girls reported being more victim to indirect aggression. Direct aggression predicted increased conduct problems in boys, whereas indirect aggression predicted increased conduct problems in girls, and conduct problems reciprocally predicted increased direct and indirect aggression. Indirect victimization showed prospective bidirectional associations with emotional symptoms and conduct problems, suggesting the potential development of vicious cycles of escalating problems in these areas.ConclusionsThe present results indicate that direct and indirect aggression, as well as direct and indirect victimization, may have different roles in the development of psychological difficulties in young adolescents. Further, the demonstration of prospective bidirectional associations points to a possible mechanism for the development of psychological difficulties, that may be described in terms of dynamical systems theory. This has potential relevance both for the prevention and the treatment of psychopathology.

Eating-related problems among 13-15 year old Swedish adolescents: Frequency and stability over a one-year period.

The frequency of eating-related problems in young adolescents, and their stability over a one-year period, was studied by the RiBED-8 (Risk Behaviours related to Eating Disorders, 8 items) in a community sample of 13-15 year old adolescents who took part in a prospective study with a 2-wave longitudinal design. The RiBED-8 was found to have good reliability and construct validity among the girls, although it did not show equally convincing psychometric properties among boys. With a cut-off of at least three critical answers on the RiBED-8, 28.5-31.0% of the girls were seen as risk cases for the development of eating disorder. Of those girls who were risk cases at Time 1, a majority (68.8%) remained so at Time 2; of those girls who were not risk cases at Time 1, 16.1% became risk cases at Time 2. It is suggested that the RiBED-8 is a brief, easily administered instrument that may be potentially useful in screening for eating-related problems among girls.

Swedish adolescent girls in special residential treatment: A person-oriented approach to the identification of problem syndromes

Abstract The purpose of this series of three cross-sectional studies was to identify typical syndromes of self-reported externalizing and internalizing problems, and examine their overlap, among adolescent girls and young women in Swedish special residential homes for young people (N = 713). The associations with some family background factors were also investigated. Data came from a research register at the Swedish National Board of Institutional Care and concerned structured interviews with all girls admitted to these homes from 1997 to 2001. An advanced clustering procedure was applied and significant syndrome structures were retrieved in both the externalizing and internalizing area. Among the nine externalizing syndromes were a low-problem syndrome and two multiple-problem syndromes, one combining aggressive behavior, alcohol use/abuse and criminality, and the other combining drug abuse with property/drug offenses. Among the seven internalizing syndromes were a low-problem syndrome, an anxiety/depression syndrome and a generalized internalizing syndrome with particularly high rates of physical and sexual abuse. Results supported the theoretical assumption, made within a holistic-interactionistic paradigm, that adjustment problems would co-occur in a limited number of syndromes. When the overlap between externalizing and internalizing syndromes was considered, good adjustment was generalized between the two areas, whereas there appeared to be an increased risk of having an internalizing syndrome among girls with externalizing syndromes related to aggressive behavior. It is of great importance to consider the full problem pattern of girls with externalizing adjustment problems, including internalizing problems and histories of physical and sexual abuse, when considering subgroups in need of different treatment regimes.

Relationship quality, well-being and, externalizing problems : The prospective importance of behavior profiles among young women who experienced care in special residential homes

Abstract This study examined the adjustment of a sample of adolescent girls and young women (N = 228) who were in compulsory care in Sweden between 1999 and 2000. Using person-oriented analyses, participants’ responses to the Adolescent Drug Abuse Diagnosis Instrument (Friedman & Utada, 1989; ADAD) at intake yielded five externalizing problem configurations. The main analyses focused on examining whether problem configuration at intake was important to participants’ adjustment at a four-year follow-up. Overall, results indicated that problem configuration can be important to later adjustment (less life satisfaction, more drug use, and problems controlling violent behavior), particularly if the problem configuration involves multiple problems at elevated levels and/or drug use. The implications of the study results are discussed in light of efforts to improve the tailoring of care and treatment for diverse youth who experience multiple problems.