Mathias Lasgaard

Loneliness, Depressive Symptomatology, and Suicide Ideation in Adolescence: Cross-Sectional and Longitudinal Analyses

The paper presents the first known longitudinal study of the relationship between loneliness, depressive symptoms, and suicide ideation in adolescence, in a stratified sample of high school students (Time 1 N = 1009; 57 % female; Time 2 N = 541; 60 % female). Cross-lagged structural equation modeling indicated that depressive symptoms led to more loneliness across time, whereas loneliness did not predict higher levels of depressive symptoms across time. Loneliness was found to be a correlate of depressive symptoms at the cross-sectional level, independent of gender, other demographic factors, multiple psychosocial variables, and social desirability. Loneliness did not predict suicide ideation over time or at the cross-sectional level, when controlling for depressive symptoms. Gender did not predict loneliness, depressive symptoms or suicide ideation across time. Future longitudinal studies of the relationship between loneliness, depressive symptoms, and suicide ideation in adolescence should use more extensive designs.

A confirmatory factor analysis of combined models of the Harvard Trauma Questionnaire and the Inventory of Complicated Grief-Revised: Are we measuring complicated grief or posttraumatic stress?

The aim of this study was to assess the factorial structure of complicated grief (CG) and investigate the relationship between CG and posttraumatic stress disorder (PTSD) through the assessment of models combining both constructs. The questionnaire was completed by elderly, married respondents with a history of at least one significant, interpersonal loss (145 males and 147 females, 60-81 years). Confirmatory factor analysis (CFA) supported a two-factor model of separation and traumatic distress in CG. To investigate the relationship between CG and PTSD three combined models were specified and estimated using CFA. A model where all five factors, the two factors of CG and the three factors of PTSD, as defined by the DSM-IV, were allowed to correlate provided the best fit. The results indicated a considerable overlap between the dimensions of CG and PTSD, and complicated grief is construct that appears to be largely accounted for by especially the intrusive component of PTSD.

The Prevalence of Four Types of Childhood Maltreatment in Denmark

Objectives: To estimate the prevalence of four types of childhood maltreatment in Denmark while taking into considerations how each of the types of maltreatment vary as a function of gender or child-protection status. Methods: Data were collected from a Danish national study conducted by The Danish National Centre for Social Research in 2008 and 2009. The study used a stratified random probability sample of young people aged 24 years. A sample of 4718 young adults were randomly selected by Statistics Denmark using the total birth cohort of all children born in 1984. The response rate was 63% leaving a total effective sample size of 2980. A structured residential or telephone interview enquired about a range of respondents maltreatment experiences. Results: Maltreatment is experienced by a significant proportion of Danish children. The reported prevalence rates were; physical neglect (3.0%), emotional abuse (5.2%), physical abuse (5.4%) and sexual abuse (3.4%). All trauma types were experienced by a greater percentage of females compared to males with the exception of physical abuse and all trauma types were experienced by a greater percentage of children given child-protection status. Conclusions: Female children and children who are given child protection status are those most at risk for experiencing maltreatment in Denmark. However, variability in prevalence rates of maltreatment across studies is problematic. Methodological variations and variation in abuse definitions may be partly attributable.

Gaps in understanding health and engagement with healthcare providers across common long-term conditions: a population survey of health literacy in 29 473 Danish citizens

Objectives To (1) quantify levels of subjective health literacy in people with long-term health conditions (diabetes, cardiovascular disease, chronic obstructive pulmonary disease, musculoskeletal disorders, cancer and mental disorders) and compare these to levels in the general population and (2) examine the association between health literacy, socioeconomic characteristics and comorbidity in each long-term condition group. Design Population-based survey in the Central Denmark Region (n=29 473). Main outcome measures Health literacy was measured using two scales from the Health Literacy Questionnaire (HLQ): (1) Ability to understand health information and (2) Ability to actively engage with healthcare providers. Results People with long-term conditions reported more difficulties than the general population in understanding health information and actively engaging with healthcare providers. Wide variation was found between disease groups, with people with cancer having fewer difficulties and people with mental health disorders having more difficulties in actively engaging with healthcare providers than other long-term condition groups. Having more than one long-term condition was associated with more difficulty in engaging with healthcare providers and understanding health information. People with low levels of education had lower health literacy than people with high levels of education. Conclusions Compared with the general population, people with long-term conditions report more difficulties in understanding health information and engaging with healthcare providers. These two dimensions are critical to the provision of patient-centred healthcare and for optimising health outcomes. More effort should be made to respond to the health literacy needs among individuals with long-term conditions, multiple comorbidities and low education levels, to improve health outcomes and to reduce social inequality in health.

Testing a Multiple Mediator Model of the Effect of Childhood Sexual Abuse on Adolescent Sexual Victimization

The present study modeled the direct relationship between child sexual abuse (CSA) and adolescent peer-to-peer sexual victimization (APSV) and the mediated effect via variables representing the number of sexual partners, sexual risk behavior, and signaling sexual boundaries. A cross-sectional study on the effect of CSA on APSV was conducted, utilizing a multiple mediator model. Mediated and direct effects in the model were estimated employing Mplus using bootstrapped percentile based confidence intervals to test for significance of mediated effects. The study employed 327 Danish female adolescents with a mean age of 14.9 years (SD = 0.5). The estimates from the mediational model indicated full mediation of the effect of CSA on APSV via number of sexual partners and sexual risk behavior. The current study suggests that the link between CSA and APSV was mediated by sexual behaviors specifically pertaining to situations of social peer interaction, rather than directly on prior experiences of sexual victimization. The present study identifies a modifiable target area for intervention to reduce adolescent sexual revictimization.

Posttraumatic stress disorder among bereaved relatives of cancer patients.

The aim of this study was to assess post-traumatic stress disorder (PTSD) and predictors of PTSD in individuals who experienced the loss of a close relative to cancer. A total of 251 bereaved relatives ages 14 to 76 (M = 41.3, SD = 16.8) were recruited at a counseling service for cancer patients and their relatives. The prevalence of current probable PTSD was 40% in the bereaved sample. A hierarchical logistic regression analysis indicated that full-time employment, perceived control, and a secure attachment style moderated the risk for PTSD. Moreover, a long period of caretaking, high levels of somatization, and dissociation were all associated with an increased risk of PTSD.

Health literacy mediates the relationship between educational attainment and health behavior: A Danish population-based study

Individuals with a lower education level frequently have unhealthier behaviors than individuals with a higher education level, but the pathway is not fully understood. The aim of this study was to investigate whether health literacy mediates the association between educational attainment and health behavior (smoking, physical inactivity, poor diet) and obesity. The study included respondents ages 25 years or older drawn from a large population-based survey conducted in 2013 (N = 29,473). Two scales from the Health Literacy Questionnaire were used: (a) Understanding health information well enough to know what to do and (b) Ability to actively engage with health care providers. Multiple mediation analyses were conducted using the Karlson-Holm-Breen method. The study showed that health literacy in general and the ability to understand health information in particular mediated the relationship between educational attainment and health behavior, especially in relation to being physically inactive (accounting for 20% of the variance), having a poor diet (accounting for 13% of the variance), and being obese (accounting for 16% of the variance). These findings suggest that strategies for improving health behavior and reducing health inequalities may benefit from adopting a stronger focus on health literacy within prevention, patient education, and other public health interventions.

The latent factor structure of acute stress disorder following bank robbery: Testing alternative models in light of the pending DSM‐5

OBJECTIVE Acute stress disorder (ASD) was introduced into the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) to identify posttraumatic stress reactions occurring within the first month after a trauma and thus help to identify victims at risk of developing posttraumatic stress disorder (PTSD). Since its introduction, research into ASD has focused on the prediction of PTSD, whereas only a few studies have investigated the latent structure of ASD. Results of the latter have been mixed. In light of the current proposal for the ASD diagnosis in the pending DSM-5, there is a profound need for empirical studies that investigate the latent structure of ASD prior to the DSM-5 being finalized. DESIGN Based on previous factor analytic research, the DSM-IV, and the proposed DSM-5 formulation of ASD, four different models of the latent structure of ASD were specified and estimated. METHOD The analyses were based on a national study of bank robbery victims (N = 450) using the acute stress disorder scale. RESULTS The results of the confirmatory factor analyses showed that the DSM-IV model provided the best fit to the data. Thus, the present study suggests that the latent structure of ASD may best be characterized according to the four-factor DSM-IV model of ASD (i.e., dissociation, re-experiencing, avoidance, and arousal) following exposure to bank robbery. CONCLUSIONS The results are pertinent in light of the pending DSM-5 and add to the debate about the conceptualization of ASD. .

Traumatic in Israeli Youth Sample

The on-going Israeli-Palestinian conflict is a cause of exposure to traumatic events for many people in the affected area. The present study investigated the prevalence and psychological impact of traumatic events among adolescents living in the Tel Aviv-area. 494 9th and 10th grade students (M = 15.6 years) reported exposure to 20 potentially traumatizing events and distress symptoms. The findings suggest that the prevalence of traumatic events was considerable among Israeli youth. Eighty-five percent of the students had been exposed to at least one traumatic event, and the two most common events recorded were almost being injured or killed (exposed students: 45%) and war (exposed students: 44%). Exposure to multiple traumatic events, the presence of recent exposure, and a number of specific events, in particular humiliation or persecution, attempted suicide, and childhood neglect, were associated with an increase in symptomatology. However, exposure to war, terrorist attacks, and not knowing if family members/friends were alive, did not increase the level of symptomatology. The apparently limited psychological impact of exposure to war-like events is discussed.

Adolescent sexual victimization: A prospective study on risk factors for first time sexual assault

The present study set out to investigate predictors of first time adolescent peer-on-peer sexual victimization (APSV) among 238 female Grade 9 students from 30 schools in Denmark. A prospective research design was utilized to examine the relationship among five potential predictors as measured at baseline and first time APSV during a 6-month period. Data analysis was a binary logistic regression analysis. Number of sexual partners and displaying sexual risk behaviors significantly predicted subsequent first time peer-on-peer sexual victimization, whereas a history of child sexual abuse, early sexual onset and failing to signal sexual boundaries did not. The present study identifies specific risk factors for first time sexual victimization that are potentially changeable. Thus, the results may inform prevention initiatives targeting initial experiences of APSV.