Runar Vilhjalmsson

Factors associated with suicide ideation in adults

Abstract The study considers numerous factors potentially related to suicide ideation in adults, including life stress, stress perceptions, social support, personality, alcohol use, chronic conditions, distress symptoms and sociodemographic background. Using data from a health survey of 825 adult residents in the urban Reykjavik area of Iceland, the study finds that financial hardship, legal stress, family difficulties, stress perceptions and low material support are significantly related to thoughts of committing suicide. Multiple chronic conditions, frequent alcohol use and various forms of distress (e.g. depression, anxiety, hopelessness, pain) are also related to suicide ideation. Furthermore, low self-esteem and external locus of control (low sense of mastery) are both associated with suicidal thoughts. No significant relationships were found between sociodemographic background and suicide ideation. The meaning of the results, and their implications for continued theoretical and clinical work in this area, are discussed.

Sociodemographic differences in patterns of sedentary and physically active behavior in older children and adolescents

Numerous studies have found that involvement in moderate‐intensity and strenuous activity has positive effects on health. This study considered the prevalence of different aspects of physical activity and sedentary behavior in 11–16‐y‐olds based on a representative national survey of 3270 Icelandic primary schoolchildren (91% response rate). All‐day sedentary behavior was extremely rare (<1%), and the vast majority (91%) were physically active (≫3 times per week) during school or leisure time, thanks largely to school physical education. Only 39% were physically active (≫3 times per week) during leisure time, and only 29% engaged in regular (≫3 times per week) leisure time strenuous exercise. Girls were more sedentary, less leisure time physically active, and less involved in leisure time strenuous exercise. Sedentary behavior increased and physically active behavior decreased with age, especially after early adolescence. However, there were no age differences in strenuous leisure time exercise. Upper‐class students were less sedentary and more physically active during leisure time than working‐class students. Finally, rural students were more sedentary during leisure time, and less physically active than students from urban areas. An interaction was found between age and residence when predicting leisure time physical activity, indicating that the inverse age‐activity relationship in urban areas is partly reversed in rural areas.

Life stress, social support and clinical depression: A reanalysis of the literature

In recent years, theorists and researchers have disagreed about the relationship between social support and mental health. Some believe that support is a direct provoking agent (i.e. lack of support constitutes strain), whereas others maintain that support is a vulnerability factor moderating the effect of life stress. Focusing on clinical depression, the article reviews the arguments and evidence supporting a strain hypothesis of social support versus a vulnerability hypothesis. Reanalyzing cross-classified data from 12 community studies of clinical depression, the study shows that the choice of model depends on the specification of functional form of the stress-clinical depression relationship. The linear probability specification suggests a vulnerability hypothesis, whereas the logit and probit specifications support a strain hypothesis. However, theoretical and statistical arguments tend to favor a logit or probit specification, and an additional analysis of data from Brown and Harris [Social Origins of Depression: A Study of Psychiatric Disorder in Women. The Free Press, New York, 1978] supports these arguments. Thus, the study concludes that the strain hypothesis of social support is more consistent with the available data.

Sport participation and perceived health status: A study of adolescents

Although it is a well-accepted notion that sport participation enhances health, the precise nature of the relationship has been unclear. Based on a national survey of Icelandic adolescents, this study evaluates the direct and indirect effects of sport participation on perceived health status. It is shown that sport participation has a substantial direct effect on perceived health, controlling for other health related behaviours, psychological distress and disease status. Sport participation also affects perceived health indirectly through distress and smoking, but does not seem to operate through alcohol consumption. The meaning of these results and their implications for future research are discussed.

Effects of Social Support on Self-Assessed Health in Adolescence.

Based on a national survey of Icelandic adolescents, this study evaluates the effects of social support on self-assessed health. The study compares four support sources, and distinguishes between direct effects and indirect effects through (1) health-related behaviors and (2) different aspects of mental health. The study indicates that parental support has the largest total effect on self-assessed health, followed by friend support, and other adult support. (Sibling support is unrelated.) The total effect of parents is due to their pervasive indirect impact, i.e., supportive parents encourage positive health behaviors and enhance mental health, which results in favorable assessment of own health. In contrast, friends and other adults affect self-assessed health in a more specific, and sometimes negative manner. Also, friends are the only support source having direct effect on self-assessed health. The implication of these results are discussed.

Direct and indirect effects of chronic physical conditions on depression: A preliminary investigation

The study focuses on the relationship between chronic physical illness and depression in the general population. Based on a representative survey of 825 adult residents in the urban Reykjavik area of Iceland, the results suggest that chronic physical conditions affect depression directly, as well as indirectly by aggravating domestic, occupational, and economic strains, and by undermining personal resources (self-esteem and mastery). These relationships persisted when sociodemographic background and previous mental health status were controlled. A nonsignificant direct relationship between chronic physical conditions and social support suggests that chronic illness does not affect support independent of domestic and economic strains. Significant direct relationships between chronic physical illness and personal resources suggest that the experience of inescapable loss lowers self-esteem and the sense of mastery. The implications and limitations of the study are discussed.

Group differences in outpatient help-seeking for psychological distress: results from a national prospective study of Icelanders.

Aims: This study focused on group differences in health care use for psychological distress. Specifically, the study examined if some subgroups and kinds of distress predicted use of particular providers. Methods: The study uses data from a repeated national postal health survey of a random sample of Icelanders aged 18—75. Response rate at the first wave was 69% (n = 1924), and 83% of the participants from the first wave also responded to the second. The dependent variables referred to use of outpatient visits to different types of professionals (doctor, psychiatrist, registered nurse, psychologist, social worker, clergy, and complementary and alternative medicine provider). Results: Gender, age, marital status, residence, education and income affected the selection of healthcare provider. Significant interactions indicated, among other things, that divorced people made the most visits to psychiatrists when depressed, that urban residents visited psychiatrists and psychologists more than others when experiencing anxiety, that the university-educated visited psychologists more when depressed, and that individuals with higher incomes visited psychiatrists, nurses and social workers less when experiencing anxiety or depression. Conclusions: Results indicate considerable group variations in help-seeking. The group in question and the nature of symptoms affected the decision where to seek help. A substantial number of distressed individuals do not seek any professional help, and there are indications of inequity in the distribution of health services. Further studies are needed to better understand the complex social selection processes involved in seeking help for psychological problems.

Financial crisis and collapsed banks: Psychological distress and work related factors among surviving employees—A nation‐wide study

AIM The study considered psychological distress among surviving bank employees differently entangled in downsizing and restructuring following the financial crisis of 2008. METHODS A cross-sectional, nationwide study was conducted among surviving employees (N = 1880, response rate 68%). Multivariate analysis was conducted to assess factors associated with psychological distress. RESULTS In the banks, where all employees experienced rapid and unpredictable organizational changes, psychological distress was higher among employees most entangled in the downsizing and restructuring process. Being subjected to downsizing within own department, salary cut, and transfer to another department, was directly related to increased psychological distress, controlling for background factors. The associations between downsizing, restructuring, and distress were reduced somewhat by adding job demands, job control, and empowering leadership to the model, however, adding social support had little effect on these associations. CONCLUSION Employees most entangled in organizational changes are the most vulnerable and should be prioritized in workplace interventions during organizational changes.

Bodily Deviations and Body Image in Adolescence

Adolescents with unusually sized or shaped bodies may experience ridicule, rejection, or exclusion based on their negatively valued bodily characteristics. Such experiences can have negative consequences for a person’s image and evaluation of self. This study focuses on the relationship between bodily deviations and body image and is based on a national survey of 3,898 students attending 9th and 10th grade (age 14-16) in the Icelandic school system (92% response rate). Girls had a considerably lower body image than boys. Overweight and heaviness were related to lower body image among both genders. Interactions with gender showed that short stature was negatively related to body image among boys, whereas underweight was positively related to body image among girls. Bodily deviations can have positive implications, as shown by the fact that tall boys and girls had a more positive image of their body than their peers of lower stature. Theoretical and practical implications of these results are discussed.

The social context of drunkenness in mid-adolescence

Aims: The aim of the study was to assess sociodemographic, parental and peer predictors of self-reported drunkenness in mid-adolescence. Methods: The data were obtained from a national school survey covering a random half of all Icelandic 9th and 10th grade students (mean age 14.7 years). The overall response rate was 92% (n = 3,913). Results: 30% of the respondents reported having been drunk or intoxicated at least once during the 30-day period prior to the survey. Multivariate logistic regression analysis showed that living with a single father, or in an urban area; having friends who get drunk or accept drunkenness; being supported by friends; having a father who gets drunk; having parents who assent to drunkenness; and lacking support from parents, were significantly associated with drunkenness. The strongest predictors of drunkenness were drunkenness among friends and friends’ acceptance of drinking. The study did not find significant differences in the odds of drunkenness by gender or parental education. Students in 10th grade had higher odds of drunkeness than 9th grade students, which was accounted for by different family and peer contexts of younger and older adolescents. Conclusions: Residence, family structure, high peer support, peer acceptance, peer drunkenness, parental acceptance, father drunkenness, and low parental support was related to higher odds of drunkenness in mid-adolescents. The results give directions to future research and interventions intended to prevent alcohol abuse in this population.