Viveca Östberg

School stressors, psychological complaints and psychosomatic pain

Background: The proportion of Scandinavian school children reporting psychosomatic pain and psychological complaints have increased in recent decades. In this study we investigated these symptoms in relation to potential stressors in the school environment.

Living conditions and psychosomatic complaints in Swedish schoolchildren.

Background: The proportion of Swedish schoolchildren that reports psychosomatic complaints has increased during recent decades, parallel to major structural changes in Swedish society. Aim: To investigate the association of psychosomatic complaints in relation to household socio‐economic conditions. Methods: Cross‐sectional study based on data from child supplements linked to nationally representative household surveys in Sweden during 2000–2003, covering a sample of 5390 children aged 10–18 y. Symptom variables were based on child interviews, while data from parental interviews were used to create socio‐economic variables. Results: Girls more often reported headache and recurrent abdominal pain (RAP) than boys, and these differences became more pronounced with age. Economic stress in the household was associated with headache (OR 1.21, p < 0.05), RAP (OR 1.46, p < 0.001) as well as difficulties falling asleep (OR 1.35, p < 0.01), while there were no consistent associations between symptoms and social class or unemployed parents. Children in single‐parent families consistently reported somewhat more symptoms than children in two‐parent families (OR 1.26 for at least two of the three symptoms, p < 0.05).

Stressor, perceived stress and recurrent pain in Swedish schoolchildren

OBJECTIVE Stress is an important etiological factor for pain. Little is known, however, about how this process is mediated. The aim of this study is to highlight how more stress corresponds with the amount of reported perceived stress, pain symptom, and the co-occurrence of two pain symptoms--headache and abdominal pain--and how these three phenomena are related. We have also studied possible gender differences. METHODS A cross-sectional study based on data from child supplements linked to national household surveys in Sweden during 2002-2003. Information concerning harassment, perceived stress, headache, and abdominal pain was gathered from a questionnaire. The study population consisted of a representative national sample of 2597 children aged 10-18 years. RESULTS Childrens reports of exposure to the stressor harassment were associated with their subjective perception of stress and recurrent pain in a stepwise manner. Having both pain symptoms was more strongly associated with the stressor harassment and perceived stress than having only one pain symptom. This was especially true of girls, who reported higher levels of stress symptoms and who had a different profile of pain symptoms than boys. CONCLUSIONS The stressor harassment, perceived stress, and recurrent pain are associated with each other in a stepwise fashion. The co-occurrence of headache and abdominal pain is much more closely associated with harassment and perceived stress than any of these symptoms separately, especially in girls.

Getting by with a little help: The importance of various types of social support for health problems

Aims: Our understanding of the relative importance of various types of social support is still limited. This study examines the overall and relative importance of various types of social support for health problems in a general population. The support resources focused on differ in character and represent companionship and emotional, instrumental, and informational types of social support. The health problems are depression, circulatory problems, and self-rated general health. Methods: The logistic regression analyses are based on a Swedish nationally representative sample of 5,053 adults, aged 18—75, interviewed in the Level of Living Survey in 2000. Panel data from the earlier interview wave in 1991 were also used. Results: The number of support resources was associated with all the health problems studied. The availability of economic support was important relative to the other support resources (or of similar importance), irrespective of marital status, social class, and own economic situation. The associations hold when earlier health status was controlled for. Having someone to talk to about personal problems and having someone for company were relevant, especially the latter. This support resource demonstrated an association with all health problems, which remains when the other support resources and earlier health status are taken into consideration. Conclusions: In the Swedish population, the number of support resources was linked to health problems, indicating the usefulness of a diverse resource pool. The multidimensional approach revealed that economic support, company, and, to a more limited extent, the opportunity to discuss personal problems were most important.

Childhood Peer Status and Adult Susceptibility to Anxiety and Depression. A 30-Year Hospital Follow-up

This study examined the extent to which sixth grade peer status could predict anxiety and/or depression in 5,242 women and 5,004 men who were born in 1953 and whose hospital records were followed up from 1973–2003. The data used was the Stockholm Birth Cohort Study. While no association could be established for men, results indicated that women who held low peer status positions in childhood were at a considerably higher risk of anxiety and/or depression later in life compared to women in average status positions. Women who held popular positions during childhood did not differ significantly from their average counterparts. These findings persisted after adjusting for family- and child-related problem-load, perceived security at school, family constellation, socioeconomic status as well as the child’s cognitive ability, ninth grade school marks and continuance to upper secondary school.

Mortality among children and young persons in Sweden in relation to childhood socioeconomic group.

More than 1.5 million children in Sweden were followed up for the period 1961-1979 with respect to mortality. Mortality differences by socioeconomic group were studied for the age groups 1-19 years. Children in families of non-manual workers, both boys and girls, had a significantly lower mortality than children of manual workers and children of self employed persons. The socioeconomic differences in risk of dying were greater among boys than among girls. For boys, the socioeconomic differences grew smaller as the boys grew older.

School performance and hospital admissions due to self-inflicted injury: a Swedish national cohort study

BACKGROUND Self-inflicted injury in youth has increased in many Western countries during recent decades. Education is the most influential societal determinant of living conditions in young people after early childhood. This study tested the hypothesis that school performance predicts self-inflicted injury. METHODS A national cohort of 447 929 children born during 1973-77 was followed prospectively in the National Patient Discharge Register from the end of their ninth and last year of compulsory school until 2001. Multivariate Cox analyses of proportional hazards were used to test hypotheses regarding grades in ninth grade as predictors of hospital admission due to self-inflicted injury. RESULTS The risk of hospital admission because of self-inflicted injury increased steeply in a step-wise manner with decreasing grade point average. Hazard ratios were 6.2 (95% confidence interval 5.5-7.0) in those with the lowest level of grade point average compared with the highest. The risks were similar for women and men. Adjustment for potential socio-economic confounders in a multivariate proportional hazards regression analysis attenuated this strong gradient only marginally. CONCLUSION School performance is a strong factor for predicting future mental ill-health as expressed by self-inflicted injury.

Prenatal parental depression and preterm birth: a national cohort study

To investigate the effects of maternal and paternal depression on the risk for preterm birth.

Friendship network characteristics and psychological well-being in late adolescence: Exploring differences by gender and gender composition

Aims: The aim of the present study was to examine the association between friendship networks and psychological well-being among 19-year-olds. Methods: The data used was a random sample of Swedish individuals born in 1990 who answered a questionnaire in 2009–2010. Friendship networks were considered in terms of three measures of emotional support. Six statements about the individual’s emotional state were used to create a summary measure of psychological well-being. Gender and gender composition were included as potentially moderating factors. The association between friendship networks and psychological well-being was analysed by means of linear regression analysis (n = 1289). Results: The results indicate that males’ and females’ friendship networks were similar with regard to quality and trust, whereas males’ networks were characterized by less self-disclosure and a stronger preference for same-gender friendships. Gender composition did not matter for the support levels. Emotional support was associated with psychological well-being but there were gender differences: females seemed to benefit more health-wise from having high-quality (and trusting) networks. Moreover, whereas self-disclosure among males was positively linked to well-being, this was not the case among females. None of these associations were moderated by gender composition. Conclusions: In sum, friendship networks are beneficial for the psychological well-being among late adolescents, but there are some important differences according to gender.

A national cohort study of parental socioeconomic status and non-fatal suicidal behaviour-the mediating role of school performance

BackgroundA link between low parental socioeconomic status and mental health problems in offspring is well established in previous research. The mechanisms that explain this link are largely unknown. The present study investigated whether school performance was a mediating and/or moderating factor in the path between parental socioeconomic status and the risk of hospital admission for non-fatal suicidal behaviour.MethodsA national cohort of 447 929 children born during 1973-1977 was followed prospectively in the National Patient Discharge Register from the end of their ninth and final year of compulsory school until 2001. Multivariate Cox proportional hazards and linear regression analyses were performed to test whether the association between parental socioeconomic status and non-fatal suicidal behaviour was mediated or moderated by school performance.ResultsThe results of a series of multiple regression analyses, adjusted for demographic variables, revealed that school performance was as an important mediator in the relationship between parental socioeconomic status and risk of non-fatal suicidal behaviour, accounting for 60% of the variance. The hypothesized moderation of parental socioeconomic status-non-fatal suicidal behaviour relationship by school performance was not supported.ConclusionsSchool performance is an important mediator through which parental socioeconomic status translates into a risk for non-fatal suicidal behaviour. Prevention efforts aimed to reduce socioeconomic inequalities in non-fatal suicidal behaviour among young people will need to consider socioeconomic inequalities in school performance.