Sexual Attraction and Non-Suicidal Self-Harm: The Role of Stressors and Psychological Mediators.

Non-suicidal self-harm (NSSH) is a serious concern for the well-being of youth. Stressors relate to greater NSSH risk, such as being non-heterosexual in a heteronormative society. Other stressors may include traumatic experiences. These relationships may be mediated by psychological factors (depressed mood, anxiety, anger, and self-esteem) as well as contextual factors (support from parents and peers). The purpose of this study was to examine NSHH ideation and behavior among Icelandic youth, as well as relationships with stressors and mediators. Students in Icelandic high schools (N = 8921, 50.8% female) completed an in-class survey in the year 2016. Results showed an elevated risk of NSSH ideation and behavior among bisexual and homosexual youth. Mediation analyses showed that, for girls, being bisexual related to greater NSSH ideation and behavior, and these relationships were mediated by depressed mood, anger, and self-esteem, as well as by support from parents and peers. For boys, however, both homosexual and bisexual attraction related to greater risk for NSSH ideation and behavior, which was mediated by depressed mood, anger, and self-esteem. These results suggest that NSSH risk factors vary by gender and, therefore, they may benefit from different interventions to stop and prevent this behavior. This is the first study of its kind in Iceland, where sexual minority stress may need further study within the Nordic context.

A Virtual Reality Courtroom for Survivors of Sexual Violence: A Mixed-Method Pilot Study on Application Possibilities.

This mixed-method pilot study examined the application possibilities of a virtual courtroom to support survivors of sexual violence who may experience courtroom-associated distress. Female sexual violence survivors (n = 13) who had testified in court following victimization entered an interactive virtual courtroom replica. Their reactions were measured quantitatively and qualitatively. The virtual courtroom evoked both subjective and physiological stress. Participants perceived the virtual reality environment as similar to the real-life courtroom. Most reported negative experiences from interacting with the criminal justice system. The virtual courtroom is a possible future strategy to support survivors when reporting violence to the justice system.

Prevalence of trauma exposure and PTSD symptoms among the Icelandic population: gender and regional differences.

AIM: The primary aim of this cross-sectional study was to provide descriptive data about the lifetime prevalence of trauma exposure with a particular focus on sexual violence and natural disasters and to assess the prevalence of symptoms of post-traumatic stress disorder (PTSD) in the Icelandic population. In addition, the aim was to investigate whether PTSD symptoms, trauma types and prevalence differed by gender and geographical location. METHOD: A representative sample of the population between the ages of 18 and 80 years was randomly selected from the Icelandic National Registrar. The study included a total of 1766 participants consisting of 930 (52.7%) women and 836 (47.3%) men, with an overall mean age of 49.9 years (standard deviation 16.1). Participants were contacted by phone and asked questions from the Lifetime Events Checklist (LEC-5) to assess lifetime exposure to traumatic events. Individuals who had experienced traumatic events completed the PTSD Checklist for DSM-5 (PCL-5) to assess PTSD symptoms. RESULTS: Exposure to trauma is common among the Icelandic population, with 84.3% of the participants experiencing at least one kind of trauma. Of those exposed to trauma, 10.5% fulfilled criteria indicating a higher risk of PTSD. The prevalence of sexual violence and other unwanted sexual experiences was relatively high (16.2% and 24.4%, respectively) compared with other national studies. Women were almost four times more likely than men to have been exposed to sexual violence (24.9% vs 6.4%), and were more likely to have been exposed to other unwanted sexual experience (35.1% vs 12.4%, respectively). Exposure to natural disasters is frequent but with great geographical variation. CONCLUSIONS: This study highlights the high prevalence of trauma in Iceland, revealing significant gender disparities in sexual violence and geographical variations in natural disaster exposure.

The role of childhood adversity and prenatal mental health as psychosocial risk factors for adverse delivery and neonatal outcomes.

OBJECTIVE: Exposure to adverse childhood experiences (ACEs) is a significant predictor for physical and mental health problems later in life, especially during the perinatal period. Prenatal common mental disorders (PCMDs) are well-established as a risk for obstetric interventions but knowledge on combined effects of multiple psychosocial risk factors is sparse. We aim to examine a comprehensive model of ACEs and PCMDs as risk factors for poor delivery and neonatal outcomes. METHOD: With structural equation modeling, we examined direct and indirect pathways between psychosocial risk and delivery and neonatal outcomes in a prospective cohort from pregnancy to birth in Iceland. RESULTS: Exposure to ACEs increased risk of PCMDs [ß = 0.538, p < .001, CI: 0.195-1.154] and preterm delivery [ß = 0.768, p < .05, CI: 0.279-1.007)]. An indirect association was found between ACEs and increased risk of non-spontaneous delivery [ß = 0.054, p < .05, CI: 0.004-0.152], mediated by PCMDs. Identical findings were observed for ACEs subcategories. CONCLUSION: ACEs are strong predictors for mental health problems during pregnancy. Both ACEs and PCMDs diagnosis are associated with operative delivery interventions and neonatal outcomes. Findings underscore the importance of identifying high-risk women and interventions aimed at decreasing psychosocial risk during the prenatal period.

Associations among posttraumatic growth, demographic characteristics, posttraumatic stress symptoms, and trauma type, with a focus on sexual violence.

This study assessed posttraumatic growth (PTG) across multiple trauma types and by demographic characteristics (i.e., sex, age, education). Moreover, we examined the association between PTG and posttraumatic stress disorder (PTSD) symptoms as well as the characteristics and predictors of PTG after sexual violence. A phone survey was conducted in a nationally representative sample of 1,766 Icelandic adults. In total, 1,528 individuals reported having experienced some form of trauma and were included in the analysis, and 563 reported experiencing sexual violence. Interpersonal trauma (e.g., sexual violence, emotional abuse, and domestic violence) was associated with the highest levels of PTG. Moderate levels of PTSD symptoms were associated with the highest levels of PTG, whereas high- or low-level PTSD symptoms were related to less PTG. Women reported significantly more PTG than men, d = 0.16 and survivors of sexual violence reported significantly more PTG than individuals who reported other forms of trauma exposure, d = 0.28. Among sexual violence survivors, no demographic factors were associated with PTG, but cumulative trauma and positive social reactions were significantly related to higher levels of PTG. This study highlights that personal growth can result from aversive experiences and suggests a curvilinear association between PTG and PTSD symptoms.

A year of Covid-19: experiences and lessons learnt by small European island states-Cyprus, Iceland and Malta.

BACKGROUND: COVID-19 became a global pandemic within weeks, as every country including small states and islands experienced a surge in cases. Small islands are known to face several challenges in the quest to curb the viral spread, but with the absence of land boarders and small population size, these factors should have played to their advantage to minimize the spread. The aim of this article was to compare and contrast the COVID-19 situation, restrictions, preparedness, management and the healthcare systems between the small population island states of Cyprus, Iceland and Malta. METHODS: Data were obtained from Ministry of Health websites and COVID dashboards of the three respective Island states in Europe. Comparisons were made between the reported cases, deaths, excess deaths, years of life lost, swabbing rates, restrictive measures, vaccination roll-out and healthcare system structures. RESULTS: Cyprus and Malta contained the COVID-19 spread better than Iceland during the first wave. However, a significantly higher viral spread and mortality rates were observed in Malta during the second waves. Similar healthcare preparedness and services, restrictions and relaxation measures were implemented across the three islands with some exceptions. Covid-19 vaccination has initiated across all Islands with Malta leading the vaccination roll-out. CONCLUSION: The small population size and island status proved to be an asset during the first wave of COVID-19, but different governance approaches led to a different COVID-19 outcomes, including high mortality rates during the transition phases and the subsequent waves.

Narcissism and Social Media: The Role of Communal Narcissism.

Agentic narcissism and vulnerable narcissism have been widely studied in relation to social media use. However, with research on communal narcissism in its early stages, the current study examines communal narcissism in relation to social media use. Specifically, the current study investigates whether communal narcissism is related to use and frequency of use of the popular social networking sites Instagram, Reddit and Twitter, and if communal narcissism relates to the importance of receiving feedback and to the quality-rating of self-presented content on those platforms. A total of 334 individuals were recruited from Amazon Mechanical Turk, with two-thirds being male (66.7%). A regression analysis showed that communal narcissism was related to increased use of Instagram and Twitter but not Reddit. Sharing content, the importance of feedback and better than average ratings had positive associations with communal narcissism. The relationship between communal narcissism and sharing on social media was fully mediated by wanting validation on social media and higher ratings of self-presented content. Communal narcissism had a notably strong relationship with wanting validation on all platforms and our results suggest that communal narcissism might be especially relevant in the context of social media use.

Haters Gonna Hate, Trolls Gonna Troll: The Personality Profile of a Facebook Troll.

Personality factors, such as the Dark Tetrad personality factors (Machiavellianism, narcissism and sadism) relate to greater online trolling. Other personality factors, such as the Big Five Personality factors, honesty-humility and negative social potency, may also play a role in cyberbullying, which is an aggressive behavior similar to trolling. The purpose of this study was to predict Facebook trolling behavior based on personality factors. A total of 139 participants completed a survey on their online behavior and personality factors. Online trolling behavior positively correlated with sadism, psychopathy and Machiavellianism, and negatively correlated with agreeableness, conscientiousness and honesty-humility. A hierarchical linear regression showed that sadism, Machiavellianism and negative social potency were the only unique predictors of online trolling behavior. Trolling was unrelated to the frequency of Facebook use and the frequency of commenting. Enjoyment of trolling fully mediated the relationship between Machiavellianism and the trolling behavior. The results thus suggested that Facebook trolling behaviors may be motivated by enjoying the manipulation of others.

Conducting national burden of disease studies in small countries in Europe- a feasible challenge?

BACKGROUND: Burden of Disease (BoD) studies use disability-adjusted life years (DALYs) as a population health metric to quantify the years of life lost due to morbidity and premature mortality for diseases, injuries and risk factors occurring in a region or a country. Small countries usually face a number of challenges to conduct epidemiological studies, such as national BoD studies, due to the lack of specific expertise and resources or absence of adequate data. Considering Europe's small countries of Cyprus, Iceland, Luxembourg, Malta and Montenegro, the aim was to assess whether the various national data sources identified are appropriate to perform national BoD studies. MAIN BODY: The five small countries have a well-established mortality registers following the ICD10 classification, which makes calculation of years of life lost (YLL) feasible. A number of health information data sources were identified in each country, which can provide prevalence data for the calculation of years lived with disability (YLD) for various conditions. These sources include disease-specific registers, hospital discharge data, primary health care data and epidemiological studies, provided by different organisations such as health directorates, institutes of public health, statistical offices and other bodies. Hence, DALYs can be estimated at a national level through the combination of the YLL and YLD information. On the other hand, small countries face unique challenges such as difficulty to ensure sample representativeness, variations in prevalence estimates especially for rarer diseases, existence of a substantial proportion of non-residents affiliated to healthcare systems and potential exclusion from some European or international initiatives. Recently established BoD networks may provide a platform for small countries to share experiences, expertise, and engage with countries and institutions that have long-standing experience with BoD assessment. CONCLUSION: Apart from mortality registries, adequate health data sources, notably for cancer, are potentially available at the small states to perform national BoD studies. Investing in sharing expert knowledge through engagement of researchers in BoD networks can enable the conduct of country specific BoD studies and the establishment of more accurate DALYs estimates. Such estimates can enable local policymakers to reflect on the relative burden of the different conditions that are contributing to morbidity and mortality at a country level.

The Impact of Sexual Abuse, Family Violence/Conflict, Spirituality, and Religion on Anger and Depressed Mood Among Adolescents.

Stressful life experiences, such as sexual abuse and family violence/conflict, relate to an increased risk of mental health problems. Religion and spirituality may prevent this negative impact, but religion and spirituality are lower among survivors of stressful life experiences. To explore this effect, we examined the relationship between childhood sexual abuse and family violence/conflict on anger and depressed mood. Survey data were collected from a large population-based sample of Icelandic adolescents (N = 7,365) on their stressful life experiences, religion, spirituality, and mental health. Survivors of stressful life experiences (sexual abuse or family violence/conflict) were significantly lower on religion and spirituality than others. A hierarchical linear regression showed that stressful life experiences contributed uniquely to higher levels of anger and depressed mood. Spirituality was associated with decreased anger and depressed mood. The religion of parents and peers was also associated with decreased anger. Religious participation, on the contrary, did not have a relationship with mental health outcomes. In addition, the negative association between spirituality and anger was stronger among survivors of sexual abuse than nonabused individuals. These results confirm previous research, indicating that survivors of stressful life experiences may experience less religion and spirituality. The results also extend existing knowledge by showing that spirituality may be even more beneficial among sexual abuse survivors, as a protective factor against anger. These findings can help in the minimization of the negative mental health impact of stressful life experiences.

Dyadic Reports Using the Parental Support after Child Sexual Abuse Measure: Psychometrics and Associations with Post-Traumatic Stress Disorder Symptoms.

This study assessed the psychometric properties of a new measure, the Parental Support after Child Sexual Abuse (PSCSA) survey, and tested the association between parents' and children's parental support reports and children's post-traumatic stress disorder (PTSD) symptoms. A total of 99 Icelandic children (86.5% girls, 6-18 years old, M = 13.9 years) starting therapy for child sexual abuse (CSA) and 98 non-offending parents (90.6% mothers, 23-58 years old, M = 41.2 years) participated in the study. Participants completed questionnaires on parental support (PSCSA) and children's PTSD symptom severity (University of California at Los Angeles Post-Traumatic Stress Disorder Reaction Index for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition). A total of 18 items were considered for the PSCSA parent version and nine for the PSCSA child version. Five reliable factors emerged for the parent version (Emotional support, Instrumental support, Self-blame, Child blame and Disbelief) using 16 items and one factor (combined Emotional and instrumental support) emerged for the child's version using eight items. On average, ratings for both Emotional and Instrumental support were higher for parents than their children. Emotional support reported by both parents and children was negatively associated with PTSD symptom severity. The PSCSA survey is a promising dyadic measure for future research and clinical use in children's advocacy centres.

WITHDRAWN: Dealing with COVID-19 in small European island states: Cyprus, Iceland and Malta.

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.

Longitudinal association between social media use and psychological distress among adolescents.

This study aimed to examine in a longitudinal cohort design whether social media use among adolescents is related to symptoms of social anxiety, depressed mood, and physical symptoms of anxiety over time. As part of the LIFECOURSE study of risk and protective factors for healthy adolescent development, three waves of school-based surveys of adolescents born in Iceland in 2004 were analyzed. Of the 3914 eligible adolescents, 2378 gave informed consent. Complete responses for this study were collected from 2211 students at the first wave, with 2052 responding roughly 12 months later, and 2097 responding in year 3. Linear mixed-effects models were used to analyze time spent on social media in relation to psychological distress over time. More time spent on social media was weakly but significantly associated with increased symptoms of depressed mood, social anxiety and symptoms of physical anxiety over time. However, the effect size of these relationships suggest they may not be of clinical relevance. The relationship between time spent on social media and symptoms of depressed mood and physical symptoms of anxiety grew stronger over time, although it is not known if this relationship is causal. The relationship between time spent on social media and all outcomes of psychological distress were stronger for girls than boys and increased social media use had a positive relationship with symptoms of depressed mood over time. The relationships found in this study were relatively small and future studies need to focus on the clinical and public health significance of these effects.

The Impact of COVID-19 on Mental Health: The Role of Locus on Control and Internet Use.

The true extent of the mental health implications of the COVID-19 pandemic are unclear, but early evidence suggests poorer mental health among those exposed to the pandemic. The Internet may have differential effects, by both connecting people with resources, or reinforce the constant checking of negative information. Moreover, locus of control becomes important in an uncontrollable pandemic. The current study aimed to examine whether exposure to COVID-19 would relate to greater symptoms of depression, anxiety and stress, and to examine the role of internet use and locus of control. Adults in the United States and five European countries (N = 1723) answered an online survey through the website Mturk. Results show elevated psychological symptoms among those who have become infected with COVID-19 or perceive themselves to be at high risk if infected. Experience using the Internet relates to fewer symptoms, but information seeking is associated with more symptoms. Internet social capital relates to fewer symptoms of depression. Having an external locus of control relates to greater symptoms. These findings suggest that public health officials need to focus on the mental health effects of the pandemic, and that internet use and locus of control could be targets to improve mental health in the population.

Active and Passive Social Media Use and Symptoms of Anxiety and Depressed Mood Among Icelandic Adolescents.

Adolescent use of social media platforms such as Facebook, Instagram, and Snapchat has increased dramatically over the last decade and now pervades their everyday social lives. Active and passive social media use may impact emotional health differently, but little is known about whether and to what extent either type of social media use influences emotional distress among young people. We analyzed population survey data collected from Icelandic adolescents (N = 10,563) to document the prevalence of social media use and investigate the relationship of both active and passive social media use with self-reported symptoms of anxiety and depressed mood. A hierarchical linear regression model revealed that passive social media use was related to greater symptoms of anxiety and depressed mood among adolescents and active social media use was related to decreased symptoms of anxiety and depressed mood, even after controlling for time spent on social media. When adding known risk and protective factors, self-esteem, offline peer support, poor body image, and social comparison to the model, active use was not related to emotional distress; however, passive use was still related to adolescent symptoms of anxiety and depressed mood. The effect of social media on emotional distress differed by gender as time spent on social media had a stronger relationship with emotional distress among girls. In addition, passive use was more strongly related to symptoms of depressed mood among girls. Future research should include risk and protective factors as mediators of different types of social media use and adolescent emotional distress.

Social Reactions to Sexual Assault Disclosure: A Qualitative Study of Informal Support Dyads.

This interview study examined 45 informal support dyads where sexual assault was disclosed. Analysis showed social reactions and appraisals of reactions varied by relationship type (family, friend, significant other). Themes identified were role reversal or "parentification" of supporters, reactions of anger and aggression toward perpetrators, supporters using their own trauma experiences to respond to survivors, and reactions of betrayal. Results revealed the potential for identifying relational patterns and dynamics occurring in social reactions through dyadic analysis not otherwise captured by a survivor-only perspective. This approach helps understand and address distinct relationship contexts to improve supporters' reactions to sexual assault disclosure.

A Short Measure of Social Reactions to Sexual Assault: The Social Reactions Questionnaire-Shortened.

Social reactions to disclosures of sexual assault have significant effects on women's postassault recovery. However, being the most widely used measure of these reactions, the 48-item Social Reactions Questionnaire (SRQ; Ullman, 2000) is too long for some research and evaluation efforts. Thus, we developed a 16-item short version, the Social Reactions Questionnaire-Shortened (SRQ-S). Three preexisting college and community samples of women survivors (N = 1,012; 1,084; and 344) were used to determine which SRQ items were most related to psychological symptoms and could form reliable subscales. The brief version was then administered in a college and community sample of 447 women survivors. Confirmatory factor analyses (CFAs) and supporting psychometrics showed the SRQ-S reliably measures three general scales of the SRQ (Turning Against, Unsupportive Acknowledgment, Positive Reactions) as well as eight 2-item subscales (e.g., Blame). The SRQ-S provides researchers and interventionists with a brief alternative measure to the original SRQ.

The increase in symptoms of anxiety and depressed mood among Icelandic adolescents: time trend between 2006 and 2016.

Background: Both research and popular media reports suggest that adolescent mental health has been deteriorating across societies with advanced economies. This study sought to describe the trends in self-reported symptoms of depressed mood and anxiety among Icelandic adolescents. Methods: Data for this study come from repeated, cross-sectional, population-based school surveys of 43 482 Icelandic adolescents in 9th and 10th grade, with six waves of pooled data from 2006 to 2016. We used analysis of variance, linear regression and binomial logistic regression to examine trends in symptom scores of anxiety and depressed mood over time. Gender differences in trends of high symptoms were also tested for interactions. Results: Linear regression analysis showed a significant linear increase over the course of the study period in mean symptoms of anxiety and depressed mood for girls only; however, symptoms of anxiety among boys decreased. The proportion of adolescents reporting high depressive symptoms increased by 1.6% for boys and 6.8% for girls; the proportion of those reporting high anxiety symptoms increased by 1.3% for boys and 8.6% for girls. Over the study period, the odds for reporting high depressive symptoms and high anxiety symptoms were significantly higher for both genders. Girls were more likely to report high symptoms of anxiety and depressed mood than boys. Conclusions: Self-reported symptoms of anxiety and depressed mood have increased over time among Icelandic adolescents. Our findings suggest that future research needs to look beyond mean changes and examine the trends among those adolescents who report high symptoms of emotional distress.

Sexual Orientation, Race, and Trauma as Predictors of Sexual Assault Recovery.

Sexual minorities and racial minorities experience greater negative impact following sexual assault. We examined recovery from sexual assault among women who identified as heterosexual and bisexual across racial groups. A community sample of women (N = 905) completed three yearly surveys about sexual victimization, recovery outcomes, race group, and sexual minority status. Bisexual women and Black women reported greater recovery problems. However, Black women improved more quickly on depression symptoms than non-Black women. Finally, repeated adult victimization uniquely undermined survivors' recovery, even when controlling for child sexual abuse. Sexual minority and race status variables and their intersections with revictimization play roles in recovery and should be considered in treatment protocols for sexual assault survivors.