Symptoms of depression and internalizing problems in early adulthood - associated factors from birth to adolescence.

PURPOSE: Even though the mechanisms behind the development of depression and internalizing problems remains unknown, many different factors have been shown to increase the risk. Longitudinal studies enable the investigation of exposure during different developmental periods during childhood. This study aims to examine factors associated with depressive and internalizing problems at age 20 in terms of sociodemographic factors, previous mental health problems and stressful life events during childhood, adolescence, and early adulthood. METHODS: A birth cohort of 1723 children were followed to age 20. At the 20-year follow-up, n = 731 (44%) participated. Standardized instruments were filled out at baseline and the 3-,12- and 20-year follow-ups. RESULTS: Depressive problems at age 20 were associated with female gender, experience of interpersonal life events reported at age 20, bullying victimization and reports on paternal mental health problems. Participants with depressive problems were also less likely to have experienced adolescence as happy and to report that their father had been a good father. Internalizing problems at age 20 were, in addition, associated with internalizing problems at age 12 and reports on maternal mental health problems. Internalizing problems were associated with a lower likelihood of experiencing adolescence as happy in the final model. CONCLUSION: Recent events (i.e. interpersonal life events and bullying) seemed to be the most influential factors on the development of internalizing and depressive problems. Internalizing problems during childhood increased the risk for internalizing problems in early adulthood, emphasizing the importance of early intervention. Fewer factors were found to increase the risk for depressive problems compared to internalizing problems.

Adolescents' Use of Pornography: Trends over a Ten-year Period in Sweden.

Using survey data from three nationally representative surveys in 2004, 2009, and 2014 among senior high school students in Sweden, this study investigates trends in adolescents' lifetime prevalence of pornography use, frequency of pornography use, and type of pornography used over time. While almost all boys and a considerable proportion of girls used pornography across the three waves, the lifetime prevalence of pornography use decreased overall for both girls and boys. The share of boys who use pornography frequently increased over the three survey cycles; those who reported using pornography daily increased from 11% in 2004 to 24% in 2014. In contrast, there was no change in girls who reported using pornography daily, while the proportion who never used pornography increased from 40% in 2004 to 51% in 2014. Adolescents appear to use a narrower range of different pornography types over the survey cycles. Multiple logistic regression models were generated to investigate factors associated with pornography use over the 10-year period. The results suggest that rule-breaking behavior, having higher economic status and higher academic achievement were related to boy's pornography use, while rule-breaking behavior, early sexual debut and victimization were associated with girls' pornography use.

Psychometric properties of the Adolescent Resilience Questionnaire (ARQ) in a sample of Swedish adolescents.

BACKGROUND: The importance of resilience, and interest in it, has increased markedly in recent years, based on the need to understand why some children and young people have a resilience to stress that others lack. At the same time, there has been a lack of instruments to measure resilience. The aim of this study was to translate the Adolescent Resilience Questionnaire (ARQ) into Swedish and investigate the psychometrics of this Swedish version. METHODS: A normative sample of 616 students aged 15-17 was recruited through the school system in five different communities. Students filled out a digitalised composite form consisting of ARQ and three other standardised questionnaires, the Sense of Coherence Scale-13 (Soc-13), the Rosenberg Self-Esteem Scale (RSES) and the Relationship Questionnaire (RQ). RESULTS: The ARQ, with five domains and twelve subscales, showed good alpha coefficients α = .95 for the total scale and subscales ranging between α = .70 to .91, except for the subscales Emotional insight (α = 0.69) and Empathy/Tolerance (α = .61). The convergent validity, which was tested for the first time in this study, was good, especially with the Internal Domain for both SOC-13 and RSES. The confirmatory factor analysis showed a satisfactory construct validity. Finally, some gender differences were seen, with boys scoring higher on the total ARQ scale. CONCLUSION: The study shows that the Swedish translation of ARQ has satisfactory psychometric properties. The ARQ could therefore be used as a tool for adolescents when evaluating the importance of resilience.

Suicidal thoughts (ideation) among elite athletics (track and field) athletes: associations with sports participation, psychological resourcefulness and having been a victim of sexual and/or physical abuse.

OBJECTIVE: To examine associations between suicidal ideation and sexual and physical abuse among active and recently retired elite athletics (track and field) athletes. METHODS: The study population consisted of all athletes (n=402) selected for a Swedish Athletics team between 2011 and 2017. Data on suicidal ideation, suicidal events (estimated through the 1 year non-sports injury prevalence), lifetime abuse experiences, sociodemographics, sense of coherence and coping strategies were collected using a cross-sectional survey. The data were analysed using binary logistic regression with suicidal ideation and non-sports injury as outcomes. RESULTS: 192 athletes (47.8%) returned data. The prevalence of suicidal ideation was 15.6% (men 17.4%; women 14.2%) and the non-sports injury prevalence was 8.0% (men 11.6%; women 5.7%). Among women, suicidal ideation was associated with having been sexually abused (OR 5.94, 95% CI 1.42 to 24.90; p=0.015) and lower sense of coherence (OR 0.90, 95% CI 0.85 to 0.96; p=0.001) (Nagelkerke R2=0.33). Among men, suicidal ideation was only associated with use of behavioural disengagement for coping (OR 1.51, 95% CI 1.18 to 1.95; p=0.001) (R2 =0.25). Among women, non-sports injury prevalence was associated with having been sexually abused (OR 8.61, 95% CI 1.34 to 55.1; p=0.023) and participating in an endurance event (OR 7.37, 95% CI 1.11 to 48.9; p=0.039 (R2 =0.23), while among men, having immigrant parents (OR 5.67, 95% CI 1.31 to 24.5; p=0.020) (R2 =0.11) was associated with injury outside sports. CONCLUSIONS: About one out of six international athletics athletes reported having experienced suicidal ideation. World Athletics and National Olympic Committees need to include suicide prevention in their athlete protection programmes.

Health care consumption and psychiatric diagnoses among adolescent girls 1 and 2 years after a first-time registered child sexual abuse experience: a cohort study in the Stockholm Region.

Child sexual abuse (CSA) is a crime against human rights with severe health consequences, and suicidal actions, stress, eating disorders, and borderline disorder are common among survivors of CSA. The objective of this study was to analyze how health care consumption patterns developed among adolescent girls in the Stockholm Region, Sweden, 1 and 2 years after the first registration of CSA experience appeared in their medical record, as compared to age-matched controls without such registration. In this cohort study, number of healthcare visits, comorbidities, and prescribed drugs were collected through the Stockholm Region administrative database (VAL), for girls age 12-17 with registration of CSA experience in their medical record (n = 519) and age-matched controls (n = 4920) between 2011 and 2018. Healthcare consumption patterns remained higher among the girls with a registered CSA experience compared to the controls, both 1 and 2 years after the first CSA experience registration. Highest odds ratios (ORs) were found for suicide attempts [OR 26.38 (12.65-55.02) and 6.93 (3.48-13.49)]; stress disorders [25.97 (17.42-38.69) and 15.63 (9.82-24.88)]; psychosis [OR 19.39 (1.75-214.13) and 9.70 (1.36-68.95)], and alcohol abuse [OR 10.32 (6.48-16.44) and 6.09 (1.98-18.67)], 1 and 2 years, respectively, after the first CSA experience registration. The drug prescriptions were also significantly higher among the girls with a CSA experience registration than for the controls. The results highlight the need to systematically evaluate and develop assessment, treatment planning, and interventions offered to adolescent girls after their first CSA experience registration.

Psychometric properties of the Child and Adolescent Trauma Screen (CATS) in a sample of Swedish children.

OBJECTIVE: The aim of this study was to investigate the psychometrics of the Swedish version of the Child and Adolescent Trauma Screen (CATS). This was to obtain access to an international instrument to identify symptoms of post-traumatic stress in children and adolescents according to the new Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5). METHOD: A total of 591 young Swedish schoolchildren aged 13-17 years old were given the CATS together with the Trauma Symptom Checklist for Children (TSCC), and the Linköping Youth Life Experience Scale (LYLES-Y). A clinical group of 42 children who had experienced a potential trauma was also given the same questionnaires. Statistical analyses were carried out for the purpose of reliability, different kinds of validity, and confirmatory factor analysis (CFA) concerning the construct of the CATS. RESULTS: The CATS showed good internal consistency on all four subscales from α = 0.73-0.89 and moderate stability (intra class correlation [ICC] = 0.57-68). The four-factor model for PTSD indicated good fit, reliability, and convergent validity. The CATS correlated strongly with the PTSD subscale on the TSCC (r = 0.82) and there were significant differences between the nonclinical and clinical groups. CONCLUSIONS: The study shows that the Swedish translation of CATS has satisfactory psychometric properties, including acceptable sensitivity and specificity. The CATS could therefore be used as a screening tool both outside and within a clinical setting.

Delayed healthcare access among victims of sexual abuse, understood through internal and external gatekeeping mechanisms.

BACKGROUND: Sexual abuse is associated with severe health consequences, and the European Union has, through the Istanbul Convention, urged its member countries to provide specialist care for victims of sexual abuse. AIM: This aim of this study was to investigate patient- and abuse-related characteristics among patients seeking help at a specialist clinic in Sweden, with focus on disclosure, mental health and appropriate healthcare access. METHODS: This is a descriptive study where journal data from 100 consecutive patients January 2017 to February 2018 were analyzed. All adult individuals (women n = 80, men n = 8) who had taken part in the standardized semi-structured intake interview at the clinic were included (n = 88). RESULTS: At admission, mean age was 40.3 (SD 11.9), mean number of psychiatric diagnoses 6.3 (2.6), and 93% of the patients scored above cut-off (≥34) on IES-R for PTSD. A majority of the patients (87%) had been exposed to childhood sexual abuse (CSA), and mean time to first disclosure was 15.9 (SD 15.3) years. In total, 82% of the patients had, despite disclosure, experienced difficulties accessing appropriate healthcare before coming to the specialist clinic. CONCLUSION: Adult victims of sexual abuse have difficulties accessing appropriate healthcare. This constitutes a gender-based equality problem. A model of gatekeeping mechanisms with two dimensions (external and internal) and three categories (Competence related, Organizational and Emotional) is proposed to understand these difficulties.

Child physical abuse, declining trend in prevalence over 10 years in Sweden.

AIM: To study trends in prevalence and risk factors of child physical abuse over 10 years in Sweden. METHODS: This study analysed responses from school surveys in 2008, 2011, 2014 and 2017 in Södermanland County, Sweden with average 5125 respondents per year, 15 and 17 years old. There were identical questions on exposure to violence and risk factors including parental employment, separated parents, disability or disease, foreign background and lack of adult support. Intimate partner violence was included at three occasions. Data were analysed with bi- and multivariate models, and mean of accumulated risks were compared. RESULTS: Child physical abuse decreased significantly between 2008 and 2017. Repeated abuse decreased to a less degree than abuse once. In bivariate analyses, the share of risk factors declined for those exposed to physical abuse. In multiple analyses, it was found significant associations with exposure. There was and a dose-relationship between numbers of accumulated risk categories and self-reported abuse. CONCLUSION: Exposure to child physical abuse decreased substantially between 2008 and 2017. However, prevalence of abuse is still unacceptable, and the finding that prevalence of the more severe forms of CPA decreased less during the same time, draws attention to the need of ongoing efforts.

Health care consumption among adolescent girls prior to diagnoses of sexual abuse, a case-control study in the Stockholm Region.

Victims of sexual abuse have more co-morbidities than other persons in the same age and the most affected group are adolescent girls. Little is known about how this is reflected in health care consumption patterns prior to the registered diagnosis. The aim of this investigation was to study health care consumption patterns among girls, 12-17 years old, 1 and 2 years prior to their diagnoses of sexual abuse. Through the Stockholm Region administrative database (VAL), data of co-morbidities, number of health care visits, and prescribed drugs were collected for cases (girls age 12-17 with diagnoses of sexual abuse, n = 519) and controls matched for age and socio-economic status (n = 4920) between 2011-2018. Health care consumption and co-morbidities were significantly higher for the cases compared to controls, with a rise 1 year before the diagnoses: the total number of health care visits (including no shows) 1 year prior to the first recording of the diagnosis was 20.4 (18.1-22.7) for the cases and 6.2 (5.8-6.6) for the controls. The most frequent visits 1 year prior to the diagnosis were to outdoor clinics, with a mean value of 19.1 (16.9-21.3) visits for the cases and 5.7 (5.3-6.1) for the controls, followed by psychiatric clinics with a mean value of 12.7 (10.6-14.8) visits for the cases and 2.0 (1.7-2.3) visits for the controls. The least visited health care clinic 1 year prior to the diagnosis was the emergency ward with a mean value of 1.3 (1.1-1.5) visits for the cases and 0.5 (0.4-0.5) visits for the controls. The most common psychiatric co-morbidities registered among the cases during the first year before the diagnosis of sexual abuse were stress, suicide attempt, and psychosis. Neuroleptics, sleeping pills, antidepressants, and tranquilizers were more frequently dispensed in cases than in controls. Similar patterns were found 2 years prior to the diagnosis. We encourage clinicians to actively ask for exposure of sexual abuse in girls with high health care consumption, making early detection and treatment of sexual abuse available as soon as possible.

Mental health in young mothers, single mothers and their children.

BACKGROUND: Parenthood is a life transition that can be especially demanding for vulnerable individuals. Young maternal age and maternal single status have been reported to increase the risk for adverse outcomes for both mother and child. The aim of this study was to investigate the effect of young maternal age and maternal single status on maternal and child mental health and child development at age 3. METHODS: A birth-cohort of 1723 mothers and their children were followed from birth to age 3. Sixty-one mothers (3.5%) were age 20 or younger, and 65 (4.0%) reported single status at childbirth. The mothers filled out standardized instruments and medical information was retrieved from the standardized clinical assessment of the children at Child Welfare Centers, (CWC). RESULTS: Young maternal age was associated with symptoms of postpartum depression whereas single status was not. Young mothers were more prone to report internalizing and externalizing problems in their children, while there was no association between single status and child behavioral problems. No differences were seen on child development (CWC scores). School drop-out was, however, a more influential factor on depressive symptoms postpartum than maternal age. CONCLUSION: Young mothers are at increased risk for symptoms of postpartum depression which indicates the need for attention in pre- and postnatal health care programs. Single mothers and their children were not found to be at increased risk for adverse outcomes. The importance of schooling was demonstrated, indicating the need for societal support to encourage adolescents to remain in school.

Lifetime history of sexual and physical abuse among competitive athletics (track and field) athletes: cross sectional study of associations with sports and non-sports injury.

OBJECTIVE: To examine associations between lifetime sexual and physical abuse, and the likelihood of injury within and outside sport in athletes involved in competitive athletics. METHODS: A cross sectional study was performed among the top 10 Swedish athletics athletes using 1 year prevalence of sports and non-sports injuries as the primary outcome measure. Associations with sociodemographic characteristics, lifetime abuse history and training load were investigated. Data were analysed using simple and multiple logistic regression models. RESULTS: 11% of 197 participating athletes reported lifetime sexual abuse; there was a higher proportion of women (16.2%) than men (4.3%) (P=0.005). 18% reported lifetime physical abuse; there was a higher proportion of men (22.8%) than women (14.3%) (P=0.050). For women, lifetime sexual abuse was associated with an increased likelihood of a non-sports injury (OR 8.78, CI 2.76 to 27.93; P<0.001). Among men, increased likelihood of a non-sports injury was associated with more frequent use of alcoholic beverages (OR 6.47, CI 1.49 to 28.07; P=0.013), while commencing athletics training at >13 years of age was associated with a lower likelihood of non-sports injury (OR 0.09, CI 0.01 to 0.81; P=0.032). Lifetime physical abuse was associated with a higher likelihood of sports injury in women (OR 12.37, CI 1.52 to 100.37; P=0.019). Among men, athletes with each parents with ≤12 years formal education had a lower likelihood of sustaining an injury during their sports practice (OR 0.37, CI 0.14 to 0.96; P=0.040). CONCLUSIONS: Lifetime sexual and physical abuse were associated with an increased likelihood of injury among female athletes. Emotional factors should be included in the comprehension of injuries sustained by athletes.

Background, experience of abuse, and mental health among adolescents in out-of-home care: a cross-sectional study of a Swedish high school national sample.

PURPOSE: To compare experiences for adverse events, especially sexual abuse, and mental health in a group of high school students in out-of-home care with a representative sample of peers of the same age and similar educational attainment living with their parents. MATERIALS AND METHODS: A sample of 5839 students in the third year of Swedish high school, corresponding to a response rate of 59.7%, answered a study specific questionnaire. Data from 41 students living in out-of-home care were compared with data from peers not in out-of-home care in a cross-sectional analyze. RESULTS: Students in out-of-home care had more often an immigrant background and a non-heterosexual orientation, had more often experienced physical and penetrative sexual abuse, and more often sought healthcare for mental problems. Disclosure of sexual abuse was less common, and acts of persuasion or adults' use of their social position was more common among students in out-of-home care. CONCLUSIONS: Even where the protective factor 'senior educational attainment' is present, risks for abuse and poor mental health are evident for adolescents in out-of-home care. Disclosure of adversity, when it has occurred, ought to be higher among these adolescents with regular contact with social services, but our findings indicate tendencies for the opposite. We therefore suggest routines to be established to screen for adverse life events and mental health actively, along with general and systematic assessments of adversity and mental health during care.

A Biopsychosocial Approach to Risk and Resilience on Behavior in Children Followed from Birth to Age 12.

An increasing prevalence of mental health problems calls for more knowledge into factors associated with resilience. The present study used multiple statistical methodologies to examine a biopsychosocial model of risk and resilience on preadolescence behavior. Data from 889 children and mothers from a birth cohort were used. An adversity score was created by combining maternal symptoms of depression, psychosocial risk and children's experiences of life events. The proposed resilience factors investigated were candidate genetic polymorphisms, child temperament, social functioning, and maternal sense of coherence. The l/l genotype of the serotonin transporter linked polymorphic region was associated with lower internalizing scores, but not mainly related to the level of adversity. An easy temperament was associated with resilience for children exposed to high adversity. Social functioning was found to be promotive independent of the risk level. The results support a multiple-level model of resilience indicating effects, though small, of both biological and psychosocial factors.

Early predictors of behavioural problems in pre-schoolers - a longitudinal study of constitutional and environmental main and interaction effects.

BACKGROUND: The early environment is important for child development and wellbeing. Gene-by-environment studies investigating the impact of the serotonin transporter gene-linked polymorphic region (5-HTTLPR) and the Brain Derived Neurotrophic Factor (BDNF) Val66Met polymorphisms by life events on mental health and behaviour problems have been inconclusive. Methodological differences regarding sample sizes, study population, definitions of adversities and measures of mental health problems obstacle their comparability. Furthermore, very few studies included children. The aim of this study was to examine the associations between a broad range of risk factors covering pregnancy and birth, genetic polymorphism, experience of multiple life events and psychosocial environment, and child behaviour at age 3, using a comparably large, representative, population-based sample. METHODS: A total of 1,106 children, and their mothers, were followed from pregnancy to age 3. Information on pregnancy and birth-related factors was retrieved from the Medical Birth Register. Questionnaires on depressive symptoms, child behaviour and child experiences of life events were filled in by the mothers. Child saliva samples were used for genotyping the 5-HTTLPR and BDNF Val66Met polymorphisms. Multiple logistic regression was used to investigate the association between psychological scales and genetic polymorphisms. RESULTS: Symptoms of postpartum depression increased the risk of both internalizing and externalizing problems. Experience of multiple life events was also a predictor of behavioural problems across the scales. No gene-by-environment or gene-by-gene-by-environment interactions were found. Children of immigrants had an increased risk of internalizing problems and parental unemployment was significantly associated with both internalizing and externalizing type of problems. CONCLUSION: This study shows the importance of the psychosocial environment for psychosocial health in preschool children, and adds to the literature of null-findings of gene-by-environment effects of 5-HTTLPR and BDNF in children.

Prevalence of Child Sexual Abuse in the Nordic Countries: A Literature Review.

This review examined child sexual abuse in the Nordic countries focusing on prevalence rates and victims' age and relationship to the perpetrator. The results show a prevalence of child sexual abuse (broadly defined) between 3-23% for boys and 11-36% for girls. The prevalence rates for contact abuse were 1-12% for boys and 6-30% for girls, while 0.3-6.8% of the boys and 1.1-13.5% of the girls reported penetrating abuse. The findings suggest an increased risk of abuse from early adolescence. In adolescence, peers may constitute the largest group of perpetrators. The results highlight the need for preventive efforts also targeting peer abuse. Future research should include cross-national and repeated studies using comparable methodology.

Viewing child pornography: prevalence and correlates in a representative community sample of young Swedish men.

Most research on child pornography use has been based on selected clinical or criminal justice samples; risk factors for child pornography use in the general population remain largely unexplored. In this study, we examined prevalence, risk factors, and correlates of viewing depictions of adult-child sex in a population-representative sample of 1,978 young Swedish men (17-20 years, Mdn = 18 years, overall response rate, 77 %). In an anonymous, school-based survey, participants self-reported sexual coercion experiences, attitudes and beliefs about sex, perceived peer attitudes, and sexual interests and behaviors; including pornography use, sexual interest in children, and sexually coercive behavior. A total of 84 (4.2 %) young men reported they had ever viewed child pornography. Most theory-based variables were moderately and significantly associated with child pornography viewing and were consistent with models of sexual offending implicating both antisociality and sexual deviance. In multivariate logistic regression analysis, 7 of 15 tested factors independently predicted child pornography viewing and explained 42 % of the variance: ever had sex with a male, likely to have sex with a child aged 12-14, likely to have sex with a child 12 or less, perception of children as seductive, having friends who have watched child pornography, frequent pornography use, and ever viewed violent pornography. From these, a 6-item Child Pornography Correlates Scale was constructed and then cross-validated in a similar but independent Norwegian sample.

Sexual debut before the age of 14 leads to poorer psychosocial health and risky behaviour in later life.

AIM: This study investigated the relationship between sexual debut before 14 years of age and socio-demographics, sexual experience, health, experience of child abuse and behaviour at 18 years of age. METHODS: A sample of 3432 Swedish high school seniors completed a survey about sexuality, health and abuse at the age of 18. RESULTS: Early debut was positively correlated with risky behaviours, such as the number of partners, experience of oral and anal sex, health behaviours, such as smoking, drug and alcohol use, and antisocial behaviour, such as being violent, lying, stealing and running away from home. Girls with an early sexual debut had significantly more experience of sexual abuse. Boys with an early sexual debut were more likely to have a weak sense of coherence, low self-esteem and poor mental health, together with experience of sexual abuse, selling sex and physical abuse. A multiple logistic regression model showed that a number of antisocial acts and health behaviours remained significant, but early sexual debut did not increase the risk of psychiatric symptoms, low self-esteem or low sense of coherence at 18 years of age. CONCLUSION: Early sexual debut was associated with problematic behaviours during later adolescence, and this vulnerability requires attention from parents and healthcare providers.

Online sexual behaviours among Swedish youth: associations to background factors, behaviours and abuse.

Sexual activity online may result in positive experiences for young people, or lead them to engage in risky behaviours possibly resulting in sexual assault or abuse. The aim of our study was to investigate associations between online sexual behaviours among Swedish youth and background factors as well as aspects of well-being. The behaviours investigated were: having sex online with a contact met online, having sex with an online contact offline, posting sexual pictures online, and selling sex online. We used data from a representative sample of 3,432 Swedish youth who were asked about their lifetime experiences as well as their experiences within the previous year. We hypothesized that more advanced online sexual behaviours were associated with more problematic background factors, worse psychosocial well-being and riskier behaviours in general. Bivariate relationships were evaluated followed by a multiple logistic regression model. Our data suggested that most Swedish youth do not perform any of the assessed online sexual behaviours. Young people who reported online sexual behaviour showed a more problematic background, rated their health as poorer, had a more sexualized life and had experienced more sexual or physical abuse. Professionals who work with young people need to help them better evaluate potential risks online and offer support when needed. Youths who sell sex online are especially at risk and need extra attention, as they might be in greater need of protection and therapeutic support.

Psychiatric symptoms in adolescents: FKBP5 genotype--early life adversity interaction effects.

Psychiatric disorders are multi-factorial and their symptoms overlap. Constitutional and environmental factors influence each other, and this contributes to risk and resilience in mental ill-health. We investigated functional genetic variation of stress responsiveness, assessed as FKBP5 genotype, in relation to early life adversity and mental health in two samples of adolescents. One population-based sample of 909 12-year-old adolescents was assessed using the Life Incidence of Traumatic Events scale and the Strengths and Difficulties Questionnaire. One sample of 398 17-year-old adolescents, enriched for poly-victimized individuals (USSS), was assessed using the Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children (TSCC). The FKBP5 rs1360780 and rs3800373 polymorphisms were genotyped using a fluorescence-based competitive allele-specific PCR. Most prominently among poly-victimized older male adolescents, the least common alleles of the polymorphisms, in interaction with adverse life events, were associated with psychiatric symptoms, after controlling for ethno-socio-economic factors. The interaction effect between rs3800373 and adverse life events on the TSCC sub-scales-anxiety, depression, anger, and dissociation-and with the rs1360780 on dissociation in the USSS cohort remained significant after Bonferroni correction. This pattern of association is in line with the findings of clinical and neuroimaging studies, and implies interactive effects of FKBP5 polymorphisms and early life environment on several psychiatric symptoms. These correlates add up to provide constructs that are relevant to several psychiatric symptoms, and to identify early predictors of mental ill-health.

Somatoform dissociation among Swedish adolescents and young adults: the psychometric properties of the Swedish versions of the SDQ-20 and SDQ-5.

BACKGROUND: Somatoform dissociation is supposed to be a vital aspect of the general concept of dissociation. The Somatoform Dissociation Questionnaire-20 (SDQ-20) and the brief version SDQ-5 are self-report instruments constructed to identify somatic dissociation. AIM: In the present study, the psychometric qualities of the Swedish version of the SDQ-20 and its brief version, the SDQ-5, were examined among adolescents and young adults. Reliability and concurrent validity were investigated. METHODS: A total of 512 adolescents and young adults participated in the study: 461 adolescents from a non-clinical sample and 50 adolescents and young adults from a clinical eating disorder outpatient unit. They completed the self-report instruments the SDQ-20, the SDQ-5 (part of SDQ-20), the Linköping Youth Life Experience Scale (LYLES, a trauma history scale) and the Dissociation Questionnaire-Sweden (Dis-Q-Sweden). RESULTS: Both internal consistency and test-retest reliability of the Swedish version of SDQ-20 were good in both the non-clinical (α = 0.83) and the clinical groups (α = 0.84); the reliability for the SDQ-5 was, however, lower (non-clinical α = 0.50, clinical α = 0.64). Significant differences were found between the clinical and non-clinical groups on both somatoform and psychoform dissociation. Correlations between the Dis-Q-Sweden, SDQ-20 and SDQ-5 were generally high. The criterion and convergent validity was acceptable for both scales but somewhat better for SDQ-20 than for SDQ-5. CONCLUSION: The advantage with both the SDQ-20 and the SDQ-5 is that they are short questionnaires, but the results suggests that SDQ-20 is preferable based on the higher-quality psychometric properties of the SDQ-20.