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Månsson, J., Ekendahl, M., Karlsson, P. & Heimdahl Vepsä, K. (2024). Atmospheres of craving: a relational understanding of the desire to use drugs. Drugs: education prevention and policy, 31(1), 130-138
Open this publication in new window or tab >>Atmospheres of craving: a relational understanding of the desire to use drugs
2024 (English)In: Drugs: education prevention and policy, ISSN 0968-7637, E-ISSN 1465-3370, Vol. 31, no 1, p. 130-138Article in journal (Refereed) Published
Abstract [en]

Aims: Craving is commonly described as an ‘intense desire’ to use drugs. Due to its relevance for addiction theories and treatment, much effort has been put into understanding how and when craving occurs. An undisputed definition of craving is however still lacking. The aim of this article is to explore how craving is experienced and resisted after cessation of substance use.

Methods: This article analyses interviews with former addiction treatment clients. By analyzing the described event of craving, the study shows the complexities in such narratives.

Findings: We found that the interaction between temporal, relational and material forces move people toward or away from craving. Craving thus seemed to be both relational and located in-between forces.

Conclusions: We conclude that craving appeared in the studied narratives to emanate from different atmospheres, with a concurrent focus on settings rather than on substances. A relational understanding of craving can add to the typical, but limited, account of craving as an individual issue. It also avoids stigmatizing ideas that people who do not resist cravings simply fail to say no. We end by asking if craving is a relevant concept within the addiction field at all.

Keywords
craving, relapse prevention, relapse, atmosphere, user perspectives, assemblage
National Category
Substance Abuse
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-211351 (URN)10.1080/09687637.2022.2142092 (DOI)000882916800001 ()2-s2.0-85142144027 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-00290
Available from: 2022-11-18 Created: 2022-11-18 Last updated: 2024-02-22Bibliographically approved
Raninen, J., Karlsson, P., Callinan, S. & Norström, T. (2024). Different measures of alcohol use as predictors of DSM-5 alcohol use disorder among adolescents – A cohort study from Sweden. Drug And Alcohol Dependence, Article ID 111265.
Open this publication in new window or tab >>Different measures of alcohol use as predictors of DSM-5 alcohol use disorder among adolescents – A cohort study from Sweden
2024 (English)In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, article id 111265Article in journal (Refereed) Published
Abstract [en]

Background and aims

This study addresses a significant gap in existing research by investigating the longitudinal relationship between various measures of alcohol use and the development of alcohol use disorders (AUDs) in a cohort of Swedish adolescents.

Methods

A prospective longitudinal survey was conducted on 3,999 adolescents in Sweden who were in 9th grade in 2017 and were followed up in 2019. Baseline assessments included lifetime alcohol use, recent use (past 30 days), risky drinking (AUDIT-C), and heavy episodic drinking (HED). Follow-up assessments comprised eleven items measuring DSM-5 AUD criteria. The study explores prospective associations between these diverse alcohol use measures and the occurrence of AUD, while also calculating population attributable fractions (PAF).

Findings

The proportion of drinkers who met the criteria for AUD at follow-up was 31.8%. All baseline measures of alcohol use exhibited associations with subsequent AUD. Notably, the HED group demonstrated the highest prevalence of AUD at 51.4% (p<.001). However, when calculating PAFs, any lifetime alcohol use emerged as the most substantial contributor, accounting for 10.8% of all subsequent AUD cases.

Conclusions

This study underscores that alcohol use during mid-adolescence heightens the risk of developing AUD in late adolescence. Among the various measures, heavy episodic drinking presents the highest risk for later AUD. From a public health perspective, preventing any alcohol use emerges as the most effective strategy to mitigate the population-level burden of AUD.

Keywords
Alcohol, adolescent, survey, DSM-5, longitudinal
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-227494 (URN)10.1016/j.drugalcdep.2024.111265 (DOI)001208143200001 ()38492254 (PubMedID)2-s2.0-85188007304 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2024-03-15 Created: 2024-03-15 Last updated: 2024-05-07Bibliographically approved
Karlsson, P., Callinan, S., Gmel, G. & Raninen, J. (2024). How well do DSM-5 criteria measure alcohol use disorder in the general population of older Swedish adolescents? An item response theory analysis. Addictive Behaviours, 154, Article ID 108007.
Open this publication in new window or tab >>How well do DSM-5 criteria measure alcohol use disorder in the general population of older Swedish adolescents? An item response theory analysis
2024 (English)In: Addictive Behaviours, ISSN 0306-4603, E-ISSN 1873-6327, Vol. 154, article id 108007Article in journal (Refereed) Published
Abstract [en]

Background

This study assesses the psychometric properties of DSM-5 criteria of AUD in older Swedish adolescents using item response theory models, focusing specifically on the precision of the scale at the cut-offs for mild, moderate, and severe AUD.

Methods

Data from the second wave of Futura01 was used. Futura01 is a nationally representative cohort study of Swedish people born 2001 and data for the second wave was collected when participants were 17/18 years old. This study included only participants who had consumed alcohol during the past 12 months (n = 2648). AUD was measured with 11 binary items. A 2-parameter logistic item response theory model (2PL) estimated the items’ difficulty and discrimination parameters.

Results

31.8% of the participants met criteria for AUD. Among these, 75.6% had mild AUD, 18.3% had moderate, and 6.1% had severe AUD. A unidimensional AUD model had a good fit and 2PL models showed that the scale measured AUD over all three cut-offs for AUD severity. Although discrimination parameters ranged from moderate (1.24) to very high (2.38), the more commonly endorsed items discriminated less well than the more difficult items, as also reflected in less precision of the estimates at lower levels of AUD severity. The diagnostic uncertainty was pronounced at the cut-off for mild AUD.

Conclusion

DSM-5 criteria measure AUD with better precision at higher levels of AUD severity than at lower levels. As most older adolescents who fulfil an AUD diagnosis are in the mild category, notable uncertainties are involved when an AUD diagnosis is set in this group.

Keywords
Alcohol use disorder, Adolescents, Psychometric, Sweden
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-227280 (URN)10.1016/j.addbeh.2024.108007 (DOI)001208291000001 ()38460492 (PubMedID)2-s2.0-85187229886 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2024-03-11 Created: 2024-03-11 Last updated: 2024-05-07Bibliographically approved
Karlsson, P., Ekendahl, M. & Raninen, J. (2024). Is there a gender paradox in the association between conduct problems and cannabis use? A cohort-study among Swedish adolescents. Drug and Alcohol Review, 43(1), 294-303
Open this publication in new window or tab >>Is there a gender paradox in the association between conduct problems and cannabis use? A cohort-study among Swedish adolescents
2024 (English)In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 43, no 1, p. 294-303Article in journal (Refereed) Published
Abstract [en]

Introduction

Conduct problems (CP) predict cannabis use prospectively but the research is mixed as to whether this association is stronger among girls. A stronger association among girls would suggest a ‘gender paradox’ as both CP and cannabis use is less common in this group. This study aimed to assess whether the longitudinal association between CP and cannabis use in Swedish adolescents is stronger among girls.

Methods

Data from two waves of a nationally representative cohort study of Swedish adolescents born in 2001 were used. Baseline measurements were collected in 9th grade (at age 15–16) and follow-up measures at 11th grade (at age 17–18).

Results

CP at baseline were significantly associated with cannabis use at follow-up adjusted for hyperactivity problems, emotional problems, socio-demographics, parental monitoring, school grades and truancy at baseline (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.06–1.24) but not when also adjusting for substance use at baseline. Boys were more likely to have used cannabis during the past year, even when controlling for prior substance use (OR 2.29, 95% CI 1.76–2.98). The association between CP and cannabis use was significantly weaker for boys (OR 0.83, 95% CI 0.72–0.95 in the fully adjusted model). The predicted probability of cannabis use was stable at 0.13 for boys across levels of CP, but ranged from 0.05 to 0.16 for girls.

Discussion and Conclusion

The longitudinal association between CP and cannabis use was stronger among girls. The findings are indicative of a ‘gender paradox’ in the association between CP and cannabis use.

Keywords
adolescents, cannabis use, conduct problems, gender, prospective
National Category
Substance Abuse
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-223155 (URN)10.1111/dar.13763 (DOI)001089192000001 ()37867405 (PubMedID)2-s2.0-85174569297 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-00378
Available from: 2023-10-23 Created: 2023-10-23 Last updated: 2024-03-05Bibliographically approved
Heimdahl Vepsä, K., Ekendahl, M., Karlsson, P. & Månsson, J. (2024). Polyphonic narratives: The mixing of Alcoholics Anonymous and relapse prevention in stories about recovery and relapse. Nordic Studies on Alcohol and Drugs
Open this publication in new window or tab >>Polyphonic narratives: The mixing of Alcoholics Anonymous and relapse prevention in stories about recovery and relapse
2024 (English)In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim:  This exploratory study analyses the interplay between the treatment philosophies of Alcoholics Anonymous (AA) and Relapse Prevention (RP) in personal stories of addiction. While the basic ideas of AA and RP are compatible in many ways, they also carry some fundamental differences.

Methods: The data consisted of interviews with 12 individuals recovering from substance use problems, who had experience of both AA and RP. The analysis drew on a dialogical narrative perspective, and the concept polyphony was used to shed light on the interplay between different treatment philosophies in personal stories of relapse.

Findings: Although sometimes resulting in incoherence, the treatment philosophies were combined idiosyncratically, in ways that appeared productive for the participants’ self-images and recovery journeys.

Conclusion: The combination of AA and RP philosophies in narratives of relapse and recovery may reflect a new treatment discourse where individualisation and responsibilisation stand in a complicated relationship with collectivism and surrendering to so-called addicting processes.

Keywords
Alcoholics Anonymous, narrative, polyphony, recovery, relapse, Relapse Prevention
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-227850 (URN)10.1177/14550725241233853 (DOI)001190147600001 ()2-s2.0-85188586008 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-00290
Available from: 2024-03-28 Created: 2024-03-28 Last updated: 2024-04-12
Sjödin, L., Karlsson, P. & Raninen, J. (2024). Psychosocial correlates of drinking transitions: A longitudinal study among adolescents in Sweden. Drug and Alcohol Review, 43(3), 643-653
Open this publication in new window or tab >>Psychosocial correlates of drinking transitions: A longitudinal study among adolescents in Sweden
2024 (English)In: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 43, no 3, p. 643-653Article in journal (Refereed) Published
Abstract [en]

Introduction: Non-drinkers have been shown in older studies to have poorer mental health and social life compared to their alcohol-using counterparts. Given the profound decline in adolescent drinking observed in most high-income countries, this pattern may have changed. This study explores drinking transitions and examines psychosocial factors among adolescents by longitudinal drinking status.

Methods: Data were based on two waves of a prospective longitudinal nationwide study (n = 4018). The first wave (T1) of data was collected in 2017 (age 15/16) and the second wave (T2) was in 2019 (age 17/18). Respondents were asked about their past year drinking status, general health, psychosomatic problems, psychiatric medication, school enjoyment, emotional symptoms, peer relationship problems, prosocial ability, friendships satisfaction and satisfaction with relation to mother/father. Comparisons by mean values were assessed and multinomial logistic regressions were used to examine associations.

Results: Abstainers and later drinkers differed significantly from early drinkers on 9/10 factors respectively at T1. Fewer psychosomatic problems, less psychiatric medication, higher school enjoyment, more emotional symptoms, higher parental relationship satisfaction, more peer problems and lower friendships satisfaction at T1 were associated with abstaining and/or later drinking. All factors were more strongly associated with abstaining. School enjoyment predicted abstaining but not later drinking.

Discussion and Conclusions: Longitudinal drinking status relates to small to moderate systematic psychosocial differences. Adolescents with better mental health, more content relationships with parents and lower friendships satisfaction are more often abstainers. Those generally worse off are more likely early drinkers but they also have better friendships.

Keywords
adolescent, alcohol, drinking, psychosocial, transition
National Category
Substance Abuse
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-215355 (URN)10.1111/dar.13632 (DOI)000941277100001 ()36855294 (PubMedID)2-s2.0-85150198067 (Scopus ID)
Available from: 2023-03-08 Created: 2023-03-08 Last updated: 2024-04-19Bibliographically approved
Karlsson, P. & Ekendahl, M. (2024). Risky drinking or risky governance?. Nordic Studies on Alcohol and Drugs
Open this publication in new window or tab >>Risky drinking or risky governance?
2024 (English)In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126Article in journal (Refereed) Epub ahead of print
Abstract [en]

The National Board of Health and Welfare (NBHW) in Sweden (Socialstyrelsen, 2023) recently updated its threshold for risky drinking, to be considered by healthcare staff in patient work. This is part of their national guidelines for the treatment and prevention of unhealthy lifestyles. The scientific basis for NBHW's threshold consists of recent guidelines published in other countries and two additional systematic reviews identified through literature searches. According to the new threshold, women and men who drink 10 or more standard units (referred to as “standard glasses”) of alcohol during a week are drinking risky (“riskbruk”). Drinking four or more standard units on one occasion at least once a month is also considered risky. As a reference, a standard unit of alcohol in Sweden is defined as 12 g of pure ethanol, corresponding to, for example, 330 ml of strong beer, or 120–150 ml of wine. Below, we raise some concerns with the threshold.

National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-226718 (URN)10.1177/14550725231220126 (DOI)001140048500001 ()2-s2.0-85181681984 (Scopus ID)
Available from: 2024-02-16 Created: 2024-02-16 Last updated: 2024-02-26
Hellberg, C., Larsson, S., Bertilsson, G., Domeij, H., Larsson Tholén, S., Kärrman-Fredriksson, M., . . . Fahlström, G. (2023). Evidence and evidence gaps in assessments and interventions in areas related to social work research and practice – an overview of four evidence maps: [Vetenskapligt kunskapsläge om utredning och insatser i socialt arbete och forskning –en sammanställning av fyra kartläggningar]. European Journal of Social Work, 26(5), 882-895
Open this publication in new window or tab >>Evidence and evidence gaps in assessments and interventions in areas related to social work research and practice – an overview of four evidence maps: [Vetenskapligt kunskapsläge om utredning och insatser i socialt arbete och forskning –en sammanställning av fyra kartläggningar]
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2023 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 26, no 5, p. 882-895Article in journal (Refereed) Published
Abstract [en]

This overview of four evidence maps is based on systematic reviews of assessment and interventions in social work practice. The aim was to investigate the evidence and evidence gaps within four important areas for social work research and practice. Descriptive data on search strategies and domains were collected from four evidence maps, on Social Assistance, Substance Dependence, Care for older adults respectively for persons with disabilities. The scientific quality and scientific evidence were assessed. Key findings were summarised by analyzing and discussing common and specific elements in the evidence maps. The overview was undertaken in close collaboration between researchers with expertise in the field and a government agency. The overview identified both evidence and evidence gaps with respect to effects and experiences of interventions and assessment methods in four evidence maps. Evidence maps provide a comprehensive picture of the state of social services research and can thereby be of use to both researchers and practitioners, and in the production of evidence based social work.

Abstract [sv]

Denna artikel är en sammanställning av resultat från fyra kartläggningar av systematiska översikter om utredningar respektive insatser i socialt arbete. Syftet var att undersöka det vetenskapliga kunskapsläget, kunskap och kunskapsluckor, inom fyra viktiga områden av praktik och forskning i socialt arbete. Deskriptiva data om sökstrategier i litteraturdatabaser samt definierade domäner hämtades från fyra kartläggningar om socialbidrag, missbruk och beroende, omsorg om äldre personer samt personer med funktionsnedsättning. Översikternas vetenskapliga kvalitet och kunskapsläget bedömdes. Nyckelresultaten sammanfattades genom analys och diskussion av generella och specifika element i kartläggningarna. Sammanställningen har gjorts i nära samarbete mellan forskare från olika ämnesområden och SBU, en svensk kunskapsmyndighet. Såväl kunskap som vetenskapliga kunskapsluckor om effekter och erfarenheter av utredningar och insatser i de fyra områdena identifierades i sammanställningen. En kartläggning ger en omfattande bild av kunskapsläget för socialt arbete och kan därför vara användbart både för forskare och praktiker på vägen mot ett evidensbaserat socialt arbete.

Keywords
Social work practice, social assistance, substance dependence, care for older adults, care for persons with disabilities, praktiskt socialt arbete, socialbidrag, missbruk och beroende, äldreomsorg, funktionshinder omsorg, evidenskartläggning, systematisk översikt
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-211002 (URN)10.1080/13691457.2022.2130182 (DOI)000871344400001 ()2-s2.0-85140376107 (Scopus ID)
Available from: 2022-11-08 Created: 2022-11-08 Last updated: 2023-10-09Bibliographically approved
Karlsson, P., Ekendahl, M. & Raninen, J. (2023). Exploring the Link between ADHD and Cannabis Use in Swedish Ninth Graders: The Role of Conduct Problems and Sensation-Seeking. Substance Use & Misuse, 58(3), 311-319
Open this publication in new window or tab >>Exploring the Link between ADHD and Cannabis Use in Swedish Ninth Graders: The Role of Conduct Problems and Sensation-Seeking
2023 (English)In: Substance Use & Misuse, ISSN 1082-6084, E-ISSN 1532-2491, Vol. 58, no 3, p. 311-319Article in journal (Refereed) Published
Abstract [en]

Background: Attention deficit hyperactivity disorder (ADHD) has in several studies been linked to substance use, including cannabis use. However, crucial gaps remain regarding how to understand this association. Analyzing the association between ADHD and substance use is complicated because of a pronounced overlap between ADHD, conduct problems, and traits such as sensation-seeking. Objectives: Using data from a large and nationally representative study among Swedish adolescents, this study explored the role of conduct problems, but also of sensation-seeking, in accounting for the association between ADHD and cannabis use. Results: There was a notable association between ADHD and cannabis use that was attenuated when conduct problems were controlled for. The association between cannabis use and conduct problems, in turn, was attenuated when sensation-seeking was controlled for. Individuals with both ADHD and conduct problems were more likely to have used cannabis than individuals with ADHD only, but not compared with individuals with conduct problems only. Conclusions: Whereas conduct problems largely explain the link between ADHD and cannabis use, sensation-seeking seems to account for the association between conduct problems and cannabis use.

Keywords
adolescent, ADHD, cannabis, conduct problems, sensation-seeking, Sweden
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-213576 (URN)10.1080/10826084.2022.2155478 (DOI)000911530200001 ()
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-00378Forte, Swedish Research Council for Health, Working Life and Welfare, 2021-01725
Available from: 2023-01-10 Created: 2023-01-10 Last updated: 2023-02-01Bibliographically approved
Ekendahl, M. & Karlsson, P. (2023). Fixed and fluid at the same time: how service providers make sense of relapse prevention in Swedish addiction treatment. Critical Public Health, 33(1), 105-115
Open this publication in new window or tab >>Fixed and fluid at the same time: how service providers make sense of relapse prevention in Swedish addiction treatment
2023 (English)In: Critical Public Health, ISSN 0958-1596, E-ISSN 1469-3682, Vol. 33, no 1, p. 105-115Article in journal (Refereed) Published
Abstract [en]

This article explores how professionals within Swedish addiction treatment (n = 18) describe and make sense of relapse prevention (RP). RP is known as a self-control programme for maintaining behavioural change, helping people deal with high-risk situations. However, since self-control techniques have been incorporated widely in the addiction treatment field, the specificities of RP have become vague. To grasp what RP ‘is’, we draw on John Law’s and Annemarie Mol’s thoughts on how logics enact objects and realities. We thus follow critical scholarship in Science and Technology Studies and view treatment as a local knowledge-making practice that may depart from how it was originally designed. A key question is how RP is potentially transformed and made-to-matter when moved from the controlled settings of theorising and experimental studies to practice. The professionals used a logic of fixity to make RP stable, structured and evidence-based, easily distinguishable from other interventions. They also used a logic of fluidity to explain how and why they tinkered with it and adapted it to the preferences of both staff and attendees. The two logics enacted two different realities of addiction treatment: one in which RP is standardised, temporally demarcated and can solve most addiction problems, and another where interventions must be individualised, continuous and adapted to local settings and needs. It did not appear contradictory to ‘make up’ RP as both fixed and fluid; the two realities exist side by side, but with different material effects.

Keywords
Relapse prevention, professionals, qualitative, logic, STS
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-195342 (URN)10.1080/09581596.2021.1951170 (DOI)000677713200001 ()2-s2.0-85110923988 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-00290
Available from: 2021-08-12 Created: 2021-08-12 Last updated: 2023-01-17Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8963-1743

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