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  • 1. Aarts, Alexander A.
    et al.
    Nilsonne, Gustav
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Zuni, Kellylynn
    Estimating the reproducibility of psychological science2015In: Science, ISSN 0036-8075, E-ISSN 1095-9203, Vol. 349, no 6251Article in journal (Refereed)
    Abstract [en]

    Reproducibility is a defining feature of science, but the extent to which it characterizes current research is unknown. We conducted replications of 100 experimental and correlational studies published in three psychology journals using high-powered designs and original materials when available. Replication effects were half the magnitude of original effects, representing a substantial decline. Ninety-seven percent of original studies had statistically significant results. Thirty-six percent of replications had statistically significant results; 47% of original effect sizes were in the 95% confidence interval of the replication effect size; 39% of effects were subjectively rated to have replicated the original result; and if no bias in original results is assumed, combining original and replication results left 68% with statistically significant effects. Correlational tests suggest that replication success was better predicted by the strength of original evidence than by characteristics of the original and replication teams.

  • 2. Abbo, Catherine
    et al.
    Ekblad, Solvig
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Waako, Paul
    Okello, Elialilia
    Muhwezi, Wilson
    Musisi, Seggane
    Psychological distress and associated factors among the attendees of traditional healing practices in Jinja and Iganga districts, Eastern Uganda: a cross-sectional study.2008In: International Journal of Mental Health Systems, E-ISSN 1752-4458, Vol. 2, no 1, p. 16-Article in journal (Refereed)
    Abstract [en]

    Psychological distress and associated factors among the attendees of traditional healing practices in Jinja and Iganga districts, Eastern Uganda: a cross-sectional study.

    Abbo C, Ekblad S, Waako P, Okello E, Muhwezi W, Musisi S.

    Karolinska Institutet, Department of Clinical Neuroscience, Section of Psychiatry, Stockholm, Sweden. cathya180@gmail.com.

    ABSTRACT: BACKGROUND: Mental health problems are a major public health concern worldwide. Evidence shows that African communities, including Uganda, use both modern and traditional healing systems. There is limited literature about the magnitude of psychological distress and associated factors among attendees of traditional healing practices. This study aimed to determine the prevalence and associated factors of psychological distress among attendees of traditional healing practices in two districts in Uganda. METHODS: Face-to-face interviews with the Lusoga version of the Self Reporting Questionnaire (SRQ-20) were carried out with 400 patients over the age of 18 years attending traditional healing in Iganga and Jinja districts in Eastern Uganda. Patients were recruited consecutively in all the traditional healers' shrines that could be visited in the area. Persons with 6 or more positive responses to the SRQ were identified as having psychological distress. Prevalence was estimated and odds ratios of having psychological distress were obtained with multiple logistic regression analysis. RESULTS: 387 questionnaire responses were analyzed. The prevalence of psychological distress in connection with attendance at the traditional healers' shrines was 65.1%. Having a co-wife and having more than four children were significantly associated with psyclogical distress. Among the socioeconomic indicators, lack of food and having debts were significantly associated with psychological distress. The distressed group was more likely to need explanations for ill health. Those who visited both the healer and a health unit were less likely to be distressed. CONCLUSION: This study provides evidence that a substantial proportion of attendees of traditional healing practices suffer from psychological distress. Associated factors include poverty, number of children, polygamy, reason for visiting the healer and use of both traditional healing and biomedical health units. These findings may be useful for policy makers and biomedical health workers for the engagement with traditional healers.

  • 3. Aboagye, Emmanuel
    et al.
    Björklund, Christina
    Gustafsson, Klas
    Hagberg, Jan
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Marklund, Staffan
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bergström, Gunnar
    Exhaustion and Impaired Work Performance in the Workplace: Associations With Presenteeism and Absenteeism2019In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 61, no 11, p. 438-444Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to investigate the association between presenteeism and absenteeism during the previous year and the current levels of exhaustion and impaired work performance in a Swedish university setting.

    Methods: In a study of 3525 employees, an ordinal logistic regression and general linear model was used to examine the association between presenteeism and absenteeism during the previous year and the current exhaustion and impaired work performance, respectively.

    Results: Presenteeism, but not absenteeism, during the previous year independently increased the risk of having moderate or severe exhaustion. Presenteeism, absenteeism, and exhaustion remained positively associated with impaired work performance when health status and other confounders had been adjusted for.

    Conclusions: Presenteeism, but not absenteeism, was associated with exhaustion. Both presenteeism and absenteeism were the salient correlates of impaired work performance.

  • 4. Aboagye, Emmanuel
    et al.
    Gustafsson, Klas
    Jensen, Irene
    Hagberg, Jan
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Marklund, Staffan
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bergström, Gunnar
    What is Number of Days in Number of Times?: Associations Between, and Responsiveness of, Two Sickness Presenteeism Measures2020In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 62, no 5, p. e180-e185Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the associations between sickness presenteeism (SP) reported as number of days with SP reported as number of times and to evaluate their responsiveness.

    Methods: The study population (n = 454) consisted of employed individuals, at risk of long-term sickness absence. Correlation analyses were performed to examine associations between the two SP measures and external constructs such as work performance, general health, and registered sick leave. Both SP constructs were measured several times to examine responsiveness.

    Results: The SP measures are moderately correlated. They moderately correlated with work performance and health status measures. SP reported as number of times seems to be more sensitive than number of days in detecting changes after rehabilitation.

    Conclusions: Numerical or categorical constructs are valid sources of data on SP. However, categorized SP seems to be more responsive.

  • 5. Achnak, Safâa
    et al.
    Griep, Yannick
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University of Calgary, Canada.
    Vantilborgh, Tim
    I Am So Tired... How Fatigue May Exacerbate Stress Reactions to Psychological Contract Breach2018In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 9, article id 231Article in journal (Refereed)
    Abstract [en]

    Previous research showed that perceptions of psychological contract (PC) breach have undesirable individual and organizational consequences. Surprisingly, the PC literature has paid little to no attention to the relationship between PC breach perceptions and stress. A better understanding of how PC breach may elicit stress seems crucial, given that stress plays a key role in employees' physical and mental well-being. Based on Conservation of Resources Theory, we suggest that PC breach perceptions represent a perceived loss of valued resources, subsequently leading employees to experience higher stress levels resulting from emerging negative emotions. Moreover, we suggest that this mediated relationship is moderated by initial levels of fatigue, due to fatigue lowering the personal resources necessary to cope with breach events. To tests our hypotheses, we analyzed the multilevel data we obtained from two experience sampling designs (Study 1: 51 Belgian employees; Study 2: 53 US employees). Note that the unit of analysis is observations rather than respondents, resulting in an effective sample size of 730 (Study 1) and 374 (Study 2) observations. In both studies, we found evidence for the mediating role of negative emotions in the PC breach-stress relationship. In the second study, we also found evidence for the moderating role of fatigue in the mediated PC breach-stress relationship. Implications for research and practice are discussed.

  • 6. Adams, John
    et al.
    Pike, Tim
    Corna, Laurie M.
    Platts, Loretta G.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Worts, Diana
    McDonough, Peggy
    Di Gessa, Giorgio
    Sacker, Amanda
    Glaser, Karen
    Price, Debora
    How do female lifecourses affect income in retirement?2016Report (Other academic)
    Abstract [en]

    This Briefing Note examines the influence of various lifecourses on income in retirement. The primary focus of this note is to consider how women’s retirement income is affected by motherhood. This includes the impact of taking time out of work to care for children, as well as the implications of the Motherhood Penalty, which is the observation that mothers tend to have reduced incomes relative to women without children.

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  • 7. Agréus, Lars
    et al.
    Hellström, Per M.
    Talley, Nicholas J.
    Wallner, Bengt
    Forsberg, Anna
    Vieth, Michael
    Veits, Lothar
    Björkegren, Karin
    Engstrand, Lars
    Andreasson, Anna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Towards a healthy stomach? Helicobacter pylori prevalence has dramatically decreased over 23 years in adults in a Swedish community2016In: United European Gastroenterology journal, ISSN 2050-6406, E-ISSN 2050-6414, Vol. 4, no 5, p. 686-696Article in journal (Refereed)
    Abstract [en]

    Background In Western countries the prevalence of Helicobacter pylori (H. pylori) infection may be declining but there is a lack of recent longitudinal population studies. We evaluated the changing epidemiology over a 23-year period in Sweden. Materials and methods In 1989, the validated Abdominal Symptom Questionnaire (ASQ) was mailed to a random sample of inhabitants (ages 22-80 years) in a Swedish community, and 1097 (87%) responded. H. pylori serology was analysed in a representative subsample (n=145). Twenty-three years later, the ASQ was mailed again using similar selection criteria, and 388 out of 1036 responders had an upper endoscopy with assessment of H. pylori and corpus atrophy status. Results The prevalence of positive H. pylori serology decreased from 37.9% (1989) to 15.8% (2012), corresponding to a decrease in odds of 75% per decade (odds ratio (OR): 0.25; 95% confidence interval (CI): 0.11-0.59, p=0.001) independent of age, gender, body mass index (BMI) and level of education, with a pattern consistent with a birth cohort effect. The prevalence increased with increasing age (p=0.001). The prevalence of H. pylori on histology in 2012 was 11.4% (95% CI 8.6-15.0). The prevalence of corpus atrophy on serology and/or histology in 2012 was 3.2% (95% CI 1.8-5.5); all cases were 57 years old. Conclusion The stomach is healthier in 2012 compared with 1989. H. pylori prevalence in adults has decreased over the last two decades to a level where clinical management might be affected.

  • 8. Ahlström, Christer
    et al.
    Anund, Anna
    Fors, Carina
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Effects of the road environment on the development of driver sleepiness in young male drivers2018In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 112, p. 127-134Article in journal (Refereed)
    Abstract [en]

    Latent driver sleepiness may in some cases be masked by for example social interaction, stress and physical activity. This short-term modulation of sleepiness may also result from environmental factors, such as when driving in stimulating environments. The aim of this study is to compare two road environments and investigate how they affect driver sleepiness. Thirty young male drivers participated in a driving simulator experiment where they drove two scenarios: a rural environment with winding roads and low traffic density, and a suburban road with higher traffic density and a more built-up roadside environment. The driving task was essentially the same in both scenarios, i.e. to stay on the road, without much interaction with other road users. A 2 x 2 design, with the conditions rural versus suburban, and daytime (full sleep) versus night-time (sleep deprived), was used. The results show that there were only minor effects of the road environment on subjective and physiological indicators of sleepiness. In contrast, there was an increase in subjective sleepiness, longer blink durations and increased EEG alpha content, both due to time on task and to night-time driving. The two road environments differed both in terms of the demand on driver action and of visual load, and the results indicate that action demand is the more important of the two factors. The notion that driver fatigue should be countered in a more stimulating visual environment such as in the city is thus more likely due to increased task demand rather than to a richer visual scenery. This should be investigated in further studies.

  • 9. Ahlström, Christer
    et al.
    Anund, Anna
    Fors, Carina
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    The effect of daylight versus darkness on driver sleepiness: a driving simulator study2018In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, no 3, article id e12642Article in journal (Refereed)
    Abstract [en]

    Driver sleepiness studies are often carried out with alert drivers during daytime and sleep-deprived drivers during night-time. This design results in a mixture of different factors (e.g. circadian effects, homeostatic effects, light conditions) that may confound the results. The aim of this study was to investigate the effect of light conditions on driver sleepiness. Thirty young male drivers (23.6 ± 1.7 years old) participated in a driving simulator experiment where they drove on a rural road. A 2 × 2 design was used with the conditions daylight versus darkness, and daytime (full sleep) versus night-time (sleep deprived). The results show that light condition had an independent effect on the sleepiness variables. The subjective sleepiness measured by Karolinska Sleepiness Scale was higher, lateral position more left-oriented, speed lower, electroencephalogram alpha and theta higher, and blink durations were longer during darkness. The number of line crossings did not change significantly with light condition. The day/night condition had profound effects on most sleepiness indicators while controlling for light condition. The number of line crossings was higher during night driving, Karolinska Sleepiness Scale was higher, blink durations were longer and speed was lower. There were no significant interactions, indicating that light conditions have an additive effect on sleepiness. In conclusion, Karolinska Sleepiness Scale and blink durations increase primarily with sleep deprivation, but also as an effect of darkness. Line crossings are mainly driven by the need for sleep and the reduced alertness at the circadian nadir. Lane position is, however, more determined by light conditions than by sleepiness.

  • 10. Ahlström, Christer
    et al.
    Fors, Carina
    Anund, Anna
    Hallvig, David
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Video-based observer rated sleepiness versus self-reported subjective sleepiness in real road driving2015In: European Transport Research Review, ISSN 1867-0717, E-ISSN 1866-8887, Vol. 7, no 4, article id 38Article in journal (Refereed)
    Abstract [en]

    Purpose: Observer-rated sleepiness (ORS) based on video recordings of the driver's face is often used when analysing naturalistic driving data. The aim of this study is to investigate if ORS ratings agree with subjective self-reported sleepiness (SRS). Methods: Forty raters assessed 54 video-clips showing drivers with varying levels of sleepiness. The video-clips were recorded during a field experiment focusing on driver sleepiness using the same cameras that are typically used in large-scale field studies. The weak results prompted a second test. Ten human factors researchers made pairwise comparisons of videos showing the same four participants in an alert versus a very sleepy condition. The task was simply to select the video-clip where the driver was sleepy. Results: The overall average percentage of video segments where ORS and SRS matched was 41 % in Test 1. ORS 0 (alert) and ORS 2 (very sleepy) were easier to score than ORS 1 and it was slightly harder to rate night-time drives. Inter-rater agreement was low, with average Pearson's r correlations of 0.19 and Krippendorff's alpha of 0.15. In Test 2, the average Pearson's r correlations was 0.35 and Krippendorff's alpha was 0.62. The correspondence between ORS and SRS showed an agreement of 35 %. Conclusions: The results indicate that ORS ratings based on real road video recordings correspond poorly with SRS and have low inter-rater agreement. Further research is necessary in order to further evaluate the usefulness of ORS as a measure of sleepiness.

  • 11. Ahlström, Christer
    et al.
    Nyström, Marcus
    Holmqvist, Kenneth
    Fors, Carina
    Sandberg, David
    Anund, Anna
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fit-for-duty test for estimation of drivers' sleepiness level: Eye movements improve the sleep/wake predictor2013In: Transportation Research Part C: Emerging Technologies, ISSN 0968-090X, E-ISSN 1879-2359, Vol. 26, p. 20-32Article in journal (Refereed)
    Abstract [en]

    Driver sleepiness contributes to a considerable proportion of road accidents, and a fit-for-duty test able to measure a driver’s sleepiness level might improve traffic safety. The aim of this study was to develop a fit-for-duty test based on eye movement measurements and on the sleep/wake predictor model (SWP, which predicts the sleepiness level) and evaluate the ability to predict severe sleepiness during real road driving. Twenty-four drivers participated in an experimental study which took place partly in the laboratory, where the fit-for-duty data were acquired, and partly on the road, where the drivers sleepiness was assessed. A series of four measurements were conducted over a 24-h period during different stages of sleepiness. Two separate analyses were performed; a variance analysis and a feature selection followed by classification analysis. In the first analysis it was found that the SWP and several eye movement features involving anti-saccades, pro-saccades, smooth pursuit, pupillometry and fixation stability varied significantly with different stages of sleep deprivation. In the second analysis, a feature set was determined based on floating forward selection. The correlation coefficient between a linear combination of the acquired features and subjective sleepiness (Karolinska sleepiness scale, KSS) was found to be R = 0.73 and the correct classification rate of drivers who reached high levels of sleepiness (KSS ⩾ 8) in the subsequent driving session was 82.4% (sensitivity = 80.0%, specificity = 84.2% and AUC = 0.86). Future improvements of a fit-for-duty test should focus on how to account for individual differences and situational/contextual factors in the test, and whether it is possible to maintain high sensitive/specificity with a shorter test that can be used in a real-life environment, e.g. on professional drivers.

  • 12. Ahlström, Christer
    et al.
    Solis-Marcos, Ignacio
    Nilsson, Emma
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    The impact of driver sleepiness on fixation-related brain potentials2020In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 29, no 5, article id e12962Article in journal (Refereed)
    Abstract [en]

    The effects of driver sleepiness are often quantified as deteriorated driving performance, increased blink durations and high levels of subjective sleepiness. Driver sleepiness has also been associated with increasing levels of electroencephalogram (EEG) power, especially in the alpha range. The present exploratory study investigated a new measure of driver sleepiness, the EEG fixation-related lambda response. Thirty young male drivers (23.6 +/- 1.7 years old) participated in a driving simulator experiment in which they drove on rural and suburban roads in simulated daylight versus darkness during both the daytime (full sleep) and night-time (sleep deprived). The results show lower lambda responses during night driving and with longer time on task, indicating that sleep deprivation and time on task cause a general decrement in cortical responsiveness to incoming visual stimuli. Levels of subjective sleepiness and line crossings were higher under the same conditions. Furthermore, results of a linear mixed-effects model showed that low lambda responses are associated with high subjective sleepiness and more line crossings. We suggest that the fixation-related lambda response can be used to investigate driving impairment induced by sleep deprivation while driving and that, after further refinement, it may be useful as an objective measure of driver sleepiness.

  • 13. Aho, Vilma
    et al.
    Ollila, Hanna M.
    Rantanen, Ville
    Kronholm, Erkki
    Surakka, Ida
    van Leeuwen, Wessel M. A.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University of Helsinki, Finland; Finnish Institute of Occupational Health, Finland.
    Lehto, Maili
    Matikainen, Sampsa
    Ripatti, Samuli
    Härmä, Mikko
    Sallinen, Mikael
    Salomaa, Veikko
    Jauhiainen, Matti
    Alenius, Harri
    Paunio, Tiina
    Porkka-Heiskanen, Tarja
    Partial Sleep Restriction Activates Immune Response-Related Gene Expression Pathways: Experimental and Epidemiological Studies in Humans2013In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 10, article id e77184Article in journal (Refereed)
    Abstract [en]

    Epidemiological studies have shown that short or insufficient sleep is associated with increased risk for metabolic diseases and mortality. To elucidate mechanisms behind this connection, we aimed to identify genes and pathways affected by experimentally induced, partial sleep restriction and to verify their connection to insufficient sleep at population level. The experimental design simulated sleep restriction during a working week: sleep of healthy men (N = 9) was restricted to 4 h/night for five nights. The control subjects (N = 4) spent 8 h/night in bed. Leukocyte RNA expression was analyzed at baseline, after sleep restriction, and after recovery using whole genome microarrays complemented with pathway and transcription factor analysis. Expression levels of the ten most up-regulated and ten most down-regulated transcripts were correlated with subjective assessment of insufficient sleep in a population cohort (N = 472). Experimental sleep restriction altered the expression of 117 genes. Eight of the 25 most up-regulated transcripts were related to immune function. Accordingly, fifteen of the 25 most up-regulated Gene Ontology pathways were also related to immune function, including those for B cell activation, interleukin 8 production, and NF-kappa B signaling (P<0.005). Of the ten most up-regulated genes, expression of STX16 correlated negatively with self-reported insufficient sleep in a population sample, while three other genes showed tendency for positive correlation. Of the ten most down-regulated genes, TBX21 and LGR6 correlated negatively and TGFBR3 positively with insufficient sleep. Partial sleep restriction affects the regulation of signaling pathways related to the immune system. Some of these changes appear to be long-lasting and may at least partly explain how prolonged sleep restriction can contribute to inflammation-associated pathological states, such as cardiometabolic diseases.

  • 14.
    Ahrén-Moonga, Jennie
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    von Blixten, Nils
    Rönnelid, Johan
    Holmgren, Sven
    af Klinteberg, Britt
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Levels of tumour necrosis factor-alpha and interleukin-6 in severely ill patients with eating disorders2011In: Neuropsychobiology, ISSN 0302-282X, E-ISSN 1423-0224, Vol. 63, no 1, p. 8-14Article in journal (Refereed)
    Abstract [en]

    Background: The underlying pathophysiology of eating disorders (ED) is dependent on complex interactions between psychological, biological and social factors. The purpose of the present study was to examine a possible increase in cytokines indicating inflammation, as measured by tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in ED patients, and to explore possible relationships between cytokines and self-reported personality traits. Methods: Female patients with severe ED (n = 26) were recruited consecutively from an inpatient clinic and were compared to age-matched healthy females (n = 12). Commercial ELISA tests developed for the measurement of serum levels of TNF-α and IL-6 were employed. Personality traits were measured using Karolinska Scales of Personality. Results: The patient group displayed increased levels of the cytokine TNF-α and a tendency towards increased IL-6 levels. Spearman's rank correlation coefficient was used to examine possible relationships between levels of cytokines and personality traits. The results showed that IL-6 levels were positively related to both somatic and psychic anxiety and to aggression scales, such as irritability and suspicion. Increased levels of TNF-α, in turn, were significantly correlated with high scores on the depression-related anxiety scale Inhibition of Aggression. However, increased levels of cytokines in the ED group did not seem to be mainly associated with symptoms of depression. Conclusion: We cannot rule out the possibility that comorbid conditions in the group contribute to the higher cytokine values. Further studies need to explore the possible influence of cytokines on the severity of ED and whether this might be mediated or moderated by specific personality traits.

  • 15.
    Akerstedt, Torbjorn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Goran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Alfredsson, Lars
    Selen, Jan
    Predicting long-term sickness absence from sleep and fatigue.2007In: J Sleep Res, ISSN 0962-1105, Vol. 16, no 4, p. 341-5Article in journal (Other academic)
    Abstract [en]

    Predicting long-term sickness absence from sleep and fatigue.

    Akerstedt T, Kecklund G, Alfredsson L, Selen J.

    Institute for Psychosocial Medicine, Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. torbjorn.akerstedt@ipm.ki.se

    Disturbed or shortened sleep is prospectively related to disease. One might also expect that sickness absence would be another consequence but very little data seem to exist. The present study used 8300 individuals in a national sample to obtain information on reports of disturbed sleep and fatigue 1 year and merged this with data on long-term sickness absence 2 years later. A logistic regression analysis was applied to the data with adjustments for demographic and work environment variables. The results showed that individuals without registered sickness absence at the start had a higher probability of entering a period of long-term (>/=90 days, odds ratio [OR] = 1.24 with 95% confidence interval [CI] = 1.02-1.51) sickness absence 2 years later if they reported disturbed sleep at the start. The figure for fatigue was OR = 1.35 (CI = 1.14-1.60). When fatigue or disturbed sleep was separately excluded the OR increased to OR = 1.44 and OR = 1.47, respectively. Intermediate sickness absence (14-89 days) showed similar but slightly weaker results. The results indicate that disturbed sleep and fatigue are predictors of long-term absence and it is suggested that impaired sleep may be part of a chain of causation, considering its effects on fatigue.

    PMID: 18036078 [PubMed - in process]

  • 16.
    Akerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Connor, Jennie
    Gray, Andrew
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Predicting road crashes from a mathematical model of alertness regulation--The Sleep/Wake Predictor.2008In: Accid Anal Prev, ISSN 0001-4575, Vol. 40, no 4, p. 1480-5Article in journal (Other academic)
    Abstract [en]

    Predicting road crashes from a mathematical model of alertness regulation--The Sleep/Wake Predictor.

    Akerstedt T, Connor J, Gray A, Kecklund G.

    Stress Research Institute, Stockholm University and Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. torbjorn.akerstedt@ki.se

    Sleepiness is related to factors such as the time of day, the time since awakening and the duration of prior sleep. The present study investigated whether actual road crashes could be predicted from a mathematical model based on these three factors (the Sleep/Wake Predictor-SWP). Data were derived from a population-based case-control study of serious injury crashes. Data on accident time (or control sampling time) and start and end of prior sleep were entered into the model (blind). The predicted sleepiness values were used in logistic regressions. The results showed a highly significant odds ratio (OR)=1.72 (confidence interval=1.41-2.09) for each incremental step of sleepiness on the output sleepiness scale (nine steps). There was also a significant interaction with blood alcohol level, showing high OR values for high sleepiness levels and alcohol levels above 50 mg% (0.05 g/dl). It was concluded that the model is a good predictor of road crashes beyond that of alcohol level, and that interaction between the two carries a very high risk.

  • 17.
    Akerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Ingre, Michael
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Broman, Jan-Erik
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Disturbed sleep in shift workers, day workers, and insomniacs.2008In: Chronobiol Int, ISSN 1525-6073, Vol. 25, no 2, p. 333-48Article in journal (Refereed)
    Abstract [en]

    Disturbed sleep in shift workers, day workers, and insomniacs.

    Akerstedt T, Ingre M, Broman JE, Kecklund G.

    Stress Research Institute, University of Stockholm, Karolinska Institutet, Stockholm, Sweden. torbjorn.akerstedt@ki.se

    Very little is known about differences in sleep between day and shift workers in representative samples of the population. This study compared a national representative sample (N=3400) of shift (with night shifts) and day workers regarding the different types of sleep disturbances and also the level of sleep symptoms with that of insomnia patients. The results showed very few differences between shift and day workers; only "too little sleep" and "nodding off at work" were marginally higher among shift workers. The results also showed that the complaints of insomnia patients for most sleep disturbances corresponded to the 2nd-16th percentile of the shift workers' levels of complaints. The results suggest, at least with the present questionnaire methodology, that shift work does not appear to be a major source of sleep disturbances and that their complaint levels bear no resemblance to those seen in insomniac patients.

  • 18.
    Akerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Ingre, Michael
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Folkard, Simon
    Axelsson, John
    Accounting for partial sleep deprivation and cumulative sleepiness in the Three-Process Model of alertness regulation.2008In: Chronobiol Int, ISSN 1525-6073, Vol. 25, no 2, p. 309-19Article in journal (Refereed)
    Abstract [en]

    Accounting for partial sleep deprivation and cumulative sleepiness in the Three-Process Model of alertness regulation.

    Akerstedt T, Ingre M, Kecklund G, Folkard S, Axelsson J.

    Stress Research Institute, University of Stockholm, Stockholm, Sweden. torbjorn.akerstedt@ki.se

    Mathematical models designed to predict alertness or performance have been developed primarily as tools for evaluating work and/or sleep-wake schedules that deviate from the traditional daytime orientation. In general, these models cope well with the acute changes resulting from an abnormal sleep but have difficulties handling sleep restriction across longer periods. The reason is that the function representing recovery is too steep--usually exponentially so--and with increasing sleep loss, the steepness increases, resulting in too rapid recovery. The present study focused on refining the Three-Process Model of alertness regulation. We used an experiment with 4 h of sleep/night (nine participants) that included subjective self-ratings of sleepiness every hour. To evaluate the model at the individual subject level, a set of mixed-effect regression analyses were performed using subjective sleepiness as the dependent variable. These mixed models estimate a fixed effect (group mean) and a random effect that accounts for heterogeneity between participants in the overall level of sleepiness (i.e., a random intercept). Using this technique, a point was sought on the exponential recovery function that would explain maximum variance in subjective sleepiness by switching to a linear function. The resulting point explaining the highest amount of variance was 12.2 on the 1-21 unit scale. It was concluded that the accumulation of sleep loss effects on subjective sleepiness may be accounted for by making the recovery function linear below a certain point on the otherwise exponential function.

  • 19.
    Akerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Axelsson, John
    Effects of context on sleepiness self-ratings during repeated partial sleep deprivation.2008In: Chronobiol Int, ISSN 1525-6073, Vol. 25, no 2, p. 271-8Article in journal (Refereed)
    Abstract [en]

    Effects of context on sleepiness self-ratings during repeated partial sleep deprivation.

    Akerstedt T, Kecklund G, Axelsson J.

    Stress Research Institute, Stockholm University, Stockholm, Sweden. torbjorn.akerstedt@ki.se

    Ratings of subjective sleepiness are often used in laboratory and field studies of sleep loss and shifted sleep hours. Some studies suggest that such ratings might fail to reflect sleepiness as shown in physiology or performance. One reason for this may be the influence of the context of the rating. Social interaction or physical activity may mask latent sleepiness. The present study attempted to approach this question. Nine subjects participated in a partial sleep-deprivation experiment (five days of 4 h of time in bed [TIB]), preceded by two baseline days (8 h TIB) and followed by three recovery days (8 h TIB). Sleepiness was self-rated on the Karolinska Sleepiness Scale (KSS; scores of 1-9) after a period of relaxation, after a reaction-time test, and after 30 min of free activities. The results showed a strong increase in subjective sleepiness during sleep restriction and a significant difference between conditions. Free activity reduced the self-rated subjective sleepiness by 1.1 KSS units compared to the level of sleepiness self-rated at the end of the reaction-time test. Thus, the results of this study indicate that the context of a sleepiness rating affects the outcome of the rating.

  • 20.
    Akerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Gillberg, Mats
    Sleep and sleepiness in relation to stress and displaced work hours.2007In: Physiol Behav, ISSN 0031-9384, Vol. 92, no 1-2, p. 250-5Article in journal (Other academic)
    Abstract [en]

    Sleep and sleepiness in relation to stress and displaced work hours.

    Akerstedt T, Kecklund G, Gillberg M.

    Karolinska Institutet, Institute for Psychosocial Medicine Box 230, S-171 77 Stockholm, Sweden. torbjorn.akerstedt@ipm.ki.se

    Sleep is an important factor in relation to accidents, long-term health and mortality. Our group has had a long-term commitment to research on sleep regulation and its consequences. Over the years we have demonstrated pronounced effects of night work on sleep and alertness, including electroencephalographically determined sleep during work. We have also demonstrated that experimental displacement of sleep will result in short sleep at daytime and increased physiological sleepiness at night and developed mathematical models for prediction of sleep duration, as well as of sleepiness and risk of sleep-related accidents. We have also looked at the concept of sleep quality and found it dependent on sleep duration, sleep continuity and content of sleep stages 3 and 4. Sleep is also clearly disturbed in patients on long-term sick leave for burnout or in non-patients with high burnout scores, in particular sleep fragmentation is increased and sleep efficiency and sleep stages 3 and 4 (SWS--deep sleep) decreased. The fragmentation in turn seems related to endocrine changes. Present work is focused on bringing this work together, connecting the links from stress to sleep to metabolic changes to disease and long-term sickness absence.

    PMID: 17585960 [PubMed - indexed for MEDLINE]

  • 21.
    Akerstedt, Torbjörn
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Ingre, Michael
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Axelsson, John
    Sleep homeostasis during repeated sleep restriction and recovery: support from EEG dynamics.2009In: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 32, no 2, p. 217-22Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVES: Sleep reduction normally causes a homeostatic response during subsequent recovery sleep, but this does not seem to be true for repeated partial sleep loss. The aim of the present study was to test the response to repeated partial sleep loss through detailed focus on spectral data and parts of sleep. DESIGN: The experiment involved 4 h of sleep across 5 days in the laboratory (partial sleep deprivation [PSD]), followed by 3 days of recovery sleep. PSD was achieved through a delayed bedtime. Nine individuals participated. To avoid "laboratory monotony," subjects were permitted to leave the lab for a few hours each day. MEASUREMENTS AND RESULTS: All sleep stages and the latencies to sleep and slow wave sleep (SWS) showed a significant reduction during PSD. However, SWS and TST (total sleep time) during the first half of sleep increased gradually across days with PSD. During the first recovery sleep, SWS was significantly increased, while stage 1 and latency to stage 3 were reduced. All were back to baseline on the second night of recovery sleep. Summed spectral power during the first 3.8 h of sleep showed a gradual and robust increase (50% above baseline) in the range 1.25-7.25 Hz across days with PSD up to first recovery sleep and then returned to baseline. CONCLUSIONS: SWS and summed power density in a broad low-frequency band respond to repeated partial sleep deprivation in a dose-response fashion during the first 4 h sleep, apparently reflecting a robust and stable homeostatic response to sleep loss.

  • 22. Albrecht, Daniel S.
    et al.
    Forsberg, Anton
    Sandstrom, Angelica
    Bergan, Courtney
    Kadetoff, Diana
    Protsenko, Ekaterina
    Lampa, Jon
    Lee, Yvonne C.
    Hoglund, Caroline Olgart
    Catana, Ciprian
    Cervenka, Simon
    Akeju, Oluwaseun
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden.
    Cohen, George
    Halldin, Christer
    Taylor, Norman
    Kim, Minhae
    Hooker, Jacob M.
    Edwards, Robert R.
    Napadow, Vitaly
    Kosek, Eva
    Loggia, Marco L.
    Brain glial activation in fibromyalgia - A multi-site positron emission tomography investigation2019In: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 75, p. 72-83Article in journal (Refereed)
    Abstract [en]

    Fibromyalgia (FM) is a poorly understood chronic condition characterized by widespread musculoskeletal pain, fatigue, and cognitive difficulties. While mounting evidence suggests a role for neuroinflammation, no study has directly provided evidence of brain glial activation in FM. In this study, we conducted a Positron Emission Tomography (PET) study using [C-11]PBR28, which binds to the translocator protein (TSPO), a protein upregulated in activated microglia and astrocytes. To enhance statistical power and generalizability, we combined datasets collected independently at two separate institutions (Massachusetts General Hospital [MGH] and Karolinska Institutet [KI]). In an attempt to disentangle the contributions of different glial cell types to FM, a smaller sample was scanned at KI with [C-11]-L-deprenyl-D2 PET, thought to primarily reflect astrocytic (but not microglial) signal. Thirty-one FM patients and 27 healthy controls (HC) were examined using [C-11]PBR28 PET. 11 FM patients and 11 HC were scanned using [C-11]-L-deprenyl-D2 PET. Standardized uptake values normalized by occipital cortex signal (SUVR) and distribution volume (V-T) were computed from the [C-11]PBR28 data. [C-11]-L-deprenyl-D2 was quantified using lambda k(3). PET imaging metrics were compared across groups, and when differing across groups, against clinical variables. Compared to HC, FM patients demonstrated widespread cortical elevations, and no decreases, in [C-11]PBR28 ITT and SUVR, most pronounced in the medial and lateral walls of the frontal and parietal lobes. No regions showed significant group differences in [C-11]-L-deprenyl-Ds signal, including those demonstrating elevated [C-11] PBR28 signal in patients (p's >= 0.53, uncorrected). The elevations in [C-11]PBR28 V-T and SUVR were correlated both spatially (i.e., were observed in overlapping regions) and, in several areas, also in terms of magnitude. In exploratory, uncorrected analyses, higher subjective ratings of fatigue in FM patients were associated with higher [C-11] PBR28 SUVR in the anterior and posterior middle cingulate cortices (p's < 0.03). SUVR was not significantly associated with any other clinical variable. Our work provides the first in vivo evidence supporting a role for glial activation in FM pathophysiology. Given that the elevations in [C-11]PBR28 signal were not also accompanied by increased [C-11]-deprenyl-D2 signal, our data suggests that microglia, but not astrocytes, may be driving the TSPO elevation in these regions. Although [C-11]-L-deprenyl-D2 signal was not found to be increased in FM patients, larger studies are needed to further assess the role of possible astrocytic contributions in FM. Overall, our data support glial modulation as a potential therapeutic strategy for FM.

  • 23.
    Albrecht, Sophie C.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The longitudinal relationship between control over working hours and depressive symptoms: Results from SLOSH, a population-based cohort study2017In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 215, p. 143-151Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychosocial work factors can affect depressive moods, but research is inconclusive if flexibility to self-determine working hours (work-time control, WTC) is associated with depressive symptoms over time. We investigated if either sub-dimension of WTC, control over daily hours and control over time off, was related to depressive symptoms over time and examined causal, reversed-causal, and reciprocal pathways.

    METHODS: The study was based on four waves of the Swedish Longitudinal Occupational Survey of Health which is a follow-up of representative samples of the Swedish working population. WTC was measured using a 5-item index. Depressive symptoms were assessed with a brief subscale of the Symptom Checklist. Latent growth curve models and cross-lagged panel models were tested.

    RESULTS: Best fit was found for a model with correlated intercepts (control over daily hours) and both correlated intercepts and slopes (control over time off) between WTC and depressive symptoms, with stronger associations for control over time off. Causal models estimating impacts from WTC to subsequent depressive symptoms were best fitting, with a standardised coefficient between -0.023 and -0.048.

    LIMITATIONS: Results were mainly based on self-report data and mean age in the study sample was relatively high.

    CONCLUSION: Higher WTC was related to fewer depressive symptoms over time albeit small effects. Giving workers control over working hours - especially over taking breaks and vacation - may improve working conditions and buffer against developing depression, potentially by enabling workers to recover more easily and promoting work-life balance.

  • 24.
    Albrecht, Sophie
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Investigating the factorial structure and availability of work time control in a representative sample of the Swedish working population2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 3, p. 320-328Article in journal (Refereed)
    Abstract [en]

    Aims: Past research has often neglected the sub-dimensions of work time control (WTC). Moreover, differences in levels of WTC with respect to work and demographic characteristics have not yet been examined in a representative sample. We investigated these matters in a recent sample of the Swedish working population. Methods: The study was based on the 2014 data collection of the Swedish Longitudinal Occupational Survey of Health. We assessed the structure of the WTC measure using exploratory and confirmatory factor analysis. Differences in WTC by work and demographic characteristics were examined with independent sample t-tests, one-way ANOVAs and gender-stratified logistic regressions. Results: Best model fit was found for a two-factor structure that distinguished between control over daily hours and control over time off (root mean square error of approximation = 0.06; 95% CI 0.04 to 0.09; Comparative Fit Index (CFI) = 0.99). Women, shift and public-sector workers reported lower control in relation to both factors. Age showed small associations with WTC, while a stronger link was suggested for civil status and family situation. Night, roster and rotating shift work seemed to be the most influential factors on reporting low control over daily hours and time off. Conclusions: Our data confirm the two-dimensional structure underlying WTC, namely the components 'control over daily hours' and 'control over time off'. Women, public-sector and shift workers reported lower levels of control. Future research should examine the public health implications of WTC, in particular whether increased control over daily hours and time off can reduce health problems associated with difficult working-time arrangements.

  • 25. Alderling, Magnus
    et al.
    de la Torre, Bartolomé
    Forsell, Yvonne
    Lundberg, Ingvar
    Sondergaard, Hans Peter
    Theorell, Tores
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Psychiatric diagnoses and circadian saliva cortisol variations in a Swedish population-based sample (the PART study).2008In: Psychother Psychosom, ISSN 1423-0348, Vol. 77, no 2, p. 129-31Article, review/survey (Other (popular science, discussion, etc.))
  • 26. Alexanderson, K.
    et al.
    Kivimäki, M.
    Ferrie, J. E.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Vahtera, J.
    Singh-Manoux, A.
    Melchior, M.
    Zins, M.
    Goldberg, M.
    Head, J.
    Diagnosis-specific sick leave as a long-term predictor of disability pension: a 13-year follow-up of the GAZEL cohort study2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 2, p. 155-159Article in journal (Refereed)
    Abstract [en]

    Background Factors that increase the risk of labour market exclusion are poorly understood. In this study, we examined the extent to which all-cause and diagnosis-specific sick leave predict subsequent disability pension (DP).

    Methods Prospective cohort study of 20 434 persons employed by the French national gas and electric company (the GAZEL study). New sick-leave spells >7 days in 1990–1992 were obtained from company records. Follow-up for DP was from 1994 to 2007.

    Results The HR, adjusted for age and occupational position, for DP was 3.5 (95% CI 2.7 to 4.5) in men and 2.6 (95% CI 1.9 to 3.5) in women with one or more sick-leave spells >7 days compared with those with no sick leave. The strongest predictor of DP was sick leave with a psychiatric diagnosis, HR 7.6 (95% CI 5.2 to 10.9) for men and 4.1 (95% CI 2.9 to 5.9) for women. Corresponding HRs for sick leave due to circulatory diagnoses in men and women were 5.6 (95% CI 3.7 to 8.6) and 3.1 (95% CI 1.8 to 5.3), for respiratory diagnoses 3.9 (95% CI 2.6 to 5.8) and 2.6 (95% CI 1.7 to 4.0), and musculoskeletal diagnoses 4.6 (95% CI 3.4 to 6.4) and 3.3 (95% CI 2.2 to 4.8), respectively.

    Conclusions Sick leave with a psychiatric diagnosis is a major risk factor for subsequent DP, especially among men. Sick leave due to musculoskeletal or circulatory disorders was also a strong predictor of DP. Diagnosis-specific sick leave should be recognised as an early risk marker for future exclusion from the labour market.

  • 27.
    Almquist, Ylva B.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Landstedt, Evelina
    Jackisch, Josephine
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hammarström, Anne
    Prevailing over Adversity: Factors Counteracting the Long-Term Negative Health Influences of Social and Material Disadvantages in Youth2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 9, article id 1842Article in journal (Refereed)
    Abstract [en]

    Disadvantaged circumstances in youth tend to translate into poor health development. However, the fact that this is not always the case has been seen as indicative of differential resilience. The current study highlights factors outside the context of the family with the potential to counteract the long-term negative influences of social and material adversity in adolescence on general health status. This study was based on two waves of questionnaire data from the Northern Swedish Cohort. From the wave in 1981 (age 16), indicators of social and material conditions as well as factors related to school, peers, and spare time were derived. From the wave in 2008 (age 43), information about self-rated health was used. Ordinal logistic regression models (n = 908) showed that adversity in youth was associated with poorer self-rated health in midlife among men and women alike, net of health status at baseline. However, having an advantaged situation with regard to school, peers, or spare time appeared to protect against the detrimental influences of disadvantaged circumstances in the family context on subsequent health. This suggests that health-promoting interventions may benefit from focusing on contexts outside the family in their effort to strengthen processes of resilience among disadvantaged youths.

  • 28. Anderson, Christopher J.
    et al.
    Bahník, Štěpán
    Barnett-Cowan, Michael
    Bosco, Frank A.
    Chandler, Jesse
    Chartier, Christopher R.
    Cheung, Felix
    Christopherson, Cody D.
    Cordes, Andreas
    Cremata, Edward J.
    Della Penna, Nicolas
    Estel, Vivien
    Fedor, Anna
    Fitneva, Stanka A.
    Frank, Michael C.
    Grange, James A.
    Hartshorne, Joshua K.
    Hasselman, Fred
    Henninger, Felix
    van der Hulst, Marije
    Jonas, Kai J.
    Lai, Calvin K.
    Levitan, Carmel A.
    Miller, Jeremy K.
    Moore, Katherine S.
    Meixner, Johannes M.
    Munafò, Marcus R.
    Neijenhuijs, Koen I.
    Nilsonne, Gustav
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Nosek, Brian A.
    Plessow, Franziska
    Prenoveau, Jason M.
    Ricker, Ashley A.
    Schmidt, Kathleen
    Spies, Jeffrey R.
    Stieger, Stefan
    Strohminger, Nina
    Sullivan, Gavin B.
    van Aert, Robbie C. M.
    van Assen, Marcel A. L. M.
    Vanpaemel, Wolf
    Vianello, Michelangelo
    Voracek, Martin
    Zuni, Kellylynn
    Response to Comment on "Estimating the reproducibility of psychological science"2016In: Science, ISSN 0036-8075, E-ISSN 1095-9203, Vol. 351, no 6277, article id 1037Article in journal (Other academic)
    Abstract [en]

    Gilbert et al. conclude that evidence from the Open Science Collaboration's Reproducibility Project: Psychology indicates high reproducibility, given the study methodology. Their very optimistic assessment is limited by statistical misconceptions and by causal inferences from selectively interpreted, correlational data. Using the Reproducibility Project: Psychology data, both optimistic and pessimistic conclusions about reproducibility are possible, and neither are yet warranted.

  • 29.
    Andreasson, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Carlsson, A. C.
    Wändell, P. E.
    High levels of leptin are associated with poor self-rated health in men and women with type 2 diabetes treated with metformin2013In: NMCD. Nutrition Metabolism and Cardiovascular Diseases, ISSN 0939-4753, E-ISSN 1590-3729, Vol. 23, no 2, p. E11-E12Article in journal (Other academic)
  • 30.
    Andreasson, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Macquarie University, Australia.
    Carlsson, Axel C.
    Önnerhag, Kristina
    Hagström, Hannes
    Waist/Hip Ratio Better Predicts Development of Severe Liver Disease Within 20 Years Than Body Mass Index: A Population-based Cohort Study2017In: Clinical Gastroenterology and Hepatology, ISSN 1542-3565, E-ISSN 1542-7714, Vol. 15, no 8, p. 1294-+Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: Obesity, commonly assessed based on body mass index (BMI), is associated with an increased risk for severe liver disease. It is not known if other measures of body composition are better determinants of risk for severe liver disease, and/or if these differ between women and men. We investigated the body composition measures that best predict the development of severe liver disease. METHODS: We collected data from the Malmo Diet and Cancer study in Sweden, comprising 16,784 women and 10,833 (mean age, 58.1 years at baseline), and followed patients for a median 19.8 years. We analyzed data on measures of body composition including BMI, waist/hip ratio, and others. We determined whether subjects were diagnosed with severe liver disease, or died from severe liver disease, until the end of 2014 using Swedish national registers. Associations between body composition measures and severe liver disease were assessed using Cox regression models, stratified by sex and adjusted for age, alcohol consumption, smoking, education, and physical activity. RESULTS: All studied measures of body composition were significantly associated with severe liver disease. Waist/hip ratio was the best predictor of severe liver disease in women (hazard ratio [HR] per standard deviation increment, 1.30; 95% confidence interval [CI], 1.16-1.46) and men (HR, 1.46; 95% CI, 1.31-1.63). BMI had the lowest HR in women (HR, 1.12; 95% CI, 1.00-1.27) and men (HR, 1.26; 95% CI, 1.12-1.42). The association between waist/hip ratio and development of liver disease was independent of BMI. CONCLUSIONS: In a Swedish population-based cohort study, we associated all measures of body composition with risk of severe liver disease. However, measures of abdominal obesity were best at predicting development of severe liver disease.

  • 31.
    Andreasson, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Macquarie University, Australia.
    Hagström, Hannes
    Sköldberg, Filip
    Önnerhag, Kristina
    Carlsson, Axel C.
    Schmidt, Peter T.
    Forsberg, Anna M.
    The prediction of colorectal cancer using anthropometric measures: A Swedish population-based cohort study with 22 years of follow-up2019In: United European Gastroenterology journal, ISSN 2050-6406, E-ISSN 2050-6414, Vol. 7, no 9, p. 1250-1260Article in journal (Refereed)
    Abstract [en]

    Background: Obesity is a risk factor for colorectal cancer (CRC).

    Objective: The objective of this article is to investigate whether anthropometric measures reflecting visceral obesity are better predictors of CRC than body mass index (BMI).

    Methods: Data were analysed from the Malmo Diet and Cancer study in Sweden, comprising 16,669 women and 10,805 men (median age 56.6 and 59.1 years) followed for a median 21.5 years. Diagnoses of CRC were identified using Swedish national registers. Cox regression was used to test the associations of BMI, waist circumference (WC), waist-hip ratio, waist-to-height ratio, waist-to-hip-to-height ratio, A Body Shape Index (ABSI) and percentage body fat with the development of CRC adjusted for age, alcohol consumption, smoking, education and physical activity in men and women.

    Results: None of the measures were significantly associated with an increased risk for CRC in women. WC was the strongest predictor of colon cancer (CC) in men and the only measure that was independent of BMI. ABSI was the only measure significantly associated with the risk of rectal cancer in men.

    Conclusions: Visceral obesity, best expressed as WC, is a risk factor for CC in men but a poor predictive marker for CRC in women.

  • 32.
    Andreasson, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Karshikoff, Bianka
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Lidberg, Lisa
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Ingvar, Martin
    Hoglund, Caroline Olgart
    Axelsson, John
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    The effect of a transient immune activation on subjective health perception in two placebo controlled randomised experiments2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 3, article id e0212313Article in journal (Refereed)
    Abstract [en]

    Background Patient-reported outcomes predict mortality and play increasingly important roles in care, but factors that modify central measures such as health ratings have been little investigated. Building on designated immune-to-brain pathways, we aimed to determine how a short-term induced inflammation response impacts self-reported health status. Methods Lipopolysaccharide injections were used to provoke acute systemic inflammatory responses in healthy men and women and were compared to placebo in two double-blind randomized experiments. In Experiment 1, 8 individuals (mean 24 years; SD = 3.7) received lipopolysaccharide 0.8 ng/kg once and placebo once in a cross-over design, and in Experiment 2, 52 individuals received either lipopolysaccharide 0.6 ng/kg or placebo once (28.6 years; SD = 7.1). Main outcomes were perceived health (general and current), sickness behaviour (like fatigue, pain and negative affect), and plasma interleukin-6, interleukin-8 and tumour necrosis factor-alpha, before and after injection. Results Compared to placebo, lipopolysaccharide lead to a deterioration in both self-rated general (Experiment 1, b = 1.88 for 0.8 ng/kg) and current health (Experiment 1 b = -3.00; and Experiment 2 b = -1.79) 1.5h after injection (p's<0.01), effects that remained after 4.5 to 5 hours (p's<0.05). The effect on current health in Experiment 2 was mediated by increased inflammation and sickness behaviour in response to lipopolysaccharide injection (beta = -0.28, p = 0.01). Conclusion Health is drastically re-evaluated during inflammatory activation. The findings are consistent with notions that inflammation forms part of health-relevant interoceptive computations of bodily state, and hint at one mechanism as to why subjective health predicts longevity.

  • 33.
    Andreasson, Anna N.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Jones, M. P.
    Walker, M. M.
    Talley, N. J.
    Nyhlin, H.
    Agréus, L.
    Prediction pathways for innate immune pathology, IBS, anxiety and depression in a general population (The POPCOL Study)2013In: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 32, p. e46-e46Article in journal (Other academic)
    Abstract [en]

    The aim of this study was to ascertain whether low grade innate inflammation contributes to a pathway of depression and anxiety via irritable bowel syndrome (IBS). We evaluated innate immune cell counts in colonic mucosa in normal subjects and those with IBS (Rome III) from a population based study in which 745 randomly selected subjects had a colonoscopy (mean age 51 years;57% women). Intraepithelial lymphocytes (IELs) per 100 enterocytes and eosinophils (eos) per five non-overlapping high power fields (HPF) were counted in 90 controls and 100 cases; immunocytochemistry (CD117) was performed for mast cells per 5HPF in 80 controls and 81 cases. IELs, mast cells and eos were individually summed over 5 sites (terminal ileum, caecum, transverse colon, sigmoid colon and rectum). Anxiety and depression scores were calculated from HADS. A causal model path model which hypothesises immune cells being associated with IBS which, in turn, is associated with elevated anxiety and depression was tested using path analysis implemented in the MPlus software. All hypothesised paths reached statistical significance (p < .05) supporting the individual hypothesized pathways. The overall model fit was reasonable although imperfect. In conclusion, a significant contribution of innate immune inflammatory load leading to anxiety and depression via IBS was found. Whether therapy directed to decreasing this inflammatory load also lifts depression and anxiety should be further explored.

  • 34.
    Andreasson, Anna N.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Schiller, Helena
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Contemplate your symptoms and re-evaluate your health2015In: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 49, p. e38-e39Article in journal (Refereed)
    Abstract [en]

    Bodily signals and how these are interpreted affect self-ratings of health. It is thus reasonable that appraisals of health are affected by imminent exposures and disease primes. We aimed to investigate whether self-ratings of health are affected by a symptom rating and if changes are substantiated in persons who report more symptoms. We used data from 813 persons who completed a questionnaire daily for 21 consecutive days. The questionnaire included a one-item self-rating of health (“pre-SRH”; 1 = excellent, 7 = very poor), a subsequent 26-item rating of physical and mental symptoms and thereafter a second (identical) self-rating of health (“post-SRH”). Paired t-tests were used to test for differences between pre-SRH and post-SRH. Mixed effect regression models were used to calculate the interaction effect of pre-SRH and symptom score on post-SRH adjusted for gender, age and if the person had been working that day (13545 observations). SRH worsened significantly (p  <<.0001) after the symptom rating, from 2.72 pre-SRH (95%CI:−2.70–2.74) to 2.77 post-SRH (95%CI:2.75–2.79). There was a significant interaction between pre-SRH and symptoms on post-SRH so that persons who reported more symptoms changed their post-SRH rating to a higher degree than those who reported fewer symptoms, irrespective of their subjective health status. The results support the notion that subjective health perception is affected by focus of attention, and that the effect depends on level of symptoms.

  • 35.
    Andreasson, Anna N.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Wicksell, B.
    Karshikoff, B.
    Lodin, K.
    Axelsson, John
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Olgart Höglund, C.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Development and preliminary validation of the Sickness Questionnaire (SicknessQ)2013In: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 32, article id e14Article in journal (Refereed)
    Abstract [en]

    The lack of questionnaires to measure subjective feelings of being sick made us develope the Sickness Questionnaire (SicknessQ) for assessment of sickness behavior in people. The objective of the present investigation was to test its internal consistency, criteria validity, and sensitivity to capture the sickness response in an experimental setting. An initial pool of items was developed based on previous research. The statistical properties of SicknessQ was assessed in 172 men and women primary care patients with acute complaints and involved three steps: (1) principal component analyses to reduce the number of items and to identify latent factor structures, (2) tests of internal consistencies of subscales, and (3) hierarchical regression analyses to test criteria validity of the subscales. Subsequently, sensitivity to change was tested in a placebo controlled experiment in which 31 blinded healthy men and women were injected with endotoxin (LPS) to provoke sickness behavior. Principal components analysis suggested a 3-factor solution with a total of 11 items measuring fatigue (5 items), pain (4 items) and emotion (2 items). The total scale as well as each of the three separate factors were significantly changed 90 min after endotoxin injection as compared to baseline (p’s < .01). In all, the new 11-item SicknessQ is highly sensitive to a mild systemic inflammation. Further studies are planned to test its usefulness and prognostic value in clinical settings.

  • 36.
    Andreasson, Anna Nixon
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet.
    Szulkin, Robert
    Undén, Anna-Lena
    von Essen, Jan
    Nilsson, Lars-Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet.
    Inflammation and positive affect are associated with subjective health in women of the general population2013In: Journal of Health Psychology, ISSN 1359-1053, E-ISSN 1461-7277, Vol. 18, no 3, p. 311-320Article in journal (Refereed)
    Abstract [en]

    Poor subjective health has been associated with higher levels of inflammatory cytokines. We investigated whether such an association would apply to women of the general population. Levels of cytokines, affect and subjective health were assessed in 347 women of the general population aged 45 to 90 years. Higher levels of interleukin-6 were associated with poor subjective health, especially in participants over 65 years of age. Positive affect was a more robust determinant of subjective health than negative affect. The presence of low-grade inflammation and absence of positive affect, rather than presence of negative affect, may be important determinants of subjective health.

  • 37.
    Andreasson, Anna Nixon
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Undén, Anna-Lena
    Elofsson, Stig
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Brismar, Kerstin
    Leptin and adiponectin: Distribution and associations with cardiovascular risk factors in men and women of the general population2012In: American Journal of Human Biology, ISSN 1042-0533, E-ISSN 1520-6300, Vol. 24, no 5, p. 595-601Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: In view of the increasing prevalence of obesity worldwide, understanding the role of the recently discovered adipokines leptin and adiponectin is of high clinical relevance. The aim of the present study was to assess the association between levels of leptin and adiponectin with age, known cardiovascular risk factors and to establish whether there are differences between men and women of the general population.

    METHODS: A total of 98 men and 107 women of the general population, aged between 20 and 74 years, underwent a medical examination at a clinical research center and fasting morning blood samples were also taken.

    RESULTS: Leptin (mean 7.5 μg l(-1) in men and 16.0 μg l(-1) in women) and adiponectin (mean 7.3 mg l(-1) in men and 11.9 mg l(-1) in women) levels were higher in women than men (Ps < 0.001). Both leptin and adiponectin levels increased with advancing age in both men and women (Ps < 0.05). Leptin was highly associated with factors for metabolic syndrome in men while in women, leptin was highly associated with inflammatory factors. Adiponectin was associated with blood lipids in both men and women, and glucose homeostasis more in women than in men.

    CONCLUSIONS: Leptin and adiponectin levels were ∼2 times and 1.5 times higher in women than in men, respectively. In addition, although leptin and adiponectin were associated to CVD risk factors in both men and women, we observed differences in specific CVD risk factor groups between men and women. These differences may be due to different regulatory mechanisms and effects of these adipokines in men and women.

  • 38.
    Andreasson, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Macquarie University, Australia.
    Schiller, Helena
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Berntson, Erik
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Brief report: Contemplate your symptoms and re-evaluate your health. A study on working adults2019In: Journal of Health Psychology, ISSN 1359-1053, E-ISSN 1461-7277, Vol. 24, no 11, p. 1562-1567Article in journal (Refereed)
    Abstract [en]

    We investigated whether self-ratings of health are affected by a symptom rating. A diary including a one-item self-rating of health ("pre-self-rated health"; 1 = excellent, 7 = very poor), a subsequent 26-item rating of symptoms, and thereafter a second (identical) health rating ("post-self-rated health") was completed by 820 persons 21 times. Self-rated health worsened significantly ( p < .0001) after the symptom rating, from 2.72 pre-self-rated health (95% confidence interval: 2.70-2.74) to 2.77 post-self-rated health (95% confidence interval: 2.75-2.79) and more so in persons who reported more symptoms ( b = .058, p < .05). The results support the notion that subjective health perception is influenced by attending to symptoms, especially so in persons with a high symptom burden.

  • 39.
    Andreasson, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Wicksell, Rikard K.
    Lodin, Karin
    Karshikoff, Bianka
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Axelsson, John
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    A global measure of sickness behaviour: Development of the Sickness Questionnaire2018In: Journal of Health Psychology, ISSN 1359-1053, E-ISSN 1461-7277, Vol. 23, no 11, p. 1452-1463Article in journal (Refereed)
    Abstract [en]

    Symptoms after inflammatory activation, so-called sickness behaviour, overlap with trans-diagnostic complaints. As no self-report questionnaire to assess sickness behaviour exists, we aimed to develop such an instrument, the Sickness Questionnaire. Items responsive to experimentally induced inflammatory activation (randomized double-blind study endotoxin (0.6 ng/kg) versus placebo, n = 52) were selected and the statistical properties were examined in 172 primary care patients. A principal component analysis indicated a one-factor solution (Cronbach's alpha = .86). This 10-item scale correlated with depression ( β = .41, p < .001), anxiety ( β = .36, p < .001), self-rated health ( β = .28, p < .001) and a single item of feeling sick ( β = .55, p < .001). The results support the adequacy of Sickness Questionnaire as a brief assessment instrument of perceived sickness behaviour.

  • 40. Andreeva, E
    et al.
    Mihályi, P
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Speed matters2011In: DEVELOPMENT OF MACRO LEVEL INDICATORS OF RESTRUCTURING AND WORKERS’ HEALTH / [ed] M. Harvey Brenner, Elena Andreeva, Berlin: Universitätsverlag der TU Berlin , 2011, , p. 355p. 166-184Chapter in book (Other academic)
  • 41. Andreeva, Elena
    et al.
    Brenner, M. Harvey
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Goldberg, Marcel
    Risk of psychological ill health and methods of organisational downsizing: a cross-sectional survey in four European countries2017In: BMC Public Health, E-ISSN 1471-2458, Vol. 17, article id 758Article in journal (Refereed)
    Abstract [en]

    Background: The manner in which organizational downsizing is implemented can make a substantial difference as to whether the exposed workers will suffer from psychological ill health. Surprisingly, little research has directly investigated this issue. We examined the likelihood of psychological ill health associated with strategic and reactive downsizing. Methods: A cross-sectional survey included 1456 respondents from France, Sweden, Hungary and the United Kingdom: 681 employees in stable workplaces (reference group) and 775 workers from downsized companies. Reactive downsizing was exemplified by the exposures to compulsory redundancies of medium to large scale resulting in job loss or surviving a layoff while staying employed in downsized organizations. The workforce exposed to strategic downsizing was represented by surplus employees who were internally redeployed and supported through their career change process within a policy context of no compulsory redundancy. Symptoms of anxiety, depression and emotional exhaustion were assessed in telephone interviews with brief subscales from Hospital Anxiety Scale (HADS-A), Hopkins Symptom Checklist (SCL-CD6) and Maslach Burnout Inventory (MBI-GS). Data were analyzed using logistic regression. Results: We observed no increased risk of psychological ill health in the case of strategic downsizing. The number of significant associations with psychological ill health was the largest for the large-scale reactive downsizing: surviving a layoff was consistently associated with all three outcome measures; returning to work after the job loss experience was related to anxiety and depression, while persons still unemployed at interview had elevated odds of anxiety. After reactive medium-scale downsizing, unemployment at interview was the only exposure associated with anxiety and depression. Conclusions: The manner in which organizational downsizing is implemented can be important for the psychological wellbeing of workers. If downsizing is unavoidable, it should be achieved strategically. Greater attention is needed to employment and health policies supporting the workers after reactive downsizing.

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  • 42. Andreeva, Elena
    et al.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Brenner, M. Harvey
    Depressive symptoms as a cause and effect of job loss in men and women: evidence in the context of organisational downsizing from the Swedish Longitudinal Occupational Survey of Health2015In: BMC Public Health, E-ISSN 1471-2458, Vol. 15, article id 1045Article in journal (Refereed)
    Abstract [en]

    Background: Few studies have examined depression as both a cause and effect of unemployment, but no prior work investigated these relationships in the context of organisational downsizing. We explored whether the exposure to downsizing is associated with subsequent depression (social causation), and whether pre-existing depression increases the risk of being laid off when organisations downsize (health selection). Methods: Two successive waves of the nationally representative Swedish Longitudinal Occupational Survey of Health represented the baseline (2008) and follow-up (2010) of this study. Analyses included 196 workers who lost their jobs through downsizing, 1462 layoff survivors remaining in downsized organisations and 1845 employees of non-downsized workplaces. The main outcomes were: (1) Depressive symptoms at follow-up, assessed with a brief subscale from the Symptom Checklist 90, categorised by severity levels (major depression, less severe symptoms and no depression) and analysed in relation to earlier downsizing exposure; (2) Job loss in persons with downsizing in relation to earlier depressive symptoms. The associations were assessed by means of multinomial logistic regression. Results: Job loss consistently predicted subsequent major depression among men and women, with a somewhat greater effect size in men. Surviving a layoff was significantly associated with subsequent major depression in women but not in men. Women with major depression have increased risks of exclusion from employment when organisations downsize, whereas job loss in men was not significantly influenced by their health. Conclusions: The evidence from this study suggests that the relative importance of social causation and health selection varies by gender in the context of organisational downsizing. Strategies for handling depression among employees should be sensitive to gender-specific risks during layoffs. Policies preventing social exclusion can be important for female workers at higher risk of depression.

  • 43. Annandale, Ellen
    et al.
    Wiklund, Maria
    Hammarström, Anne
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Theorising women’s health and health inequalities: shaping processes of the ‘gender-biology nexus’2018In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, article id 1669353Article in journal (Refereed)
    Abstract [en]

    Since the theoretical frameworks and conceptual tools we employ shape research outcomes by guiding research pathways, it is important that we subject them to ongoing critical reflection. A thoroughgoing analysis of the global production of women?s health inequality calls for a comprehensive theorization of how social relations of gender and the biological body mutually interact in local contexts in a nexus with women?s health. However, to date, the predominant concern of research has been to identify the biological effects of social relations of gender on the body, to the relative neglect of the co-constitutive role that these biological changes themselves may play in ongoing cycles of gendered health oppressions. Drawing on feminist and gender theoretical approaches, and with the health of women and girls as our focus, we seek to extend our understanding of this recursive process by discussing what we call the ?shaping processes? of the ?gender-biology nexus? which call attention to not only the ?gender-shaping of biology? but also the ?biologic-shaping of gender?. We consider female genital mutilation/cutting as an illustration of this process and conclude by proposing that a framework which attends to both the ?gender-shaping of biology? and the ?biologic-shaping of gender? as interweaving processes provides a fruitful approach to theorising the wider health inequalities experienced by women and girls.

  • 44.
    Annell, Stefan
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Swedish Defence Recruitment Agency, Sweden.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Sverke, Magnus
    Stockholm University, Faculty of Social Sciences, Department of Psychology. North-West University, South Africa.
    Means of Sustainable Recruitment: The Importance of Selection Factors and Psychosocial Working Conditions in Predicting Work and Health OutcomesManuscript (preprint) (Other academic)
    Abstract [en]

    Research on selection factors often focuses on how to identify suitable candidates, while fewer studies have investigated the long-term effects of such selection factors once the suitable candidates have started working and faced the work situation. The overall aim of the present study was to examine the relative importance of selection factors (general intelligence, personality, and physical fitness), measured during recruitment, and psychosocial working conditions (e.g., workload, job control, and job challenge)for four different outcomes (job satisfaction, organizational citizenship behavior, occupational retention, and health). Data came from a longitudinal study of newly hired police officers in Sweden (N = 508), including information from both the recruitment process and a three-and-a-half year follow-up. Results of hierarchical multiple regression analyses show that psychosocial working conditions were far more important than the selection factors in predicting the four outcomes. The strong effects of psychosocial working conditions for new officers’ work-related attitudes and health suggest that employers, to ensure sustainability, need to focus on activities facilitating the organizational and professional entrance of newcomers by providing a sound work climate.

  • 45.
    Annell, Stefan
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Sverke, Magnus
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Sustainable Recruitment: Individual Characteristics and Psychosocial Working Conditions Among Swedish Police Officers2018In: Nordic Journal of Working Life Studies, E-ISSN 2245-0157, Vol. 8, no 4, p. 3-24Article in journal (Refereed)
    Abstract [en]

    Selection research has typically focused on how to identify suitable candidates, while less is known regarding the long-term effects of various selection factors once the suitable candidates have start-ed working. The overall aim of this study was to examine the relative importance of selection fac-tors (measured during recruitment), and psychosocial working conditions (once candidates started working) for four outcomes, namely (1) job satisfaction, (2) organizational citizenship behavior, (3) occupational retention, and (4) health. Data came from a longitudinal study of newly hired police officers in Sweden (N = 508), including recruitment data and a follow-up after 3.5 years. Results of hierarchical multiple regression analyses showed that psychosocial working conditions were more important than selection factors in predicting the four outcomes. The findings suggest that employers, to ensure sustainability, need to focus on activities that facilitate newcomers’ enter-ing in the organization and their professions by providing a sound work climate.

  • 46. Anund, A.
    et al.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fors, C.
    Ihlström, J.
    Ingre, Michael
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Radun, Igor
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Söderström, B.
    Bussförares arbetstider kopplat till trötthet [Bus drivers' working hours and the relationship to fatigue]2014Report (Other (popular science, discussion, etc.))
  • 47. Anund, Anna
    et al.
    Ahlström, Christer
    Fors, Carina
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Are professional drivers less sleepy than non-professional drivers?2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 1, p. 88-95Article in journal (Refereed)
    Abstract [en]

    Objective It is generally believed that professional drivers can manage quite severe fatigue before routine driving performance is affected. In addition, there are results indicating that professional drivers can adapt to prolonged night shifts and may be able to learn to drive without decreased performance under high levels of sleepiness. However, very little research has been conducted to compare professionals and non-professionals when controlling for time driven and time of day.

    Method The aim of this study was to use a driving simulator to investigate whether professional drivers are more resistant to sleep deprivation than non-professional drivers. Differences in the development of sleepiness (self-reported, physiological and behavioral) during driving was investigated in 11 young professional and 15 non-professional drivers.

    Results Professional drivers self-reported significantly lower sleepiness while driving a simulator than nonprofessional drivers. In contradiction, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness. They also drove faster. The reason for the discrepancy in the relation between the different sleepiness indicators for the two groups could be due to more experience to sleepiness among the professional drivers or possibly to the faster speed, which might unconsciously have been used by the professionals to try to counteract sleepiness.

    Conclusion Professional drivers self-reported significantly lower sleepiness while driving a simulator than non-professional drivers. However, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness, and they drove faster.

  • 48. Anund, Anna
    et al.
    Ahlström, Christer
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Rumble strips in centre of the lane and the effect on sleepy drivers2011In: Industrial Health, ISSN 0019-8366, E-ISSN 1880-8026, Vol. 49, no 5, p. 549-558Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the effects of sleep loss on behavioural and subjective indicators of sleepiness on a road containing a milled rumble strip in the centre of the lane. Particular attention was paid to behavioural and subjective indicators of sleepiness when using the centre lane rumble strip, and to possible erratic driving behaviour when hitting a rumble strip. In total 9 regular shift workers drove during the morning hours after a full night shift and after a full night sleep. The order was balanced. The experiment was conducted in a moving base driving simulator on rural roads with a road width of 6.5 and 9 meters. Out of the 1,636 rumble strip hits that occurred during the study, no indications of erratic driving behaviour associated with the jolt caused by making contact with the centre lane rumble strip could be found. Comparing the alert condition with the sleep deprived condition, both the standard deviation of lateral position (SDLP) and the Karolinska Sleepiness Scale (KSS) increased for sleepy drivers. For the two road widths, the drivers drove closer to the centre line on the 6.5-meter road. The KSS and the SDLP increased with time on task. This simulator study indicates that rumble strips in the centre of the lane may be an alternative to centreline and edgeline rumble strips on narrow roads.

  • 49. Anund, Anna
    et al.
    Fors, Carina
    Hallvig, David
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Observer Rated Sleepiness and Real Road Driving: An Explorative Study2013In: PLOS ONE, E-ISSN 1932-6203, Vol. 8, no 5, article id e64782Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to explore if observer rated sleepiness (ORS) is a feasible method for quantification of driver sleepiness in field studies. Two measures of ORS were used: (1) one for behavioural signs based on facial expression, body gestures and body movements labelled B-ORS, and (2) one based on driving performance e.g. if swerving and other indicators of impaired driving occurs, labelled D-ORS. A limited number of observers sitting in the back of an experimental vehicle on a motorway about 2 hours repeatedly 3 times per day (before lunch, after lunch, at night) observed 24 participant's sleepiness level with help of the two observer scales. At the same time the participant reported subjective sleepiness (KSS), EOG was recorded (for calculation of blink duration) and several driving measure were taken and synchronized with the reporting. Based on mixed model Anova and correlation analysis the result showed that observer ratings of sleepiness based on drivers' impaired performance and behavioural signs are sensitive to extend the general pattern of time awake, circadian phase and time of driving. The detailed analysis of the subjective sleepiness and ORS showed weak correspondence on an individual level. Only 16% of the changes in KSS were predicted by the observer. The correlation between the observer ratings based on performance (D-ORS) and behavioural signs (B-ORS) are high (r = .588), and the B-ORS shows a moderately strong association (r = .360) with blink duration. Both ORS measures show an association (r>0.45) with KSS, whereas the association with driving performance is weak. The results show that the ORS-method detects the expected general variations in sleepy driving in field studies, however, sudden changes in driver sleepiness on a detailed level as 5 minutes is usually not detected; this holds true both when taking into account driving behaviour or driver behavioural signs.

  • 50. Anund, Anna
    et al.
    Fors, Carina
    Ihlstrom, Jonas
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    An on-road study of sleepiness in split shifts among city bus drivers2018In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 114, p. 71-76Article in journal (Refereed)
    Abstract [en]

    Bus drivers often work irregular hours or split shifts and their work involves high levels of stress. These factors can lead to severe sleepiness and dangerous driving. This study examined how split shift working affects sleepiness and performance during afternoon driving. An experiment was conducted on a real road with a specially equipped regular bus driven by professional bus drivers. The study had a within-subject design and involved 18 professional bus drivers (9 males and 9 females) who drove on two afternoons; one on a day in which they had driven early in the morning (split shift situation) and one on a day when they had been off duty until the test (afternoon shift situation). The hypothesis tested was that split shifts contribute to sleepiness during afternoon, which can increase the safety risks. The overall results supported this hypothesis. In total, five of the 18 drivers reached levels of severe sleepiness (Karolinska Sleepiness Scale 8) with an average increase in KSS of 1.94 when driving in the afternoon after working a morning shift compared with being off duty in the morning. This increase corresponded to differences observed between shift workers starting and ending a night shift. The Psychomotor Vigilance Task showed significantly increased response time with split shift working (afternoon: 0.337 s; split shift 0.347 s), as did the EEG-based Karolinska Drowsiness Score mean/max. Blink duration also increased, although the difference was not significant. One driver fell asleep during the drive. In addition, 12 of the 18 bus drivers reported that in their daily work they have to fight to stay awake while driving at least 2-4 times per month. While there were strong individual differences, the study clearly showed that shift working bus drivers struggle to stay awake and thus countermeasures are needed in order to guarantee safe driving with split shift schedules.

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