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  • 1. Abrahamsen, Annbjørg Selma
    et al.
    Johannesen, Ása
    Debes, Fróði
    van Leeuwen, Wessel M. A.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Weihe, Pál
    Working environment and fatigue among fishers in the north Atlantic: a field study2023Inngår i: International Maritime Health, ISSN 1641-9251, E-ISSN 2081-3252, Vol. 74, nr 1, s. 1-14Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: This study investigates how Faroese deep-sea fishers’ exposure to work-related stressors affects their sleep, sleepiness, and levels of fatigue. Being constantly exposed to the unpredictable and harsh North Atlantic Ocean, having long work hours and split sleep for up to 40 days consecutively, they will arguably suffer from fatigue.

    Materials and methods: One hundred and fifty seven fishers participated in this study, and data was gathered throughout 202 days at sea. Subjective data was collected at the start and end of trips via questionnaires, sleep and sleepiness diaries and supplemented by objective sleep data through actigraphs. Ship movements were logged with a gyroscope connected to a laptop. A noise metre measured each work station and resting area, and noise exposure profiles were calculated based on each participant’s activity and location. Linear mixed-effect models investigated the effects of work exposure variables on sleep efficiency, and cumulative link mixed models measured effects on the Karolinska Sleepiness Scale and physical fatigue scale.

    Results: Time of day followed by ship movement were the exposure variables with the highest impact on the outcome variables of sleep efficiency, sleepiness and physical fatigue. The number of days at sea revealed correlations to outcome variables either by itself or interacting with the sleep periods per day. Crew size, shift system or noise did not impact outcome variables when in the model with other variables. Larger catches improved sleep efficiency but did not affect sleepiness and physical fatigue ratings.

    Conclusions: The findings indicate a chronically fatigued fisher population, and recommends urgent attention being paid to improving the structure of vessels and installing stabilators for greater stability at sea; work schedules being evaluated for protection of health; and work environments being designed that fulfill human physiological requirements in order to ensure the wellbeing and safety of those at sea.

  • 2. Abrahamsen, Annbjørg Selma
    et al.
    Weihe, Pál
    van Leeuwen, Wessel M. A.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Debes, Fróði
    Impact of work exposure on cognitive performance in Faroese deep-sea fishers: a field study2022Inngår i: International Maritime Health, ISSN 1641-9251, E-ISSN 2081-3252, Vol. 73, nr 3, s. 150-161Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: This study examines the impact of work-related exposure on the cognitive performance of Faroese deep-sea fishers. Faroese fishing crews work long hours in demanding and noisy environments amidst highly uncertain and challenging weather conditions. These factors, together with compromised patterns of rest and sleep, are known to increase fatigue. Our aim was to study if changes could be measured in fishers’ cognitive performance at the end of the trip when compared with the baseline measure at the beginning.

    Materials and methods: Data was collected over 15 months (May 2017 to July 2018) from 157 fishers on 18 fishing trips which involved 202 investigative days on board. Questionnaires and six computerised cognitive tests: Simple Reaction Time, Numeric Working Memory, Corsi Blocks, Rapid Visual Information Processing, Digit Vigilance, and Card Sorting Test were used for data collection at the beginning and end of the trip. Differences between the outcomes on the two test points were analysed with one-way ANOVA comparing the performances at the beginning and end of the voyage, and two-way ANOVA to examine the interactive effect of chronotype and test occasions on the outcomes. Mixed models were used to test for the effects of predictor variables.

    Results: Significant declines in cognitive performance were observed from the beginning to the end of the trip, with decreases in visuospatial memory and reaction times, and increases in cognitive lapses. Furthermore, slowing in response times was observed in the second half of the Digit Vigilance test when comparing the halves.

    Conclusions: Declines in performance were observed from the start to the end of the trip. Furthermore, fishers performed significantly worse in the second half of some parted tests, and evening types seem less influenced by irregular work hours. These findings call for improving the safety of the vessels and their crew.

  • 3. Abrahamsen, Annbjørg
    et al.
    Weihe, Pál
    Debes, Fróði
    van Leeuwen, Wessel MA.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Sleep, Sleepiness, and Fatigue on Board Faroese Fishing Vessels2022Inngår i: Nature and Science of Sleep, ISSN 1179-1608, Vol. 14, s. 347-362Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: Faroese fishers have four times more accidents than workers on land. The aim was to understand fishers’ fatigue better and how their work and sleep patterns influenced their sleepiness levels and cognitive performance.

    Materials and Methods: A total of 157 Faroese fishers wore wrist-worn actigraphs at sea and one week on land and filled in sleep and sleepiness diaries during the trip. Furthermore, a 3-minute simple reaction time (SRT) test was completed at the beginning and end of the trip. The ship’s movement and noise were also logged. The actiwatch results were analysed with mixed methods repeated measures. The sleepiness registrations and performance on the SRT-test were analysed with paired t-test. The ship movements (Pitch and roll) were divided into approximately three same-sized groups (lowest 1/3, medium 1/3, and highest 1/3) and compared against the Karolinska Sleepiness Scores (KSS ranging from 1– 9) ≥ 7 and physical tiredness (ranging from 1– 9) scores ≥ 7. Chi-square tests were used to determine the significance of these differences. Mean sleepiness scores at sea, and the proportion of sleepiness scores ≥ 7 were calculated, as well as sleepiness scores as a function of the time of day.

    Results: While at sea, fishers had more split sleep, slept less, and had lower sleep efficiency than onshore. Sleepiness was higher at the end of the trip, and cognitive decline was found. The number of major lapses was higher at the end of the trip, but with no significant difference between the median reaction times.

    Conclusion: The crew on-board the freezer longliner, who worked 8– 8 shifts, slept the most, had the longest continuous sleep periods, the highest sleep efficiency, the lowest sleepiness levels, and the highest noise exposure during their time off.

  • 4. Aczel, Balazs
    et al.
    Szaszi, Barnabas
    Nilsonne, Gustav
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    van den Akker, Olmo R.
    Albers, Casper J.
    van Assen, Marcel Alm
    Bastiaansen, Jojanneke A.
    Benjamin, Daniel
    Boehm, Udo
    Botvinik-Nezer, Rotem
    Bringmann, Laura F.
    Busch, Niko A.
    Caruyer, Emmanuel
    Cataldo, Andrea M.
    Cowan, Nelson
    Delios, Andrew
    van Dongen, Noah N. N.
    Donkin, Chris
    van Doorn, Johnny B.
    Dreber, Anna
    Dutilh, Gilles
    Egan, Gary F.
    Gernsbacher, Morton Ann
    Hoekstra, Rink
    Hoffmann, Sabine
    Holzmeister, Felix
    Huber, Juergen
    Johannesson, Magnus
    Jonas, Kai J.
    Kindel, Alexander T.
    Kirchler, Michael
    Kunkels, Yoram K.
    Lindsay, D. Stephen
    Mangin, Jean-Francois
    Matzke, Dora
    Munafò, Marcus R.
    Newell, Ben R.
    Nosek, Brian A.
    Poldrack, Russell A.
    van Ravenzwaaij, Don
    Rieskamp, Jörg
    Salganik, Matthew J.
    Sarafoglou, Alexandra
    Schonberg, Tom
    Schweinsberg, Martin
    Shanks, David
    Silberzahn, Raphael
    Simons, Daniel J.
    Spellman, Barbara A.
    St-Jean, Samuel
    Starns, Jeffrey J.
    Uhlmann, Eric Luis
    Wicherts, Jelte
    Wagenmakers, Eric-Jan
    Consensus-based guidance for conducting and reporting multi-analyst studies2021Inngår i: eLIFE, E-ISSN 2050-084X, Vol. 10, artikkel-id e72185Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Any large dataset can be analyzed in a number of ways, and it is possible that the use of different analysis strategies will lead to different results and conclusions. One way to assess whether the results obtained depend on the analysis strategy chosen is to employ multiple analysts and leave each of them free to follow their own approach. Here, we present consensus-based guidance for conducting and reporting such multi-analyst studies, and we discuss how broader adoption of the multi-analyst approach has the potential to strengthen the robustness of results and conclusions obtained from analyses of datasets in basic and applied research.

  • 5. Ahlström, Christer
    et al.
    van Leeuwen, Wessel
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Krupenia, Stas
    Jansson, Herman
    Finér, Svitlana
    Anund, Anna
    Kecklund, Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Real-Time Adaptation of Driving Time and Rest Periods in Automated Long-Haul Trucking: Development of a System Based on Biomathematical Modelling, Fatigue and Relaxation Monitoring2022Inngår i: IEEE transactions on intelligent transportation systems (Print), ISSN 1524-9050, E-ISSN 1558-0016, Vol. 23, nr 5, s. 4758-4766Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Hours of service regulations govern the working hours of commercial motor vehicle drivers, but these regulations may become more flexible as highly automated vehicles have the potential to afford periods of in-cab rest or even sleep while the vehicle is moving. A prerequisite is robust continuous monitoring of when the driver is resting (to account for reduced time on task) or sleeping (to account for the reduced physiological drive to sleep). The overall aims of this paper are to raise a discussion of whether it is possible to obtain successful rest during automated driving, and to present initial work on a hypothetical data driven algorithm aimed to estimate if it is possible to gain driving time after resting under fully automated driving. The presented algorithm consists of four central components, a heart rate-based relaxation detection algorithm, a camera-based sleep detection algorithm, a fatigue modelling component taking time awake, time of day and time on task into account, and a component that estimates gained driving time. Real-time assessment of driver fitness is complicated, especially when it comes to the recuperative value of in-cab sleep and rest, as it depends on sleep quality, time of day, homeostatic sleep pressure and on the activities that are carried out while resting. The monotony that characterizes for long-haul truck driving is clearly interrupted for a while, but the long-term consequences of extended driving times, including user acceptance of the key stakeholders, requires further research.

  • 6. Ahlström, Christer
    et al.
    Zemblys, Raimondas
    Jansson, Herman
    Forsberg, Christian
    Karlsson, Johan
    Anund, Anna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Swedish National Road and Transport Research Institute (VTI), Sweden; Linköping University, Sweden.
    Effects of partially automated driving on the development of driver sleepiness2021Inngår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 153, artikkel-id 106058Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective of this study was to compare the development of sleepiness during manual driving versus level 2 partially automated driving, when driving on a motorway in Sweden. The hypothesis was that partially auto-mated driving will lead to higher levels of fatigue due to underload. Eighty-nine drivers were included in the study using a 2 ? 2 design with the conditions manual versus partially automated driving and daytime (full sleep) versus night-time (sleep deprived). The results showed that night-time driving led to markedly increased levels of sleepiness in terms of subjective sleepiness ratings, blink durations, PERCLOS, pupil diameter and heart rate. Partially automated driving led to slightly higher subjective sleepiness ratings, longer blink durations, decreased pupil diameter, slower heart rate, and higher EEG alpha and theta activity. However, elevated levels of sleepiness mainly arose from the night-time drives when the sleep pressure was high. During daytime, when the drivers were alert, partially automated driving had little or no detrimental effects on driver fatigue. Whether the negative effects of increased sleepiness during partially automated driving can be compensated by the positive effects of lateral and longitudinal driving support needs to be investigated in further studies.

  • 7.
    Albrecht, Sophie C.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Kecklund, Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Leineweber, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    The mediating effect of work-life interference on the relationship between work-time control and depressive and musculoskeletal symptoms2020Inngår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 46, nr 5, s. 469-479Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives Evidence shows that work-time control (WTC) affects health but underlying mechanisms are still unclear. Work-life interference (WLI) might be a step on the causal pathway. The present study examined whether WLI mediates effects on mental and physical health and contrasted these to other causal pathways.

    Methods Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, N=26 804) were used. Cross-lagged analyses were conducted to estimate if WLI mediated effects from WTC (differentiating between control over daily hours and time off) to subsequent depressive and musculoskeletal symptoms. Other causal directions (reversed mediation, direct and reversed direct effects) and robustness of mediation (by including covariates) were examined.

    Results WLI partially mediated the relationship of WTC (control over daily hours/time off) with both health outcomes. Indirect effect estimates were small for depressive symptoms (-0.053 for control over time off and -0.018 for control over daily hours) and very small for musculoskeletal symptoms (-0.007 and -0.003, respectively). While other causal directions were generally weaker than causal mediational pathways, they played a larger role for musculoskeletal compared to depressive symptoms. Estimates relating to control over time off were in general larger than for control over daily hours.

    Conclusions Our results suggest that WLI mediates part of the effect from WTC to mental/musculoskeletal symptoms, but small estimates suggest that (i) WTC plays a small but consistent role in effects on health and (ii) particularly regarding musculoskeletal disorders, other causal directions and mediators need to be further examined.

  • 8.
    Albrecht, Sophie C.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Leineweber, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Kecklund, Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Tucker, Philip
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Swansea University, Swansea, UK.
    Prospective effects of work-time control on overtime, work-life interference and exhaustion in female and male knowledge workers2024Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 52, nr 2, s. 205-215Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: Employee-based flexible working hours are increasing, particularly among knowledge workers. Research indicates that women and men use work–time control (WTC; control over time off and daily hours) differently: while men work longer paid hours, women use WTC to counteract work–life interference. In a knowledge-worker sample, we examined associations between WTC and overtime, work–life interference and exhaustion and tested whether gender moderates the mediating role of overtime. Methods: The sample contained 2248 Swedish knowledge workers. Employing hierarchical regression modelling, we examined effects of control over time off/daily hours on subsequent overtime hours, work–life interference and exhaustion in general and in gender-stratified samples. Using conditional process analysis, we tested moderated mediation models. Results: Control over time off was related to less work–life interference (βmen= −0.117; 95% confidence interval (CI): −0.237 to 0.003; βwomen= −0.253; 95% CI: −0.386 to −0.120) and lower exhaustion (βmen= −0.199; 95% CI: −0.347 to −0.051; βwomen= −0.271; 95% CI: −0.443 to −0.100). For control over daily hours, estimates were close to zero. While men worked more overtime (42 min/week), we could not confirm gender moderating the indirect effect of control over time off/daily hours on work–life interference/exhaustion via overtime. Independent of gender, effects of control over time off on work–life interference were partly explained by working fewer overtime hours. Conclusions: Control over time off was related to lower exhaustion and better work–life balance (in particular for women). We found no evidence for men’s work–life interference increasing with higher WTC owing to working more overtime. Knowledge workers’ control over time off may help prevent work–life interference and burnout.

  • 9.
    Albrecht, Sophie Charlotte
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Leineweber, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Ojajärvi, Anneli
    Oksanen, Tuula
    Kecklund, Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Härmä, Mikko
    Association of work-time control with sickness absence due to musculoskeletal and mental disorders: An occupational cohort study2020Inngår i: Journal of Occupational Health, ISSN 1341-9145, E-ISSN 1348-9585, Vol. 62, nr 1, artikkel-id e12181Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Work-time control is associated with lower sickness absence rates, but it remains unclear whether this association differs by type of diagnosis and sub-dimension of work-time control (control over daily hours and control over time off) and whether certain vulnerable groups benefit more from higher levels of work-time control.

    Methods: Survey data from the Finnish 10-town study in 2004 were used to examine if baseline levels of work-time control were associated with register data on diagnose-specific sickness absence for 7 consecutive years (n = 22 599). Cox proportional hazard models were conducted, adjusted for age, sex, education, occupational status, shift work including nights, and physical/mental workload.

    Results: During follow-up, 2,818 individuals were on sick leave (>= 10 days) due to musculoskeletal disorders and 1724 due to mental disorders. Employees with high (HR = 0.80, 95% CI 0.74-0.87; HR = 0.76, 95% CI 0.70-0.82, respectively) and moderate (HR = 0.83, 95% CI 0.77-0.90; HR = 0.85, 95% CI 0.79-0.91, respectively) levels of control over daily hours/control over time off had a decreased risk of sickness absence due to musculoskeletal disorders. Sub-group analyses revealed that especially workers who were older benefitted the most from higher levels of work-time control. Neither sub-dimension of work-time control was related to sickness absence due to mental disorders.

    Conclusions: Over a 7-year period of follow-up, high and moderate levels of work-time control were related to lower rates of sickness absence due to musculoskeletal disorders, but not due to mental disorders.

  • 10.
    Albrecht, Sophie
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Leineweber, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Kecklund, Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Tucker, Philip
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Swansea University, UK.
    Prospective effects of work-time control on overtime, work-life interference and exhaustion in female and male knowledge workersManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Aims: Employee-based flexible working hours are increasing, particularly among knowledge workers. Research indicates that women and men use work–time control (WTC; control over time off and daily hours) differently: while men work longer paid hours, women use WTC to counteract work–life interference. In a knowledge-worker sample, we examined associations between WTC and overtime, work–life interference and exhaustion and tested if gender moderates the mediating role of overtime.

    Methods: The sample contained 2248 Swedish knowledge workers. Employing hierarchical regression modelling, we examined effects of control over time off/daily hours on subsequent overtime hours, work–life interference and exhaustion in general and in gender-stratified samples. Using conditional process analysis, we tested moderated mediation models.

    Results: Control over time off was related to less work–life interference (βmen=-0.117; CI95%: -0.237 to 0.003; βwomen=-0.253; CI95%: -0.386 to -0.120) and lower exhaustion (βmen=-0.199; CI95%: -0.347 to -0.051; βwomen=-0.271; CI95%: -0.443 to -0.100). For control over daily hours, estimates were close to zero. While men worked more overtime (42 minutes/week), we could not confirm gender moderating the indirect effect of control over time off/daily hours on work–life interference/exhaustion via overtime. Independent of gender, effects of control over time off on work–life interference were partly explained by working fewer overtime hours.

    Conclusion: Control over time off was related to lower exhaustion and better work–life balance (in particular for women). We found no evidence for men’s work–life interference increasing with higher WTC due to working more overtime. Knowledge workers’ control over time off may aid to prevent work–life interference and burnout.

  • 11. Alexandersson, Bjarki
    et al.
    Hamad, Yousef
    Andreasson, Anna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska University Hospital, Sweden; Macquarie University, Australia.
    Rubio, Carlos A.
    Ando, Yugo
    Tanaka, Kyosuke
    Ichiya, Tamaki
    Rezaie, Reza
    Schmidt, Peter T.
    High-Definition Chromoendoscopy Superior to High-Definition White-Light Endoscopy in Surveillance of Inflammatory Bowel Diseases in a Randomized Trial2020Inngår i: Clinical Gastroenterology and Hepatology, ISSN 1542-3565, E-ISSN 1542-7714, Vol. 18, nr 9, s. 2101-2107Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND & AIMS: There is debate over the optimal method for colonoscopic surveillance of patients with inflammatory bowel diseases. Guidelines recommend chromoendoscopy, but the value of chromoendoscopy in high-definition colonoscopy has not been proven. Furthermore, the value of random biopsies is controversial. METHODS: We performed a prospective study of 305 patients with ulcerative colitis or Crohn's colitis referred for surveillance colonoscopy at a university hospital in Sweden, from March 2011 through April 2016. Patients randomly assigned to a group that received high-definition chromoendoscopy with indigo carmine (HD-CE; n=152), collection of 32 random biopsies, and targeted biopsies or polypectomies or to a group that received high-definition white light endoscopy (HD-WLE; n=153), collection of 32 random biopsies, and targeted biopsies or polypectomies. The primary endpoint was number of patients with dysplastic lesions. RESULTS: Dysplastic lesions were detected in 17 patients with HD-CE and 7 patients with HD-WLE (P=.032). Dysplasias in random biopsies (n=9760) were detected in 9 patients: 6 (3.9%) in the HD-CE group and 3 (2.0%) in the HD-WLE group (P=.72). Of the 9 patients with dysplasia, 3 patients (33%) had primary sclerosing cholangitis-only 18% of patients (54/305) included in the study had primary sclerosing cholangitis. The number of dysplastic lesions per 10 min of withdrawal time was 0.066 with HD-CE and 0.027 with HD-WLE (P=.056). CONCLUSIONS: In a randomized trial, we found HD-CE with collection of random biopsies to be superior to HD-WLE with random biopsies for detection of dysplasia per colonoscopy. These results support the use of chromoendoscopy for surveillance of patients with inflammatory bowel diseases. ClinicalTrials.gov no: NCT01505842.

  • 12. Alexandersson, Bjarki T.
    et al.
    Andreasson, Anna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden; Macquarie University, North Ryde, Australia.
    Hedin, Charlotte
    Broms, Gabriella
    Schmidt, Peter T.
    Forsberg, Anna
    Inflammatory Bowel Disease Is not Linked to a Higher Rate of Adverse Events in Colonoscopy: a Nationwide Population-based Study in Sweden2023Inngår i: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 17, nr 12, s. 1962-1967Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and Aims: Inflammatory bowel disease may cause long-standing inflammation and fibrosis and may increase the risk of adverse events in colonoscopy. We evaluated whether inflammatory bowel disease and other potential risk factors are associated with bleeding or perforation in a nationwide, population-based, Swedish study.

    Methods: Data from 969 532 colonoscopies, including 164 012 [17%] on inflammatory bowel disease patients, between 2003 and 2019, were retrieved from the National Patient Registers. ICD-10 codes for bleeding [T810] and perforation [T812] within 30 days of the colonoscopy were recorded. Multivariable logistic regression was used to test if inflammatory bowel disease status, inpatient setting, time period, general anaesthesia, age, sex, endoscopic procedures, and antithrombotic treatment were associated with higher odds for bleeding and perforation.

    Results: Bleeding and perforation were reported in 0.19% and 0.11% of all colonoscopies, respectively. Bleeding [odds ratio 0.66, p <0.001] and perforation [odds ratio 0.79, p <0.033] were less likely in colonoscopies in individuals with inflammatory bowel disease status. Bleeding and perforation were more common in inpatient than in outpatient inflammatory bowel disease colonoscopies. The odds for bleeding but not perforation increased between 2003 to 2019. General anaesthesia was associated with double the odds for perforation.

    Conclusions: Individuals with inflammatory bowel disease did not have more adverse events compared with individuals without inflammatory bowel disease status. However, the inpatient setting was associated with more adverse events, particularly in inflammatory bowel disease status. General anaesthesia was associated with a greater risk of perforation.

  • 13. Alexandersson, Bjarki T.
    et al.
    Hugerth, Luisa W.
    Hedin, Charlotte
    Forsberg, Anna
    Talley, Nicholas J.
    Agreus, Lars
    Järbrink-Sehgal, Ellionore
    Engstrand, Lars
    Andreasson, Anna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Sweden; Macquarie University, Australia.
    Schmidt, Peter T.
    Diverticulosis is not associated with altered gut microbiota nor is it predictive of future diverticulitis: a population-based colonoscopy study2023Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 58, nr 10, s. 1131-1138Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The etiopathogenesis of diverticular disease is unknown.

    Objective: To compare the fecal and mucosa-associated microbiota between participants with and without diverticulosis and participants who later developed diverticulitis versus those that did not from a population-based study.

    Methods: The PopCol study, conducted in Stockholm, Sweden, invited a random sample of 3556 adults to participate, of which 745 underwent colonoscopy. Overall, 130 participants (17.5%) had diverticulosis. 16S rRNA gene sequencing was conducted on available sigmoid biopsy samples from 529 and fecal samples from 251 individuals. We identified individuals who subsequently developed acute diverticulitis up to 13 years after sample collection. In a case-control design matching for gender, age (+/−5 years), smoking and antibiotic exposure, we compared taxonomic composition, richness and diversity of the microbiota between participants with or without diverticulosis, and between participants who later developed acute diverticulitis versus those who did not.

    Results: No differences in microbiota richness or diversity were observed between participants with or without diverticulosis, nor for those who developed diverticulitis compared with those who did not. No bacterial taxa were significantly different between participants with diverticulosis compared with those without diverticulosis. Individuals who later developed acute diverticulitis (2.8%) had a higher abundance of genus Comamonas than those who did not (p = .027).

    Conclusions: In a population-based cohort study the only significant difference was that those who later develop diverticulitis had more abundance of genus Comamonas. The significance of Comamonas is unclear, suggesting a limited role for the gut microbiota in the etiopathogenesis of diverticular disease.

  • 14. Aljeaidi, Muhamad
    et al.
    Keen, Claire
    Bell, J. Simon
    Cooper, Tina
    Robson, Leonie
    Tan, Edwin C. K.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Monash University, Australia; The University of Sydney, Australia.
    Dry Eyes, Ocular Lubricants, and Use of Systemic Medications Known or Suspected to Cause Dry Eyes in Residents of Aged Care Services2020Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, nr 15, artikkel-id 5349Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Ocular issues are common, burdensome, and under-researched among residents of aged care services. This study aims to investigate the prevalence of dry eyes or use of ocular lubricants among residents, and the possible association with systemic medications known or suspected to cause dry eyes. A cross-sectional study of 383 residents of six aged care services in South Australia was conducted. Data were extracted from participants' medical histories, medication charts, and validated assessments. The main exposure was systemic medications known to cause, contribute to, or aggravate dry eyes. The primary outcome was documented dry eyes or regular administration of ocular lubricants. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between systemic medications and dry eyes/use of ocular lubricants. Dry eyes were documented for 53 (13.8%) residents and 98 (25.6%) residents were administered ocular lubricants. Overall, 116 (30.3%) residents had documented dry eyes/used ocular lubricants. Of these, half (n= 58) were taking a medication known to cause, contribute to, or aggravate dry eyes. Taking one or more medications listed as known to cause dry eyes was associated with having dry eyes/use of ocular lubricants (OR 1.83, 95% CI 1.15-2.94). In sub-analyses, no individual medication was associated with dry eyes/use of ocular lubricants. Dry eyes and use of ocular lubricants are common in residential aged care. Our hypothesis generating findings suggest the need for further research into the clinical significance of systemic medications as a possible cause of dry eyes.

  • 15. Aljeaidi, Muhamad S.
    et al.
    Tan, Edwin C. K.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. The University of Sydney, Australia; Monash University, Australia .
    The association between polypharmacy and cognitive ability in older adults: A national cohort study2022Inngår i: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 18, nr 3, s. 2505-2509Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Polypharmacy, the use of multiple medications by one individual, may be associated with adverse health outcomes including poor cognition. However, it remains unclear whether a longitudinal relationship exists.

    Objectives: To investigate the association between polypharmacy and 3-year cognitive ability in older adults.

    Methods: A longitudinal cohort study of older adults 65 years and older, residing in the community, who participated in waves 12 (2012), 13 (2013) and 16 (2016) of the Household Income and Labour Dynamics (HILDA) Survey was conducted. Polypharmacy was defined as the regular use of 5 or more prescription medications. Cognitive ability was assessed using backwards digit span test (BDS), 25-item version of the National Adult Reading Test (NART-25) and symbol-digit modalities test (SDM). Linear regression was used to test the longitudinal association between polypharmacy and cognitive test scores at 3 years. All analyses were adjusted for age, sex, education, comorbidities, socioeconomic and lifestyle factors, and baseline cognitive test scores.

    Results: A total of 2141 participants (mean age 72.9 years, 54.4% female) were included in the study sample. Polypharmacy was present in 27.3%. After adjusting for potential confounders, polypharmacy was negatively associated with cognitive ability at 3 years: BDS: −0.067 (95% CI = −0.353 to −0.051), NART-25: −0.071 (95% CI = −1.428 to −0.294), SDM: −0.073 (95% CI = −2.960 to −0.696).

    Conclusion: Polypharmacy was associated with poorer cognitive ability at 3 years, even after adjusting for comorbidities and other confounders. Future research should consider the long-term impact of polypharmacy on cognitive ability, and identify strategies to optimise medication use and cognition in older adults.

  • 16.
    Andreasson, Anna
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden; Macquarie University, Australia.
    Axelsson, John
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Bosch, Jos A.
    Balter, Leonie J. T.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Poor sleep quality is associated with worse self-rated health in long sleep duration but not short sleep duration2021Inngår i: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 88, s. 262-266Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Unhealthy sleep duration, either short or long, is associated with worse health and central subjective dimensions of sleep and health such as fatigue. It has been argued that the link between sleep duration and health may depend on the quality of the slept hours, and on its functional impact (ie, fatigue). The present study therefore assessed whether the relationship between last night's sleep duration and general self-rated health (SRH) differs as a function of sleep quality, and secondly, whether current fatigue and sleep quality are factors linking sleep duration and SRH. The present cross-sectional dataset involved 1304 individuals (57% female, M age = 28.8, range 18-79). Participants completed surveys for general SRH, previous night's sleep duration and sleep quality, and current fatigue. Results showed the expected inverted U-shaped (ie, quadratic) relation between last night's sleep duration and SRH and a linear relation between last night's sleep quality and SRH. However, long sleep duration was only associated with poorer SRH in individuals who also reported poor sleep quality. Further, the quadratic relationship between sleep duration and SRH was partially mediated by fatigue and sleep quality. The results of this multi-study analysis suggest that SRH is particularly poor in those who slept both long and with poor quality the night before, while good sleep quality may protect those with a long sleep duration from poor SRH. Thus, last night's long sleep does not seem to be associated with poor subjective health unless it is coupled with poor sleep quality. Furthermore, fatigue and sleep quality are potential pathways linking short and long sleep duration with SRH. Different dimensions of sleep interact in their association with health, and future research will benefit from an integrative approach. 

  • 17.
    Andreasson, Anna
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Macquarie University, Australia; Karolinska Institutet, Sweden.
    McNaughton, David
    Beath, Alissa
    Lodin, Karin
    Wicksell, Rikard K.
    Lekander, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Jones, Michael P.
    Properties of the Sickness Questionnaire in an Australian sample with chronic medically unexplained symptoms2020Inngår i: Brain, Behavior, & Immunity - Health, ISSN 2666-3546, Vol. 3, artikkel-id 100059Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Sickness behavior including malaise, fatigue and increased pain sensitivity is thought to be adaptive and facilitate recovery from disease. However, it may also reduce functioning and health if symptoms persists, which is why validated instruments for its assessment are needed. We evaluated the English translation of the Sickness Questionnaire (SicknessQ) in an Australian population of 156 participants with high level of persistent musculoskeletal pain and/or gastrointestinal symptoms without an organic explanation. The SicknessQ total score had an adequate model fit and no other models were found to fit data better. The SicknessQ correlated most strongly with fatigue, stress, anxiety and depression, which explained 62% of the variance in SicknessQ, but not with physical functioning. The mean score (8.9; 95 %CI: 8.0–9.8) was in between those previously reported in a general population sample and in primary care patients. In conclusion, the evaluation of the English version of the SicknessQ in an Australian sample with significant, chronic unexplained medical symptoms supports the use of the English version of the total SicknessQ score as an overall measure of sickness behavior.

  • 18.
    Andreasson, Anna
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Macquarie University, Australia; Karolinska Institutet, Sweden.
    Talley, Nicholas J.
    Walker, Marjorie M.
    Jones, Michael P.
    Platts, Loretta G.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Wallner, Bengt
    Kjellström, Lars
    Hellström, Per M.
    Forsberg, Anna
    Agréus, Lars
    An Increasing Incidence of Upper Gastrointestinal Disorders Over 23 Years: A Prospective Population-Based Study in Sweden2021Inngår i: American Journal of Gastroenterology, ISSN 0002-9270, E-ISSN 1572-0241, Vol. 116, nr 1, s. 210-213Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: We hypothesized that the prevalence of functional dyspepsia and gastroesophageal reflux disease in the community may be increasing.

    METHODS: Randomly selected adults were surveyed on 4 occasions: 1988 (n = 1,151, 21–79 years, response rate [rr] = 90%), 1989 (n = 1,097, 22–80 years, rr = 87%), 1995 (n = 1,139, 20–85 years, rr = 76%), and 2011 (n = 1,175, 20–93 years, rr = 63%).

    RESULTS: In functional dyspepsia, the odds of postprandial distress syndrome tripled over 23 years' follow-up (odds ratio [OR]: 3.55; 95% confidence interval [CI]: 2.60–4.84, mixed-effect regression analysis), whereas a small decrease in epigastric pain syndrome was observed (OR: 0.65, 95% CI: 0.42–1.00). The odds of reporting gastroesophageal reflux disease doubled (OR: 2.02; 95% CI: 1.50–2.73).

    DISCUSSION: The underlying mechanisms behind the increase in postprandial distress syndrome and gastroesophageal reflux disease remain to be determined.

  • 19.
    Andreasson, Anna
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Stockholm, Sweden; Macquarie University, North Ryde, Australia.
    Tognetti, Arnaud
    Jones, Mike
    Lekander, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Stockholm, Sweden.
    Lasselin, Julie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Stockholm, Sweden.
    Assessing sickness behavior in the French: Validation of the French translation of the sickness questionnaire (SicknessQ) in a non-clinical French population2023Inngår i: Brain, Behavior, & Immunity - Health, ISSN 2666-3546, Vol. 34, artikkel-id 100708Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The Sickness Questionnaire (SicknessQ) is a questionnaire developed to assess symptoms of sickness behavior, including somatic, behavioral, and affective dimensions. To promote cross-cultural assessments of sickness behavior, we aim to expand the use of this questionnaire to other populations and languages. The aim of the present study was to evaluate the French translation of SicknessQ in a French-speaking general population during the COVID-19 pandemic. One hundred and thirty-nine individuals completed the SicknessQ online, along with the construct criteria measures of self-rated health, state anxiety (STAI-S), and depressive symptoms (PHQ-9). The principal component analyses revealed two components: the first component included seven items concerning mood, motivation and experiences of fatigue and pain; the second component included three items concerning somatic sickness symptoms. Higher scores on the total scale and the two component subscales were associated with poorer self-rated health and higher STAI-S and PHQ-9 scores. Since the associations with construct criteria variables were relatively similar between the single- and the two-dimensional solutions, both the total scale and the subscales of the two components of the French SicknessQ can be used in future studies to measure sickness behavior in French-speaking populations.

  • 20.
    Anund, Anna
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Swedish National Road and Transport Research Institute, Linköping, Sweden; Rehabilitation Medicine, Linköping University, Linköping, Sweden.
    Ihlström, Jonas
    Threats and violence towards urban bus drivers in Sweden: Drivers experiences and general recommendations to prevent violence and threats2022Inngår i: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 72, nr 4, s. 1279-1287Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Approximately 30% of Swedish urban bus drivers report having been exposed to threats or violence. As 50% of drivers have voiced concerns about the occurrences, threats and violence also represent contributing factors to driver stress and fatigue. OBJECTIVE: The aim of this study was to explore bus drivers' experience of threats and violence; how threats and violence manifests and how the problem is handled by drivers. Gaining understanding of the circumstances is important to reduce the number of threats and violent incidents to provide healthy and attractive working conditions for drivers. METHODS: This study is based on in-depth interviews with 12 urban bus drivers in the City of Malmö in Sweden. RESULTS: Urban bus drivers experience threats daily from passengers, although physical violence occurs less often. The most common situations resulting in threats involve asking passengers to show valid tickets, denying child carriages onboard and running late to a bus stop. The drivers have not received clear guidelines as to strategic handling of the invalid ticket situation. CONCLUSIONS: Recommendations include a clear policy and consensus with regard to handling invalid tickets, providing drivers with guidelines for appropriate procedures for passengers refusing to pay, improving reporting routines and establishing a strategy for the Public Transportation provider and operator to follow with regard to reports, in-vehicle surveillance cameras including informing passengers that they are being video recorded as well as harmonizing the location of alarm buttons on buses. 

  • 21. Aries, M. B. C.
    et al.
    Fischl, G.
    Lowden, Arne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Beute, F.
    The relationship of light exposure to sleep outcomes among office workers. Part 1: Working in the office versus at home before and during the COVID-pandemic2024Inngår i: Lighting Research and Technology, ISSN 1477-1535, E-ISSN 1477-0938, Vol. 56, nr 2, s. 113-125Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The relationship between everyday light exposure and sleep was studied for office workers. The study was conducted during the upswing of the COVID-19 pandemic, enabling a comparison between Office and Home Workdays. Fifteen full-time office employees were monitored for a period of 4–6 weeks. They wore a light-tracking device on their clothes and had a sleep tracker at home. Compared to an Office Workday, light exposure was lower in the afternoon and total sleep time was almost 5 minutes longer on a Home Workday. Sleep efficiency was the same on both workday types. A higher median illuminance level in the afternoon was significantly related to later sleep onset on an Office Workday. Higher median illuminance levels in the morning were related to earlier awakening. Counter to expectations, higher light levels in the evening were also related to earlier awakening. Everyday light exposure matters for sleep quality but may affect circadian functioning differently than the often more extreme light interventions employed in laboratory experiments. Moreover, differences in outcomes between Office and Home Workdays signal the need for further investigation to provide supportive light levels during workhours.

  • 22.
    Aronsson, Gunnar
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi.
    Hagberg, J.
    Björklund, Christina
    Aboagye, Emmanuel
    Marklund, S.
    Leineweber, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Bergström, Gunnar
    Health and motivation as mediators of the effects of job demands, job control, job support, and role conflicts at work and home on sickness presenteeism and absenteeism2021Inngår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 94, nr 3, s. 409-418Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The first objective was to contribute to a better understanding of the contrasting and paradoxical results in studies of work environment factors and sickness presence and sickness absence. A second objective was to examine if, and under what conditions, employees choose to replace sickness absence with sickness presence, i.e., so-called substitution.

    Methods: The study utilizes a large body of cross-sectional questionnaire data (n = 130,161) gathered in Sweden from 2002 to 2007 in connection with a comprehensive health promotion initiative. Health and motivation were analyzed as mediators of the effects of five job factors, job control, job support, job demand, role conflict and “work to family conflict” on sickness presence and absence.

    Results: The results concerning job demands indicate substitution in that increased job demands are associated with increased presenteeism and reduced absenteeism. The direct effect of higher job support was increased absenteeism, but via the health and motivation paths, the total effect of more social support was health-promoting and associated with a reduction in sickness absence and sickness presence. High job control emerged as the most pronounced health-promoting factor, reducing sickness presenteeism as well as absenteeism. More role conflicts and work-to-family conflicts were directly and indirectly associated with decreased health and increased absenteeism as well as presenteeism. earlier research.

    Conclusion: The mediation analyzes shed light on some of the paradoxes in research on sickness presenteeism and sickness absenteeism, especially regarding job demands and job support. The substitution effect is important for workplace policy and occupational health practice.

  • 23.
    Axelsson, John
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Andersson, Marit
    Sömnsmart: hur du sover dig till bättre hälsa / med professor John Axelsson och Marit Andersson2022Bok (Annet (populærvitenskap, debatt, mm))
    Abstract [sv]

    En praktisk och lättillgänglig bok om ett av våra största orosmoment och hälsoproblem idag, nämligen sömnen. John Axelsson, välkänd sömnforskare och professor, vill bidra till att minska vår oro kring sömnen men också ge handfasta verktyg kring hur man kan tänka och hantera perioder med lite sömn.

    Här finns råd för småbarnsföräldern, skolbarn, tonåringen eller dig som har en neuropsykiatrisk diagnos. Boken baseras på såväl John Axelssons egen forskning som andra sömnforskares. Den går på ett pedagogiskt sätt igenom olika aspekter av sömn, så att du kan fatta bättre beslut kring din egen sömn. Till exempel hur du kan beta av en sömnskuld eller få förståelse för hur du kan hjälpa din hjärna att fungera bättre i vardagen. Dygnsrytmer, sömnmyter och spännande rön om drömmar tas förstås också upp.

  • 24.
    Axelsson, John
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Ingre, Michael
    Kecklund, Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Lekander, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Wright, Kenneth P.
    Sundelin, Tina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden; New York University, USA.
    Sleepiness as motivation: a potential mechanism for how sleep deprivation affects behavior2020Inngår i: Sleep, ISSN 0161-8105, E-ISSN 1550-9109, Vol. 43, nr 6, artikkel-id zsz291Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    STUDY OBJECTIVES: To determine how sleepiness and sleep deprivation drive the motivation to engage in different behaviors.

    METHODS: We studied the sleepiness of 123 participants who had been randomized to sleep deprivation or normal sleep, and their willingness to engage in a range of everyday behaviors.

    RESULTS: Self-reported sleepiness was a strong predictor of the motivation to engage in sleep-preparatory behaviors such as shutting one's eyes (OR=2.78, 95%CI: 2.19-3.52 for each step up on the Karolinska Sleepiness Scale) and resting (OR=3.20, CI: 2.46-4.16). Sleepiness was also related to the desire to be cared for by a loved one (OR=1.49, CI: 1.22-1.82), and preparedness to utilize monetary and energy resources to get to sleep. Conversely, increased sleepiness was associated with a decreased motivation for social and physical activities (e.g., be with friends OR=0.71, CI: 0.61-0.82; exercise OR=0.65, CI: 0.56-0.76). Sleep deprivation had similar effects as sleepiness on these behaviors. Neither sleepiness nor sleep deprivation had strong associations with hunger, thirst, or food preferences.

    CONCLUSIONS: Our findings indicate that sleepiness is a dynamic motivational drive that promotes sleep-preparatory behaviors and competes with other drives and desired outcomes. Consequently, sleepiness may be a central mechanism by which impaired alertness, e.g., due to insufficient sleep, contributes to poor quality of life and adverse health. We propose that sleepiness helps organize behaviors toward the specific goal of assuring sufficient sleep, in competition with other needs and incentives. A theoretical framework on sleepiness and its behavioral consequences are likely to improve our understanding of several disease mechanisms.

  • 25. Bagge, Ann-Sophie Lindqvist
    et al.
    Lekander, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Sweden.
    Bagge, Roger Olofsson
    Carlander, Anders
    Mental health, stress, and well-being measured before (2019) and during (2020) COVID-19: a Swedish socioeconomic population-based study2023Inngår i: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Compare mental health, stress, and well-being in the Swedish population as measured before and during the COVID-19 pandemic. Methods: Repeated cross-sectional design using data measured before (Jan-2019; n = 2791) and during (Oct/Nov-2020; n = 2926) COVID-19 pandemic in Swedish population-representative cohorts. Following constructs were measured: anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory-II), stress (Perceived Stress Scale-10 items), health-related quality of life (HRQOL[Functional Assessment of Cancer Therapy-General Population]) and self-rated health (SRH) was assessed with a single-item question. Results: When adjusting for age, sex, education, and income there were significantly higher levels of anxiety (M = 9.15 vs. 8.48, p < 0.01) and depression (M = 3.64 vs. 3.30, p = 0.03), lower levels of stress (M = 14.06 vs. 14.91, p < 0.001), but worsened HRQOL (M = 76.40 vs. 77.92, p < 0.01) and SRH (M = 6.91 vs. 7.20, p < 0.001), observed in 2020 compared to 2019. For the negative effects seen in anxiety, depression, HRQOL, and SRH, higher income and education had a protective effect. The decrease in stress was also correlated with higher income. Conclusions: The COVID-19 pandemic led to a small but significant worsening in mental health and well-being in the general Swedish population, where higher socioeconomic status seemed to have a protective effect.

  • 26. Bakker, Bram
    et al.
    Zabłocki, Bartosz
    Baker, Angela
    Riethmeister, Vanessa
    Marx, Bernd
    Iyer, Girish
    Anund, Anna
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Swedish National Road and Transport Research Institute (VTI), Sweden; Linköping University, Sweden.
    Ahlström, Christer
    A Multi-Stage, Multi-Feature Machine Learning Approach to Detect Driver Sleepiness in Naturalistic Road Driving Conditions2022Inngår i: IEEE transactions on intelligent transportation systems (Print), ISSN 1524-9050, E-ISSN 1558-0016, Vol. 23, nr 5, s. 4791-4800Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Driver fatigue is a contributing factor in about 20% of all fatal road crashes worldwide. Countermeasures are urgently needed and one of the most promising and currently available approaches for that are in-vehicle systems for driver fatigue detection. The main objective of this paper is to present a video-based driver sleepiness detection system set up as a two-stage model with (1) a generic deep feature extraction module combined with (2) a personalised sleepiness detection module. The approach was designed and evaluated using data from 13 drivers, collected during naturalistic driving conditions on a motorway in Sweden. Each driver performed one 90-minute driving session during daytime (low sleepiness condition) and one session during night-time (high sleepiness condition). The sleepiness detection model outputs a continuous output representing the Karolinska Sleepiness Scale (KSS) scale from 1-9 or a binary decision as alert (defined as KSS 1-6) or sleepy (defined as KSS 7-9). Continuous output modelling resulted in a mean absolute error (MAE) of 0.54 KSS units. Binary classification of alert or sleepy showed an accuracy of 92% (sensitivity = 91.7%, specificity = 92.3%, F1 score = 90.4%). Without personalisation, the corresponding accuracy was 72%, while a standard fatigue detection PERCLOS-based baseline method reached an accuracy of 68% on the same dataset. The developed real-time sleepiness detection model can be used in the management of sleepiness/fatigue by detecting precursors of severe fatigue, and ultimately reduce sleepiness-related road crashes by alerting drivers before high levels of fatigue are reached.

  • 27. Balieiro, Laura Cristina Tibiletti
    et al.
    Gontijo, Cristiana Araújo
    Marot, Luisa Pereira
    Teixeira, Gabriela Pereira
    Fahmy, Walid Makin
    de Castro Moreno, Claudia Roberta
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. University of São Paulo, Brazil.
    Maia, Yara Cristina de Paiva
    Crispim, Cibele Aparecida
    Circadian misalignment measured by social jetlag from early to late pregnancy and its association with nutritional status: a longitudinal study2021Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 11, nr 1, artikkel-id 18678Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A mismatch between circadian and social clocks leads to a circadian misalignment, which has been widely measured by social jetlag (SJL). There are several studies measuring SJL, but it has not been studied in pregnant women. Therefore, this study aimed to identify the occurrence of SJL throughout pregnancy and to verify whether there is an effect of pre-pregnancy body mass index (BMI) on SJL throughout pregnancy. The baseline of the present study was conducted with 205 1st trimester pregnant women of whom 100 were followed in their 2nd and 3rd trimester. SJL was calculated based on the absolute difference between mid-sleep time on workdays versus work-free days. The pre-pregnancy BMI and current BMI (kg/m2) were calculated. Linear regression and Generalised Estimating Equation (GEE) adjusted for confounders were used to determine the association between SJL and the gestational trimesters (time), and anthropometric variables. Most of the pregnant women (54.5%) presented SJL > 1 h in the first gestational trimester. We also found an isolated effect of the gestation trimester on the SJL mean. In this sense, pregnant women had a decrease in SJL from the second to the third trimester (1.33 ± 0.08 versus 1.12 ± 0.07, respectively; p = 0.012). GEE analyzes showed that pregnant women of a normal weight showed a decrease in SJL from the second to the third trimester (1.29 ± 0.11 and 0.93 ± 0.08, respectively, p = 0.032), but this was not found in the other groups of nutritional status (underweight, overweight and obesity). In addition, a positive association between SJL and pre-gestational BMI in the third trimester (β = 0.200, p = 0.046) was found. SJL is quite prevalent during the gestational period and excessive BMI both before and during pregnancy is associated with an increased risk of having SJL > 1 h in the third and second trimesters, respectively. In addition, pregnant women of normal weight—but not underweight or overweight—had decreased SJL from the second to the third trimester.

  • 28.
    Balter, Leonie J. T.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Axelsson, John
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Sleep and subjective age: protect your sleep if you want to feel young2024Inngår i: Proceedings of the Royal Society of London. Biological Sciences, ISSN 0962-8452, E-ISSN 1471-2954, Vol. 291, nr 2019, artikkel-id 20240171Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The current studies examined the impact of insufficient sleep and sleepiness on the subjective experience of age. Study 1, a cross-sectional study of 429 participants (282 females (66%), 144 males, 3 other gender; age range 18-70), showed that for each additional day of insufficient sleep in the last 30 days, subjective age increased by 0.23 years. Study 2, an experimental crossover sleep restriction study (n = 186; 102 females (55%), 84 males; age range 18-46), showed that two nights of sleep restriction (4 h in bed per night) made people feel 4.44 years older compared to sleep saturation (9 h in bed per night). Additionally, moving from feeling extremely alert (Karolinska Sleepiness Scale (KSS) score of 1) to feeling extremely sleepy (KSS score of 9) was associated with feeling 10 years older in both studies. These findings provide compelling support for insufficient sleep and sleepiness to exert a substantial influence on how old we feel, and that safeguarding sleep is probably a key factor in feeling young.

  • 29.
    Balter, Leonie J. T.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Sweden.
    Li, Xueqi
    Schwieler, Lilly
    Erhardt, Sophie
    Axelsson, John
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Sweden.
    Olsson, Mats J.
    Lasselin, Julie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Sweden.
    Lekander, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Sweden.
    Lipopolysaccharide-induced changes in the kynurenine pathway and symptoms of sickness behavior in humans2023Inngår i: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 153, artikkel-id 106110Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Metabolites of the kynurenine pathway are hypothesized to be implicated in inflammation-associated depression, but there is a lack of experimental studies in humans assessing the kinetics of kynurenine metabolites in relation to experimentally-induced sickness. The aim of the present study was to assess changes in the kynurenine pathway and to explore its relation to symptoms of sickness behavior during an acute experimental immune challenge.

    This double-blind placebo-controlled randomized cross-over study included 22 healthy human participants (n = 21 both sessions, Mage = 23.4, SD = 3.6, nine women) who received an intravenous injection of 2.0 ng/kg lipopolysaccharide (LPS) and saline (placebo) on two different occasions in a randomized order. Blood samples (0 h, 1 h, 1.5 h, 2 h, 3 h, 4 h, 5 h, 7 h post-injection) were analyzed for kynurenine metabolites and inflammatory cytokines. The intensity of symptoms of sickness behavior was assessed using the 10-item Sickness Questionnaire at 0 h, 1.5 h, 3 h, 5 h, and 7 h post-injection.

    LPS induced significantly lower concentrations of plasma tryptophan (at 2 h, 4 h, 5 h, and 7 h post-injection), kynurenine (at 2 h, 3 h, 4 h, and 5 h post-injection), nicotinamide (at 4 h, 5 h, and 7 h post-injection), and higher levels for quinolinic acid at 5 h post-injection as compared to placebo. LPS did not affect kynurenic acid, 3-hydroxykynurenine, and picolinic acid. The development of the sickness symptoms was largely similar across items, with the highest levels around 1.5–3 h post-injection. Changes in plasma levels of kynurenine metabolites seem to coincide rather than precede or follow changes in subjective sickness. Exploratory analyses indicate that higher Sickness Questionnaire total scores at 1.5–5 h post-injection were correlated with lower kynurenic acid and nicotinamide levels.

    These results lend further support for LPS-induced changes in the kynurenine pathway, but may not, as interpreted from blood levels, causally link to LPS-induced acute symptoms of sickness behavior. Future research may consider a larger sample to further scrutinize the role of the kynurenine pathway in the sickness response.

  • 30.
    Balter, Leonie J. T.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Matheson, Granville J.
    Sundelin, Tina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Sterzer, Philipp
    Petrovic, Predrag
    Axelsson, John
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Experimental Sleep Deprivation Results in Diminished Perceptual Stability Independently of Psychosis Proneness2022Inngår i: Brain Sciences, ISSN 2076-3425, E-ISSN 2076-3425, Vol. 12, nr 10, artikkel-id 1338Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Psychotic disorders as well as psychosis proneness in the general population have been associated with perceptual instability, suggesting weakened predictive processing. Sleep disturbances play a prominent role in psychosis and schizophrenia, but it is unclear whether perceptual stability diminishes with sleep deprivation, and whether the effects of sleep deprivation differ as a function of psychosis proneness. In the current study, we aimed to clarify this matter. In this preregistered study, 146 participants successfully completed an intermittent version of the random dot kinematogram (RDK) task and the 21-item Peters Delusion Inventory (PDI-21) to assess perceptual stability and psychosis proneness, respectively. Participants were randomized to sleep either as normal (8 to 9 h in bed) (n = 72; Mage = 24.7, SD = 6.2, 41 women) or to stay awake through the night (n = 74; Mage = 24.8, SD = 5.1, 44 women). Sleep deprivation resulted in diminished perceptual stability, as well as in decreases in perceptual stability over the course of the task. However, we did not observe any association between perceptual stability and PDI-21 scores, nor a tendency for individuals with higher PDI-21 scores to be more vulnerable to sleep-deprivation-induced decreases in perceptual stability. The present study suggests a compromised predictive processing system in the brain after sleep deprivation, but variation in psychosis trait is not related to greater vulnerability to sleep deprivation in our dataset. Further studies in risk groups and patients with psychosis are needed to evaluate whether sleep loss plays a role in the occurrence of objectively measured perceptual-related clinical symptoms.

  • 31.
    Balter, Leonie J. T.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Stockholm, Sweden.
    Raymond, Jane E.
    Working memory load impairs transfer learning in human adults2023Inngår i: Psychological Research, ISSN 0340-0727, E-ISSN 1430-2772, Vol. 87, s. 2138-2145Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Transfer of learning refers to successful application of previously acquired knowledge or skills to novel settings. Although working memory (WM) is thought to play a role in transfer learning, direct evidence of the effect of limitations in WM on transfer learning is lacking. To investigate, we used an acquired equivalence paradigm that included tests of association and transfer learning. The effects of imposing an acute WM limitation on young adults was tested (within-subjects design: N = 27 adults; Mage = 24 years) by conducting learning transfer tests concurrent with a secondary task that required carrying a spatial WM load when performing the learned/transfer trial (Load condition) to acutely limit WM resources or no WM load (No-Load condition; WM was unloaded prior to performing the learned/transfer trial). Analyses showed that although success on the transfer trials was high in the No-Load condition, performance dropped to chance in the Load condition. Performance on tests of learned associations remained high in both conditions. These results indicate that transfer of learning depends on access to WM resources and suggest that even healthy young individuals may be affected in their ability to cross-utilize knowledge when cognitive resources become scarce, such as when engaging in two tasks simultaneously (e.g., using satellite navigation while driving).

  • 32.
    Balter, Leonie J. T.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Sundelin, Tina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Axelsson, John
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Sickness and sleep health predict frustration and affective responses to a frustrating trigger2021Inngår i: Scientific Reports, E-ISSN 2045-2322, Vol. 11, nr 1, artikkel-id 1542Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Fluctuations in health and sleep are common, but we know surprisingly little about how these daily life stressors affect one's level of frustration and sensitivity to becoming frustrated. In this pre-registered study, 517 participants (Mage = 30.4, SD = 10.4) reported their current sickness symptoms, health status, sleepiness, and sleep duration and quality the previous night. They also rated their general frustration and mood before and after a mild frustration-eliciting task. In the task, participants were instructed to copy geometric shapes onto a piece of paper, without lifting the pen from the paper. Participants were given three minutes to copy the eight shapes, but in order to induce frustration half of them were unsolvable. The study was subsequently repeated in an independent sample (N = 113). Frustration increased in response to the task; however, those with the worst sickness symptoms or sleep health reduced or did not change their frustration levels. Instead, across both studies, frustration was already high at baseline for these individuals. These findings indicate that being sick or having poor sleep is related to high general frustration, but resilience to further frustration due to mild frustrating situations.

  • 33.
    Balter, Leonie J. T.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Stockholm, Sweden.
    Sundelin, Tina
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet, Stockholm, Sweden.
    Holding, Benjamin C.
    Petrovic, Predrag
    Axelsson, John
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi. Karolinska Institutet Stockholm Sweden.
    Intelligence predicts better cognitive performance after normal sleep but larger vulnerability to sleep deprivation2023Inngår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 32, nr 4, artikkel-id e13815Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Fluid intelligence is seen as a beneficial attribute, protecting against stress and ill-health. Whether intelligence provides resilience to the cognitive effects of insufficient sleep was tested in the current pre-registered experimental study. Participants (N = 182) completed the Raven's test (measuring fluid intelligence) and a normal night of sleep or a night of total sleep deprivation. Sleepiness and four cognitive tests were completed at 22:30 hours (baseline), and the following day after sleep manipulation. At baseline, higher fluid intelligence was associated with faster and more accurate arithmetic calculations, and better episodic memory, but not with spatial working memory, simple attention or sleepiness. Those with higher fluid intelligence were more, not less, impacted by sleep deprivation, evident for arithmetic ability, episodic memory and spatial working memory. We need to establish a more nuanced picture of the benefits of intelligence, where intelligence is not related to cognitive advantages in all situations.

  • 34.
    Balter, Leonie J. T.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Wiwe Lipsker, Camilla
    Wicksell, Rikard K.
    Lekander, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Karolinska Institutet, Sweden.
    Neuropsychiatric Symptoms in Pediatric Chronic Pain and Outcome of Acceptance and Commitment Therapy2021Inngår i: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 12, artikkel-id 576943Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Considerable heterogeneity among pediatric chronic pain patients may at least partially explain the variability seen in the response to behavioral therapies. The current study tested whether autistic traits and attention-deficit/hyperactivity disorder (ADHD) symptoms in a clinical sample of children and adolescents with chronic pain are associated with socioemotional and functional impairments and response to acceptance and commitment therapy (ACT) treatment, which has increased psychological flexibility as its core target for coping with pain and pain-related distress. Children and adolescents aged 8-18 years (N = 47) were recruited. Patients and their parents completed questionnaires pre- and post-ACT of 17 sessions. Correlational analyses and mixed-effects models were used to assess the role of autistic traits and ADHD symptoms in pretreatment functioning and ACT-treatment response. Outcome variables were degree to which pain interfered with daily activities (i.e., pain interference, sleep, and physical and school functioning), socioemotional functioning (i.e., depressive symptoms, emotional, and social functioning), psychological inflexibility, and pain intensity. Autistic traits and ADHD symptoms, pain frequency, and pain duration were measured at pretreatment only. Higher autistic traits were associated with greater pain interference, higher depression, and greater psychological inflexibility. Higher ADHD symptomatology was associated with greater pretreatment pain interference, lower emotional functioning, greater depression, and longer duration of pain. Across patients, all outcome variables, except for sleep disturbances and school functioning, significantly improved from pre- to post-ACT. Higher autistic traits were associated with greater pre- to post-ACT improvements in emotional functioning and sleep disturbance and non-significant improvements in pain interference. ADHD symptomatology was not associated with treatment outcome. The current results showed that neuropsychiatric symptoms in pediatric chronic pain patients are associated with lower functioning, particularly pain interfering with daily life and lower socioemotional functioning. The results suggest that not only pediatric chronic pain patients low in neuropsychiatric symptoms may benefit from ACT, but also those high in autism traits and ADHD symptoms. With the present results in mind, pediatric chronic pain patients higher in autistic traits may actually derive extra benefit from ACT. Future research could assess whether increased psychological flexibility, the core focus of ACT, enabled those higher in autism traits to cope relatively better with pain-related distress and thus to gain more from the treatment, as compared to those lower in autism traits. Moreover, to address specific effects of ACT, inclusion of an appropriate control group is key.

  • 35. Bankins, Sarah
    et al.
    Griep, Yannick
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Radboud University, The Netherlands; Pontificia Universidad Javeriana, Colombia.
    Hansen, Samantha D.
    Charting directions for a new research era: addressing gaps and advancing scholarship in the study of psychological contracts2020Inngår i: European Journal of Work and Organizational Psychology, ISSN 1359-432X, E-ISSN 1464-0643, Vol. 29, nr 2, s. 159-163Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The nature of work and the contexts in which firms operate have changed significantly in the many decades since the study of psychological contracts (PCs) at work began in earnest. These changes have altered the contours of the traditional employer-employee relationship and are key motivators of this Special Issue. We seek to chart new directions for PC research over the next decade by widening the theoretical and methodological lenses used to explore PC processes. In the introductory editorial we briefly outline the PC construct, overview the collected papers, and discuss the next exciting wave of PC research (exploring PC dynamics, PC counterparties, and the PC context) inspired by this collection.

  • 36. Barck-Holst, P.
    et al.
    Nilsonne, Å.
    Åkerstedt, Torbjörn
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Hellgren, C.
    Reduced working hours and work-life balance2022Inngår i: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, Vol. 12, nr 4, s. 450-463Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Little is known about how reduced working hours affects the work-life balance of staff in the Swedish social services, or their recovery off-work in terms of specific everyday choices. Staff at a Swedish social work agency participating in a longitudinal trial of work-time reduction in the public services were interviewed about their experiences of work and private life after their work hours were reduced (n = 12). All the interviewees described feeling more positive anticipatory emotions when going to work, several felt that their relationships with colleagues had improved, and most felt their relationships with clients had improved. Several worried less over work, and most perceived the risk for exhaustion syndrome to be lower. Most experienced more positive anticipatory emotions when returning home from work, most of those with children felt that their relationships with their children improved, and those with partners felt their romantic relationships also improved. Several devoted more time to parents and siblings. Most devoted more time to friendship, and all described having more time for recovery activities. Several worried less over their private life. A process that established and maintained a positive work-life balance is suggested by the interviews as a whole, related to increased control over private life, a larger capacity to meet private demands, improved recovery in terms of both quantity and quality, and having access to more sources of formal and informal social support. 

  • 37. Berg, Noora
    et al.
    Nummi, Tapio
    Bean, Christopher G.
    Westerlund, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Virtanen, Pekka
    Hammarström, Anne
    Risk factors in adolescence as predictors of trajectories of somatic symptoms over 27 years2022Inngår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 32, nr 5, s. 696-702Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Somatic symptoms among adolescents are common, yet little is known about long-term trajectories of somatic symptoms and the factors in adolescence that shape them. We examined individual, family and schoolbased factors at age 16 as predictors of trajectories of somatic symptoms over 27 years. Methods: Participants from the Northern Swedish Cohort (n ¼ 1001) responded to questions about individual factors (e.g. health behaviours), family factors (e.g. contact with parents, social and material adversity) and school satisfaction at age 16; as well as 10 somatic symptoms at ages 16, 18, 21, 30 and 43. Teacher assessments at age 16 included overall ability at school and peer relations. Age 16 predictors of somatic symptom trajectory group membership were analysed using multinomial logistic regression. Results: Poor contact with mother and poor school satisfaction were significant predictors of adverse symptom trajectories among both men and women. Low birth weight and low parental academic involvement were contributing factors for women, while smoking and social adversity were more relevant factors for men. Conclusions: Our findings emphasize the importance of a holistic approach that considers the unique contributions of individual, family and school-based factors in the development of trajectories of somatic symptoms from adolescence to middle age.

  • 38. Berg, Noora
    et al.
    Virtanen, Marianna
    Lintonen, Tomi
    Hammarström, Anne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Uppsala University, Sweden.
    The contribution of drinking culture at comprehensive school to heavy episodic drinking from adolescence to midlife2020Inngår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 30, nr 2, s. 357-363Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The school context is associated with adolescent alcohol use, but it is not clear whether this association continues into adulthood. This study examined whether exposure to drunkenness oriented drinking culture in 9th grade school class is associated with individuals' heavy episodic drinking (HED) from adolescence to midlife. Methods: Participants in the 'Northern Swedish Cohort' study aged 16 years in 1981 were followed-up when aged 18, 21, 30 and 43 (N = 1080). Individual-level factors were HED, positive attitudes towards drunkenness, early initiation of HED and peer-oriented spare-time. School class-level drinking culture was measured as classmate reported HED, positive attitudes, early initiation of HED and peer-oriented spare time. Multilevel log-binomial regression analyses were adjusted for gender, parental socioeconomic background, family structure and HED at age 16. Results:After adjustment for sociodemographic factors several cross-sectional and longitudinal associations were found between class-level indicators of drinking culture and individual HED. After additional adjustment for age 16 HED, most associations attenuated. The risk ratio (95% confidence interval) for engaging in HED at age 43 was 1.58 (1.03-2.42) times higher for those who at age 16 had many classmates reporting positive attitude towards drunkenness. Conclusions: These findings suggest that drinking culture in school may have a long-lasting impact on drinking habits in adulthood. The associations with HED at follow-ups are likely mediated by HED in adolescence. Studies on alcohol use would benefit from taking into account both individual and contextual factors in a life course perspective.

  • 39.
    Bergman, Louise E.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi.
    Bernhard-Oettel, Claudia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi.
    Bujacz, Aleksandra
    Leineweber, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Toivanen, Susanna
    Comparing Depressive Symptoms, Emotional Exhaustion, and Sleep Disturbances in Self-Employed and Employed Workers: Application of Approximate Bayesian Measurement Invariance2021Inngår i: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 11, artikkel-id 598303Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Studies investigating differences in mental health problems between self-employed and employed workers have provided contradictory results. Many of the studies utilized scales validated for employed workers, without collecting validity evidence for making comparisons with self-employed. The aim of this study was (1) to collect validity evidence for three different scales assessing depressive symptoms, emotional exhaustion, and sleep disturbances for employed workers, and combinators; and (2) to test if these groups differed. We first conducted approximate measurement invariance analysis and found that all scales were invariant at the scalar level. Self-employed workers had least mental health problems and employed workers had most, but differences were small. Though we found the scales invariant, we do not find them optimal for comparison of means. To be more precise in describing differences between groups, we recommend using clinical cut-offs or scales developed with the specific purpose of assessing mental health problems at work.

  • 40.
    Bernhard-Oettel, Claudia
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi.
    Bergman, Louise E.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi.
    Leineweber, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Toivanen, Susanna
    Flourish, fight or flight: health in self-employment over time-associations with individual and business resources2024Inngår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 97, s. 263-278Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: Using COR theory to study developments of health and other key resources in self-employed workers in Sweden over 6 years, this study: (1) explored whether the heterogenous group of self-employed workers contained subgroups with different health trajectories, (2) investigated whether these were more typical for certain individuals (with respect to age, gender, sector, education, employment status), and (3) compared the different health trajectories regarding resource development in mental well-being, business resources, employment status, work ability. Method: The study used data from the Swedish longitudinal occupational survey of health (SLOSH) and included participants working as self-employed or combiner (N = 2642). Result: Five trajectories were identified with latent class growth curve model analysis (LCGM). Two health trajectories with (1) very good, respective (2) good stable health (together comprising 78.5% of the participants), (3) one with moderate stable health (14.8%), (4) one with a U-shaped form (1.9%), and (5) one with low, slightly increasing health (4.7%). The first two trajectories flourish: they maintained or increased in all key resources and were more likely to remain self-employed. Trajectories three and five consist of those who fight to maintain or increase their resources. Workers in the U-shaped health trajectory show signs of fight and flight after loss in health and other key resources. Conclusions: Studying subgroups with different resource developments over time was suitable to understand heterogeneity in self-employed workers. It also helped to identify vulnerable groups that may benefit from interventions to preserve their resources.

  • 41.
    Bernhard-Oettel, Claudia
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi.
    Eib, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Arbets- och organisationspsykologi. Uppsala University, Sweden.
    Griep, Yannick
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. University of Calgary, Canada.
    Leineweber, Constanze
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    How Do Job Insecurity and Organizational Justice Relate to Depressive Symptoms and Sleep Difficulties: A Multilevel Study on Immediate and Prolonged Effects in Swedish Workers2020Inngår i: Applied Psychology: an international review, ISSN 0269-994X, E-ISSN 1464-0597, Vol. 69, nr 4, s. 1271-1300Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Drawing on stress and justice literature, we argue that perceptions of job insecurity induce feelings of low procedural justice, which has immediate and prolonged negative effects on health (depressive symptoms, sleep difficulties). Moreover, we explore whether the strength of the job insecurity-justice relationship differs between individuals as a function of their average level of job insecurity over time. Finally, we explore whether the procedural justice-health relationship differs between individuals as a function of variability in justice perceptions over time. We analyzed Swedish panel data from permanent workers over four consecutive waves (with a two-year time lag between waves) using multilevel analysis, separating within- and between-person variance. Results showed that job insecurity associated negatively with procedural justice at the same time point for all waves. Prolonged effects were less stable. We found immediate (but not prolonged) indirect effects of job insecurity on health outcomes via procedural justice. Average levels in job insecurity over time moderated the within-person job insecurity-justice relationship. However, variability in procedural justice over time did not moderate the within-person justice-health relationship. In conclusion, disentangling within- and between-person variability of job insecurity and justice perceptions contributes to the understanding of health effects.

  • 42. Berthelsen, Hanne
    et al.
    Muhonen, Tuija
    Bergström, Gunnar
    Westerlund, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Dollard, Maureen F.
    Benchmarks for Evidence-Based Risk Assessment with the Swedish Version of the 4-Item Psychosocial Safety Climate Scale2020Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, nr 22, artikkel-id 8675Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of the present study was to validate the short version of The Psychosocial Safety Climate questionnaire (PSC-4, Dollard, 2019) and to establish benchmarks indicating risk levels for use in Sweden. Cross-sectional data from (1) a random sample of employees in Sweden aged 25-65 years (n = 2847) and (2) a convenience sample of non-managerial employees from 94 workplaces (n = 3066) were analyzed. Benchmarks for three PSC risk levels were developed using organizational compliance with Occupational Safety and Health (OSH) regulations as criterion. The results support the validity and usefulness of the Swedish PSC-4 as an instrument to indicate good, fair, and poor OSH practices. The recommended benchmark for indicating good OSH practices is an average score of >12.0, while the proposed cutoff for poor OSH practices is a score of <= 8.0 on the PSC-4. Scores between these benchmarks indicate fair OSH practices. Furthermore, aggregated data on PSC-4 supported its reliability as a workplace level construct and its association with quantitative demands, quality of leadership, commitment to the workplace, work engagement, job satisfaction, as well as stress and burnout. Thus, the Swedish version of PSC-4 can be regarded as a valid and reliable measure for both research and practical use for risk assessment at workplaces.

  • 43. Berthelsen, Hanne
    et al.
    Owen, Mikaela
    Westerlund, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Does workplace social capital predict care quality through job satisfaction and stress at the clinic? A prospective study2021Inngår i: BMC Public Health, E-ISSN 1471-2458, Vol. 21, nr 1, artikkel-id 1320Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Welfare societies like Sweden face challenges in balancing the budget while meeting the demand for good quality healthcare. The aim of this study was to analyse whether care quality, operationalized as survival of dental fillings, is predicted by workplace social capital and if this effect is direct or indirect (through stress and/or job satisfaction among staff at the clinic), controlling for patient demographics.

    Methods: The prospective design includes A) work environment data from surveys of 75 general public dental clinics (aggregated data based on 872 individual ratings), and B) register-based survival of 9381dental fillings performed during a 3-month period around the time of the survey, and C) patient demographics (age, gender, income level and birth place). Using a multi-level discrete-time proportional hazard model, we tested whether clinic-level social capital, stress, and job satisfaction could predict tooth-level filling failure, controlling for patient demographics. One direct and two indirect pathways, moderated by filling tooth, location, and filling type, were tested.

    Results: High workplace social capital reduced the risk of early failure of fillings in molar teeth, mediated by group-perceived job satisfaction (indirect path: OR=0.93, p<.05, direct path from job satisfaction: OR=0.89, p<.05). Contrary to expectations, we found no support for a direct effect from social capital on care quality or for the indirect pathway via stress at the clinic level.

    Conclusions: Workplace social capital boosted the quality of dental fillings through increased levels of job satisfaction. In addition, staff at clinics with higher social capital reported less stress and higher levels of job satisfaction. These results indicate that promotion of social capital may improve both occupational health and care quality.

  • 44. Berthelsen, Hanne
    et al.
    Owen, Mikaela
    Westerlund, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Leadership, work environment and caries prevention - what is good for the staff, is also good for the patients2023Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 81, nr 3, s. 196-201Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Dental caries is a health problem that can be prevented. The aim of this study is to analyse if the quality of leadership, in Swedish Public Dental Health clinics, influences the extent to which patients with caries receive preventive care, and if any such effect is mediated through a collaborative work climate, clear role expectations and a low average level of burnout among staff.

    Methods: The multilevel cross-sectional design includes work environment data from surveys of 75 general public dental clinics, register-based data on preventive measures provided to 5398 patients who received a dental filling due to a caries diagnosis, and patient demographics. Using a multilevel path analysis with logistic regression, we tested a model with one direct and three indirect pathways, controlling for the potential confounding effect of patient demographic factors.

    Results: Leadership quality, as assessed by the staff at the clinic, was associated with increased odds of patients with caries receiving prevention, controlling for patient demographic factors. Leadership quality was also positively related to a collaborative work climate, clear role expectations and a low average level of burnout among staff. Against expectations, however, no indirect effect from leadership quality on prevention through the other work environment factors was found.

    Conclusions: In conclusion, the quality of leadership in Swedish Public Dental Health clinics was positively related to a good work environment for staff and to delivery of preventive care to patients experiencing caries.

  • 45. Berthelsen, Hanne
    et al.
    Owen, Mikaela
    Wretlind, Katharina
    Westerlund, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Does staff-assessed care quality predict early failure of dental fillings?: A prospective study2020Inngår i: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 48, nr 5, s. 387-394Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The aim of this study was to evaluate staff-assessed care quality as an indicator of register-based measures of care quality at dental clinics, more specifically register-based measures of survival of dental fillings and initiation of preventive treatments for caries patients.

    Methods: This prospective study includes data from cross-sectional workplace psychosocial risk assessment surveys at dental clinics and register data on survival of dental fillings, and initiation of preventive treatment for caries patients obtained from the Swedish Quality Registry for Caries and Periodontal Disease (SKaPa) Demographic background data on the age, gender, income level and place of birth of patients was obtained from Statistics Sweden (SCB). The data were analysed using discrete-time multilevel survival analysis and multiple linear regression analysis.

    Results: The results showed that staff-assessed care quality rated by the total staff or by dental nurses at the clinic predicted the risk of replacement of dental fillings made due to a caries diagnosis during the 3-year follow-up period, controlling for potential confounding due to patient demographic characteristics (age, sex, income and country of birth). In contrast, the better the staff-assessed care quality at the clinic, the smaller the proportion of the patients received preventive care in addition to operative caries therapy when controlling for potential confounding due to patient demographics. Care quality assessed by dentists at the clinic did not predict either of these outcome measures.

    Conclusions: Premature failure of dental fillings is costly for both patients and society, which leads to a need for relevant measures for following dental care quality. Our findings indicate that staff-assessed care quality - a cheap and easy measure to collect and follow continuously in dental practice - can be used to monitor aspects of quality in real time in order to facilitate continuous improvement and quickly amend quality problems. Also, it can be used for integrating quality improvement in systematic work environment risk management.

  • 46. Berthelsen, Hanne
    et al.
    Westerlund, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Bergström, Gunnar
    Burr, Hermann
    Validation of the Copenhagen Psychosocial Questionnaire Version III and Establishment of Benchmarks for Psychosocial Risk Management in Sweden2020Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, nr 9, artikkel-id 3179Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study presents the Swedish standard version of the Copenhagen Psychosocial Questionnaire, COPSOQ III, and investigates its reliability and validity at individual and workplace levels with the aim of establishing benchmarks for the psychosocial work environment. Cross-sectional data from (1) a random sample of employees in Sweden aged 25-65 years (N = 2847) and (2) a convenience sample of non-managerial employees at 51 workplaces (N = 1818) were analysed. Internal consistency reliability was evaluated as well as the effects of sex, work sector and blue/white-collar work. Population benchmarks and mean scores for major occupational groups were computed based on weighted data. ICC(1) and ICC(2) estimates were computed to evaluate aggregation to the workplace level and Pearson inter-correlations to evaluate construct validity at individual and aggregated levels. The reliability and scale characteristics were satisfactory, with few exceptions, at both individual and workplace levels. The strength and direction of correlations supported the construct validity of the dimensions and the amount of variance explained by workplace justified aggregation to the workplace level. The present study thus supports the use of COPSOQ III for measurement at the workplace level and presents benchmarks for risk management as well as for research purposes.

  • 47. Beute, F.
    et al.
    Lowden, Arne
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet. Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Biologisk psykologi.
    Aries, M. B. C.
    The relationship of light exposure to sleep outcomes among office workers. Part 2: Comparison of days with and without social constraints2024Inngår i: Lighting Research and Technology, ISSN 1477-1535, E-ISSN 1477-0938, Vol. 56, nr 2, s. 126-135Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Social constraints posed by work schedules influence sleep duration and timing. Everyday light exposure can help (or hinder) sleep outcomes. This study investigated the differences in the relationship between light exposure and sleep outcomes on days with and without social constraints using ambulatory assessment for 4–6 weeks for 15 office employees. The effects of light on sleep were investigated for both clock time and wake time (related to individual sleep times). Participants were exposed to more light during the morning and afternoon on workdays, and sleep times were later on days without social constraints. The relationship between light exposure and sleep was more pronounced, or sometimes even only present, for days without social constraints. In addition, no differences were found between clock time and wake time, which underlines the complexity of the relationship between everyday light exposure and sleep. Despite increased light exposure during workdays, the effects of light on sleep were more pronounced on days without social constraints. It may signal that office workers need a more substantial circadian stimulus (i.e. higher light exposure) for light to influence sleep outcomes on days with social constraints.

  • 48. Bi, Yu-Han
    et al.
    Pei, Jin-Jing
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Hao, Changfu
    Yao, Wu
    Wang, Hui-Xin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    The relationship between chronic diseases and depression in middle-aged and older adults: A 4-year follow-up study from the China Health and Retirement Longitudinal Study.2021Inngår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 289, s. 160-166Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Evidence of the association between common chronic diseases and depression is sparse.

    Methods: Totally 7819 participants aged 45+ without depression at baseline were followed-up (2011-2015) to detect incident depression. Chronic diseases and depression were defined by self-reported diagnosis and the Center for Epidemiological Studies Depression Scale (CES-D10), respectively. Cox proportional hazards model was used to explore the association between chronic diseases and depression adjusting for age, gender, education, marital/living conditions, area, smoking, drinking, economic status, BMI and health insurance.

    Results: During an average of 3.42 years follow-up, 2271 participants developed depression (85 per 1000 person-year). Chronic diseases were related to significantly higher risk of depression (HR = 1.38). A higher risk of depression was also associated with specific diseases: stomach/other digestive diseases (HR = 1.19), diabetes (HR = 1.22), arthritis/rheumatism (HR = 1.30), and kidney diseases (HR = 1.34) (P < 0.05). The risk of depression increased with increasing in the number of chronic diseases (1: HR = 1.27, 2: HR = 1.49, and 3+: HR = 1.51, P-trend < 0.001). No significant difference was observed across age, gender, education, and area.

    Limitations: Chronic diseases and depression were based on self-reported diagnosis and measurement scale, respectively, which could lead to information bias. Some unmeasured confounders might have biased the results.

    Conclusions: The occurrence of depression in people aged 45+ is associated with number of chronic diseases in a dose-response fashion. These results may provide guidance on preventing depression and improving the quality of life in middle and late adulthood.

  • 49.
    Bishop, Lauren
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Max Planck Institute for Demographic Research, Germany; University of Helsinki, Finland.
    Högnäs, Robin S.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    Role of hospitalisation for substance misuse in marital status transitions: a 47-year follow-up of a Swedish birth cohort2024Inngår i: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 78, nr 3, s. 153-159Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Substantial research suggests that the risk of substance misuse is higher among individuals who remain unmarried or experience marital dissolution, whereas marriage tends to be protective. However, few studies have considered the role of substance misuse for transitions between discrete marital status categories. The current study aims to estimate associations between substance misuse and marital status transitions from ages 20–66.

    Methods Our study population was a national Swedish cohort born in 1953 (n=71 901), followed from 1973 to 2019. Annual marital status and hospitalisation records for substance misuse were derived from the Total Population and National Patient registers, respectively. We used a five-state multistate model to estimate associations between substance misuse and marital status transitions—the state space included never married, married, divorced and widowed with death as the absorbing state. We further used fixed-effect models to estimate the effects of substance misuse on transitions out of marriage.

    Results Findings suggested that individuals’ substance misuse was associated with an increased risk of transitioning from married to divorced (HR=3.54, 95% CI 3.40 to 3.69) or widowed (HR=1.71, 95% CI 1.46 to 2.01), and transitioning to death from all states. Substance misuse was also negatively associated with transitioning from never married to married (HR=0.59, 95% CI 0.57 to 0.61), and into remarriage after divorce (HR=0.86, 95% CI 0.80 to 0.92). The fixed-effect results suggested that substance misuse increased the risk of transitioning to divorce and widowhood, net of sociodemographic characteristics.

    Conclusion Substance misuse is associated with an increased risk of marital dissolution and death when accounting for nearly 50 years of marital biographies.

  • 50.
    Bishop, Lauren
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Max Planck Institute for Demographic Research.
    Högnäs, Robin S.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Stressforskningsinstitutet.
    The role of hospitalization for substance misuse in marital status transitions: A 47-year follow-up of a Swedish birth cohortManuskript (preprint) (Annet vitenskapelig)
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