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  • 1.
    Bergström, Malin
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Fransson, Emma
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Modin, Bitte
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Berlin, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. National Board of Health and Welfare, Sweden.
    Gustafsson, Per A.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Fifty moves a year: is there an association between joint physical custody and psychosomatic problems in children?2015Inngår i: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 69, nr 8, s. 769-774Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: In many Western countries, an increasing number of children with separated parents have joint physical custody, that is, live equally much in their parent's respective homes. In Sweden, joint physical custody is particularly common and concerns between 30% and 40% of the children with separated parents. It has been hypothesised that the frequent moves and lack of stability in parenting may be stressful for these children.

    Methods: We used data from a national classroom survey of all sixth and ninth grade students in Sweden (N=147839) to investigate the association between children's psychosomatic problems and living arrangements. Children in joint physical custody were compared with those living only or mostly with one parent and in nuclear families. We conducted sex-specific linear regression analyses for z-transformed sum scores of psychosomatic problems and adjusted for age, country of origin as well as children's satisfaction with material resources and relationships to parents. Clustering by school was accounted for by using a two-level random intercept model.

    Results: Children in joint physical custody suffered from less psychosomatic problems than those living mostly or only with one parent but reported more symptoms than those in nuclear families. Satisfaction with their material resources and parent–child relationships was associated with children's psychosomatic health but could not explain the differences between children in the different living arrangements.

    Conclusions: Children with non-cohabitant parents experience more psychosomatic problems than those in nuclear families. Those in joint physical custody do however report better psychosomatic health than children living mostly or only with one parent. Longitudinal studies with information on family factors before and after the separation are needed to inform policy of children's postseparation living arrangements.

  • 2.
    Bergström, Malin
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Modin, Bitte
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Fransson, Emma
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Rajmil, Luis
    Berlin, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. National Board of Health and Welfare, Sweden.
    Gustafsson, Per A.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Living in two homes-a Swedish national survey of wellbeing in 12 and 15 year olds with joint physical custody2013Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, artikkel-id 868Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background The practice of joint physical custody, where children spend equal time in each parent's home after they separate, is increasing in many countries. It is particularly common in Sweden, where this custody arrangement applies to 30 per cent of children with separated parents. The aim of this study was to examine children's health-related quality of life after parental separation, by comparing children living with both parents in nuclear families to those living in joint physical custody and other forms of domestic arrangements.

    Methods Data from a national Swedish classroom study of 164,580 children aged 12 and 15-years-old were analysed by two-level linear regression modelling. Z-scores were used to equalise scales for ten dimensions of wellbeing from the KIDSCREEN-52 and the KIDSCREEN-10 Index and analysed for children in joint physical custody in comparison with children living in nuclear families and mostly or only with one parent.

    Results Living in a nuclear family was positively associated with almost all aspects of wellbeing in comparison to children with separated parents. Children in joint physical custody experienced more positive outcomes, in terms of subjective wellbeing, family life and peer relations, than children living mostly or only with one parent. For the 12-year-olds, beta coefficients for moods and emotions ranged from -0.20 to -0.33 and peer relations from -0.11 to -0.20 for children in joint physical custody and living mostly or only with one parent. The corresponding estimates for the 15-year-olds varied from -0.08 to -0.28 and from -0.03 to -0.13 on these subscales. The 15-year-olds in joint physical custody were more likely than the 12-year-olds to report similar wellbeing levels on most outcomes to the children in nuclear families.

    Conclusions Children who spent equal time living with both parents after a separation reported better wellbeing than children in predominantly single parent care. This was particularly true for the 15-year-olds, while the reported wellbeing of 12-years-olds was less satisfactory. There is a need for further studies that can account for the pre and post separation context of individual families and the wellbeing of younger age groups in joint physical custody.

    Fulltekst (pdf)
    fulltext
  • 3.
    Berlin, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Out-of-Home Care and Educational Outcomes: Prevalence, Patterns and Consequences2020Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The aim of this thesis is to examine educational stratification in the context of out-of-home care (OHC; foster family care, residential care) and to place one of society’s most vulnerable groups in the fields of social stratification and family complexity research. About 5% of the Swedish population experience OHC during childhood or adolescence. OHC is not only a matter of protecting children and youth; it is also intended to improve future opportunities and compensate for adverse childhood factors. However, a vast body of international research, including Swedish studies, shows that a substantial proportion of young people from OHC have poor school performance and low educational attainment as adults. Furthermore, this is strongly associated with their high risk of other adverse outcomes in life. To date there are no signs of improvement in this regard, and the disadvantage of having a low education is increasing in today’s knowledge-based society.

    Many previous OHC studies have relied on small, local samples, and longitudinal data are often lacking. In this respect, Swedish researchers are well positioned to contribute to the field through research based on our high-quality population registers. The main data source in this thesis – the Child Welfare Intervention Register – covers half a century of OHC data. Based on these data, an overview of OHC prevalence in Sweden and patterns of educational outcomes are presented in the introductory chapter. The thesis further consists of five individual studies investigating different aspects of the transition through the educational system to adult life among children and youth from OHC. Two of the five studies focus on children who spent most of their childhood in OHC and for whom society has assumed a long-term commitment of parental responsibilities.

    The descriptive data show that patterns of poor educational outcomes in the OHC population have remained stable as long as they can be followed in the registers. Study I shows that youth who exited long-term care were disadvantaged as compared to youth without OHC experience, both in terms of educational attainment and regarding the strong association between poor school performance and other adverse outcomes in young adulthood. Up to 55% of their excess risks of later psychosocial problems were statistically attributable to dismal school performance. Study II shows that 54% of clients in substance-misuse treatment in the 1980s had been in OHC, half before their teen years and half as teenagers. In this group, OHC was associated with excess mortality during the 30-year follow-up from exit from treatment, with statistical significance mainly for females who had entered OHC before their teens. School failure was more common in the OHC population than for misuse clients without OHC experience, and was strongly associated with the excess mortality of females. Two Nordic comparative studies (Studies III and IV) show that the OHC population had a substantially higher risk of not completing upper-secondary education across countries, and that poor performance in primary school inflicted a greater risk in OHC youth of being NEET in young adulthood than for their peers without OHC experience. Study V shows that the intergenerational transmission of education was weak and inconsistent in the foster care setting, and that living in a highly educated foster family did not have a robust positive effect on foster children’s educational outcomes.

    Fulltekst (pdf)
    Out-of-Home Care and Educational Outcomes
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    Omslagsframsida
  • 4.
    Berlin, Marie
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Kääriälä, Antti
    Lausten, Mette
    Andersson, Gunnar
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Brännström, Lars
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Long-term NEET among young adults with experience of out-of-home care: A comparative study of three Nordic countriesManuskript (preprint) (Annet vitenskapelig)
  • 5.
    Berlin, Marie
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. National Board of Health and Welfare (Socialstyrelsen), Sweden.
    Mensah, Tita
    Lundgren, Frida
    Klingberg, Gunilla
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS). Karolinska Institutet, Sweden.
    Vinnerljung, Bo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan. Karolinska Institutet, Sweden.
    Cederlund, Andreas
    Dental healthcare utilisation among young adults who were in societal out-of-home care as children: A Swedish National Cohort Study2018Inngår i: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 27, nr 4, s. 325-336Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We used Swedish national registers to analyse dental health care among young adults with childhood experience of out-of-home care (OHC), in Cox regression analyses. All 1.7 million Swedish residents born in 1980-1994 were included, of whom 4% had been in OHC. The population was followed up in the Dental Health Register from age 20 to 29, during the period 2009-2014. We found that persons with short or long OHC experience made emergency dental care visits more often than their majority-population peers: 17-23% versus 9-10%, (adjusted Hazard ratios [HR:s] 1.60-2.02); they more often had tooth extractions, 9-12% versus 3% (HR:s 2.33-3.03); but less regularly visited a dentist for planned check-ups, 61-77% versus 80-87% (HR:s 0.76-0.78). Since dental health in young adulthood reflects dental health and dental care in childhood, the findings of this study call for improved preventive dental health care for children in OHC.

  • 6.
    Berlin, Marie
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. National Board of Health and Welfare, Sweden.
    Vinnerljung, Bo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan. National Board of Health and Welfare, Sweden.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    School performance in primary school and psychosocial problems in young adulthood among care leavers from long term foster care2011Inngår i: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 33, nr 12, s. 2489-2494Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We used data from Swedish national registers for ten entire birth year cohorts (1972–1981) to examine psychosocial outcomes in young adulthood for youth that left long term foster care after age 17, comparing them with majority population peers, national adoptees and peers who had received in-home interventions before age 13. The population was followed in the registers from age 16 to 2005. Data were analyzed in Cox regression models.

    Youth who left long term foster care had six-to eleven fold sex and birth year adjusted excess risks for suicide attempts, substance abuse and serious criminality from age 20, and for public welfare dependency at age 25. Overrisks were considerably lower for the in-home intervention group and the national adoptees. Adjusting results for poor school performance in the final year in primary school (ages 15–16) reduced overrisks by 38–52% for care leavers from long term foster care.

    Irrespective of issues of causality, poor school performance seems to be a major risk factor for future psychosocial problems among youth who age out of long term foster care. The results suggest that promoting foster children's school performance should be given high priority by agencies.

  • 7.
    Berlin, Marie
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. The Swedish National Board of Health and Welfare, Sweden.
    Vinnerljung, Bo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för folkhälsovetenskap. Karolinska Institutet, Sweden.
    Brännström, Lars
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Educational outcomes of children from long-term foster care: Does foster parents’ educational attainment matter?2019Inngår i: Developmental Child Welfare, ISSN 2516-1032, Vol. 1, nr 4, s. 344-359Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Parental education is a robust predictor of children’s educational outcomes in general population studies, yet little is known about the intergenerational transmission of educational outcomes in alternative family settings such as children growing up in foster care. Using Swedish longitudinal register data on 2,167 children with experience of long-term foster care, this study explores the hypothesized mediating role of foster parents’ educational attainment on foster children’s educational outcomes, here conceptualized as having poor school performance at age 15 and only primary education at age 26. Results from gender-stratified regression analyses suggest that there was an association between foster parental educational attainment and foster children’s educational outcomes but that the educational transmission was weak and inconsistent and differed somewhat between males and females. For males, lower educational attainment in foster parents was associated with poor school performance but was not associated with educational attainment at age 26. The reverse pattern was found among females: the educational gradient was inconsistent for poor school performance but appeared in educational attainment. The results indicate that supported interventions for improving foster children’s educational achievements are needed, even when placements are relatively stable and foster parents have a long formal education.

  • 8.
    Berlin, Marie
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    von Grieff, Ninive
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Skogens, Lisa
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    The relationbetween out-of-home care, early school failure, and prematuremortality: A 30-year follow-up of people treated for substancemisuse in Sweden2020Inngår i: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Evidence from Swedish and international studies show that a high proportionof children from out-of-home care (OHC) have poor school performanceand that this is strongly associated with their substantial risk ofadverse development in future life. However, risk factors for poor schoolperformance and adverse development are difficult to disentangle sincethey are often interrelated and enforce each other over the life course.This study examines premature mortality in relation to early school failure(drop-out from compulsory school) and OHC experience in childhood(0–17 years of age) among clients who were in treatment for substancemisuse in the early 1980s (N = 1,036). The analyses were based on recordlinkages between interview data collected during treatment and nationalregister data covering approximately 30 years of follow-up, from exit fromtreatment until 2013. Our results showed that 54 per cent had beenplaced in OHC as children, half before their teens and half as teenagers.The OHC population had a higher prevalence of school failure comparedwith clients who had not been exposed to childhood OHC. OHC wasassociated with an excess mortality, although this was only significantfor females who had entered OHC before their teens. Adjusting results forschool failure reduced their excess mortality by half, and additional lifecourse factors associated with mortality among people with substancemisuse adjusted for most of the remaining excess mortality. School failurewas strongly associated with the excess mortality of females, but not withthe excess mortality of males.

    Fulltekst (pdf)
    fulltext
  • 9.
    Björkenstam, Charlotte
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. Karolinska Institutet, Sweden; University of California, USA.
    Ekselius, Lisa
    Berlin, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan. National Board of Health and Welfare, Sweden.
    Gerdin, Bengt
    Björkenstam, Emma
    Suicide risk and suicide method in patients with personality disorders2016Inngår i: Journal of Psychiatric Research, ISSN 0022-3956, E-ISSN 1879-1379, Vol. 83, s. 29-36Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The influence of psychopathology on suicide method has revealed different distributions among different psychiatric disorders. However, evidence is still scarce. We hypothesized that having a diagnosis of personality disorder (PD) affect the suicide method, and that different PD clusters would influence the suicide method in different ways. In addition, we hypothesized that the presence of psychiatric and somatic co-morbidity also affects the suicide method. Method: We examined 25,217 individuals aged 15-64 who had been hospitalized in Sweden with a main diagnosis of PD the years 1987-2013 (N = 25,217). The patients were followed from the date of first discharge until death or until the end of the follow-up period, i.e. December 31, 2013, for a total of 323,508.8 person-years, with a mean follow up time of 11.7 years. The SMR, i.e. the ratio between the observed number of suicides and the expected number of suicides, was used as a measure of risk. Results: Overall PD, different PD-clusters, and comorbidity influenced the suicide method. Hanging evidenced highest SMR in female PD patients (SMR 34.2 (95% CI: 29.3-39.8)), as compared to non-PD patients and jumping among male PD patients (SMR 24.8 (95% CI: 18.3-33.6)), as compared to non PD-patients. Furthermore, the elevated suicide risk was related to both psychiatric and somatic comorbidity. Conclusion: The increased suicide risk was unevenly distributed with respect to suicide method and type of PD. However, these differences were only moderate and greatly overshadowed by the overall excess suicide risk in having PD. Any attempt from society to decrease the suicide rate in persons with PD must take these characteristics into account.

  • 10.
    Hjern, Anders
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Rajmil, Luis
    Bergström, Malin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Berlin, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. National Board of Health and Welfare .
    Gustafsson, Per A.
    Modin, Bitte
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Migrant density and well-being - A national school survey of 15-year-olds in Sweden2013Inngår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, nr 5, s. 823-828Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The aim of this study was to investigate the impact of migrant density in school on the well-being of pupils with a migrant origin in first as well as second generation. Methods: Cross-sectional analysis of data from a national classroom survey of 15-year-old Swedish schoolchildren. The study population included 76 229 pupils (86.5% participation) with complete data set from 1352 schools. Six dimensions of well-being from the KIDSCREEN were analysed in two-level linear regression models to assess the influence of migrant origin at individual level and percentage of students with a migrant origin at school level, as well as interaction terms between them. Z-scores were used to equalize scales. Results: A high density (>50%) of pupils with a migrant origin in first or second generation was associated with positive well-being on all six scales for foreign-born pupils originating in Africa or Asia compared with schools with low (<10%) migrant density. The effect sizes were 0.56 for boys and 0.29 for girls on the comprehensive KIDSCREEN 10-index (P<0.001) and 0.61 and 0.34, respectively, for psychological well-being (P<0.001). Of the boys and girls born in Africa or Asia, 31.6% and 34.6%, respectively, reported being bullied during the past week in schools with low (<10%) migrant density. Conclusions: Pupils born in Africa or Asia are at high risk for being bullied and having impaired well-being in schools with few other migrant children. School interventions to improve peer relations and prevent bullying are needed to promote well-being in non-European migrant children.                 

  • 11. Kääriälä, Antti
    et al.
    Berlin, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. The National Board of Health and Welfare (Socialstyrelsen), Sweden.
    Lausten, Mette
    Hiilamoa, Heikki
    Ristikari, Tiina
    Early school leaving by children in out-of-home care: A comparative study of three Nordic countries2018Inngår i: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 93, s. 186-195Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Previous studies have reported that children and adolescents who have been placed in out-of-home care for the protection of their safety and welfare face considerably high risks for early school leaving. Our study adds to the literature by comparing the association between children's exposure to placement in care and lack of secondary education (i.e. post-compulsory education after age 16) across three Nordic countries: Denmark, Finland, and Sweden. We use data from national registers for children born in 1987, following them until age 23. The datasets for Denmark (N = 55,995, of whom 3056 are in care), Finland (N = 58,855, of whom 1884 are in care), and Sweden (N = 100,152, of whom 3209 are in care) cover the entire birth cohort. To estimate and compare country-specific risks, we calculate average marginal effects from binary logistic regression and adjust the effects for birth mother's socio-economic and health-related background. As expected, the results show that in each country, children placed in care had a significantly higher risk for early school leaving. After adjusting for maternal background, young adults who experienced out-of-home care were 24 to 39 percentage points more likely than their peers never in care to have not completed secondary education. Those placed in care for the first time at teenage were the most likely to have low attainment. In Finland and Sweden, children in care had a similar excess risk for early school leaving, whereas in Denmark the risk was higher. We discuss these results and recommend developing effective interventions to improve the educational attainment of children in care. The difference between Denmark and the other two requires further investigation.

  • 12.
    Modin, Bitte
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Plenty, Stephanie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutet för social forskning (SOFI). Institute for Futures Studies (IFFS), Sweden.
    Brolin Låftman, Sara
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Bergström, Malin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Berlin, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. National Board of Health and Welfare, Sweden.
    Gustafsson, Per A.
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    School Contextual Features of Social Disorder and Mental Health Complaints—A Multilevel Analysis of Swedish Sixth-Grade Students2018Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, nr 1, artikkel-id 156Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study addressed school-contextual features of social disorder in relation to sixth-grade students' experiences of bullying victimization and mental health complaints. It investigated, firstly, whether the school's concentrations of behavioural problems were associated with individual students' likelihood of being bullied, and secondly, whether the school's concentrations of behavioural problems and bullying victimization predicted students' emotional and psychosomatic health complaints. The data were derived from the Swedish National Survey of Mental Health among Children and Young People, carried out among sixth-grade students (approximately 12-13 years old) in Sweden in 2009. The analyses were based on information from 59,510 students distributed across 1999 schools. The statistical method used was multilevel modelling. While students' own behavioural problems were associated with an elevated risk of being bullied, attending a school with a higher concentration of students with behavioural problems also increased the likelihood of being bullied. Attending a school with higher levels of bullying victimization and behavioural problems predicted more emotional and psychosomatic complaints, even when adjusting for their individual level analogues. The findings indicate that school-level features of social disorder influence bullying victimization and mental health complaints among students.

  • 13.
    Skogens, Lisa
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    von Greiff, Ninive
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Berlin, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Bergmark, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    A 30-year follow-up of substnace misusers in Sweden – differences and predictors of mortality between women and men2019Inngår i: Addiction Research and Theory, ISSN 1606-6359, E-ISSN 1476-7392, Vol. 27, nr 4, s. 328-336Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Differing results on gender specific factors related to mortality risks among substance misusers highlights the need for further research. The present article is based on a 30-year follow-up study on substance misusers treated in residential care for drug problems in Sweden in 1982-1983 aiming to identify and compare gender differences in predictors of mortality.

    Method: Original data consists of personal interviews with 1163 substance misusers treated in inpatient units in Sweden during 1982-1983. The outcome variable is death retrieved from the National Cause of Death Register held by the National Board of Health and Welfare. Gender differences and similarities regarding predictors of mortality was estimated in univariate and multivariate models, using Cox proportional hazards models.

    Results: School failure, imprisonment and being a parent without custody of the child seem to constitute risk factors for mortality among women, but not among men. A social network of friends seemed to be more important for men. Treatment-dropout was a significant risk factor for premature death among men, but not among women. Both gender reporting alcohol as their self-reported most dominant substance misuse showed higher mortality risks compared with those with stimulants as dominant substance misuse.

    Conclusions: Imprisonment was highly predictive of mortality for the women, suggesting that this group is important to pay particular attention to. Suggested differences in the importance of social factors need to be investigated more thoroughly. The substantial hazard revealed for women with polydrug misuse including alcohol calls for attention to this in treatment for substance misuse.

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  • 14.
    von Greiff, Ninive
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Skogens, Lisa
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete - Socialhögskolan.
    Berlin, Marie
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen. The National Board of Health and Welfare, Sweden.
    Social inclusion of clients treated for substance abuse in Sweden in the 1980s: A 27-year follow-up2019Inngår i: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 36, nr 4, s. 314-329Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To investigate social inclusion/exclusion in terms of criminality, substance abuse and participation in the labour market in clients treated for substance abuse in Sweden in the 1980s during a follow-up period of 27 years.

    Method: SWEDATE data are used for background information on the clients. The data were collected through interviews with clients registered for treatment in 31 in-patient treatment units in 1982 and 1983. Data on labour market status, education and medication related to drugs were collected from public registers. The study population consisted of 1132 individuals, who were followed from the year after exiting from treatment (Year 1) until the end of the follow-up (December 2013).

    Results: Among those who survived, the women seem to have succeeded better in terms of social inclusion both at an aggregated level and when the individual pathways were followed during the follow-up period. When comparing pathways between adverse and non-adverse groups during the follow-up period the results show movements from being adverse to non-adverse but also the opposite. In the last follow-up in 2013, the majority of the clients defined as non-adverse for the last nine years were in some way established in the labour market (including studies). In total, about two fifths of the group were in some way established in the labour market.

    Conclusions: The fairly high proportion of clients moving between being adverse and non-adverse during the follow-up might support the perspective suggesting that dependence should not be considered as chronic.

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