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  • 1.
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Växelvis boende: inte den sämsta lösningen2011In: Leva PS!, Vol. September, p. 41-43Article in journal (Other (popular science, discussion, etc.))
  • 2.
    Bergström, Malin
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Fransson, Emma
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fabian, Helena
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Sarkadi, Anna
    Salari, Raziye
    Preschool children living in joint physical custody arrangements show less psychological symptoms than those living mostly or only with one parent2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 2, p. 294-300Article in journal (Refereed)
    Abstract [en]

    Aim

    Joint physical custody (JPC), where children spend about equal time in both parent's homes after parental separation, is increasing. The suitability of this practice for preschool children, with a need for predictability and continuity, has been questioned.

    Methods

    In this cross-sectional study, we used data on 3656 Swedish children aged three to five years living in intact families, JPC, mostly with one parent or single care. Linear regression analyses were conducted with the Strengths and Difficulties Questionnaire, completed by parents and preschool teachers, as the outcome measure.

    Results

    Children in JPC showed less psychological problems than those living mostly (adjusted B 1.81; 95% CI [0.66 to 2.95]) or only with one parent (adjusted B 1.94; 95% CI [0.75 to 3.13]), in parental reports. In preschool teacher reports, the adjusted Betas were 1.27, 95% CI [0.14 to 2.40] and 1.41, 95% CI [0.24 to 2.58], respectively. In parental reports, children in JPC and those in intact families had similar outcomes, while teachers reported lower unadjusted symptom scores for children in intact families.

    Conclusion

    Joint physical custody arrangements were not associated with more psychological symptoms in children aged 3–5, but longitudinal studies are needed to account for potential preseparation differences.

  • 3.
    Bergström, Malin
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fransson, Emma
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Köhler, Lennart
    Wallby, Thomas
    Mental health in Swedish children living in joint physical custody and their parents' life satisfaction: A cross-sectional study2014In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 55, no 5, p. 433-439Article in journal (Refereed)
    Abstract [en]

    This study compared the psychological symptoms of 129 children in joint physical custody with children in single care and nuclear families, using a nationally representative 2011 survey of 1,297 Swedish children aged between four and 18 years. The outcome measure was the Strengths and Difficulties Questionnaire (SDQ) and its association with three dimensions of parental life satisfaction was investigated. Linear regression analyses showed higher SDQ-scores for children in joint physical custody (B = 1.4, p < 0.001) and single care (B = 2.2, p < 0.001) than in nuclear families, after adjustment for socio-demographic variables. The estimates decreased to 1.1 and 1.3, respectively, after being adjusted for parental life satisfaction ( p < 0.01). Our findings confirm previous research that showed lower symptom scores for children in nuclear families than children in single care and joint physical custody. Parental life satisfaction should be investigated further as a possible explanation of differences in symptom load between children in different living arrangements.

  • 4.
    Bergström, Malin
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fransson, Emma
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Berlin, Marie
    Stockholm University, Faculty of Social Sciences, Department of Sociology. National Board of Health and Welfare, Sweden.
    Gustafsson, Per A.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Fifty moves a year: is there an association between joint physical custody and psychosomatic problems in children?2015In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 69, no 8, p. 769-774Article in journal (Refereed)
    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.

  • 5.
    Bergström, Malin
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Fransson, Emma
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Wells, Michael B.
    Köhler, Lennart
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Children with two homes: Psychological problems in relation to living arrangements in Nordic 2- to 9-year-olds2019In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, no 2, p. 137-145Article in journal (Refereed)
    Abstract [en]

    Aim: Joint physical custody, children spending equal time in each parents’ respective home after a parental divorce, is particularly common in Nordic compared with other Western countries. Older children have been shown to fare well in this practice but for young children there are few existing studies. The aim of this paper is to study psychological problems in 2- to 9-year-old Nordic children in different family forms. Methods: Total symptom score according to the Strengths and Difficulties Questionnaire as well as scores showing externalizing problems were compared among 152 children in joint physical custody, 303 in single care and 3207 in nuclear families through multiple linear regression analyses. Results: Children in single care had more psychological symptoms than those in joint physical custody (B = 1.08; 95% CI 0.48 to 1.67) and those in nuclear families had the least reported symptoms (B = −0.53; 95% CI −0.89 to −0.17). Externalizing problems were also lower in nuclear families (B = −0.28, 95% CI −0.52 to −0.04) compared with joint physical custody after adjusting for covariates. Conclusions: Young children with non-cohabiting parents suffered from more psychological problems than those in intact families. Children in joint physical custody had a lower total problem score than those in single care after adjusting for covariates. Longitudinal studies with information on family factors before the separation are needed to inform policy of young children’s post-separation living arrangements.

  • 6.
    Bergström, Malin
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Fransson, Emma
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Rajmil, Luis
    Berlin, Marie
    Stockholm University, Faculty of Social Sciences, Department of Sociology. National Board of Health and Welfare, Sweden.
    Gustafsson, Per A.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Living in two homes-a Swedish national survey of wellbeing in 12 and 15 year olds with joint physical custody2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, article id 868Article in journal (Refereed)
    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.

  • 7.
    Bergström, Malin
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Sarkadi, Anna
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Fransson, Emma
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    "We also communicate through a book in the diaper bag" - Separated parents' ways to coparent and promote adaptation of their 1-4 year olds in equal joint physical custody2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 4, article id e0214913Article in journal (Refereed)
    Abstract [en]

    Joint physical custody (JPC) refers to a practice where children with separated parents share their time between the parents' respective homes. Studies on parents' views of JPC for young children are scarce. The aim of this interview study was to explore parents' perceptions on how they experience and practice equally shared JPC for their 1-4 year-olds in Sweden. Forty-six parents (18 fathers and 28 mothers) of 50 children (31 boys and 19 girls) under 5 years of age were interviewed. Parents were recruited through information in the media and represented a broad range of socioeconomic backgrounds, as well as both voluntary and court-ordered custody arrangements. The interviews were semi-structured and analyzed using systematic text condensation. Two themes emerged regarding the research question. In the first theme, Always free, never free, parents described their striving to coparent without a love relationship. While they appreciated the freedom of being a half-time parent, doing things one's own way, they felt constrained by the long-term commitment to live close to and keep discussing child rearing issues with the ex-partner. Good communication was key and lessened parent's feelings of being cut-off from half of the child's life. When JPC was ordered by court or conflicts were intense, parents tried to have less contact and worried when the children were in the other home. The second theme, Is it right, is it good?, included descriptions of how the parents monitored the child's responses to the living arrangement and made changes to optimize their adjustment. Adaptations included visits for the child with the other parent mid-week, shared meals or adapting schedules. In conclusion, these parents worked hard to make JPC work and cause minimal damage to their children. Most parents were pleased with the arrangements with the notable exception of couples experiencing ongoing conflict.

  • 8.
    Brolin Låftman, Sara
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Joint physical custody, turning to parents for emotional support, and subjective health: a study of adolescents in Stockholm, Sweden2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 5, p. 456-462Article in journal (Refereed)
    Abstract [en]

    Aims: Among children with separated parents, the arrangement of joint physical custody, i.e. children living equally much in both parents’ homes, has increased substantially during the last decades in Sweden. To date, empirical research on the living conditions of this group is limited. This study analyses family type differences in turning to parents for emotional support and in subjective health among adolescents. The focus of the study is adolescents in joint physical custody, who are compared with those living with two original parents in the same household; those living (only) in a single-parent household; and those living (only) in a reconstituted family. Methods: The data come from the Stockholm School Survey of 2004, a total population survey of students in grade 9 (15–16 years) in Stockholm (n=8,840). Ordinary least squares (OLS) regressions were conducted. Results: Turning to both parents about problems is most commonly reported by adolescents in intact families, followed by those in joint physical custody. Adolescents in non-traditional family types report worse subjective health than adolescents in intact families, but the difference is smaller for those in joint physical custody than for those living with a single parent. The slightly poorer health of adolescents in joint physical custody than those in intact families is not explained by their lower use of parents as a source of emotional support. Conclusions: The study suggests that joint physical custody is associated with a higher inclination to use parents as a source of emotional support and better subjective health than other post-divorce family types.

  • 9.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Barn i växelvis boende – en forskningsöversikt2015Report (Other academic)
    Abstract [sv]

    Varje år separerar föräldrar till ungefär 50 000 barn i Sverige. Sedan 1980-talet bor en ökande andel av dessa barn växelvis efter separationen. Växelvis boende innebär att barnen flyttar regelbundet mellan sina föräldrars respektive hem och bor ungefär lika mycket hos båda. En högre andel barn bor i växelvis boende i Sverige än i något annat land, ca 35-40 procent av de barn som har särlevande föräldrar, totalt cirka 200 000 barn.

    Denna rapport har skrivits av forskare i Elvis-projektet på CHESS vid Stockholms Universitet/Karolinska institutet på uppdrag av Socialstyrelsen. Den ger en sammanfattning av den forskningsbaserade kunskapen om hälsa och välbefinnande hos barn i växelvis boende. När det gäller barn under sex år, där kunskapsläget är mest osäkert, ger rapporten en heltäckande bild av den internationella forskningen, inklusive en översikt av den psykologiska teoribildningen på området. För skolbarnen finns det ett ganska stort antal svenska studier och därför har vi här valt att lägga fokus på dessa och endast komplettera med särskilt relevant forskning från andra länder. Att det finns mer forskning kring skolbarn beror delvis på att växelvis boende är vanligare för de åldersgrupperna, men främst på att man lättare kan ta in deras egna åsikter och erfarenheter, medan forskning kring de yngre barnen är mer komplicerad metodologiskt sett, och därför mer resurskrävande.

    Anknytningsteorins betoning av kvaliteten i interaktionen mellan små barn och deras vårdgivare ger anledning att särskilt skärskåda konsekvenserna av växelvist boende för de yngsta barnen. Resultaten från studierna av barn 0-3 år ger inte en entydig bild av barns välbefinnande och anknytningsrelationer. Flera av de få studierna håller låg vetenskaplig kvalitet och studerar små grupper. En tillräcklig empirisk bas för de yngsta barnen i växelvis boende saknas därmed. Sammantaget visar studierna att föräldrars samarbetsförmåga, sätt att hantera konflikter och lyhördhet för barnets behov spelar större roll än boendeform.

    I rapporten presenteras tio svenska tvärsnittsstudier av skolbarn från 10 års ålder i stora nationellt eller regionalt representativa surveyundersökningar samt en studie med biologiska data. I en majoritet av studierna rapporteras barn i växelvis boende ha mindre psykisk ohälsa och bättre välbefinnande än jämnåriga som bor med bara en förälder. Detta mönster är likartat hos pojkar och flickor. Tvärsnittsdesignen i samtliga studier gör dock att man bör vara försiktig med alltför definitiva slutsatser, eftersom denna design inte gör det möjligt att fullt ut ta hänsyn till skillnader i bakomliggande faktorer som t ex föräldrars hälsa, sociala situation och kommunikation sinsemellan.

    Studier pekar på olika faktorer som kan tänkas förklara att barn i växelvis boende överlag verkar ha en större chans till god psykisk hälsa än barn som bor med enbart en förälder. Barn i växelvis boende har genomsnittligt bättre materiella resurser än barn som bor med bara en förälder. Även med god kontroll för socioekonomiska skillnader mellan olika slags familjer visar dock merparten av studierna att skolbarn och tonåringar i växelvis boende mår bättre än de som bor enbart med en förälder, varför det är rimligt att spekulera i andra fördelar med växelvis boende. En möjlig förklaring skulle kunna vara att barn i växelvis boende har tillgång till, och stöd från, båda sina föräldrar. Barn i växelvis boende har också oftare en god relation till båda sina föräldrar än de som bor med enbart eller mest med en förälder.

    En rad kunskapsluckor identifieras i rapporten. Studier av god metodologisk kvalitet som fokuserar på de yngsta barnen, framför allt 0-3 år, saknas i särskilt hög grad. Longitudinella studier som har förutsättningar att mäta förändringar i psykisk hälsa och välbefinnande före och efter att föräldrar separerar är också mycket angelägna, liksom studier med ett individperspektiv som kan ge vägledning för beslut om boendeform för särskilt sårbara barn när föräldrar separerar. Ökningen av andelen barn som bor växelvis är en av de största förändringarna i barns livsvillkor i Sverige under de senaste åren. Det är också en förändring som är en uppenbart påverkbar faktor i barns liv. Det är således angeläget att resurser görs tillgängliga för att fylla de kunskapsluckor som identifieras.

    Avslutningsvis kan konstateras att det saknas forskning som kan ge ett definitivt svar på vilka konsekvenser växelvis boende har för barns hälsa och välbefinnande efter att föräldrar separerat. Med denna begränsning är det ändå värt att notera är att inte finns någon studie som tyder på att barns hälsa skulle vara sämre i växelvis boende än i boende med enbart en förälder från 4 års ålder, men att avsaknaden av kunskap om barn 0-3 år gör att några slutsatser inte alls bör dras om denna åldersgrupp.

  • 10.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Brolin Låftman, Sara
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    The Living Conditions of Children with Shared Residence – the Swedish Example2018In: Child Indicators Research, ISSN 1874-897X, E-ISSN 1874-8988, Vol. 11, no 3, p. 861-883Article in journal (Refereed)
    Abstract [en]

    Among children with separated parents, shared residence–i.e., joint phys-ical custody where the child is sharing his or her time equally between two custodialparents’homes–is increasing in many Western countries and is particularly commonin Sweden. The overall level of living among children in Sweden is high; however, thepotential structural differences between children in various post-separation familyarrangements have not been sufficiently studied. Potential risks for children with sharedresidence relate to the daily hassles and stress when having two homes. This study aimsat investigating the living conditions of children with shared residence compared withchildren living with two custodial parents in the same household and those living withone custodial parent, respectively. Swedish national survey data collected from childrenaged 10–18 years (n≈5000) and their parents were used. The outcomes were groupedinto: Economic and material conditions, Social relations with parents and peers, Healthand health behaviors, Working conditions and safety in school and in the neighbor-hood, and Culture and leisure time activities. Results from a series of linear probabilitymodels showed that most outcomes were similar for children with shared residence andthose living with two custodial parents in the same household, while several outcomeswere worse for children living with one parent. However, few differences due to livingarrangements were found regarding school conditions. This study highlights the in-equalities in the living conditions of Swedish children, with those living with oneparent having fewer resources compared with other children.

  • 11.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Folkesson, Lisa
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Exploring salivary cortisol and recurrent pain in mid-adolescents living in two homes2014In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 21, p. S23-S23Article in journal (Refereed)
    Abstract [en]

    Introduction: Every year, around 50.000 children in Sweden experience a separation between their parents. Joint physical custody (JPC), where the child alternates homes between the parents for about equal amount of time, has become a common living arrangement after parental separation. Children living in two homes can benefit from everyday contact with both parents and access to both parents’ financial resources. However, children can also experience stress from constantly moving and from exposure to any parental conflict. Yet, research on JPC and stress-related biological functioning is limited. The aimof this study was to investigate how living arrangements (intact family/JPC) relate toHPA-axis activity and recurrent pain in mid-adolescents. Methods: Mid-adolescents (106 girls and 51 boys) provided demographic details, self-reports of recurrent pain (headache, stomachache, neck/shoulder and back pain) and salivary samples. Salivary cortisol samples were collected: 1) immediately at awakening, 2) +30 minutes, 3) +60 minutes, and 4) at 8 p.m. Results: Hierarchical regressions showed that living arrangements did not predict morning cortisol levels, the diurnal cortisol rhythm nor recurrent pain. However, sex was significantly associated with both morning cortisol and recurrent pain. Conclusion: Living arrangements were not linked to HPA-axis activity or recurrent pain in this group of well-functioning mid-adolescents. Although this is the first study investigating how living arrangements relate to HPA-axis functioning, which means that additional research is needed, the findings suggest that these mid-adolescents have adapted to their living arrangements and that other factors seem more pertinent for HPA-functioning and subjective health complaints.

  • 12.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Folkesson, Lisa
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Exploring salivary cortisol and recurrent pain in mid-adolescents living in two homes2014In: BMC Psychology, E-ISSN 2050-7283, Vol. 2, no 1, p. 1-7, article id 46Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Each year, around 50.000 children in Sweden experience a separation between their parents. Joint physical custody (JPC), where the child alternates homes between the parents for about equal amount of time, has become a common living arrangement after parental separation. Children in two homes could benefit from everyday contact with both parents and access to both parents' financial resources. However, children could experience stress from being constantly moving and potentially exposed to parental conflicts. Still, studies on JPC and biological functioning related to stress, are lacking. The aim of this study was to investigate how living arrangements (intact family/JPC) relate to HPA-axis activity and recurrent pain in mid-adolescents.

    METHODS: Mid-adolescents (106 girls and 51 boys) provided demographic details, self-reports of recurrent pain (headache, stomachache, neck/shoulder and back pain) and salivary samples. Salivary cortisol samples were collected: 1) immediately at awakening, 2) +30 minutes, 3) +60 minutes, and 4) at 8 p.m. The cortisol awakening response (CAR) was computed using an established formula. Additionally, the diurnal decline between the waking and 8 p.m. samples was computed.

    RESULTS: Hierarchical multiple regressions showed that living arrangements (intact family/JPC) was not associated with morning cortisol (CAR), the diurnal cortisol decline or with recurrent pain. However, sex was a significant predictor of both cortisol measures and recurrent pain with girls exhibiting a higher cortisol awakening response and a greater diurnal decline value as well as reporting more recurrent pain than did boys.

    CONCLUSIONS: Living arrangements were not associated with HPA-axis activity or recurrent pain in this group of well-functioning mid-adolescents. Although this study is the first to investigate how living arrangements relate to HPA-axis functioning and additional studies are needed, the tentative findings suggest that these mid-adolescents have adapted to their living arrangements and that other factors play a more pertinent role for HPA-functioning and subjective health.

  • 13.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    What Can We Say Regarding Shared Parenting Arrangements for Swedish Children?2018In: Journal of Divorce and Remarriage, ISSN 1050-2556, E-ISSN 1540-4811, Vol. 59, no 5, p. 349-358Article in journal (Refereed)
    Abstract [en]

    Joint physical custody (JPC) refers to children living alternatively and about equally with both parents after a parental separation or divorce. The practice has been debated in relation to child well-being because of the frequent moves imposed on children and the potential stress from living in 2 homes. This study describes the background to the high frequency of Swedish children in JPC and the results from research on Swedish children’s well-being in this living arrangement. Children in JPC report better well-being and mental health than children who live mostly or only with 1 parent. No Swedish studies have found children’s health to be worse in JPC than in sole parental care from child age of 3 years and beyond. The existing literature cannot, however, inform us about the mechanisms behind the findings. The risks of selection effects into living arrangements are plausible. For this purpose, longitudinal studies are warranted.

  • 14.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Sarkadi, Anna
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska University Hospital, Sweden.
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Why should they live more with one of us when they are children to us both?: Parents' motives for practicing equal joint physical custody for children aged 0–42016In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 66, p. 154-160Article in journal (Refereed)
    Abstract [en]

    Joint physical custody, i.e., children spending an equal amount of time in both parents' home after a separation or divorce, is increasing in many countries. In line with the national policy to promote paternal involvement in parenting, two-thirds of Swedish preschoolers with non-cohabiting parents live in two homes. Internationally, there has been a debate regarding the benefits or risks with joint physical custody for infants and toddlers. The aim of this qualitative study was to explore the reasons given by divorced parents for sharing joint physical custody of children 0-4 years of age. Interviews were conducted with 46 parents (18 fathers and 28 mothers) and analyzed using systematic text condensation. Two themes emerged in response to the research question. In the theme Same rights and responsibilities, parents described that joint physical custody was 'a given' as both parents were seen to have equal rights to and responsibility for the children. Both men and women described involved fatherhood as an ideal goal. In the theme For the sake of the child, parents emphasized that joint physical custody was in the best interest of the child. Some parents had conflicts with their ex-spouses, but were still convinced of the benefits of joint physical custody and strove to make it work.

  • 15.
    Fransson, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Turunen, Jani
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Psychological complaints among children in joint physical custody and other family types: Considering parental factors2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 2, p. 177-183Article in journal (Refereed)
    Abstract [en]

    Aims: Increasing proportions of Scandinavian children and children in other Western countries live in joint physical custody, moving between parents’ homes when parents live apart. Children and parents in non-intact families are at risk of worse mental health. The potential influence of parental ill-health on child well-being in the context of differing living arrangements has not been studied thoroughly. This study investigates the psychological complaints of children in joint physical custody in comparison to children in sole parental care and nuclear families, while controlling for socioeconomic differences and parental ill-health. Methods: Data were obtained from Statistics Sweden’s yearly Survey of Living Conditions 2007–2011 and child supplements with children 10–18 years, living in households of adult participants. Children in joint physical custody (n=391) were compared with children in sole parental care (n=654) and children in nuclear families (n=3,639), using a scale of psychological complaints as the outcome measure. Results: Multiple regression modelling showed that children in joint physical custody did not report higher levels of psychological complaints than those in nuclear families, while children in sole parental care reported elevated levels of complaints compared with those in joint physical custody. Adding socioeconomic variables and parental ill-health only marginally attenuated the coefficients for the living arrangement groups. Low parental education and parental worry/anxiety were however associated with higher levels of psychological complaints. Conclusions: Psychological complaints were lower among adolescents in joint physical custody than in adolescents in sole parental care. The difference was not explained by parental ill-health or socioeconomic variables.

  • 16. Gustavsson, Per A.
    et al.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Berlin, Marie
    Skolans betydelse för barns och ungas psykiska hälsa – en studie baserad på den nationella totalundersökningen i årskurs 6 och 9 hösten 20092012Report (Other academic)
  • 17.
    Hjern, Anders
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Rajmil, Luis
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Berlin, Marie
    Stockholm University, Faculty of Social Sciences, Department of Sociology. National Board of Health and Welfare .
    Gustafsson, Per A.
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Migrant density and well-being - A national school survey of 15-year-olds in Sweden2013In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, no 5, p. 823-828Article in journal (Refereed)
    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.                 

  • 18.
    Liu, Can
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Cnattingius, S.
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Prenatal parental depression and preterm birth: a national cohort study2016In: International Journal of Gynecology & Obstetrics, ISSN 0020-7292, E-ISSN 1879-3479, Vol. 123, no 12, p. 1973-1982Article in journal (Refereed)
    Abstract [en]

    Objective

    To investigate the effects of maternal and paternal depression on the risk for preterm birth.

    Design

    National cohort study.

    Setting

    Medical Birth Register of Sweden, 2007–2012.

    Population

    A total of 366 499 singleton births with linked information for parents’ filled drug prescriptions and hospital care.

    Methods

    Prenatal depression was defined as having filled a prescription for an antidepressant drug or having been in outpatient or inpatient hospital care with a diagnosis of depression from 12 months before conception until 24 weeks after conception. An indication of depression after 12 months with no depression was defined as ‘new depression’, whereas all other cases were defined as ‘recurrent depression’.

    Main outcome measures

    Odds ratios (ORs) for very preterm (22–31 weeks of gestation) and moderately preterm (32–36 weeks of gestation) births were estimated using multinomial logistic regression models.

    Results

    After adjustment for maternal depression and sociodemographic covariates, new paternal prenatal depression was associated with very preterm birth [adjusted OR (aOR) 1.38, 95% confidence interval (95% CI) 1.04–1.83], whereas recurrent paternal depression was not associated with an increased risk of preterm birth. Both new and recurrent maternal prenatal depression were associated with an increased risk of moderately preterm birth (aOR 1.34, 95% CI 1.22–1.46, and aOR 1.42, 95% CI 1.32–1.53, respectively).

    Conclusions

    New paternal and maternal prenatal depression are potential risk factors for preterm birth. Mental health problems in both parents should be addressed for the prevention of preterm birth.

  • 19.
    Modin, Bitte
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Plenty, Stephanie
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI). Institute for Futures Studies (IFFS), Sweden.
    Brolin Låftman, Sara
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Berlin, Marie
    Stockholm University, Faculty of Social Sciences, Department of Sociology. National Board of Health and Welfare, Sweden.
    Gustafsson, Per A.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    School Contextual Features of Social Disorder and Mental Health Complaints—A Multilevel Analysis of Swedish Sixth-Grade Students2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 1, article id 156Article in journal (Refereed)
    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.

  • 20.
    Turunen, Jani
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology. Karlstad University, Sweden.
    Fransson, Emma
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Self-esteem in children in joint physical custody and other living arrangements2017In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 149, p. 106-112Article in journal (Refereed)
    Abstract [en]

    Objectives: Parental support has been shown to be important for children's self-esteem, which in turn is related to later important life outcomes. Today, an increasing number of children in the Western world spend time in both the parents' respective households after a separation. Children who live with both parents report more parental support than children who live only with one parent after a divorce. We took the opportunity of the commonness of children sharing their time between their parents' homes in Sweden to investigate children's self-esteem in relation to family type. Study design and methods: With nationally representative survey data (ULF) collected from both parents and children, we analyze differences in children's self-esteem among 4823 10-18 year olds in nuclear families, joint physical custody and those living mostly or only with one parent after a separation using ordinary least squares regression, adjusting for demographic and socioeconomic characteristics. Results: We found no significant difference in self-esteem between children who lived equally much with both parents, mostly with one parent and those in nuclear families, whereas children in single care showed lower self-esteem compared with children in the other living arrangements. The difference was not explained by socioeconomic factors. Conclusion: The self-esteem of children who share their time between their parent's respective homes after a separation does not deviate from that in their peers in nuclear families. Instead, those in single care reported lower self-esteem than those in the other living arrangements. These differences were not explained by socioeconomic factors. Longitudinal studies are needed to establish pre- and post-separation family characteristics that influence self-esteem and well-being in young people.

  • 21. Wells, Michael B.
    et al.
    Massoudi, Pamela
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Swedish child health nurses treat fathers more equally in 2014 than 2004, but mothers remain their primary focus2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 8, p. 1302-1308Article in journal (Refereed)
    Abstract [en]

    Aim: This study focused on Swedish child health nurses' attitudes and the support they provided to fathers and mothers, highlighting changes from 2004 to 2014. Method: In 2014, 363 child health nurses in Stockholm County completed a 23-item questionnaire, similar to the questionnaire by Massoudi et al. in 2004, on their attitudes and the support they gave to fathers and mothers. Analyses were completed using chi-square tests of nurses' attitudes and support to fathers and mothers, and the results from the 2004 and 2014 studies were compared. Results: In 2014, the vast majority of nurses fully agreed that it was important to have close contact with both parents, but more than two-thirds did not feel they had the same competencies for mothers and fathers and three quarters found it complicated to support both parents. The majority viewed fathers more equally in 2014 than in 2004 and although they did provide more support to both parents, mothers in 2014 still received more support than fathers. Conclusion: While Swedish child health nurses viewed fathers as more equal to mothers in 2014 than 2004, mothers still received the majority of the parenting support.

1 - 21 of 21
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