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  • 51.
    Modin, Bitte
    et al.
    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).
    Almquist, Ylva
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Childhood peer status and adult susceptibility to anxiety and depression: A 30-year hospital follow-up2011In: Journal of Abnormal Child Psychology, ISSN 0091-0627, E-ISSN 1573-2835, Vol. 39, no 2, p. 187-199Article in journal (Refereed)
    Abstract [en]

      This study examined the extent to which sixth grade peer status could predict anxiety and/or depression in 5,242 women and 5,004 men who were born in 1953 and whose hospital records were followed up from 1973–2003. The data used was the Stockholm Birth Cohort Study. While no association could be established for men, results indicated that women who held low peer status positions in childhood were at a considerably higher risk of anxiety and/or depression later in life compared to women in average status positions. Women who held popular positions during childhood did not differ significantly from their average counterparts. These findings persisted after adjusting for family- and child-related problem-load, perceived security at school, family constellation, socioeconomic status as well as the child’s cognitive ability, ninth grade school marks and continuance to upper secondary school.

  • 52.
    Plenty, Stephanie
    et al.
    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).
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Augustine, Lilly
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Psychosocial working conditions: An analysis of emotional symptoms and conduct problems amongst adolescent students2014In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 37, no 4, p. 407-417Article in journal (Refereed)
    Abstract [en]

    This study explored how psychosocial features of the schoolwork environment are associated with students' mental health. Data was drawn from 3699 ninth grade (15 year-old) Swedish students participating in the Health Behaviour in School-Aged Children survey. Using Structural Equation Modelling, perceived school demands, decision control and social support from teachers, classmates and parents were examined in relation to students' emotional and conduct problems. Higher demands were associated with greater emotional symptoms and conduct problems. Although weaker social support predicted emotional symptoms and conduct problems, the relative influence of teachers, classmates and parents differed. Teacher support was more closely associated with conduct problems, particularly for girls, while classmate support was more strongly related to emotional symptoms. The findings indicate that while excessive school pressure is associated with poorer mental health, social support can assist in optimising adolescents' emotional health and adaptive behaviour, as well as shaping perceptions of demands. (C) 2014 The Foundation for Professionals in Services for Adolescents.

  • 53.
    Ramberg, Joacim
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Brolin Låftman, Sara
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Health Equity Studies (CHESS).
    School effectiveness and students' perceptions of teacher caring: A multilevel study2019In: Improving Schools, ISSN 1365-4802, E-ISSN 1475-7583, Vol. 22, no 1, p. 55-71Article in journal (Refereed)
    Abstract [en]

    The effective schools literature has shown that school-contextual aspects matter for students’ academic and social outcomes. A potential link here may be the quality of the relationships between teachers and students, but few studies have investigated whether features of school effectiveness are in fact associated with students’ perceptions of teacher caring, which is the main purpose of this study. Based on recently collected data from 150 senior-level school units in Stockholm, school effectiveness in terms of teacher-assessed ‘school leadership’, ‘teacher cooperation and consensus’, and ‘school ethos’ (n = 2073) was analyzed in relation to perceived teacher caring as reported by students (n = 8022). Two-level linear regression analyses showed that all three aspects of school effectiveness were predictive of higher levels of perceived teacher caring among students. The findings suggest that these features of school effectiveness constitute an important foundation for promoting the quality of teachers’ relationships with their students.

  • 54.
    Rehnberg, Johan
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Fors, Stefan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Fritzell, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Poverty after 63: the impact of selective mortalityManuscript (preprint) (Other academic)
    Abstract [en]

    Background: The amount and share of older people in developed countries are growing dramatically and poverty among them is relatively high. If life expectancy continues to increase and a larger segment of the population reaches old age, we may expect to see increased poverty rates among the old.

    Objective: The objective of this study was to examine poverty rates in six cohorts aged 63-101 in Sweden during 1990 to 2006, as well as the impact of selective mortality on old age poverty rates during the study period.

    Methods: We used Swedish total population data with 1 293 434 individual observations. We calculated poverty rates for six cohorts of women and men aged 63 to 86 at baseline, and followed the cohorts for 15 years. The impact of selective mortality on poverty rates was assessed by comparing poverty in the complete cohort with a sample of the cohort that survived for the duration of the follow-up period.

    Results: Poverty rates increased with age for men and women in all six cohorts. Women experienced substantially higher poverty rates than did men. Those who survived during the 15-year follow-up period had 8-32 percent lower poverty rate at baseline compared to the complete cohort poverty rate. Men experienced larger poverty differences between the complete cohort sample and the survivor sample in the younger cohorts than did women. Women experienced larger poverty differences between the complete sample and the survivor sample in the oldest cohort than did men.

    Conclusion: Selective mortality influences poverty rates greatly. In a scenario where everyone lives longer and other things is held constant, the results from this study suggest that poverty rates among the old could be substantially higher.

  • 55.
    Rojas, Yerko
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI). Södertörn University, Sweden.
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Peer Status Position within School-Based Hierarchies and Excessive Fat Accumulation in Adulthood—A 30 Year Follow up of a Stockholm Cohort2019In: Behavioral Sciences, ISSN 0084-5396, E-ISSN 1866-2447, Vol. 9, no 8, article id 85Article in journal (Refereed)
    Abstract [en]

    Disadvantaged socioeconomic status is arguably the one exposure that has most consistently been linked to obesity, even more strongly so than diet and physical inactivity, which are the two main perceived root causes of weight gain. However, we still know very little about the relationship between having a disadvantaged social position and excessive fat accumulation, particularly when it comes to whether the relationship in question can also be seen as a long-term one, i.e., spanning from childhood to adulthood. By making use of the unique Stockholm Birth Cohort Multigenerational Study, the present study uses generalized ordered logistic regressions to examine the association between sociometrically assessed peer status position in school at age 13 and excessive fat accumulation at age 32. The results suggest that the odds of having excessive fat accumulation are about 0.5 times lower among popular and accepted children (ORs = 0.52 and 0.56, respectively), compared to those with a marginalized peer status position, independent of other obesogenic risk factors measured both prior and subsequent to peer status position. Our results give support to the notion that improved weight status may be another positive consequence of policies aiming to increase social inclusion within schools.

  • 56.
    Rostila, Mikael
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Almquist, Ylva B.
    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).
    Edling, Christofer
    Rydgren, Jens
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Social Network Characteristics and Daily Smoking among Young Adults in Sweden2013In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 10, no 12, p. 6517-6533Article in journal (Refereed)
    Abstract [en]

    A large number of studies have shown that friends’ smoking behavior is strongly associated with an individual’s own risk for smoking. However, few studies have examined whether other features of social networks, independently or conjointly with friends’ smoking behavior, may influence the risk for smoking. Because it is characterized by the growing importance of friendship networks, the transition from adolescence to young adulthood may constitute a particularly relevant period on which to focus our investigation of network influences on smoking behavior. The aim of this study was therefore to examine the consequences of peer smoking as well as other network characteristics (friends’ other health behaviors, relationship content, and structural aspects of the network) on the risk for smoking among young adults. The data was based on a cross-sectional survey of Swedish 19-year-olds carried out in 2009 (n = 5,695) with a response rate of 51.6%. Logistic regression was the primary method of analysis. The results show that having a large percentage of smokers in one’s network was by far the most important risk factor for daily smoking. The risk of daily smoking was 21.20 (CI 14.24. 31.54) if 76%–100% of the network members smoked. Having a high percentage of physically active friends was inversely associated with daily smoking. The risk of smoking was 0.65 (CI 0.42. 1.00) if 76%–100% of the network members were physically active. No main associations between the other network characteristics (relationship content and structural aspects of the network) and smoking were found. However, there was an interaction between the percentage of smokers in the network and relationship content (i.e., trust, relationship quality and propensity to discuss problems): positive relationship content in combination with peer smoking may increase the risk of smoking. Women with a high percentage of smokers in their networks were also at higher risk of daily smoking than were men with many smoking friends. Hence, it is important to consider the interplay between peer smoking and other network characteristics on the risk of smoking, where features of networks which traditionally are seen as constructive may occasionally provide the impetus to smoke. Future studies should use longitudinal data to study whether these findings reflect peer selection or peer influence.

  • 57.
    Straatmann, Viviane S.
    et al.
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). University of Liverpool, United Kingdom.
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Oliveira, Aldair J.
    Veiga, Gloria V.
    Rostila, Mikael
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Lopes, Claudia S.
    Stability and bidirectional relationship between physical activity and sedentary behaviours in Brazilian adolescents: Longitudinal findings from a school cohort study2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 1, article id e0211470Article in journal (Refereed)
    Abstract [en]

    Purpose

    We investigated the stability, correlations and bidirectional relationship of light physical activities (PA), moderate and vigorous PA (MVPA), television viewing (TV) and video game/computer use (VG) in Brazilian adolescents.

    Methods

    Adolescent Nutritional Assessment Longitudinal Study-ELANA is a middle school cohort study conducted in Rio de Janeiro-Brazil in 2010-2012. Self-reported data on PA (International Physical Activity Questionnaire-IPAQ) and screen activities were obtained from 810 adolescents (mean ages of 10.9 years old (SD 0.78) for girls; 11 years old (SD 0.85) for boys) to perform autoregressive cross-lagged structural equation models in two time points for PA and three time points for screen activities.

    Results

    There was no significant stability of light PA and MVPA for boys and girls. Moderate stability of screen activities were found for both genders, with a significant coefficient of TV for boys (T1-T2:0.29; T2-T3:0.27 p<0.001); and VG for boys (T1-T2:0.33; T2-T3:0.35 p<0.001) and girls (T1-T2:0.26; T2-T3:0.37 p<0.01). Significant lagged effects were obtained only among girls:light PA had effect on VG (-0.10 p<0.01), as well as in the opposite direction of TV on light PA (-0.03 p<0.01) and TV on MVPA (-0.11 p<0.01).

    Conclusion

    The light PA, MVPA and screen activities (among girls) did not demonstrate stability over time. A warning scenario was suggested by the stability of high amounts of screen activities among boys over time. Screen activities had bidirectional association with light PA and MVPA among girls over time.

  • 58. Straatmann, Viviane S.
    et al.
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Oliviera, Aldair J.
    Rostila, Mikael
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Lopes, Claudia S.
    Cross-lagged structural equation models for the relationship between health-related state and behaviours and body bullying in adolescence: findings from longitudinal study ELANA2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 1, article id e0191253Article in journal (Refereed)
    Abstract [en]

    We investigated the stability and the directionality of being body bullied and a set of four variables– 1) Body Mass Index (BMI), 2) moderate and vigorous physical activity (MVPA), 3) television time (TV) and 4) video game/computer time (VG)-, termed in the present study as ‘health-related state and behaviours (HRSB)’–across adolescence. The Adolescent Nutritional Assessment Longitudinal Study (ELANA) is a cohort study conducted among middle school students from two public and four private schools in Rio de Janeiro-Brazil. We analysed data from 2010 (T1) and 2012 (T2) among 810 adolescents (aged 9–15 at T1). Gender-specific structural equation models (SEM) were estimated, including autoregressive paths for the HRSB and being body bullied over time, correlations at T1 and T2, respectively, and cross-lagged effects. The results presented significant stability coefficients for almost all variables over time in both genders (except for MVPA in boys and girls and TV time among girls). There were positive correlations between BMI and being body bullied, as well as between TV and VG for boys (0.32, p<0.001 and 0.24, p<0.001, respectively) and girls (0.30, p<0.001 and 0.30, p<0.001, respectively) at T1. It remained significant at T2 (boys: 0.18, p<0.05 and 0.16, p<0.01; girls: 0.21, p<0.01 and 0.22, p<0.01, respectively). Examining the cross-lagged paths between being body bullied and HRSB, we observed that the reciprocal model provided the best fit for boys, indicating that BMI at T1 had a significant effect in being body bullied at T2 (0.12, p<0.05) and being body bullied at T1 had an effect on VG at T2 (0.14, p<0.01). Among girls the forward causation model showed the best fit, demonstrating a significant effect of being body bullied at T1 on VG at T2 (0.16, p<0.01). Apart from MVPA, both being body bullying and HRSB were largely stable across adolescence. For boys and girls alike, exposure to being body bullied seemed to increase their time spent on VG, while for boys BMI also predicted being body bullied. This study highlighted the complex interplay between being body bullied and HRSB and the importance of acknowledging gender differences in this context.

  • 59.
    Torssander, Jenny
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI). Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Trajectories of economic, work-, and health-related disadvantage and subsequent mortality risk: Findings from the 1953 Stockholm Birth Cohort2017In: Advances in Life Course Research, ISSN 1569-4909, E-ISSN 1879-6974, Vol. 31, p. 57-67Article in journal (Refereed)
    Abstract [en]

    To experience difficulties such as poverty, joblessness, or mental disease, may not only impair one's current life situation but could also involve increased later-life mortality risks. Although various types of disadvantage often are interrelated, little attention has been paid to the multifaceted interplay between disadvantages and subsequent mortality. We extended the current research by (1) identifying life-course trajectories of economic, work- and health-related disadvantage, and (2) assessing relative mortality risks for different life-course trajectories. The disadvantages included were unemployment, social assistance recipiency, and severe mental illness in 1992-1999, whereas the follow-up of all-cause mortality covered the years 2000-2008. Results based on the Stockholm Birth Cohort study of individuals born 1953, utilizing (1) sequence and (2) survival analyses, revealed seven life-course trajectories of disadvantage, some of which were related to elevated mortality risks. In particular, life courses characterized by persistent and coexisting disadvantages during the 1990s were associated with comparably higher mortality in the 2000s. Conversely, temporary disadvantage, even if characterized by high intensity and/or combined with other difficulties, was not associated with increased mortality risks. To pay simultaneous attention to different types of disadvantages, as well as the routes in and out of them, is thus central for understanding inequalities in mortality.

  • 60. Wall-Wieler, Elizabeth
    et al.
    Almquist, Ylva
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Liu, Can
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Intergenerational transmission of out-of-home care in Sweden: A population-based cohort study2018In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 83, p. 42-51Article in journal (Refereed)
    Abstract [en]

    The objective of this study is to examine the intergenerational transmission of out-of-home care. This population-based study used data from the Swedish National Registers and included all children born in Sweden between 1990 and 2012 (followed for up to 13 years), whose parents were both born in Sweden between 1973 and 1980 (278 327 children; 145 935 mothers; 146 896 fathers). Cox regression models are used to obtain crude and adjusted hazard ratios (HR) of OHC placement among children based on parents’ history of OHC. Compared with children whose parents both did not have a history of OHC, the risk of being placed in OHC was greater when both parents spent time in OHC (crude HR = 48.70, 95% CI 41.46–57.21; adjusted HR = 3.04, 95% CI = 2.54–3.64), however, children who had only one parent who spent time in care were also at higher risk (mothers only adjusted HR = 2.37, 95% CI = 2.08–2.70; fathers only adjusted HR = 1.33, 95% CI = 1.13–1.55). The crude rate of placement in OHC was highest for children whose parents were placed in care during adolescence, but after adjusting for social and behavioral covariates, children whose parents were in care in early childhood were at greater risk of OHC than children whose parents were in care in adolescence. To reduce this intergenerational transmission of OHC, more supports should be provided to parents who spent time in OHC to ensure a successful transition to parenthood.

  • 61. Zetterström Dahlqvist, Heléne
    et al.
    Landstedt, Evelina
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Gillander Gådin, Katja
    A non-randomised pragmatic trial of a school-based group cognitive-behavioural programme for preventing depression in girls2017In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 76, article id 1396146Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the effectiveness of the DISA-programme in preventing depressive symptoms (DS) in adolescent girls, as implemented in a real-world school setting, accounting for baseline socioeconomic and psychosocial factors, and to investigate whether the effects of these baseline variables on DS differed between intervention participants and non-participants. In this non-randomised pragmatic trial, an electronic questionnaire was disseminated in 2011 (baseline) and 2012 (follow-up) in schools in one municipality in northern Sweden. Pupils (total n=275; intervention participants identified in the questionnaire: n=53; non-participants: n=222) were 14-15 years old at baseline. The groups were compared by means of SEM. DISA could not predict differences in DS at follow-up in this real-life setting. In the overall sample, sexual harassment victimisation (SH) at baseline was associated with DS at follow-up and the estimate for SH increased in the DISA-participants compared to the overall sample.

  • 62.
    Östberg, Viveca
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Almquist, Ylva B.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Folkesson, Lisa
    Stockholm University, Faculty of Social Sciences, Department of Psychology. 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).
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    The Complexity of Stress in Mid-Adolescent Girls and Boys2015In: Child Indicators Research, ISSN 1874-897X, E-ISSN 1874-8988, Vol. 8, no 2, p. 403-423Article in journal (Refereed)
    Abstract [en]

    In many Western countries adolescents, especially girls, report high levels of stress and stress-related health complaints. In this study we investigate the concept of stress in a group of 14-15 year-olds (grade 8 in two Stockholm schools) using a multiple methods approach. The aim is to analyse stress, and gender differences in stress, as indicated by a measure of perceived stress (questionnaires, n = 212), the diurnal variation in the biomarker cortisol (saliva samples, n = 108) and the students' own accounts of stress (semi-structured interviews, n = 49). The results were generated within the traditional framework of each method and integrated at the point of interpretation. The hypothesis that adolescent girls experience more stress than boys was confirmed by all methods used. In the questionnaire, the most commonly experienced aspects of perceived stress were the same among girls and boys, but girls consistently reported higher frequencies. The saliva samples showed that girls had greater cortisol output in the morning. In the individual semi-structured interviews, girls and boys discussed stress in similar ways but both acknowledged a gender gap to the disadvantage of girls. The results as a whole suggests an interpretation of gender differences that focuses girls' attitudes, perceived expectations and coping strategies in relation to school performance, with their focus on achievement, marks, hard work, and worries about the future. The findings point to a need of an increased awareness about the role of perceived expectations in the stress process, and that these expectations and their impact on stress may differ by the gender of the student.

  • 63.
    Östberg, Viveca
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Almquist, Ylva B.
    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.
    Brolin Låftman, Sara
    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).
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Triangulation of stress in adolescence2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no supplement 2, p. 220-220Article in journal (Refereed)
    Abstract [en]

    Large scale surveys show that perceived stress and stress-related complaints are common among young people. Perceived stress increase with age and are more common in girls than boys, resulting in late adolescent girls reporting the highest frequencies. The knowledge is however more limited regarding other measurements and meanings of stress. The purpose of this study is to use a small-scale multiple methods data collection to perform an empirical triangulation of stress in the age group 14–15 years, i.e. to analyse stress, and gender differences in stress, as it appears in questionnaires, biomarkers and interviews within the same population. The study population includes all pupils in the 8th and 9th grades (ages 14–16 years) in two elementary schools in Stockholm, Sweden (n = 545). The data collection was divided into three parts where information was gathered through class room questionnaires (n = 413), saliva sampling (5 time points during the day, number of students delivering complete samples = 190) and semi-structured qualitative interviews (49 pupils in grade 8, mean length 50 minutes).

    In the questionnaires, girls consistently report higher levels of perceived stress. This is true for the activation scale (mean value boys = 2.51, girls = 3.11, p < 0.00) and the pressure scale (boys = 2.62, girls = 3.33, p < 0.00). According to the saliva sampling, girls have higher cortisol concentration both at awakening and 30 minutes later (p < 0.00). According to the qualitative interviews, no distinct differences in boys’ and girls’ associations with the word “stress” were found. However, both male and female interviewees had a perception of girls being more stressed about schoolwork than boys. Many times they linked this to girls way of thinking or coping with life demands, including worries about the future. In conclusion, the picture of adolescent girls being more stressed than boys is largely confirmed by all methods used here.

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