Additional file 2. Table S2 Autoregressive standardized effects and correlations (with SE) betwee... more Additional file 2. Table S2 Autoregressive standardized effects and correlations (with SE) between personality traits and subjective well-being (SWB). Analyses conducted with full information maximum likelihood (FIML) estimation.
Background The DECIDE (Developing and Evaluating Communication Strategies to Support Informed Dec... more Background The DECIDE (Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence) framework aims to facilitate decision making and to improve dissemination and implementation of recommendations in the health care and public health sector. The aim of this study was to investigate if the DECIDE framework is applicable in the public health field in Sweden. Methods The DECIDE framework was presented and discussed in interviews with stakeholders and governmental organisations and tested in stakeholder panels. Content analyses were performed. Findings The informants were positive to the DECIDE framework. However, two criteria regarding individual autonomy and method sustainability were felt to be missing. Importance of the composition of the DECIDE stakeholder panel was highlighted, as was the significant role of the chair. Discussion The international DECIDE health system and public health evidence to recommendation framework might be...
Introduction Subjective well-being (SWB) is a contributing factor for building resilience and a r... more Introduction Subjective well-being (SWB) is a contributing factor for building resilience and a resource for positive outcomes, e.g. study achievement and work performance. Earlier studies have examined associations between and prospective effects of personality traits on SWB, but few addressed the role that SWB plays in formation of personality over time. The purpose of our study was to examine associations and prospective effects of SWB on personality traits and vice versa in a cohort sample of secondary school students in Sweden who completed self-reported measures of SWB and personality traits at baseline (N = 446, 76% females) and at 15–18 month follow-up (N = 283, 71% females). Methods SWB was defined and measured by the WHO-5 Well-being Index and the Satisfaction with Life Scale. The Big Five Inventory was used to measure personality traits. Autoregressive models were used to analyse associations and potential prospective effects of SWB on personality traits and vice versa. R...
Trots att majoriteten av homosexuella, bisexuella och transpersoner uppger att de har ett gott al... more Trots att majoriteten av homosexuella, bisexuella och transpersoner uppger att de har ett gott allmänt hälsotillstånd, visar flera internationella undersökningar att både den allmänna och den psykiska hälsan är sämre bland homo-och bisexuella kvinnor och män jämfört med heterosexuella (Bailey, 1999;
Background: The dual continuum model suggests that positive mental health not only implies the ab... more Background: The dual continuum model suggests that positive mental health not only implies the absence of mental illness, but also constitutes an entity of its own. Measures that encompass both positive and negative mental health in young adults are rare. Thus, we assessed whether dimensions corresponding to positive and negative mental health could be identified in a sample of young individuals. Additionally, we explored how such dimensions were associated with potential health-related factors. Methods: We obtained data from the Swedish National Public Health Survey 2004-2009 (23,394 women, 18,274 men, aged 16-29 years). We used exploratory factor analysis (EFA) to identify relevant factors revealed by the 12-item General Health Questionnaire (GHQ-12) and confirmatory factor analysis (CFA) to verify the factor structure. We tested the significance of the difference between effects of potential health-related factors on positive mental health (PMH) and negative mental health (NMH). Results: The EFA for the GHQ-12 revealed a two factor model with negative items that had high positive loadings on one factor and lower negative loadings on the other factor. The positive items had loading trends that were opposite those of the negative items. The fit of this model was supported by the CFA, which yielded a significantly better match than a unidimensional model. When we investigated the associations between GHQ-scores and potential predictors of health, we found that most potential predictors had significant and opposing effects on both PMH and NMH; with the strongest effects from suicidal ideation and perceived humiliation. Conclusions: Our results could be seen to indicate that positive and negative mental health are distinct and complementary constructs. Still, the results of our factor analysis may specifically reflect the wording of the items. We conclude that the GHQ-12 is an appropriate tool for its original purpose, to detect "psychiatric morbidity". More refined measures, including predictors of health, are needed to assess PMH and validate the bidimensionality hypothesis.
Background: Since 1988, self-reported mental health problems in Sweden have increased more among ... more Background: Since 1988, self-reported mental health problems in Sweden have increased more among young people than in any other age group. Young adults aged 18-29 with minor mental health problems were welcomed to four (at most) counselling sessions led by psychotherapists. The present study aimed to evaluate the method's appropriateness and usefulness. Methods: The study population was recruited consecutively during six months (N = 74) and consisted of 59 women and 15 men. Fifty-one, 46 women and five men, met the criterion for a personal semi-structured interview three months post intervention. Self-assessed health data were collected on three occasions using the General Health Questionnaire (GHQ-12), Pearlin's Personal Mastery Scale and two items from the Swedish Living Conditions Surveys. Thirteen women and six men were not statistically assessed due to incomplete data, but were interviewed by telephone. Four men refused to be interviewed and became dropouts. Results: The largest group of the study population had long been troubled by their problem(s): 43 percent for over three years and 28 percent for over one year. Among those personally interviewed, 76 percent reported psychological distress (> 3 GHQ points) before the counselling. After the counselling, GHQ-12 distress decreased by 50 percent while mastery and perceived health status increased significantly. A majority experienced an improved life situation, found out something new about themselves and could make use of the sessions afterwards. Personal participant session contentment was about 70 percent and all counsellees would recommend the intervention to a friend. Those interviewed by telephone were not statistically assessed due to incomplete health data. Their personal contentment was just under 50 percent, though all except one would recommend the counselling to a friend. Their expectations of the intervention were more result-orientated compared to the more process-directed personally-interviewed group. Conclusion: This evaluation shows a clear improvement in self-rated mental and general health, mastery and control in the group completing the study agreement. The intervention seems to be effective for young adults with minor mental health problems, but due to the skewed genderdistribution it is unclear if the method is appropriate for men. After the proposed internal quality improvements, this short-term counselling could enhance mental and general health among young people.
Background: Mental health problems in young people, i.e. those self-reported as well as registere... more Background: Mental health problems in young people, i.e. those self-reported as well as registered diagnoses, have been of concern for decades. For Western societies, most studies indicate a rise in symptoms, but also in diagnoses of depression, anxiety and stress in younger age groups since the 1990s. The increase follows a pattern of societal changes, namely a prolongation of young people’s years in education, later entry into the labour market with frequently insecure conditions, longerstanding time without own housing and postponed building of partnership and family. A large number of studies focusing on young people’s mental ill health have been carried out, but less attention has been paid to positive mental health (PMH) in the age group of 16-29 years. PMH allows a view where building on strengths, capacity and health promotion is accentuated rather than leaning on deficit models and prevention of mental ill health. A balanced consideration of both aspects of mental health sh...
Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-m... more Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-matched peers. Mental ill health among students is associated with impaired academic achievement, worse occupational preparedness, and lower future occupational performance. Research on mental health promoting and mental ill health preventing interventions has shown promising short-term effects, though the sustainability of intervention benefits deserve closer attention. We aimed to identify, appraise and summarize existing data from randomized control trials (RCTs) reporting on whether the effects of mental health promoting and mental ill health preventing interventions were sustained at least three months post-intervention, and to analyze how the effects vary for different outcomes in relation to follow-up length. Further, we aimed to assess whether the effect sustainability varied by intervention type, study-level determinants and of participant characteristics. A systematic search in ...
The aim of this study was to investigate the associations between a series of empirically known r... more The aim of this study was to investigate the associations between a series of empirically known risk and protective factors and suicidality among trans people in Sweden. Methods: Participants were self-selected anonymously to a web-based survey conducted in 2014. Univariable and multivariable logistic regression analyses were performed to assess associations between contributing factors and suicide ideation in the past 12 months and lifetime suicide attempts. Results: The analysis included 796 trans individuals, between 15 and 94 years of age, who live in Sweden. A total of 37% of respondents reported that they have seriously considered suicide during the past 12 months and 32% had ever attempted a suicide. Offensive treatment during the past three months and lifetime exposure to transrelated violence were significantly associated with suicidality. Less satisfaction with contacts with friends and acquaintances and with one's own psychological wellbeing were associated with suicide ideation in the past 12 months. Lack of practical support was associated with lifetime suicide attempts. Conclusions: Our findings show that suicidality is directly correlated with trans-related victimization. Preventing targeted victimization is, therefore, a key preventive intervention against this elevated suicidality.
International Journal of Environmental Research and Public Health, Dec 14, 2018
Mental health has decreased in young people since the 1990s, and mental health promotion is an ur... more Mental health has decreased in young people since the 1990s, and mental health promotion is an urgent matter. A first step is to identify which social determinants could be of importance for intervention. We used the Stockholm Public Health Cohort, a longitudinal population-based health survey, completed by 31,000 inhabitants in the Stockholm County. We focused on the 18-29 age group, n = 3373 (60% females, 40% males) and aimed at assessing which social determinants predict stable mental health, measured as scoring <3 points on the General Health Questionnaire 12 at all time points: 2002, 2007, 2010, and 2014. Forty-six percent of males and 36% of females reported stable mental health. Among the 17 predictors on sociodemographics, socioeconomics, social capital, health behavior, and victimization, six predicted stable mental health in the following order: occupation and especially employment, emotional support, male gender, being born in Sweden, absence of financial strain, and consumption of fruit and berries. In the 30-84 age group, 66% males and 55% females reported stable mental health. Nine determinants in the following rank predicted stable mental health: absence of financial strain, occupation and especially being self-employed, emotional support, male gender, physical activity, instrumental support, interpersonal trust, community trust, and absence of hazardous alcohol consumption. Interaction analysis showed significant difference between the younger and older group regarding physical activity and absence of financial strain with importance being higher for the older group. Our findings indicate that the determinants of health differ across the life-course with fewer predictors related to social capital and health behavior in the younger group compared to the older. We conclude that health-promoting interventions should be lifespan-sensitive.
Additional file 2. Table S2 Autoregressive standardized effects and correlations (with SE) betwee... more Additional file 2. Table S2 Autoregressive standardized effects and correlations (with SE) between personality traits and subjective well-being (SWB). Analyses conducted with full information maximum likelihood (FIML) estimation.
Background The DECIDE (Developing and Evaluating Communication Strategies to Support Informed Dec... more Background The DECIDE (Developing and Evaluating Communication Strategies to Support Informed Decisions and Practice Based on Evidence) framework aims to facilitate decision making and to improve dissemination and implementation of recommendations in the health care and public health sector. The aim of this study was to investigate if the DECIDE framework is applicable in the public health field in Sweden. Methods The DECIDE framework was presented and discussed in interviews with stakeholders and governmental organisations and tested in stakeholder panels. Content analyses were performed. Findings The informants were positive to the DECIDE framework. However, two criteria regarding individual autonomy and method sustainability were felt to be missing. Importance of the composition of the DECIDE stakeholder panel was highlighted, as was the significant role of the chair. Discussion The international DECIDE health system and public health evidence to recommendation framework might be...
Introduction Subjective well-being (SWB) is a contributing factor for building resilience and a r... more Introduction Subjective well-being (SWB) is a contributing factor for building resilience and a resource for positive outcomes, e.g. study achievement and work performance. Earlier studies have examined associations between and prospective effects of personality traits on SWB, but few addressed the role that SWB plays in formation of personality over time. The purpose of our study was to examine associations and prospective effects of SWB on personality traits and vice versa in a cohort sample of secondary school students in Sweden who completed self-reported measures of SWB and personality traits at baseline (N = 446, 76% females) and at 15–18 month follow-up (N = 283, 71% females). Methods SWB was defined and measured by the WHO-5 Well-being Index and the Satisfaction with Life Scale. The Big Five Inventory was used to measure personality traits. Autoregressive models were used to analyse associations and potential prospective effects of SWB on personality traits and vice versa. R...
Trots att majoriteten av homosexuella, bisexuella och transpersoner uppger att de har ett gott al... more Trots att majoriteten av homosexuella, bisexuella och transpersoner uppger att de har ett gott allmänt hälsotillstånd, visar flera internationella undersökningar att både den allmänna och den psykiska hälsan är sämre bland homo-och bisexuella kvinnor och män jämfört med heterosexuella (Bailey, 1999;
Background: The dual continuum model suggests that positive mental health not only implies the ab... more Background: The dual continuum model suggests that positive mental health not only implies the absence of mental illness, but also constitutes an entity of its own. Measures that encompass both positive and negative mental health in young adults are rare. Thus, we assessed whether dimensions corresponding to positive and negative mental health could be identified in a sample of young individuals. Additionally, we explored how such dimensions were associated with potential health-related factors. Methods: We obtained data from the Swedish National Public Health Survey 2004-2009 (23,394 women, 18,274 men, aged 16-29 years). We used exploratory factor analysis (EFA) to identify relevant factors revealed by the 12-item General Health Questionnaire (GHQ-12) and confirmatory factor analysis (CFA) to verify the factor structure. We tested the significance of the difference between effects of potential health-related factors on positive mental health (PMH) and negative mental health (NMH). Results: The EFA for the GHQ-12 revealed a two factor model with negative items that had high positive loadings on one factor and lower negative loadings on the other factor. The positive items had loading trends that were opposite those of the negative items. The fit of this model was supported by the CFA, which yielded a significantly better match than a unidimensional model. When we investigated the associations between GHQ-scores and potential predictors of health, we found that most potential predictors had significant and opposing effects on both PMH and NMH; with the strongest effects from suicidal ideation and perceived humiliation. Conclusions: Our results could be seen to indicate that positive and negative mental health are distinct and complementary constructs. Still, the results of our factor analysis may specifically reflect the wording of the items. We conclude that the GHQ-12 is an appropriate tool for its original purpose, to detect "psychiatric morbidity". More refined measures, including predictors of health, are needed to assess PMH and validate the bidimensionality hypothesis.
Background: Since 1988, self-reported mental health problems in Sweden have increased more among ... more Background: Since 1988, self-reported mental health problems in Sweden have increased more among young people than in any other age group. Young adults aged 18-29 with minor mental health problems were welcomed to four (at most) counselling sessions led by psychotherapists. The present study aimed to evaluate the method's appropriateness and usefulness. Methods: The study population was recruited consecutively during six months (N = 74) and consisted of 59 women and 15 men. Fifty-one, 46 women and five men, met the criterion for a personal semi-structured interview three months post intervention. Self-assessed health data were collected on three occasions using the General Health Questionnaire (GHQ-12), Pearlin's Personal Mastery Scale and two items from the Swedish Living Conditions Surveys. Thirteen women and six men were not statistically assessed due to incomplete data, but were interviewed by telephone. Four men refused to be interviewed and became dropouts. Results: The largest group of the study population had long been troubled by their problem(s): 43 percent for over three years and 28 percent for over one year. Among those personally interviewed, 76 percent reported psychological distress (> 3 GHQ points) before the counselling. After the counselling, GHQ-12 distress decreased by 50 percent while mastery and perceived health status increased significantly. A majority experienced an improved life situation, found out something new about themselves and could make use of the sessions afterwards. Personal participant session contentment was about 70 percent and all counsellees would recommend the intervention to a friend. Those interviewed by telephone were not statistically assessed due to incomplete health data. Their personal contentment was just under 50 percent, though all except one would recommend the counselling to a friend. Their expectations of the intervention were more result-orientated compared to the more process-directed personally-interviewed group. Conclusion: This evaluation shows a clear improvement in self-rated mental and general health, mastery and control in the group completing the study agreement. The intervention seems to be effective for young adults with minor mental health problems, but due to the skewed genderdistribution it is unclear if the method is appropriate for men. After the proposed internal quality improvements, this short-term counselling could enhance mental and general health among young people.
Background: Mental health problems in young people, i.e. those self-reported as well as registere... more Background: Mental health problems in young people, i.e. those self-reported as well as registered diagnoses, have been of concern for decades. For Western societies, most studies indicate a rise in symptoms, but also in diagnoses of depression, anxiety and stress in younger age groups since the 1990s. The increase follows a pattern of societal changes, namely a prolongation of young people’s years in education, later entry into the labour market with frequently insecure conditions, longerstanding time without own housing and postponed building of partnership and family. A large number of studies focusing on young people’s mental ill health have been carried out, but less attention has been paid to positive mental health (PMH) in the age group of 16-29 years. PMH allows a view where building on strengths, capacity and health promotion is accentuated rather than leaning on deficit models and prevention of mental ill health. A balanced consideration of both aspects of mental health sh...
Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-m... more Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-matched peers. Mental ill health among students is associated with impaired academic achievement, worse occupational preparedness, and lower future occupational performance. Research on mental health promoting and mental ill health preventing interventions has shown promising short-term effects, though the sustainability of intervention benefits deserve closer attention. We aimed to identify, appraise and summarize existing data from randomized control trials (RCTs) reporting on whether the effects of mental health promoting and mental ill health preventing interventions were sustained at least three months post-intervention, and to analyze how the effects vary for different outcomes in relation to follow-up length. Further, we aimed to assess whether the effect sustainability varied by intervention type, study-level determinants and of participant characteristics. A systematic search in ...
The aim of this study was to investigate the associations between a series of empirically known r... more The aim of this study was to investigate the associations between a series of empirically known risk and protective factors and suicidality among trans people in Sweden. Methods: Participants were self-selected anonymously to a web-based survey conducted in 2014. Univariable and multivariable logistic regression analyses were performed to assess associations between contributing factors and suicide ideation in the past 12 months and lifetime suicide attempts. Results: The analysis included 796 trans individuals, between 15 and 94 years of age, who live in Sweden. A total of 37% of respondents reported that they have seriously considered suicide during the past 12 months and 32% had ever attempted a suicide. Offensive treatment during the past three months and lifetime exposure to transrelated violence were significantly associated with suicidality. Less satisfaction with contacts with friends and acquaintances and with one's own psychological wellbeing were associated with suicide ideation in the past 12 months. Lack of practical support was associated with lifetime suicide attempts. Conclusions: Our findings show that suicidality is directly correlated with trans-related victimization. Preventing targeted victimization is, therefore, a key preventive intervention against this elevated suicidality.
International Journal of Environmental Research and Public Health, Dec 14, 2018
Mental health has decreased in young people since the 1990s, and mental health promotion is an ur... more Mental health has decreased in young people since the 1990s, and mental health promotion is an urgent matter. A first step is to identify which social determinants could be of importance for intervention. We used the Stockholm Public Health Cohort, a longitudinal population-based health survey, completed by 31,000 inhabitants in the Stockholm County. We focused on the 18-29 age group, n = 3373 (60% females, 40% males) and aimed at assessing which social determinants predict stable mental health, measured as scoring <3 points on the General Health Questionnaire 12 at all time points: 2002, 2007, 2010, and 2014. Forty-six percent of males and 36% of females reported stable mental health. Among the 17 predictors on sociodemographics, socioeconomics, social capital, health behavior, and victimization, six predicted stable mental health in the following order: occupation and especially employment, emotional support, male gender, being born in Sweden, absence of financial strain, and consumption of fruit and berries. In the 30-84 age group, 66% males and 55% females reported stable mental health. Nine determinants in the following rank predicted stable mental health: absence of financial strain, occupation and especially being self-employed, emotional support, male gender, physical activity, instrumental support, interpersonal trust, community trust, and absence of hazardous alcohol consumption. Interaction analysis showed significant difference between the younger and older group regarding physical activity and absence of financial strain with importance being higher for the older group. Our findings indicate that the determinants of health differ across the life-course with fewer predictors related to social capital and health behavior in the younger group compared to the older. We conclude that health-promoting interventions should be lifespan-sensitive.
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Papers by Regina Winzer