Despite a well-documented gender pattern of adolescent mental health, public health research investigating possible influencing factors from a gender-theoretical approach is scarce. This study aimed to explore what factors and circumstances are related to adolescent mental health and to apply a gender analysis to the findings in order to improve the understanding of the relationships between life circumstances and the gendered patterning of mental health among young people.   The study population was 16-19-year-old Swedish students and data was collected by means of focus groups (N=29) and self-administered questionnaires (N=1,663, 78.3% response rate) in school settings. Mental health problems were defined in a broad sense including the adolescents’ own understandings, perceived stress, psychological distress and deliberate self-harm.   The mental health problems of perceived stress, psychological distress and deliberate self-harm were twice as common among girls as boys. The findings suggest that adolescent mental health is associated with the life circumstances of social relationships, demands and responsibility taking and experiences of violence and harassment.  Supportive relationships with friends, family and teachers were found to be of importance to positive mental health, whereas poor social relationships, loneliness and lack of influence were associated with mental health problems.  Perceived demands and responsibility taking regarding school work, relationships, future plans, appearance and financial issues were strongly related to mental health problems, particularly among girls regardless of social class. The results indicate that physical violence, sexual assault, bullying and sexual harassment are severe risk factors for mental health problems in young people. Boys and girls experienced different types of violence, and the victim-perpetrator relationships of physical violence differed. These diverging experiences appeared to influence the associations with mental health problems in boys and girls.   A gender analysis provides the tools to gain knowledge about the ways that boys’ and girls’ lives are shaped by gender relations and constructions at different levels in society and how these life circumstances represent risk- or protective factors for mental health. For example, unequal power structures and the ways girls are expected to ‘do’ femininity likely influence their life circumstances in ways that place them at greater risk of mental health problems. Hegemonic constructions of masculinity and advantaged positions likely contribute to life circumstances that are positive for mental health but are also implying risk factors for poor mental health among boys, e.g., violence. It is also important to recognise how the intertwined cultural and structural aspects of gender and social class influence the lives and mental health of boys and girls. In conclusion, gendered and class-related mechanisms at the different levels in society influence the distribution of risk factors unevenly among boys and girls, which could be a possible explanation for the gender differences in reports of perceived stress, psychological distress and deliberate self-harm.   The likelihood of gender and socioeconomic differences in mental health problems should be taken into account in prevention and health promotion strategies at all levels in society. A greater awareness about gender relations and the gendered social circumstances under which young people live is required. The school environment is an important arena with respect to prevention and health promotion. There is also a need for a joint action against violence and harassment at all levels in society. Implications do not only concern young people; social policy and legislation should focus on reducing gender and class inequalities in general. / Sammanfattning Svensk titel: Livsvillkor och ungdomars psykiska hälsa: uppfattningar, associationer och en genusanalys.   Trots ett väldokumenterat genusmönster i ungdomars psykiska hälsa finns det en kunskapslucka i den folkhälsovetenskapliga forskningen avseende genusteoretiska analyser av sambanden mellan ungas livsvillkor och psykisk hälsa. Föreliggande studie syftade till att undersöka vilka faktorer och omständigheter som är relaterade till psykiska problem, samt att analysera fynden ur ett genusperspektiv för att fördjupa förståelsen av relationerna mellan ungas livsvillkor och genusmönster i psykiska hälsa.   Studiepopulationen var gymnasielever i åldern 16-19 år. Studien genomfördes i skolmiljö och data insamlades genom fokusgrupper (N=29) och en enkätstudie (N=1,663, 78.3% svarsfrekvens). En bred definition av psykisk ohälsa tillämpades vilken representerades av ungdomarnas egen förståelse, samt de psykiska problemen upplevd stress, psykiska besvär samt självskadebeteende.   Resultaten visade att stress, psykiska besvär och självskadebeteende var dubbelt så vanligt bland flickor som bland pojkar. Psykiska problem var relaterade till livsvillkoren sociala relationer, krav och ansvarstagande samt utsatthet för våld och trakasserier. Stödjande relationer med vänner, familj och lärare var av stor betydelse för psykisk hälsa medan dåliga relationer, ensamhet och brist på inflytande var relaterat till psykiska problem. Psykiska problem var starkt kopplade till erfarenheter av höga krav och ansvarstagande avseende skolarbete, relationer, framtidsplaner, utseende och ekonomi, i synnerhet bland flickor oavsett socioekonomisk bakgrund. Resultaten indikerar att olika former av våld och trakasserier är allvarliga riskfaktorer för psykiska problem och att flickors och pojkars skiljda erfarenheter av olika former av våld samt relationen till förövaren, kan vara relaterade till skillnader i psykiska problem.   Genusanalysen av resultaten föreslår att flickors livsvillkor påverkas av ojämlika maktstrukturer och konstruktioner av femininitet och att dessa livsvillkor bidrar till en ökad risk för psykisk ohälsa bland flickor. Livsvillkor kopplade till manlig överordning och hegemoniska konstruktioner av maskulinitet influerar sannolikt pojkars psykiska hälsa positivt. Dessa villkor kan dock också innebära risk faktorer för psykiska problem, t.ex. i fråga om våld. Studien uppmärksammar även hur kulturella och strukturella aspekter av både genus och social klass kan påverka livsvillkor och psykisk hälsa för pojkar och flickor. Studiens slutsats är att genusifierade och klassrelaterade mekanismer på olika nivåer i samhället bidrar till en skev fördelning av riskfaktorer för psykiska problem vilket kan vara en möjlig förklaring till skillnaderna mellan pojkar och flickor i fråga om upplevd stress, psykiska besvär och självskadebeteende.   Genus- och socioekonomiska skillnader i psykiska problem bör tas i beaktande i preventivt och hälsofrämjande arbete på alla nivåer i samhället. Detsamma gäller för en ökad medvetenhet om hur ungas livsvillkor är relaterade till psykisk hälsa och hur dessa villkor är genus- och klassrelaterade. Studien uppmärksammar skolan som en viktig arena för preventivt och hälsofrämjande arbete samt att gemensamma insatser krävs på olika arenor för att motverka våld och trakasserier. Implikationer av studien omfattar även generella samhällspolitiska insatser för minskad ojämlikhet. Nyckelord: Stress; psykiska besvär; självskadebeteende; gymnasieelever; maskulinitet; femininitet; sociala determinanter; sociala relationer; krav; ansvarstagande; våld och trakasserier; skola. / Forskarutbildningsämne: Hälsovetenskap.

Thesis (Ph. D.)--University of Oklahoma. / Includes bibliographical references (leaves 148-162).

Medical students experience elevated levels of psychological distress and they are reluctant to seek professional help for mental health problems. They are also reticent to notify authorities about colleagues experiencing psychological distress. Yet, young people are more likely to seek help from peers than from any other source and we know very little about the help that these peers provide to their distressed colleagues. The current research explored medical students’ approaches to colleagues experiencing psychological distress: firstly, to determine whether they notice the distress of colleagues; secondly, to explore what determines consideration to intervene and help colleagues; and thirdly, the range of helping behaviours provided. Comparisons were made with students from other professional tertiary disciplines. Students from all six years of an undergraduate medical course were compared with convenience samples from Psychology, Law and Mechanical Engineering at The University of Adelaide. Students were recruited for one of three studies which employed a variety of measures, including the Kessler Measure of Psychological Distress (K10), a Retrospective Helping Behaviour Instrument (RHBI) and a Hypothetical Helping Behaviour Instrument (HHBI). Psychological distress (as determined by the K10) among the disciplines surveyed (N = 949) was 4.4 times that of age-matched population normative data. Despite this high rate of distress, students consistently rated the distress of their colleagues as significantly lower than the colleagues’ own self ratings. All disciplines were equally inaccurate in detecting the distress of their colleagues. Analysis of hypothetical helping behaviours, in response to a vignette, indicated that medical students offered more help to non-medical students than they did to fellow medical students; however, the quality of help delivered to fellow medical students was superior. Non-medical students offered more help to medical students than they did to students from their own discipline, but the quality of help they offered did not change between the two disciplines. Analysis of the mixed method RHBI indicated that discipline had an effect on the types of help provided to distressed colleagues, the reasons for and for not helping a colleague, and general helping concerns. Three main types of help were provided: social support, academic assistance and therapeutic assistance. Medical students from Year 3 onwards offered a diverse array of helping behaviours, whilst law and mechanical engineering students primarily offered academic support. Help was considered more frequently than it was actually given and reasons for and against providing help were associated with belief or doubt about the benefit of helping, positive or detrimental effects for the helper, the closeness or lack of friendship with the helpee, and confidence to help. This research has improved our understanding of the mechanisms that produce helping behaviour. It has also provided a rich inventory of the type of help offered by the medical students and by other tertiary students. This knowledge is crucial in the development of effective approaches to assisting distressed students, particularly in regards to the theoretical and practical development of peer support programmes. Peer support programmes take into account young peoples’ preferences to speak to peers. Peer support programmes that build on the students’ existing behaviours and resources (those behaviours identified in this research) have an increased chance of acceptance and validity. Such programmes may offer a viable adjunct to formal support services and, more importantly, may have far reaching effects in breaking down the stigma of mental health problems within professions such as Medicine. / Thesis (Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 2009

Medical students experience elevated levels of psychological distress and they are reluctant to seek professional help for mental health problems. They are also reticent to notify authorities about colleagues experiencing psychological distress. Yet, young people are more likely to seek help from peers than from any other source and we know very little about the help that these peers provide to their distressed colleagues. The current research explored medical students’ approaches to colleagues experiencing psychological distress: firstly, to determine whether they notice the distress of colleagues; secondly, to explore what determines consideration to intervene and help colleagues; and thirdly, the range of helping behaviours provided. Comparisons were made with students from other professional tertiary disciplines. Students from all six years of an undergraduate medical course were compared with convenience samples from Psychology, Law and Mechanical Engineering at The University of Adelaide. Students were recruited for one of three studies which employed a variety of measures, including the Kessler Measure of Psychological Distress (K10), a Retrospective Helping Behaviour Instrument (RHBI) and a Hypothetical Helping Behaviour Instrument (HHBI). Psychological distress (as determined by the K10) among the disciplines surveyed (N = 949) was 4.4 times that of age-matched population normative data. Despite this high rate of distress, students consistently rated the distress of their colleagues as significantly lower than the colleagues’ own self ratings. All disciplines were equally inaccurate in detecting the distress of their colleagues. Analysis of hypothetical helping behaviours, in response to a vignette, indicated that medical students offered more help to non-medical students than they did to fellow medical students; however, the quality of help delivered to fellow medical students was superior. Non-medical students offered more help to medical students than they did to students from their own discipline, but the quality of help they offered did not change between the two disciplines. Analysis of the mixed method RHBI indicated that discipline had an effect on the types of help provided to distressed colleagues, the reasons for and for not helping a colleague, and general helping concerns. Three main types of help were provided: social support, academic assistance and therapeutic assistance. Medical students from Year 3 onwards offered a diverse array of helping behaviours, whilst law and mechanical engineering students primarily offered academic support. Help was considered more frequently than it was actually given and reasons for and against providing help were associated with belief or doubt about the benefit of helping, positive or detrimental effects for the helper, the closeness or lack of friendship with the helpee, and confidence to help. This research has improved our understanding of the mechanisms that produce helping behaviour. It has also provided a rich inventory of the type of help offered by the medical students and by other tertiary students. This knowledge is crucial in the development of effective approaches to assisting distressed students, particularly in regards to the theoretical and practical development of peer support programmes. Peer support programmes take into account young peoples’ preferences to speak to peers. Peer support programmes that build on the students’ existing behaviours and resources (those behaviours identified in this research) have an increased chance of acceptance and validity. Such programmes may offer a viable adjunct to formal support services and, more importantly, may have far reaching effects in breaking down the stigma of mental health problems within professions such as Medicine. / Thesis (Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 2009

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Thesis (Ph.D.)--University of Tennessee Health Science Center, 2006. / Title from title page screen (viewed on October 26, 2007 ). Research advisor: Mona Newsome Wicks, Ph.D., RN. Document formatted into pages (xii, 174 p. : ill.) Vita. Abstract. Includes bibliographical references (p. 115-132).

Diss. (sammanfattning) Linköping : Univ., 2004. / Härtill 6 uppsatser.

Lic. (sammanfattning) Göteborg : Univ., 2004. / Härtill 2 uppsatser.

Diss. Göteborg : University, 2006. / Härtill 4 uppsatser.

Para citação, referenciar também o artigo: Adaptação cultural e validação para a língua portuguesa da Parental Stress Scale: Neonatal Intensive Care Unit (PSS:NICU) (http://repositorio.unifesp.br/handle/11600/6920) conforme determinação da autora. / Made available in DSpace on 2015-07-22T20:50:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-06-24 / Introdução: a internação de um recém-nascido na Unidade de Terapia Intensiva Neonatal (UTIN) é um acontecimento inesperado e assustador com o qual os pais não estavam preparados para lidar.Esse evento, que gera sofrimento na família, traz para os profissionais da saúde uma demanda de cuidado, cujo intuito é amenizar as repercussões dessa hospitalização no cotidiano da família. Como enfermeira neonatologista, a autora percebe o estrese dos pais no ambiente neonatal e a necessidade de instrumentos objetivos para identificá-lo e para elaborar as intervenções de enfermagem. No Brasil não encontramos um instrumento para avaliar este tipo de estresse. A escala Parenteral Stress Scale Neonatal Intensive Care Unit(PSS:NICU) é um instrumento desenvolvido por Margaret S. Milles nos Estados Unidos, cuja finalidade é avaliar esse tipo de estresse, tem sido utilizado em vários países. Objetivo: fazer a tradução, a adaptação cultural e a validação da PSS:NICU na língua portugues. Método: fora, utilizadas as etapas de tradução e adaptação cultural proposta Guillemin et al.(1993) que incluem tradução, retradução, análise por um comitê de revisores e preteste da escala. Foi reaizada também análise da confiabilidade por meio do teste e reteste e da consistência interna. Foi feita a validação clínica da versão da escala PSS:NICU na língua portuguesa a uma amostra de 163 país em dois hospitais no Estado de São Paulo.Resultados: a escala na língua portuguesa foi prestada e o nível de compreensão dela foi considerado adequado. A investigação da confiabilidade mostrou boa consistência interna na aplicação a pais brasileiros.Os valores obtidos dos coeficientes de correlação intraclasse ficaram em torno de 0,70, mostrando-se uma boa estabilidade entre as duas avaliações. A análise fatorial pelo método de componentes principais utilizou os mesmos critérios da escala original, com rotação Varimax, que apresentaram grau de variância adequado de 57,9%.Os escores de estresse dos pais foram de 2,3(pouco estressante) na subescala "sons e imagens"; 2,9(moderadamente estressante)na subescala "aparência e comportamento do bebê" e 3,7(muito estressante) na subescala "alteração papel de pais" na métrica 1(Nível de Ocorrência de Estresse")e 2,2; 2,6 e 3,4(pouco, moderadamente e muito estresse) respectivamente na métrica 2(Nível Geral de Estresse").Conclusão: a PSS:NICU na versão em português é uma ferramenta válida e confiável para avaliar o estresse de pais na Unidade de Terapia Intensiva Neonatal. / TEDE / BV UNIFESP: Teses e dissertações