Diss. Linköping : Univ., 2002. / På omsl. felaktigt: Gustafsson Holmström.

ABSTRACT INTRODUCTION: Studies on the topic of adverse childhood experiences (ACEs) and childhood obesity collectively indicate an association, but there is a lack of replication in nationally representative sample of children aged 10-17 years. This study aims to expand on the definition of ACEs to include: socio-economic hardship, racial discrimination, witness or victim of neighborhood violence, and bereavement, and to examine their individual and joint association with BMI levels, especially childhood obesity (primary outcome). METHODS: The 2011-2012 National of Children’s Health (NSCH) was used for this study (N=45,309). One child interview weight was produced; hence, the estimates are generalized to all non-institutionalized children 10-17 years of age in the US and each state. Statistical methods used included descriptive statistics and multivariable multinomial logistic regression models. ACEs examined included: (1) Socioeconomic hardship, (2) Parental divorce or separation, (3) Bereavement, (4) Incarcerated family member, (5) Witness to domestic violence, (6) Victim/witness of neighborhood violence, (7) Household mental illness, (8) Household substance abuse, (9) Racial discrimination. BMI for the same sex and age (10-17 years) percentile relative measurement, using growth charts recommended by CDC, among children and teens were used as indicators of BMI. BMI-95th percentile or greater was considered obese. RESULTS: The prevalence of childhood obesity and ACE exposure was higher for boys compared to girls. Controlling for gender, among those who were obese, White-non-Hispanic children had the highest prevalence of obesity compared to other races for both genders. Southern States constituted 80% and 60 % of top 10 states with the highest prevalence of childhood obesity and ACE, respectively. Approximately 25.4 million (89.5%) children aged 10-17 years had experienced 3 or less ACE. The most prevalent ACE category of nine asked about for child was-living with parents who were either divorced or separated after his/her birth (26.77%) and the least prevalent was living with a parent who died (4.84 %). ACEs were not mutually exclusive, and all nine categories of ACEs were interrelated. The adjusted odds ratio of covariates to their reference groups that were only statistically significant for childhood obesity relative to healthy weight encompassed: a) Place of residence in metropolitan statistical area, b) two or more chronic health conditions of 18 asked about, c) Watching TV, videos, or playing video games across categories >1 to≥4 hours, d) family members in the household eat a meal together 7 days of the week, e) and computer, cell phone or electronic device use ≤1 hour. Moreover, the explanatory variables, namely, age, sex, the physical health status of parents, and physical activity, were strongly related to childhood obesity (associated both with higher odds and lower odds of outcome) compared to overweight and underweight BMI categories. CONCLUSIONS: This is the first study to explore the co-occurrence, individual and joint association of ACEs with childhood obesity using nationally representative sample of children aged10-17 years in the U.S. Having childhood obesity, BMI-95th percentile or above was strongly related to ACE dichotomy, ACE score ≥2 and two ACE types (socioeconomic hardship and bereavement) than the probability of overweight, BMI-85th to 94th percentile. Underweight-BMI less than 5th percentile had only statistically significant association with socioeconomic hardship ACE category. Sociodemographic, parental, and childhood related factors were also independently associated with childhood obesity.

Bakgrund: Psykisk ohälsa kan vara allt från tillfälliga psykiska besvär till livslånga funktionsnedsättningar. En åttondel av världens befolkning lever med psykiatriska tillstånd. Sjuksköterskan upplever svårigheter i vårdandet av patienter med psykisk ohälsa. Bristande anknytning mellan barnet och föräldern kan påverka barnets utveckling negativt. Syfte: Syftet var att sammanställa och beskriva upplevelser av att vara barn till en eller flera föräldrar med psykisk ohälsa. Metod: Litteraturstudie med deskriptiv design och tematisk dataanalys. Genom sökning i databaserna Pubmed och Cinahl sammanställdes 11 artiklar som redovisas i resultatdelen. Huvudresultat: Identifierade teman var psykiska sjukdomen och den sjuka föräldern, inverkan på känslor och beteende, och barnens upplevelser av stöd. Barnen upplevde att den psykiskt sjuka föräldern var olik andra föräldrar och att hemsituationen var oförutsägbar. Barnen beskrev att den sjuka föräldern var mindre involverad i deras liv. Det beskrevs även positiva aspekter hos föräldern. Barnen upplevde negativa känslor relaterade till förälderns sjukdomssymtom och barnen kunde olika mycket om sjukdomen. Barnen ville gömma förälderns ohälsa och ha tid och rum för sig själva bortom sjukdomen. Barnen upplevde ett utökat ansvar men att de fick stöd både inom och utanför familjen. Slutsats: Barn till föräldrar med psykisk ohälsa känner negativa känslor och kan bli dåligt behandlade av sina sjuka föräldrar. Kunskapen om barns upplevelser ger sjuksköterskan bättre förutsättningar att stötta dessa barn inom olika vårdsammanhang. Sjuksköterskan bör se till att barnet eller den psykiska ohälsan inte hamnar i skymundan utan bör ha ett helhetsperspektiv på situationen. / Background: Mental illness can be anything from temporary psychological problems to lifelong mental disabilities. One eighth of the world's population lives with psychiatric conditions. The nurse experiences difficulties in the care of patients with mental illness. Lack of connection between the child and the parent can adversely affect the child's development. Aim: The aim was to compile and describe experiences of being a child of one or more parents with mental illness. Method: Literature study with descriptive design and thematic data analysis. By searching the databases Pubmed and Cinahl, 11 articles were compiled which are reported in the results section. Main results: Identified themes were the mental illness and the ill parent, the impact on emotions and behaviour, and the children's experiences of support. The children felt that the mentally ill parent was different from other parents and that the home situation was unpredictable. The children described that the sick parent was less involved in their lives. Positive aspects of the parent were also described. The children experienced negative emotions related to the parent's disease symptoms and the knowledge about the disease differed among the children. The children wanted to hide the parent's mental illness and have time and space for themselves beyond the illness. The children experienced an extended responsibility but they also received support both inside and outside the family. Conclusion: Children of parents with mental illness feel negative emotions and may be treated badly by their ill parents. The knowledge of children's experiences gives the nurse better conditions to support these children in different care contexts. The nurse should ensure that neither the child nor the mental illness is overlooked, and should have a holistic perspective on the situation.

This study used self-report of older adolescent/young adult children from a general college population to examine if violent parental conflict tactics predict the use of similarly violent tactics in the same-sex and opposite-sex peer relationships of offspring. Conflict Tactics Scale date from 256 subjects indicate that parental violence within the marital dyad is predictive of violence in both same-sex and opposite-sex peer relationships. Surprisingly high frequencies of violence were reported within parents' marriages and by subjects in their current peer relationships. Implications of these findings are discussed.

Bakgrund: Psykiatriska sjukdomar och tillstånd påverkar miljontals människor världen över och flera av de drabbade är föräldrar. Många föräldrar drabbade av psykisk sjukdom kan ta hand om ett barn, medan andra kan göra situationen värre för barnet. Föräldrarna kan bland annat brista i empati, vilket kan påverka barnets utveckling negativt. Hur påverkad barnet blir beror på hur många riskfaktorer respektive skyddsfaktorer som finns. Därför är det av stor betydelse att öka förståelsen för upplevelserna och omvårdnadsbehoven hos barn till föräldrar med psykisk sjukdom. Syfte: Syftet var att beskriva barns erfarenheter av att leva med en förälder drabbad av psykisk sjukdom. Metod: En litteraturöversikt med systematisk ansats valdes som metod. Litteratursökningen genomfördes i tre databaser och femton vetenskapliga originalartiklar inkluderades i resultatet. Artiklarna granskades enligt SBU:s kvalitetsgranskningsmall och resultatet analyserades tematiskt. Resultat: Tre huvudteman togs fram; Emotionella problem, Bristande kommunikation och stöd samt upplevelse av hanterbarhet. I de emotionella problemen ingick rädsla, oro, osäkerhet, skuld, och ensamhet. I bristande kommunikation och stöd ingick kommunikation och stöd. I upplevelse av hanterbarhet ingick ansvarstagande och undvikande. Slutsats: Barnen lider av olika emotionella problem, som kan bero på olika faktorer såsom bristande kunskap och information hos barnen, föräldrar och vårdpersonal. Barnen hanterade sina emotionella problem på olika sätt, vilket kunde bero på barnens ålder och mogenhetsgrad. Men ju mindre information de fick desto svårare blev barnens emotionella problem. / Background: Mental illness affects millions of people worldwide and several of those affected are parents. Many who sufferers of mental illness can take care of a child, while others can make the situation worse for the child. The parents can, among other things, lack empathy, which can negatively affect the child's development. How affected the child is depends on how many risk factors and protective factors there are. Therefore, it is of great importance to increase understanding of the experiences and nursing needs of children of parents with mental illness. Aim: The aim was to describe children's experiences of living with a parent affected by a mental illness. Method: A literature review with systematic approach was done. The literature search was conducted in three databases and fifteen original scientific articles were included in the results. The articles were reviewed according to SBU's quality review template and the results were analyzed thematically. Results: Three main themes emerged: Emotional problems, Lack of communication and support and experience of manageability. The emotional problems included fear, worry, uncertainty, guilt, and loneliness. Lack of communication & support included communication and support. The experience of manageability included taking responsibility and avoidance. Conclusion: The children suffer from various emotional problems, which can be due to various factors such as a lack of knowledge and information on the part of the children, parents and healthcare staff. The children dealt with their emotional problems in different ways, which could depend on the children's age and level of maturity. But the less information they received, the worse the emotional problems became.