University of Macau / Faculty of Social Sciences and Humanities / Department of Psychology

Bakgrund: Mobbning utgör ett allvarligt problem i svenska skolor. Huvudvärk, magont, ryggont, nacksmärtor och trötthet är frekventa psykosomatiska symtom hos elever utsatta för mobbning. En viktig uppgift för skolsköterskan kan vara förebyggandet av mobbning. Syfte: var att studera om det finns samband mellan upplevelsen av att vara utsatt för mobbning och förekomst av psykosomatiska symtom hos skolbarn i årskurs 5 och 7. Metod: Studien var en tvärsnittsstudie utifrån registerdata inhämtad från Folkhälsoinstitutet. I studien ingick totalt 7596 svenska skolbarn i åldern 11 och 13 år. Materialet analyserades bivariat och med multivariata regressionsmodeller. Resultat: Skolbarn som upplevde sig mobbade visade sig ha fler psykosomatiska symtom än skolbarn som inte var mobbade (OR= 2.73). Flickor hade fler psykosomatiska symtom än pojkar (OR= 1.76). Skolbarn i årskurs 7 hade fler psykosomatiska än barnen i årskurs 5 (OR=2.73).  Skolbarn som var stressade av skolarbetet uppvisade fler psykosomatiska symtom (OR= 3.38). Flickor var mindre ofta mobbade än pojkar. (OR= 0.86).  Skolbarn som ej trivdes i skolan var oftare utsatta för mobbning än elever som trivdes i skolan (OR=1.52).   Slutsats: Mobbning och stress av skolarbetet utgör en fara för skolbarns hälsa. Skolbarn som blir mobbade trivs även sämre i skolan. / Introduction: Bullying is a serious problem in Swedish schools. Headache, stomachache, back pain and tiredness are frequent psychosomatic symptoms. An important task for the school nurse may be the prevention of bullying. Aim: was to study potential links between the experience of being the victim of bullying and the occurrence of psychosomatic symptoms among school children in grades 5 and 7. Method: The study was a cross sectional study based on register data was obtained from the Folkhälsoinstitutet. This study included a total of 7596 schoolchildren between the ages of 11 and 13 years. Material was analysed with bivariate and multivariate regression models. Results: Schoolchildren who felt bullied were found to have more psychosomatic symptoms than schoolchildren who were not bullied. (OR= 2.73). The girls had more psychosomatic symptoms than boys. (OR= 1.76). Schoolchildren in grades 7 had more psychosomatic symptoms than children in grade 5. (OR=2.73). Schoolchildren that were stressed by school work showed more psychosomatic symptoms. (OR= 3.38). The girls were less often bullied than boys. (OR=0.86). School children who are not happy in school were more often exposed to bullying than students who enjoyed school. (OR=1.52). Conclusion: Bullying and stress of schoolwork is a danger to school children’s health. School children who are bullied feel even worse in school.

The aims of the thesis were to study relationships between the effects of online gaming and gambling and negative social consequences and ill health among adolescents and to determine whether gaming and gambling activities occur together. The papers in this thesis used epidemiological methods to obtain self-report information from Swedish adolescents aged 13–18 years. Time spent in online gaming was associated with negative social consequences, and this relationship was explained by online gaming motives. Gaming for fun and social motives was associated with a reduced risk of negative social consequences, whereas gaming to escape problems, gain status, or meet demands from others was associated with an increased risk. Increased online gaming time on weekdays increased the probability of having depressive, musculoskeletal, or psychosomatic symptoms, and was related to online gaming motives. The probability of ill health was low in those who reported gaming for fun or social motives. Adolescents with symptoms of attention deficit hyperactivity disorder (ADHD) were more sensitive to gambling frequency and to developing a gambling problem. However, among those identified as susceptible, adolescents with ADHD were equally affected compared with other susceptible participants in terms of their gambling frequency. Boys had a higher probability than girls of participating in online gambling in association with online gaming. Having at least one parent born outside Scandinavia was associated with a higher probability of online gambling, especially among girls. The effect of alcohol use as a factor contributing to online gambling was greater among boys than among girls. The results of this thesis contribute new knowledge about sex differences in online gaming and gambling behaviours and add to the limited research on online gaming and online gambling behaviours among adolescent girls. Gaming motives may be helpful for identifying online gamers needing support to reduce their unhealthy gaming behaviour. Information about factors related to gaming and gambling problems may be of interest to clinicians in psychiatry, psychology and social work, as well as to policymakers, parents and teachers involved in adolescent health and development. Effect preventive strategies should consider the sex differences in gaming and gambling behaviour in adolescents.

published_or_final_version / abstract / toc / Social Work and Social Administration / Doctoral / Doctor of Philosophy

To study the differences in levels of alexithymia, depresion, anxiety and socioeconomic status between a sample of adolescents diagnosed with ICD-10 Persistent Somatoform Pain Disorder N=120 and healthy adolescents controls N=240, and further to survey the method of family conflicts resolution in the somatizing adolescents.Using the Toronto alexithymia scale and Hospital anxiety and Depresion scale and questionary to the subjects and their parents to assess each family's SES and method of conflict resolution. The rate of alexithymia in somatizing adolescents was 69,2percent, which was significantly higher than inhealthy controls(22,9percent, p<o.001). Similarly the rate of anxiety was significantly higher in the somatizers(61,6percent) versus controls(23,3percent, p<0.0010.The method of conflict resolution in the families of somatizing adolescents was more often by quarreling or fighting(6,7percent), silence or not solving the problem at all(44,1percent), and rarely by discussion(17,6percent).

The World Health Organization (1969) has declared that heart disease is the largest plague that ever faced humanity. Myocardial Infarction (MD, in addition to causing more deaths than all other diseases of the heart combined, is responsible for changes, and in many cases deterioration, in the quality of life of survivors. Intervention programs tend to focus on preventing re-occurrence of MI. At the same time there is an urgent need for sophisticated rehabilitation programs that aim to improve quality of life after MI. It is speculated here that identification of the personality factors that relate to the different adjustment patterms of different subgroups of post-MI patients will assist in the design of an efficient rehabilitation program. Accordingly, the present study focuses on the inquiry of the psychological mechanisms that mediate between the Type A behavior pattern (TABP) and adjustment style. An integrated crisis and developmental theory based on psychoanalytical, attachment and social learning theories is proposed. The Thesis put forward is that TABP is not a homogeneous pattern and that interpersonal dependency is an underlying personality factor that subdivides Type A patients to subgroups with different developmental and adjustment patterns. It is claimed here that dependent Type A patients have a dependent-independent developmental psychodynamic conflict, and that for them, TABP is an adopted defense mechanism. They are expected to have more adjustment difficulties to the specific characteristics of the post-MI crisis than inde pendent Type A patients for whom TABP is a socially learned developmental process in an urban Western environment. Type B patients, who also lack the psychodynamic conflict, are expected to adjust as a group better than dependent Type A patients. Seventy-nine white urban South African males aged 30-60 years, after clinical MI, were tested. A combination of qualitative and quantitative methods of assessment was used in order to test the relationships between personality factors and adjustment, which was defined by multi-dimensional criteria (32 indices of adjustment) that related to various aspects of life in the post-MI period. The results confirmed the heterogeneity of TABP, dependent Type A patients adjusted less well than independent Type A patients to 16 out of 32 indices of adjustment. As expected for the same 16 indices, the behavior of Type B patients was better adjusted than dependent Type A patients. The outcomes of the adjustment of post-MI patients to all 32 indices is discussed. On the basis of the study's results and the crisis and developmental theory set out here, a differential rehabilitation program is proposed that relates to the different needs of the subgroups of post-MI patients. / Thesis (Ph.D.)-University of Natal, Durban, 1986.

Barnmisshandel är ett globalt folkhälsoproblem som resulterar i stora hälsokonsekvenser.Flera studier har visat att barnmisshandel kan leda till psykisk ohälsa hos de som utsatts,såsom depression och ångest. Det är dock få studier som har undersökt sambandet mellanbarnmisshandel och psykosomatiska symtom hos skolelever. Syftet med studien var attundersöka förekomsten av utsatthet (fysisk barnmisshandel och/eller barn som bevittnat våld)och psykosomatiska symtom bland elever i årskurs nio. Syftet var också att undersökasambandet mellan utsatthet och psykosomatiska symtom. Studien var en tvärsnittsstudie och gjordes utifrån redan insamlad data från den nationellakartläggningen om barnmisshandel 2011. Studiepopulationen bestod av 3207 elever i niondeklass och svarsfrekvensen var 84 procent. Specifikt utvalda frågor ur datamaterialetbearbetades utifrån deskriptiva frekvenstabeller, chi²- test och oddskvoter (OR) med 95procent konfidensintervall. Resultatet beskriver förekomsten av barnmisshandel och/eller bevittnat våld, psykosomatiskasymtom en gång i veckan eller oftare och sambandet dem emellan samt bakgrundsfaktorersom har samband med psykosomatiska symtom. Det var 18 procent av skoleleverna somangav att de någon gång blivit fysisk bestraffade och 7 procent angav att de bevittnat våldmellan föräldrarna. Det var 34 procent av eleverna som rapporterade 1-2 symtom en gång iveckan eller oftare och 26 procent rapporterade 3 eller fler symtom en gång i veckan elleroftare. Det statistsikt signifikanta sambandet mellan fysisk misshandel och psykosomatiskasymtom framkom vara starkare om eleven hade multipla symtom (OR=4,254). Det fannsinget statistiskt signifikant samband mellan att bevittnat våld och 1-2 psykosomatiskasymtom. Däremot fanns ett signifikant samband mellan att ha bevittnat våld hemma och 3eller fler symtom (OR=3,903). / Child abuse is a global public health problem with major health consequences. Several studieshave shown that child abuse can result in mental health problem, such as depression andanxiety. However, there have been few studies about the association between child abuse andpsychosomatic symptoms in schoolchildren. The aim of the study has been to investigate theprevalence of physical child abuse and/or children who have witnessed partner violence andpsychosomatic symptoms. The aim was also to examine physical child abuse associated withpsychosomatic symptoms.The study was a cross- sectional study and was based on already collected data from aNational Survey about Child Abuse 2011. The study constituted of 3207 students in 9th gradeand the response rate was 84 percent. In this study were questions selected from the NationalSurvey about Child Abuse 2011 and data were processed by descriptive tables, chi²- tests andodds ratio (OR) with 95 percent confidence intervals. The results describe the incidence of child abuse and/or children who have witnessed partnerviolence, psychosomatic symptoms once a week or more and the association between themand background factors associated with psychosomatic symptoms. It was 18 percent of thestudents who reported they had been physical punished and 7 percent reported they havewitnessed violence between parents. It was 34 percent of the students who indicated that theyhad 1-2 symptoms once a week or more and 26 percent of the students who indicated that theyhad 3 or more symptoms once a week or more. There were a statistic significant associationbetween physical abuse and psychosomatic symptoms and it was even stronger if the studenthad multiple symptoms (OR=4,254). There were no statistic significant association betweenwitnessing violence and 1-2 psychosomatic symptoms. However, there were a statisticsignificant association between witnessing violence and 3 or more symptoms (OR=3,903).

Family and school are the two major socialization agents for young people with important implications for their social, psychological and cognitive development. This thesis aimed to investigate the extent to which family conditions in terms of parental attachment and support (PAS) and school conditions in terms of participation and teacher support were associated with adolescents’ psychosomatic health. The thesis also explored whether school participation and support (SPS) could compensate for the potentially negative health implications of experiencing poor relational support at home. Association patterns according to gender and grade were also investigated. Data were derived from a classroom survey of all ninth and eleventh-grade students carried out in Stockholm 2006 (n=9,560). Results from linear regression analyses showed that both PAS and SPS were negatively associated with psychosomatic complaints. Gender and grade differences were also noted in respect to PAS and SPS as well as in the interaction between them. The study failed to find a compensatory function of school characteristics for less advantaged students, but modifying effects were nevertheless found. Students with a combination of high PAS and low SPS had worse health than expected, thus indicating that poor condition in school modifies the positive health effect of PAS in a negative way.

Mitral Valve Prolapse Syndrome (MVPS) is a benign psychosomatic cardiac condition that can severely impair one's quality of life. Symptoms targeted in this study include, atypical chest pain, palpitations, anxiety, panic, and shortness of breath.This study was undertaken to examine the effects of a diaphragmatic breathing intervention on the symptoms and underlying mechanism of dysautonomia in a small group of symptomatic females with MVPS. The intervention was based on both yoga theory and cardiorespiratory empirical studies.Seven of eight participant's completed the nine week study using a single subject multiple baseline design across subjects. Participant's began a respiratory retraining intervention, in a weekly staggered pair start, after the first week of baseline measurement. Respiratory training consisted of a four week training in diaphragmatic breathing with home practice three times a day.Autonomic, behavioral, and cognitive systems were assessed. Dependent measures included State and Trait Anxiety, Anxiety Sensitivity, a Symptom Checklist, and Respiratory Sinus Arrhythmia (RSA). RSA is a current noninvasive measure of parasympathetic tone. Data on thoracic and abdominal respiratory predominance, respiration rate, diet, exercise, and adherence were also gathered.Data were analyzed via visual inspection of trends and phase average changes. Treatment effect sizes were calculated for standardized measures to indicate the meaningfulness of change.Two of the seven participants demonstrated a decrease in total symptom frequencies over the course of intervention. One participant demonstrated a weekly progression of lowered state anxiety scores from baseline through intervention. In terms of phase averages, three participants showed a lowering of state anxiety. All seven participants demonstrated lowered trait anxiety scores from pre to post intervention. Two of the seven participants demonstrated a meaningful pre to post intervention decrease in anxiety sensitivity. Respiratory training was effective in stabilizing abdominal respiration. Results regarding vagal tone could not be determined due to unreliable ECG data.In general, results were poor with several inconsistencies. Adherence rates were low and it did not appear that a therapeutic level of change in respiration rate was achieved. Controlling respiration rate may be a critical factor in the therapeutic effectiveness of respiratory retraining interventions. / Department of Counseling Psychology and Guidance Services

En la presente tesis doctoral se estudian las características de los pacientes aquejados de reumatismos psicógenos en función de cuatro parámetros: clínico, psicométrico, farmacológico y psico-fisiológico. A partir de este planteamiento se propone una hipótesis explicativa del trastorno interpretable desde una perspectiva cortico-visceral.