<abstract><title style='display:none'>Abstract</title><sec id="j_sjcapp-2017-003_s_001"><title style='display:none'>Background</title>Mental health problems in adolescents have become a major public health challenge in many western countries. Many adolescents participate in noncompetitive or competitive sports for leisure. The aim of this study was to examine the association between participation in noncompetitive or competitive sports and mental health problems among Norwegian adolescents.</sec><sec id="j_sjcapp-2017-003_s_002"><title style='display:none'>Method</title>Data from a cross-sectional survey conducted among Norwegian junior high (N=9414) and high school students (N=10,571) aged 13 to 22 years were examined. The Strengths and Difficulties Questionnaire (SDQ) was used for measuring mental health problems, in the form of total symptom scores and impact on daily life. Participation in sports was categorized as follows: 1) not participating; 2) participating in noncompetitive sports; and 3) participating in competitive sports. Sports were divided into individual and team sports. Weekly exercise, healthy diet, and number of friends were investigated as mediating factors, and age, gender, and perceived economic status were controlled for in the analysis.</sec><sec id="j_sjcapp-2017-003_s_003"><title style='display:none'>Results</title>Adolescents participating in either noncompetitive or competitive sports had fewer total symptoms and less impact of problems on their daily life compared with those not participating in sports. In particular, participation in team sports as opposed to participation in individual sports seemed to be associated with fewer mental health problems. Weekly exercise, healthy diet, and number of friends were found to be partially mediating factors, explaining some, but not all, of the association between participation in either sports group. Participation in competitive sports, especially, was associated with fewer mental health problems.</sec><sec id="j_sjcapp-2017-003_s_004"><title style='display:none'>Conclusions</title>Participation in sports, either noncompetitive or competitive, is associated with fewer mental health problems in adolescents. This negative association is strongest for those participating in competitive sports. Further research is needed to explore the mechanisms underlying this relationship.</sec></abstract>

Association Between Participating in Noncompetitive or Competitive Sports and Mental Health among Adolescents – a Norwegian Population-based Cross-sectional Study

<abstract><title style='display:none'>Abstract</title><sec id="j_sjcapp-2015-016_s_001"><title style='display:none'>Background:</title>Autism spectrum disorder (ASD) is currently not curable, but it may be malleable to varying degrees in response to different interventions to improve outcomes.</sec><sec id="j_sjcapp-2015-016_s_002"><title style='display:none'>Objective:</title>We conducted a systematic review of interventions aimed at ameliorating social communication impairments in patients with ASD. This study was registered in the International Prospective Register of Systematic Reviews (no. CRD42013003780).</sec><sec id="j_sjcapp-2015-016_s_003"><title style='display:none'>Methods:</title>We focused on the ASD interventions that are frequently applied in Swedish clincial practice to address ASD. To ensure stakeholder involvement, we also conducted two surveys with three major Swedish ASD interest organizations to assess perceived research priorities for ASD treatment. With the use of this rationale for selection, Early Intensive Behavioral Intervention [EIBI], Treatment and Education of Autistic and Related Communication Handicapped Children [TEACCH], social skills training groups, and interventions that involved significant others were reviewed. A bibliographic search was conducted via five databases: Medline, PubMed, PsycInfo, CINAHL, and ERIC. Identified articles were screened for relevance by two independent reviewers, who also assessed the risk of bias in randomized controlled trials using systematic checklists.</sec><sec id="j_sjcapp-2015-016_s_004"><title style='display:none'>Results:</title>A total of 7264 citations were identified as being published before February 2013, and 109 studies (18 of EIBI, 18 of social skills training, 4 of TEACCH, and 69 of interventions involving significant others) were included in the analysis. The included studies provided some support for the positive effects of each of the interventions; this is especially true if the most recently published research (March 2013 through August 2015) is considered, and a crude updated search for relevant randomized controlled trials was performed. The interventions that involve the significant others of individuals with ASD form a heterogenous area of treatment strategies that require subcategorization for future review.</sec><sec id="j_sjcapp-2015-016_s_005"><title style='display:none'>Conclusions:</title>These findings provide preliminary support for treatments that are commonly used in clinical practice for the treatment of ASD in Sweden. However, larger and more rigorously designed and controlled studies are still needed before definitive conclusions regarding their effects can be made.</sec></abstract>

A Systematic Review of Social Communication and Interaction Interventions for Patients with Autism Spectrum Disorder

How should we classify complex neurodevelopmental disorders?

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Objective</title>
Replicated evidence shows a weak or non-significant correlation between different methods of evaluating executive functions (EF). The current study investigates the association between rating scales and cognitive tests of EF in a sample of children with ADHD and executive dysfunction.
</sec>
<sec><title style='display:none'>Method</title>
The sample included 139 children (aged 6–13) diagnosed with ADHD and executive dysfunctions. The children completed subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB). Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Children’s Organizational Skills Scale (COSS).
</sec>
<sec><title style='display:none'>Analysis</title>
Pairwise Spearman correlations were calculated between the composite and separate subscales of cognitive tests and rating scales. In secondary analyses, pairwise Spearman correlations were conducted between all composite scales and subscales, stratified by child sex and child ADHD subtype.
</sec>
<sec><title style='display:none'>Results</title>
The correlation analyses between composite scores yielded no significant correlations. The results when comparing CANTAB TO and BRIEF GE are r=−.095, p=.289, and r=.042, p=.643 when comparing CANTAB TO and COSS TO. The analyses between all composite scales and subscales found one significant negative correlation (r=−.25, p&lt;.01). There are significant cross-method differences when stratified by the ADHD-Inattentive subtype, showing significant negative correlations (moderate) between CANTAB and BRIEF composite (r=−.355, p=.014) and subscales.
</sec>
<sec><title style='display:none'>Discussion</title>
It is possible that the different methods measure different underlying constructs of EF. It may be relevant to consider the effects of responder bias and differences in ecological validity in both measurement methods.
</sec>
<sec><title style='display:none'>Conclusion</title>
The results found no significant correlations. The expectation in research and clinical settings should not be to find the same results when comparing data from cognitive tests and rating scales. Future research might explore novel approaches to EF testing with a higher level of ecological validity, and designing EF rating scales that capture EF behaviors more so than EF cognition.
</sec>
</abstract>

Executive functioning in children with ADHD Investigating the cross-method correlations between performance tests and rating scales

<abstract><title style='display:none'>Abstract</title>In this article, the authors provide a narrative review of the mounting evidence base on personality disorder in childhood and adolescence. Topics covered include diagnostic validity, prevalence, developmental issues, comorbidity, risk and protective factors, and treatment. Novel indicated prevention and early intervention programs for borderline personality disorder in adolescence are given special priority. To conclude, directions for future research are provided.</abstract>

Personality Disorder in Childhood and Adolescence comes of Age: a Review of the Current Evidence and Prospects for Future Research

<abstract><title style='display:none'>Abstract</title><sec id="j_sjcapp-2017-002_s_001"><title style='display:none'>Background:</title>The Strengths and Difficulties Questionnaire (SDQ) measures behavioral problems among children and adolescents. Prior research in Sweden has included child self-report <italic>or</italic> parent ratings from community <italic>or</italic> population data.</sec><sec id="j_sjcapp-2017-002_s_002"><title style='display:none'>Objective:</title>To provide child-reported <italic>and</italic> parent-rated SDQ norms for 11- to 16-year-olds, as well as data on child–parent agreement and parental sociodemographic correlates: education, employment status, and quality of life.</sec><sec id="j_sjcapp-2017-002_s_003"><title style='display:none'>Method:</title>A random population sample with 600 children aged 11 to 16 years, 100 per age group, and one of their parents (N=1200) yielded a sampling pool of 1158 participants and a 34.8% response rate, including 175 child–parent pairs and 27 and 26 child/parent singletons. Responses to child and parent versions of the extended SDQ were analyzed by child gender and age. Child–parent agreement was evaluated using the Prevalence- and Bias-Adjusted Kappa and Bland–Altman plots.</sec><sec id="j_sjcapp-2017-002_s_004"><title style='display:none'>Results:</title>Older children reported greater difficulties compared with younger children, while girls reported a higher negative impact of difficulties on daily life in comparison to boys. Child–parent item-by-item agreement was fair to slight on 15 of the 25 SDQ items, perfect to moderate on 9 items, and less than chance on 1 item, but generally high regarding dichotomous assignment to the “raised difficulties” or “normal” groups, based on subscales and the total SDQ score. Greater difficulties for children were reported by parents born outside Sweden, parents of children born outside Sweden, parents lacking regular employment, and parents with lower education or lower quality of life. In relation to other child–parent pairs, parents born outside Sweden perceived greater difficulties for their children compared with the children’s own ratings. Parents with better physical health and social relationships rated their children as having fewer difficulties compared with the rates reported by children.</sec><sec id="j_sjcapp-2017-002_s_005"><title style='display:none'>Conclusions:</title>Gender differences contrasted with prior Swedish studies showing higher ratings for boys on hyperactivity and total difficulties and for girls on emotional symptoms. However, findings on increased difficulties with age concurred with prior studies. Research on children’s mental health should be widely and systematically conducted at regular intervals and encompasses large, representative samples in order to inform national public health and health-care policy regarding measures to support children and enhance their mental health.</sec></abstract>

Child self-report and parent ratings for the Strengths and Difficulties Questionnaire: Norms and agreement in a Swedish random population sample

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Background</title>
Parents of children with neurodevelopmental conditions (NDC) are at risk of experiencing elevated levels of parental stress. Access to robust instruments to assess parental stress is important in both clinical and research contexts. Objective: We aimed to evaluate the psychometric properties of a Swedish version of the Parental Stress Scale (PSS), completed by parents of 3- to 17-year-old children, with and without NDCs.
</sec>
<sec><title style='display:none'>Method</title>
Main analyses were conducted on data from three independent samples: a community sample (<italic>n</italic>=1018), a treatment-seeking sample of parents of children with various disabilities (<italic>n</italic>=653), and a sample of parents of children with Attention-Deficit/Hyperactivity Disorder (ADHD) who themselves reported varying ADHD symptom severities (<italic>n</italic>=562). Additional analyses were enabled by the use of data from a complementary test-retest sample (<italic>n</italic>=337).
</sec>
<sec><title style='display:none'>Results</title>
The internal consistency of the PSS was good (Cronbach’s alpha, <italic>α</italic>=.87) and its test-retest reliability moderate (ICC=.66). The scale correlated in the expected direction with related constructs (<italic>r=</italic>.50–.56 in the community sample). An exploratory factor analysis found its internal structure to reflect two aspects of parental stress: Lack of Parental Rewards and Role Satisfaction (factor 1, <italic>α</italic>=.90) and Parental Stressors and Distress (factor 2, <italic>α</italic>=.85). The treatment-seeking parents of children with disabilities reported higher parental stress than community reference parents (<italic>p</italic>&lt;.001; Cohen’s <italic>d</italic>=1.17). Moreover, we found that parents with high ADHD symptom severity reported higher parental stress than parents with low ADHD symptom severity (<italic>p</italic>&lt;.001; <italic>d</italic>=0.39).
</sec>
<sec><title style='display:none'>Conclusion</title>
In summary, we found evidence in support of the reliability and validity of the PSS, which overall was judged to be useful as a measure of parental stress in a Swedish context. In addition, our results underline the importance of considering parental stress and related needs in assessments and intervention planning involving families of children with NDCs.
</sec>
</abstract>

Psychometric Properties of the Parental Stress Scale in Swedish Parents of Children with and without Neurodevelopmental Conditions

Eleven years with Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

<abstract>
<title style='display:none'>Abstract</title>
<sec>
<title style='display:none'>Background</title>
Prolonged stress is a risk factor for developing mental illness and stress-related diseases. As there has been an increase in self-reported psychological symptoms and diagnosis of mental illness among Scandinavian adolescents, more knowledge of stress prevalence in this age group is needed.
</sec>
<sec>
<title style='display:none'>Aim</title>
This literature review will investigate a possible increase in stress prevalence among Scandinavian adolescents, aged 13-18, between the years 2000 and 2019.
</sec>
<sec>
<title style='display:none'>Methods</title>
A systematic literature search was conducted in the PubMed and PsycInfo databases. In addition, a grey literature search was conducted to find relevant surveys and reports. Altogether, nine papers and nine surveys, and reports containing relevant data were identified, assessed for risk of bias, and included in the analysis.
</sec>
<sec>
<title style='display:none'>Results</title>
The results show higher stress scores among the older participants in the age group 13-18 years and a gender difference, where girls score higher than boys. The literature neither supports nor rejects the hypothesis that stress levels have increased among adolescents in Scandinavia, from year 2000 to 2019. Only two of the included studies used a validated stress questionnaire and there was a substantial risk of non-response bias. Therefore, the existing literature is considered insufficient to determine if there has been an increase in stress over time. A majority of the papers, surveys, and reports had moderate risk of bias.
</sec>
<sec>
<title style='display:none'>Conclusions</title>
Further research using validated stress questionnaires in representative populations is needed to investigate changes in stress prevalence among Scandinavian adolescents. Also, the age and gender difference in stress prevalence among 13-18-year-olds may be of relevance for planning preventive interventions to reduce stress.
</sec>
</abstract>

Did Stress Prevalence Among Adolescents in Scandinavia Change from 2000 to 2019? A literature review

<abstract>
<title style='display:none'>Abstract</title>
<sec>
<title style='display:none'>Background</title>
Children with disabilities are at heightened risk of sexual violence compared to non-disabled peers.
</sec>
<sec>
<title style='display:none'>Objective</title>
We aimed to examine the associations between ten childhood disabilities and sexual victimization.
</sec>
<sec>
<title style='display:none'>Methods</title>
Data were drawn from the Danish Psychiatric Case Register, the Criminal Register, and other population-based registers. Children born between 1994 and 2001 (n=570,351) were followed until 18 years of age. Using logistic regression, the association between the disabilities and risk of sexual victimisation was estimated.
</sec>
<sec>
<title style='display:none'>Results</title>
We identified 8,860 cases of sexual victimization towards children and adolescents. In the fully adjusted models, children with a diagnosis of ADHD, speech disability and intellectual disability were at highest risk of sexual victimization. Children with comorbid disabilities were particularly vulnerable to sexual victimization.
</sec>
<sec>
<title style='display:none'>Conclusions</title>
We found that children with certain types of disability have a higher risk of sexual victimization. Our findings indicate that educational institutions and health care professionals should be aware of and have specialized training in, recognizing and assessing sexual victimization among children with disabilities.
</sec>
</abstract>

Sexual Violence against Children with Disabilities: A Danish National Birth Cohort Prospective Study

<abstract>
<title style='display:none'>Abstract</title>
<sec>
<title style='display:none'>Background</title>
Adolescence is a critical period for mental development where the consequences of psychopathologies can be exceedingly harmful, and compassion has been identified as a protective factor for adolescents’ mental well-being.
</sec>
<sec>
<title style='display:none'>Aim</title>
The aim of this study was to explore three perspectives of compassion – Self-compassion, Compassion for others, and Compassion from others – and their relationship with depression and suicidal ideation in adolescents.
</sec>
<sec>
<title style='display:none'>Method</title>
This Swedish cross-sectional study included 259 psychiatric patients (ages 16–22). Participants completed a survey including the self-assessment scales “Reynolds Adolescent Depression Scale – Second Edition” (RADS-2), “Suicidal Ideation Questionnaire – Junior Version” (SIQ-JR), and “Compassion Engagement and Action Scale – Youth” (CEAS-Y). Linear regression analyses were used to determine whether participants’ levels of compassion predicted depression and suicidal ideation.
</sec>
<sec>
<title style='display:none'>Results</title>
Self-compassion and Compassion from others significantly predicted both depression and suicidal ideation. Girls, on average, reported higher levels of depressive symptoms and suicidal ideation and lower levels of self-compassion compared to boys. The correlation between compassion and depressive symptoms, however, appeared to be stronger in boys. There was also a positive correlation between Compassion for others and suicidal ideation.
</sec>
<sec>
<title style='display:none'>Conclusions</title>
The results suggest that Self-compassion and Compassion from others may have a significant protective effect against depression and suicidal ideation, especially in boys. However, due to the relatively small sample of boys (n = 40), further research is needed before any solid conclusion can be drawn regarding possible gender differences. Additionally, the combination of low Self-compassion and higher levels of Compassion for others may be associated with suicidal ideation.
</sec>
</abstract>

Compassion in three perspectives: Associations with depression and suicidal ideation in a clinical adolescent sample

<abstract><title style='display:none'>Abstract</title><sec id="j_sjcapp-2014-011_s_001"><title style='display:none'>Background:</title>Adults with autism spectrum disorders (ASDs) and with intelligence quotients in the normal range are disproportionately affected by unemployment.</sec><sec id="j_sjcapp-2014-011_s_002"><title style='display:none'>Objective:</title>We sought to assess special interests that could bear potential for employment as well as factors deemed relevant for work performance in adults with ASD.</sec><sec id="j_sjcapp-2014-011_s_003"><title style='display:none'>Method:</title>A newly compiled self-report online questionnaire was administered to high-functioning adults with ASD to assess special interests as well as factors that both interfere with and facilitate work performance.</sec><sec id="j_sjcapp-2014-011_s_004"><title style='display:none'>Results:</title>Participants reported that they spent an average of 26 hours per week on their special interests, and their average level of proficiency was rated as very good. Although special interests were reported to be in the social sciences and the creative fields as often as they were in the natural sciences and technology/engineering, the most common approach taken within those fields was systemizing rather than a creative or knowledge-acquiring pursuit. Social interaction problems with coworkers and superiors as well as sensory issues were most often rated as interfering with work performance. In addition, mental underload was rated as an important factor that interfered with work performance, whereas excessive demands were not. Among the factors most often reported to facilitate work performance were employers’ and colleagues’ awareness of the individual’s ASD diagnosis.</sec><sec id="j_sjcapp-2014-011_s_005"><title style='display:none'>Conclusion:</title>Our data suggest that special interests among individuals with ASD may bear important potential for employment. Given the focus on systemizing in this population, recent efforts to create job opportunities in the information technology sector specifically for high-functioning individuals with ASD are a promising start. However, these efforts should be expanded into other fields.</sec></abstract>

Toward the Successful Employment of Adults with Autism: A First Analysis of Special Interests and Factors Deemed Important for Vocational Performance

<abstract><title style='display:none'>Abstract</title>Background: Stressor experience is an important topic of research concerning adolescent health and ill-health. For this, valid and reliable measures of adolescent stress are needed. The Adolescent Stress Questionnaire 2 was developed to tap into stressor domains specific for adolescence. Psychometric evaluations in Australian and European samples have indicated adequate psychometric properties. However, the ASQ-2 is quite extensive, which may render its use in large cohort studies, where several aspects of adolescent health are investigated, inconvenient and problematic.Objective: To evaluate the psychometric properties of a short version of the ASQ-2 (ASQ-S) in terms of construct validity and factorial invariance across gender.Method: The ASQ-2 was translated into Swedish and items were retained from nine of the ten scales based on factor loadings. One scale (stress of emerging adult responsibilities) was removed entirely due to low internal consistency and variance explained. The remaining 27 items were piloted and then included in an ongoing 5-year longitudinal study involving the participation of all students in the 7th and 8th grade in public schools from three Swedish municipalities (N = 2768, 47.5 % girls, mean age 13.64 years). For this study data from the first and second wave was used.Results: A nine factor Confirmatory Factor Analysis (CFA) showed a good fit to the data and invariance across sexes was supported. The nine scales correlated positively with depressive symptoms, anxiety and worry and negatively with self-esteem. Girls reported higher stress levels than boys in eight of the nine scales. Stressors related to peer pressure predicted reported levels of anxiety and worry one year later, whereas stressors related to romantic relationships predicted depressive symptoms.Conclusions: Overall this study suggests that the ASQ-S could be a valid measure of adolescent stressor experience and psychometrically equivalent to the full ASQ-2.</abstract>

Development of a Shortened Version of the Adolescent Stress Questionnaire (ASQ-S): construct validity and sex invariance in a large sample of Swedish adolescents

<abstract><title style='display:none'>Abstract</title><sec id="j_sjcapp-2014-010_s_001"><title style='display:none'>Background:</title>Autism spectrum disorder (ASD) is diagnosed more often in males than females, with the male-to-female gender ratio reported to be around 4.3:1 to 5:1. It is possible that the underrecognition of ASD in females partially contributes to this uneven ratio. Recent attention has been placed on understanding the processes that give rise to this gender difference in ASD prevalence. Socialization may contribute to the unique presentation of ASD in females, which may underlie this condition’s subsequent underidentification in this group.</sec><sec id="j_sjcapp-2014-010_s_002"><title style='display:none'>Objective:</title>The purpose of this case series is to demonstrate how symptoms of ASD may uniquely manifest in females without co-occurring intellectual impairment.</sec><sec id="j_sjcapp-2014-010_s_003"><title style='display:none'>Method:</title>An examination of three case examples of young women diagnosed with ASD will illustrate the processes that contribute to the atypical manifestation and underidentification of ASD in females.</sec><sec id="j_sjcapp-2014-010_s_004"><title style='display:none'>Results:</title>Across cases, the females in this study demonstrated shared symptom presentations within three domains: 1) unique core symptom manifestation (insistence on sameness, lack of social engagement, and social processing difficulties); 2) heightened psychiatric comorbidities with internalizing disorders (anxiety, depression, and borderline personality traits); and 3) emotional dysregulation. These three domains reflect specific processes that may help to explain the underidentification of ASD in females via diagnostic overshadowing.</sec><sec id="j_sjcapp-2014-010_s_005"><title style='display:none'>Conclusions:</title>Consideration of atypical symptom presentations, heightened comorbidities, and emotion regulation difficulties may help with the understanding of why ASD symptoms in females are commonly underidentified or identified later than they are in males. Social difficulties in combination with internalizing psychiatric disorders and emotional dysregulation may lead to the development of a specific symptom presentation in females that obscures the detection of ASD symptoms. Suggestions for clinical practice are made to promote the accurate identification of ASD and to inform case formulation and treatment planning.</sec></abstract>

Underidentification of Autism Spectrum Disorder in Females: A Case Series Illustrating the Unique Presentation of this Disorder in Young Women

<abstract><title style='display:none'>Abstract</title>Background: The results of several international studies indicate a high prevalence of language and communication impairments among children who are referred to child psychiatric services. However, these impairments are likely to remain undetected unless language and communication impairments are evaluated during the psychiatric assessment.Aims: The aim of the present study is to investigate the specific association between general and specific mental health problems, as expressed by the problem scales of Child Behavior Checklist (CBCL) and Teachers Report Form (TRF), and pragmatic skills and pragmatic language impairments (PLI) as defined the Pragmatic Composite of the Child Communication Checklist (CCC-PC).Methods: Children aged from 8 to 13 years (n = 73) were recruited in sequence following referral to a child and adolescent psychiatry (CAMHS) outpatient clinic within 12 months. Children with possible or established autism or intellectual disability were excluded. Standardized instruments measuring language, communication and mental health symptoms were distributed to parents and teachers, an intelligence test administered for clinical purposes, and demographic information was included.Results: The parent reports showed PLI among 38% of the children and revealed strong associations with the CBCL scales for emotional problems, thought problems and, especially, social and withdrawal symptoms, which mean more associations to internalized and non-externalized problems. PC-scores were at similar levels and PLI was reported by teachers at similar rates (compared to parent reports) with moderate agreement. Teacher PC-scores showed associations to only one TRF-scale, social problems. The CCC-PC subscale with the strongest associations to mental health symptoms was «Use of Context» («Social Relationships» do not contribute to the CCC-PC scores).Conclusion: There was a general increase in PC-scores and increased prevalence of PLI in this clinical sample. PC-scores correlated with symptom scores for internalizing and non-externalizing problems scales. The strongest common factors appear to be related to the social aspects of mental health. Pragmatic skills should be considered as a protective factor for mental health rather than investigating pragmatic impairment as a risk or vulnerability factor.</abstract>

Pragmatic language impairment general and specific associations to mental health symptom dimensions in a child psychiatric sample

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