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The COVID-19 pandemic profoundly affected the emotional well-being of pregnant women. In Sweden, no national lockdown was implemented; instead, healthcare restrictions were imposed, most notably limiting partner involvement in perinatal care. This marked a significant shift from standard practices that emphasize partner participation as a key component for maternal support and well-being. This study aimed to explore women's experiences of being pregnant during the COVID-19 pandemic. A qualitative interview study was conducted in Sweden, including 30 pregnant women. The data were analyzed using content analysis with an inductive approach. Four overarching themes were identified: Living in the Shadow of the Pandemic, Missing Out on the Shared Journey, Unpredictability Creates Worry and Fear, and Adaptation and Growth in a Threatening World. The findings describe pregnant women's experiences during the COVID-19 pandemic as a period marked by vulnerability, partner exclusion, uncertainty and emotional strain. However, many participants also demonstrated resilience and developed adaptive strategies. A recurring desire emerged for more inclusive, consistent healthcare practices and clearer communication tailored to the needs of expectant families. The findings highlight the importance of patient-centered, accessible perinatal healthcare and contribute to the existing research by emphasizing the role of support systems and national guidelines in safeguarding maternal and family well-being during future pandemics.

Adolescent mental health is a growing global concern, with depressive and anxiety symptoms on the rise over recent decades. The significance of supportive social relationships, particularly within family and peer groups, is well-established in research. However, limited evidence exists on the impact of social relationships in predicting the developmental trajectories of mental health problems over time. This study aims to fill this gap by identifying groups with distinct trajectories of depressive and anxiety symptoms among adolescents and exploring the impact of various factors, including family relationships, peer relationships, sex, and country of origin, on predicting individuals' likelihood of belonging to specific trajectories. Data come from a community sample of Swedish young people born in 1997 and 1999 (N = 1834, 50% female) and followed over 12 years (four waves conducted at three-year intervals). The Group-Based Trajectory Modeling (GBTM) was used to identify profiles of young people longitudinally. Moreover, multinomial logistic regression models were conducted to examine the predictive effects of social relationships, sex and country of origin on depressive and anxiety symptom trajectories. Four groups were identified for both depression (Stable-Low, Declining, Rising-D, Persistent High) and anxiety (Low and Declining, Stable-Moderate, Rising-A, High). Positive social relationships with family and peers emerged as robust predictors across depressive and anxiety symptom trajectories. Female participants consistently exhibited higher mean scores of depressive and anxiety symptoms than males, while participants originating from countries outside the Nordic region were at higher risk of belonging to risky depressive symptom trajectory groups. These findings highlight the critical importance of strengthening supportive family and peer environments for preventive strategies and targeted interventions in adolescent mental health.

Monetary reward processing during gambling is associated with dopaminergic functioning. Emotional reactivity to different gambling stimuli can be indexed by autonomic nervous system (ANS) responses measured by skin conductance responses (SCR) and heart rate (HR). Genetic markers regulating neural dopaminergic activity, such as the D2 dopamine receptor, might confer differential sensitivity to gambling stimuli, which may also be modulated by previous exposure to gambling. To date, no previous studies have explored the relationship between genetic markers of the D2 dopamine receptor, real-life gambling exposure and ANS responses during gambling. Hence, this study explored associations and interactions between DRD2 C957T (rs6277) and ANKK1 Taq1A (rs1800497) genotypes, real-life gambling frequency and autonomic responses during reward anticipation and outcome delivery in a slot machine task producing wins, near-misses and full-misses. Participants (n = 270) performed a computerized slot machine task with recordings of SCRs and HR responses during gambling performance and provided saliva samples for DNA extraction. Taq1A A1 carriers showed increased SCRs and HR responses during reward anticipation and to wins. Greater responsivity during anticipation, as well as to wins and full-misses, was also observed in C957T heterozygotes. Regarding real-life gambling involvement, higher gambling frequency among Taq1A A1 carriers was associated with decreased HR responses during anticipation and to wins. Results suggest that polymorphic variants of the D2 dopamine receptor may confer differential sensitivity to different gambling stimuli which may further be modulated by real-life gambling exposures. However, further studies are needed in well powered samples of gamblers and control subjects.

Introduction: The interplay between genetic and environmental factors, as explored through studies of gene-environment interactions (cGxE), has illuminated the complex dynamics influencing behavior and cognition, including decision-making processes. In this study, we investigated the differential susceptibility effects of the 5-HTTLPR and MAOA genotypes on decision-making under risk using the Iowa Gambling Task.

Methods: Data from 264 participants (138 women, 126 men) aged 18-22 years, from the 2015 wave of the Survey of Adolescent Life in V & auml;stmanland (SALVe Cohort) was analyzed. Participants provided genetic data including the MAOA and 5-HTTLPR genotypes, and completed the Iowa Gambling Task (IGT) to evaluate decision-making behavior. Parent reports, including assessments of positive parenting styles and early life stress were used for cGxE analysis.

Results: In a General Linear Model, significant interactions were found among males for the 5-HTTLPR, with SS/SL carriers showing higher net scores with positive parenting and lower scores with less positive parenting in relation to decision-making under risk in the IGT (trials 61-100), indicating differential susceptibility effects. Male LL carriers showed minimal fluctuation in IGT scores. Similar effects were observed for males with the MAOA S-allele. No significant interactions were found for females.

Discussion: In conclusion, our study indicates that the 5-HTTLPR and MAOA genes demonstrate susceptibility to environmental factors in influencing decision-making under risk among males, as assessed by the Iowa Gambling Task. We anticipate that these findings will contribute to advancing the understanding of the complex interactions between genetic and environmental factors in shaping human behavior and decision-making.

Estrogens are suggested to affect mood by binding to widespread estrogen receptors in the brain and therewith modulating a variety of neurosignaling pathways. Single nucleotide polymorphisms (SNPs) in the genes encoding estrogen receptors might influence these actions and thereby play a role in the genetic foundation of mood disorders. Several SNPs in the estrogen receptor 1 (ESR1) gene have been studied in relation to anxiety and depression, while confounders and interaction with psychosocial factors have largely been overlooked. The present study investigated the effect of the functional polymorphisms rs2234693 (PvuII) and rs9340799 (XbaI) in the ESR1 gene on depression and anxiety symptoms as well as their interaction with early life adversities and parenting in two independent female cohorts, considering relevant confounding factors. In adolescent females (n = 1036), the rs9340799 minor allele (G) was found to protect against increasing anxiety symptoms from age 14 to 17, whereas, in young adult females (n = 1314, mean age: 22.2 years), it was associated with a greater risk of experiencing above-threshold anxiety symptoms. No genetic effect was found for rs2234693 and depressive symptoms in either cohort. A significant three-way gene-environment interaction was observed between rs9340799, stressful early life events, and supportive parenting on anxiety symptoms in female adolescents. These findings suggest a potential differential plasticity of the G allele in relation to anxiety symptoms in female youth. By incorporating longitudinal assessments and gene-environment analyses, this study contributes to the literature on internalizing symptoms in females in the context of estrogen-related constitutive vulnerability.

Background:

Onset of depression and anxiety can occur before, during, or after pregnancy, and ongoing conditions can either improve or deteriorate at all stages. National and international guidelines recommend that maternal health care should contribute to improving pregnant women's mental health by consistently asking pertinent questions during pregnancy and offering necessary support and care. The implementation of a program for psychosocial assessment has been carried out in a region in Sweden. The program includes the identification of risk factors and ongoing mental ill-health, consultation with psychologists within maternal and child health care, and care pathways to other health care providers.

Objective:

The general aim of this research project is to investigate the effects of a program for psychosocial assessment during pregnancy on patients, as well as to evaluate the experiences of midwives and psychologists when working with the program.

Methods:

A multimethod study design will be used to evaluate possible effects of a program for psychosocial assessment during pregnancy, including a pre-and postimplementation comparison, alongside a qualitative study of the professionals' perspectives. Data sources for the research project include patient data from the Swedish Pregnancy Register, medical records, questionnaire responses, and interviews with midwives and psychologists.

Results:

The recruitment process is completed, and data collection and analysis are ongoing. The dissemination plan includes several publications of original research and two doctoral theses.

Conclusions:

This study's results are expected to be relevant for maternal health care, both nationally and internationally, as scientific evaluations of the effects of implementing a program for psychosocial assessment during pregnancy are scarce. The implementation and evaluation of the program may hopefully, in the future, serve as a model for more standardized and effective care. It may influence national policies and attract attention as a model for improving perinatal mental health and maternity care.

International Registered Report Identifier (IRRID): DERR1-10.2196/67179

Purpose: Although anxiety disorders are common worldwide and often associated with significant impairment, many cases remain undetected and thus untreated. A lack of adequate screening partly explains this treatment gap, and easy-to-use screening instruments are needed to capture more than one type of anxiety disorder. The aim was to evaluate the psychometric properties of one such promising instrument: the Adult Anxiety Scale, AAS-15, intended to measure social anxiety disorder (social phobia), generalized anxiety disorder, and panic disorder.

Materials and methods: The Swedish version of the AAS-15 was evaluated in a community sample (N = 1066, mean age 22.93 years, 64.4% women).

Results: The psychometric properties were found to be good. Internal consistency ranged from very good to excellent, and a confirmatory factor analysis supported a three-factor model consistent with the three anxiety disorder dimensions that it purported to assess.

Conclusion: This evaluation of the AAS-15 supports the view of the scale as a useful tool for assessing social anxiety disorder, generalized anxiety disorder, and panic disorder. With strong psychometric properties, quick and easy administration, and coverage of the most common types of anxiety disorders in adults, the AAS-15 is a valuable addition to standardized assessment and anxiety screening in a variety of healthcare settings.

Objective:

Recently, an increased trend toward nondrinking among adolescents has arisen. Thus, the aim of this study was to evaluate the popular view in Sweden that adolescents have replaced alcohol with illicit drugs or other substances and to examine whether the use of illicit drugs, cigarettes, and/or snus among moderate and heavy alcohol users has changed.

Method:

Data were taken from a large population-based health survey distributed in 1995, 1997, 2001, 2004, 2006, 2008, 2010, 2012, 2014, 2017, and 2020, covering all students in 9th grade (15–16 years) and 11th grade (17–18 years) in a mid-sized Swedish county.

Results:

The proportion of nondrinkers who used other substances was very low, varying from 1.1% to 3.3% for illicit drugs, from 1.0% to 7.6% for current smoking, and from 1.2% to 6.2% for snus use. Further, no change was found in illicit drug use among moderate and heavy alcohol users from 2004 to 2017, but current smoking and snus use decreased. However, when compared with low alcohol users, moderate and heavy alcohol users had a higher probability of illicit drug use, cigarette smoking, and snus use.

Conclusions:

Adolescents have not replaced alcohol with other substances. When compared with low alcohol users, moderate and heavy alcohol users are more likely to use illicit drugs and nicotine. The low prevalence of substance use among nondrinkers may indicate that preventing alcohol use could have additional positive effects on illicit drug and nicotine use.

Anxiety symptoms and sleep problems typically emerge during adolescence and are frequently intertwined. However, there is a dearth of knowledge concerning their reciprocal influence and whether physical activity might play a protective role in this relationship. The present study aims at filling this gap exploring also the moderating role of sex. 915 13-year-old Swedish adolescents (56% girls) answered a survey conducted four times: at ages 13 (T1), 16 (T2), 19 (T3), and 22 (T4). A random intercept cross-lagged panel model was used. At within-levels, sleep problems and anxiety symptoms had a bidirectional positive association in middle adolescence. Vigorous physical activity and anxiety symptoms showed a reciprocal negative association from middle adolescence. Vigorous physical activity and sleep problems were reciprocally associated only in late adolescence. Associations were the same for girls and boys. This study demonstrated that the relations between anxiety symptoms, sleep problems, and vigorous physical activity cannot be understood without adopting a developmental perspective and that middle adolescence is a crucial period to plan interventions to reduce anxiety symptoms and sleep problems.

Introduction: The COVID-19 pandemic led to a surge in mental health issues and psychological distress, disruption to work/studying conditions, and social isolation particularly among young adults. Changes in these factors are differentially associated with alcohol use. Moreover, the relationship between these factors are bidirectional and may have fluctuated throughout the different phases of the pandemic. However, studies focusing on young adults had conflicting results, short follow-up periods, and lacked comprehensive data to describe underlying mechanisms.

Methods: 1067 young adults participated in repetitive measures termed wave 4 (2021) of the Survey of Adolescent Life in Västmanland Cohort “SALVe” Cohort. Of these, 889 also completed pre-pandemic measurements termed wave 3 (2018). Participants completed the Alcohol Use Disorders Identification Test (AUDIT) to evaluate alcohol consumption and harmful use. Cross-sectional associations between perceived changes in alcohol use and shift in individual, mental health, and work environment factors were examined using Chi-square tests. Logistic regression was utilized to identify pre-pandemic predictors of harmful consumption during the pandemic.

Results: Harmful consumption decreased only in females following the COVID-19 pandemic. Participants who reported increased feelings of depression, anxiety, and loneliness were more likely to increase their alcohol use. Interestingly, the subgroup who felt less lonely and met their friends more often, as well as those who continued working/studying from their regular workplace also had an increased likelihood of higher consumption. Only pre-pandemic ADHD and delinquency symptoms predicted harmful alcohol consumption following the pandemic.

Conclusion: Females reduced harmful alcohol consumption during the COVID-19 pandemic. While those who suffered the burden of social isolation and distress were more likely to increase their alcohol use, young adults who felt less lonely and met their friends more often also had a similar outcome. The relationship between loneliness and alcohol consumption among young adults is influenced by the social factors that may be facilitated by drinking.