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Burnout is a psychological consequence of prolonged work-related stress. Previous studies have concluded that guilt feelings could explain the development of the burnout process and its relationship with other health disorders. The aim of this study was to evaluate the mediating role of guilt feelings in the relationship between burnout and psychosomatic problems. The sample comprised 714 Brazilian teachers (82.10% women). Burnout was assessed using the Spanish Burnout Inventory (SBI). The hypotheses were evaluated together using a path model to test the mediating role of guilt feelings in the development of burnout and its relationship with psychosomatic problems. Two models were constructed: the hypothesized model (i.e., indolence → guilt → psychosomatic problems) vs. the alternative model (i.e., indolence → psychosomatic problems → guilt). According to the results, the hypothesized model obtained a satisfactory fit to the data, whereas the alternative model's fit was found to be inadequate. We concluded that the hypothesized model was a good representation of the relationship among burnout, guilt feelings and psychosomatic problems. We recommend taking into consideration feelings of guilt to improve the diagnosis of burnout.

Purpose: To analyze potential associations between sociodemographic factors and adolescents' worry about family finances and other types of worries during the COVID-19 pandemic and the potential associations between different worry themes and psychosomatic problems., Methods: From December 2020 to March 2021, 3,068 16-17 years old students in Sweden completed a questionnaire about the impact of the COVID-19 pandemic on their schooling and everyday life. From April to June 2020, 70% of these students also responded to questions about their psychosomatic health. Logistic regression was applied to analyze the associations between sociodemographic factors and different worry themes and estimate the association between worry and psychosomatic problems., Results: Across all 13 worry themes, girls reported worry to a higher degree than boys. In most of the cases, adolescents with a lower parental educational background or immigrant background reported more frequent worrying. This was most evident for worry about family finances. The differences between adolescents with a Swedish background and those with a foreign background were large except for worry about climate change. All worry themes were associated with the students' psychosomatic health. Those who often or always experienced worry were more likely to report psychosomatic problems. Worry about family finances showed the highest odds ratio and marginal effect., Discussion: Worry about family finances during the COVID-19 pandemic turns out to be a strong and socially structured stressor that may widen the health inequalities among young people. This underlines the need for preventive and promoting measures aimed at supporting socioeconomic disadvantaged groups., (Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

We carried out a survey in the Czech Republic between January and February 2021 to evaluate the impact of COVID-19 on doctors working in the COVID-19 unit. A rise in 250,000 cases were seen in the Czech Republic during the time of the survey. The indirect impact of the disease on doctors working in COVID-19 units and strategies to control the situation in the Czech Republic were evaluated here. About 35% doctors were concerned with health issues, 40% had tested positive for SARS-CoV-2 antigen, 51% reported lack of support for those who had contracted COVID-19 and 163 agreed that medical, psychological counselling and financial services should be provided. Most doctors experienced moderate and severe degrees of psychological impact. Doctors with the least working experience and those with at least 21 to 35 years were most affected. Mental fatigue was the most common reported psychosomatic effect. The effects were higher in doctors who were more concerned about working in COVID-19 units. Around 87% agreed that the best strategy in controlling the situation in the Czech Republic would be 'preventive measures in combination with vaccination'. History shows us that pandemics can occur in multiple waves. Subsequent waves, inadequate support as well as unparalleled workload can lead to a serious rise in psychological disorders amongst HCWs worldwide.

Medical education is highly demanding and evidence shows that medical students are three times more susceptible to deteriorating physical and mental health than the average college student. While trait anxiety may further increase such risk, little is known about the role of trait mindfulness in mitigating these effects. Here we examine the protective role of specific mindfulness facets as mediators in pathways from trait anxiety to perceived stress, psychosomatic burden and sleep-wake quality in medical students, across repeated measurements throughout the first trimester of the school year. Preclinical medical students enrolled in the second year of the Medical School of University of Bologna completed self-report questionnaires examining personality traits as well as physical and psychological wellbeing. Data were collected at the beginning (Time 1: N = 349) and the end of the first trimester (Time 2: N = 305). As students approached the end of the trimester and upcoming exams, reported levels of perceived stress, psychosomatic problems and difficulties in wakefulness increased significantly compared to the beginning of the trimester. Mediation results showed that trait anxiety predicted such outcomes whereas the protective role of mindfulness facets in mitigating these effects was significant only at Time 2. Specific facets of Nonjudging of inner experience and Acting with awareness proved to be the most effective mediators. Findings highlight that the beneficial role of mindfulness facets in mitigating negative consequences of trait anxiety on medical student wellbeing is revealed in high-pressure periods and when self-regulation is needed the most. Cultivating awareness and nonjudgmental acceptance of one's inner experiences is a crucial self-regulation resource that can help medical students sustain their wellbeing as they learn and throughout their high-pressure education and professional careers., (© 2021. The Author(s).)

Aims: To characterize changes in patterns of adolescent substance use in Sweden between 1988 and 2011, and to assess whether sex and psychosomatic problems were associated with substance use and whether these associations changed over time., Design: Secondary analysis of repeated cross-sectional survey data. Survey data were collected eight times and analyzed as four cohorts (1988-91, 1995-98, 2002-05 and 2008-11)., Setting and Participants: The sample included all 15-16-year-olds in Värmland County, Sweden (n = 20 057)., Measurements: Binary-coded substance use measures included life-time use of alcohol and tobacco, getting drunk and past school year use of inhalants. An eight-item scale was used to assess psychosomatic problems., Findings: A three-class model fitted the data best (i.e. non/low use, mainly alcohol use and polysubstance use). The patterns of substance use were different among cohorts; most notably, adolescents in the last cohort had lower odds of being included in the alcohol and polysubstance use classes rather than the non/low use class than in the earlier cohorts (all Ps < 0.001). Males had higher odds than females of being in the polysubstance use class rather than the non/low use class among the first three cohorts (all Ps < 0.001) but not the last. Sex was not associated with inclusion in the alcohol use class rather than the non/low use class. Adolescents who reported more psychosomatic problems had higher odds of being included in the alcohol and polysubstance use classes rather than the non/low use class (all Ps < 0.001). The associations of sex and psychosomatic problems with class inclusion did not change during the study period., Conclusions: Between 1988 and 2011, patterns of substance use among adolescents in Sweden shifted away from polysubstance use and alcohol use to non-use or low use. Associations between patterns of substance use and sex and psychosomatic problems remained largely consistent across the study period., (© 2020 Society for the Study of Addiction.)

Background: An overarching objective in research comparing different sample groups is to ensure that the reported differences in outcomes are not affected by differences between groups in the functioning of the measurement instruments, i.e. the items have to work in the same way for the different sample groups to be compared. Lack of invariance across sample groups are commonly called Differential Item Functioning (DIF). There is a sense in which the DIF of an item can be taken account of by resolving (splitting) the item into group specific items, rather than deleting the item. Resolving improves fit, retains the reliability and content provided by the item, and compensates for the DIF in estimation of person parameters on the scale of the instrument. However, it destroys invariance of the item's parameter value among the groups. Whether or not a DIF item should be resolved depends on whether the source of the DIF is relevant or irrelevant for the content of the variable. The present paper shows how external information can be used to investigate if the gender DIF found in the item "Stomach ache" in a psychosomatic symptoms scale used among adolescents may reflect abdominal pain because of a biological factor, the girls' menstrual periods., Methods: Swedish data from the international Health Behaviour in School-aged Children study (HBSC) collected in 2005/06, 2009/10 and 2013/14 were used, comprising a total of 18,983 students in grades 5, 7 and 9. A composite measure of eight items of psychosomatic problems was analysed for DIF with respect to gender and menstrual periods using the Rasch model., Results: The results support the hypothesis that the source of the gender DIF for the item "Stomach ache" is a gender specific biological factor. In that case the DIF should be resolved if the psychosomatic measure is not intended to tap information about abdominal pain caused by a gender specific biological factor. In contrast, if the measure is intended to tap such information, the DIF should not be resolved., Conclusions: The conceptualisation of the measure governs whether the item showing DIF should be resolved or not.

Aims: The aim of the present study was to examine changes over time in the relationship between self-reported school demands and psychosomatic problems, also considering the impact of student influence and teacher support., Methods: Data from a cross-sectional study (Young in Värmland) including eight data collections (1988-2011) among Swedish students aged 15-16 were used ( n = 20,115). Analyses with multinomial logistic regression and descriptive statistics were applied., Results: Between 1988 and 2011, the proportions of students with a higher degree of psychosomatic problems increased, as did the proportion of students experiencing school demands that were too high. Finer-level analyses based on stratification of student groups did not show any associations at the aggregated level between increases of school demands and psychosomatic problems. Similarly, individual level analyses showed that the strength of the association between school demands and psychosomatic problems was not affected by year of investigation., Conclusions: Changes in school demands over time could not explain the increasing trend in psychosomatic problems among adolescents. Since the relationship between school demands and psychosomatic problems is strong across time, there is, however, a continued need for school-based interventions. More studies are required to gain further understanding of adolescent mental health from a trend perspective.

The study had two goals: (1) to explore the relations between self-assessed childhood depression and other adaptive and clinical variables (2) to identify predictor variables of childhood depression. Participants were 420 students aged 7-10 years old (53.3% boys, 46.7% girls). Results revealed: (1) positive correlations between depression and clinical maladjustment, school maladjustment, emotional symptoms, internalizing and externalizing problems, problem behaviors, emotional reactivity, and childhood stress; and (2) negative correlations between depression and personal adaptation, global self-concept, social skills, and resilience (sense of competence and affiliation). Linear regression analysis including the global dimensions revealed 4 predictors of childhood depression that explained 50.6% of the variance: high clinical maladjustment, low global self-concept, high level of stress, and poor social skills. However, upon introducing the sub-dimensions, 9 predictor variables emerged that explained 56.4% of the variance: many internalizing problems, low family self-concept, high anxiety, low responsibility, low personal self-assessment, high social stress, few aggressive behaviors toward peers, many health/psychosomatic problems, and external locus of control. The discussion addresses the importance of implementing prevention programs for childhood depression at early ages.

Objective: Worldwide there are frequent reports on increasing psychosomatic problems, anxiety, emotional distress, conduct problems, and depression among adolescents. Recently, it was contended that secular studies on such aspects of adolescent mental health can only be evaluated adequately when data on symptom prevalence are analyzed together with data on functional impairment. Still, this has not yet been done in epidemiological time-trend studies on any aspect of adolescent mental health. Therefore, this study aims to investigate if, and to what extent, changes in adolescents' symptoms of psychosomatic problems are affected when data on functional impairment are taken into account simultaneously., Methods: A repeated cross-sectional population study relating self-reported symptoms of psychosomatic problems to functional impairment; covering the time-period 1988-2011 and including 19.823 adolescents 15-16years old in eight cohorts in one geographically defined population (Värmland, Sweden)., Results: The proportion of adolescents with psychosomatic problems had increased significantly from 1988 to 2005/2008. In all cohorts the proportion of girls with psychosomatic problems was significantly higher than the proportion of boys reporting symptoms. Over the same period, there was a corresponding significant increase of the proportion of participants with symptoms of psychosomatic problems in combination with functional impairment. Adding functional impairment to the measure of psychosomatic problems decreased the prevalence rates, while the shapes of the trend-curves stayed congruent in form., Conclusion: The long-term pattern of increasing psychosomatic problems among adolescents remains evident, even when taking functional impairment data into account. Previously observed trends of a deteriorating adolescent mental health are thus consistent with this study., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Aims: Profound changes in family structure took place in many countries, during the second part of the previous century. The purpose of this paper is to analyse the association between the type of family residency and psychosomatic problems in younger and older adolescents, particularly focusing on alternate residency, and to examine the impact of child-parent relations., Methods: We used data collected in 2009 by Statistics Sweden among 172,298 Swedish students in Grade 6 and Grade 9 (approximate ages 12 and 15 years old); comprising 80% and 86%, respectively, of the entire population of students in those grades. We collected the data with a questionnaire, completed anonymously in school: We used the Psychosomatic Problems (PSP) scale as the outcome measure., Results: The type of family residency showed a weaker association with psychosomatic problems than the child-parent relationships did. Living in non-intact families increased the probability of adolescent psychosomatic problems by 0-0.05, compared to intact families. In Grade 9, there were no differences in psychosomatic problems between the students in alternate residency and those living with their two parents; and in Grade 6, these differences were relatively small. In comparison, a worse relationship with parents increased the probability of psychosomatic problems by 0.11-0.17, depending on the school grade and type of family residency., Conclusions: The structure of the family, as well as the child-parent relationships needs to be taken into account, to properly estimate the magnitude of the family situation as a determinant of adolescent psychosomatic problems. Our results justify universal intervention at the policy level., (© 2015 the Nordic Societies of Public Health.)

Objective: To investigate the factors associated with exposure to in-real-life (IRL) bullying, cyberbullying, and both IRL and cyberbullying and to explore the relationship between these types of bullying and mental health among 13-16-year-old Swedish boys and girls., Methods: Data was derived from a cross-sectional web-based study of 13-16-year-old students in northern Sweden (n=1214, response rate 81.9%)., Results: The combination of IRL- and cyberbullying was the most common type of bullying. A non-supportive school environment and poor body image were related to exposure to bullying for both genders but the relationship was more distinct in girls. All types of bullying were associated with depressive symptoms in both boys and girls and all forms of bullying increased the likelihood of psychosomatic problems in girls., Conclusions: Cyberbullying can be seen as an extension of IRL bullying. A combination of IRL- and cyberbullying seems to be particularly negative for mental health. Interventions should focus on improved school environment and body image as well as anti-violence programmes. Gender aspects of bullying need to be acknowledged., (© 2014 the Nordic Societies of Public Health.)

Background and Objective: A previous meta-analysis showed that being bullied during childhood is related to psychosomatic problems, but many other studies have been published since then, including some longitudinal studies. We performed a new meta-analysis to quantify the association between peer victimization and psychosomatic complaints in the school-aged population., Methods: We searched online databases up to April 2012, and bibliographies of retrieved studies and of narrative reviews, for studies that examined the association between being bullied and psychosomatic complaints in children and adolescents. The original search identified 119 nonduplicated studies, of which 30 satisfied the prestated inclusion criteria., Results: Two separate random effects meta-analyses were performed on 6 longitudinal studies (odds ratio = 2.39, 95% confidence interval, 1.76 to 3.24) and 24 cross-sectional studies (odds ratio = 2.17, 95% confidence interval, 1.91 to 2.46), respectively. Results showed that bullied children and adolescents have a significantly higher risk for psychosomatic problems than non-bullied agemates. In the cross-sectional studies, the magnitude of effect size significantly decreased with the increase of the proportion of female participants in the study sample. No other moderators were statistically significant., Conclusions: The association between being bullied and psychosomatic problems was confirmed. Given that school bullying is a widespread phenomenon in many countries around the world, the present results indicate that bullying should be considered a significant international public health problem.