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The overall aim of the present study was to examine the construct validity of different versions of the Shirom-Melamed Burnout Questionnaire/Measure (SMBQ/M) suggested in previous work, as well as to provide normative data for a large population-based sample in Sweden with a broad range in age. Cross-sectional data from the Västerbotten Environmental Health Study in Sweden were used. The 3406 participants (56% women) in this study, aged 18–79 years, constituted a random sample stratified for age and sex. Participants responded to a questionnaire including the 4-factor 22-item version of the SMBM as well as background questions and a number of validated questionnaire instruments assessing for example, sleep disturbance, depression, anxiety, perceived stress, and somatic symptoms. The dimensionality of different versions of the SMBM were examined with confirmatory factor analysis. A modified 4-factor 19-item model of the SMBM provided good model-fit, and two 2-factor models (11-item and 6-item) provided excellent model fit. The relationships to relevant psychological constructs provided support for convergent validity for the suggested versions of the SMBM. Finally, normative data were obtained for a broad age group for the different versions. In conclusion, we suggest that for assessing the core of the burnout construct in terms of emotional and physical exhaustion and cognitive weariness, the SMBM-11 or SMBM-6 for repeated measures, are to be used. For a broader assessment of burnout incorporating both symptoms and information about the process of exhaustion via the subscales of listlessness and tension, we recommend the use of the modified 4-factor SMBM-19.

Helplessness and hopelessness are transdiagnostic and aggravating factors of mental ill health, but their relation with somatization is not well documented. The main objectives were to identify somatic symptoms that are particularly associated with helplessness, referred to as somatic symptoms of helplessness (SS-He), and hopelessness, referred to as somatic symptoms of hopelessness (SS-Ho), determine increased risk of helplessness and hopelessness if having these symptoms and a certain number of these symptoms, and determine sensitivity and specificity in identifying helplessness and hopelessness based on number of these symptoms in a general Swedish sample. Population-based data from validated questionnaire instruments were used from 3,210 participants who constituted case groups of helplessness and hopelessness, and corresponding reference groups. Among 15 common somatic symptoms, five SS-He (e.g., feeling tired/having low energy) and five SS-Ho (e.g., dizziness) were identified, showing increased risk of helplessness and hopelessness that ranged from the factor 1.73 to 2.58 and from 1.44 to 1.92, respectively, which decreased considerably when controlled for depression and anxiety. The risk of helplessness increased by the factor 1.49 for each additional SS-He, and by 1.38 for each SS-Ho. A cutoff of two/three or more SS-He showed a sensitivity of 81.7/63.7% and a specificity of 40.6/61.4% in identifying helplessness, and 77.4/54.6% and 40.4/66.1%, respectively, in identifying hopelessness based on two/three or more SS-Ho. Primary care clinicians may consider further investigation of helplessness and hopelessness as well as depression and anxiety if presenting with these symptoms.

To determine whether dementia could explain the association between poor olfactory performance and mortality risk within a decade-long follow-up period.Prospective cohort study.Betula Study, Umeå, Sweden.A population-based sample of adult participants without dementia at baseline aged 40 to 90 (N = 1,774).Olfactory performance using the Scandinavian Odor-Identification Test (SOIT) and self-reported olfactory function; several social, cognitive, and medical risk factors at baseline; and incident dementia during the following decade.Within the 10-year follow-up, 411 of 1,774 (23.2%) participants had died. In a Cox model, the association between higher SOIT score and lower mortality was significant (hazard ratio (HR) = 0.74 per point interval, 95% confidence interval (CI) = 0.71-0.77, P.001). The effect was attenuated, but remained significant, after controlling for age, sex, education, and health-related and cognitive variables (HR = 0.92, 95% CI = 0.87-0.97, P = .001). The association between SOIT score and mortality was retained after controlling for dementia conversion before death (HR = 0.92, 95% CI = 0.87-0.97, P = .001). Similar results were obtained for self-reported olfactory dysfunction.Poor odor identification and poor self-reported olfactory function are associated with greater likelihood of future mortality. Dementia does not attenuate the association between olfactory loss and mortality, suggesting that olfactory loss might mark deteriorating health, irrespective of dementia.

Nonspecific building-related symptoms (NBRS) is a combination of general, skin and mucosal symptoms related to certain buildings. Despite high prevalence in the general population and severe symptomatology in certain cases there is no scientific documentation of quality of life in NBRS. The purpose of this study was to illuminate how individuals with NBRS experience daily life. Data were collected through descriptive, written texts and through telephone interviews with 11 individuals diagnosed with NBRS, and qualitative content analysis was conducted. Three main content areas were identified: (1) attitudes from the surrounding (categories: being questioned and lack of understanding from others; from zero to full support); (2) consequences (difficulties with daily activities; financial difficulties; affecting family and friends; emotional consequences); and (3) coping (learning to accept and finding solutions; avoiding; struggling; finding the positive; making one's home a sanctuary). As a conclusion, NBRS may affect several aspects of daily life, resulting in considerable alterations, limitations and emotional impact for the afflicted person and his/her family. Both environmental factors and attitudes from the surrounding can contribute to this impact on daily life. Strategies needed to cope with this impact may include both problem-focused and emotion-focused strategies, such as struggling, avoiding trigger factors and finding positive aspects.

This study tested the hypothesis of a positive relation between deliberate self-harm and poor self-image in adolescents and investigated the relation between substance abuse (drugs, cigarettes, and alcohol) and deliberate self-harm. One-hundred thirteen high-school students, aged predominantly 16-18 years, responded to the 16-item version of the Deliberate Self-Harm Inventory, the 36-item Structural Analysis of Social Behavior, and single questions about use of drugs, cigarettes, and alcohol. The results showed a positive relation between deliberate self-harm and poor self-image, and between deliberate self-harm and cigarette smoking and alcohol consumption. These results imply that poor self-image and a large extent of substance use may be markers for identifying adolescents at risk for deliberate self-harm.

The perceived stress scale (PSS) has been translated to several languages and validated in many cultures. The longer 14-item version (PSS-14), has been translated to Swedish and validated for Swedish use. However, the Swedish version of the shorter 10-item version (PSS-10) has not been validated before. Therefore, the aim of this study was to evaluate the Swedish version of the PSS-10 with regard to reliability and validity, and to provide normative data. Data from 3,406 individuals who took part in the Västerbotten Environmental Health Study in Sweden were used. The respondents constitute a random sample, aged 18 to 79 years, and stratified for age and sex. They responded to the Swedish version of the PSS-10 as well as to the hospital anxiety and depression scale, and the Shirom Melamed burnout questionnaire for assessment of construct validity. The results show that the PSS-10 provides approximately normally distributed data, has good internal reliability (Cronbach's alpha 0.84), and has good construct validity with anxiety (r = 0.68), depression (r = 0.57), and mental/physical exhaustion (r = 0.71). The favorable psychometric properties of the Swedish version of the PSS-10 suggest use of the instrument for assessing perceived stress in Swedish and similar populations.

The lack of an available Swedish version of the Patient Health Questionnaire 15-Item Somatic Symptom Severity Scale (PHQ-15) motivated the present psychometric evaluation of such a version as well as providing normative data for the PHQ-15. Data from 3,406 individuals who took part in the Vasterbotten Environmental Health Study in Sweden were used. The respondents constitute a random sample, aged 18 to 79 years, stratified for age and sex. They responded to a Swedish translation of the PHQ-15 as well as the Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the Shirom Melamed Burnout Questionnaire for assessment of convergent validity. The distribution of PHQ-15 scores was positively skewed and mesokurtic in shape, and the internal consistency of the PHQ-15 was satisfactory. Correlation coefficients between PHQ-15 score and the measures of anxiety, depression, stress and mental/physical exhaustion indicate satisfactory validity. Normative data for PHQ-15 scores as well as for categories of somatic symptom severity are provided. The favorable psychometric properties of the Swedish version of the PHQ-15 suggest use of this instrument for quantification of somatization in Swedish and similar populations, and has the advantage of available normative data.

Aims and objectives. To study coping strategies, social support and responsibility for improvement in chemical intolerance (CI). Background. Limited knowledge of CI among health professionals and l ...

The objective of this study was to examine workers' mental interpretation models developed in response to occupational chemical exposure. The study was performed in six companies within the reinforced plastics industry in northern Sweden, in which styrene was used; 32 workers participated in the study. Each worker performed between four and seven exposure measurements. Before receiving each result of the second to seventh measurements, the workers were asked to predict the level of their next exposure measurement. Their predictions were evaluated with respect to two judgmental principles: coherence (that the predictions are based on logical decision rules, that is, the mean value of the prior exposure levels); and correspondence (the predictions have high empirical accuracy) by calculating the mean absolute percent forcast error (MAPE). The coherence principle was tested by comparing each of the workers' predictions with the mean, median, and last exposure level (last value) of the prior measurements. The correspondence principle was tested by comparing the worker's prediction with the outcome of the measurement. The coherence principle was found to be the best descriptor of the workers' predictions and the median model had the best fit. The mean model had a similar but significantly poorer fit (MAPE values of 29 and 31, respectively). The correspondence model had a poor fit with a MAPE of 54. The workers' predictions were generally lower than their average exposures. We conclude that the workers' interpretation model can be best described by a coherence model rather than by a correspondence model.

Development and evaluation of a category ratio scale with semantic descriptors : The environmental annoyance scale

The study investigated whether the P600/SPS component is sensitive to the richness of semantic content in sentences. ERPs were recorded while 30 native Swedish speakers read sentences, of which half were syntactically correct and half contained a syntactic violation. Both kinds of sentences came in one of three types of descending semantic completeness: semantically coherent sentences, sentences which were incoherent due to violations of selectional restrictions, or sentences of pseudo words, hence void of lexical content. In the semantically coherent sentences a P600/SPS was found for the syntactic violation. A less salient positivity was found for the violation in the semantically incoherent sentences. No P600/SPS was found for the syntactic violation in the pseudo word sentences and no LAN component in any sentence type. The results are interpreted as supporting the hypothesis that the P600/SPS component reflects a semantically based reanalysis process.

Olfactory (H2S) and trigeminal (CO2) event-related potentials (ERPs) were studied with respect to circadian rhythm and desensitization. ERPs, perceived odor and pain intensity, oral temperature, blood pressure, heart rate, nasal volume, and sleepiness were assessed four times at 04:00, 08:00, 12:00, 16:00, 20:00, and 24:00 hr in five young men. For each of these 24 sessions per participant, H2S and CO2 were each presented in 15 series of five stimuli with a 5-s ISI within and 30-s ISI between series. ERP amplitudes, but not latencies, followed a circadian rhythm (largest at 16:00 and smallest at 04:00) similar to oral temperature and opposite to sleepiness. Amplitudes decreased (most pronounced at 16:00 and 20:00) and latencies increased with repeated stimulation, suggesting desensitization, in accordance with odor and pain intensity. These findings imply that circadian rhythm and desensitization should be considered in chemosensory ERP studies.

A series of studies was initiated to model the organization of semantic memory in Alzheimer's disease (AD) patients using multidimensional scaling (MDS) and Pathfinder analyses. The resulting models (cognitive maps or semantic networks) embed studied stimuli in a coordinate space or network where distances between points are assumed to reflect psychological proximity between items. The organization of semantic networks in verbal and sensory domains were modeled based upon the frequency of the subject's choice of two concepts as most alike. Results suggested that while the organization of concepts in the semantic networks of AD patients was primarily based upon a concrete perceptual dimension in both verbal and olfactory domains, those of normal controls subjects were predominantly organized by an abstract conceptual attribute. Also, networks of AD patients were more complex and chaotic than normal, that is, they consisted of more unnecessary connections and of atypical strengths of association between concepts.

The ability in normal elderly to verbally recall previously presented odors and to learn this task across trials was studied by applying a design which compared performance on the California Verbal Learning Test (CVLT) with an analogous odor test. Results suggest that both immediate and delayed recall of odors, both free and cued, as well as the ability to learn across trials is impaired in normal aging, perhaps more so for olfaction than for audition, which can be referred to poor use of semantic-clustering strategies and poor identification. Olfactory decline in memory in normal aging is, however, far from as affected as in Alzheimer's disease (AD). Two studies of persons with questionable AD demonstrated significant deficits in both recognition memory and identification of odors. Although further research is required, the findings from these 'pre-clinical' cases imply that performance on olfactory-mediated tasks may contribute to early diagnosis of AD.

For studying changes in the sensory sensitivities, psychophysical methods offer a variety of models. The psychophysical approach also holds for applications on indoor air quality. The human senses can be used for characterizing environments in terms of effects on health and comfort, and have been used by the WHO for determining recommended exposure limits. The use of psychophysical methods for air pollution applications is illustrated by two studies on effects on sensory functions in smokers and passive smokers. Olfactory as well as auditory effects were found. Furthermore, methodological findings are presented, such as obtaining information on detectability and perceived intensity in the very same estimation procedure. The results also demonstrate the need for calibrating scales with regard to individual scaling behavior in perceived intensity measurements as well as the capability of the master scale principle for performing such a calibration.