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8. Increased Risk for Substance Use-Related Problems in Autism Spectrum Disorders: A Population-Based Cohort Study

Author

Butwicka, Agnieszka, Långström, Niklas, Larsson, Henrik, Lundström, Sebastian, Serlachius, Eva, Almqvist, Catarina, Frisén, Louise, and Lichtenstein, Paul

Abstract

Despite limited and ambiguous empirical data, substance use-related problems have been assumed to be rare among patients with autism spectrum disorders (ASD). Using Swedish population-based registers we identified 26,986 individuals diagnosed with ASD during 1973-2009, and their 96,557 non-ASD relatives. ASD, without diagnosed comorbidity of attention deficit hyperactivity disorder (ADHD) or intellectual disability, was related to a doubled risk of substance use-related problems. The risk of substance use-related problems was the highest among individuals with ASD and ADHD. Further, risks of substance use-related problems were increased among full siblings of ASD probands, half-siblings and parents. We conclude that ASD is a risk factor for substance use-related problems. The elevated risks among relatives of probands with ASD suggest shared familial (genetic and/or shared environmental) liability.

Published
2017
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17. Childhood Neurodevelopmental Disorders and Violent Criminality: A Sibling Control Study

Author

Lundström, Sebastian, Forsman, Mats, Larsson, Henrik, Kerekes, Nora, Serlachius, Eva, Långström, Niklas, and Lichtenstein, Paul

Abstract

The longitudinal relationship between attention deficit hyperactivity disorder (ADHD) and violent criminality has been extensively documented, while long-term effects of autism spectrum disorders (ASDs), tic disorders (TDs), and obsessive compulsive disorder (OCD) on criminality have been scarcely studied. Using population-based registers of all child and adolescent mental health services in Stockholm, we identified 3,391 children, born 1984-1994, with neurodevelopmental disorders, and compared their risk for subsequent violent criminality with matched controls. Individuals with ADHD or TDs were at elevated risk of committing violent crimes, no such association could be seen for ASDs or OCD. ADHD and TDs are risk factors for subsequent violent criminality, while ASDs and OCD are not associated with violent criminality.

Published
2014
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19. Effects of internet-delivered cognitive behavioral therapy on use of child sexual abuse material: A randomized placebo-controlled trial on the Darknet

Author

Lätth, Johanna, primary, Landgren, Valdemar, additional, McMahan, Allison, additional, Sparre, Charlotte, additional, Eriksson, Julia, additional, Malki, Kinda, additional, Söderquist, Elin, additional, Öberg, Katarina Görts, additional, Rozental, Alexander, additional, Andersson, Gerhard, additional, Kaldo, Viktor, additional, Långström, Niklas, additional, and Rahm, Christoffer, additional

Published
2022
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22. Relative Immaturity and ADHD: Findings from Nationwide Registers, Parent- and Self-Reports

Author

Halldner, Linda, Tillander, Annika, Lundholm, Cecilia, Boman, Marcus, Långström, Niklas, Larsson, Henrik, and Lichtenstein, Paul

Abstract

Background: We addressed if immaturity relative to peers reflected in birth month increases the likelihood of ADHD diagnosis and treatment. Methods: We linked nationwide Patient and Prescribed Drug Registers and used prospective cohort and nested case-control designs to study 6-69 year-old individuals in Sweden from July 2005 to December 2009 (Cohort 1). Cohort 1 included 56,263 individuals diagnosed with ADHD or ever used prescribed ADHD-specific medication. Complementary population-representative cohorts provided DSM-IV ADHD symptom ratings; parent-reported for 10,760 9-year-old twins born 1995-2000 from the CATSS study (Cohort 2) and self-reported for 6,970 adult twins age 20-47 years born 1959-1970 from the STAGE study (Cohort 3). We calculated odds ratios (OR:s) for ADHD across age for individuals born in November/December compared to January/February (Cohort 1). ADHD symptoms in Cohorts 2 and 3 were studied as a function of calendar birth month. Results: ADHD diagnoses and medication treatment were both significantly more common in individuals born in November/December versus January/February; peaking at ages 6 (OR: 1.8; 95% CI: 1.5-2.2) and 7 years (OR: 1.6; 95% CI: 1.3-1.8) in the Patient and Prescribed Drug Registers, respectively. We found no corresponding differences in parent- or self-reported ADHD symptoms by calendar birth month. Conclusion: Relative immaturity compared to class mates might contribute to ADHD diagnosis and pharmacotherapy despite absence of parallel findings in reported ADHD symptom loads by relative immaturity. Increased clinical awareness of this phenomenon may be warranted to decrease risk for imprecise diagnostics and treatment. We speculate that flexibility regarding age at school start according to individual maturity could reduce developmentally inappropriate demands on children and improve the precision of ADHD diagnostic practice and pharmacological treatment.

Published
2014
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23. Family Income in Early Childhood and Subsequent Attention Deficit/Hyperactivity Disorder: A Quasi-Experimental Study

Author

Larsson, Henrik, Sariaslan, Amir, Långström, Niklas, D'Onofrio, Brian, and Lichtenstein, Paul

Abstract

Background: Studies have found negative associations between socioeconomic position and attention deficit/hyperactivity disorder (ADHD), but it remains unclear if this association is causal. The aim of this study was to determine the extent to which the association between family income in early childhood and subsequent ADHD depends on measured and unmeasured selection factors. Methods: A total of 811,803 individuals born in Sweden between 1992 and 2000 were included in this nationwide population-based cohort study. Diagnosis of ADHD was assessed via the Swedish national Patient Register and the Swedish Prescribed Drug Register. Annual family income during offspring's first 5 years in life was collected prospectively from the Swedish Integrated Database for Labour Market Research and divided into quartiles by (lower) family disposable income. We predicted ADHD from family income while controlling for covariates and also comparing differently exposed cousins and siblings to control for unmeasured familial confounding. Results: The crude analyses suggested that children exposed to lower income levels were at increased risk for ADHD (HR[subscript Quartile 1] = 2.52; 95% CI, 2.42--2.63; HR[subscript Quartile 2] = 1.52; 95% CI, 1.45-1.58; HR[subscript Quartile 3] = 1.20; 95% CI, 1.14-1.15). his dose-dependent association decreased after adjustment for measured covariates (HR[subscript Quartile 1] = 2.09; 95% CI, 2.00-2.19; HR[subscript Quartile 2] = 1.36; 95% CI, 1.30-1.42; HR[subscript Quartile 3] = 1.13; 95% CI, 1.08-1.18). Although the association was attenuated in cousin comparisons (HR[subscript Quartile 1] = 1.61; 95% CI, 1.40-1.84; HR[subscript Quartile 2] = 1.28; 95% CI, 1.12-1.45; HR[subscript Quartile 3] = 1.14; 95% CI, 1.01-1.28) and sibling comparison models (HR[subscript Quartile 1] = 1.37; 95% CI, 1.07-1.75; HR[subscript Quartile 2] = 1.37; 95% CI, 1.12-1.68; HR[subscript Quartile 3] = 1.23; 95% CI, 1.04-1.45), it remained statistically significant across all levels of decreased disposable family income. Conclusions: Our results indicated that low family income in early childhood was associated with increased likelihood of ADHD. The link remained even after controlling for unmeasured selection factors, highlighting family income in early childhood as a marker of causal factors for ADHD.

Published
2014
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32. The Swedish twin registry: Establishment of a biobank and other recent developments

Author

Magnusson, Patrik KE, Almqvist, Catarina, Rahman, Iffat, Ganna, Andrea, Viktorin, Alexander, Walum, Hasse, Halldner, Linda, Lundstrom, Sebastian, Ullen, Fredrik, Langstrom, Niklas, Larsson, Henrik, Nyman, Anastasia, Gumpert, Clara Hellner, Rastam, Maria, Anckarsater, Henrik, Cnattingius, Sven, Johannesson, Magnus, Ingelsson, Erik, Klareskog, Lars, de Faire, Ulf, Pedersen, Nancy L, and Lichtenstein, Paul

Published
2013

36. Effects of internet-delivered cognitive behavioral therapy on use of child sexual abuse material : A randomized placebo-controlled trial on the Darknet

Author

Lätth, Johanna, Landgren, Valdemar, McMahan, Allison, Sparre, Charlotte, Eriksson, Julia, Malki, Kinda, Söderquist, Elin, Öberg, Katarina Görts, Rozental, Alexander, Andersson, Gerhard, Kaldo, Viktor, Långström, Niklas, Rahm, Christoffer, Lätth, Johanna, Landgren, Valdemar, McMahan, Allison, Sparre, Charlotte, Eriksson, Julia, Malki, Kinda, Söderquist, Elin, Öberg, Katarina Görts, Rozental, Alexander, Andersson, Gerhard, Kaldo, Viktor, Långström, Niklas, and Rahm, Christoffer

Abstract

Introduction The use of child sexual abuse material (CSAM) is an international public health and child protection challenge. Objective To investigate whether Prevent It, a therapist-supported, internet-delivered, eight-week, cognitive behavioral therapy, reduces CSAM viewing among users. Methods We conducted a global online single-blind (participants), parallel-group, superiority, randomized, psychological placebo-controlled trial with a one-month follow-up, 2019–2021 (ISRCTN76841676). We recruited anonymous participants, mainly from Darknet forums. Inclusion criteria: age 18+ years, past week CSAM use, and sufficient English language skills; exclusion criteria: severe psychiatric illness or non-serious intent to participate. The main outcome was change in self-reported, weekly viewing time from pre- to post-treatment, according to the Sexual Child Molestation Risk Assessment+. Results A total of 160 participants (157 male, 2 non-binary, and 1 not reporting gender) from all world regions (age intervals [%]: 18–29 [49]; 30–39 [30]; 40–49 [15]; 50–59 [6]) were randomized (1:1) to Prevent It (N = 80) or Placebo (N = 80). Between-group, intention-to-treat analyses suggested a significantly larger decrease in viewing time in Prevent It participants vs. controls pre- to post-treatment (Prevent It: N = 76, Placebo: N = 78, estimate −0.25, 95 % CI, −0.46 to −0.04, p = .017, Cohen's d 0.18). Negative side effects from treatment were fewer in Prevent It compared to control participants and neither group reported severe adverse events. Conclusion We provide initial support for the feasibility, efficacy, and safety of Prevent It to reduce CSAM viewing among motivated users. Further research is needed to validate these findings.

Published
2022
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38. The child and adolescent twin study in Sweden (CATSS)

Author

Anckarsater, Henrik, Lundstrom, Sebastian, Kollberg, Linnea, Kerekes, Nora, Palm, Camilla, Carlstrom, Eva, Langstrom, Niklas, Magnusson, Patrik KE, Halldner, Linda, Bolte, Sven, Gillberg, Christopher, Gumpert, Clara, Rastam, Maria, and Lichtenstein, Paul

Published
2011

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