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• Cyberbullying victimisation was associated with youth drinking. • The link with traditional bullying victimisation varied depending on the measure. • The patterns were similar for any alcohol use and drunkenness. • Interventions should consider both traditional bullying and cyberbullying. Victims of bullying are at an increased risk not only of developing adverse mental health, but also of engaging in health risk behaviours. One way in which adolescents may cope with the health-related consequences of bullying victimisation is through substance use such as alcohol and narcotics, as posited by the self-medication hypothesis. Indeed, previous research has found a link between traditional (face-to-face) bullying victimisation and alcohol use among adolescents, albeit with some inconsistencies. However, studies examining both traditional bullying and cyberbullying among youth often report an association only between cyberbullying victimisation and drinking. The current study seeks to add to this field of research by analysing the predictive capacity of traditional and cyberbullying victimisation for youth drinking whilst also adjusting for bullying perpetration and sociodemographic characteristics. In the analyses, we distinguished between occasional and frequent victimisation, and performed separate investigations of how specific types of traditional bullying and cyberbullying victimisation are related to youth drinking. Data were obtained from the Swedish Health Behaviour in School-aged Children (HBSC) survey, with pooled cross-sectional information from 2013/14 and 2017/18 collected among 13- and 15-year-old students (n = 7126). Any alcohol use and drunkenness during the past 30 days were used as dependent variables. The respondents were categorised as non-victims, occasional victims, and frequent victims of traditional and cyberbullying, respectively. Binary logistic regression analyses were performed to examine the associations between bullying victimisation and youth drinking. The results showed that 21.2% of students reported that they had been bullied at least once or twice in the past months, either as victims of traditional bullying only (8.3%), cyberbullying only (7.8%), or both (5.1%). When both types of bullying victimisation were mutually adjusted for, only cyberbullying remained significantly associated with an increased risk of drinking. However, when specific types of face-to-face bullying victimisation were analysed, several statistically significant associations with youth drinking were found, even when controlling for cyberbullying victimisation. Associations with any alcohol use and drunkenness were overall very similar. To conclude, this study corroborates previous research which has shown youth drinking to be more consistently related with cyberbullying victimisation than with traditional bullying victimisation. The study also extends previous knowledge by showing that the association between traditional bullying victimisation and youth drinking differs depending on the operationalisation of victimisation. Future research might benefit from examining this more thoroughly. The findings highlight that interventions targeting bullying and its effects should consider both face-to-face and online victimisation. [ABSTRACT FROM AUTHOR]

Drawing upon ideas stemming from social disorganisation theory, this study explores how structural and social aspects of the school context affect youth substance-use behaviours in terms of smoking, alcohol and/or drug use. A key focus is to investigate the joint effect of school collective efficacy and schools' substance-use norms on students' substance use. Analyses are based on combined information from two independent data collections conducted in 2014 among ninth grade students (n = 5122) and teachers (n = 1105) in 81 senior-level schools in Stockholm. Results from multilevel analyses confirm previous research by suggesting that the proneness to engage in substance use varies depending on the socioeconomic profile of the school. Youth in socioeconomically advantaged schools were more prone to engage in substance use than youth in disadvantaged school settings. Furthermore, collective incentives for exerting social control against substance use seem to be weaker in schools where conventional values towards substance use (anti-substance-use norms) are suppressed. [ABSTRACT FROM AUTHOR]

Background: Gambling is not uncommon among adolescents, and a non-trivial minority has serious problems with gambling. Therefore, enhanced knowledge about factors that may prevent against problematic gambling among youth is needed. Prior research has shown that a strong school ethos, which can be defined as a set of attitudes and values pervading at a school, is associated with a lower inclination among students to engage in various risk behaviours. Knowledge about the link between school ethos and adolescent gambling is however scarce. The aim of the study was to investigate the association between teacher-rated school ethos and student-reported gambling and risk gambling, when controlling also for sociodemographic characteristics at the student- and the school-level.Methods: Data from two separate cross-sectional surveys were combined. The Stockholm School Survey (SSS) was performed among 5123 students (aged 17-18 years) in 46 upper secondary schools, and the Stockholm Teacher Survey (STS) was carried out among 1061 teachers in the same schools. School ethos was measured by an index based on teachers' ratings of 12 items in the STS. Adolescent gambling and risk gambling were based on a set of single items in the SSS. Sociodemographic characteristics at the student-level were measured by student-reported information from the SSS. Information on sociodemographic characteristics at the school-level was retrieved from administrative registers. The statistical method was multilevel regression analysis. Two-level binary logistic regression models were performed.Results: The analyses showed that higher teacher ratings of the school's ethos were associated with a lower likelihood of gambling and risk gambling among students, when adjusting also for student- and school-level sociodemographic characteristics.Conclusions: This study showed that school ethos was inversely associated with students' inclination to engage in gambling and in risk gambling. In more general terms, the study provides evidence that schools' values and norms as reflected by the teachers' ratings of their school's ethos have the potential to counteract unwanted behaviours among the students. [ABSTRACT FROM AUTHOR]

Background: The sibling bond is often the longest relationship in an individual's life, spanning both good and bad times. Focusing on the latter, we investigated whether a cancer diagnosis in one adult sibling is predictive of psychiatric illness in the other, and if any such effect differs according the 'sociodemographic closeness' between the siblings in terms of sex, age, education, marital status and residence. Methods: We used hospital records to identify psychiatric diagnoses (2005–2019) in a Swedish total-population cohort born in 1953, and cancer diagnoses (2005–2017) in their full siblings. By means of emulated clinical trials, the cohort member's risk of a diagnosis within two years following a first exposure (or non-exposure) to a sibling's cancer was analyzed through Cox regression. Results: Exposed cohort members had a higher risk of psychiatric diagnosis than unexposed (HR = 1.15; CI: 1.08–1.23), with men displaying a higher risk (1.19; CI: 1.09–1.31) than women (HR = 1.11; CI: 1.01–1.22). Sub-analyses of the exposed group showed that women with a cancer-stricken sister had a higher risk of adverse psychiatric outcomes (HR = 1.31; CI: 1.07–1.61) than women with a cancer-stricken brother. Furthermore, unmarried cohort members ran a higher risk, both when the cancer-stricken sibling was married (HR = 2.03; CI: 1.67–2.46) and unmarried (HR = 2.61; CI: 2.16–3.15), than in cases where both siblings were married. No corresponding difference were detected for 'closeness' in age, education and residence. Conclusions: In line with theories of linked lives, our findings suggest that negative events in one sibling's life tend to 'spill over' on the other sibling's wellbeing, at least during the 15-year-long period leading up to retirement age. [ABSTRACT FROM AUTHOR]

Being bullied at school is strongly related to psychological health complaints at the same time point. Studies have also found long-term associations, but few have combined a prospective design with children’s own reports on bullying, and conducted gender-specific analyses. The present study assesses health consequences in young adulthood of self-reported victimization in adolescence using data from Child-LNU in 2000 and the follow-up in 2010 (including 63% of the original sample,n = 813). At ages 10–18 a clear cross-sectional association was found for both girls and boys. Among girls, exposure to bullying also predicted psychological complaints 10 years later, at ages 20–28 (OR = 2.86). This association was not explained by socioeconomic circumstances, neither in adolescence nor in young adulthood. Instead, it can partly be understood as victimization, among adolescent girls, being associated with negative self-image and psychological health as well as with deficits in social resources more generally. [ABSTRACT FROM PUBLISHER]

This study explores the relative contribution of parental and teacher support to adolescents' psychosomatic health complaints, with a particular focus on gender and age differences. Based on a survey of 49,172 ninth- and eleventh-grade students in Stockholm (2006-2014), structural equation modeling results demonstrated negative associations between parental and teacher support on psychosomatic health complaints. Parental support had a stronger association with the outcome among girls than boys. It was also more important than teacher support for psychosomatic health complaints. Parental support was more important for younger girls' health compared to older girls, with opposite patterns for teacher support. These findings highlight the need to consider gender and age to understand the links between social support and health during adolescence. [ABSTRACT FROM AUTHOR]

Aim: This study explores the association between the psychosocial work environment in school and students' somatic health complaints. With its point of departure from the Demand-Control-Support (DCS) model, the aim was to examine how aspects of decision control and social support can moderate stress-related health implications of high psychological demands. Methods: Data come from two cross-sectional waves of the Swedish version of Health Behaviour in School-aged Children (HBSC 2005/2006 and 2009/2010), which consists of a total of 9427 11-, 13- and 15-year-old students. A two-level random intercept model was applied, with school class as the level 2 unit. Results: Findings showed significant associations between school demands and somatic health complaints for all studied age groups, with a slight increase in strength with age. Decision control as well as social support from teachers, parents and peers consistently predicted a favorable association with health. An age pattern emerged in the analyses of stress-moderating resources. For 11 year olds parental support was the only resource that displayed a significant interaction with demands in relation to somatic health complaints, whereas for 13 year olds, decision control and support from teachers and parents all demonstrated moderating effects on student health. For 15 year olds, however, it was peer support that acted as a buffering resource in the studied relationship. Conclusions: The psychosocial work environment is an important predictor of students' health complaints. Overall, social support was a better stress-moderating resource than decision control, but some "buffers" were more important at certain ages than others. [ABSTRACT FROM AUTHOR]

Using multilevel modeling, this study examined how different types of bullying, involving both peers and teachers, relate to psychosomatic health complaints. Data were obtained via the Stockholm School Survey from 41,032 ninth- and eleventh-grade students in the years 2004, 2006, 2008, and 2010. Results showed that students involved in bullying as either a bully, a victim, or both a bully and a victim displayed poorer psychosomatic health than those not involved in bullying. Victims of peer-bullying also reported significantly poorer health than perpetrators. Two class-aggregated measures of bullying remained positively associated with ninth-grade student health complaints even when their individual-level analogues were taken into account. Thus, both the proportion of victims of teacher-bullying and peer-bullying in the school class appeared to generate health problems that go beyond the directly exposed students. However, an interaction revealed that the latter association was confined to female students only. [ABSTRACT FROM AUTHOR]

This study investigates cross-cultural differences in the interrelation between school performance, school segregation, and stress-related health among 9th-grade students in the greater Stockholm and Helsinki areas. Contrary to the Swedish case, it has been proposed that school performance in Finland is largely independent of the specific school attended and of socioeconomic background. Finland also stands out as a contrast to Sweden considering their better performance in the Programme for International Student Assessment (PISA) surveys. Our first 2 hypotheses explore whether there is a greater degree of school segregation in Stockholm than in Helsinki, and our second pair of hypotheses test whether Finland’s school success has come at a price in terms of increased student stress. Our results largely confirm that Stockholm schools are less “equal” and more segregated than those in Helsinki. We also find that school performance is more strongly linked to stress-related complaints among students in Helsinki than in Stockholm, especially among Finnish girls. [ABSTRACT FROM PUBLISHER]

Aims: According to the workplace theory of effort–reward imbalance (ERI), individuals who perceive a lack of reciprocity between their effort spent at work and the rewards received in turn are at an increased risk of stress-related ill-health. It is also assumed that being overcommitted to work is linked to an increased risk of stress-related ill-health. This study applies the effort–reward imbalance model to the school setting. It aims to analyse the associations that effort–reward imbalance and overcommitment share with somatic pain and self-rated health among adolescents. Methods: Data are from the School Stress and Support Study (TriSSS), involving students in grades 8 and 9 (ages 14–16 years) in two schools in Stockholm, Sweden, during 2010 (n=403). Information on effort–reward imbalance and health outcomes was gathered from self-report questionnaires. An adjusted short version of ERI was used. Factor analysis showed that extrinsic effort, reward and overcommitment constitute three distinct dimensions. The designed measures demonstrated sound psychometric properties both for the full sample and for subgroups. Ordered logistic regressions were conducted. Results: The analyses showed that low reward and higher overcommitment were associated with greater somatic pain and poorer self-rated health. Furthermore, effort–reward imbalance was linked with an elevated risk of somatic pain and poorer self-rated health. Conclusions: Students are more likely to experience stress-related ill-health when they perceive an imbalance between their effort and rewards. In addition, high overcommitment is associated with an increased risk of ill-health among students. [ABSTRACT FROM PUBLISHER]

Background Similar to having a less advantaged socioeconomic position, children in lower peer status positions typically experience a situation characterized by less power, influence and command over resources, followed by worse health outcomes. The aim of this study was to examine whether peer status position is further associated with increased risks for premature all-cause mortality. Methods Data were drawn from a 1953 cohort born in Stockholm, Sweden. Peer status positions were established through survey data on peer nominations within the school class at age 13, whereas national registers were used to identify all-cause mortality across ages 14–67. Differences in hazard rates and median survival time, according to peer status position, were estimated with Cox regression and Laplace regression, respectively. Results Although differences in hazard rates were not large, they were consistent and clear, also after taking childhood socioeconomic status into account. Regarding median survival time, the number of years lost increased gradually as peer status decreased, with a difference of almost 6 years when comparing individuals in the lowest and highest positions. Conclusions Children's positions in the peer status hierarchy play a role for their chances of health and survival, pointing to the relevance of addressing opportunities for positive peer interaction and mitigating any adverse consequences that may stem from negative experiences within the peer context. [ABSTRACT FROM AUTHOR]

PURPOSE: Although the literature reports adverse birth outcomes following ambient heat, less work focuses on cold. We, moreover, know of no studies of cold that examine stillbirth. We tested the relation between cold ambient temperature during pregnancy in Sweden and four outcomes: stillbirth, preterm, birth weight for gestational age, and birth length. We examined births from 1915 to 1929 in Uppsala, Sweden, which-unlike most societies today-experienced substandard indoor-heating and fewer amenities to provide shelter from cold. METHODS: We retrieved data on almost 14,000 deliveries from the Uppsala Birth Cohort Study. We linked a validated, daily ambient temperature series to all pregnancies and applied Cox proportional hazards (stillbirth and preterm) and linear regression models (birth weight and length). We tested for nonlinearity using quadratic splines. RESULTS: The risk of stillbirth rose as ambient temperature during pregnancy fell (hazard ratio for a 1°C decrease in temperature, 1.08; 95% confidence interval, 1.00 to 1.17). Cold extremes adversely affected preterm and birth length, whereas warm extremes increased preterm risk. We observed no relation between cold and birth weight for gestational age. CONCLUSION: In historical Sweden, cold temperatures during pregnancy increased stillbirth and preterm risk and reduced birth length among live births. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Although the literature reports adverse birth outcomes following ambient heat, less work focuses on cold. We, moreover, know of no studies of cold that examine stillbirth. We tested the relation between cold ambient temperature during pregnancy in Sweden and four outcomes: stillbirth, preterm, birth weight for gestational age, and birth length. We examined births from 1915 to 1929 in Uppsala, Sweden, which—unlike most societies today—experienced substandard indoor-heating and fewer amenities to provide shelter from cold. Methods: We retrieved data on almost 14,000 deliveries from the Uppsala Birth Cohort Study. We linked a validated, daily ambient temperature series to all pregnancies and applied Cox proportional hazards (stillbirth and preterm) and linear regression models (birth weight and length). We tested for nonlinearity using quadratic splines. Results: The risk of stillbirth rose as ambient temperature during pregnancy fell (hazard ratio for a 1°C decrease in temperature, 1.08; 95% confidence interval, 1.00 to 1.17). Cold extremes adversely affected preterm and birth length, whereas warm extremes increased preterm risk. We observed no relation between cold and birth weight for gestational age. Conclusion: In historical Sweden, cold temperatures during pregnancy increased stillbirth and preterm risk and reduced birth length among live births. [Copyright &y& Elsevier]

ABSTRACT BACKGROUND Feeling accepted by peers is important for young people's health but few studies have examined the overall degree of acceptance in school and its health consequences. The purpose of the study was to investigate whether health complaints among Swedish students can be attributed to the acceptance climate in their school class even when the health effects of their own (individual) acceptance score have been taken into account. METHODS The data used were from the Health Behaviour in School-aged Children ( HBSC) study for the years 2001 to 2002, 2005 to 2006, and 2009 to 2010, consisting of 13,902 5th-, 7th-, and 9th-grade Swedish students nested into 742 school classes. The statistical analyses were performed by means of linear regression multilevel analysis. RESULTS The results indicated that the variation in subjective health complaints could be ascribed partly to the school-class level (boys: 5.0%; girls: 13.5%). Peer acceptance at the individual level demonstrated a clear association with health: the lower the acceptance, the higher the complaint scores. For girls, but not for boys, the overall degree of peer acceptance in the school class demonstrated a contextual effect on health, net of acceptance at the student level. Interaction analyses also revealed an increasingly favorable health among poorly accepted girls as the acceptance climate in the school class declined. CONCLUSIONS A lower overall degree of peer acceptance in the school class is associated with poorer health among girls. However, girls who themselves feel poorly accepted are not as negatively affected health-wise by a poor acceptance climate, as are well-accepted girls. [ABSTRACT FROM AUTHOR]

Background: The practice of joint physical custody, where children spend equal time in each parent's home after they separate, is increasing in many countries. It is particularly common in Sweden, where this custody arrangement applies to 30 per cent of children with separated parents. The aim of this study was to examine children's health-related quality of life after parental separation, by comparing children living with both parents in nuclear families to those living in joint physical custody and other forms of domestic arrangements. Methods: Data from a national Swedish classroom study of 164,580 children aged 12 and 15-years-old were analysed by two-level linear regression modelling. Z-scores were used to equalise scales for ten dimensions of wellbeing from the KIDSCREEN-52 and the KIDSCREEN-10 Index and analysed for children in joint physical custody in comparison with children living in nuclear families and mostly or only with one parent. Results: Living in a nuclear family was positively associated with almost all aspects of wellbeing in comparison to children with separated parents. Children in joint physical custody experienced more positive outcomes, in terms of subjective wellbeing, family life and peer relations, than children living mostly or only with one parent. For the 12-year-olds, beta coefficients for moods and emotions ranged from -0.20 to -0.33 and peer relations from -0.11 to -0.20 for children in joint physical custody and living mostly or only with one parent. The corresponding estimates for the 15-year-olds varied from -0.08 to -0.28 and from -0.03 to -0.13 on these subscales. The 15-year-olds in joint physical custody were more likely than the 12-year-olds to report similar wellbeing levels on most outcomes to the children in nuclear families. Conclusions: Children who spent equal time living with both parents after a separation reported better wellbeing than children in predominantly single parent care. This was particularly true for the 15-year-olds, while the reported wellbeing of 12-years-olds was less satisfactory. There is a need for further studies that can account for the pre and post separation context of individual families and the wellbeing of younger age groups in joint physical custody. [ABSTRACT FROM AUTHOR]

Abstract: The increase in the use of mobile phones and the Internet has given rise to new opportunities for people to meet and communicate. However, there are also dark sides to these new forms of communication. One of these is cyberbullying, i.e. bullying via mobile phone and the Internet. Given that cyberbullying is a relatively new phenomenon, empirical knowledge is still limited and particularly so in Sweden, which in international comparison has reported low rates of bullying in general. The aim of the study is to investigate: 1) the prevalence of cyberbullying among students in Stockholm, Sweden; 2) the overlap between cyberbullying and traditional forms of school bullying, and 3) the association between the experience of cyberbullying and subjective health. The study uses the Stockholm School Survey of 2008 which is a total population survey of students in grade 9 of compulsory school (i.e. aged 15–16) and in the second year of upper secondary school (i.e. aged 17–18) in Stockholm and eighteen of its surrounding municipalities (N=22,544). About 5% of the students are victims of cyberbullying, 4% are perpetrators, and 2% are both victims and perpetrators. There is some overlap between cyberbullying and traditional bullying: those who are victims of traditional bullying are at increased risk of also being victims of cyberbullying; while being a traditional bully is strongly associated with the likelihood of also being a cyberbully. However, many students who are involved in cyberbullying are not involved in traditional bullying. OLS regression analyses show that being a victim of cyberbullying remains associated with worse subjective health when being the victim of traditional bullying and socioeconomic factors are taken into account. In addition, perpetrators of cyberbullying as well as students who are both victims and bullies, have worse subjective health than those who are not involved in cyberbullying. [Copyright &y& Elsevier]

Background The aim of this study was to explore the impact of mid-life income and old-age pensions on the risk of mortality in later life. Furthermore, the study explored whether income inequalities in old-age mortality can be explained by differences in early childhood development, social class during childhood, education or marital status. Methods The study sample comprises all individuals born at Uppsala Academic Hospital during the period 1915-1924 who had retired but not died or emigrated by 1991 (n=4156). Information on social and biological conditions was retrieved from national registries. Results The results show that income during mid-life and income during retirement were associated with old-age mortality. However, mutually adjusted models showed that income in mid-life was more important for women's late-life mortality and that income during retirement was more important for men's late-life mortality. Furthermore, differences in education and marital status seemed to explain a substantial part of income inequalities in late-life mortality. Conclusions It is unlikely that egalitarian social policies aimed at older populations can eradicate health inequalities accumulated over the life course. However, retirement income appears to have an effect on late-life mortality that is independent of the effect of income in mid-life, suggesting that egalitarian pension schemes could affect health inequalities in later life or, at the very least, slow down further accumulation of inequalities. [ABSTRACT FROM AUTHOR]

Background Intelligence at a single time-point has been linked to health outcomes. An individual's IQ increases with longer schooling, but the validity of such increase is unclear. In this study, we assess the hypothesis that individual change in the performance on IQ tests between ages 10 and 20 years is associated with mortality later in life.Methods The analyses are based on a cohort of Swedish boys born in 1928 (n = 610) for whom social background data were collected in 1937, IQ tests were carried out in 1938 and 1948 and own education and mortality were recorded up to 2006. Structural equation models were used to estimate the extent to which two latent intelligence scores, at ages 10 and 20 years, manifested by results on the IQ tests, are related to paternal and own education, and how all these variables are linked to all-cause mortality.Results Intelligence at the age of 20 years was associated with lower mortality in adulthood, after controlling for intelligence at the age of 10 years. The increases in intelligence partly mediated the link between longer schooling and lower mortality. Social background differences in adult intelligence (and consequently in mortality) were partly explained by the tendency for sons of more educated fathers to receive longer schooling, even when initial intelligence levels had been accounted for.Conclusions The results are consistent with a causal link from change in intelligence to mortality, and further, that schooling-induced changes in IQ scores are true and bring about lasting changes in intelligence. In addition, if both these interpretations are correct, social differences in access to longer schooling have consequences for social differences in both adult intelligence and adult health. [ABSTRACT FROM AUTHOR]

Aim: To study socio-demographic patterns of obesity in Chinese children and adolescents. Methods: Data came from the 2005 cycle of the Chinese National Survey on Student's Constitution and Health. In all, 231 326 subjects aged 7-18 years, distributed across 622 schools and 30 provinces, were analysed. Multilevel modelling was used to estimate variations at individual, school area and province levels. Results: The prevalence of obesity varied enormously across different areas. Young people living in high socioeconomic and urban areas had higher body mass index (BMI) and higher odds of overweight and obesity than those living in lower socioeconomic and rural areas. Subjects living in provinces with a higher standard of living, as indicated by less perinatal mortality, lower Engel coefficient, and higher personal expenditure on health had higher BMI and higher odds of overweight and obesity than those living in less affluent provinces. An interaction between gender and urbanicity revealed that boys in urban areas were especially prone to obesity. Conclusion: In contrast to most present-day high income countries, obesity among young people in China is associated with affluence and urban residence. Intervention and strategy for obesity prevention should be targeting high socioeconomic families in urban areas, perhaps with particular focus on boys. [ABSTRACT FROM AUTHOR]

The article summarizes studies of social determinants of health under different phases of life which appear in the March 2011 issue of the "International Journal of Behavioral Medicine." A study investigated the life-course socioeconomic status (SES) in line with personality patterns in adulthood using the five-factor model. Another study examined the premature mortality among middle-aged Hungarian men and women of various social backgrounds. It relates an investigation into the interaction of people's level of hostility with situational circumstances.

This study examined the extent to which sixth grade peer status could predict anxiety and/or depression in 5,242 women and 5,004 men who were born in 1953 and whose hospital records were followed up from 1973-2003. The data used was the Stockholm Birth Cohort Study. While no association could be established for men, results indicated that women who held low peer status positions in childhood were at a considerably higher risk of anxiety and/or depression later in life compared to women in average status positions. Women who held popular positions during childhood did not differ significantly from their average counterparts. These findings persisted after adjusting for family- and child-related problem-load, perceived security at school, family constellation, socioeconomic status as well as the child's cognitive ability, ninth grade school marks and continuance to upper secondary school. [ABSTRACT FROM AUTHOR]

Abstract: This study explores the psychosocial working conditions of 7930 Swedish 9th grade students, distributed over 475 classes and 130 schools, in relation to their subjective health using multilevel modeling. At the individual level, students with “strained” working conditions in school (i.e. those experiencing a high level of demands in combination with a low level of control) demonstrated significantly worse health compared to students in “low-strain” situations. “Strained” conditions in combination with a weak school-related sense of coherence were especially unfavourable for health. These findings remained significant when support from teachers, school marks, norm-breaking behaviours, family-relations and certain class- and school-contextual conditions were adjusted for. Thus, while demands are an essential part of school work, this study suggests that high levels of control and a strong school-related sense of coherence can protect against the more detrimental effects on health that high demands at school may cause. [ABSTRACT FROM AUTHOR]

While research into educational inequalities emphasises childhood socio-economic status, this study adds another dimension of status into the analysis; namely, the child's own social position among its peers. The aim was to examine whether socio-economic status and peer status can both be linked to educational transitions and, if so, whether they constitute overlapping paths. In a second step of analyses, the relationship between peer status and adult unemployment was investigated. Data were derived from a longitudinal study using a 1953 cohort born in Stockholm, Sweden. Our results suggest that children with higher socio-economic status and children with higher peer status are consistently more likely than their lower status peers to proceed to the next level of education, and that the effects of socio-economic status and peer status hardly overlapped at all. Furthermore, educational differences by peer status seem to involve consequences for the studied subjects' contemporary labour market opportunities. [ABSTRACT FROM AUTHOR]

This study contributes to the understanding of how social mortality patterns are reproduced across generations by documenting associations of women's marital status at childbirth in the beginning of last century with selected health indicators across three subsequent generations of their offspring, and by highlighting a special set of plausible mechanisms linked to this particular event in history. We use the Multigenerational Uppsala Birth Cohort Study (UBCoS) database consisting of 12,168 individuals born at Uppsala University Hospital in 1915–1929 (UG1), their children (UG2) and grandchildren (UG3). Results showed that men and women born outside wedlock (BOW) in early twentieth century Sweden were at an increased risk of adult mortality compared to those who were born in wedlock (BIW), and the men were also significantly less likely to reach their 80th birthday. The question of childhood social disadvantage and its long-term consequences for health is then taken one step further by examining their offspring in two subsequent generations in terms of four specific anthropometric and psychological outcomes at the time of military conscription, all known to predict disease and mortality later in life. Results showed that sons of men BOW as well as sons and grandsons of women BOW had significantly lower psychological functioning and cognitive ability. Regarding body mass index and height, however, significant associations were found only among descendants of men BOW. The anthropometric and psychological disadvantages found among descendents of individuals BOW were partly mediated by their social class background. The four outcomes observed early in the lives of UG2s and UG3s do in fact constitute early health determinants, each potentially influencing longevity and mortality risk in these generations. We conclude that the social disadvantage imposed on those BOW in early twentieth century Sweden appears to be reproduced as a health disadvantage in their children and grandchildren, with likely consequences for mortality among these. [Copyright &y& Elsevier]

Abstract: Men born out of wedlock in early twentieth century Sweden who never married have previously been shown to have a doubled mortality risk from ischaemic heart disease compared to the corresponding group of men born to married parents. This study further explores the question of childhood social disadvantage and its long-term consequences for cardiovascular health by examining the two subsequent generations. The question posed is whether the sons and grandsons of men and women born out of wedlock in early twentieth century Sweden have an increased risk of circulatory disease compared with the corresponding descendants of those born inside marriage. We examined this by use of military conscription data. The material used is the Uppsala Birth Cohort Multigenerational database consisting of individuals born at Uppsala University Hospital between 1915 and 1929 (UG1), their children (UG2) and grandchildren (UG3). Conscription data were available for UG2s born between 1950 and 1982 (n =5,231) and UG3s born between 1953 and 1985 (n =10,074) corresponding to 72.1% and 73.6%, respectively, of all males born in each time-period. Logistic regression showed that significant excess risk of circulatory disease diagnoses was present only among descendants of men born outside marriage, with sons and grandsons demonstrating odds ratios of 1.64 and 1.83, respectively, when BMI and height at the time of conscription, father''s social class in mid-life and father''s or grandfather''s history of circulatory disease had been adjusted for. Separate analyses showed that the effect of the maternal and paternal grandfather was of approximately the same magnitude. Further analyses revealed an interaction between the father''s social class and the grandfather''s legitimacy status at birth on UG3-men''s likelihood of having a circulatory disease, with elevated odds only among those whose fathers were either manual workers or self-employed. The results of this study suggest that social disadvantage in one generation can be linked to health disadvantage in the subsequent two generations. [Copyright &y& Elsevier]

Abstract: In the class room a hierarchical structure of social relations typically develops in which the child''s position is a marker of the view of the others, i.e. the extent to which he or she is an accepted and valued member of the group. The status distribution in the school class is likely to correspond to differences in personal characteristics, including behaviours and competencies, and to generate a differential distribution of perceived expectations, treatment, resources and emotions. We argue that these phenomena constitute parts in a developmental process which, through mediators such as self-view and subsequent life choices, may affect adult health. The purpose of this paper is to study whether and how peer status is associated with self-reported health in mid-life. Data was derived from a cohort study of individuals born in Aberdeen, Scotland, between 1950 and 1956. We use information about childhood circumstances, including peer status nominations, collected in the early 1960s, and information about adult circumstances derived from a postal questionnaire carried out among more than 6000 individuals in 2001–2003. Multivariate analyses yielded a graded association between peer status and adult health problems in the form of limiting longstanding illness and less than good self-rated health. These associations could not be explained by socioeconomic circumstances or differences in individual behaviour and cognitive score in childhood. It was rather subsequent socioeconomic career that seemed to explain the association found among men. For women, a significant association remained, suggesting alternative pathways or mechanisms. [Copyright &y& Elsevier]

This study examines whether men who were born outside marriage in early twentieth century Sweden run a higher risk of dying from ischaemic heart disease (IHD) in middle and old age compared to men who were born inside marriage. Analyses are based on the male half of the Uppsala Birth Cohort Study, Sweden, consisting of all 7411 boys who were born alive at the Uppsala Academic Hospital during the period 1915–1929. The statistical method used is Cox regression. The results demonstrated a statistically significant excess mortality among men born outside marriage, which could not be explained by either social class of origin or birth weight for gestational age. Instead, this elevated mortality was largely explained by the more than doubled mortality risk among those men born outside wedlock who never married in relation to the corresponding group of men born to married parents. Even when three indicators of adult socio-economic status were adjusted for, men who never married and were born outside marriage still ran a 93 per cent higher risk of dying from IHD than men who never married but were born inside marriage. This intervening effect of adult marital status was restricted to the category of never married men. Thus, although divorcees demonstrated an even higher mortality risk in relation to the married than did those who never married, this was equally true for men born inside and men born outside marriage. In the concluding section of the paper I argue that these findings should be understood in terms of the childhood social stigma that the illegitimate children experienced. This stigma may have resulted in an increased susceptibility, which in combination with the “failure” in adulthood to comply with the established norms of society regarding matrimony led to higher levels of IHD mortality in middle and old age. [Copyright &y& Elsevier]

Evaluates the sex-specific patterns of mortality by birth order in four stages of the life-course in Sweden. Application of the Poisson and logistics regression analysis; Tendency of lateborn siblings to demonstrate higher mortality risks; Indication of a long-term influence of childhood birth order position on mortality.

This study examines birth order differences in third-grade school marks and achieved education based on the 14,192 boys and girls who were born at the Uppsala Academic Hospital, Sweden, during the period 1915-29. The methods used for the corresponding analyses are OLS regression and logistic regression. In the analysis of third-grade school marks, a subsample is used. The results showed that school marks worsened and the chances of having completed upper secondary school declined with increasing birth order. Neither biological nor social factors at birth explained the quite dramatic differences found between birth order categories. [ABSTRACT FROM AUTHOR]

Social relationships across and within generations are associated with intergenerational income mobility. Parents affect their children's future opportunities through socialization and by conveying various resources to the child during upbringing. However, self-acquired social contacts of children, such as friendships in school, might also affect long-term outcomes. Children from less privileged homes may gain access to additional resources through contact with privileged friends and their parents. This study examines whether having a classroom friend with high parental income (privileged friend) is associated with upward income mobility. Furthermore, it explores where in the parental income distribution a privileged friend matters most. We use data from the Stockholm Birth Cohort Multigenerational Study (n  = 10,641), which is a prospective study of individuals born in 1953 who lived in the greater Stockholm area in 1963. We fit classroom fixed-effects models to estimate the association between having a privileged childhood friend and adult income as well as parental income and adult income along with the interaction of privileged friend and parental income. Results show that cohort members who had a privileged classroom friend had higher adult income, and that this income gain was greater among those whose parents belonged to the lowest income quartile, compared with those whose parents had higher incomes. These results are robust to adjustments for childhood socioeconomic background, personal attributes, and adult educational attainment. Our findings indicate that having an economically privileged friend in the school class bolsters adult income and upward income mobility of children from families with low income. [ABSTRACT FROM AUTHOR]

Objective: In a previous study we demonstrated that the occurrence of sexual jokes in the class was associated with higher levels of psychological health complaints. Building on and extending these findings, the aim of the current study was to examine if exposure to sexual jokes at the student and at the class level was inversely associated with students' life satisfaction. Data were derived from the 2017/18 Swedish Health Behaviour in School-aged Children (HBSC) study, with students aged 11, 13 and 15 years (n = 3710 distributed across 209 classes). Exposure to sexual jokes at the student level was captured by one item. Exposure to sexual jokes at the class level was calculated by aggregating this measure. The Cantril ladder was used to operationalise life satisfaction. Two-level logistic regression analyses were performed. Results: Students who were exposed to sexual jokes at school were less likely to report high life satisfaction (OR 0.38, 95% CI 0.27–0.53). An inverse association was found between the class proportion of students who were exposed to sexual jokes and students' likelihood of reporting high life satisfaction, whilst adjusting for exposure to sexual jokes at the student level (OR 0.98, 95% CI 0.97–0.9994). The findings highlight the importance of promoting a school climate without sexual harassment. [ABSTRACT FROM AUTHOR]

Equitable access to high-quality schools is important for student achievement. However, the increasing attention placed on adolescent mental health promotion suggests that school contextual factors and school achievement may also play an important role for students' psychological well-being. This study examined the relationships between school ethos, academic achievement, psychological distress and aggressive behaviour among Swedish students, further considering the role of school sociodemographic composition. Analyses were based on two separate data collections in Stockholm, one among teachers (n = 2089) and the other among students aged 15–16 (n = 9776; 49.7% girls). Using multilevel structural equation modelling, the relations between teachers' reports of school ethos and students' reports of achievement, psychological distress and aggressive behaviour were tested. Analyses showed a positive relationship between a school's ethos and average academic achievement. At the school level, higher academic achievement was in turn associated with less psychological distress among students, providing an indirect pathway between school ethos and psychological distress. At the individual level, students with higher academic achievement reported less psychological distress and aggressive behaviour. These findings indicate that schools' value-based policies and practices can play a role for students' academic performance, and through this, for their psychological well-being. [ABSTRACT FROM AUTHOR]

Background: Students who are subjected to sexual harassment at school report lower psychological well-being than those who are not exposed. Yet, it is possible that the occurrence of sexual harassment in the school class is also stressful for those who are not directly targeted, with potential negative effects on well-being for all students. Aim: The aim was to examine whether exposure to sexual jokes at the student level and at the class level was associated with students' psychological complaints, and if these associations differed by gender. Method: Data from the Swedish Health Behaviour in School-aged Children (HBSC) of 2017/18 was used, with information from students aged 11, 13 and 15 years (N =3720 distributed across 209 classes). Psychological health complaints were constructed as an index based on four items. Exposure to sexual jokes at the student level was measured by one item, and at the class level as the class proportion of students exposed to sexual jokes, in per cent. Two-level linear regression analyses were performed. Results: Students who had been exposed to sexual jokes at school reported higher levels of psychological complaints, especially boys. Furthermore, the class proportion of students who had been exposed to sexual jokes was also associated with psychological complaints, even when adjusting for student-level exposure to sexual jokes, gender, grade and class size. Conclusions: Sexual jokes seem to be harmful for those who are directly exposed, but may also affect indirectly exposed students negatively. Thus, a school climate free from sexual jokes may profit all students. [ABSTRACT FROM AUTHOR]

We assessed whether the level of time-pressure reported by a school's teachers is predictive of student bullying perpetration. We combined data from two surveys conducted in 129 schools in 2016: the Stockholm School Survey performed among students in grades 9 and 11 (n = 10,668), and the Stockholm Teacher Survey carried out among senior level (grades 7–9) and upper secondary school (grades 10–12) teachers (n = 2259). Multilevel path analyses showed that teachers' stress and time-pressure increased with declining school leadership functioning. Teachers' level of time-pressure was, in turn, positively associated with student traditional and cyberbullying behaviour, through its effect on the school staff's tendency (not) to intervene against bullying, but not through the teachers' stress level. We conclude that schools with leadership that provides opportunities for the teachers to focus on their main mission can counteract bullying among the students and therefore indirectly also to promote student health. [ABSTRACT FROM AUTHOR]

The aim of the present study is to assess the association between problematic alcohol consumption in the family and youth alcohol consumption and to explore the extent to which this association is moderated by conditions in school in terms of schools' degree of student focus. We use data from the Stockholm School Survey performed among 10,757 ninth grade students and the Stockholm Teacher Survey performed among 2,304 teachers in the same schools. Multilevel logistic regressions were performed. The results showed that problematic alcohol consumption in the family was associated with a higher likelihood of heavy drinking among adolescents. The association was weaker in schools with a strong student focus, indicating a compensatory effect of conditions in school. [ABSTRACT FROM AUTHOR]

We read with interest the recent paper by Sariaslan I et al i .[1] investigating the associations between childhood family income and three outcomes observed later in life: psychiatric disorders, substance misuse and violent crime arrests. To illustrate our point, assume that childhood family income has a causal effect on the neighbourhood in which a family resides while the children are growing up: the higher the income, the more affluent the neighbourhood. [Extracted from the article]

Background: The practice of joint physical custody, where children spend equal time in each parent's home after they separate, is increasing in many countries. It is particularly common in Sweden, where this custody arrangement applies to 30 per cent of children with separated parents. The aim of this study was to examine children's health-related quality of life after parental separation, by comparing children living with both parents in nuclear families to those living in joint physical custody and other forms of domestic arrangements.Methods: Data from a national Swedish classroom study of 164,580 children aged 12 and 15-years-old were analysed by two-level linear regression modelling. Z-scores were used to equalise scales for ten dimensions of wellbeing from the KIDSCREEN-52 and the KIDSCREEN-10 Index and analysed for children in joint physical custody in comparison with children living in nuclear families and mostly or only with one parent.Results: Living in a nuclear family was positively associated with almost all aspects of wellbeing in comparison to children with separated parents. Children in joint physical custody experienced more positive outcomes, in terms of subjective wellbeing, family life and peer relations, than children living mostly or only with one parent. For the 12-year-olds, beta coefficients for moods and emotions ranged from -0.20 to -0.33 and peer relations from -0.11 to -0.20 for children in joint physical custody and living mostly or only with one parent. The corresponding estimates for the 15-year-olds varied from -0.08 to -0.28 and from -0.03 to -0.13 on these subscales. The 15-year-olds in joint physical custody were more likely than the 12-year-olds to report similar wellbeing levels on most outcomes to the children in nuclear families.Conclusions: Children who spent equal time living with both parents after a separation reported better wellbeing than children in predominantly single parent care. This was particularly true for the 15-year-olds, while the reported wellbeing of 12-years-olds was less satisfactory. There is a need for further studies that can account for the pre and post separation context of individual families and the wellbeing of younger age groups in joint physical custody. [ABSTRACT FROM AUTHOR]

This study investigates associations between aspects of school climate, measured by students’ assessments aggregated to the class level, and exposure to bullying, measured at the individual level. The data were derived from the Stockholm School Survey of 2006–2010 with information from 16,418 ninth-grade students (aged 15–16 years) distributed over 871 classes and 259 schools. Three-level binary logistic regression was applied. Two of the studied school climate aspects in particular were linked with the occurrence of bullying: In classes where a high proportion of students claimed to be aware of the school rules and in classes where a high proportion of students stated that adults intervene against bullying, fewer students reported having been bullied. The findings imply that striving toward a school climate characterized by transparent rules and clear disapproval of harassments may help to reduce bullying. [ABSTRACT FROM PUBLISHER]

Reports on a study replicating studies undertaken by Phillips et al which suggested that early prenatal growth restriction is linked to marital status and susceptibility to cardiovascular disease. Methods; Results; Conclusion that prenatal growth may not explain why unmarried people have higher death rates.

Background In many Western countries, an increasing number of children with separated parents have joint physical custody, that is, live equally much in their parent's respective homes. In Sweden, joint physical custody is particularly common and concerns between 30% and 40% of the children with separated parents. It has been hypothesised that the frequent moves and lack of stability in parenting may be stressful for these children. Methods We used data from a national classroom survey of all sixth and ninth grade students in Sweden (N=147839) to investigate the association between children's psychosomatic problems and living arrangements. Children in joint physical custody were compared with those living only or mostly with one parent and in nuclear families. We conducted sex-specific linear regression analyses for z-transformed sum scores of psychosomatic problems and adjusted for age, country of origin as well as children's satisfaction with material resources and relationships to parents. Clustering by school was accounted for by using a two-level random intercept model. Results Children in joint physical custody suffered from less psychosomatic problems than those living mostly or only with one parent but reported more symptoms than those in nuclear families. Satisfaction with their material resources and parent-child relationships was associated with children's psychosomatic health but could not explain the differences between children in the different living arrangements. Conclusions Children with non-cohabitant parents experience more psychosomatic problems than those in nuclear families. Those in joint physical custody do however report better psychosomatic health than children living mostly or only with one parent. Longitudinal studies with information on family factors before and after the separation are needed to inform policy of children's postseparation living arrangements. [ABSTRACT FROM AUTHOR]

This study examined how psychosocial conditions at school are associated with prosocial behaviour, a key indicator of positive mental health. Participants were 3,652 Swedish Grade 9 students from the Health Behaviour in School-aged Children study. Structural equation modelling demonstrated that students who experience more manageable school demands and greater social support from teachers and classmates are more likely to display caring, sharing, and cooperative behaviours. However, those that feel acutely stressed, particularly girls, also reported greater prosocial behaviour. Teacher support played a greater role in girls' prosocial behaviour and perceptions of school demands than boys'. The findings extend knowledge of the importance of psychosocial work conditions for adolescent health to positive mental health. [ABSTRACT FROM PUBLISHER]

Aims: Among children with separated parents, the arrangement of joint physical custody, i.e. children living equally much in both parents’ homes, has increased substantially during the last decades in Sweden. To date, empirical research on the living conditions of this group is limited. This study analyses family type differences in turning to parents for emotional support and in subjective health among adolescents. The focus of the study is adolescents in joint physical custody, who are compared with those living with two original parents in the same household; those living (only) in a single-parent household; and those living (only) in a reconstituted family. Methods: The data come from the Stockholm School Survey of 2004, a total population survey of students in grade 9 (15–16 years) in Stockholm (n=8,840). Ordinary least squares (OLS) regressions were conducted. Results: Turning to both parents about problems is most commonly reported by adolescents in intact families, followed by those in joint physical custody. Adolescents in non-traditional family types report worse subjective health than adolescents in intact families, but the difference is smaller for those in joint physical custody than for those living with a single parent. The slightly poorer health of adolescents in joint physical custody than those in intact families is not explained by their lower use of parents as a source of emotional support. Conclusions: The study suggests that joint physical custody is associated with a higher inclination to use parents as a source of emotional support and better subjective health than other post-divorce family types. [ABSTRACT FROM PUBLISHER]

Objective: Building on findings reported in a previous publication, the objective of this study is to explore if teacher-rated indicators of school ethos modify the association between problematic familial alcohol use and heavy episodic drinking among upper secondary students. Data were based on combined information from two separate surveys conducted in 2016 among 4709 students and 1061 teachers in 46 Stockholm upper secondary schools, with linked school-level information from administrative registers. Multilevel binary logistic regression analyses were performed. Results: Problematic familial alcohol use was associated with an increased likelihood of heavy episodic drinking among upper secondary students (OR 1.36, 95% CI 1.12–1.65). Cross-level interactions revealed that the association was weaker among students attending schools with higher levels of teacher-rated ethos. This was true for overall school ethos (OR 0.79, 95% CI 0.65–0.97) and for four of five studied sub-dimensions of ethos: staff stability (OR 0.78, 95% CI 0.65–0.95); teacher morale (OR 0.79, 95% CI 0.65–0.97); student focus (OR 0.80, 95% CI 0.65–0.97); and academic atmosphere (OR 0.79, 95% CI 0.65–0.96). The sub-dimension "structure and order for dealing with unwanted behaviour" did however not moderate the association between problematic familial alcohol use and heavy episodic drinking (OR 0.95, 95% CI 0.77–1.18). [ABSTRACT FROM AUTHOR]

Stress and stress-related complaints such as fatigue and depressed mood are common among teachers. Yet, knowledge about the links between the overall level of teacher stress within a school and individual student outcomes is scarce. This study investigates if the levels of teacher-reported stress, fatigue and depressed mood within a school are associated with students' ratings of their school satisfaction and perceived teacher caring, respectively. Data derives from two separate data collections performed in upper secondary schools in 2016, the Stockholm School Survey (SSS) and the Stockholm Teacher Survey (STS), which were linked together (5367 students and 1045 teachers in 46 schools). Two-level linear regression analyses were performed. Results showed negative associations between school-level teacher stress, fatigue, and depressed mood and students' school satisfaction and perceived teacher caring, even when controlling for student- and school-level sociodemographic characteristics. The findings suggest that teacher stress may have negative implications for students. [ABSTRACT FROM AUTHOR]

Truancy is a problem associated with a range of negative consequences at the individual and societal level, both in the short and the long term. Few earlier studies have investigated the association between school effectiveness and truancy. The aim of this study is to examine the links between three teacher-rated features of school effectiveness – school leadership, teacher cooperation and consensus, and school ethos – and student-reported truancy. Data were collected in 2016 among 4,956 students and 1,045 teachers in 46 upper secondary schools in Stockholm. Results from two-level binary logistic regression analyses show that higher teacher ratings of the school leadership and of the school ethos (but not of teacher cooperation and consensus) are associated with a lower likelihood of truancy at the student-level, even when adjusting for student- and school-level sociodemographic characteristics. The findings indicate that effective school characteristics may contribute to reducing students' inclination to play truant. [ABSTRACT FROM AUTHOR]

Introduction: Future orientation (FO) refers to individuals' beliefs and feelings about their future. Earlier research has primarily investigated correlates of FO at the individual and family level, but it seems likely that FO is also shaped by other central agents or institutions, such as the school. Earlier studies have found positive associations between "school effectiveness" and student performance, and negative associations in relation to e.g., bullying, delinquency, and health risk behaviors. The current study investigated three teacher-reported features of school effectiveness - school leadership, teacher cooperation and consensus, and school ethos - and their links with student-reported FO.Methods: Survey data were collected in 2016 among 5131 students (aged 17-18 years) and 1061 teachers in 46 upper secondary schools in Stockholm, Sweden, and merged with school-level register data. Two-level binary logistic regression analyses were performed.Results: The analyses showed that higher teacher ratings of school leadership and school ethos were associated with a greater likelihood of reporting an optimistic FO among students. Teacher cooperation and consensus was however not associated with students' FO.Conclusion: The findings indicate that the school environment contributes to shaping students' beliefs about their future. Thus, enhancing features of school effectiveness may be a way of promoting a positive development and brighter objective future prospects for the young, via pathways such as good student-teacher relations and academic motivation and achievement. [ABSTRACT FROM AUTHOR]

This study examines whether 3 teacher-rated aspects of school effectiveness differ across school segregation profiles in Stockholm, and to what extent these indicators are associated with the academic achievement of 9th-grade students. Analyses were based on 2 cross-sectional data collections performed in 2014 and 2016, respectively (147 school units), one among teachers (n = 2,024) and the other among 9th-grade students (n = 9,151). Multilevel analysis was applied, estimating 2-level random intercept linear regression models. Results show that teachers’ ratings of school leadership, teacher cooperation, and school ethos, as well as student-reported marks differ across school segregation profiles. Findings further reveal significant associations between these school effectiveness indicators and student performance, even when taking student family background and the school’s student body composition into consideration. In part, these associations are also identified within segregation profiles. Moreover, results show that school ethos acts as a mediator between school segregation profile and student achievement. [ABSTRACT FROM AUTHOR]

Background: Intra-generational social mobility, which describes the mobility within an individual’s own working life, is seldom studied among employees with psychiatric disorders (EPD). There is need of knowledge of the intra-generational mobility patterns, in a broader perspective, among EPD. Aims: To investigate intra-generational social mobility in employed individuals diagnosed with affective disorder, personality disorder, schizophrenia and drug dependence in a national Swedish cohort. Method: We identified a national sample of employed Swedish adults born in 1939–1949 (N = 876, 738), and among them individuals with a first-time hospital admission for affective psychosis, neurosis and personality disorder, alcoholism, drug dependence or schizophrenia in 1964–1980 (N = 18, 998). Employed individuals without hospital admission for such diagnoses were utilised as a comparison group (N = 866, 442). Intra-individual social class changes between 1980 and 1990 among EPD and the comparison group were described through summary statistics and graphs. Results: EPD more often held Low manual occupations at baseline in 1980 than the comparison group (44% vs. 28%), although parental social class was similar. In 1990, 19% of EPD and 4% of the comparison group had lost contact with the labour market. Social stability was less common among EPD (49 %) than in the comparison group (67%). Mobility out of the labour force increased and social stability decreased by number of inpatient admissions. Employees diagnosed with affective psychosis or neurosis and personality disorder fared better in the labour market than employees with schizophrenia. Conclusion: Employees suffering from psychiatric disorder do not maintain their social class or remain in the labour force to the same extent as individuals without those problems, irrespective of their parental class. Our results support the social drift hypothesis that individuals with poor psychiatric health move downward in the social hierarchy. [ABSTRACT FROM AUTHOR]