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Addressing challenges of validity and internal consistency of mental health measures in a 27- year longitudinal cohort study - the Northern Swedish Cohort study.

https://arctichealth.org/en/permalink/ahliterature277188
Source
BMC Med Res Methodol. 2016 Jan 07;16:4
Publication Type
Article
Date
Jan-07-2016
Author
Anne Hammarström
Hugo Westerlund
Kaisa Kirves
Karina Nygren
Pekka Virtanen
Bruno Hägglöf
Source
BMC Med Res Methodol. 2016 Jan 07;16:4
Date
Jan-07-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anxiety - diagnosis - psychology
Chi-Square Distribution
Depression - diagnosis - psychology
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Mental Health - statistics & numerical data
Prospective Studies
Reproducibility of Results
Sensitivity and specificity
Socioeconomic Factors
Surveys and Questionnaires
Sweden
Young Adult
Abstract
There are inherent methodological challenges in the measurement of mental health problems in longitudinal research. There is constant development in definitions, taxonomies and demands concerning the properties of mental health measurements. The aim of this paper was to construct composite measures of mental health problems (according to today's standard) from single questionnaire items devised in the early 1980s, and to evaluate their internal consistency and factorial invariance across the life course using the Northern Swedish Cohort.
All pupils in the last year of compulsory school in Luleå in 1981 (n?=?1083) form a prospective cohort study where the participants have been followed with questionnaires from the age of 16 (in 1981) until the age of 43 (in 2008). We created and tested the following composite measures from self-reports at each follow-up: depressive symptoms, anxiety symptoms, functional somatic symptoms, modified GHQ and positive health. Validity and internal consistency were tested by confirmatory factor analysis, including tests of factorial invariance over time.
As an overall assessment, the results showed that the composite measures (based on more than 30-year-old single item questions) are likely to have acceptable factorial invariance as well as internal consistency over time.
Testing the properties of the mental health measures used in older studies according to the standards of today is of great importance in longitudinal research. Our study demonstrates that composite measures of mental health problems can be constructed from single items which are more than 30 years old and that these measures seem to have the same factorial structure and internal consistency across a significant part of the life course. Thus, it can be possible to overcome some specific inherent methodological challenges in using historical data in longitudinal research.
Notes
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PubMed ID
26743433 View in PubMed
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Are the health consequences of temporary employment worse among low educated than among high educated?

https://arctichealth.org/en/permalink/ahliterature100357
Source
Eur J Public Health. 2010 Sep 30;
Publication Type
Article
Date
Sep-30-2010
Author
Anne Hammarström
Pekka Virtanen
Urban Janlert
Author Affiliation
1 Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
Source
Eur J Public Health. 2010 Sep 30;
Date
Sep-30-2010
Language
English
Publication Type
Article
Abstract
BACKGROUND: Despite the inconsistent findings of the growing amount of research analysing the possible health consequences of temporary employment, there is a lack of heterogeneous perspectives. The aim of the study was to analyse whether the health consequences of temporary employment are worse among low educated compared with high educated, after control for health-related selection. METHODS: A 26-year follow-up study of a cohort of all school leavers in a middle-sized industrial town in northern Sweden was performed between 1981 and 2007. Of those still alive of the original cohort, 94% participated during the whole period. For this study, a sample of participants with temporary and permanent employment contracts between the age of 30 and 42 years was selected (n?=?660). RESULTS: In multivariate logistic regression analyses, an additive synergistic interaction effect was found for low education and high exposure to temporary employment in relation to suboptimal self-rated health, after controlling for health-related selection and sex. An additive antagonistic interaction was found between low education in combination with high exposure to temporary employment in relation to psychological distress, whereas no interaction was found for depressive symptoms. CONCLUSION: Our hypothesis regarding worse health effects of temporary employment among low educated was partly confirmed. Our results indicate the need to analyse temporary employment from a more heterogeneous perspective as well as in relation to different health outcomes.
PubMed ID
20884663 View in PubMed
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The association between long-term accumulation of temporary employment, the cortisol awakening response and circadian cortisol levels.

https://arctichealth.org/en/permalink/ahliterature130510
Source
Psychoneuroendocrinology. 2012 Jun;37(6):789-800
Publication Type
Article
Date
Jun-2012
Author
Per E Gustafsson
Urban Janlert
Pekka Virtanen
Anne Hammarström
Author Affiliation
Department of Public Health and Clinical Medicine, Umeå University, SE-901 85 Umeå, Sweden. Per.E.Gustafsson@fammed.umu.se
Source
Psychoneuroendocrinology. 2012 Jun;37(6):789-800
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adult
Algorithms
Area Under Curve
Circadian Rhythm - physiology
Cohort Studies
Employment - psychology
Female
Humans
Hydrocortisone - metabolism
Male
Questionnaires
Regression Analysis
Saliva - metabolism
Socioeconomic Factors
Sweden
Abstract
Temporary employment is an increasingly common contract type, which has not been investigated in a psychoneuroendocrinological context despite previous observations of associations between adverse work and employment conditions and hypothalamic-pituitary-adrenal (HPA) axis dysregulations. The present study aims to examine whether the 12-year accumulation of temporary employment is related to circadian cortisol levels, and if any association is independent of current employment conditions. Participants were drawn from the prospective Northern Swedish Cohort (n=791, 74% of the original cohort). At age 43 years, retrospective reports of employments over the last 12 years and of current social conditions were collected by questionnaire, and one-day salivary cortisol profile was measured (at awakening, +15 min post-awakening, pre-lunch, bedtime). Results indicated a gradually higher magnitude of the cortisol awakening response (CAR) in subjects with no (0 months in temporary employment; mean CAR=34%), moderate (1-25 months in temporary employment; mean CAR=41%) and heavy (>25 months in temporary employment; mean CAR=51%) exposure (p=.020), remaining after adjustment for potential confounders and for current employment conditions (p=.028). The higher CAR was explained by lower awakening rather than higher post-awakening cortisol levels. Cortisol levels at all times of the day except post-awakening displayed tendencies to negative relations to temporary employment; as indicated by a lower Area Under of Curve (regression coefficient=5.0%, p=.038 after adjustment). This study thus suggests that the long-term exposure to temporary employment might confer HPA dysregulations in the form of increased dynamics of the CAR and circadian suppression.
PubMed ID
21996053 View in PubMed
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Association of contractual and subjective job insecurity with sickness presenteeism among public sector employees.

https://arctichealth.org/en/permalink/ahliterature141949
Source
J Occup Environ Med. 2010 Aug;52(8):830-5
Publication Type
Article
Date
Aug-2010
Author
Tarja Heponiemi
Marko Elovainio
Jaana Pentti
Marianna Virtanen
Hugo Westerlund
Pekka Virtanen
Tuula Oksanen
Mika Kivimäki
Jussi Vahtera
Author Affiliation
Service System Research Unit, National Institute for Health and Welfare, Helsinki, Finland. tarja.heponiemi@thl.fi
Source
J Occup Environ Med. 2010 Aug;52(8):830-5
Date
Aug-2010
Language
English
Publication Type
Article
Keywords
Absenteeism
Adolescent
Adult
Aged
Attitude
Cross-Sectional Studies
Employment
Faculty
Female
Finland
Humans
Male
Middle Aged
Nurses
Occupational Health
Personnel Management - statistics & numerical data
Public Sector - statistics & numerical data
Young Adult
Abstract
We examined the associations of contractual job insecurity (fixed-term vs permanent employment contract) and subjectively assessed job insecurity with sickness presenteeism among those who had no sickness absences during the study year.
Survey data from a sample of 18,454 Public sector employees were gathered in 2004 (the Finnish Public Sector study).
Fixed-term employees were less likely to report working while ill (odds ratio = 0.88, 95% confidence interval = 0.77 to 0.99) than permanent employees. Subjective insecurity was associated with higher levels of working while ill, and this association was stronger among older employees. These results remained after adjustments for demographics, health-related variables, and optimism.
Our results suggest that subjective job insecurity might be even more important than contractual insecurity when a public sector employee makes the decision to go to work despite feeling ill.
PubMed ID
20657303 View in PubMed
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Children of boom and recession and the scars to the mental health--a comparative study on the long term effects of youth unemployment.

https://arctichealth.org/en/permalink/ahliterature275737
Source
Int J Equity Health. 2016;15:14
Publication Type
Article
Date
2016
Author
Pekka Virtanen
Anne Hammarström
Urban Janlert
Source
Int J Equity Health. 2016;15:14
Date
2016
Language
English
Publication Type
Article
Keywords
Cohort Studies
Economic Recession - statistics & numerical data
Female
Humans
Long Term Adverse Effects - epidemiology - psychology
Male
Mental Health - standards - statistics & numerical data
Surveys and Questionnaires
Sweden - epidemiology
Unemployment - psychology - statistics & numerical data
Abstract
Earlier research shows that there is an association between unemployment and poor mental health, and that recovery from the damages to mental health obtained during unemployment remains incomplete over a long period of time. The present study relates this 'mental health scarring' to the trade cycle, exploring if those exposed to youth unemployment during boom differ from those exposed during recession with respect to mental health in the middle age.
The sample consists of two cohorts from the same industrial town in Northern Sweden: the cohort born in 1965 and the cohort born in 1973 included all pupils attending the last grade of compulsory school, respectively, in 1981 and in 1989. Their depressiveness and anxiousness were assessed by questionnaires at age 21 and again at age 43/39. Mental health at follow-up was related to exposure to unemployment during age years 21-25. Statistical significance of the cohort*exposure interactions from binary logistic regression analyses were used to assess the cohort differences in the mental health between Cohort65 and Cohort73, entering the labour market, respectively, during a boom and a recession.
Compared to the unexposed, high exposure to unemployment at the age from 21 to 25 was associated to increased probability of poor mental health in the middle age in both in Cohort65 (odds ratio 2.19 [1.46-3.30] for anxiousness and 1.85 [1.25-2.74]for depressiveness) and in Cohort73 (odds ratio 2.13 [1.33-3.39] for anxiousness and 1.38 [0.89-2.14] for depressiveness). The differences between the cohorts also turned out as statistically non-significant.
The scars of unemployment exposure onto future health seem to be rather insensitive to economic trades. Thus, at the population level this would mean that the long-term health costs that can be attributed to youth unemployment are more widespread in the generation that suffers of recession around the entry to the work life.
Notes
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PubMed ID
26792092 View in PubMed
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Co-occurrence of depressive, anxiety, and somatic symptoms: trajectories from adolescence to midlife using group-based joint trajectory analysis.

https://arctichealth.org/en/permalink/ahliterature310193
Source
BMC Psychiatry. 2019 08 01; 19(1):236
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
08-01-2019
Author
Tea Lallukka
Gashaw B Mekuria
Tapio Nummi
Pekka Virtanen
Marianna Virtanen
Anne Hammarström
Author Affiliation
Department of Public Health, University of Helsinki, Helsinki, Finland. tea.lallukka@helsinki.fi.
Source
BMC Psychiatry. 2019 08 01; 19(1):236
Date
08-01-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Anxiety - epidemiology - psychology
Comorbidity
Depression - epidemiology - psychology
Female
Humans
Longevity
Longitudinal Studies
Male
Medically Unexplained Symptoms
Somatoform Disorders - epidemiology - psychology
Surveys and Questionnaires
Sweden - epidemiology
Abstract
Co-occurrence of mental and somatic symptoms is common, and recent longitudinal studies have identified single trajectories of these symptoms, but it is poorly known whether the symptom trajectories can also co-occur and change across the lifespan. We aimed to examine co-occurring symptoms and their joint trajectories from adolescence to midlife.
Longitudinal data were derived from Northern Sweden, where 506 girls and 577 boys aged 16?years participated at baseline in 1981 (99.7% of those initially invited), and have been followed up in four waves until the age of 43. Survey data were collected about depressive, anxiety, and somatic symptoms. Potential joint development of this three-component symptom set was examined with multiple response trajectory analysis, a method that has not been previously used to study co-occurrence of these symptoms.
We identified a five trajectory solution as the best: "very low" (19%), "low" (31%), "high" (22%), "late sharply increasing" (16%) and a "very high increasing" (12%). In the "late sharply increasing" and "very high increasing" groups the scores tended to increase with age, while in the other groups the levels were more stable. Overall, the results indicated that depressive, anxiety, and somatic symptoms co-exist from adolescence to midlife.
The multiple response trajectory analysis confirmed high stability in the co-occurrence of depressive, anxiety, and somatic symptoms from adolescence to midlife. Clinicians should consider these findings to detect symptoms in their earliest phase in order to prevent the development of co-occurring high levels of symptoms.
PubMed ID
31370894 View in PubMed
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Developmental pathways of multisite musculoskeletal pain: what is the influence of physical and psychosocial working conditions?

https://arctichealth.org/en/permalink/ahliterature284749
Source
Occup Environ Med. 2017 Jul;74(7):468-475
Publication Type
Article
Date
Jul-2017
Author
Subas Neupane
Päivi Leino-Arjas
Clas-Håkan Nygård
Jodi Oakman
Pekka Virtanen
Source
Occup Environ Med. 2017 Jul;74(7):468-475
Date
Jul-2017
Language
English
Publication Type
Article
Keywords
Adult
Female
Finland - epidemiology
Food Industry
Humans
Logistic Models
Longitudinal Studies
Male
Middle Aged
Musculoskeletal Pain - epidemiology - etiology - psychology
Occupational Diseases - epidemiology - etiology - psychology
Regression Analysis
Risk factors
Stress, Psychological - psychology
Surveys and Questionnaires
Workplace - psychology
Abstract
To investigate the developmental pathways of multisite musculoskeletal pain (MSP) and the effect of physical and psychosocial working conditions on the development of MSP trajectories.
The study was conducted among food industry workers (N=868) using a longitudinal design. Surveys were conducted every 2 years from 2003 to 2009. The questionnaire covered MSP, physical and psychosocial working conditions (physical strain, environmental factors, repetitive movements, awkward postures; mental strain, team support, leadership, possibility to influence) and work ability. MSP as an outcome was defined as the number of painful areas of the body on a scale of 0-4. Latent class growth modelling and multinomial logistic regression were used to analyse the impact of working conditions on MSP pathways.
Five MSP trajectories (no MSP 35.6%, persistent MSP 28.8%, developing MSP 8.8%, increasing MSP 15.3% and decreasing MSP 11.5%) were identified. In a multivariable model, the no MSP pathway was set as the reference group. High physical strain (OR 3.26, 95% CI 2.10 to 5.04), poor environmental factors (3.84, 2.48 to 5.94), high repetitive movements (3.68, 2.31 to 5.88) and high mental strain (3.87, 2.53 to 5.92) at baseline predicted the persistent MSP pathway, allowing for poor work ability (2.81, 1.84 to 4.28) and female gender (1.80, 1.14 to 2.83). High physical strain and female gender predicted the developing MSP pathway. High physical strain, poor environmental factors and high repetitive movements predicted the increasing and decreasing MSP pathways.
A substantial proportion of individuals reported having persistent MSP, and one-third reported changing patterns of pain. Adverse physical working conditions and mental strain were strongly associated with having high but stable levels of MSP.
PubMed ID
27815429 View in PubMed
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Does the association between musculoskeletal pain and sickness absence due to musculoskeletal diagnoses depend on biomechanical working conditions?

https://arctichealth.org/en/permalink/ahliterature268540
Source
Int Arch Occup Environ Health. 2015 Apr;88(3):273-9
Publication Type
Article
Date
Apr-2015
Author
Subas Neupane
Päivi Leino-Arjas
Clas-Håkan Nygård
Helena Miranda
Anna Siukola
Pekka Virtanen
Source
Int Arch Occup Environ Health. 2015 Apr;88(3):273-9
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Biomechanical Phenomena
Cohort Studies
Female
Finland - epidemiology
Food Industry
Humans
Male
Middle Aged
Musculoskeletal Diseases - complications - epidemiology
Occupational Diseases - epidemiology
Pain - complications - epidemiology
Registries
Regression Analysis
Sick Leave - statistics & numerical data
Sprains and Strains
Surveys and Questionnaires
Abstract
To investigate single-site and multi-site musculoskeletal pain as predictors of future sickness absence due to musculoskeletal disorders (MSD) among blue-collar employees in food industry, and to study to what extent this relationship depends on physical loading at work.
Survey responses of 901 employees on working conditions and musculoskeletal pain during the past week were linked to their future sickness absence records obtained from the personnel register of a food industry company. Negative binomial regression models were computed to determine associations of pain in one and in multi-site with the number of sickness absence days due to MSD during a four-year follow-up. Analyses were made in the whole cohort and stratified by the occurrence of repetitive movements and awkward postures (low/high).
Multi-site pain occurred among 59 % in the total cohort and predicted sickness absence with a rate ratio of 1.48 [95 % confidence interval (CI) 1.21-1.80], adjusted for age, gender, biomechanical and psychosocial working conditions, body mass index and physical exercise. Similar associations were seen in the sub-cohorts with a low occurrence of repetitive movements (RR 2.18, CI 1.69-2.80) and awkward postures (RR 1.78, CI 1.39-2.28), but not in the sub-cohorts with a high occurrence of these exposure. Single-site pain was not predictive of sickness absence.
A very high level of sickness absence in biomechanically strenuous work was found. Multi-site pain predicted sickness absence due to MSD among the employees with low exposure, but not among those with high exposure.
PubMed ID
24989906 View in PubMed
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Do physical or psychosocial factors at work predict multi-site musculoskeletal pain? A 4-year follow-up study in an industrial population.

https://arctichealth.org/en/permalink/ahliterature122935
Source
Int Arch Occup Environ Health. 2013 Jul;86(5):581-9
Publication Type
Article
Date
Jul-2013
Author
Subas Neupane
Helena Miranda
Pekka Virtanen
Anna Siukola
Clas-Håkan Nygård
Author Affiliation
School of Health Sciences, 33014 University of Tampere, Tampere, Finland. subas.neupane@uta.fi
Source
Int Arch Occup Environ Health. 2013 Jul;86(5):581-9
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Adult
Biomechanical Phenomena
Female
Finland
Follow-Up Studies
Food-Processing Industry
Health Surveys
Humans
Interpersonal Relations
Job Satisfaction
Leadership
Logistic Models
Male
Middle Aged
Musculoskeletal Pain - etiology - psychology
Occupational Diseases - etiology - psychology
Occupational Exposure - adverse effects
Professional Autonomy
Prospective Studies
Questionnaires
Risk factors
Abstract
Musculoskeletal pain at multiple sites is common among working-age people and greatly increases work disability risk. Little is known of the work-related physical and psychosocial factors contributing to multi-site pain.
Survey responses from 734 employees (518 blue- and 216 white-collar; 65?% female) of a food processing company were collected twice, in 2005 and 2009. Information on musculoskeletal pain during the preceding week, and on environmental, biomechanical and psychosocial work exposures were obtained through a structured questionnaire. The association of multi-site pain with work exposures was estimated with logistic regression by gender and age group.
At baseline, 54?% of informants reported pain in more than one area, and 50?% at 4-year follow-up. Forty percent of all employees had multi-site pain both at baseline and at follow-up. Among those with multi-site pain at baseline, 69?% had multi-site pain at follow-up. Both repetitive work and awkward work postures at baseline were associated with multi-site pain at follow-up. Psychosocial factors (low job satisfaction, low team spirit, and little opportunity to exert influence at work) also strongly predicted multi-site pain at follow-up, especially among younger workers and men.
This prospective study provides new evidence of the high occurrence and persistence of musculoskeletal pain at multiple body sites in an industrial population with a strong association between biomechanical and psychosocial exposures at work and multi-site pain. Prevention of multi-site pain with many-sided modification of work exposures is likely to reduce work disability.
PubMed ID
22752311 View in PubMed
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Employment status and differences in the one-year coverage of physician visits: different needs or unequal access to services?

https://arctichealth.org/en/permalink/ahliterature167233
Source
BMC Health Serv Res. 2006;6:123
Publication Type
Article
Date
2006
Author
Pekka Virtanen
Mika Kivimäki
Jussi Vahtera
Markku Koskenvuo
Author Affiliation
School of Public Health, University of Tampere, Tampere, Finland. pekka.j.virtanen@uta.fi
Source
BMC Health Serv Res. 2006;6:123
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Dental Care - utilization
Employment - classification - statistics & numerical data
Female
Finland
Health Care Surveys
Health Services - utilization
Health Services Needs and Demand - statistics & numerical data
Humans
Insurance Coverage
Male
Middle Aged
Occupational Health Services - utilization
Odds Ratio
Office Visits - utilization
Outpatient Clinics, Hospital - utilization
Patient Acceptance of Health Care - statistics & numerical data
Primary Health Care - utilization
Private Practice - utilization
Regression Analysis
Abstract
The dichotomy employed vs. unemployed is still a relevant, but rather crude measure of status in current labour markets. Also, studies concerning the association of employment status with health have to specify the type of the employment as well as the characteristics of the unemployment. This study aims to reveal differences and potential inequalities in physician visits among seven groups in the core-periphery structures of the labour markets.
A total of 16,000 Finns responded to a postal survey in 2003. Their visits to physicians in public primary health care, occupational health care, private health services, hospital outpatient clinics and dental care services during previous year were measured as indicators of service utilisation. Participants were classified as employees having a permanent or fixed-term and full-time or part-time contract and as those experiencing short-term, prolonged or long-term unemployment. Differences in the one-year coverage of physician visits between these groups of employees were analysed using logistic regression analyses where differences in the need for services were controlled for by including demographics and self-rated health assessments in the models.
Permanently employed respondents had visited a physician most often, and the need-adjusted regression models showed significantly lower odds ratios for a visit among fixed-term employees (OR 0.65, 95% CI 0.53-0.81) and in particular among the long-term unemployed (OR 0.21, 95% CI 0.14-0.31). A stratified analysis according to health care sector showed the lowest odds ratios in occupational health care and private physicians (ORs between 0.05 and 0.73) and also low odds ratios for dentists (ORs between 0.45 and 0.91), whereas visits to public primary health care were more common among non-permanent employees and the unemployed (ORs between 1.46 and 2.39).
The use of physician services varies according to labour market status, being relatively low among the non-permanently employed and the unemployed. This underuse is emphasised when clinical need is taken into account. The main reasons for the variance evidently lie in the structures of the Finnish health service system. The result may indicate non-optimal health care of the population on the periphery of the labour market, but it may also reflect the importance of employment status as a context for need and the decision to visit a physician.
Notes
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PubMed ID
17014702 View in PubMed
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