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The current study was designed to extend the parenting literature by testing the moderating role of the family’s emotional climate, operationalized with parent-adolescent emotional closeness and adolescent feelings of being overly controlled by parents on the longitudinal associations between parent-driven communication efforts (i.e. parental behavioral control and solicitation of information from their adolescent), adolescent-driven communication efforts (i.e. adolescent disclosure and secrecy) and adolescent psychosocial functioning (i.e. emotional problems, conduct problems, delinquency, and wellbeing). We conducted a series of cross-lagged models controlling for adolescent gender and ethnicity using a two-wave Swedish longitudinal set of self-report data (N = 1515, 51% girls, M age = 13.0 and 14.3 years at T1 and T2, respectively). Multi-group analyses revealed that the negative links between T1 parental control and T2 adolescent delinquency, T1 parental solicitation and T2 adolescent conduct problems and delinquency, and T1 emotional problems and T2 adolescent disclosure were moderated by the family’s emotional climate. When the family’s emotional climate was positive, the parenting strategies had a more positive effect on adolescent psychosocial functioning, and adolescents with emotional problems communicated more openly with their parents. These findings suggest that the relational context in the family is an important protective factor and add specificity to the previously established role of parent-adolescent communication in adolescent psychosocial development. In terms of preventive interventions, strategies to enhance the family’s emotional climate should be considered prior to teaching specific parenting strategies.

PurposeThe purpose of this article is to present the Gothenland Millennium Cohort, describe the data collection process, present key measures used and summarise some of the key findings to date in order to stimulate collaboration and use of the cohort data. This research programme was originally established to study pathways to alcohol and drug use, behavioural problems, mental health issues, and the factors that promote or prevent these outcomes. The Cohort aims to support scientific research and doctoral education through a longitudinal study that tracks individuals from early adolescence through adulthood. This programme is multidisciplinary (social work, psychology, disability research) with the goal of producing high-quality research that deepens our understanding of how early-life vulnerabilities, risks and protective factors influence long-term wellbeing, including health and welfare, in diverse populations.ParticipantsIn 2013, all school-registered adolescents, in grades 6 and 7 (aged 12 and 13), in four municipalities in Gothenland region (ie, southern Sweden) born in year 2000 or 2001, were invited to participate. Of 2150 invited adolescents, 1885 (88%) accepted participation in the programme and 1760 (93.4%) participated in at least one of the annual data collection waves up to grade 9 (Wave 4), with participation rates ranging from 70% to 85% per wave. Wave 5 questionnaires were collected during the second year of upper secondary school (grade 11). In Wave 5, half (50.4 %; n = 949) of the adolescents participated. In Wave 6, interviews were conducted with a selection of participants in their last year of upper secondary school (grade 12). Parents were surveyed in Waves 1 and 2 by self-report questionnaires (response rate = 32%; 41%). Data were also gathered from teachers (attrition <30% across Waves 1–4). Child welfare service records and population-based register data have also been collected.Findings to dateOver 240 publications have been produced as of September 2025 in the areas of disability and everyday functioning, child-parent relationships, child welfare, substance use and criminal behaviour, mental health, trauma, harassment, and sexuality.Future plansThese include continued investigation of wellbeing and its related indicators during adolescence as well as in emerging adulthood, continued efforts to secure funding and an age 25 expansion of the cohort data.

The study explores the qualifications and competency needs of professionals working at Swedish Maria clinics, specialized in treating youth with co-occurring substance use and mental health problems. A web-based survey was conducted among 87 professionals working at the clinics to assess their qualifications, competence in managing co-occurring problems and perceived needs for further training. Most professionals had high educational qualifications, with backgrounds in social work, nursing and psychology. Although health care and social services professionals had generally similar competencies, there were some notable differences in their professionalism and competency needs. Healthcare professionals were more likely to report competence in managing severe psychiatric conditions. In contrast, social services professionals more often reported using a broader range of treatment methods. Both groups identified a need for further education in managing severe psychiatric conditions, such as trauma, psychosis and eating disorders. Social services professionals more frequently emphasized the need for family-oriented approaches, while healthcare professionals more often identified a need for more in-depth knowledge related to substance use. While professionals at the clinics generally possess strong qualifications, there are differences in their confidence and expertise relating to managing complex mental health conditions. Tailored training initiatives that address specific needs based on professionals’ educational backgrounds and organizational affiliations could enhance inter-professional collaboration and improve treatment outcomes for youth with co-occurring substance use and mental health problems.

Background The aim of the study was to investigate how general family relations, reported changes in family interaction and involvement with peers during the Covid-19 pandemic, and following rules and recommendations during the pandemic relate to adolescent smoking, alcohol use, inebriation, and use of narcotics during Covid-19. Methods An online national survey of Swedish adolescents (n = 1818) aged 15–19 years was conducted in June 2020. Hierarchical regression analysis was used to predict adolescents’ reported change in substance use during the pandemic. Person-oriented analyses, were used to identify clusters of participants characterized by similar patterns of substance use following ANOVA analysis with Scheffe post hoc tests testing differences between clusters in terms of family relations, reported changes in family interaction and involvement with peers during the Covid-19 pandemic, and following rules and recommendations during the pandemic. Results Higher general family conflict, increased involvement with peers, a strained relationship with parents, and less compliance with rules and restrictions during the pandemic predicted a reported increase in adolescent substance use during this period. The grouping of scores for adolescent smoking, alcohol use, inebriation, and use of narcotics resulted in a six-cluster solution. One cluster (n = 767) either did not use or had decreased use of substances during the Covid-19 pandemic. Five other clusters, thus risk clusters, had retained or increased use of substances during the pandemic. Poor general family relations, increased peer involvement, and difficulties to conform to the rules and restrictions during the covid-19 pandemic were characteristics of risk clusters. Conclusions Most of adolescents in our study did not increase their substance use during the pandemic. However, adolescents with poor family relations who turn to peers during stressful times and who have difficulty following the government’s rules and restrictions, are at risk of increased substance use during the pandemic. This is a potential threat both to adolescents themselves and others in their surroundings which is why at-risk adolescents and their families need more attention from public health and social services during this time of crisis.

Background Few population studies have assessed the prevalence of various psychiatric disorders separately for sexual and gender minority groups, and none in an adolescent population. Given the increased mental health problems in sexual and gender minority groups combined, the present study aimed to estimate prevalence of mental disorders in separate sexual minority groups as well as gender discontent persons in community-recruited adolescents in Sweden. Methods The present study is based on two waves (at 17 and 18 years of age) of a longitudinal cohort study ( N  = 949; 56% with female and 44% male legal gender, of which 1.7% reported gender discontent). Diagnostic data of 20 mental health disorders (psychiatric, substance use, and addictive behavior disorders) for each group of sexual orientation (asexual, homosexual, bisexual, and heterosexual) and gender discontent are reported, based on structured screening and subsequent diagnostic procedures. Results The largest prevalence of mental health disorders was detected in homosexual girls and in bisexuals of both genders. Among asexual individuals, and among homosexual boys, none of the participants fulfilled the mental health disorders assessed. Gender discontent was associated with a moderately higher number of mental health disorders. Conclusion Mental health services, both in specialized psychiatry and in community-based services targeting the mental health of adolescents may need to take into consideration the increased vulnerability for mental health disorders in bisexual individuals and in female homosexual individuals. Further research with larger samples is essential to better understand mental health in asexual individuals, young male homosexuals, and transgender or gender discontent populations.

Screen time among children and adolescents has increased dramatically, raising concerns about its impact on development and mental health. While research highlights both potential benefits and risks, excessive use has been linked to issues like anxiety, depression, and gaming addiction. Despite growing concern, effective interventions are scarce. Recognizing the importance of family dynamics in child development, we propose a family-centered program to address problematic gaming and excessive screen use in a clinical population. By involving both children and parents, we aim to create a more comprehensive approach to prevention and treatment. This study aims to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical child and adolescent psychiatry (CAP) population. We will monitor the recruitment rate; track the retention and attendance rates of both parents and children; and assess whether each session's objectives are met, the content is delivered within the allotted time, and the necessary resources (eg, facilitators and materials) are available. Additionally, we will gather qualitative and quantitative feedback from participants through postprogram surveys and individual interviews with both children and parents. A total of 10 families with ongoing contact with CAP in Skåne, Sweden, will be recruited and offered participation in a family-centered group program targeting children aged 10-18 years with reported difficulties regarding screen gaming or screen use. The intervention to be tested is a newly developed, family-centered, psychoeducational, cognitive behavioral therapy-based intervention addressing both positive and negative aspects of screen use; setting boundaries; the connection between thoughts, feelings, and behaviors; conflict triggers; and sleep hygiene. The primary goal of the pilot study is to test the feasibility of the program, as well as recruitment and the analysis of participants' experiences with the program. A total of 11 children and their parents were enrolled during first quarter of 2024. A 4-session pilot was delivered in first quarter of 2024, and the first results are expected in the third quarter of 2024. The overarching goal of this pilot study is to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical CAP population. The insights gained from this study will guide our future research, which will focus on conducting a larger-scale evaluation of the intervention's impact on family screen time conflicts and inform future strategies for the implementation of family-centered interventions in child and youth clinics. ClinicalTrials.gov NCT06098807; https://clinicaltrials.gov/study/NCT06098807. DERR1-10.2196/56387.

Internalizing and externalizing problems increase during adolescence. However, these problems may be mitigated by adequate parenting, including effective parent–adolescent communication. The ways in which parent-driven (i.e., parent behavior control and solicitation) and adolescent-driven (i.e., disclosure and secrecy) communication efforts are linked to adolescent psychological problems universally and cross-culturally is a question that needs more empirical investigation. The current study used a sample of 1087 adolescents (M = 13.19 years, SD = 0.90, 50% girls) from 12 cultural groups in nine countries including China, Colombia, Italy, Jordan, Kenya, Philippines, Sweden, Thailand, and the United States to test the cultural moderation of links between parent solicitation, parent behavior control, adolescent disclosure, and adolescent secrecy with adolescent internalizing and externalizing problems. The results indicate that adolescent-driven communication, and secrecy in particular, is intertwined with adolescents’ externalizing problems across all cultures, and intertwined with internalizing problems in specific cultural contexts. Moreover, parent-driven communication efforts were predicted by adolescent disclosure in all cultures. Overall, the findings suggest that adolescent-driven communication efforts, and adolescent secrecy in particular, are important predictors of adolescent psychological problems as well as facilitators of parent–adolescent communication.

Well implemented, universal parental support is often effective in families with younger children, but research on their effects on families with adolescent children is scarce. In this study, a trial of the universal parent training intervention \"Parent Web\" in early adolescence is added to the social emotional learning intervention Promoting Alternative Thinking Strategies (PATHS®), completed in early childhood. The Parent Web is a universal online parenting intervention based on social learning theory. The intervention aims to promote positive parenting and family interaction through five weekly modules completed over 6-8 weeks. The main hypothesis is that participants in the intervention group will exhibit significant pre- to post- intervention-related benefits relative participants in the comparison group. The aims of this study are: 1) provide Parent Web as a booster aimed at improving parenting support and practices at the transition into adolescence to a cohort of parents whose children have previously participated in preschool PATHS, and 2) examine the effects of the universal edition of Parent Web. The study has a quasi-experimental design with pre- and post-testing. The incremental effects of this internet-delivered parent training intervention are tested in parents of early adolescents (11-13 years) who participated in PATHS when 4-5 years old compared to a matched sample of adolescents with no prior experience of PATHS. The primary outcomes are parent reported child behavior and family relationships. Secondary outcomes include self-reported parent health and stress. The proposed study is one of the few trials to test the effects of universal parental support in families of early adolescents and will therefore contribute to the understanding of how mental health in children and young people can be promoted across developmental periods through a continuum of universal measures.

Screen use, including gaming and social media, has increased over the past decade, potentially having adverse effects on child development and mental health. To prevent the potential problems arising from excessive screen use (ESU) and problem gaming (PG) scholars have developed a Family centered program for PG and ESU (FAME) involving both children and at least one parent in the program. The aim of this study was to explore the experiences of children's and parents' participation in the pilot-FAME program. Out of ten families who participated in the pilot-FAME, eight children (age 12-15; two girls), along with ten parents, out of which three fathers, participated in individual semi-structured interviews involving questions about a) families' perceptions of the program and b) suggestions for improvement of the program. The data were analyzed with Reflexive Thematic Analysis. Four distinct themes were constructed: Theme 1, \"Positivity regarding program\", Theme 2, \"Criticism regarding the program\", Theme 3, \"Program delivery\", and Theme 4, \"Content development\". Specifically, while the program was well-received for its group format and the peer support it facilitated, making adaptions such as incorporating more discussion and learning opportunities, along with extending the duration, would have potential to improve its delivery and feasibility. The pilot-FAME program shows promise in addressing the challenges associated with PG and ESU among children and their parents. With further refinements, the program could become an effective tool for supporting healthy family dynamics and screen use.

Background While recent studies suggest a high prevalence of Internet gaming disorder (IGD) in child and adolescent psychiatry (CAP) clinics, little is known about the factors contributing to problematic gaming among these patients. Given the well-established role of parenting and parent-child relationships in the development of problem behaviors, this study aimed to explore parent-child relationships within a Swedish cohort of CAP patients with IGD. Methods A total of 72 adolescents from CAP clinics in Skane, Sweden, diagnosed with IGD based on DSM-V criteria (73% boys), aged 13 to 18 years were included in the study. The adolescents completed the Game Addiction Scale for Adolescents (GASA) and reported on aspects of parent-child communication, such as parental control and adolescent disclosure and secrecy, and family climate. Adolescents were categorized as engaged, problem or addicted gamers based on core approach. Independent sample t-tests, Pearsons’s correlations, and multivariate regression analyses were used to address the study goals. Results Independent sample t-tests revealed that girls showed lower levels of parental knowledge than boys. Bivariate correlation analyses showed that IGD-symptoms were related to lower levels of child disclosure, while multivariate regression analyses revealed that higher IGD-symptoms were predicted by high levels of child secrecy and low child disclosure. Conclusion Parent-child relationships, in particular adolescent information management to parents, plays an important role for the level of IGD-symptoms in a clinical sample of adolescents. We suggest that therapeutic interventions for IGD should integrate family-focused strategies, such as parent training programs fostering open communication between parents and their children.