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Research question: Is parental attachment related to the integration of donor conception into identity among adolescents in heterosexual-couple and lesbian-couple families following identity-release oocyte and sperm donation?

Design: A cross-sectional survey was conducted in 2022–2023 as part of a longitudinal study on two-parent families with donor-conceived children. Of 128 donor-conceived adolescents approached, 100 (78% response rate) participated. Adolescents’ attachment to their parents was measured with the validated Inventory of Parent and Peer Attachment instrument, and integration of donor conception into identity with the Donor Conception Identity Questionnaire subscales Curiosity and Avoidance. Data analyses were performed with multiple linear regression analyses.

Results: Adolescents with more secure ratings of attachment to their father/co-mother were less curious about their donor origin (P = 0.010). Although showing a rather small effect (R2 = 0.073), the significant relationship remained when controlling for donation group, gender and age. No relationship was found concerning attachment to the birth mother (P = 0.125). Parental attachment was not related to feelings of avoidance with regards to their donor conception. Overall, the adolescents reported high ratings of attachment security to both parents and relatively low ratings of curiosity and avoidant feelings concerning the donor conception.

Conclusion: Among adolescents in heterosexual-couple and lesbian-couple families, attachment to the co-parent rather than the birth mother appears influential for their curiosity about the donor conception, which points to the psychological complexities of donor conception in families with potential access to donor information.

This study sought to investigate if heterosexual-couple parents with adolescent children following identity-release oocyte donation (OD), sperm donation (SD) or standard IVF differed with regard to psychological distress, family functioning, and parent-child relationships. The prospective longitudinal Swedish Study on Gamete Donation consists of couples recruited when starting treatment between 2005 and 2008 from seven Swedish university hospitals providing gamete donation. This study concerns the fifth wave of data collection and included a total of 205 mothers and fathers with adolescent children following OD (n = 73), SD (n = 67), or IVF with own gametes (n = 65). OD/SD parents had used identity-release donation and most had disclosed the donor conception to their child. Parents answered validated instruments measuring symptoms of anxiety and depression (HADS), family functioning (GF6+) and parent-child relationship. Results found that parents following OD or SD did not differ significantly from IVF-parents with regard to symptoms of anxiety and depression, family functioning, and perceived closeness and conflicts with their child. Irrespective of treatment group, most parents were within normal range on psychological distress and family functioning and reported positive parent-child relationships. However, SD mothers to a larger extent reported anxiety symptoms above cut-off compared to OD mothers (31% vs. 7.3%, p = 0.018). In conclusion, the present results add to previous research by including families with adolescent children following identity-release oocyte and sperm donation, most of whom were aware of their donor conception. Largely, our results confirm that the use of gamete donation does not interfere negatively with mothers’ and fathers’ psychological well-being and perceived family functioning.

STUDY QUESTION: Can the application of the theory of planned behavior (TPB) help predict heterosexual parents' disclosure of donor conception to their children?

SUMMARY ANSWER: Parents with a stronger will to act in accordance with social norms favoring disclosure were more likely to start the disclosure process within the next 5-9 years.

WHAT IS KNOWN ALREADY: In contrast to single mothers by choice and same-sex couples, heterosexual couples need to make an active decision to disclose their use of donor conception to their child. While disclosure at an early age is encouraged by international guidelines, many heterosexual-couple parents struggle with this. A previous study has found an association between parental scores of TPB factors and disclosure intention, but so far, no study has applied the TPB to predict parents' disclosure behavior.

STUDY DESIGN, SIZE, DURATION: The present study is based on the fourth and fifth waves of data collection (T4 and T5) in a nation-wide longitudinal study. Participating parents had conceived through identity-release oocyte donation (n = 68, response rate 65%) and sperm donation (n = 62, response rate 56%) as part of a heterosexual couple. PARTICIPANTS/MATERIALS, SETTING, METHODS: The present study is part of the prospective longitudinal Swedish Study on Gamete Donation (SSGD). Consecutive recruitment of couples starting oocyte or sperm donation treatment was conducted at all seven fertility clinics providing gamete donation in Sweden during a 3-year period (2005-2008). Participants were requested to complete postal surveys at five time points. The present study includes heterosexual-couple parents following oocyte or sperm donation who participated at the two latest time points when their children were 7-8 years old (T4), and 13-17 years old (T5). At T4, participants completed the study-specific TPB Disclosure Questionnaire (TPB-DQ) measuring attitudes and intentions to disclose the donor conception to the child, and disclosure behavior was assessed at both T4 and T5. Data from those participants who had not yet disclosed at T4 were analyzed using survival analysis with Cox regressions. MAIN RESULTS AND THE ROLE OF CHANCE: Forty participants had not disclosed the donor conception to their children at T4 and, out of these, 13 had still not disclosed at T5. We found a significant association between scores of the TPB factor Subjective norms at T4 and their subsequent disclosure behavior at T5 (HR = 2.019; 95% CI: 1.36-3.01). None of the other factors were significantly associated with disclosure behavior.

LIMITATIONS, REASONS FOR CAUTION: The present study concerns heterosexual-couple parents with children conceived following treatment with gametes from open-identity donors, which limits the generalizability of our findings to other groups and contexts. Other limitations include the risk of systematic attrition due to the longitudinal study design and decreased statistical power due to few participants.

WIDER IMPLICATIONS OF THE FINDINGS: Our findings highlight the importance of perceived subjective norms for parents' disclosure behavior and indicate that the co-parent's opinion about disclosure is of particular relevance in this regard. Counselors should focus on supporting prospective parents to initiate and maintain a healthy and open dialogue about concerns around building a family with donor conception.

Objective: To estimate the prospective association between the exposure to three types of gender-based violence and harassment (GBVH) and psychotropic medication.

Methods: Information on three measures of workplace GBVH-sexual harassment (1) from superiors or colleagues, (2) from others (eg, clients) and (3) gender harassment from superiors or colleagues-were retrieved from the biannual Swedish Work Environment Survey 2007-2013 (N=23 449), a representative sample of working 16-64 years old registered in Sweden. The survey answers were merged with data on antidepressants, hypnotics/sedatives and anxiolytics from the Swedish Prescribed Drug Register. Cox proportional hazards analyses with days to purchase as time scale and first instance of medicine purchase as failure event were fitted, adjusted for demographic and workplace factors.

Results: Workers who reported exposure to gender harassment only (HR 1.2, 95% CI 1.07 to 1.36), to sexual but not gender harassment (HR 1.21, 95% CI 1.04 to 1.40), or to gender and sexual harassment (HR 1.31, 95% CI 1.08 to 1.60) had an excess risk of psychotropics use in comparison to workers who reported neither of the exposures in the past 12 months. We found no interaction between the exposures and gender in the association with psychotropics use.

Conclusions: Exposure to sexual or gender harassment at the workplace may contribute to the development of mental disorders.

Purpose: We investigated the association between hyperacusis and aspects of psychosocial work environment in a general population. The objectives were to investigate (1) prevalence and characteristics (among age, sex, access to social support at home, education, smoking, physical exercise, and perceived general health) of hyperacusis in a general working population and (2) associations between hyperacusis and psychosocial factors in the work environment. The psychosocial work aspects included effort, reward, overcommitment, worry, and social and emotional support.

Methods: Using data from a sample stratified for age and sex from the Österbotten Environmental Health Study in Finland, currently employed participants with self-reported hyperacusis and referents were compared on questionnaire instruments quantifying six aspects of their psychosocial work environment.

Results: Among 856 currently employed participants, 47 constituted a hyperacusis group and 809 a reference group. The hyperacusis group scored significantly higher than the referents on worry at work, social support at work, and reward at work, but not on emotional support at work, work overcommitment, or effort at work. About 40% of the hyperacusis group scored on the upper quartile of the three former work environment factors, with odds ratios ranging from 1.91 to 2.56.

Conclusions: The results suggest that worrying about aspects at work, perceiving low social support, and not perceiving being rewarded at work are associated with hyperacusis.

Sound intolerance refers to an adverse reaction to sounds at sound pressure levels most people do not find bothersome. It is sometimes associated with hearing loss and tinnitus, but neither conditions are a prerequisite for being intolerant to sounds. The processes underlying the heightened reactions to sound, or how sound intolerance is related to other afflictions is not fully known, and research in this area can still be described as being in an early stage. This thesis aims to broaden the knowledge about sound intolerance and the sub-category of hyperacusis by using cross-sectional epidemiological and quasi-experimental methods of inquiry.

The thesis consists of three studies, each approaching the subject from a different perspective with the aim to better understand various characteristics of sound intolerance in general, its relation to psychosocial factors in the work environment, and its effects during noise exposure. Studies I & II are cross-sectional studies using two different data sets with similar design. Study I was based on data from a stratified sample in the Västerbotten Environmental Health Study. It examined the characteristics, background descriptions and comorbidities of self-reported and physician diagnosed individuals with hyperacusis, and compared them to a healthy referent group. Analyses revealed that a majority of both hyperacusis groups actively tried to avoid sound sources, and experienced that they for the most part could affect the environment to make it less noisy. There were significantly increased risks for other diagnosed illnesses in the hyperacusis groups compared to the healthy referent group, with large odds ratios (ORs) for the psychiatric illnesses anxiety, depression, post-traumatic stress disorder and exhaustion syndrome. Other common illnesses were tinnitus, hearing impairment and musculoskeletal disorders. Study II used data from the Österbotten Environmental Health Study and focused on the psychosocial work environment for people with hyperacusis. Working participants with hyperacusis who were employed/on leave of absence/paternal leave/long-term sick listed were compared to a working sample without hyperacusis on measures of effort-reward imbalance, work over commitment, emotional and social support and worry at work. The hyperacusis group scored significantly higher on worry, social support, and reward, whereas the groups did not differ significantly with respect to emotional support, over commitment or effort. In the final study, a quasi-experimental design was employed to investigate how individuals with sound intolerance react to noise exposure over time, in terms of perceived sound intensity, unpleasantness, rated distractibility, symptoms, heart rate variability and cognitive performance. Participants were divided into three groups of equal size based on their self-rated sound intolerance, which resulted in low, medium, and high sound intolerance groups. Results revealed large variations across individuals in several outcome variables. Compared to the other two groups, the high sound intolerance group perceived the noise as more unpleasant, stronger, and more distracting. They further rated the symptoms as higher in intensity, showed deviations in heart rate variability, and performed poorer on a cognitive task selected to measure inhibition.

In conclusion, the results suggest that persons with sound intolerance have relatively poor general health and hearing as well as high odds of comorbidity with various symptoms, including psychiatric diagnoses and functional somatic syndromes. In a working population, the sound intolerant show high odds for worrying about things at work, perceiving low social support at work and not feeling rewarded at work. Finally, the results suggest that persons with high sound intolerance have increased distractibility, sound unpleasantness, symptoms over time as well as lowered heart rate variability and cognitive performance when exposed to sounds.

Ljudintolerans syftar på en negativ reaktion på ljud vid ljudtrycksnivåer som de flesta människor inte finner obehagligt. Vilka processer som ligger bakom de förhöjda reaktionerna eller relationerna till andra åkommor är ännu oklart. Syftet med den här avhandlingen är att bredda kunskapen om ljudintolerans och dess underkategori hyperakusi, genom bruket av tvärsektionella och kvasi-experimentella metoder.           Avhandlingen består av tre studier som angriper ämnet från olika perspektiv, med syfte att bättre förstå generella egenskaper hos ljudintolerans; relationen till psykosociala arbetsmiljöfaktorer; samt effekterna av en ljudexponering i kontrollerad laboratoriemiljö. Studie I bestod av tvärsnittsdata från Miljöhälsostudien i Västerbotten och avhandlade egenskaper, bakgrundsdata och komorbiditeter för självrapporterade och läkardiagnostiserade individer med hyperakusi, jämfört med en referensgrupp utan dessa besvär. Resultaten visade att en majoritet av båda hyperakusi-grupperna försökte undvika ljudkällor, och upplevde att de för det mesta kunde påverka miljön för att göra den mindre bullrig. Det var en signifikant ökad risk för flera samsjukligheter för den självrapporterade gruppen jämfört med referenterna, med stora oddskvoter för såväl psykiatriska, muskuloskeletala och otorinolaryngologiska diagnoser, som funktionella somatiska syndrom. Studie II var även den en tvärsnittsstudie, den här gången med data från Miljöhälsostudien i Österbotten. Fokus för denna studie var kopplingen mellan ljudintolerans och psykosociala arbetsmiljöfaktorer. Personer med hyperakusi som arbetade, var tjänstlediga, föräldralediga eller långtidssjukskrivna, jämfördes med motsvarande grupp utan hyperakusi. Resultaten visade signifikant högre risk att skatta högt på enkätinstrument som mätte oro, brist på socialt stöd och brist på belöning. Ingen signifikant skillnad fanns för variablerna lågt känslomässigt stöd, överengagemang på arbetsplatsen och ansträngning. Den tredje och sista studien var en kvasi-experimentell laboratoriestudie. Syftet var att studera hur personer med ljudintolerans reagerade på ljudstimuli över en längre tidsperiod, med avseende på upplevd intensitet, obehag, distraktionsgrad, symptom, hjärtslagsvariabilitet och kognitiv prestation. Deltagarna delades upp i tre grupper baserat på deras egenskattade ljudintolerans. Resultaten visade på signifikanta skillnader; gruppen med hög ljudintolerans upplevde ljudet som mer obehagligt, distraherande och starkare. De rapporterade även kraftigare symptom, lägre hjärtslagsvariabilitet och sämre prestation på inhibitionsuppgiften jämfört med grupperna med låg och medelhög ljudintolerans. Sammantaget föreslår resultaten från studierna i den här avhandlingen att personer med ljudintolerans använder undvikande beteende, har generell sämre hälsa och större samsjuklighet än normalt. Yrkesarbetande med ljudintolerans löper större risk för att oroa sig för saker på jobbet, upplever lägre socialt stöd och känner sig inte så belönade på arbetsplatsen. Slutligen föreslår resultaten att personer med hög ljudintolerans upplever hög distraktion, obehag, och symptom över tid samt sänkt hjärtslagsvariabilitet och presterar relativt dåligt på kognitiva uppgifter vid exponering för ljud.

Background: Hyperacusis is intolerance of certain everyday sounds that causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities. 

Objective: The aim of this report is to summarize the key findings and conclusions from the Third International Conference on Hyperacusis.

Topics covered: The main topics discussed comprise (1) diagnosis of hyperacusis and audiological evaluations, (2) neurobiological aspect of hyperacusis, (3) misophonia, (4) hyperacusis in autism spectrum disorder, (5) noise sensitivity, (6) hyperacusis-related distress and comorbid psychiatric illness, and (7) audiologist-delivered cognitive behavioral therapy for hyperacusis.

Conclusions: Implications for research and clinical practice are summarised.

The aims of the study were (1) to investigate the effects of participation in low impact body conditioning classes on physical fitness in sedentary women at different ages and (2) to examine the correspondence between physical self-concept and participation in, and fitness change after, the participation. Ninety-two sedentary women (mean age 44.2 years) participated in 11-weeks of bi-weekly classes that included cardiovascular, strength, core, endurance and mobility exercises, all performed in synchrony with music. Cardiorespiratory fitness, maximal lifting strength, mobility and balance tests were performed pre- and post the exercise period and the short-form Physical Self-Description Questionnaire (PSDQ-S) was completed. Zero-order Spearman correlation analyses showed that women who rated the PSDQ-S dimension Sport competence higher participated in a larger number of sessions (rs=0.24, p=0.040). At post-tests, all participants had increased their balance, the participants aged 20-34 years had increased their lifting strength, and the participants aged 35-65 years had increased their cardiorespiratory fitness and mobility. Most PSDQ-S dimensions did not affect performance change, but the perception of being physically active was related to increased cardiovascular fitness. We conclude that women with a sedentary lifestyle who wish to increase their physical capacity benefit from music exercise and that inquiries about perceived sport competence and physical activity can improve recommendations made by strength and conditioning professionals.

There is a need for better understanding of various characteristics in hyperacusis in the general population. The objectives of the present study were to investigate individuals in the general population with hyperacusis regarding demographics, lifestyle, perceived general health and hearing ability, hyperacusis-specific characteristics and behavior, and comorbidity. Using data from a large-scale population-based questionnaire study, we investigated individuals with physician-diagnosed (n=66) and self-reported (n=313) hyperacusis in comparison to individuals without hyperacusis (n=2995). High age, female sex, and high education were associated with hyperacusis, and that trying to avoid sound sources, being able to affect the sound environment, and having sough medical attention were common reactions and behaviors. Posttraumatic stress disorder, chronic fatigue syndrome, generalized anxiety disorder, depression, exhaustion, fibromyalgia, irritable bowel syndrome, migraine, hearing impairment, tinnitus, and back/joint/muscle disorders were comorbid with hyperacusis. The results provide ground for future study of these characteristic features being risk factors for development of hyperacusis and/or consequences of hyperacusis.