To Örebro University

Links between psychopathic personality traits and internalizing and externalizing behaviors are established in terms of their conceptual and behavioral correspondence. Few studies have explored these behavioral problems as prospective predictors of psychopathic personality traits. We aimed to address this gap by investigating how internalizing and externalizing behaviors in adolescence predicted psychopathic personality traits in early adulthood, and if associations vary by sex. Using the Risk Factors for Antisocial Behavior (RFAB) study (N = 539), internalizing and externalizing behavior were assessed via the Youth Self-Report (at ages 14-15, 16-18 years) and psychopathic personality traits were assessed via the Triarchic Psychopathy Measure (at ages 19-20 years). Hierarchical multiple regression were conducted to examine associations between internalizing and externalizing behaviors in adolescence and psychopathic personality traits in early adulthood. Interactions were used to test sex differences. Internalizing behavior in adolescence predicted dimensions disinhibition and boldness (p's < .017). Externalizing behavior predicted all three dimensions: disinhibition, boldness, and meanness (p's < .017). No significant interactions were found between sex and internalizing or externalizing behaviors. Findings suggest that internalizing and externalizing behaviors in adolescence may serve as early indicators of psychopathic personality traits in early adulthood.

BACKGROUND: ADHD is a neurodevelopmental disorder linked to impulsivity and self-regulation difficulties. While the association between ADHD and nicotine dependence is well-established, less is known about the association with smokeless tobacco use, such as snuff. Given the adverse health effects of nicotine during pregnancy, this study examines whether women diagnosed with ADHD are more likely to use snuff prior to and early in pregnancy, and whether they persist in use between these periods. This study also explores the associations between ADHD and snuff use in the presence of common psychiatric disorders: depression, anxiety and substance use disorders (SUDs).

METHODS: Using Swedish population-based registers, we identified women who gave birth between 2000 and 2020. ADHD was defined based on clinical diagnoses and/or ADHD medication prescriptions. Snuff use was self-reported during a prenatal care visit. Logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs) for snuff use prior to and early in pregnancy among women with ADHD, adjusting for sociodemographic factors. We also stratified the analyses by depression, anxiety, and/or SUDs to assess potential differences in associations.

RESULTS: Women diagnosed with ADHD were more likely to use snuff prior to pregnancy (adjOR = 1.89, 95% CI: 1.83-1.95), early in pregnancy (adjOR = 2.43, 95% CI: 2.32-2.55), as well as be persistent snuff users (adjOR = 2.39, 95% CI: 2.27-2.52) compared to women without ADHD. Stratification by common psychiatric disorders revealed that the associations between ADHD and snuff use prior to and early in pregnancy were strongest among women diagnosed with ADHD without depression, anxiety, and/or SUDs.

CONCLUSIONS: ADHD is an important risk factor for snuff use prior to and early in pregnancy, underscoring the need for targeted interventions to prevent nicotine use in young women with ADHD as part of integrated care.

TRIAL REGISTRATION: Retrospectively registered.

Parental criminality is a risk factor for crime, but little is known about why some individuals exposed to this risk refrain from crime. We explored associations of resting heart rate (RHR), systolic blood pressure (SBP), cognitive ability (CA), and psychological functioning (PF) with criminal convictions among men with a convicted parent, accounting for unmeasured familial factors in sibling analyses. Data were         obtained from Swedish registers, including all men born in Sweden between 1958 and 1992 with a convicted parent (N = 495,109), followed for up to 48 years. The potential protective factors were measured at mandatory conscription. Outcomes were conviction of any, violent, and nonviolent crime. Survival analyses were used to test for associations, adjusting for measured covariates and unmeasured familial factors. Higher levels of RHR, SBP, CA, and PF were associated with reduced risk of criminality after adjusting for covariates. RHR associations were largely explained by familial factors. CA and PF associations were not due to sibling-shared confounders, in line with a causal interpretation. SBP results, indicating a protective effect against non-violent crime, warrant further investigation.

IMPORTANCE: Depression and factors reflecting neighborhood social structure (ie, socioeconomic deprivation, ethnic heterogeneity, residential mobility, and urbanicity) have each been linked to criminal convictions. However, how the association between depression and crime varies across different neighborhood types, and the extent to which it reflects unmeasured familial confounding, remains unclear.

OBJECTIVE: To examine whether the association between depression and violent and nonviolent criminal convictions varies across neighborhood types, and to assess the extent to which unmeasured familial factors contribute to the association.

DESIGN, SETTING, AND PARTICIPANTS: This population-based matched cohort and sibling-comparison study used data from Swedish national registers from 1986 to 2020. Follow-up spanned from 2001 to 2020. Statistical analyses were performed from January to November 2025. The cohort included individuals with a diagnosis of depression, each matched to 5 population controls without depression by birth year, sex, and neighborhood type. EXPOSURE: Outpatient depression diagnosis (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes F32-F33.9) recorded from 2001 to 2020.

MAIN OUTCOMES AND MEASURES: The primary outcomes were violent and nonviolent criminal convictions after diagnosis, identified through the National Crime Register. Conditional logistic regression estimated odds ratios (ORs) across 4 neighborhood types (resource-limited, rural low-diversity, urban professional, and urban affluent neighborhoods), with sibling comparisons used to assess familial confounding.

RESULTS: Among 571 470 matched individuals, 95 245 (36 297 male [38.1%]; median [IQR] age at first diagnosis, 20 [17-24] years) had depression. Depression was associated with increased odds of both violent and nonviolent convictions across all neighborhood types in unadjusted models. After adjustment for prior convictions, substance use disorder, and attention-deficit/hyperactivity disorder, associations remained significant in all but resource-limited neighborhoods (violent conviction OR, 1.14 [95% CI, 0.97-1.33]; nonviolent conviction OR, 1.01 [95% CI, 0.92-1.11]). A second sample included 42 585 individuals with depression and their full siblings without depression (total, 85 170 individuals). Sibling comparisons showed partial attenuation, indicating that familial confounding accounted for some, but not all, of the associations. Sibling-matched estimates were largely consistent with fully adjusted general population-matched estimates (eg, violent convictions in rural low-diversity neighborhoods: sibling-matched OR, 1.50 [95% CI, 1.33-1.69] vs general population-matched OR, 1.51 [95% CI, 1.39-1.65]).

CONCLUSIONS AND RELEVANCE: In this cohort study of the Swedish general population, the association between depression and criminal convictions varied across neighborhood types and was partially explained by familial factors. These findings underscore the relevance of considering contextual and familial influences and may offer insights for prevention and intervention strategies responsive to neighborhood social environments.

OBJECTIVES: Self-rated memory impairment is common in older age and has been related to objective cognitive decline and dementia. Recently, there has been growing interest in early-life predictors of late-life cognition, but research has been limited due to the absence of data spanning the entire lifespan. The present study investigated whether psychological health, social well-being, socioeconomic status (SES), and cognitive abilities at age 10 and 13 predicted subjective memory almost six decades later.

METHODS: Psychological health, social well-being, SES, and cognitive abilities were measured with standardized tests and questionnaires at age 10 and 13. Subjective memory, anxiety, and depressive symptoms were measured with the Prospective and Retrospective Memory Questionnaire (PRMQ) and Hospital Anxiety and Depression Scale (HADS) at age 67 (n = 625).

RESULTS: In a longitudinal autoregressive structural equation model (SEM), higher levels of psychological health at age 13 predicted lower levels of subjective memory at age 67. This association was independent of current anxiety and depressive symptoms. The model did not provide sufficient support that social well-being, SES, cognitive ability, and school performance at age 13 predicted subjective memory at age 67. Additional analysis revealed that psychological health at age 13, but not at age 10, and anxiety symptoms at age 67 uniquely predicted subjective memory at age 67.

DISCUSSION: These findings extend prior research by showing that psychological health is a robust predictor of subjective memory. Interventions targeting early-life psychological health may help identify individuals with different prospective cognitive outcomes in later life.

Low resting heart rate (RHR) is considered the best-replicated biological correlate for antisocial and conventional criminal behaviors, but there is limited research investigating whether this extends to white-collar crime. Using longitudinal data (n = 707,490) from multiple population-based Swedish registers and Cox proportional hazard regressions, results suggest that after accounting for demographic and criminality covariates, low RHR is not associated with white-collar criminality (aHR: 1.02, 95 % CI [0.99, 1.06]) whereas high RHR is associated with a lower risk of white-collar criminality (aHR: 0.92, 95 % CI [0.89, 0.95]), compared to average RHR. Findings indicate that low RHR is not associated with white-collar criminality, per se, but high RHR is a protective factor, reducing the risk of white-collar criminality.

Purpose: We investigated how multidimensional neighborhood types, capturing the complexity of neighborhood social structure, related to criminal convictions and substance use disorders (SUDs) in Sweden while accounting for residential mobility and shared familial influences.

Methods: Using nationwide Swedish register data (1991-2020), we followed 1.82 million individuals born 19852002 across five neighborhood types previously identified using latent class analysis. These were defined by socioeconomic and demographic indicators, with the most common type (rural low-diversity neighborhoods) serving as the reference category. Associations between neighborhood types, violent and nonviolent convictions, and SUDs were estimated using Cox proportional hazards models with hazard ratios (HRs) and 95% confidence intervals (CIs). Neighborhood type was modeled as a time-varying exposure, capturing residential changes over time. Sibling comparison models were applied to account for familial confounding.

Results: Risks of violent convictions, nonviolent convictions, and SUDs were highest in resource-limited neighborhoods (i.e., socioeconomically deprived areas with high residential turnover; violent: adjusted HR (aHR) = 4.70, 95% CI 4.26-5.19; nonviolent: aHR = 2.07, 95% CI 1.92-2.22; SUDs: aHR = 3.36, 95% CI 3.093.65). Moderate increases were observed in urban high-diversity neighborhoods (i.e., characterized by ethnic heterogeneity), whereas risks were lowest in socioeconomically advantaged urban areas. Associations were attenuated but remained statistically significant in sibling comparisons. Sex differences were modest and followed similar patterns across outcomes.

Conclusion: Neighborhoods marked by socioeconomic disadvantage and residential instability, rather than ethnic diversity, were linked to higher risks of criminal convictions and SUDs. Remaining associations after familial adjustment suggest modest but meaningful contextual effects.

Background: Neighborhoods shape daily life through physical and social structures, such as socioeconomic conditions, population density, and resident turnover. Decades of research link neighborhood characteristics to health and behavioral outcomes. However, these factors are often studied independently, neglecting their interrelated nature.

Methods: Using Swedish population registry data, we employed latent class analyses to identify neighborhood typologies across six timepoints spanning 1991-2020. Neighborhoods, defined by Demographic Statistical Areas, were characterized by socioeconomic conditions, ethnic heterogeneity, residential instability, and urbanicity. Latent transition analyses examined changes over time.

Results: Four neighborhood types emerged in the early period (1991-2000): Rural Low-Diversity (45 %), Urban Professional (27 %), Urban Affluent (21 %), and Resource-Limited (7 %). From 2001 onwards, five types were identified, with the addition of Urban High-Diversity (9 %) and Rural Resource-Limited (3 %). Three types, Rural Low-Diversity, Urban Professional, and Urban Affluent, persisted across 30 years, representing 87-93 % of neighborhoods, with over 90 % of neighborhoods retaining their classification over time.

Conclusions: This multidimensional framework offers a foundation for future research, urban planning, and policy development.

BACKGROUND: Maternal attention-deficit/hyperactivity disorder (ADHD) has been associated with various pregnancy outcomes, but the degree to which that association is explained by concomitant mental disorders and smoking during pregnancy remains unclear.OBJECTIVE: To investigate the association between maternal ADHD and pregnancy outcomes.

METHODS: Through the Swedish Medical Birth Register, we identified 977,266 women who gave birth to a live singleton between January 1, 2006, and December 1, 2020 (1,617,121 pregnancies). Of these, 1.3% (12,553 women; 17,434 pregnancies) had an ADHD diagnosis prior to pregnancy. The primary outcome was preterm birth (< 37 weeks), with secondary outcomes being postterm birth (> 41 weeks), small for gestational age, large for gestational age, birth weight (≤ 2500, 2501-3500, > 4500 g), acute and planned cesarean section, assisted vaginal delivery, preeclampsia, and gestational diabetes. Generalized linear mixed-effects models adjusted for maternal age, year of childbirth, maternal education, comorbid mental disorders, and smoking during pregnancy.

RESULTS: There were 1089 (6.6%) preterm births among women with ADHD, and 73,423 (4.9%) preterm births among women without an ADHD diagnosis, corresponding to a crude OR of 1.33 (95% CI 1.25, 1.42). This association attenuated to nonsignificance after adjusting for maternal age, year of childbirth, maternal education, and comorbid mental disorders (adjOR = 1.06, 95% CI: 0.99, 1.13). Fully adjusted models revealed that ADHD was associated with an increased risk of having a large for gestational age baby (adjOR = 1.16, 95% CI: 1.06, 1.26) and undergoing a planned caesarean section (adjOR = 1.16, 95% CI: 1.06, 1.26). Sensitivity analyses using a broader ADHD definition suggested associations with preterm birth (adjOR = 1.09, 95% CI: 1.04, 1.15) and acute caesarean section (adjOR = 1.09, 95% CI: 1.04, 1.13).

CONCLUSIONS: After adjustments for comorbid mental disorders and smoking during pregnancy, maternal ADHD was not associated with preterm birth. An increased risk of delivering large for gestational age babies and undergoing planned caesarean sections was found in women with ADHD.

Introduction: The current study examined longitudinal links between adolescent body mass index and body bulk with externalizing behaviors using data from the University of Southern California’s Risk Factors for Antisocial Behavior twin project.

Methods: The sample included 1,260 individuals (51% females), with 603 twin pairs (254 monozygotic; 349 dizygotic). Body mass index and body bulk were derived from measures of height and weight obtained at age 13-14 .Externalizing behavior was measured using the Youth Self-Report at age 13-14 and the Adult Self-Report at age 19-20.

Results: Higher body mass index and greater body bulk were associated with higher levels of externalizing behavior both concurrently at age 13-14, and prospectively at age 19-20 (B’s = 0.11-0.42, p’s < .05). Twin modeling indicated high heritability for body mass index and body bulk (h2 = 0.73-0.81) and moderate heritability for externalizing behavior (h2 = 0.31-0.41). Bivariate models suggested that genetic factors contributed to the modest covariance between body size and externalizing behavior, although the genetic correlation estimates were imprecise.

Conclusion: Findings are consistent with the possibility that some genetic influences are shared between body size and externalizing behavior; however, the modest phenotypic associations and uncertainty surrounding the genetic correlation estimates warrant cautious interpretation.