Eva Samuelsson | Stockholm University (original) (raw)

Papers by Eva Samuelsson

Frontiers in Psychiatry, 2022

The gambling market is a complex field of conflicting stakeholders and interests involving dimens... more The gambling market is a complex field of conflicting stakeholders and interests involving dimensions, such as economy, health, social inequality and morals. The division of responsibility between gamblers, the gambling industry and the regulating state for limiting the harmful effects of this activity, however, are unclear. The aim of this study was to explore how gamblers in the Swedish market attribute responsibility to various actors within the gambling field. Qualitative interviews were conducted with gamblers experiencing extensive gambling problems. Based on a discourse analytical approach, five ideological dilemmas were identified, highlighting the tension between the, often contradictory, values that the participants need to relate to. On the individual level, the gamblers emphasize their own responsibility for their problem, thereby showing accountability in relation to themselves, their significant others and their peers as agents in recovery. On the corporate and state levels however, the participants argue for a stronger public health approach, where the gambling companies should take further responsibility by living up to the legal regulations and where the state should ensure compliance and safeguard funding for treatment and research. The essential paradox between the individual responsibility discourse of self-regulation and the prevailing medical discourse of the gambler's incapacity for self-control signifies an impossible equation that imposes feelings of guilt and shame upon an individual who is concurrently considered as both responsible and incapable. In order to reduce harm, the gambling industry must be more proactive with coercive external control measures to fulfill the duty of care they claim to adhere to, and the regulating state must ensure its compliance.

Journal of Youth Studies, 2020

Since the 2000s, there has been a worldwide trend of decreased alcohol consumption among young pe... more Since the 2000s, there has been a worldwide trend of decreased alcohol consumption among young people. Although recent studies have given multiple explanations for this, we know little about the meaning of alcohol for this generation as they enter adulthood. The aim of this article is therefore to describe and analyze the age-related views toward alcohol among this group as they transition from adolescents to adults. The study was based on 39 qualitative interviews with people aged 17–21. Theoretical concepts such as doing age and symbolic boundaries were used to analyze the material and investigate how age can structure alcohol use, and how alcohol consumption can be narrated to produce maturity and adulthood. The analysis showed that participants presented their relation to alcohol in nuanced and responsible ways, signaling maturity. The participants’ navigation of acceptable alcohol consumption differs in terms of agency and control in different life phases. ‘Doing adulthood’ in relation to alcohol for abstainers and drinkers seems to center on the same understandings of legitimate behavior: being moderate, nuanced, and in control. This focus linked alcohol to the position these emerging adults hold in wider society, given that participants incorporated societal demands for a neoliberal lifestyle.

International Journal of Drug Policy, 2020

Background: With the emerging technologies of the Internet and smartphones during the last decade... more Background: With the emerging technologies of the Internet and smartphones during the last decades, the gambling environment has undergone a massive transformation. In Sweden, and Europe in general, online gambling has more than doubled since 2007. Method: The paper studies online gambling venues (OGVs) as relational actors of addiction. By drawing on the actor-network theory (ANT) and assemblage thinking, we examine how OGVs, as actors in specific networks of attachment, enable the development of gambling addiction and facilitate its continuation. The data consists of life story interviews with 34 online gamblers. Results: Online gambling venues extend the scope of gambling opportunities through space, providing an easy portable 24-hours-a-day access to gambling online and on smartphones. This increases the spatial mobility of gambling to diverse contexts. By linking gambling to more unpredictably evolving patterns of relations, online gambling venues also increase gambling's temporal mobility to intrude in the habitual trajectories of everyday life. By enhancing the gambling mobility through space and time, OGVs simultaneously extend the scope of situations in which gambling may transform from a controlled activity into an addiction. It is then that the actor-networks of gambling infiltrate in the actor-networks of work, domestic life and leisure, and start to feed processes where they are translated to serve the interests of gambling. Conclusion: By giving us tools to challenge simplistic and taken-for-granted explanations of gambling addiction and by allowing us to grasp the flux and changing nature of addiction as a relational pattern of heterogeneous contextual attachments, the actor-network theory can help us to understand the complexity and multiplicity of gambling problems. The knowledge on what kinds of contextual attachments in diverse actor-networks enable harmful gambling and sustain unhealthy relations helps practitioners to focus treatment interventions especially on these contextual linkages and their configurations.

Journal of Youth Studies , 2020

Research shows that young people’s online practices have become a continuous, seamless and routin... more Research shows that young people’s online practices have become a continuous, seamless and routine part of their physical and social worlds. Studies report contradictory findings on whether social media promotes intoxication-driven drinking cultures among young people or diminishes their alcohol consumption. By applying actor-network theory, our starting point is that the effects of social media depend on what kinds of concerns mediate its use. Social media alone cannot make young people drink more or less but influences their drinking in relation to specific attachments that we call here ‘assemblages’. The data consist of individual interviews among girls (n = 32) and boys (n = 24) between 15 and 19 years old from Sweden, covering topics such as alcohol use, social media habits and leisure time activities. The paper maps the variety of assemblages that mediate young people’s online practices and analyzes how young people’s drinking-related social media assemblages increase, decrease or exclude their alcohol consumption. The analysis shows that social media-related attachments seem to reduce our interviewees’ use of alcohol by providing competing activities, by transforming their drinking under the public eye, by reorganizing their party rituals to be less oriented towards drinking and by facilitating parents’ monitoring of their drinking situations.

Nordic Studies on Alcohol and Drugs, 2019

The Problem Gambling Severity Index (PGSI) is a screening instrument frequently used to identify ... more The Problem Gambling Severity Index (PGSI) is a screening instrument frequently used to identify risk and problem gambling. Even though the PGSI has good psychometric properties, it still produces a large proportion of mis-classifications. Aims: To explore possible reasons for mis-classifications in problem gambling level by analysing previously classified moderate-risk gamblers' answers to the PGSI items, in relation to their own current and past gambling behaviours. Methods: Semi-structured telephone interviews were conducted with 19 participants reporting no negative consequences from gambling. They were asked the PGSI questions within an eight-year time frame (2008 to 2016). Ambiguous answers to PGSI items were subject to content analysis. Results: Several answers to the PGSI items contained ambiguities and misinterpretations, making it difficult to assess to what extent their answers actually indicated any problematic gambling over time. The item about feelings of guilt generated accounts rather reflecting self-recrimination over wasting money or regretting gambling as a meaningless or immoral activity. The item concerning critique involved mild interpretations such as being ridiculed for buying lottery tickets or getting comments for being boring. Similar accounts were given by the participants irrespective of initial endorsement of the items. Other possible reasons for misclassifications were related to recall bias,
language difficulties, selective memory, and a tendency to answer one part of the question without taking the whole question into account. Conclusions: Answers to the PGSI can contain a variety of meanings based on the respondents’ subjective interpretations. Reports of lower levels of harm in the population should thus be interpreted with caution. In clinical settings it is important to combine use of screening instruments with interviews, to be able to better understand gamblers’
perceptions of the gambling behaviour and its negative consequences.

I denna rapport redovisas hur öppenvården för missbruksproblematik är organiserad och vilka insat... more I denna rapport redovisas hur öppenvården för missbruksproblematik
är organiserad och vilka insatser som erbjuds i
Södertörnskommunerna och Region Gotland. Kartläggningen visar
på lokal variation i öppenvårdslandskapet, inte så mycket gällande
vilka specifika insatser som erbjuds, men i hög grad gällande dess
innehåll, antalet alternativ som kan erbjudas och på vilket sätt
insatserna erbjuds. Organisatoriskt finns stor variation i fråga om
grad av marknadsorientering och i vilken utsträckning insatser
erbjuds som bistånd eller service. Den viktiga fråga som återstår att
besvara är dock hur väl insatserna fungerar för den enskilde som tar
del av dessa insatser. Även om vissa kommuner har utformat egna
system för att följa upp de insatser som erbjuds, saknas generellt
tillämpning av systematisk uppföljning och tillvaratagande av
brukarnas erfarenheter. Ytterligare utmaningar som verksamheterna
står inför är att få till fungerande samverkan kring personer med
komplexa vårdbehov, att kunna erbjuda insatser anpassade för vissa
målgrupper och psykosocialt stöd i form av tryggt boende och
meningsfull sysselsättning – åtgärder som kräver samverkan med
övriga aktörer i samhället.

On the 1st of January 2018, the Swedish legislation was subject to change due to a need to clarif... more On the 1st of January 2018, the Swedish legislation was subject to change due to a need to clarify the responsibility of care givers to prevent and provide support and treatment for gambling problems. The aim of this study has been to review the current situation of available support and treatment for gambling problems in Sweden, before the change in legislation took place. The Public Health Agency of Sweden and the Support Line (a telephone hotline service) has provided relevant information. Interviews have been conducted with sixteen key actors in the gambling treatment field representing municipalities, regional health care, authorities and non-governmental organisations. The interview material was analysed using thematic analysis. Preliminary results were presented for a group of treatment providers to validate the results and to collect further comments. The study showed that support and treatment for people with gambling problems are fragmentary and arbitrary on the national level. Support and treatment is available in some parts of the country but often relying on individual treatment providers’ own engagement, which creates a vulnerable situation in terms of availability and continuity of competence. The treatment offered is mainly cognitive behavioural therapy and there is a need to diversify and integrate various treatment options for different target groups. Non-governmental organisations play an important role by offering complimentary support as such, but also when treatment is not available. The main conclusion was that the municipal social services and the regional healthcare system in general are badly equipped to meet the needs of problem gamblers due to lack of resources and competence. Further efforts to provide education for personnel and implementation of screening routines to facilitate early detection in social services and health care settings are suggested. Despite ongoing development work, the legislative changes are challenging for municipalities and regional health care to accomplish satisfactory cooperation based on the needs of gamblers and their concerned significant others. A follow-up study will take place during 2019/2020 to review the development of support and treatment for gambling problems after the implementation of the new legislation.

Addiction Research & Theory, 2018

Background: Gambling participation and problems change over time and are influenced by a variety ... more Background: Gambling participation and problems change over time and are influenced by a variety of individual and contextual factors. However, gambling research has only to a small extent studied gamblers' own perceptions of transitions in and out of problem gambling. Method: Qualitative telephone interviews were made with 40 gamblers who had repeatedly participated in the Swelogs Swedish Longitudinal Gambling Study. The framework approach was used for analyses, resulting in a multiple-linkage typology. Results: Our analyses revealed four configurations of gambling: (a) stable low frequency with no or minor harm, (b) decreasing high frequency with occasional harm, (c) fluctuating with moderate harm, and (d) increasing high frequency with substantial harm. Natural recovery and return to previous levels of gambling intensity were common. Change occurred either gradually, as a result of adjustment to altered personal circumstances, or drastically as a consequence of determined decisions to change. Personal and contextual factors such as psychological well-being, supportive relationships, and meaningful leisure activities played a part in overcoming harmful gambling and keeping gambling on a non-problematic level. Gambling advertising was commonly perceived as aggressive and triggering. Conclusions: The experience of harm is highly subjective, which should be taken into account when developing preventive measures. Considering the fluid character of gambling problems, help and support should be easily accessible and diversified. To repeatedly be interviewed about gambling and its consequences can contribute to increased reflection on, and awareness of, one's own behaviours and the societal impacts of gambling.

Contemporary Drug Problems, Jul 10, 2015

Men’s and women’s drinking tend to elicit different societal reactions, which may be attributed t... more Men’s and women’s drinking tend to elicit different societal reactions, which may be attributed to different perceptions of masculinity and femininity. This study analyzes addiction care practitioners’ constructions of substance use and treatment needs in relation to gender. Data were collected by means of six focus group interviews with 30 addiction care practitioners. An interpretative repertoire of difference emerged, whereby women were constructed as being different from men in psychological, social, and biological respects. The practitioners related to gender in addiction care as an ideological dilemma resulting from the contradictory ideals of on the one hand treating everybody equally and on the other giving special attention to what is regarded as women’s needs. Reflections
emerged regarding the need to be aware of one’s own stereotyped assumptions, and also to be attentive toward men’s specific problems, thus constituting a reflective repertoire. In order to avoid potentially stereotyped treatment, the application of a gender-sensitive approach should acknowledge the variety of ways in which femininity and masculinity may be performed.

Stockholm Studies in Social Work 30, Feb 13, 2015

The aim of this thesis has been to study boundary-making in addiction care practitioner’s percept... more The aim of this thesis has been to study boundary-making in addiction care practitioner’s perceptions of substance use and treatment. The four papers are based on three data collections in Swedish outpatient addiction care: a) a survey conducted in 2006 (n=655), b) a factorial survey using randomly constructed vignettes conducted in 2011 (n=474), and c) a focus group interview study from 2013 (n=30) with a sample of the respondents from the factorial survey.
The analyses show that practitioners tend to draw boundaries between various forms of substance use, with alcohol use being perceived as a less severe problem than narcotics use and requiring less extensive treatment measures. There are also partially varying perceptions in different parts of addiction care. By comparison with social services staff, regional healthcare staff generally see a greater need for treatment, recommend medical treatment to a greater extent, and display less confidence in the possibility of handling problematic use without professional treatment. Despite an ongoing medicalization at the policy level, psychosocial treatment interventions appear to have legitimacy in both regional healthcare and social services settings.
Boundary-making processes are also found in relation to the specific user’s age, family situation, socio-economic status and in some cases gender, with young women’s drinking being seen as more severe than young men’s drinking for example. The boundary-making between different substance users may be interpreted as a sign of an approach based on a professional consideration of the person’s socially exposed situation, which might require more comprehensive support. At the same time, it may be an expression of a stereotyped approach, involving a normative evaluation of women’s behaviour as being more deviant than men’s, thereby having a limiting effect on the conduct norms that regulate women’s behaviour and making the problems of men invisible. To avoid disparities in addiction care delivery, it is of major importance that practitioners are given room to reflect upon the assumptions and values that underlie the assessments they make in practice. Combining a factorial survey with focus group interviews is proposed as one means of facilitating this type of reflection.

Addiction Research & Theory, Early Online, doi:10.3109/16066359.2013.856887

The aim of this study was to examine the influence of user, staff and work unit characteristics o... more The aim of this study was to examine the influence of user, staff and work unit characteristics on addiction care practitioners’ assessments of the severity of alcohol and drug use. A factorial survey was conducted among 489 social workers, therapists, nurses, doctors and executives from 77 addiction care units in the three largest Swedish counties. Staff assessed the severity of 10 fictive scenarios, vignettes (n = 4724), describing persons with varying social characteristics who were users of alcohol, cannabis or cocaine. The effects of user, respondent and work-unit variables on the practitioners’ severity assessments were estimated using multilevel regression analysis. The results show that perceived severity was influenced not only by the substance, the frequency and character of the negative consequences of the use, but also by the age, socio-economic status and family situation of the user. Women, older respondents and respondents with a medical education rather than a social work education were on average more inclined to assess the vignettes as being more severe. Analyses of various interactions revealed that practitioners viewed the drinking of young men as being less severe than that of young women. Doctors saw women's use as more problematic than men's, irrespective of the context. To conclude, alcohol and drug consumption is judged by different norms, depending on various characteristics of the users, of the practitioners and also of their workplaces. To avoid potential negative consequences of the application of such varying standards in addiction care, more individual reflection and workgroup discussion are needed.

Nordic Studies on Alcohol and Drugs. Volume 30, Issue 1-2, Pages 51–66, ISSN (Online) 1458-6126, ISSN (Print) 1455-0725, DOI: 10.2478/nsad-2013-0005, Feb 2013

AIMS - The objective of the study was to explore perceptions of different addictions among Swedis... more AIMS - The objective of the study was to explore perceptions of different addictions among Swedish addiction care personnel. DATA - A survey was conducted with 655 addiction care professionals in the social services, health care and criminal care in Stockholm County. Respondents were asked to rate the severity of nine addictions as societal problems, the individual risk to getting addicted, the possibilities for self-change and the perceived significance of professional treatment in finding a solution. RESULTS - The images of addiction proved to vary greatly according to its object. At one end of the spectrum were addictions to hard drugs, which were judged to be very dangerous to society, highly addictive and very hard to quit. At the other end of the spectrum were smoking and snuff use, which were seen more as bad habits than real addictions. Some consistent differences were detected between respondents from different parts of the treatment system. The most obvious was a somewhat greater belief in self-change among social services personnel, a greater overall change pessimism among professionals in the criminal care system and a somewhat higher risk perception and stronger emphasis on the necessity of treatment among medical staff. CONCLUSION - Professionals’ views in this area largely coincide with the official governing images displayed in the media, and with lay peoples’ convictions.

Conference Presentations by Eva Samuelsson

Books by Eva Samuelsson

Research Reports In Public Health Sciences, 2020

New legislation of the responsibility of social services and health care services to offer suppor... more New legislation of the responsibility of social services and health care services to offer support and treatment for gambling problems was introduced in Sweden on the 1st of January 2018. In this report, a follow-up study of the development of help-seeking, availability of support and treatment and collaboration between care givers is presented. The aim of the study was to identify progress and remaining challenges to offer people with gambling problems and their concerned significant others the help they need. Interviews were conducted with 16 key representatives from relevant authorities, organisations, self-help groups and treatment options before the new regulations (see Forsström & Samuelsson, 2018) took place and two years after. This report also describes a survey conducted by the Public Health Agency, results from the support line for gamblers on the development of treatment availability in municipalities and regions as well as data from self-help groups. The study shows that the new legislation, along with the reregulation of the gambling market (Gambling Act 2018:1138) that took place in 2019, has given gambling problems a more prominent position in care services. The level of knowledge of gambling problems has generally increased among staff. In all, more people with gambling problems tend to turn to social services, health care services and self-help groups for support. However, the level of help-seeking is still low relative to the estimation of severe gambling problems in the population. Specific information campaigns are suggested to reach certain subgroups that tend to refrain from seeking help.

Journal articles in English by Eva Samuelsson

Critical Gambling Studies, 2022

Japan has one of the highest rates of severe gambling problems in the world. However, the gamblin... more Japan has one of the highest rates of severe gambling problems in the world. However, the gambling forms that cause the most harm-pachinko and pachislot-are not recognized as gambling in the key legislation. They are understood as entertainment. On the basis of two group interviews with those who have experienced problems with gambling, this study explores how they have dealt with the shame, guilt, and stigma of pachinko-related gambling problems. The narrative analysis shows that the participants carry self-stigma as a result of self-reproach and others' condemnation of their behavior. Feelings of shame, guilt, and fear of being stigmatized have distinctly hindered the process of seeking help. The participants describe how their gambling, which they had attempted to limit, had led to isolation from normal life. The isolation and the failures to control the gambling increased their feelings of shame and destructive behavior. Considering the characteristics of the zone, the loss of self, and the shame, guilt and stigma of failing to control excessive pachinko gambling, it is unreasonable to place the main responsibility on the individual gambler. To reduce gambling harms in Japan and the stigma associated with pachinko and pachislot problems, these gambling forms need to be acknowledged as public health concerns and categorized as gambling in the legislation.

International Gambling Studies, 2022

Youth gambling is commonly described in policy and research as a high-risk behavior. To design re... more Youth gambling is commonly described in policy and research as
a high-risk behavior. To design relevant measures to prevent gam-
bling problems among youth, it is important to understand how
youth themselves relate to gambling. To explore how youth navi-
gate their position on gambling in the context of their everyday
lives, we conducted qualitative interviews with 35 participants aged
17–21 years in Sweden; 15 had gambled and 20 had experience of
others’ gambling. The thematic analysis showed that both gamblers
and non-gamblers overall had negative attitudes toward gambling
and emphasized repeatedly discourses of personal responsibility in
it. The participants used various neutralization techniques to navi-
gate the economic and addictive risks of gambling. Youth who
gambled distanced themselves from the risks of gambling by draw-
ing a line between themselves and excessive gamblers, between
safe and unsafe gambling, or highlighted how their skills and
strategic thinking made gambling less problematic. Also, gambling
in liminal circumstances abroad or in alcohol-serving venues
offered a safe time and place for gambling by separating it from
everyday life practices. The findings provide important cues to how
young people locate gambling in their everyday life, which is useful
knowledge for policy and prevention.

International Journal of Drug Policy, 2022

Background: The Covid-19 restrictions-as they made young people's practices in their everyday lif... more Background: The Covid-19 restrictions-as they made young people's practices in their everyday life visible for reflection and reformation-provide a productive opportunity to study how changing conditions affected young people's well-being and drinking practices. Methods: The data is based on qualitative interviews with 18-to 24-year-old Swedes (n = 33) collected in the Autumn 2021. By drawing on the socio-material approach, the paper traces actants, assemblages and trajectories that moved the participants towards increased or decreased well-being during the lockdown. Results: The Covid-19 restrictions made the participants reorganize their everyday life practices emphatically around the home and communication technologies. The restrictions gave rise to both worsened and improved well-being trajectories. In the worsened well-being trajectories, the pandemic restrictions moved the participants towards loneliness, loss of routines, passivity, physical barriers, self-centered thoughts, negative effects of digital technology, sleep deficit, identity crisis, anxiety, depression, and stress. In the improved well-being trajectories, the Covid-19 restrictions brought about freedom to study from a distance, more time for significant others, oneself and for one's own hobbies, new productive practices at home and a better understanding of what kind of person one is. Both worsened and improved well-being trajectories were related to the aim to perform well, and in them drinking practices either diminished or increased the participants' capacities and competencies for well-being. Conclusions: The results suggest that material domestic spaces, communication technologies and performance are important actants both for alcohol consumption and well-being among young people. These actants may increase or decrease young people's drinking and well-being depending on what kinds of relations become assembled.

Frontiers in Psychiatry, 2022

The predominant gambling policy to respond to the adverse consequences of excessive gambling has ... more The predominant gambling policy to respond to the adverse consequences of excessive gambling has been the Reno Model, which places the responsibility for gambling-caused problems on gamblers themselves. The newly implemented Japanese gambling policy, which shares basic premises with the Reno Model, focuses on the individual pathology of gamblers. However, this model lacks other critical perspectives: environmental and structural factors. To fully understand the harms caused by gambling; it is important to also pay attention to the negative consequences for affected others. In this brief report, we explore family members’ experiences of gambling problems within the specific context of the Japanese gambling policy. Interviews with family members reveal self-stigma of being bad parents which elicits shame and efforts to maintain secrecy, as well as public stigma involving labeling, isolation, risks of status loss, social exclusion and discrimination. The focus on individual pathology in Japanese legislation as well as in public and professional perception, reinforces self-blame, anxiety, and remorse on the part of affected family members. When contrasted with the lived experiences of gamblers’ family members, the inconsistencies and unreasonableness of the individual pathology paradigm in Japanese gambling policy become evident. It is necessary to shift the focus of gambling policies from individual to socio-political-cultural factors, investigating how these factors influence gambling-caused harm, especially in the Japanese context.

Frontiers in Psychiatry, 2022

Journal of Youth Studies, 2020

International Journal of Drug Policy, 2020

Journal of Youth Studies , 2020

Nordic Studies on Alcohol and Drugs, 2019

Addiction Research & Theory, 2018

Contemporary Drug Problems, Jul 10, 2015

Stockholm Studies in Social Work 30, Feb 13, 2015

Addiction Research & Theory, Early Online, doi:10.3109/16066359.2013.856887

Nordic Studies on Alcohol and Drugs. Volume 30, Issue 1-2, Pages 51–66, ISSN (Online) 1458-6126, ISSN (Print) 1455-0725, DOI: 10.2478/nsad-2013-0005, Feb 2013

Research Reports In Public Health Sciences, 2020

Critical Gambling Studies, 2022

International Gambling Studies, 2022

International Journal of Drug Policy, 2022

Frontiers in Psychiatry, 2022

Addiction Science & Clinical Practice, 2022

Background: Despite their crucial role in bridging science and practice, not much is known about ... more Background: Despite their crucial role in bridging science and practice, not much is known about counselors offering treatment for Problem Gambling (PG). This study maps current treatment, the type of change techniques that are prioritized in treatment and how counselors perceive their clinical competence in their work with PG clients. Methods: A sample of PG counselors from the healthcare and social services (N = 188, mean age: 49 years, 67% women) completed an online survey. A principal component analysis was conducted to map prioritized types of change techniques, and a multiple regression analysis was carried out to analyze predictors of counselors' role adequacy in their clinical work. Results: There was a large variation in the type of treatments offered for PG (mean 3.6). Cognitive Behavioral Therapy (CBT) and Motivational Interviewing were the most common treatments offered and motivation was rated as the most important type of change technique prioritized in the treatment of PG. A principal component analysis identified four components reflecting different types of change techniques prioritized by the counselors: (1) standard CBT, e.g., gambling cognitions, craving management, and finding alternative activities, (2) assessment of PG, (3) family orientation, i.e., involvement of concerned significant others in treatment, and (4) focus on exposure strategies. Counseling more clients monthly was associated with higher levels of willingness, adequacy and legitimacy in their clinical work with clients with PG. Additionally, offering CBT was a predictor for higher role adequacy and providing counseling on the origins of and consequences of PG. Conclusion: There was a large heterogeneity among the treatments offered and what change techniques that were prioritized among the PG counselors. Clinical experience is of importance for developing competence in treating clients with PG. This finding suggests there could be benefits to establishing specialized, more visible treatment units where PG counselors could gain adequate clinical experience, thus increasing clinical competence for treating PG.

International Journal of Environmental Research and Public Health, 2022

In recent years, a vast body of research has investigated trends of declining alcohol consumption... more In recent years, a vast body of research has investigated trends of declining alcohol consumption among youths. However, the extent to which restrictive-youth approaches towards drinking are maintained into adulthood is unclear. The aim of this study is to explore how young people’s relation to alcohol changes over time. Our data are based on longitudinal qualitative in-depth interviews with 28 participants aged 15 to 23 conducted over the course of three years (2017–2019). The study draws on assemblage thinking by analysing to what kinds of heterogeneous elements young people’s drinking and abstinence are related and what kinds of transformations they undergo when they get older. Five trajectories were identified as influential. Alcohol was transformed from unsafe to safe assemblages, from illegal to legal drinking assemblages, from performance-orientated to enjoyment-orientated assemblages, and from immature to mature assemblages. These trajectories moved alcohol consumption towards moderate drinking. Moreover, abstinence was transformed from authoritarian assemblages into self-reflexive assemblages. Self-control, responsibility, and performance orientation were important mediators in all five trajectories. As the sober generation grows older, they will likely start to drink at more moderate levels than previous generations.

International Journal of Drug Policy, 2020

Background: The article examines the interplay between the practices of heavy drinking and exerci... more Background: The article examines the interplay between the practices of heavy drinking and exercise among young people. The comparison helps to clarify why young people are currently drinking less than earlier and how the health-related discourses and activities are modifying young people's heavy drinking practices. Methods: The data is based on interviews (n = 56) in Sweden among 15-17-year-olds and 18-19-year-olds. By drawing on Pierre Bourdieu's concepts of habitus, field, and capital, we examine what kinds of resources young people accumulate in the fields of heavy drinking and exercise, how these resources carry symbolic value for distinction, and what kind of health-related habitus they imply. Results: The analysis shows that young people's practices in the social spaces of intoxication and exercise are patterned around the 'social health' and 'physical health' approaches and shaped by gendered binaries of masculine dominance. The 'physical health' approach values capable, high-performative, and attractive bodies, whereas the 'social health' approach is oriented towards accumulating social capital. The analysis demonstrates that these approaches affect the interviewees' everyday life practices so that the 'physical health' approach has more power over the 'social health' approach in transforming them. Conclusion: As the 'physical health' approach appears to modify young people's practices of drinking to be less oriented to intoxication or away from drinking, this may partly explain why young people are drinking less today than earlier. Compared to drinking, the physical health-related social spaces also seem to provide more powerful arenas within which to bolster one's masculine and feminine habitus. This further suggests that intoxication may have lost its symbolic power among young people as a cool activity signalling autonomy, maturity, and transgression of norms.

International Journal of Drug Policy, 2019

Recent surveys have found a strong decrease in alcohol consumption among young people and this tr... more Recent surveys have found a strong decrease in alcohol consumption among young people and this trend has been identified in European countries, Australia and North America. Previous research suggests that the decline in alcohol consumption may be explained by changes in parenting style, increased use of social media, changes in gender identities or a health and fitness trend. We use qualitative interviews with drinking and non-drinking young people from Sweden (N = 49) to explore in what way and in what kinds of contexts these explanations may hold true and how they alone or together may explain declining alcohol consumption among young people. By using the pragmatist approach, we pay attention to what kinds of concerns, habits, practices, situations and meanings our interviewees relate to adolescents' low alcohol consumption or decline in drinking. By analyzing these matters, we aim to specify the social mechanisms that have reduced adolescents' drinking. Our paper discovers social mechanisms similar to previous studies but also a few that have previously been overlooked. We propose that the cultural position of drinking may have changed among young people so that drinking has lost its unquestioned symbolic power as a rite of passage into adulthood. There is less peer pressure to drink and more room for competing activities. This opening of a homogeneous drinking culture to the acceptance of differences may function as a social mechanism that increases the success of other social mechanisms to reduce adolescents' drinking. Furthermore, the results of the paper suggest a hypothesis of the early maturation of young people as more individualized, responsible, reflective, and adult-like actors than in earlier generations. Overall, the paper provides hypotheses for future quantitative studies to examine the prevalence and distribution of the identified social mechanisms, as well as recommends directions for developing effective interventions to support young people's healthy lifestyle choices.

International Journal of Drug Policy, 2020

Journal of Youth Studies, 2020

Research shows that young people’s online practices have become a continuous, seamless and routin... more Research shows that young people’s online practices have become a continuous, seamless and routine part of their physical and social worlds. Studies report contradictory findings on whether social media promotes intoxication-driven drinking cultures among young people or diminishes their alcohol consumption. By applying actor-network theory, our starting point is that the effects of social media depend on what kinds of concerns mediate its use. Social media alone cannot make young people drink more or less but influences their drinking in relation to specific attachments that we call here‘assemblages’. The data consist of individual interviews among girls (n= 32) and boys (n= 24)between 15 and 19 years old from Sweden, covering topics such as alcohol use, social media habits and leisure time activities. The paper maps the variety of assemblages that mediate young people’s online practices and analyzes how young people’s drinking-related social media assemblages increase, decrease or exclude their alcohol consumption. The analysis shows that social media-related attachments seem to reduce our interviewees’ use of alcohol by providing competing activities, by transforming their drinking under the public eye, by reorganizing their party rituals to be less oriented towards drinking and by facilitating parents’ monitoring of their drinking situations.