Arna Hauksdóttir

Background: Young people not in employment, education, or training (NEET) are a major concern presenting extensive societal and personal costs. Adverse childhood experiences (ACEs) can have longstanding harmful effects on health, education and employment participation. This study examined if ACEs are associated with NEET status among young Icelandic women, and whether perceived coping ability and social support moderate this relationship. Methods: Using data from 6 101 women aged 18–29 in the Stress-And-Gene-Analysis cohort, NEET status was self-reported, ACEs were assessed with the ACE-International Questionnaire (13 items), current perceived coping ability with the Connor-Davidson Resilience Scale and social support with the Multidimensional Scale of Perceived Social Support. Logistic regression estimated associations between ACEs (total score, categorical score, and individual subtypes) and NEET status. Moderation by perceived coping ability and social support was assessed using interaction models, with effects evaluated on the absolute scale using predicted probabilities and differences in predicted NEET probability across ACE levels. Multiple imputation addressed missing data. Results: After adjustment for sociodemographic factors, ACEs were strongly associated with NEET in a dose-dependent manner. Compared with women having 0 ACEs, women with ≥ 5 ACEs had almost sixfold higher odds of NEET (OR 5.62 [95% CI 3.60–8.78]), and each additional ACE increased odds by 23% (OR 1.23 [1.18–1.29]). When examined separately, all ACE subtypes—especially emotional neglect, emotional abuse, mental illness in the household and bullying—were associated with NEET. Analyses of predictive probabilities indicated that the association between ACEs and NEET was stronger among women with low coping ability, whereas social support did not modify this association. Conclusions: ACEs are strongly associated with NEET status among young women with low coping ability exacerbating the association, while social support showed no modifying effect. This suggests deep-rooted impacts of childhood adversity may depend more on internal adaptive capacity than on external social resources, highlighting coping capacity as potential target for intervention.

Background: Pre-existing psychiatric disorders have been associated with the severity of acute respiratory infections, including COVID-19, particularly in hospitalized populations. However, the underlying mechanisms, especially in community-based populations, remain unknown, limiting preparedness for future pandemics. We investigated the role of genetic liability for psychiatric disorders and related traits in COVID-19 and other respiratory infection severity among individuals reporting SARS-CoV-2 testing and available respiratory symptom data. Methods: We included population-based cohort data from Denmark, Estonia, Iceland, Norway, and the United Kingdom (N = 78,507; 62% female; 41% SARS-CoV-2-positive; May 2020—March 2023). Respiratory infection severity was defined by self-reported days bedridden and an eleven-symptom composite score during the acute illness phase. Polygenic scores (PGSs) for eight psychiatric disorders and the personality trait neuroticism indexed genetic liability. Meta-analysed estimates from stepwise-adjusted regression analyses controlling for education, lifestyle, and psychiatric and somatic diagnosis history were used to assess associations between PGSs and acute respiratory infection severity, stratified by COVID-19 status. Results: Higher genetic liability to insomnia, major depression (MD), and neuroticism was consistently associated with longer time bedridden (relative risk ratios per 1 SD change in PGS: 1.07–1.14, 95% confidence intervals [CIs]: 1.03–1.21) and more symptoms (incident rate ratios [IRRs]: 1.02–1.04, 95% CIs: 1.01–1.05) due to COVID-19. PGSs for insomnia, MD, neuroticism, anxiety disorder, bipolar disorder, and schizophrenia were also linked to higher non-COVID-19 symptom count (IRRs: 1.01–1.05, 95% CIs: 1.00–1.07). These associations remained robust after adjustment for lifestyle, education and medical comorbidities. Individuals in the highest MD PGS decile reported 20% more symptoms in non-COVID-19 illness and 10% more in COVID-19 compared with the bottom decile. No consistent associations were detected with attention-deficit/hyperactivity disorder, alcohol dependence and post-traumatic stress disorder. No genetic link was observed with ischaemic heart disease or type 2 diabetes. Conclusions: Shared genetics may contribute to the link between psychiatric conditions and respiratory infection severity in community settings. Our results underscore the role of psychiatric genetic liability, beyond diagnosed psychiatric disorders, in contributing to both COVID-19 and other respiratory infection severity. These findings provide insights that may improve future risk stratification and public health strategies targeting respiratory viruses.

Background: There is a need for scalable and simple interventions for trauma-exposed people. In this case series, we built on our previous case study and case series findings and further explored the use and potential effectiveness of a brief novel intervention to reduce the number of past intrusive memories of trauma. The imagery competing task intervention consists of a memory reminder and the visuospatial task Tetris played with mental rotation, targeting 1 intrusive memory at a time. Here, we test remote delivery of the intervention, including guidance from researchers without specialist mental health training, in a sample of women in Iceland with current intrusive memories from trauma. Objective: In a case series of trauma-exposed women, we aimed to explore whether this brief novel intervention reduces the number of established intrusive memories (primary outcome) and improves general functioning and symptom reduction in posttraumatic stress, depression, and anxiety (secondary outcomes). The acceptability of the intervention along with adaptations, that is, delivery by psychology students without specialist mental health training and digital delivery, was explored. Methods: Participants (N=8) monitored the number of intrusive memories from an index trauma (occurring 3‐16 years previously) in a daily diary at baseline, during the intervention, and postintervention at 1-month and 3-month follow-ups. The intervention was delivered digitally with guidance from clinical psychologists or psychology students. A repeated AB design was used (“A”: preintervention baseline, “B”: intervention phase). Intrusions were targeted one by one, creating repetitions of an AB design (ie, length of baseline “A” and intervention “B” varied for each memory). Results: The number of intrusive memories reduced for all participants from the baseline phase compared with the intervention phase, although the reduction was minimal for 2 participants (6.3%‐93%). The number of intrusive memories continued to reduce for 6 out of 8 participants (58%‐100% reduction at 1-month follow-up; 72%‐100% reduction at 3-month follow-up). Symptoms of posttraumatic stress, depression, and anxiety were reduced for most participants postintervention and continued to decrease during the follow-up periods. Functioning was improved for 7 of the 8 participants from baseline to postintervention and continued to improve at the follow-up assessments for 3 participants. The intervention delivered digitally and partly by students was perceived to be an acceptable way to reduce the frequency of intrusive memories by all participants (mean rating 9.5 out of 10). Conclusions: Data from this case series of traumatized women provide preliminary evidence for the effectiveness of this novel brief intervention in reducing intrusive memories of trauma occurring several years ago and in improving functioning and reducing core symptom burden. This study will inform a randomized controlled trial of this novel intervention, which may have considerable implications for large-scale clinical management of traumatized populations.

In Table 1, the units for the last row were labelled incorrectly. The value in the parentheses represents the number of individuals affected by serious infections, as some individuals had > 1 event of a serious infection. The revised variable is “No. of serious infections (n individuals).” We apologize for this error. This correction applies to the August 1 2025 First Release and print issue. The online version has been corrected. J Rheumatol 2025; doi: 10.3899/jrheum.2025-0029

Background: Violence exposure has been associated with cardiovascular disease. Less is known about underlying mechanisms, including early cardiometabolic risk factors, and possible sex differences of such associations. Methods: We used data from the Swedish LifeGene study on 23 215 men and women, aged 18 to 50 years. Participants answered the Life Stressor Checklist‐Revised regarding physical and sexual violence alongside questions on medical diagnoses of hypertension, diabetes, dyslipidemia, and smoking history in 2009 to 2016. At a clinical visit, blood pressure, body mass index, glycated hemoglobin, total cholesterol, apolipoprotein B/apolipoprotein A1 ratio, and hs‐CRP (high‐sensitivity C‐reactive protein) were measured. Modified Poisson and linear regression were used to test the association between violence and cardiometabolic risk factors. Results: At mean age 33±8 years, lifetime exposure to violence was reported by 23% of women and 15% of men. Those exposed to violence reported higher prevalence of smoking (prevalence ratio [PR], 1.74 [95% CI, 1.56–1.94]) and diagnosis of hypertension (PR, 1.36 [95% CI, 1.15–1.60]) but not hyperlipidemia (PR, 1.06 [95% CI, 0.82–1.36]). Men and women exposed to violence had higher body mass index (Beta, 0.45 [95% CI, 0.39–0.63]) and hs‐CRP (Beta, 0.08 [95% CI, 0.04–0.13]), after multivariable adjustment, whereas no differences were observed in glycated hemoglobin (B, 0.04 [95% CI, −0.11 to 0.18]) or total cholesterol (Beta, −0.01 [95% CI, −0.05 to 0.02]), and systolic blood pressure was marginally lower among individuals exposed to violence (B, −0.42 [95% CI, −0.78 to −0.06]). Conclusions: In a young healthy Swedish sample, lifetime exposure to physical and/or sexual violence was associated with some but not all early cardiometabolic risk factors among both men and women.

Background: Knowledge of the impact of perimenopause on women with attention-deficit/hyperactivity disorder (ADHD) is lacking. We compared levels of perimenopausal symptoms and prevalence of severe perimenopausal symptoms among women with and without ADHD across age groups. Methods: In this cohort study, we used data from the population-based Stress-and-Gene-Analysis cohort study. ADHD diagnosis was self-reported at baseline and 5-year follow-up. At follow-up, we assessed ADHD symptoms using the Adult ADHD Self-Report Scale, perimenopausal symptoms (psychological, somatic, and urogenital) using Menopause Rating Scale (MRS), and general physical symptoms using Patient Health Questionnaire. We described mean scores and mean difference on MRS among women with and without ADHD with linear regression models and contrasted the prevalence of severe perimenopausal symptoms among women with and without ADHD, calculating prevalence ratios (PRs) with 95% confidence intervals (CIs) using modified Poisson regression models. Results: Women with ADHD (n = 535) had higher total perimenopausal symptom scores (18.0 vs. 13.0, p < 0.01) than women without ADHD (n = 4,857). The difference was most pronounced among women aged 35–39 years (19.0 vs. 12.5, p < 0.01). The prevalence of severe perimenopausal symptoms was significantly higher among women with ADHD compared to those without, both overall (54.2% vs. 30.1%, PR = 1.80, 95% CI = 1.64–1.98) and on all subdimensions (psychological: 58.6% vs. 36.0%, PR = 1.63, 95% CI = 1.51–1.76; somatic: 30.4% vs. 13.9%, PR = 2.20, 95% CI = 1.88–2.57; uro-genital: 43.2% vs. 27.5%, PR = 1.57, 95% CI = 1.40–1.77). Conclusion: Women with ADHD have higher prevalence of severe perimenopausal symptoms. These symptoms present at an earlier age than among women without ADHD, indicating an earlier onset age of perimenopause in ADHD.

Objective: To analyze antimicrobial use and serious infections (SI) among patients with psoriatic arthritis (PsA) before and after initiating tumor necrosis factor inhibitor (TNFi) treatment. Methods: In this nationwide matched cohort study, we extracted data on patients with PsA initiating TNFi from 2005 to 2018 from the ICEBIO registry and matched them by age, sex, and calendar time to 5 randomly selected comparators from the general population. All filled prescriptions for antimicrobials, glucocorticoids, and methotrexate 2 years before and after initiating TNFi treatment were extracted from the Icelandic Prescription Medicines Register. All infection-related hospitalizations, a proxy for SI, were extracted from the Icelandic Hospital Discharge Register. Results: The study included 399 PsA patients and 1986 matched comparators. Patients received more antimicrobial prescriptions before TNFi treatment, with a mean number of prescriptions per year of 1.26 vs 0.60 ( P < 0.001). The mean number of prescriptions increased to 1.64 ( P < 0.001) in the 12 months following TNFi initiation but returned to baseline thereafter. No statistically significant increase in SI was found. Adjusted for covariates, patients with PsA had a hazard ratio of 1.43 (95% CI 1.18-1.72, P < 0.001) for receiving a prescription for antimicrobials following TNFi treatment initiation compared to before TNFi treatment. The risk was increased in the first year after treatment initiation but not in the second year, suggesting a transient effect. Conclusion: Following TNFi initiation, antimicrobial use rose temporarily, with no significant increase in SI. These results support the safety of TNFi in PsA management, and the risk of SI should not weigh heavily in treatment decisions.

Background: There is emerging evidence that a brief cognitive task intervention may reduce the frequency of intrusive memories, even long-standing memories of older trauma. However, evaluations to date have involved in-person researcher contact. We investigated the feasibility and acceptability of remote delivery to women (n = 12) in Iceland who had experienced trauma on average two decades earlier. Method: Participants monitored intrusive memories in a daily diary for one week (i.e., baseline phase), completed (at least) two guided, remote intervention sessions (e.g., via secure video platform), and were encouraged to continue to use the intervention self-guided. Results: Eight participants completed the primary outcome and reported fewer intrusive memories in Week 5 (M = 6.98, SD = 5.73) compared to baseline (M = 25.98, SD = 29.39) – a 68% reduction. Intrusions decreased at each subsequent time point; at 3-months (n = 7) there was a 91% reduction compared to baseline. Other psychological symptoms reduced and functioning improved. Importantly, participant ratings and qualitative feedback support feasibility and acceptability. Conclusion: Findings suggest the feasibility of remote delivery of the brief imagery-competing task intervention by non-specialists (who were not mental health professionals) and hold promise for developing psychotherapeutic innovations supporting women with intrusive memories even decades after trauma.