Profiles

Patrik Karlsson. Foto: Vilhelm Stokstad

Patrik Karlsson

Universitetslektor

Visa sidan på svenska
Works at Department of Social Work
Telephone 08-16 32 56
Email patrik.karlsson@socarb.su.se
Visiting address Sveavägen 160, Sveaplan
Room 764
Postal address Institutionen för socialt arbete 106 91 Stockholm

Publications

A selection from Stockholm University publication database
  • Patrik Karlsson, Tommy Lundström. European Journal of Social Work

    This article aims to alert social work researchers and practitioners to the importance of engaging in research and debate about how to approach and understand ADHD among children in general and locked-after children in care in particular. Social work researchers have largely been absent from academic discussions about the ‘ADHD epidemic’ despite the fact that the prevalence of ADHD diagnosis and medication is very high in child welfare populations. The social work profession can make important contributions to understanding a phenomenon that is common among children and adolescent clients, that is often co-morbid with other conditions such as conduct disorder and that is linked to social adversity. We argue that research on ADHD in the child welfare systems should be a top priority in social work, and outline some important questions that need to be addressed by both researchers and social workers.

  • 2019. Sam Larsson (et al.).
  • Mats Ekendahl, Josefin Månsson, Patrik Karlsson.

    There is a lack of research on how youth make sense of substance abuse treatment. The aim of this article was to explore how young people in Stockholm, Sweden, perceive outpatient treatment for cannabis use, position themselves as subjects in relation to it, and how they respond to staff’s appeals to rationality and responsible action. The data, consisting of 18 interviews with clients recruited from six treatment centers, were explored using narrative and thematic analysis. Results show that the young clients understood their histories in a responsibilized way where the risk information about cannabis they received was considered crucial. Those who resisted treatment rejected cannabis problematizations by staff, did not value interventions and felt that they had control over their use. Those who complied with treatment said that cannabis problematizations helped them acknowledge their own difficulties, handle substance dependence and mature. We conclude that treatment resistance among young cannabis users would perhaps be prevented if the adult world acknowledged that some believe it is rational and responsible to use cannabis. While the criminal offense of substance use is often expiated through ‘treatment’ in Sweden, young clients establishing a substance use identity could possibly be avoided if cannabis was not equated with risk.

  • Patrik Karlsson (et al.). Nordic Studies on Alcohol and Drugs

    Background:

    It is often assumed that illicit drug use has become normalised in the Western world, as evidenced for example by increased prevalence rates and drug-liberal notions in both socially advantaged and disadvantaged youth populations. There is accumulating research on the characteristics of young illicit drug users from high-prevalence countries, but less is known about the users in countries where use is less common. There is reason to assume that drug users in low-prevalence countries may be more disadvantaged than their counterparts in high-prevalence countries, and that the normalisation thesis perhaps does not apply to the former context.

    Aim:

    This article aims to explore to what extent such assertions hold true by studying the characteristics of young illicit drug users in Sweden, where prevalence is low and drug policy centres on zero tolerance.

    Material and Method:

    We draw on a subsample (n = 3374) of lifetime users of illicit drugs from four waves of a nationally representative sample of students in 9th and 11th grade (2012–2015). Latent class analysis (LCA) on ten indicators pertaining to illicit drug use identified four classes which we termed “Marijuana testers”, “Marijuana users”, “Cannabinoid users” and “Polydrug users”.

    Findings:

    Indications of social advantage/disadvantage such as peer drug use, early substance-use debut and truancy varied across groups, particularly between “Marijuana testers” (low scores) and “Polydrug users” (high scores).

    Conclusions:

    Our findings corroborate the idea that the majority of those who have used illicit drugs in the Swedish youth population have tried marijuana a few times only. We discuss whether or not the comparably large share of socially advantaged “Marijuana testers” in a comparably small sample of lifetime users can be interpreted as a sort of normalisation in a prohibitionist drug policy context.

  • Mats Ekendahl, Patrik Karlsson, Renate Minas. Nordic Social Work Research

    EU citizens from Central and Eastern Europe travelling to cities in other countries to make a better living have become an issue of major political concern across Europe. This study explores how professionals from Swedish municipal social service organizations in urban areas construct the phenomenon of poor visiting EU citizens. The impact of social constructions on the practice and design of policies makes it important to analyse how target groups, such as poor visiting EU citizens, are characterized and what normative assumptions are made about them. The study is theoretically based on Schneider and Ingram’s work on ‘Social Constructions of Target Populations’. Interviews with social workers in the three largest cities in Sweden were conducted. The results suggest a clear ambivalence among interviewees regarding how to conceptualize EU citizens. They were careful not to highlight any subgroups, instead defining the group as consisting of different individuals with varying needs. While the interviewees constructed members of the target group in a way similar to what Schneider and Ingram describe as dependents, they also attributed them with some agency. We conclude that this may be a reflection of the political and organizational setting in which social work with poor visiting EU citizens is conducted in Sweden.

  • Mats Ekendahl, Patrik Karlsson, Josefin Månsson.

    Liberal views on cannabis use are widespread in many Western countries, but prohibitionism remains strong in Sweden. According to Swedish drug policy, comprehensive prevention and treatment interventions are necessary because young people are considered particularly vulnerable to cannabis-related harm. In this article, we examine how staff at Swedish outpatient treatment centers for young substance users (called “MiniMaria”) use different logics when legitimizing their work in youth treatment. We also analyze how this legitimizing process contributes to both justifying solutions and constituting the cannabis “problem” that MiniMaria centers are established to handle. This will shed light on what “drug reality” the staff make up through their articulations. Eighteen interviews with social workers from six MiniMaria centers in the Stockholm region were analyzed. To illustrate how staff made sense of their work, we used the concepts of “problem representation”, “legitimation”, and “logics”. We identified four logics: A scientific and a structural logic linked to knowledge claims, policy goals, and organizational setting, and a professional and a procedural logic linked to work experience, client interaction, and therapeutic methods. Participants used logics to emphasize that the character of the cannabis problem demands wide-ranging interventions and to explain how they made youth cannabis users realize they need treatment. The structural logic of drug prohibitionism was only mentioned as a last resort when other logics were not applicable, for example, when a young person refused to engage in treatment and quit using cannabis. The strategic use of logics provided MiniMaria with a moral legitimacy that represented youth cannabis use as a high-profile problem and young people as in need of protection and control. This legitimizes prevention of youth cannabis use in a national setting where cannabis prevalence and harm remains relatively low.

  • Jonas Raninen (et al.). Drug and Alcohol Review
  • Patrik Karlsson (et al.). Nordic Studies on Alcohol and Drugs

    Background and aims:

    The school-class context is a crucial social environment for young people but substance use researchers have largely overlooked potential influences operating at this level. This study explores associations between school-class and individual-level factors and cannabis use in Swedish youth.

    Data and methods:

    Data comprised four waves (2012–2015) of the Swedish Council for Information on Alcohol and Other Drugs’ (CAN) nationally representative school surveys among individuals in 9th and 11th grade. For the present analyses, we had data on totally 28,729 individuals from 2377 unique school classes. Multilevel logistic regressions predicted lifetime and 10+ times use of cannabis from both individual-level predictors and school-class-level measures derived from the individual-level variables.

    Results:

    There were individual-level associations between most predictor variables and cannabis use. An early debut of tobacco use and binge drinking as well as low cannabis related risk perceptions had strong associations with cannabis use. Conversely, several school-class-level variables had aggregate relationships with cannabis use, most notably the overall level of risk perceptions in the school class. Some of the school-class factors predicted cannabis use over and above the individual-level covariates, suggesting the presence of contextual effects. Surprisingly, while female gender was negatively related with cannabis use at the individual level, a higher proportion of females in the classroom increased the odds for lifetime cannabis use even after controlling for individual and other contextual-level covariates.

    Conclusions:

    Youth cannabis use is related to various factors at both the individual and school-class level in Sweden. Truancy and perceived risk related to cannabis use had contextual associations with cannabis use. The positive contextual association between a higher proportion of females in the classroom and lifetime use should be explored further.

  • 2017. Patrik Karlsson, Anders Bergmark, Tommy Lundström. International Journal of Social Welfare 26 (2), 177-187

    Research indicates that a number of psychosocial interventions are effective for reducing behavioural problems in youth. These interventions are now often included on best practice lists aiming to facilitate informed treatment choices among practitioners. However, analyses in neighbouring research areas have highlighted serious shortcomings in how primary studies are analysed and how studies are synthesised in research reviews. This study took a closer look at the evidence of efficacy for psychosocial interventions that aim to reduce behavioural problems in youth, as shown in systematic research reviews by the Cochrane and the Campbell Collaborations (n = 8). The findings suggest a bias towards overemphasising the efficacy of the interventions in several reviews, an over-confidence in the validity of the findings in some reviews and, overall, a somewhat uncertain evidence base for the efficacy of the interventions. Systematic reviews are crucial for summarising research but more attention to methodological issues may be needed in this area.

  • 2017. Hugo Stranz, Patrik Karlsson, Stefan Wiklund. European Journal of Social Work 20 (5), 711-723

    This article explores and analyses, with the help of both client and social worker data on 423 applications for social assistance in Sweden, (i) the extent to which social assistance benefits and labour market strengthening measures are granted and (ii) factors concerning clients as well as social workers that are associated with the granting of benefits. Considering (i), the results show that social assistance is granted in about 74% of cases while only 6% of applicants are granted additional labour market strengthening measures. With regard to (ii), the results indicate that the granting of benefits seems to depend on abroad spectrum of factors at both the client and the social worker levels. For example, more experienced social workers are less willing to grant social assistance while chances increase when an applicant is already registered at the local public employment service and/or social insurance office. Moreover, the granting of benefits also co-varies withmore or less invariable factors at the client level: social workers are in general more generous towards women and people born outside Sweden, but rather less generous vis-à-vis single parents. The findings are discussed in terms of workfare and professionalization among social workers.

  • 2016. Patrik Karlsson, Charlotta Magnusson, Johan Svensson. Drug And Alcohol Dependence 168, 45-51

    Background

    Parental drinking has been shown to be associated with offspring drinking. However, the relationship appears to be more complex than often assumed and few studies have tracked it over longer time periods.

    Aims

    To explore the long-term (10-year) transmission of familial drinking during adolescence to offspring drinking patterns in young adulthood.

    Design

    Swedish longitudinal study, assessing the relationship between familial drinking in 2000 and offspring drinking in 2010 using simultaneous quantile regression analysis (n = 744).

    Data

    Data on familial drinking was gathered from the Swedish level-of-living surveys (LNU) and from partner LNU in 2000 while data on offspring drinking in young adulthood was gathered from LNU 2010. Drinking among offspring, parents and potential stepparents was measured through identical quantity-frequency indices referring to the past 12 months in 2010 and 2000 respectively.

    Results

    Young adults whose families were abstainers in 2000 drank substantially less across quintiles in 2010 than offspring of non-abstaining families. The difference, however, was not statistically significant between quintiles of the conditional distribution. Actual drinking levels in drinking families were not at all or weakly associated with drinking in offspring. Supplementary analyses confirmed these patterns.

    Conclusion

    The association between familial drinking and offspring drinking in young adulthood exhibits clear non-linear trends. Changes in the lower part of the familial drinking distribution are strongly related to drinking in young adults, but the actual levels of drinking in drinking families appear less important in shaping the drinking patterns of the offspring in young adulthood.

  • 2016. Hugo Stranz, Stefan Wiklund, Patrik Karlsson. Nordic Social Work Research 6 (3), 174-187

    By utilising data on nearly 1 200 individuals subject to investigations in the three Swedish personal social services (PSS) domains – child welfare (CW), social assistance (SA) and substance abuse treatment (SAT) – this article aims at describing and analysing the individuals processed in PSS as well as the outcome of the filtering process. Specific attention is paid to the extent the PSS domains differ in these respects. The main findings are: (i) a large proportion of clients subject to investigation are men, singles (most common without children in SA and SAT) and a born outside of Sweden (CW and SA). In terms of overall predicaments, SAT raw material seem more exposed than that of SA whereas there are fairly low concentration of abuse and neglect in CW; (ii) recidivism rates are high in all PSS domains: about half of the sample are already known by the agencies; (iii) out-screening are similar in SA and SAT (about 25%) but substantially higher in CW (about 50%). The investigative process is associated with considerably low external and in particular internal referring, indicating an apparent silo mentality between the PSS domains.

  • 2016. Karin Heimdahl, Patrik Karlsson. Addiction Research and Theory 24 (3), 236-247

    The aim of this scoping review was to give an overview of efficacy research on psychosocial interventions aimed at substance-abusing parents with children of up to the age of three. Throughout the overview, there was a focus on underlying assumptions and how the problem descriptions motivating the interventions corresponded with the solutions, i.e. the interventions in question. The data consisted of peer reviewed intervention studies (n = 22) identified through literature searches in online databases. Randomised controlled trial studies as well as quasi-experimental and pre-post studies were included. The results showed that all the studies included bar one focused exclusively on women as parents. Moreover, while the problem descriptions in the studies tended to be quite broad, framing parental substance abuse as a problem influenced by social and structural conditions, the solutions presented in the form of interventions generally had a narrower focus, addressing the individual parent from a psychological perspective only. In conclusion, the review points out the need for developing and evaluating interventions aimed at substance-abusing fathers as well as mothers, and also underscores the importance of these interventions being focused on a broader range of factors rather than just addressing deficits at the level of the individual.

  • 2016. Karin Heimdahl, Patrik Karlsson.
  • 2016. Mats Ekendahl, Patrik Karlsson. Evidence in European social drug research and drug policy, 51-67

    The idea of placing the views of service users at the centre of evidence-based practice has been praised in theory but rather neglected in empirical drug treatment research. Knowledge is scarce about how users’ perspectives are handled in policy and practice. In this chapter, we explore how Swedish opioid substitution treatment (OST) was perceived by users themselves and how their views were taken up by the Swedish National Board of Health and Welfare in developing new treatment regulations for OST. We argue that, despite the current valorisation of ‘the user’s voice’ across the health professions, the concept basically has no meaning in Swedish drug policy. The user preferences we identified (such as a desire for less suspicious staff, and acceptance of some drug use on top of their prescription) appeared to be more or less impossible to realise given the core prohibitionist values underpinning Swedish OST policy. While user involvement is commonly described as a keystone in the ‘evidence movement’, our analysis, of a contemporary policymaking process in the field of drug treatment, indicates that it served more as a rhetorical device than as a sine qua non of OST.

  • 2015. Patrik Karlsson, Tommy Lundström. Socialmedicinsk Tidskrift 92 (5), 553-565

    ADHD är den snabbast växande psykiatriska diagnosen bland unga i Sverige. Till många av de diagnostiserade förskrivs också läkemedel. I artikeln analyseras geografiska skillnader i förskrivning. De kommunala skillnaderna är mycket stora men skillnaderna kan bara i viss grad förklaras av variabler på kommunal nivå. Kommunernas tillhörighet till landsting tycks ha stor betydelse för nivån på förskrivning och systemfaktorer som olikartad organisering, mer eller mindre explicit policy och professionell hållning diskuteras som tänkbara förklaringar till skillnader som inte endast kan ha att göra med förekomst av fenomenet.

  • 2015. Patrik Karlsson, Anders Bergmark. Addiction 110 (3), 420-428

    Background and Aims

    A crucial, but under-appreciated, aspect in experimental research on psychosocial treatments of substance use disorders concerns what kinds of control groups are used. This paper examines how the distinction between different control group designs has been handled by the Cochrane and the Campbell Collaborations in their systematic reviews of psychosocial treatments of substance abuse disorders.

    Methods

    We assessed Cochrane and Campbell reviews (n = 8) that were devoted to psychosocial treatments of substance use disorders. We noted what control groups were considered and analysed the extent to which the reviews provided a rationale for chosen comparison conditions. We also analysed whether type of control group in the primary studies influenced how the reviews framed the effects discussed and whether this was related to conclusions drawn.

    Results

    The reviews covered studies involving widely different control conditions. Overall, little attention was paid to the use of different control groups (e.g. head-to-head comparisons vs. untreated controls) and what this implies when interpreting effect sizes. Seven of eight reviews did not provide a rationale for the choice of comparison conditions.

    Conclusions

    Cochrane- and Campbell reviews of the efficacy of psychosocial interventions with substance use disorders seem to underappreciate that use of different control group types yields different effect estimates. Most reviews have not distinguished between different control group designs and therefore have provided a confused picture regarding absolute and relative treatment efficacy. A systematic approach to treating different control group designs in research reviews is necessary for meaningful estimates of treatment efficacy.

  • 2015. Ekendahl Mats, Patrik Karlsson.
  • 2015. Karin Heimdahl, Patrik Karlsson.
  • 2015. Mats Ekendahl, Patrik Karlsson. Nordic Studies on Alcohol and Drugs 32 (4), 395-410

    AIMS – Providing risk information on licit substances is a central health promotion strategy. Thereis, however, very little knowledge about public attitudes on this information. In this exploratorystudy we analyse the extent to which Swedish adults: 1) trust risk information regarding alcohol,cigarettes and wet snuff (“snus”) provided by public authorities, 2) perceive risk informationregarding alcohol, cigarettes and snus as consistent, and 3) have received an adequate amountof risk information from public authorities regarding these substances. The aim is also toinvestigate if certain characteristics among participants are related to their perceptions of suchrisk information. METHODS – A questionnaire was mailed to a random sample of individuals aged18 to 70 (n=1623, 54% response rate). Descriptive statistics and logistic regression techniqueswere used to process data. RESULTS – Participants trusted risk information concerning cigarettes,snus and alcohol provided by public authorities, and reported that they had received an adequateamount of it. Information about cigarettes was seen as more trustworthy and consistent thaninformation about alcohol and snus. The study suggests that attitudes on risk information aresubstance-specific and associated in complex ways with gender, age, education and experience ofown substance use. CONCLUSION – While only a first attempt to map an under-investigated area,our study highlights complexities in how people perceive risk information about licit substances. Italso indicates that the general population in Sweden receives what is seen as an adequate amountof knowledge from public authorities, and finds it consistent and trustworthy.

  • 2014. Patrik Karlsson, Anders Bergmark, Tommy Lundström. Evidence & Policy 10 (1), 61-76

    We explore how four evidence-producing organisations in the US go ahead when they rate the evidence base for psychosocial interventions, using the Incredible Years programme as our case study. The findings demonstrate variation in the procedures and resulting evidence claims across the organisations, with some organisations being strict and some being permissive. The presence of such conflicting practices highlights central challenges for the evidence-based practice framework and its ambition of obtaining uniform evidence statements. We conclude that practitioners and policy makers should be aware of such variation in order to be able to make informed decisions regarding which programmes to use.

  • 2014. Mats Ekendahl, Patrik Karlsson. Paper presented at 40th Annual Alcohol Epidemiology Symposium of the Kettil Bruun Society, Torino, Italy, 9 - 13 June 2014.

    Aims: Providing risk information regarding licit substances is a central strategy in public health promotion. The aim of this paper is to explore the extent to which a random sample of Swedes: 1) trust risk information regarding alcohol, cigarettes and wet snuff (“snus”) provided by public authorities, 2) perceive risk information regarding alcohol, cigarettes and snus as contradictory, and 3) have received an adequate amount of risk information from public authorities regarding these licit substances. Methods: A questionnaire was mailed to Swedish adults aged 18 to 70 (n=1623, 54% response rate). Descriptive statistics and logistic regression techniques were used to process data. Results: Participants trusted risk information concerning cigarettes, snus and alcohol provided by public authorities, and reported that they had received an adequate amount of information. Information about cigarettes was seen as more trustworthy and consistent than information about alcohol and snus. Conclusion: The study suggests that attitudes toward risk information are substance-specific and associated with gender, age, education and experience of own substance use. While highlighting complexities in how people perceive risk information, our data also illustrate that the general population in Sweden seems to be quite well equipped when it comes to risk information about licit substances.

  • 2013. Mats Ekendahl, Patrik Karlsson.
  • 2013. Karin Heimdahl, Patrik Karlsson.
  • 2013. Karin Heimdahl, Patrik Karlsson.
  • 2012. Patrik Karlsson, Anders Bergmark. Nordic Studies on Alcohol and Drugs 29 (3), 281-282
  • 2012. Patrik Karlsson, Anders Bergmark. Nordic Studies on Alcohol and Drugs 29 (3), 253-265

    AIMS - We critically discuss the campaign "Knowledge to Practice". A popular assumption within the evidence-based practice (EBP) framework is that guidelines for best practices are useful for increasing the inflow of research into practice. In Sweden, an initiative known as "Knowledge to Practice" (KTP) has since 2008 been devoted to implementing the National Board of Health and Welfare's guidelines for substance abuse treatment in practice. MATERIAL - Our critical discussion is based on an analysis of available documents describing the KTP campaign. RESULTS - We argue that the implementation process is marred with problems all the way from the beginning, where the guidelines are produced, to the final stage of local "adoption". The vague character of the guidelines coupled with unclear usages of key concepts such as "service user involvement" and EBP as well as a perspective of EBP that in certain respects undermine the legitimacy of its own mission lead us to raise serious doubt about KTP. CONCLUSSIONS - We conclude that KTP can be seen as a clear example of a general unawareness of the two main, largely incompatible "models" of EBP identified in the literature. Further, KTP may as a consequence of this have had the unintended effect of disseminating vague and unclear conceptions of EBP to practitioners.

  • 2012. Patrik Karlsson. Socialvetenskaplig tidskrift 19 (3-4), 217-231
  • 2012. Patrik Karlsson. Nordisk Alkohol- og narkotikatidsskrift (NAT) 29 (4), 413-427

    Aims - To explore the association between subjective experiences of drinking and alcohol-related risk perceptions. Methods - The data is based on a questionnaire with questions about beliefs, use habits and experiences of alcohol and tobacco sent to a random sample of 3,000 Swedes aged 18 to 70 years (response rate= 1,623 individuals, or 54%). In this study, those respondents who had ever been drinking alcohol were included (1,536 individuals). The data were analysed statistically by cross tabs and multiple logistic regression. Results - With some exceptions, the results generally showed that differences in subjective experiences of drinking were related to risk perceptions of alcohol consumption. In particular, those who had more negative than positive subjective experiences of alcohol consumption had substantially higher risk perceptions than those who had more positive than negative experiences, controlling for alcohol consumption and potential confounders. There were also several significant differences between individuals differently involved in alcohol consumption, net of subjective experiences. Conclusions - Subjective experiences of alcohol consumption appear to be an important construct in relation to alcohol-related risk perceptions. To understand the link between personal experiences and risk perceptions pertaining to alcohol consumption, both objective measures of personal experiences and subjective measures should be considered.

  • 2012. Patrik Karlsson. Journal of Substance Use 17 (1), 41-50

    This article explores the relationship between affective associations with alcohol and binge drinking. Prior research on the proximal determinants of alcohol consumption has typically focused on cognitive factors such as outcome expectancies, leaving aside affect (i.e. emotional factors). Participants in this study were a random, nationally representative sample of Swedes aged between 18 and 70 (n = 1623, response rate 54%). The results showed that affective associations with alcohol are related to binge drinking, even after controlling for gender, age, education, family situation and perceived risk. This article concludes that affective associations probably should be considered in explanatory frameworks of alcohol consumption, although more research is needed on the causal relationship of affective associations to drinking habits.

     

  • 2011. Patrik Karlsson. Nordic Studies on Alcohol and Drugs 28 (2), 149-157
  • 2011. Stig Elofsson, Patrik Karlsson.
  • 2010. Patrik Karlsson. Pleasure, pain and profit. European perspectives on drugs, 21-34
  • 2010. Patrik Karlsson. Nordic Studies on Alcohol and Drugs 27 (3), 259-268
  • 2009. Patrik Karlsson, Anders Bergmark. Nordisk Alkohol- och Narkotikatidskrift 26 (1), 5-19
  • 2009. Patrik Karlsson. Alkohol och droger, 87-100
  • 2009. Patrik Karlsson. Socionomen (8), 16-19
  • 2008. Patrik Karlsson. Journal of Alcohol and Drug Education 52 (3), 9-17
Show all publications by Patrik Karlsson at Stockholm University

Last updated: March 22, 2019

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