Study question: Do donor-conceived adolescents in lesbian- and heterosexual-couple families intend to request information about their identity-release oocyte or sperm donor?

Summary answer: While more than half of adolescents intended to request donor information, being uncertain about making such requests was quite common, particularly among adolescents reporting better family functioning and those conceived with donor sperm in heterosexual-couple families.

What is known already: Increasing numbers of children conceived with identity-release gamete donation are approaching the age when they can obtain donor information, but there is very little knowledge about their perspectives regarding this possibility, particularly among those conceived with donor oocytes.

Study design, size, duration: The present cross-sectional survey study was conducted 2022-2023 as part of a longitudinal follow-up of lesbian- and heterosexual-couple families following identity-release sperm donation (SD-L, SD-H) or oocyte donation (OD-H). We approached parents in a total of 216 families with a survey and also requested their consent to contact their donor-conceived child, provided he/she was aware of the donor conception. Parents in 165 families participated in this follow-up and, among these, parents in 123 families (75%) also provided contact information to their child(ren). Out of 128 approached adolescents, 100 completed the survey (78% response rate). Following exclusion of four adolescents with known/directed donors, the study sample consisted of 96 donor-conceived children aged 13-16 years (47 SD-L, 27 SD-H, and 22 OD-H), most of whom had been aware of their donor conception from an early age.

Participants/materials, setting, method: The present study was based on the fifth wave of data collection of the Swedish Study on Gamete Donation, which used consecutive recruitment of recipient couples starting donation treatment 2005-2008. In Sweden, recipients of donor gametes receive no information about the donor. Only the donor-conceived person has the legal right, when sufficiently mature, to request information about the donor, including his/her identity. Study-specific items were used to assess adolescents' experiences and perceptions of disclosure issues, interest in requesting any donor information (identifying and/or non-identifying) as well as interest in contact with the donor and same-donor peers. Family relationships were assessed with the FAD GF6+ and study-specific items measuring perceived parent-child closeness and resemblance. Comparisons between the three donation groups (SD-L, SD-H, OD-H) were performed with χ2 test and Fisher exact test. Multinomial logistic regression analysis was performed in two separate models to investigate if the intention to request donor information was associated with family type (lesbian/heterosexual-couple) and with donation type in heterosexual-couple families (SD-H/OD-H).

Main results and the role of chance: More than half (58%) of adolescents intended to request information about the donor (as soon as possible or sometime in the future), while 1 in 10 had no such intention, and a third of adolescents were uncertain. Regression analysis showed no significant effect of family form (lesbian/heterosexual-couple) on the intention to request donor information, but better family functioning (FAD GF6+) was associated with being uncertain about making such requests (P = 0.036) (OR 0.19, 95% CI 0.04-0.90). The second regression analysis, restricted to adolescents from heterosexual-couple families, showed that those from SD-H families were more likely than OD-H adolescents to be uncertain about requesting donor information (P = 0.028) (OR 0.17, 95% CI 0.04-0.82), when controlling for gender, family functioning, and closeness with the non-genetic parent. The most common motivations for intending to request donor information were to look for resemblance to the donor and to learn about one's heritage, and one in five was motivated by a desire to contact the donor. The adolescents wanted to receive information about the donor's background (78%), identity (61%), and openness to being contacted (52%), with no significant differences between donation groups. In addition, a third of the adolescents were interested in contact with same-donor peers, irrespective of donation group or existence of siblings in the family.

Limitations, reasons for caution: Participants were recruited from a multicenter longitudinal cohort study of families following donor conception and achieved a high response rate among adolescents, but we cannot exclude the possibility of attrition bias with less well-functioning families opting out of the longitudinal study over time. Also, despite a relatively large study sample, small subgroups limit statistical power, and results should therefore be regarded with caution. Finally, the study was conducted in Sweden with mandatory identity-release donation, limiting generalizability to other contexts.

Wider implications of findings: Among young people who are aware of their conception with identity-release donation from an early age, a majority intend to obtain information about the donor. Type of donation and quality of family relationships seem to have relevance for adolescents' interest in seeking donor information, but more research is necessary. There appears to be a considerable variation regarding interest in different types of information, ranging from non-identifying characteristics to the donor's identity and openness to contact. These findings suggest that release of donor information should be adapted to the individual wishes of the donor-conceived person.

Study funding/competing interest(s): This study was funded by the Swedish Research Council (grant number 2021-03174) and Umeå University. The authors have no conflict of interest to declare.

Purpose: Gender-based harassment (GBH) is a persistent workplace problem with substantial consequences for employees and organizations. Although organizational conditions are assumed to shape harassment risk, longitudinal evidence on modifiable organizational antecedents remains limited. Building on organizational justice theory and the perpetrator-predation paradigm, this study examines whether procedural justice and supportive managerial leadership prospectively predict GBH.

Methods: Using data from the Swedish Longitudinal Occupational Survey of Health (SLOSH) from 2018 and 2020 (n ≈ 5000), we estimated cross-lagged associations between self-reported procedural justice, managerial leadership, and experienced and witnessed GBH within a structural equation modelling framework.

Results: Experienced GBH was reported by 3%-4% and witnessed GBH by 6%-9% of the working sample. Higher procedural justice in 2018 was associated with a very small decreased risk of experienced (β = -0.001, p = 0.018) and a small decreased risk of witnessed (β = -0.052, p < 0.001) GBH in 2020. Higher managerial leadership scores were associated with a small decreased risk of experienced GBH (β = -0.036, p = 0.017). No reverse associations were observed.

Conclusion: The findings provide longitudinal evidence that organizational justice and leadership, although relatively weak, shape harassment risk environments over time. By demonstrating prospective associations while accounting for reverse and stability effects, the study advances understanding of organizational antecedents of GBH beyond predominantly cross-sectional research.

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

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

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

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

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

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

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

Introduction: The objective of this study was to investigate the bi-directional associations between experienced and witnessed gender-based harassment (GBH) on the one hand, and depressive symptoms and psychological treatment on the other, in an occupational setting. GBH are behaviors that derogate, demean, or humiliate an individual based on his or her gender.

Methods: The analyses were based on data from the Swedish Longitudinal Occupational Survey of Health at 2018 (T1) and 2020 (T2), including 6,679 working participants (60.3% women) with a majority in the age range of 45-64. Using cross-lagged structural equational models, we analyzed experienced and witnessed GBH in relation to depressive symptoms and having received psychological treatment (talked to a counselor or psychological professional) over time.

Results: Our results showed that neither experienced nor witnessed GBH was prospectively associated with depressive symptoms or psychological treatment over two years. Both higher levels of depressive symptoms (beta = 0.002, p <= 0.001) and having received psychological treatment (beta = 0.013, p = 0.027) weakly predicted experiences of GBH over time. Having received psychological treatment was furthermore weakly associated with witnessed GBH (beta = 0.019, p = 0.012).

Discussion: In conclusion, the hypothesized associations between exposure to GBH and mental health outcomes were not statistically significant, while a weak reverse association was noted. More research addressing bidirectional associations between GBH and mental health outcomes are needed.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Conclusions: Implications for research and clinical practice are summarised.