Adolescents In Norway Research Articles

The psychometric properties of the Hopkins Symptom Checklist-10: a Rasch analysis based on adolescent data from Norway.

The Hopkins Symptom Checklist (HSCL-10) is widely used for both clinical and epidemiological purposes to measure psychological distress among adolescents and adults. The purpose of this study was to investigate the psychometric properties of the HSCL-10 among adolescents in Norway using Rasch analysis. The study is based on cross-sectional data from the Norwegian Youth Health Surveys, conducted by the Norwegian Institute of Public Health in 2001 and 2009. The target group comprised of 15- to 16-year olds (Grade 10 students) in Hedmark County, Norway. Ten items with four response categories, intended to measure anxiety and depression, were analysed. The analysis focused on invariance, including differential item functioning (DIF) across genders and years of investigations. In addition, the categorization of the items, targeting, possible multidimensionality and response dependency, was analysed. The HSCL-10 shows good reliability and on the whole, the items work well. However, one item, 'Sleeping difficulties', clearly misfit and some items work differently for boys and girls and between years of investigations. There is also need for a better targeting of the scale. The HSCL-10 has the potential to measure the psychological distress among adolescents but there is a room for improvement. Further judgement needs to be made as to whether the misfitting item 'Sleeping difficulties' should be removed or retained.

Willingness to Compete: Family Matters

This paper studies the role of family background in explaining differences in the willingness to compete in a cognitive task. By combining data from a lab experiment conducted with a fairly representative sample of adolescents in Norway and high-quality register data on family background, we show that family background is fundamental in two important ways. First, boys from low socioeconomic status families are less willing to compete than boys from better-off families, even when controlling for confidence, performance, risk preferences, time preferences, social preferences, and psychological traits. Second, family background is crucial for understanding the large gender difference in the willingness to compete. Girls are much less willing to compete than boys among children from better-off families, whereas we do not find any gender difference in willingness to compete among children from low socioeconomic status families. Our data suggest that the main explanation of the role of family background is that the father’s socioeconomic status is strongly associated with boys’ willingness to compete. We do not find any association between the willingness to compete for boys or girls and the mother’s socioeconomic status or other family characteristic that may potentially shape competition preferences, including parental equality and sibling rivalry. This paper was accepted by Uri Gneezy, behavioral economics.

Willingness to Compete: Family Matters

This paper studies the role of family background in explaining differences in the willingness to compete. By combining data from a lab experiment conducted with a representative sample of adolescents in Norway and high quality register data on family background, we show that family background is fundamental in two important ways. First, boys from low socioeconomic status families are less willing to compete than boys from better off families, even when controlling for confidence, performance, risk preferences, time preferences, social preferences, and psychological traits. Second, family background is crucial for understanding the large gender difference in the willingness to compete. Girls are much less willing to compete than boys among children from better off families, whereas we do not find any gender difference in willingness to compete among children from low socioeconomic status families. Our data suggest that the main mechanism explaining the role of family background is that the father’s socioeconomic status has a large effect on the boys’ willingness to compete, but no effect on the girls. We do not find any effect on the willingness to compete for boys or girls of the mother’s socioeconomic status or other family characteristic that may potentially shape competition preferences, including parental equality and sibling rivalry.

Municipal-level differences in depressive symptoms among adolescents in Norway: Results from the cross-national Ungdata study.

This study aimed to investigate municipal-level variations and individual- and municipal-level predictors of high levels of depressive symptoms among Norwegian adolescents. We used data from the Norwegian cross-national Ungdata study. We included 77,424 adolescents from 171 municipalities attending junior high school (Grades 8-10; age 13-16 years) from 2011 to 2013. Multilevel (two-level) logistic regression models were applied for the data analyses. The study revealed that 11% of adolescents reported high levels of depressive symptoms. The median odds ratio without adjusting for any individual- or municipal-level predictors was 1.24, indicating a small between-municipalities variability for high levels of depressive symptoms. All individual-level factors, such as gender, school grade, family income, substance use behaviours, bullying and dissatisfaction with different aspects of life, were significantly associated with high levels of depressive symptoms (p < 0.05). As to municipal-level factors, a low annual budgets for municipal health services was the sole significant predictor of high levels of depressive symptoms between municipalities. Municipal-level factors and variables related to survey characteristics explained a moderate proportion of the variation in high levels of depressive symptoms between municipalities. The cluster heterogeneity in high levels of depressive symptoms was small between municipalities in Norway. Further research should examine the geographic clustering of mental health problems at the school and neighbourhood level.

Self-perceived risk and prevalent chlamydia infection among adolescents in Norway: a population-based cross-sectional study

ObjectivesRisk judgements are key factors in adolescents’ decisions related to sexual health. We examine the associations between self-perceived risk and prevalent chlamydia infection, and sexual behaviours related to risk perception...

Meeting sexual partners online: associated sexual behaviour and prevalent chlamydia infection among adolescents in Norway: a cross-sectional study

ObjectivesEvidence is mixed as to whether meeting sexual partners online (‘internet-partners’) is associated with risky sexual behaviour and/or sexually transmitted infection transmission. Accordingly, we sought to estimate the prevalence of...

Use of prescribed opioids by children and adolescents: Differences between Denmark, Norway and Sweden.

There are few studies on the use of opioids among children and adolescents. The aim of this study was to determine the 1-year prevalence of prescribed opioid dispensing in Denmark, Norway and Sweden, and to compare gender and age differences in the use of weak and strong opioids between the three countries. Data on the dispensing of opioids were collected from the websites of the complete national prescription databases in the three countries. All individuals aged 0-19 with at least one prescription of opioids during the study period were included. The 1-year prevalence of opioid use among young individuals aged 0-19 years increased during the study period (2006-2012) in Denmark from 2.5 to 3.4 per thousand, in Norway from 10.7 to 13.4 per thousand and in Sweden from 5.9 to 7.1 per thousand. In all three countries, more boys than girls used opioids between the ages of 0 and 10, whereas girls were the major users in the age range 11-19. Use of opioids in all three countries was dominated by weak opioids, codeine being the most dominant in Norway and Sweden and tramadol in Denmark. The 1-year prevalence of prescribed opioid use among children and adolescents in Norway was far higher than in Denmark and Sweden. During the study period, an increasing use of opioids among children and adolescents was observed in all three countries.

Comparability of the Social Skills Improvement System to the Social Skills Rating System: A Norwegian Study

The Social Skills Improvement System-Rating Scales (SSIS-RS) is a multi-informant instrument assessing social skills and problem behavior in children and adolescents. It is a revised version of the Social Skills Rating System (SSRS). A Norwegian translation of the SSRS has been validated, but this has not yet been done for the Norwegian translation of the SSIS-RS. This study compared the Norwegian versions of the SSRS and the SSIS-RS administered to samples of children (aged 8–12 and 13–16 years) and their parents and teachers (n = 599). The results indicated moderate to strong relations between the common subscales across all forms of the two instruments and acceptable to excellent internal consistency across all common subscales. We conclude that the SSIS-RS is a good instrument for measuring social skills and problem behavior among children and adolescents in Norway.

A school based study of time trends in food habits and their relation to socio-economic status among Norwegian adolescents, 2001-2009.

BackgroundIn recent years, adolescents’ food habits have become a major source of concern, and substantial policy and intervention efforts have been made to influence adolescents to consume more fruit and vegetables and less sweets and soft drink. Particular attention has been devoted to the social gradient in food habits, aiming to reduce dietary inequality. However, few internationally published studies have evaluated trends in teenagers’ food habits, or investigated how dietary inequalities develop.MethodsWe used Norwegian cross-sectional data from the international Health Behaviour in School-Aged Children (HBSC) study, collected via three nationally representative and comparable questionnaire surveys in 2001, 2005 and 2009. Food habits were identified by students’ consumption of fruit, vegetables, sweets and sugar rich soft drink. Socio-economic status (SES) was measured with the Family Affluence Scale (FAS). Multilevel logistic regression was used to analyze the data.ResultsThe analyses indicated an overall positive trend in food habits among adolescents in Norway. Students were more likely to consume fruit (OR 1.76, CI 1.61-1.92) and vegetables (OR 1.51, CI 1.37-1.66) daily in 2005 as compared to 2001, and were less likely to consume sweets (OR 0.58, CI 0.51-0.66 resp. OR 0.77, CI 0.67-0.90) and soft drink (OR 0.55, CI 0.49-0.62 resp. OR 0.84, CI 0.73-0.96) daily when comparing, respectively, 2005 with 2001 and 2009 with 2005. Across all survey years, students with higher SES were more likely to eat fruit (OR 1.47, CI 1.32-1.65) and vegetables (OR 1.40, CI 1.24-1.58) daily than did students with lower SES. Our analyses indicated that the socio-economic differences were stable in the period 2002 - 2010, with uniform improvement in fruit and vegetable consumption across all SES levels. No significant associations between SES and intake of sweets and sugar-added soft drink were found.ConclusionThe study identifies an overall improvement in diet among adolescents over a period characterized by onset of as well as ongoing initiatives targeting young people’s food habits. However, the observed socio-economic gradient in fruit and vegetable consumption remained unchanged.

Early drinking onset: a study of prevalence and determinants among 13-year-old adolescents in Norway.

Early drinking onset is associated with different psychosocial adjustment problems among adolescents. The aim of this study was to assess determinants associated with early drinking and to identify factors predicting early drinking onset among adolescents. The study included 1,550 eighth-graders with a mean age of 13.5years from 41 schools. A total of 24% (boys 29%, girls 19%) had ever drunk alcohol, while 14% had drunk some alcohol in the last 30days. Further, early drinking was associated with gender, religion, school performance, smoking and bullying in the bivariate tests. Predictors of early drinking onset were identified by generalized linear mixed models with two multivariable models created. The first model included social and environmental variables. Entering intentions, expectancies, attitudes and norms into the multivariable analysis resulted in a significant improvement of the model fit constituting 86% in the second model. The percentage correctly classified those (56%) who had been drinking in the second model which was two times higher compared to the first model. Gender, religion and smoking emerged as significant predictors of drinking in both models.

Mental Health Problems and School Outcomes Among Immigrant and Non-immigrant Early Adolescents in Norway

Mental health problems in children and adolescents, especially those of immigrant backgrounds, have been of major concern in recent literature. Symptoms of emotional, conduct, or a combination of these problems, furthermore, can impact, and be impacted by, school-related outcomes, such as perceived school stress, classmate support, and teacher support. The present study assessed whether having high levels of such symptoms would predict these school outcomes in 2,248 Norwegian adolescent students between fifth and eighth grades, 51 % of whom were of immigrant background. Seventy-three percent of the immigrant students were second generation. Findings indicate that there are more similarities than differences between immigrant and non-immigrant youth. Immigrant and non-immigrant girls did not differ in prevalence of any symptom category, while immigrant and non-immigrant boys did not differ in conduct problems or comorbid emotional and conduct problems. More immigrant than non-immigrant boys in our sample were in the high-risk group of emotional problems, indicating that this may be a particularly vulnerable group. Our results indicate that disordered symptom groups better explained perceived school stress and classmate support than immigrant status. School stress and low support from classmates were associated with high risk for emotional, conduct, and comorbid problems for all youth, regardless of immigrant status. These findings are encouraging because they indicate that second generation immigrant youth in Norway may not be at greater risk for developing emotional and conduct problems when compared to their non-immigrant peers.

Prevalence of psychiatric disorders among unaccompanied asylum-seeking adolescents in norway.

Unaccompanied asylum-seeking children (UASC) are known to be subjected to several potentially traumatic life events, risking more mental health problems than other populations of same age. In this study, we aimed to explore the prevalence of psychiatric morbidity at an early stage after arrival to the host country. We performed structured clinical interviews (CIDI) with 160 male UASC from different countries (Afghanistan, Somalia, Iran), after four months in Norway. Most of the participants had experienced life threatening events (82%), physical abuse (78%), or loss of a close relative (78%) in their former life. Altogether 41.9% of the participants fulfilled diagnostic criteria for a current psychiatric disorder. The most prevalent diagnosis was PTSD (30, 6%), followed by MDD (9, 4%), Agoraphobia (4, 4%) and GAD (3, 8%). Implications of this vulnerability call for more mental health resources in the early stages of the asylum process. Increased awareness of psychiatric morbidity in UASC may improve the prognosis, give more appropriate care, and ease the integration process on all levels of society.

Prior adversities predict posttraumatic stress reactions in adolescents following the Oslo Terror events 2011

BackgroundFormer studies suggest that prior exposure to adverse experiences such as violence or sexual abuse increases vulnerability to posttraumatic stress reactions in victims of subsequent trauma. However, little is known about how such a history affects responses to terror in the general adolescent population.ObjectiveTo explore the role of prior exposure to adverse experiences as risk factors for posttraumatic stress reactions to the Oslo Terror events.MethodWe used data from 10,220 high school students in a large cross-sectional survey of adolescents in Norway that took place seven months after the Oslo Terror events. Prior exposure assessed was: direct exposure to violence, witnessing of violence, and unwanted sexual acts. We explored how these prior adversities interact with well-established risk factors such as proximity to the events, perceived life threat during the terror events, and gender.ResultsAll types of prior exposure as well as the other risk factors were associated with terror-related posttraumatic stress reactions. The effects of prior adversities were, although small, independent of adolescents’ proximity to the terror events. Among prior adversities, only the effect of direct exposure to violence was moderated by perceived life threat. Exposure to prior adversities increased the risk of posttraumatic stress reactions equally for both genders, but proximity to the terror events and perceived life threat increased the risk more in females.ConclusionsTerror events can have a more destabilizing impact on victims of prior adversities, independent of their level of exposure. The findings may be relevant to mental health workers and others providing post-trauma health care.

Dental erosion: a widespread condition nowadays? A cross-sectional study among a group of adolescents in Norway

Objective. This study aimed to investigate the prevalence, distribution and severity of erosive wear in a group of 16–18-year-olds in the western part of Norway. A second aim was to describe possible associations between caries experience, socioeconomic background and origin of birth. Materials and methods. Adolescents (n = 795) attending recall examinations at Public Dental Service (PDS) clinics were also examined for dental erosive wear on index surfaces, using the Visual Erosion Dental Examination scoring system (VEDE). Results. In total, 795 individuals were examined. Dental erosive wear was diagnosed in 59% of the population (44% erosive wear in enamel only, 14% combination of enamel and dentine lesions, 1% erosive wear in dentine only). The palatal surfaces of upper central incisors and occlusal surfaces of first lower molars were affected the most (33% and 48% of all surfaces, respectively). Cuppings on molars were registered in 66% of the individuals with erosive wear. Erosive wear was significantly more prevalent among men (63%) than women (55%) (p = 0.018). Conclusions. There were no significant associations between dental erosive wear and caries experience, socioeconomic background or origin of birth.

Dentist-specific variation in diagnosis of caries - a multilevel analysis

There are few studies on practice variation within dentistry. This contrasts with medicine where numerous studies exist. A major finding from the field of medicine is that the size of the physician-specific effects depends on the degree of uncertainty in diagnosis. The physician-specific effects are small for diseases where the diagnostic criteria are unambiguous. Conversely, the effects are large for diseases where the diagnostic criteria are less unambiguous. To assess the size of provider-specific variation in the diagnosis of caries among children and adolescents in Norway and to determine whether this variation depends on uncertainty in diagnosis. Data on caries diagnosis for 709611 children and adolescents aged 6-18years were analysed using multilevel regression. Level-1 was patients and level-2 was public dental officers and dental hygienists. Caries was measured according to the following localization of the lesion: in the outer half of the enamel, in the inner half of the enamel, in the outer third of the dentine, in the middle and inner third of the dentine, to the pulp. The degree of uncertainty in diagnosis is expected to be least the deeper into the dentine the lesion goes. Our sample included 87.5% of all individuals aged 6-18years. The provider-specific variation, measured as the intraclass correlation coefficient, ranged from 15% for caries lesions localized in the outer half of the enamel to 2% for caries to the pulp. The size of provider-specific variation in the diagnosis of caries is fairly low. The size of the variability is dependent on the level of diagnostic uncertainty, which is coherent with the practice style hypothesis.

O23.3 Predictors of Self-Assessed Risk of Chlamydia Trachomatis Infection Among Adolescents in Norway

BackgroundAdolescents commonly underestimate their own risk of chlamydia infections. We aimed to examine the association between chlamydia prevalence and perceived risk of infection, and the predictors of perceived risk, among...

Willingness to Compete in a Gender Equal Society

A number of experimental studies have found that females are more competitively inclined than males, and it has been argued that this difference potentially can explain a wide range of real world economic phenomena, including observed gender differences in labor markets (Balafoutas and Sutter, 2012; Flory et al., 2010; Gneezy et al., 2003; Gneezy and Rustichini, 2004; Niederle and Vesterlund, 2007, 2011; Sutter and R¨utzler, 2010). Recent evidence suggests that the gender difference in willingness to compete largely reflects cultural norms, which has been seen as providing justification for gender equalizing public policies aiming at eliminating this asymmetry between males and females (Gneezy et al., 2009).The Scandinavian countries have for a long time pursued such policies, and are today considered among the most gender equal societies in the world; in fact, Norway ranks highest on the UN gender equality index comprising measures of educational attainment, labor market participation and health.1 Still, in a large lab experiment conducted with adolescents in Norway, we find a substantial gender difference in the willingness to compete, in line with what has been observed in Sweden (C´ardenas et al., 2012). We argue that these observations from Scandinavia provide a challenge to the gender policy debate, namely how to view preference differences in free and gender equal societies. Economists have traditionally assigned great importance to respecting individual preferences, as exemplified by the recent literature on libertarian paternalism (Sunstein and Thaler, 2008), but have been more willing to consider policies that nudge people in a particular direction if this is to overcome a particular behavioral bias, for example when individuals hold incorrect beliefs about their own abilities.

Involvement in bullying as predictor of suicidal ideation among 12- to 15-year-old Norwegian adolescents

The aim of this study was to examine relationships between bullying and suicidal ideation. A total of 2,464 adolescents in Norway were assessed at two time points, 1 year apart [i.e., at ages 14 (T1) and 15 (T2)], with identical questionnaires. Suicidal ideation was measured by four items including both active and passive suicidal thoughts. ANOVA and standard linear regression methods were applied. Both bullied adolescents and adolescents who were aggressive toward others had significantly higher levels of suicidal ideation (p < 0.001) at age 14 (T1) than noninvolved adolescents. In the group being bullied, girls had higher levels of suicidal ideation than boys did. This was not the case for the group of adolescents who were the aggressors. In cross-sectional multivariate analyses, both being bullied and being aggressive toward others were significant (p < 0.001) predictors of suicidal ideation at age 14 (T1), when gender, age and socioeconomic status, and depressing symptom levels were controlled for. In the controlled longitudinal multivariate analyses, being bullied (p < 0.001) at age 14 (T1) predicted suicidal ideation at age 15 (T2), while aggressiveness toward others did not. Bullied adolescents (both genders) were at risk for suicidal ideation, and having an additional risk if they were depressed.

Family affluence and cultural capital as indicators of social inequalities in adolescent’s eating behaviours: a population-based survey

BackgroundDietary inequality, via socio-economic inequality, may involve several mechanisms. Different aspects of adolescents’ socio-economic circumstances should therefore be considered in order to make effective interventions to promote healthy eating in the young population. Indicators designed to tap socio-economic status among adolescents in particular will facilitate a better understanding of the concept of socio-economic status and how it influences health behaviour among young people. The purpose of this study was to evaluate if material capital and cultural capital individually and independently contribute to the prediction of eating habits in the Norwegian adolescent population.MethodsThe analysis is based on survey data from the Health Behaviour in School-Aged Children study. The Family Affluence Scale (number of cars, holidays, PC and bedrooms) and number of books in the household were used as indicators of socio-economic status, respectively measuring material capital and cultural capital. Their influence on adolescent’s consumption of fruit, vegetables, sweets, soft drinks, and consumption of breakfast and dinner was evaluated. Pearson’s correlation, logistic regression and ridit transformation analysis were used to analyse the data.ResultsHigher family affluence was shown to predict consumption of more fruit (OR 1.52) and vegetables (OR 1.39) and consumption of breakfast (OR 1.61) and dinner (1.35). Cultural capital was significantly associated to consumption of fruit (OR 1.85), vegetables (OR 2.38) sweets (OR .45), sugary soft drinks (OR .26), breakfast (OR 2.13) and dinner (OR 1.54). Cultural capital was the strongest predictor to healthy eating among adolescents in Norway.ConclusionsMaterial capital and cultural capital individually and independently contributed to the prediction of healthy eating patterns among adolescents in Norway. Cultural capital is an understudied dimension of the socio-economic status concept and the influence on health behaviour needs to be explored in future studies. Initiatives to promote healthy eating should focus on education, habits and consciousness of a healthy diet, but also at reducing the high cost of fruit and vegetables. There is further a need for developing appropriate indicators for adolescent socio-economic status.

Early sexual behaviour and Chlamydia trachomatisinfection – a population based cross-sectional study on gender differences among adolescents in Norway

BackgroundEarly sexual behaviour has been shown to differ significantly between genders, but few studies have addressed this topic to explain the commonly observed differences in chlamydia rates between adolescent girls and boys. Our study aimed to determine chlamydia prevalence in adolescents aged 15–20 years in a high-incidence area in Norway, and to identify gender-specific early sexual behaviours associated with infection.MethodsA population based cross-sectional study was conducted among all high school students in five towns in Finnmark county in 2009, using a web-based questionnaire and real-time Chlamydia trachomatis PCR in first-void urine samples (participation rate 85%, 800 girls/818 boys, mean age 17.2 years). Crude and multivariable logistic regression models were applied with chlamydia test result as dependent variable.ResultsPrevalence of chlamydia infection was 5.7% (95% confidence interval, CI, 4.4–7.3%). Girls were twice as likely to be infected as boys (7.3%, 5.3–9.7 vs 3.9%, 2.3–6.0). Girls reported earlier sexual debut, older partners, higher lifetime number of partners, and were poorer condom users. In girls, higher maternal education (odds ratio, OR, 2.2, 95% CI 1.1–4.4), ≥2 sexual partners past 6 months (OR 3.6, 1.8–7.3), and partner meeting venue at a private party, bar or disco (OR 5.0, 1.1–22.7) increased the odds of infection in the multivariable model. In boys, condom use at first intercourse (OR 0.06, 0.01–0.42) decreased the odds of infection, while having an older last sexual partner (OR 3.7, 1.3–11.0) increased the odds. In all participants, the risk of infection increased if residence outside the family home during school year (OR 2.0, 1.2–3.6), and decreased if condom was used at last intercourse (OR 0.2, 0.1–0.8).ConclusionsWe detected significant gender differences in chlamydia prevalence and sexual behaviours, and accordingly differing independent risk factors for chlamydia infection. We suggest that accumulation of essentially different experiences in the early sexually active years contribute to gender disparities in chlamydia risk in individuals this age. Gender-specific approaches may be the best alternative to control chlamydia infection in age group 15–20 years.