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GP-diagnosed internalizing and externalizing problems and dropout from secondary school: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature298624
Source
Eur J Public Health. 2018 06 01; 28(3):474-479
Publication Type
Journal Article
Date
06-01-2018
Author
Øystein Hetlevik
Tormod Bøe
Mari Hysing
Author Affiliation
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Source
Eur J Public Health. 2018 06 01; 28(3):474-479
Date
06-01-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Cross-Sectional Studies
Female
General practitioners
Humans
Male
Mental Disorders - diagnosis
Norway
Schools
Student Dropouts - statistics & numerical data
Young Adult
Abstract
Dropout from secondary education is a major concern in many Western countries because it is associated with later adverse consequences at the individual and societal level. Efforts have thus been made to identify precursors for dropout. The aim of the study was to examine the risk for not finishing secondary education by age 20 when mental health problems were diagnosed during general practitioner (GP) consultations.
National registries were linked to assess the association between GP-diagnosed internalizing and externalizing problems from the ages of 15-20 years and school dropout in a sample of 63 970 Norwegians, adjusting for health and social background factors. Relative risks (RR) were estimated by Poisson regression.
Dropout was bivariately related to both internalizing (RR = 2.2 among girls and 1.7 among boys) and externalizing problems (RR = 2.7 for girls and 2.0 for boys), though the associations were somewhat attenuated in the adjusted analyses. After controlling for somatic comorbidity and parent education level, the absolute risk for not fulfilling secondary education by age 20 was 43% among girls and 60% among boys with internalizing problems and approximately 15% points higher with externalizing problems. The highest absolute risk for dropout was found for boys and girls who have both externalizing and internalizing problems. However, with some overlap in the confidence intervals, the added impact of internalizing problems when added to externalizing problems is uncertain.
Intervention for mental health problems by a GP could benefit adolescent education outcomes and mental well-being.
PubMed ID
29534184 View in PubMed
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Low Family Income and Behavior Problems in Norwegian Preschoolers: Is Child Emotionality a Marker for Sensitivity of Influence?

https://arctichealth.org/en/permalink/ahliterature279387
Source
J Dev Behav Pediatr. 2016 Apr;37(3):213-22
Publication Type
Article
Date
Apr-2016
Author
Tormod Bøe
Mari Hysing
Henrik Daae Zachrisson
Source
J Dev Behav Pediatr. 2016 Apr;37(3):213-22
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Biomarkers
Child Behavior - psychology
Child, Preschool
Cohort Studies
Family
Humans
Norway
Poverty - psychology
Problem Behavior - psychology
Temperament - physiology
Abstract
Poor children have higher rates of mental health problems than more affluent peers, also in progressive welfare states such as Norway. Temperamental characteristics may render some children more sensitive to the adverse influence of poor economy.
This study examined the direct associations between family income-to-needs and mental health and assessed moderation by early temperamental characteristics (i.e., emotionality).
Using data from the Norwegian Mother and Child Cohort Study, associations between income-to-needs across children's first 3 years and internalizing and externalizing problems when children were 5 years old were examined. Differential sensitivity to family income-to-needs was assessed by investigating how emotionality, when children were one-and-a-half and 3 years old, moderated these associations.
Significant main effects of income-to-needs and emotionality and a significant interaction effect between income-to-needs and emotionality were found for externalizing problems, but not for internalizing problems.
Children in poor families with an emotionally reactive temperament had higher scores on externalizing problems when they were 5 compared with their less emotionally reactive peers.
Notes
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Comment In: J Dev Behav Pediatr. 2016 Apr;37(3):248-5027035696
PubMed ID
27035694 View in PubMed
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Sleep and body mass index in adolescence: results from a large population-based study of Norwegian adolescents aged 16 to 19 years.

https://arctichealth.org/en/permalink/ahliterature262143
Source
BMC Pediatr. 2014;14:204
Publication Type
Article
Date
2014
Author
Børge Sivertsen
Ståle Pallesen
Liv Sand
Mari Hysing
Source
BMC Pediatr. 2014;14:204
Date
2014
Language
English
Publication Type
Article
Keywords
Adolescent
Body mass index
Cross-Sectional Studies
Female
Health Surveys
Humans
Logistic Models
Male
Norway
Obesity - diagnosis - etiology
Overweight - diagnosis - etiology
Risk factors
Self Report
Sex Factors
Sleep
Sleep Apnea, Obstructive - complications
Sleep Initiation and Maintenance Disorders - complications
Thinness - diagnosis - etiology
Abstract
The aim of this study was to examine the association between body mass index (BMI) and sleep duration, insomnia and symptoms of obstructive sleep apnea (OSA) in adolescents.
Data were taken from a large population based study of 9,875 Norwegian adolescents aged 16-19. BMI was calculated from the self-reported body weight and categorized according to recommended age and gender specific cut offs for underweight, overweight and obesity. Detailed sleep parameters (sleep duration, insomnia, and OSA symptoms) were reported separately for weekdays and weekends. Data were analyzed using Pearson's chi-squared test and ANOVAs for simple categorical and continuous comparisons, and multinomial logistic regressions for analyses adjusting for known confounders.
There was evidence for a curvilinear relationship between BMI and both sleep duration and insomnia for girls, whereas the relationship was linear for boys. Compared to the average weekday sleep duration among adolescents in the normal weight range (6 hrs 29 min), both underweight (5 hrs 48 min), overweight (6 hrs 13 min) and obese (5 hrs 57 min) adolescents had shorter sleep duration. OSA symptoms were linearly associated with BMI. Controlling for demographical factors as well as physical activity did not attenuate the associations. Additional adjustment for depression reduced the association between insomnia and obesity to a non-significant level. The evidence for a link between both underweight and overweight/obesity, and short sleep duration and OSA symptoms remained in the fully adjusted analyses. The associations were generally stronger for girls.
This is one of the first population-based studies to investigate the relationship between sleep and BMI in adolescents while simultaneously controlling for important confounding factors. These findings require further research to investigate the temporal association between weights and sleep problems.
Notes
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PubMed ID
25128481 View in PubMed
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Trajectories of sleep problems from childhood to adolescence: a population-based longitudinal study from Norway.

https://arctichealth.org/en/permalink/ahliterature286006
Source
J Sleep Res. 2017 Feb;26(1):55-63
Publication Type
Article
Date
Feb-2017
Author
Børge Sivertsen
Allison G Harvey
Ståle Pallesen
Mari Hysing
Source
J Sleep Res. 2017 Feb;26(1):55-63
Date
Feb-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Child
Female
Humans
Longitudinal Studies
Male
Norway
Prospective Studies
Sleep Wake Disorders - complications
Time Factors
Young Adult
Abstract
The aim of the current study was to assess the development and stability of sleep problems from childhood to late adolescence. This was a longitudinal cohort study of 2026 children, who completed three comprehensive health surveys, at age 7-9, 11-13 and 16-19 years. Data on difficulties with initiating and/or maintaining sleep (DIMS: assessed using a single item) and time in bed (TIB) were collected at all three waves, while insomnia assessed in line with the DSM-5 criteria and sleep duration were also assessed in the last wave. Negative binomial regression analyses were used to examine prospective associations. Sleep problems in 7-9-year-old children were found to persist into late adolescence for approximately one-third of the participants, both with regard to DIMS and short TIB. Children having chronic DIMS at the first two waves had nearly twice the risk of fulfilling the DSM-5 criteria later for insomnia in late adolescence [adjusted relative risk RR: 1.91]. Short TIB at age 11-13 was also associated with increased risk of subsequent short sleep duration (adjusted RR: 1.32) and TIB (adjusted RR: 1.40). These findings have important implications for practitioners and families. Although the majority of children will outgrow their problems once they reach late adolescence, the results also demonstrate that sleep problems are likely to become chronic for one in every third child with a sleep problem early in life. Given the many negative consequences of insomnia in adulthood, these findings call for increased awareness of childhood sleep problems as a public health concern.
PubMed ID
27530929 View in PubMed
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Academic performance in adolescents with delayed sleep phase.

https://arctichealth.org/en/permalink/ahliterature273720
Source
Sleep Med. 2015 Sep;16(9):1084-90
Publication Type
Article
Date
Sep-2015
Author
Børge Sivertsen
Nick Glozier
Allison G Harvey
Mari Hysing
Source
Sleep Med. 2015 Sep;16(9):1084-90
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Absenteeism
Adolescent
Adolescent Behavior - psychology
Educational Measurement
Female
Humans
Life Style
Male
Norway
Self Report
Sleep Wake Disorders - psychology
Socioeconomic Factors
Young Adult
Abstract
Delayed sleep phase (DSP) in adolescence has been linked to reduced academic performance, but there are few population-based studies examining this association using validated sleep measures and objective outcomes.
The youth@hordaland-survey, a large population-based study from Norway conducted in 2012, surveyed 8347 high-school students aged 16-19 years (54% girls). DSP was assessed by self-report sleep measures, and it was operationalized according to the International Classification of Sleep Disorders - Second Edition. School performance (grade point average, GPA) was obtained from official administrative registries, and it was linked individually to health data.
DSP was associated with increased odds for poor school performance. After adjusting for age and gender, DSP was associated with a threefold increased odds of poor GPA (lowest quartile) [odds ratio (OR)?=?2.95; 95% confidence interval (CI): 2.03-4.30], and adjustment for sociodemographics and lifestyle factors did not, or only slightly, attenuate this association. Adjustment for nonattendance at school reduced the association substantially, and in the fully adjusted model, the effect of DSP on poor academic performance was reduced to a non-significant level. Mediation analyses confirmed both direct and significant indirect effects of DSP on school performance based on school absence, daytime sleepiness, and sleep duration.
Poor academic performance may reflect an independent effect of underlying circadian disruption, which in part could be mediated by school attendance, as well as daytime sleepiness and short sleep duration. This suggests that careful assessment of sleep is warranted in addressing educational difficulties.
PubMed ID
26298783 View in PubMed
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Sleep and use of alcohol and drug in adolescence. A large population-based study of Norwegian adolescents aged 16 to 19 years.

https://arctichealth.org/en/permalink/ahliterature266678
Source
Drug Alcohol Depend. 2015 Apr 1;149:180-6
Publication Type
Article
Date
Apr-1-2015
Author
Børge Sivertsen
Jens Christoffer Skogen
Reidar Jakobsen
Mari Hysing
Source
Drug Alcohol Depend. 2015 Apr 1;149:180-6
Date
Apr-1-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior - psychology
Alcohol drinking - epidemiology
Comorbidity
Depression - epidemiology
Dose-Response Relationship, Drug
Female
Humans
Male
Norway - epidemiology
Self Report
Sleep - physiology
Sleep Initiation and Maintenance Disorders - epidemiology - physiopathology - psychology
Substance-Related Disorders - epidemiology
Young Adult
Abstract
Changes in sleep patterns and increased substance involvement are common in adolescence, but our knowledge of the nature of their association remains limited. The aim of this study was to examine the association between several sleep problems and sleep behaviours, and use and misuse of alcohol and illicit drugs using data from a large population-based sample.
A large population-based study from Norway conducted in 2012, the youth@hordaland study, surveyed 9328 adolescents aged 16-19 years (54% girls). Self-reported sleep measures provided information on sleep duration, sleep deficit, weekday bedtime and bedtime difference and insomnia. The main dependent variables were frequency and amount of alcohol consumption and illicit drug use, in addition to the presence of alcohol and drug problems as measured by CRAFFT.
The results showed that all sleep parameters were associated with substance involvement in a dose-response manner. Short sleep duration, sleep deficit, large bedtime differences and insomnia were all significantly associated with higher odds of all alcohol and drug use/misuse measures. The associations were only partly attenuated by sociodemographics factors and co-existing symptoms of depression and ADHD.
To the best of our knowledge, this is the first population-based study to examine the association between sleep, and alcohol and drug use, by employing detailed measures of sleep behaviour and problems, as well as validated measures on consumption of alcohol and illicit drug use. The findings call for increased awareness of the link between sleep problems and alcohol and drugs use/misuse as a major public health issue.
PubMed ID
25707706 View in PubMed
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The Strengths and Difficulties Questionnaire (SDQ): Factor Structure and Gender Equivalence in Norwegian Adolescents.

https://arctichealth.org/en/permalink/ahliterature281568
Source
PLoS One. 2016;11(5):e0152202
Publication Type
Article
Date
2016
Author
Tormod Bøe
Mari Hysing
Jens Christoffer Skogen
Kyrre Breivik
Source
PLoS One. 2016;11(5):e0152202
Date
2016
Language
English
Publication Type
Article
Keywords
Adolescent
Female
Humans
Male
Norway
Surveys and Questionnaires
Abstract
Although frequently used with older adolescents, few studies of the factor structure, internal consistency and gender equivalence of the SDQ exists for this age group, with inconsistent findings. In the present study, confirmatory factor analysis (CFA) was used to evaluate the five-factor structure of the SDQ in a population sample of 10,254 16-18 year-olds from the youth@hordaland study. Measurement invariance across gender was assessed using multigroup CFA. A modestly modified five-factor solution fitted the data acceptably, accounting for one cross loading and some local dependencies. Importantly, partial measurement non-invariance was identified, with differential item functioning in eight items, and higher correlations between emotional and conduct problems for boys compared to girls. Implications for use clinically and in research are discussed.
Notes
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PubMed ID
27138259 View in PubMed
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Socioeconomic status and children's mental health: results from the Bergen Child Study.

https://arctichealth.org/en/permalink/ahliterature128647
Source
Soc Psychiatry Psychiatr Epidemiol. 2012 Oct;47(10):1557-66
Publication Type
Article
Date
Oct-2012
Author
Tormod Bøe
Simon Øverland
Astri J Lundervold
Mari Hysing
Author Affiliation
Centre for Child and Adolescent Mental Health, Uni Health, Uni Research, PO Box 7800, 5020, Bergen, Norway. Tormod.Boe@uni.no
Source
Soc Psychiatry Psychiatr Epidemiol. 2012 Oct;47(10):1557-66
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Child
Child Behavior Disorders - diagnosis - psychology
Female
Humans
Logistic Models
Longitudinal Studies
Male
Mental Disorders - diagnosis - psychology
Mental health
Norway
Parents
Poverty
Psychiatric Status Rating Scales
Questionnaires
Risk factors
Socioeconomic Factors
Abstract
It is generally accepted that mental health problems are unequally distributed across population strata defined by socioeconomic status (SES), with more problems for those with lower SES. However, studies of this association in children and adolescents are often restricted by the use of global measures of mental health problems and aggregation of SES-indicators. We aim to further elucidate the relationship between childhood mental health problems and SES by including more detailed information about mental health and individual SES-indicators.
The participants (N = 5,781, age 11-13) were part of the Bergen Child Study (BCS). Mental health was assessed using the teacher, parent and self-report versions of the Strengths and Difficulties Questionnaire (SDQ), including an impact section, used to measure symptom dimensions and probability of psychiatric disorders. Parent reports of family economy and parental education were used as SES measures.
For each SES indicator we confirmed an inverse relationship across all the symptom dimensions. Poor family economy consistently predicted mental health problems, while parental education level predicted externalizing disorders stronger than internalizing disorders.
In this Norwegian sample of children, family economy was a significant predictor of mental health problems as measured across a wide range of symptom dimensions and poor economy predicted a high probability of a psychiatric disorder. Longitudinal studies of the impact of low family income as well as other SES factors on externalizing and internalizing symptom dimensions and disorders are called for.
PubMed ID
22183690 View in PubMed
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Use of alcohol, tobacco and illicit drugs among ethnic Norwegian and ethnic minority adolescents in Hordaland county, Norway: the youth@hordaland-survey.

https://arctichealth.org/en/permalink/ahliterature293536
Source
Ethn Health. 2018 01; 23(1):43-56
Publication Type
Journal Article
Date
01-2018
Author
Jens Christoffer Skogen
Tormod Bøe
Børge Sivertsen
Mari Hysing
Author Affiliation
a Alcohol and Drug Research Western Norway , Stavanger University Hospital , Stavanger , Norway.
Source
Ethn Health. 2018 01; 23(1):43-56
Date
01-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adolescent Behavior
Alcohol Drinking - ethnology
Cross-Sectional Studies
Ethnic Groups - statistics & numerical data
Europe
Female
Humans
Male
Minority Groups - statistics & numerical data
Norway - epidemiology
Prevalence
Self Report
Smoking - epidemiology
Social Class
Street Drugs
Tobacco
Tobacco, Smokeless - utilization
Abstract
To describe potential differences in unhealthy behaviours among ethnic Norwegian adolescents and minority adolescents from countries within the European Union, European Economic Area or US (EU/EEA countries) and adolescents from non-EU/EEA countries. Specifically, we aimed to investigate ethnic differences in use of alcohol, tobacco and illicit drugs, and potential confounding due to socio-demographic characteristics.
Cross-sectional population-based study of adolescents aged 16-19 (N?=?10,122), with self-reported ethnicity as grouping variable, and self-reported use of alcohol, tobacco and illicit drugs as dependent variables.
We found that minority adolescents from EU/EEA and non-EU/EEA countries differed from ethnic Norwegian adolescents on important indicators of unhealthy behaviours. Compared to Norwegian adolescents, adolescents from EU/EEA were more likely to report having tried to smoke, to be a daily smoker and to ever having tried an illicit drug (adjusted odds ratio (OR) ranging from 2.01 to 3.74). They were, however, less likely to have tried snus (a form of smokeless tobacco; adjusted OR 0.64; confidence interval (CI) 95% 0.43-0.97) and to report daily snus use (adjusted OR 0.31; CI95% 0.15-0.67). There were no differences in having tried alcohol. Non-EU/EEA adolescents were less likely to have ever tried alcohol (OR 0.24; CI95% 0.18-0.31), snus (OR 0.47; CI95% 0.34-0.65) and to smoke (0.68; CI95% 0.52-0.91), and less likely to report daily snus use (OR 0.36; CI95% 0.21-0.62) compared to Norwegian adolescents. There were no differences with regard to having tried illicit drugs and reporting being a daily smoker. All differences observed were robust to adjustment for age, gender and family socio-economic status.
The presents study identified important differences in unhealthy behaviours across different ethnic groups in Norway. The differences in the prevalence of unhealthy behaviours among ethnic minorities are still relevant in a public health perspective, and potential mechanisms should be investigated further.
PubMed ID
27764960 View in PubMed
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Pediatric sleep problems and social-emotional problems. A population-based study.

https://arctichealth.org/en/permalink/ahliterature277428
Source
Infant Behav Dev. 2016 Feb;42:111-8
Publication Type
Article
Date
Feb-2016
Author
Mari Hysing
Børge Sivertsen
Susan Garthus-Niegel
Malin Eberhard-Gran
Source
Infant Behav Dev. 2016 Feb;42:111-8
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Adult
Affective Symptoms - epidemiology - psychology
Causality
Child
Child Behavior Disorders - epidemiology - psychology
Child Development - physiology
Child, Preschool
Cohort Studies
Female
Gestational Age
Humans
Infant
Logistic Models
Longitudinal Studies
Maternal Age
Mothers
Norway - epidemiology
Pregnancy
Research Design
Risk factors
Sleep Wake Disorders - epidemiology - psychology
Surveys and Questionnaires
Abstract
To examine the association between sleep and social-emotional development in two-year-old toddlers.
The study is part of a longitudinal cohort study, the Akershus Birth Cohort Study, which targeted all women giving birth at Akershus University Hospital in Norway. The current study is from the fourth round of the study, including 2014 women two years after delivery. The Brief Infant Sleep Questionnaire (BISQ) and the Ages and Stages Questionnaire: Social Emotional (ASQ:SE) were filled out by the mothers and were used to assess toddler sleep, and social-emotional development, respectively. Other domains of development (communication problems, gross motor problems, and fine motor problems) were assessed with the Ages and Stages Questionnaire (ASQ). Confirmatory factor analysis was conducted on the ASQ:SE, and logistic regression analyses were used to examine both crude associations between sleep variables and social-emotional problems, and adjusting for potential confounders.
The mean sleep duration of the toddlers was 12h and 27 min; the majority of the children (54%) had 1-2 awakenings per night, while 10% of the children had a sleep onset latency of more than 30 min. All sleep parameters, including short sleep duration, nocturnal awakenings and sleep onset problems, were significantly associated with social-emotional problems in a dose-response manner. For example, sleeping less than 11h per night was associated with a five-fold increase in the odds of social-emotional problems, compared to sleeping 13-14 h per night. Adjusting for potential confounders, including maternal age, maternal education, marital status, parity, gestational age, child birth-weight and other developmental problems, did not, or only slightly, attenuate the associations between any of the sleep variables and social-emotional problems.
Short sleep duration, nocturnal awakenings and sleep onset problems were all associated with higher odds of social-emotional problems, even after accounting for developmental problems and demographic factors. Thus, a broad assessment of sleep and social-emotional problems when toddlers present with either can be useful.
PubMed ID
26774862 View in PubMed
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