Internationally adopted adolescents are at increased risk for mental health problems. However, little is known about problematic alcohol and drug use, which are important indicators of maladjustment. The aim of this study was to examine the level of problematic alcohol and drug use in internationally adopted adolescents compared to their nonadopted peers. The study is based on data from the youth@hordaland-survey, which was conducted in Hordaland County, Norway, in the spring of 2012. All adolescents born from 1993 to 1995 residing in Hordaland at the time of the study were invited to participate. Information on adoption was obtained from the Central Adoption Registry and linked to self-report data from the youth@hordaland-survey. Among 10,200 participants, 45 were identified as internationally adopted. No significant differences were found between international adoptees and their peers regarding whether or not they had tried alcohol or illicit drugs or their patterns of drinking behavior. However, adopted adolescents had a higher mean score on a measure of problematic alcohol and drug use compared to their nonadopted peers. The difference was attenuated and no longer significant when adjusting for measures of depression and attention-deficit/hyperactivity disorder. Results from a structural equation model indicated a full mediation effect of mental health problems on the association between adoption status and problematic alcohol and drug use. Our findings indicate that internationally adopted adolescents experience more problematic alcohol and drug use than their nonadopted peers, and the difference can largely be explained by mental health problems. (PsycINFO Database Record
The association between depression and smoking is firmly established, but how the association develops remains unclear. The aim of this study was to examine development of the smoking-depression association from early adolescence to adulthood.
Cross-sectional and longitudinal analyses of the smoking-depression association from adolescence to adulthood.
A cohort of adolescents (initially, 924 pupils) in the Norwegian Longitudinal Health Behaviour Study (NLHB) was followed over nine data collection waves from ages 13 to 30 years.
Daily smoking and depressed mood were measured in each wave.
In the cross-sectional analyses, daily smoking and depression were significantly associated (P-value range from P?
Background Findings from studies on the association between smoking and socioeconomic status are mixed. While adolescent smoking is reduced in many countries, use of smokeless tobacco seems to increase. Associations between socioeducational status and smoking as well as use of snus (smokeless tobacco), and to what extent these associations had changed significantly from 2004 to 2007 (a period of relatively abrupt changes in tobacco use in Norway), were examined. Methods Data from two national representative cross-sectional studies of Norwegian 16-20 year olds, where participants were asked questions allowing us to construct indicators of socioeducational status, was used. Information was also collected about the adolescents' smoking and use of snus, as well as their intentions with regard to future use of these products. Results Adolescents with a lower socioeducational status had much higher odds for smoking compared to those with higher socioeducational status (ORs ranged from 2.9 to 3.8). There was no similar association between socioeducational status and snus use (ORs ranged from 0.6 to 1.2). No support was found for a change in the socioeducational status-smoking/snus use association from 2004 to 2007. Conclusions Adolescents' socioeducational status was associated with smoking for boys and girls, while there was no similar association with snus use. This may indicate that snus truly deviates from how smoking is distributed across social strata or that snus is at a much earlier stage in the social diffusion process.
There is a higher prevalence of anxiety and depression among adults with lower educational attainment. Delayed completion of high school (HS) is common and represents a potentially complicating factor in the relationship between educational attainment and anxiety and depression. This study aims to investigate whether delayed HS completion is associated with symptom levels of anxiety and depression in adulthood and whether it interacts with later educational attainment in predicting symptom-levels of anxiety and depression in adulthood.
The sample consisted of 10 149 participants from the Nord-Trøndelag Health Survey (HUNT 3) between 30 and 46 years of age in 2006. The outcome variables were symptoms of anxiety and depression as measured by the HADS scale. Variables measuring educational attainment were obtained from the National Educational Database in Norway. We used linear regression to estimate associations between educational attainment, delayed HS completion and symptom levels of anxiety and depression in adulthood.
We found delayed HS completion to be associated with higher symptom levels of both anxiety and depression. There was a dose-response association suggesting that each additional year of delay in HS was associated with higher symptom levels for both anxiety and depression. Mean symptom levels of both anxiety and depression were significantly lower among individuals who completed HS within a normative timeframe vs those who were substantially delayed in their HS completion. For anxiety symptoms, we found a statistically significant interaction between delayed HS completion and later educational attainment. This interaction suggested that individuals with a combination of being delayed in HS and having no higher educational attainment had significantly higher levels of anxiety symptoms than all other combinations of later educational attainment and normative/delayed HS completion. For depression, associations between predictors and symptom levels were additive.
Delayed HS completion is associated with symptom levels of both depression and anxiety and interacts with later educational attainment in predicting symptom levels of anxiety. Individuals with a combination of delayed HS completion and lower educational attainment had particularly high symptom levels of anxiety.
Cites: J Epidemiol Community Health. 2010 May;64(5):447-5219679710
Schools are an important arena for smoking prevention. In many countries, smoking rates have been reduced among adolescents, but the use of smokeless tobacco is on the rise in some of these countries. We aimed to study the associations between schools' restrictions on smoking and snus and on the use of these tobacco products among students in upper secondary school. We employed data from a national representative study of 1444 Norwegian students, aged 16-20 years. Respondents were asked about their schools' restrictions on snus and smoking and own use of these products. We examined associations between restrictions and the use, controlling for age, gender, type of school and regional differences. We found clear consistent associations between schools' restrictions on tobacco use and less use of these products. More explicit pervasive restrictions were strongly associated with the prevalence of use. This first study on the associations between schools' restrictions on snus and the prevalence of snus use corroborate what has been found in many studies on smoking restrictions and smoking. Strict school tobacco policies may be an important tool if health authorities are interested in implementing measures to limit or reduce snus use among adolescents.
BACKGROUND: Norway passed legislation banning smoking in restaurants, bars and other public spaces in 2004. This study tracks changes in hospitality workers' attitudes towards Norway's ban over three time points, using growth modelling analysis to examine predictors of attitude change. METHODS: Participants were a national sample of 1525 bar and restaurant workers. Surveys were conducted, by phone or internet, one month before the ban's implementation and at 4 and 12 months thereafter. Exploratory principal components analysis of nine survey items revealed one primary attitude component. A latent growth model was fitted to the data to examine trajectories of attitude change and individual differences in rate of change. RESULTS: Respondents supported the ban before implementation and increased support at 4 months (p=0.021) and again at 12 months (p=0.001). Concern for one's job followed a quadratic trend, increasing at 4 months and decreasing at 12 months (p
Using data from the Health Behaviour in School-aged Children survey, this study used a repeated cross-sectional design to examine associations between daily smoking, gender, and self-reported health complaints in five cohorts of adolescents over a 16-year period.
Data were from nationally representative cohorts of 15-year-old youth in Norway in 1993/1994, 1997/1998, 2001/2002, 2005/2006, and 2009/2010 (n total = 7761). Dependent variables were psychological, somatic, and total health complaints. A mixed GLM model examined main and interaction effects of smoking (daily, intermittent, nonsmoking), year, and gender in predicting complaints. Time periods were segmented to compare trends across smoking groups in specific periods.
Prevalence of daily smoking declined from 15.5% (1993/1994) to 6.0% (2009/2010). All health complaint scores were significantly higher for smokers and for girls (vs. boys). Smoking status by year interactions were significant for all complaint variables during the period of sharpest decline of daily smoking prevalence (2001/2002-2005/2006), with daily smokers experiencing increases in health complaints while intermittent and nonsmokers did not. Smoking status by gender interactions were significant for all health complaint variables, indicating that the main effect for gender (females higher) was even stronger among smokers compared with nonsmokers. Using year as unit of analysis, the size of mean differences between daily smokers and intermittent/nonsmokers in total complaints was significantly negatively correlated with daily smoking prevalence (-.963, n = 5, p
Results from previous studies examining the dimensionality and factorial invariance of the Satisfaction with Life Scale (SWLS) are inconsistent and often based on small samples. This study examines the factorial structure and factorial invariance of the SWLS in a Norwegian sample.
Confirmatory factor analysis (AMOS) was conducted to explore dimensionality and test for measurement invariance in factor structure, factor loadings, intercepts, and residual variance across gender and four age groups in a large (N = 4,984), nationally representative sample of Norwegian men and women (15-79 years).
The data supported a modified unidimensional structure. Factor loadings could be constrained to equality between the sexes, indicating metric invariance between genders. Further testing indicated invariance also at the strong and strict levels, thus allowing analyses involving group means. The SWLS was shown to be sensitive to age, however, at the strong and strict levels of invariance testing.
In conclusion, the results in this Norwegian study seem to confirm that a unidimensional structure is acceptable, but that a modified single-factor model with correlations between error terms of items 4 and 5 is preferred. Additionally, comparisons may be made between the genders. Caution must be exerted when comparing age groups.
Cites: Percept Mot Skills. 2000 Aug;91(1):62-811011872
Studies on adolescent smoking indicate that the smoking behaviours of their parents, siblings and friends are significant micro-level predictors. Parents' socioeconomic status (SES) is an important macro-level predictor. We examined the longitudinal relationships between these predictors and the initiation and development of adolescents' smoking behaviour in Norway.
We employed data from The Norwegian Longitudinal Health Behaviour Study (NLHB), in which participants were followed from the age of 13 to 30. We analysed data from the first 5 waves, covering the age span from 13 to 18, with latent curve modeling (LCM).
Smoking rates increased from 3% to 31% from age 13 to age 18. Participants' smoking was strongly associated with their best friends' smoking. Parental SES, parents' smoking and older siblings' smoking predicted adolescents' initial level of smoking. Furthermore, the same variables predicted the development of smoking behaviour from age 13 to 18. Parents' and siblings' smoking behaviours acted as mediators of parents' SES on the smoking habits of adolescents.
Parents' SES was significantly associated, directly and indirectly, with both smoking initiation and development. Parental and older siblings' smoking behaviours were positively associated with both initiation and development of smoking behaviour in adolescents. There were no significant gender differences in these associations.
Cites: J Health Econ. 2006 Mar;25(2):214-3315964090
The innovative treatment model Improving Access to Psychological Therapies (IAPT) and its Norwegian adaptation, Prompt Mental Health Care (PMHC), have been evaluated by cohort studies only. Albeit yielding promising results, the extent to which these are attributable to the treatment thus remains unsettled.
To investigate the effectiveness of the PMHC treatment compared to treatment as usual (TAU) at 6-month follow-up.
A randomized controlled trial with parallel assignment was performed in two PMHC sites (Sandnes and Kristiansand) and enrolled clients between November 9, 2015 and August 31, 2017. Participants were 681 adults (aged =18 years) considered for admission to PMHC due to anxiety and/or mild to moderate depression (Patient Health Questionnaire [PHQ-9]/Generalized Anxiety Disorder scale [GAD-7] scores above cutoff). These were randomly assigned (70:30 ratio; n = 463 to PMHC, n = 218 to TAU) with simple randomization within each site with no further constraints. The main outcomes were recovery rates and changes in symptoms of depression (PHQ-9) and anxiety (GAD-7) between baseline and follow-up. Primary outcome data were available for 73/67% in PMHC/TAU. Sensitivity analyses based on observed patterns of missingness were also conducted. Secondary outcomes were work participation, functional status, health-related quality of life, and mental well-being.
A reliable recovery rate of 58.5% was observed in the PMHC group and of 31.9% in the TAU group, equaling a between-group effect size of 0.61 (95% CI 0.37 to 0.85, p