Leisure-time physical activity trajectories from adolescence to adulthood in relation to several activity domains: a 27-year longitudinal study.

BACKGROUND: Insufficient physical activity (PA) levels among adolescents and adults make promoting PA a public health priority. Although most people exhibit low or decreasing levels of PA, other groups increase or maintain high levels of activity. These different groups may engage differently in activity domains during their leisure time. This study aimed to identify distinct trajectories of leisure-time vigorous physical activity (LVPA) and to explore whether these trajectories are characterised by differences in four activity domains (participation in organised sports clubs, diversity in leisure-time activities, outdoor recreation, and peer PA) over the life course. METHODS: Data were drawn from the Norwegian Longitudinal Health Behaviour Study. The sample of participants (n = 1103, 45.5% female) was surveyed 10 times from age 13 years in 1990 to age 40 years in 2017. LVPA trajectories were identified using latent class growth analysis, and mean differences in activity domains were studied using the one-step BCH approach. RESULTS: Four trajectories were identified: active (9%), increasingly active (12%), decreasingly active (25%), and low active (54%). Overall, this analysis showed a declining tendency in LVPA from age 13 to 40 years except for the increasingly active trajectory. Belonging to a trajectory with a higher LVPA level was related to higher mean levels of the included activity domains. Compared with those in the increasing trajectory, people belonging to the decreasing trajectory reported higher mean participation levels in and age at becoming a member of sports clubs, diversity in leisure-time activities, and best friend's activity level during adolescence. However, in young adulthood, people in the increasingly active trajectory reported significantly higher mean levels for the same variables. CONCLUSIONS: The development of LVPA from adolescence to adulthood is heterogeneous, suggesting the need for targeted health promotion initiatives. The largest trajectory group included more than 50 percent and was characterized by low levels of LVPA, less engagement in PA domains and fewer active friends. There seems to be little carry-over effect of engagement in organised sports in adolescence regarding level of LVPA later in life. Changes in social surroundings throughout the life span, such as having friends who are more or less engaged in PA, may assist or hinder health enhancing engagement in LVPA.

The relationship between substance use disorder and gambling disorder: A nationwide longitudinal health registry study.

Aim: This study aimed to examine the co-morbidity and temporal relationship between substance abuse disorders (SUDs) and gambling disorder (GD). Method: Cross-tabulated census data were retrieved from the Norwegian Patient Registry. The data included the number of patients by year of first-time incidence of GD and/or SUD diagnoses, age and sex from 2008 to 2017. Results: Approximately 22.5% of GD patients were also diagnosed with SUD, whereas 0.7% of SUD patients were also diagnosed with GD. Among GD patients, males had a greater risk of SUD in the same year compared to females, whereas the risk of SUD a year or more after the onset of GD was greater among females compared to males. Among SUD patients, males had a greater risk of GD in all age categories and across all time periods except among those aged 40-66 years. The risk of GD three to four years after the onset of SUD among those aged 40-66 years was similar between SUD males and females. Discussion: The overall co-morbidity of SUD and GD was low. However, the risk of the other addictive disorder was contingent upon the nature of the first disorder. The risk of SUD among GDs over time was greater among females compared to males. Conclusions: The risk of the other addictive disorder appears to be contingent upon the first addictive disorder. There are sex differences in the risk trajectories of the other addictive disorder over time between GD patients and SUD patients.

Gamblers' use of measures to prevent gambling problems and reduce harm.

In this study, the use of measures to control gambling were investigated. Data from gamblers (N = 5,878) participating in a cross-sectional survey in 2019 based on random sampling from the Norwegian Population Registry, were analysed. The survey included questions about use of eight measures, which comprised the dependent variables. Questions about sociodemographics, gambling behaviour, gambling problems, self-reported impact from gambling advertisement and beliefs in measures to control gambling comprised the predictor variables. Logistic regression analyses were employed to identify significant predictors. Use of measures varied, ranging from 0.8% (contacting help services) to 23.2% (pre-commitment to affordable loss limits). All predictors had at least one significant association with the actual use of measures. Being a moderate risk or problem gambler was the most consistent predictor and was associated with the use of all eight measures. Being born outside Norway in a western or non-western country was associated with use of seven of the eight measures, whereas gambled online and participated in low-risk game only (inversely) were associated with use of six measures. Gender, age, game spending and beliefs in the usefulness of measures were associated with use of four measures. Participation in random games only was inversely associated with use of three measures. Self-reported impact from gambling advertisement was only (inversely) associated with self-testing for gambling problems. Several mechanisms responsible for the associations between predictors and the dependent variables are suggested, e.g., younger gamblers and moderate risk or problem gamblers may use these measures as they may acknowledge personal susceptibilities for developing gambling problems, such as impaired impulse control. Online gambling on the other hand was associated with use of various measures as the latter more often are integrated in online than offline gambling. Notably, the beliefs in measures as helpful was a significant predictor of use of four of the measures, which illustrates that positive views on the use of measures are not consistently associated with actual use of all the measures. Characteristics of the gamblers (e.g., place of birth, moderate risk or problem gambler), the game itself and the online distribution seem to be the most consistent predictors.

Nordic adolescents responding to demanding survey scales in boring contexts: Examining straightlining.

INTRODUCTION: Straightlining, or identical responses across all items within a multi-item scale, is often taken as an indication that responses to all items in a questionnaire are of poor quality. The purpose of this study was to examine straightlining on two scales: The Sense of Unity Scale (SUS) and the short version of the Warwick-Edinburgh Mental Well-being Scale (SWEMWBS). METHODS: Data stem from the 2017-2018 data collections in four Nordic countries of the Health Behaviour in School-children study (HBSC) (15-year-old students only; 50.9% girls; n = 5928). Data were weighted to adjust for oversampling of Swedish-speaking Finnish students and to equalize sample size across countries. The main analyses were done with general linear modeling with adjustments for cluster effects (school classes). RESULTS: The proportion with straightlining on SUS was 22.8%, varying from 5.8% among Swedish girls to 46.4% among Finnish boys. The proportion with straightlining on SWEMWBS was 18.4%, varying from 5.2% among Norwegian girls to 46.0% among Finnish boys. Straightlining on one of the scales correlated with straightlining on the other one. Straightlining tended to inflate Cronbach's α values and reduce number of factors in factor analyses. Associations between the two scales and external variables tended to be lower among straightlining students. Associations between external variables (other than SUS/SWEMWBS) are on average slightly weaker among straightliners. Straightlining students obtained more favorable scores on several resource-related variables. CONCLUSION: Although some problems have been identified, straightlining does not serve well as a general indicator of poor data quality.

Regulatory Measures' Effect on Gambling Participation: Experiences From Norway.

The purpose of gambling regulation can be to ensure revenue for the public, to prevent crime and gambling problems. One regulatory measure involves restriction of what games can be offered in a market. In this study, the effects of two regulatory market changes are investigated: First, a restriction of availability when slot machines were banned from the Norwegian market in 2007, and second the introduction of regulated online interactive games to the same market in 2014. Data collected from the general population in the period from 2005 through 2018, comprising 2,000 respondents every year, are used to investigate how participation in gambling changed over time. The respondents were asked if they took part in various games or lotteries. Logistic regression analyses were used to predict the proportion participating in five groups of games and if changes in participation coincided with major market changes. The first change was associated with a reduction in gambling on slot machines as well as a reduction in gambling participation overall. Following the slot machine ban, results show an increase in women participating in games offered in land-based bingo premises. A general increase in gambling on foreign websites was also seen, albeit much smaller than the reduction in slot machine gambling. The increases can partly be explained as substitution of one type of gambling with another. New regulated online interactive games were introduced in 2014. Despite the relatively large growth of such games internationally, Norway included, increased online gambling in general and an increased marketing of foreign gambling websites, the participation on foreign websites seemed stable. However, the overall participation in online interactive games increased. The introduction of the regulated alternative seems to have had a channelizing effect. Overall, the changes in gambling participation coinciding with two major regulatory changes can be explained by transformations of physical and social availability, and in terms of mechanisms outlined by the model of total consumption.

Cross-national time trends in adolescent alcohol use from 2002 to 2014.

BACKGROUND: Adolescent alcohol consumption is a major public health concern that should be continuously monitored. This study aims (i) to analyze country-level trends in weekly alcohol consumption, drunkenness and early initiation in alcohol consumption and drunkenness among 15-year-old adolescents from 39 countries and regions across Europe and North America between 2002 and 2014 and (ii) to examine the geographical patterns in adolescent alcohol-related behaviours. METHODS: The sample was composed of 250 161 adolescents aged 15 from 39 countries and regions from Europe and North America. Survey years were 2002, 2006, 2010 and 2014. The alcohol consumption and drunkenness items of the HBSC questionnaire were employed. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression models with robust variance. RESULTS: Data show a general decrease in all four alcohol variables between 2002 and 2014 except for some countries. However, there is variability both within a country (depending on the alcohol-related behaviour under study) and across countries (in the beginning and shape of trends). Some countries have not reduced or even increased their levels in some variables. Although some particularities have persisted over time, there are no robust patterns by regions. CONCLUSIONS: Despite an overall decrease in adolescent alcohol consumption, special attention should be paid to those countries where declines are not present, or despite decreasing, rates are still high. Further research is needed to clarify factors associated with adolescent drinking, to better understand country specificities and to implement effective policies.

Tinder Use and Romantic Relationship Formations: A Large-Scale Longitudinal Study.

The current paper aims to investigate if Tinder use predicts romantic relationship formation 1 year later and to identify demographic, personality, mental health, and substance use covariates in the relationship between Tinder use and romantic relationship formation. Data were collected by online surveys (two waves) among students in Bergen, Norway. The first survey was administered during fall 2015 (T1). The follow-up took place 1 year later (fall 2016, T2). The sample consisted of the 5253 participants who reported to be single at T1. The surveys included questions about Tinder use, demographics, personality (the Five-Factor Model's personality traits), mental health (i.e., symptoms of depression and anxiety), alcohol use, and use of illegal substances. Bivariate comparisons were conducted to assess differences in demographics, personality traits, mental health, and substance use between Tinder users and non-Tinder users. Further, crude and adjusted binary logistic regressions were employed to investigate if Tinder use at T1 predicted romantic relationship formation at T2, when controlling for relevant covariates. Tinder users differed from non-users on almost all included variables. Compared to non-users, Tinder users were younger and more likely to be men, born in Norway, childless, and non-religious. Tinder users had higher scores on extroversion and agreeableness and lower scores on openness compared to non-users. Further, compared to non-users, Tinder users reported more symptoms of anxiety and were more likely to have hazardous, harmful, or dependent alcohol use and to report use of illegal substances. Compared to non-users, Tinder users had a higher likelihood of having formed a romantic relationship at T2 in the crude model (p < 0.05) and when controlling for demographic (p < 0.05) and mental health (p < 0.05) covariates. However, when controlling for personality, substance use, and all included covariates, the difference in likelihood of romantic relationship formation was no longer significant. In conclusion, the current results suggest that Tinder users have a higher likelihood of forming romantic relationship longitudinally, but that this increased likelihood can be explained by Tinder users' personality and substance use characteristics.

Patterns of Health-Related Gender Inequalities-A Cluster Analysis of 45 Countries.

PURPOSE: The paper explores gender inequalities between 45 countries across 10 health indicators among adolescents and whether those differences in health correlate with gender inequality in general. METHODS: Data from 71,942 students aged 15 years from 45 countries who participated in the 2018 Health Behaviour in School-aged Children survey were analyzed. For this purpose, 10 indicators were selected, representing a broad spectrum of health outcomes. The gender differences in the countries were first presented using odds ratios. Countries with similar risk profiles were grouped together using cluster analyses. For each of the 10 indicators, the correlation with the Gender Inequality Index was examined. RESULTS: The cluster analysis reveals systematic gender inequalities, as the countries can be divided into seven distinct groups with similar gender inequality patterns. For eight of the 10 health indicators, there is a negative correlation with the Gender Inequality Index: the greater the gender equality in a country, the higher the odds that girls feel fat, have low support from families, have low life satisfaction, have multiple health complaints, smoke, drink alcohol, feel school pressure, and are overweight compared with boys. Four indicators show a divergence: the higher the gender equality in a country in general, the larger the differences between boys and girls regarding life satisfaction, school pressure, multiple health complaints, and feeling fat. CONCLUSIONS: Countries that are geographically and historically linked are similar in terms of the health risks for boys and girls. The results challenge the assumption that greater gender equality is always associated with greater health equality.

Opioid and Polydrug Use Among Patients in Opioid Maintenance Treatment.

PURPOSE: Opioid maintenance treatment reduces a person's use of heroin. However, frequent substance use in treatment is a problem. AIM: To examine the association between opioid maintenance treatment and opioid/polydrug use, and whether social factors, adverse experiences, social resources, and quality of life are associated with opioid/polydrug use during the first 12 months in treatment. PATIENTS AND METHODS: Forty-seven participants from treatment units in Bergen, Norway participated in five waves of data collection. Every third month, a structured face-to-face interview collected self-reported data on sociodemographic characteristics, opioid/polydrug use, participants' social resources or adverse experiences, and quality of life. Data were collected as part of KVARUS, the National Quality Register for Substance Abuse Treatment. A multilevel binary logistic regression analysis was conducted to examine the association of opioid/polydrug use and time in current treatment. The analysis included regressions of opioid/polydrug use on time-invariant baseline adverse experiences and social resources, and time-varying reports of quality of life. RESULTS: There was a significant negative association between time in treatment and use of opioids, b =-0.89, SE = 0.19, p = <0.01. Furthermore, a negative association of age at substance use on polydrug use was found, b =-0.40, SE =0.19, p = 0.03. A higher overall quality of life was significantly associated with lower odds of opioid use during opioid maintenance treatment, b = -0.62, SE = 0.23, p = < 0.01. Social dimensions, participants' adverse experiences, and social resources were not associated with polydrug or opioid use. CONCLUSION: Opioid maintenance treatment is associated with lowered opioid use, but to a lesser degree with polydrug use. Our findings add quality of life as an important factor that should be given particular attention because it can offer insight to aspects that can affect the patients' opioid use.

The Norwegian remote intervention programme for problem gambling: Short- and long-term outcomes.

Background and aim: Although problem gambling typically involves substantial distress, few seek face-to-face treatment. In Norway, problem gamblers can participate in a governmental supported internet- and telephone-based intervention programme. The current study aimed to evaluate the outcomes of this programme in terms of gambling behaviour, gambling-related cognitions and mental health in a one group pre-test post-test design with a follow-up assessment. Methods: The sample consisted of the 67 participants who completed the intervention programme within a one-year timeframe. Gambling behaviour (SOGS-R), gambling-related cognitions (GBQ) and mental health (SCL-90-R) were measured pre-intervention, post-intervention and at a 6-12 months follow-up. A total of 25 (37.3%) participants completed the follow-up assessment. T-tests were conducted to investigate development in gambling behaviour, gambling-related cognitions and mental health from pre-intervention to post-intervention and follow-up. Results: The analyses showed a significant reduction in gambling behaviour, gambling problems, gambling-related cognitive distortions and mental health symptoms from pre-intervention to post-intervention and follow-up. The corresponding effect sizes for the reductions in gambling and gambling-related cognitive distortions were very large, while the effect sizes for the reductions in mental distress were moderate. Conclusion: The internet/telephone programme appears to have several positive outcomes including reduction in gambling behaviour, gambling problems, gambling-related cognitive distortions and symptoms of mental disorders both in the short and long term. Another positive outcome of participation appears to be a lowered threshold for seeking additional treatment. The current study entails, however, important limitations, and future studies should investigate the outcomes of the programme while including a control group.

A Cross-National Analysis of the Psychometric Properties of the Geriatric Anxiety Inventory.

OBJECTIVES: Assessing late-life anxiety using an instrument with sound psychometric properties including cross-cultural invariance is essential for cross-national aging research and clinical assessment. To date, no cross-national research studies have examined the psychometric properties of the frequently used Geriatric Anxiety Inventory (GAI) in depth. METHOD: Using data from 3,731 older adults from 10 national samples (Australia, Brazil, Canada, The Netherlands, Norway, Portugal, Spain, Singapore, Thailand, and United States), this study used bifactor modeling to analyze the dimensionality of the GAI. We evaluated the "fitness" of individual items based on the explained common variance for each item across all nations. In addition, a multigroup confirmatory factor analysis was applied, testing for measurement invariance across the samples. RESULTS: Across samples, the presence of a strong G factor provides support that a general factor is of primary importance, rather than subfactors. That is, the data support a primarily unidimensional representation of the GAI, still acknowledging the presence of multidimensional factors. A GAI score in one of the countries would be directly comparable to a GAI score in any of the other countries tested, perhaps with the exception of Singapore. DISCUSSION: Although several items demonstrated relatively weak common variance with the general factor, the unidimensional structure remained strong even with these items retained. Thus, it is recommended that the GAI be administered using all items.

Cyberbullying and traditional bullying among Nordic adolescents and their impact on life satisfaction.

Aims: The aim of this study was to investigate the prevalence of cybervictimization in the six Nordic countries and to assess its overlap with traditional bullying. A further aim was to examine potential associations between life satisfaction, on the one hand, and traditional bullying and cyberbullying on the other. Methods: Analyses were based on data from the 2013/2014 Health Behaviour in School-aged Children study. It included 32,210 boys and girls, aged 11, 13, and 15, living in the six Nordic countries. Results: The prevalence of cyberbullying by both pictures and by messages was around 2% in all the Nordic countries except Greenland. There it was considerably higher. The prevalence of being bullied in a traditional manner varied widely by country. For boys, this type of bullying was most frequent in the youngest age group and then decreased steadily in the older age groups. Girls were on average more likely to be cyberbullied. Cyberbullying was more common among 13- and 15-year-olds than 11-year-olds. Higher family affluence was unrelated to the risk of cyberbullying. However, it was related to traditional bullying and combined forms of bullying. Compared with intact families, cybervictimization was commoner among single-parent families and stepfamilies. Adjusting for age, gender, family affluence, and family structure, those subjected to cyberbullying had lower life satisfaction than those who were not bullied. Conclusions: We found relatively little overlap between cyberbullying and traditional bullying, indicating that the two may be separate phenomena stemming from different mechanisms, at least in the Nordic context.

The associations between low-level gaming, high-level gaming and problematic alcohol use.

The current study aimed to investigate associations between gaming and different patterns of problematic alcohol use, controlling for important demographics, personality and mental health covariates. Data was collected by an online survey during fall 2016 (N = 5217). Students who had participated in a survey among students in Bergen, Norway, one year earlier were invited to participate. Crude and adjusted binary logistic regression analyses were conducted in order to assess the relationship between different patterns of problematic alcohol use and gaming (i.e. low-level gaming and high-level gaming vs. no gaming) while controlling for important covariates. The different gaming groups were categorised based on the number of symptoms of "gaming addiction" (in total seven) that they endorsed: 4 > symptoms = low-level gaming, 4 ≤ symptoms = high-level gaming. Only 0.2% (n = 11) endorsed all seven symptoms. Low-level gaming was positively associated with patterns of problematic alcohol use in the crude analyses; these associations became non-significant when controlling for demographic variables. High-level gaming was inversely associated with patterns of problematic alcohol use when controlling for demographics, personality, and mental health covariates. The inverse relationship between high-level gaming and problematic alcohol use (when controlling for covariates) suggest that heavy investment in gaming may protect against excessive alcohol use and alcohol-related harm. Possible explanations discussed for the inverse associations include high-level gamers having less available time to drink, intoxication being incompatible with gaming, and/or high-level gamers experiencing sufficient satisfaction/escape and social bonding by gaming, hence having less need for alcohol.

Leisure-time physical activity and participation in organized sports: Changes from 1985 to 2014 in Finland and Norway.

Participation in organized sports is a popular and important part of the lives of children and adolescents and is associated with improved psychological and social health, as well as an increased likelihood of meeting physical activity (PA) recommendations. Changes in modern society, including increased car ownership and use of technology and electronic media, have led to an additional focus on the importance of health-enhancing PA among children and adolescents. The aim of this article was to study the secular changes in self-reports of participation in organized sports clubs and leisure-time vigorous physical activity (LVPA), and whether the relationship between participation in organized sports clubs and LVPA has changed from 1985 to 2014. Questionnaire data were collected in two cross-sectional samples of Finnish and Norwegian 11-, 13- and 15-year-olds in 1985/1986 (n = 7137) and 2014 (n = 9218). Overall, participation in organized sports clubs and level of LVPA appears to have changed in the same direction in the two Nordic countries. The proportion of 11-year-olds reporting to be participants in organized sports clubs increased from 1985/1986 to 2014. There was an overall increase in self-reported LVPA. The association between participation in sports clubs and LVPA was stronger in 2014 than in 1985/1986. The findings indicated subgroup differences, in particular with regard to a steeper increase in LVPA and participation in sports clubs among Finnish girls. We suggest that attention should be given to the role of organized sports to better understand secular changes in PA.

Cross-country comparisons of trends in adolescent psychosomatic symptoms - a Rasch analysis of HBSC data from four Nordic countries.

BACKGROUND: To analyse the psychometric properties of the HBSC Symptom Checklist (HBSC-SCL) on psychosomatic symptoms with a focus on the operating characteristics of the items, and on the impacts of measurement distortions on the comparisons of person measures across time and between countries. METHODS: Data were collected in 1993/94, 1997/98, 2001/02, 2005/06, 2008/09, 2013/14 in Denmark, Finland, Norway and Sweden as part of the Health Behaviour in School-aged Children (HBSC) study. Data comprised 116,531 students 11, 13 and 15 years old. Rasch analysis was conducted of the HBSC-SCL consisting of eight items with a focus on Differential Item Functioning (DIF) and item threshold ordering. The impacts of DIF and threshold disordering on trend analyses were analysed in a subsample consisting of 15 years old students. RESULTS: One item shows evidence of severe DIF and the categorisation of some items does not seem to work as intended. Analyses of changes based on proportions of psychosomatic symptoms show that bad item functioning affects some comparisons between countries across time: A four percentage point difference between 15 years old girls in Finland and Sweden concerning the rate of increase of psychosomatic symptoms from 1994 to 2014 disappears when the problems with DIF and disordered item thresholds are taken into account. Although the proportions of students with psychosomatic symptoms are clearly higher 2014 than 1994 in all four countries the shape of most trends is nonlinear. CONCLUSIONS: Some of the cross-country comparisons were distorted because of DIF and problems related to disordering of the item thresholds. The comparisons among girls between Finland and Sweden were affected by the problems pertaining to the original measure of psychosomatic symptoms, while the trend patterns among boys were not much affected. In addition to confirming increasing rates of adolescent mental health problems in the Nordic countries, the substantive analyses in the current study show that Finland is joining Sweden in having the sharpest increase among older adolescents, in particular among girls. To improve the functioning of the scale the DIF item could be removed or replaced and response categories collapsed in post hoc analyses.

Predictors of Gamblers Beliefs About Responsible Gambling Measures.

Responsible gambling (RG) measures are methods aimed at reducing and preventing negative consequences associated with gambling. Some RG measures are set by authorities or gambling operators while others are available as features for gamblers to use themselves (e.g. budget tools where personal monetary limits are set prior to gambling). The present study is based on a general gambler population and investigates how RG measures with some specific RG features are assessed by the gamblers. The data was collected in 2013 and 2015. The samples were drawn from the Norwegian Population Registry. In total 9129 gamblers participated. Gamblers were asked to state to which degree they agreed that ten specific RG measures help or would help them controlling their gambling. Overall, between 35 and 42% neither agreed nor disagreed, but among those with an opinion, most agreed. A multiple regression analysis identified eleven variables as significant predictors of positive beliefs about RG measures: female gender, young age, playing random games only, being a moderate risk or problem gambler, reporting high impact from gambling advertisements as well as the personality traits agreeableness, openness and neuroticism. Playing low risk games only, reporting a high amount of spending on gambling and the personality trait extraversion were inversely related to positive beliefs about RG measures. The total explained variance was however only 7.1%. Positive beliefs about RG measures can relate to needs for external based countermeasures to minimize or reduce problems. Negative views may reflect a wish to play without obstacles, take risks or to trust in self-control.

Health complaints among adolescents in Norway: A twenty-year perspective on trends.

PURPOSE: Examine time trends in health complaints among adolescents in Norway between 1994 and 2014 and among population subgroups, e.g., age and gender, as well as their interactions. METHODS: Norwegian data on 11-16-year-olds were drawn from the Health Behaviour in School-aged Children survey (HBSC) and analyzed for 1994 (n = 4,952), 1998 (n = 5,026), 2002 (n = 5,023), 2006 (n = 4,711), 2010 (n = 4,342) and 2014 (n = 3,422). Design adjusted linear regression that accounts for clustering effects was used to examine mean scores of two subscales of the HBSC-symptom checklist: psychological and somatic health complaints. RESULTS: Psychological and somatic health complaints among adolescents in Norway followed somewhat different trajectories, but the mean scores of both types of health complaints appeared to increase during the 20-year period. For psychological health complaints, there was a three-way interaction between age, gender and time, indicating that increasing trends in health complaints depended on both age and gender, in which older adolescent girls had a greater increase over time relative to younger adolescents and boys. CONCLUSIONS: Findings from this study, together with earlier findings, suggest that there has been an increasing trend in health complaints among adolescents in Norway from 1994 to 2014, especially among older adolescent girls. Future research should examine if trends in health complaints also depend on gender and age in other contexts. This will help the planning and implementation of tailored and effective interventions.

Are Video Games a Gateway to Gambling? A Longitudinal Study Based on a Representative Norwegian Sample.

The scope and variety of video games and monetary gambling opportunities are expanding rapidly. In many ways, these forms of entertainment are converging on digital and online video games and gambling sites. However, little is known about the relationship between video gaming and gambling. The present study explored the possibility of a directional relationship between measures of problem gaming and problem gambling, while also controlling for the influence of sex and age. In contrast to most previous investigations which are based on cross-sectional designs and non-representative samples, the present study utilized a longitudinal design conducted over 2 years (2013, 2015) and comprising 4601 participants (males 47.2%, age range 16-74) drawn from a random sample from the general population. Video gaming and gambling were assessed using the Gaming Addiction Scale for Adolescents and the Canadian Problem Gambling Index, respectively. Using an autoregressive cross-lagged structural equation model, we found a positive relationship between scores on problematic gaming and later scores on problematic gambling, whereas we found no evidence of the reverse relationship. Hence, video gaming problems appear to be a gateway behavior to problematic gambling behavior. In future research, one should continue to monitor the possible reciprocal behavioral influences between gambling and video gaming.

A Cross-Lagged Study of Developmental Trajectories of Video Game Engagement, Addiction, and Mental Health.

Objectives: Video game addiction has been associated with an array of mental health variables. There is a paucity of longitudinal studies investigating such associations, and studies differentiating addicted gaming from problem and engaged (i.e., frequent but non-problem) gaming. The current explorative study investigate the natural course of gaming behavior in three sub-studies. The aim of study 1 was to investigate antecedents and consequences of video game addiction measured as a unidimensional construct (pathological gaming). Aim of study 2 was to investigate the same associations in terms of typologies of gamers ("engaged," "problem," "addicted"). Furthermore, study 3 aimed to investigate the estimated stability and transitions occurring between the aforementioned typologies, and a non-pathological gaming group. Methods: A nationally representative sample of 3,000 adolescents aged 17.5 years was drawn from the population registry of Norway in 2012 and invited to participate in annual surveys spanning 3 years (NT1 = 2,059, NT2 = 1,334, NT3 = 1,277). The respondents completed measures of video game addiction, depression, anxiety, loneliness, aggression, and alcohol use disorder. Statistical analysis comprised cross-lagged path modeling, Satorra-Bentler chi square test (study 1), regression analyses (study 2), hidden Markov model of transition probabilities (study 3). Results: Findings in study 1 showed that depression and loneliness were reciprocally associated with pathological gaming. Physical aggression was identified as an antecedent, and anxiety was a consequence of pathological gaming. Investigation of the three typologies of gamers (study 2) identified loneliness and physical aggression as antecedents, and depression as a consequence of all typologies. Depression was found to be an antecedent of problem and engaged gamers. Loneliness was found as a consequence of problem gamers, and anxiety was a consequence of addicted gamers. High alcohol consumption was found antecedent to addicted gamers, and low alcohol consumption was found antecedent to problem gamers. The estimated stability of video game addiction was 35%. Conclusion: A reciprocal relationship between pathological gaming and measures of mental health problems seems to exist. The stability of video game addiction indicates a condition that for a substantial number of people does not resolve spontaneously over the course of 2 years.