The prevalence of potentially traumatic events in the seventh survey of the population-based Tromsø study (Tromsø 7).

Aims: Potentially traumatic events (PTEs) can have detrimental consequences for an individual's physical and mental health. Exposure to PTEs is therefore increasingly assessed in population-based studies. Consistent with this trend, the most recent wave of the longitudinal population-based Tromsø study (Tromsø 7) in Northern Norway included a list of PTEs. The aim of the present study was to describe the prevalence of PTEs in the sample and examine demographic correlates of reported PTE exposure in this group. Methods: In Tromsø 7, a total of 21,083 participants aged ⩾40 years (52.5% female, mean age 57.3 years) were asked about exposure to nine PTEs that occurred in childhood, in adulthood and in the previous year. Differences between demographic groups in exposure to PTEs were examined using chi-square tests and logistic regression analyses. Results: Overall, 67% of the participants reported at least one PTE across the three time intervals. A life-threatening illness or serious accident of a loved one (36.8%) or of the respondent (24.0%) and bullying (21.5%) were the most frequently reported PTEs. Female sex, younger age, indigenous or immigrant ethnicity and higher education were associated with an increased likelihood of reporting at least one PTE. Group differences with respect to specific PTEs were observed. Conclusions: The experience of PTEs is common among the participants in the Tromsø 7 study. The current study lays the foundation for further research into the associations between PTEs and physical and mental health within the Tromsø study.

Epidemiology of comorbid hazardous alcohol use and insomnia in 19 185 women and men attending the population-based Tromsø Study 2015-2016.

BACKGROUND: Hazardous alcohol use is known to be comorbid with insomnia problems. The present study examined the prevalence of insomnia and if the odds of insomnia differed between women and men with a hazardous alcohol use. METHODS: Cross-sectional data from the seventh survey of the Norwegian population-based Tromsø Study 2015-2016 (participation 65%). The sample included 19 185 women and men 40-96 years. Hazardous alcohol use was defined by the Alcohol Use Disorder Identification Test (AUDIT) and insomnia by the Bergen Insomnia Scale. Covariates included socio-demographics, shift work, somatic conditions and mental distress defined by Hopkins Symptom Check List-10 (HSCL-10). Mental distress was also included as a moderator. RESULTS: Insomnia was more prevalent among participants with a hazardous alcohol use (24.1%) than without (18.9%), and participants who had hazardous alcohol use had higher odds of insomnia (odds ratio = 1.49, 95% CI = 1.20, 1.85). The association turned non-significant after adjustment for mental distress. Adding mental distress as a moderator variable revealed a higher odds of insomnia among hazardous alcohol users having no or low-to-medium levels of mental distress, but not among participants with high levels of mental distress. CONCLUSION: Insomnia was more prevalent among women and men reporting hazardous alcohol use. When mental distress was treated as a moderator, hazardous alcohol use did not yield higher odds for insomnia among those with high levels of mental distress. This suggests that mental distress may play an important role in the association between hazardous alcohol use and insomnia. And that the impact of alcohol on insomnia may differ depending on the severity of mental distress.

Dental anxiety and potentially traumatic events: a cross-sectional study based on the Tromsø Study-Tromsø 7.

OBJECTIVE: The objectives of the study were to describe the prevalence of dental anxiety and the possible associations between dental anxiety and potentially traumatic events in an adult population. METHOD: The study is based on cross-sectional questionnaire data from the 7th wave of the Tromsø Study, a study of the adult general population in the municipality of Tromsø carried out in 2015-2016. The Modified Dental Anxiety Scale was used to measure dental anxiety across potentially traumatic events, oral health, dental attendance (avoidance) and current mental health symptoms (Hopkins Symptom Checklist). Individuals with high and low dental anxiety scores were compared to investigate differences in the distribution of potentially traumatic events, current mental health symptoms, avoidance, sex and oral health, and hierarchical multivariable regression was used to study the influence of traumatic events on dental anxiety. RESULTS: High dental anxiety was reported by 2.9% of the sample and was most prevalent among females and in the youngest age groups. Individuals with high dental anxiety reported more current mental health symptoms, and they were more likely to report poorer oral health and more irregular dental visits compared to individuals with no or lower dental anxiety scores. Concerning traumatic events, the reporting of painful or frightening dental treatment showed the biggest difference between those with high dental anxiety and low dental anxiety scores (a moderate effect). The hierarchical regression model indicated that reporting sexual abuse, traumatic medical treatment in hospital and childhood neglect significantly predicted dental anxiety in the step they were entered in, but only sexual abuse remained a significant individual contributor after controlling for current mental health symptoms. CONCLUSIONS: The prevalence of high dental anxiety was lower than expected (2.9%), but dentally anxious individuals expressed a high burden of mental health symptoms, poor oral health and the avoidance of dental care. The regression analysis indicated that experiences with sexual abuse could affect dental anxiety levels in the absence of generalised symptoms of anxiety and depression.

Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: results from the Northern Babies Longitudinal Study (NorBaby).

BACKGROUND: Families can experience the postpartum period as overwhelming and many report a special need for support. The Newborn Behavioral Observation (NBO) aims to promote a positive parent-infant relationship by sensitising parents to the infant's signals. This article evaluates the NBO as a universal preventive intervention within the regular well-baby clinic service on measures of maternal depressive symptoms, parental stress, the mother-infant relationship and satisfaction/benefit of the postpartum follow-up. METHODS: This investigation is part of a larger longitudinal study comprising 220 women and 130 of their partners recruited between 2015 and 2017. The study had a non-randomised cluster-controlled design with 6 measurement points. This article is based on a sample of 196 women using data from T1 (gestational weeks 13-39), T4 (5-15 weeks postpartum) and T5 (3-9 months postpartum). Participants were allocated to a group receiving the NBO (n = 82) and a care as usual comparison group (n = 114). We measured maternal depressive symptoms and parental stress using the Edinburgh Postnatal Depression Scale (EPDS) and the Parenting Stress Index (PSI). The mother-infant relationship was assessed with the Parental Reflective Functioning Questionnaire (PRFQ), the Maternal Postnatal Attachment Scale (MPAS) and the Maternal Confidence Questionnaire (MCQ). Participants also answered questions about satisfaction/benefit of the postpartum follow-up. RESULTS: A Mann-Whitney U test indicated that participants in the NBO-group learned significantly more than the comparison group from the follow-up about the baby's signals in relation to sleep/sleep patterns, social interaction and crying/fuzziness. Multivariate analyses of covariance (MANCOVA) and repeated measures ANCOVA found no significant differences between the groups for the mother-infant relationship domain and few differences in depressive symptoms and parental stress. The repeated measures ANCOVA found that participants in the NBO-group scored slightly higher on parental stress, although the difference was small. CONCLUSIONS: The results indicate that the NBO-group learned more than the comparison group about reading their child's signals in important everyday situations. However, the benefits of the NBO were limited for depressive symptoms, parental stress and self-reported mother-infant relationship. The study sample was generally well-functioning, and the results indicate that the benefits of the NBO may be limited within a well-functioning sample. TRIAL REGISTRATION: ClinicalTrials, NCT02538497, Registered 2 September 2015.

Gender differences in the bidirectional relationship between alcohol consumption and sleeplessness: the Tromsø study.

BACKGROUND: The degree to which the relationship between alcohol use and sleeplessness is unidirectional or reciprocal is unclear due to great variation among the results of previous studies. The aim of the present study was to investigate if the relationship between alcohol use and sleeplessness is bidirectional by exploring how the change in and stability of alcohol use were related to sleeplessness, and vice versa, how the change in and stability of sleeplessness were related to alcohol use, in a longitudinal study spanning 13 years. METHOD: Data were collected from 9941 adults who participated in two waves (T1: 1994-1995, and T2: 2007-2008) of the Tromsø Study, a Norwegian general population health study. Alcohol use was measured by questions asking about the frequency of drinking, amounts of alcohol normally consumed and the frequency of binge drinking, whereas sleeplessness was measured by one item asking about the frequency of experiencing sleeplessness. Variables representing change in and stability of consumption of alcohol and sleeplessness from T1 to T2 were created. Logistic regression analyses, stratified by gender, were used to analyze the data. RESULTS: Men reporting stable high (OR = 2.11, p. < .001) or increasing (OR = 1.94, p. < .01) consumption of alcohol from T1 to T2 had a significantly higher risk of reporting sleeplessness at T2. Likewise, men experiencing stable (OR = 1.84, p. < .01) or increasing (OR = 1.78, p. < .001) sleeplessness from T1 to T2 had a significantly higher risk of reporting high consumption of alcohol at T2. No significant effects were detected among women. CONCLUSION: The findings indicate a bidirectional relationship between high consumption of alcohol and sleeplessness only among men. Thus, healthcare professionals ought to be informed about the health risks associated with excessive drinking and struggling with sleeplessness, especially in men.

Change in physical activity is not associated with change in mental distress among adolescents: the Tromsø study: Fit Futures.

BACKGROUND: Previous research shows that physical activity has a protective effect on mental distress in adults, but the relationship is less researched and seems more ambiguous for adolescents. Studies in this field have typically been cross-sectional by design and based on self-reported physical activity measures, which are known to be vulnerable to response bias. The aim of this study was to investigate the relationship between change in objectively assessed physical activity as measured by accelerometer and change in mental distress among adolescents using longitudinal data from The Tromsø Study: Fit Futures. METHOD: This study was based on data from 676 upper-secondary school students (mean age 16.23 years at baseline, 45.26% boys) from The Tromsø Study: Fit Futures. Physical activity, mental distress and covariates were measured at baseline (T1) and follow-up (T2) 2 years later. Physical activity was objectively measured with an ActiGraph GT3X accelerometer over 7 days. Mental distress was measured with the Hopkins Symptom Checklist-10 (HSCL-10). Change score variables were computed as the difference between T1 and T2 in number of steps, number of minutes of moderate to vigorous physical activity (MVPA) and mental distress between T1 and T2, and analyzed using linear regression analysis. RESULTS: Changes in steps per day were not associated with changes in mental distress in neither the crude, partially, nor fully adjusted model. Neither was changes in minutes of MVPA per day. Interaction effects between change in both steps per day and minutes of MVPA and gender were also not statistically significant, nor was the interaction effects between baseline levels of mental distress and physical activity. CONCLUSION: The results of our study indicate that for adolescents in the sample, change in physical activity is unrelated to change in mental distress over a two-year period.

Attitudes Towards the Use of Routine Outcome Monitoring of Psychological Therapies Among Mental Health Providers: The EBPAS-ROM.

Implementation of routine outcome monitoring (ROM) in mental health care is progressing slowly. Knowledge about factors influencing ROM implementation, including health providers' attitudes towards ROM, is necessary. Based on a survey of 662 psychologists and nurses, this article describes (1) the development of a short instrument measuring provider attitudes towards ROM, derived from the Evidence-based Practice Attitude Scale (EBPAS), and (2) how attitudinal domains relate to clinicians' current use of standardized instruments for treatment evaluation. The EBPAS-ROM showed concurrent validity in predicting aspects important for the implementation of ROM, including perceived limitations and the value of organizational support.

Mental distress predicts divorce over 16 years: the HUNT study.

BACKGROUND: The association between mental distress and divorce is well established in the literature. Explanations are commonly classified within two different frameworks; social selection (mentally distressed people are selected out of marriage) and social causation (divorce causes mental distress). Despite a relatively large body of literature on this subject, selection effects are somewhat less studied, and research based on data from both spouses is scarce. The purpose of the present study is to investigate selection effects both at the individual level and the couple level. METHODS: The current study is based on couple-level data from a Norwegian representative sample including 20,233 couples. Long-term selection effects were tested for by means of Cox proportional hazard models, using mental distress in both partners at baseline as predictors of divorce the next 16 years. Three identical sets of analyses were run. The first included the total sample, whereas the second and third excluded couples who divorced within the first 4 or 8 years after baseline, respectively. An interaction term between mental distress in husband and in wife was specified and tested. RESULTS: Hazard of divorce was significantly higher in couples with one mentally distressed partner than in couples with no mental distress in all analyses. There was also a significant interaction effect showing that the hazard of divorce for couples with two mentally distressed partners was higher than for couples with one mentally distressed partner, but lower than what could be expected from the combined main effects of two mentally distressed partners. CONCLUSIONS: Our results suggest that mentally distressed individuals are selected out of marriage. We also found support for a couple-level effect in which spouse similarity in mental distress to a certain degree seems to protect against divorce.

Factors differentiating risk of sexual abuse victimization by adults and peers among adolescents.

BACKGROUND: Research suggests that around half of all cases of sexual abuse among children and adolescents are perpetrated by peers. Yet, there is limited understanding of the distinct risk factors associated with adult versus peer offenders. OBJECTIVE: To identify factors that increase the risk of sexual abuse victimization and explores variations in these factors depending on whether the perpetrator was an adult or a peer. PARTICIPANTS AND SETTING: 9240 secondary school students aged between 12 and 16 years (M = 14, SD = 0.88) in Norway participated. METHODS: An electronic questionnaire was administered in schools to investigate experiences of sexual abuse and potential risk factors. The data were analyzed using multiple logistic regression analyses. RESULTS: Two factors were related to a greater risk of being a victim of sexual abuse committed by an adult than a peer: background from a non-European country (OR = 1.93, p = 0.038) and other experiences of violence (OR = 1.63-2.91, p < 0.005). The use of alcohol was found to be related to a greater risk of victimization by peers than by adults (OR = 0.53, p = 0.031). CONCLUSIONS: Adolescents vulnerable to sexual abuse exhibit common traits, regardless of whether the perpetrator is an adult or peer. Yet, specific factors heighten the risk with peers over adults, and vice versa. Recognizing distinct risk factors for abuse by adults and peers enables decision-makers and community workers to create targeted prevention strategies for children and adolescents.

Alcohol use and spousal mental distress in a population sample: the Nord-Trøndelag Health Study.

BACKGROUND: It is a widely held notion that alcohol abuse is related to mental distress in the spouse. Research has substantiated this notion by showing a tendency for spouses of alcohol abusers to experience more mental distress than spouses of non-abusers. However, the picture seems to be more complex, as some results do not show a significant effect or even less mental distress among spouses of alcohol abusers with the highest alcohol consumption. The present study investigates the association between spousal mental distress and both a high consumption of alcohol and having experienced alcohol related problems. METHODS: Norwegian population-based questionnaire data from the Nord-Trøndelag Health Study (HUNT 2) were analyzed. In total 11,584 couples were eligible for analysis. Alcohol consumption was measured by numerical indicators of alcohol amount and frequency of drinking, whereas alcohol-related problems (i.e. having been criticized for excessive drinking) were measured by the CAGE Alcohol Screening Questionnaire. Multivariate hierarchical regression analyses were performed. RESULTS: Results revealed that alcohol consumption was significantly associated with a decrease in spousal mental distress, whereas alcohol-related problems were associated with an increase in spousal mental distress when adjusted for each other. Interaction effects indicated that couples discordant for drinking problems experienced more mental distress than spouses concordant for drinking problems. CONCLUSIONS: The results of our study indicate that alcohol-related problems constitute a clear risk factor for spousal mental distress. On the other hand, a high consumption of alcohol per se was related to lower levels of spousal mental distress, after adjusting for the alcohol-related problems perceived by the alcohol consumer him/herself. All effect sizes were small, but the trends were clear, challenging the notion that a high consumption of alcohol is exclusively and under all circumstances negative for the spouse.

More mental health problems after divorce in couples with high pre-divorce alcohol consumption than in other divorced couples: results from the HUNT-study.

BACKGROUND: Divorce is associated with mental health problems, and heavy drinking is related to higher risk of divorce. Less is known about the effects of divorce in couples where one or both drinks heavily. There are, however, reasons to expect different consequences of divorce in heavy risk using couples compared to other couples. Spouses of abusers may experience the divorce as a relief, whereas abusers may find it extra difficult to be left single. The aim of the study is to compare the effect of divorce on mental health in heavy drinking couples to the effect in couples who drink less. METHODS: Registry data were matched with data from the Nord-Trøndelag Health Study (HUNT 1 (T1) and 2 (T2)), enabling longitudinal analyses of approximately 11,000 couples. Interaction terms between 1) alcohol use on T1 and divorce between T1 and T2 (11 year time lag), and 2) alcohol use on T1 and time since divorce at T2 for all divorced couples were tested to examine changes in mental health between T1 and T2 for a) spouses of high-risk compared to low-risk users, and b) high-risk compared to low-risk users themselves. Data were analyzed using multivariate analysis of variance. RESULTS: There was a general effect of divorce on change in mental health between T1 and T2. We observed a significantly stronger worsening in mental health in female high-risk users and their spouses than in divorced low-risk users and their spouses. The results also suggest that the strain after divorce lasts longer in women with a high alcohol consumption and their spouses. CONCLUSIONS: Divorce seems to affect couples where one or both drink heavily more than couples with a low consumption. Also there was some evidence of a slower healing of mental health problems after divorce in alcohol exposed couples than in other couples. The results only reached significance for female high consumers and their spouses, but due to limited statistical power, safe conclusions about gender specific effects cannot be drawn.

Associations between stressful life events in childhood/adolescence and adulthood: results from the 7th Tromsø survey.

BACKGROUND: Exposure to highly stressful life events (SLEs), such as accidents, violence, or serious illness, is common. With the accumulation of SLEs, the risk of detrimental somatic and mental health outcomes increases. To understand patterns of SLE exposure, research into the associations between SLEs is needed. METHOD: The sample comprised 21,069 participants of the population-based Tromsø7 (2015/2016) study (52.7% female, mean age = 57.3 years, SD = 11.4 years). Participants were asked whether they had experienced eleven SLEs in childhood/adolescence and adulthood. Correlations, network analysis, and logistic regression analysis were used to examine the associations between SLEs. RESULTS: Medium-sized to large correlations between SLEs in childhood/adolescence and SLEs in adulthood were found. Two clusters of SLEs emerged in the network analysis in childhood/adolescence and in adulthood, respectively, interpreted as interpersonal (e.g. violence and sexual abuse) and impersonal SLEs (e.g. a life-threatening illness or serious accident). SLEs in childhood/adolescence predicted the number of SLEs in adulthood as well as exposure to the specific SLE categories in adulthood. Childhood neglect was an important predictor of SLE exposure in adulthood. CONCLUSIONS: Public health policies should focus on the prevention of SLEs and the early intervention after SLE exposure, especially childhood neglect.

Highly stressful life events (SLEs) are systematically interconnected.SLEs in childhood and adolescence are associated with exposure to SLEs in adulthood.Childhood physical and emotional neglect is strongly related to other SLEs in childhood/adolescence and adulthood.

Non-random mating and convergence over time for alcohol consumption, smoking, and exercise: the Nord-Trøndelag Health Study.

Spouses tend to have similar lifestyles. We explored the degree to which spouse similarity in alcohol use, smoking, and physical exercise is caused by non-random mating or convergence. We used data collected for the Nord-Trøndelag Health Study from 1984 to 1986 and prospective registry information about when and with whom people entered marriage/cohabitation between 1970 and 2000. Our sample included 19,599 married/cohabitating couples and 1,551 future couples that were to marry/cohabitate in the 14-16 years following data collection. All couples were grouped according to the duration between data collection and entering into marriage/cohabitation. Age-adjusted polychoric spouse correlations were used as the dependent variables in non-linear segmented regression analysis; the independent variable was time. The results indicate that spouse concordance in lifestyle is due to both non-random mating and convergence. Non-random mating appeared to be strongest for smoking. Convergence in alcohol use and smoking was evident during the period prior to marriage/cohabitation, whereas convergence in exercise was evident throughout life. Reduced spouse similarity in smoking with relationship duration may reflect secular trends.

Paternal and maternal alcohol abuse and offspring mental distress in the general population: the Nord-Trøndelag health study.

BACKGROUND: The degree to which parental alcohol abuse is a risk factor for offspring mental distress is unclear, due to conflicting results of previous research. The inconsistencies in previous findings may be related to sample characteristics and lack of control of confounding or moderating factors. One such factor may be the gender of the abusing parent. Also, other factors, such as parental mental health, divorce, adolescent social network, school functioning or self-esteem, may impact the outcome. This study examines the impact of maternal and paternal alcohol abuse on adolescent mental distress, including potentially confounding, mediating or moderating effects of various variables. METHODS: Data from the Nord-Trøndelag Health Study (HUNT), a Norwegian population based health survey, from 4012 offspring and their parents were analyzed. Parental alcohol abuse was measured by numerical consumption indicators and CAGE, whereas offspring mental distress was measured by SCL-5, an abbreviated instrument tapping symptoms of anxiety and depression. Statistical method was analysis of variance. RESULTS: Maternal alcohol abuse was related to offspring mental distress, whereas no effect could be shown of paternal alcohol abuse. Effects of maternal alcohol abuse was partly mediated by parental mental distress, offspring social network and school functioning. However, all effects were relatively small. CONCLUSIONS: The results indicate graver consequences for offspring of alcohol abusing mothers compared to offspring of alcohol abusing fathers. However, small effect sizes suggest that adolescent offspring of alcohol abusing parents in general manage quite well.

Alcohol use and mental distress as predictors of non-response in a general population health survey: the HUNT study.

PURPOSE: To investigate to what degree alcohol use and mental distress are associated with non-response in a population-based health study. METHODS: From 1995 to 1997, 91,488 persons were invited to take part in a health study at Nord-Trøndelag, Norway, and the response rate was 69.2%. Demographics were available for everyone. Survey answers from a previous survey were available for most of the participants and a majority of non-participants. In addition, the survey responses from spouses and children of the invitees were used to predict participation in the aforementioned study. Crude and adjusted ORs for a number of predictors, among these alcohol consumption and mental distress, are reported. RESULTS: Both heavy drinkers (OR = 1.27) and abstainers (OR = 1.64) had a higher probability of dropping out in comparison to people who usually do not drink. High levels of mental distress (OR = 1.84) also predicted attrition. CONCLUSION: Alcohol use and mental distress are moderately associated with non-response, though probably not a major cause, as controlling for other variables weakened the associations. Nevertheless, the moderate but clear underrepresentation at the crude level of people with high alcohol consumption, abstainers and people with poor mental health should be taken into consideration when interpreting results from health surveys.

Affective Valence and Enjoyment in High- and Moderate-High Intensity Interval Exercise. The Tromsø Exercise Enjoyment Study.

Introduction: Exercise at high intensity may cause lower affective responses toward exercise compared with moderate intensity exercise. We aimed to elucidate affective valence and enjoyment in high- and moderate-high interval exercise. Methods: Twenty recreationally active participants (9 females, 11 males, age range: 20-51 years) underwent three different treadmill running exercise sessions per week over a 3-week period, in randomized order; (1) CE70: 45 min continuous exercise at 70% of heart rate maximum (HRmax), (2) INT80: 4 × 4 min intervals at 80% of HRmax, (3) INT90: 4 × 4 min intervals at 90% of HRmax. Pre-tests included graded submaximal steady state intensities and a test to exhaustion for determining peak oxygen uptake and HRmax. Affective valence (pleasure/displeasure) was measured before, during and after the sessions using the Feeling Scale (FS). Enjoyment was assessed before and after the sessions applying the Physical Activity Enjoyment Scale (PACES) and during the sessions using the Exercise Enjoyment Scale (EES). Results: The participants felt lower pleasure (between-sessions effect: p = 0.02, p η2: 0.13) during INT90 sessions (FS: 1.08, 95% CI: 0.35-1.92) compared with INT80 (FS: 2.35, 95% CI: 1.62-3.08, p = 0.052) and CE70 sessions (FS: 2.45, 95% CI: 1.72-3.18, p = 0.03), with no differences between INT80 and CE70 sessions (p = 1.00). There were higher enjoyment after INT80 sessions (PACES: 101.5, 95% CI: 95.7-107.3) versus CE70 sessions (PACES: 91.3 95% CI: 85.5-97.1, p = 0.046), and no differences between INT90 (PACES: 98.2, 95% CI: 92.4-103.4) and CE70 (p = 0.29) or INT80 (p = 1.00). For enjoyment during exercise, CE70 were perceived more enjoyable, and INT80 and INT90 less enjoyable in week 2 (EES: week x session: p = 0.01, p η2: 0.11; CE70: 4.3, 95% CI: 3.6-4.9, INT80: 4.6, 95% CI: 3.9-5.2, INT90: 4.0, 95% CI: 3.4-4.7) and 3 (EES: CE70: 4.2, 95% CI: 3.7-4.8, INT80: 4.8, 95% CI: 4.2-5.3, INT90: 4.3, 95% CI: 3.8-4.9) than in week 1 (EES: CE70: 3.5, 95% CI: 3.0-4.0, INT80: 5.0, 95% CI: 4.5-5.5, INT90: 4.5, 95% CI: 4.0-5.0). Conclusion: The negative affective consequences associated with high intensity interval exercise can be alleviated by keeping the intensity at or around 80% of HRmax while preserving the beneficial enjoyment responses associated with interval exercise.

Corrigendum: C-Reactive Protein and TGF-α Predict Psychological Distress at Two Years of Follow-Up in Healthy Adolescent Boys: The Fit Futures Study.

[This corrects the article DOI: 10.3389/fpsyg.2022.823420.].

C-Reactive Protein and TGF-α Predict Psychological Distress at Two Years of Follow-Up in Healthy Adolescent Boys: The Fit Futures Study.

Objective: The scarcity of research on associations between inflammatory markers and symptoms of depression and anxiety during adolescence has yielded inconsistent results. Further, not all studies have controlled for potential confounders. We explored the associations between baseline inflammatory markers and psychological distress including moderators at follow-up in a Norwegian adolescent population sample. Methods: Data was derived from 373 girls and 294 boys aged 15-18 years at baseline, in the Fit Futures Study, a large-scale 2-year follow-up study on adolescent health. Baseline data was gathered from 2010 to 2011 and follow-up data from 2012 to 2013. Psychological distress was measured with Hopkins Symptom Checklist (HSCL-10). Serum levels of the following inflammatory markers were measured: C-reactive protein (CRP), Interleukin 6 (IL-6), Transforming growth factor alpha (TGF-α), Tumor necrosis factor alpha variant 1 (TRANCE), and variant 2 (TWEAK). Independent associations between baseline inflammatory markers and HSCL-10 at follow-up were explored by linear regressions, in sex-stratified analyses. Results: In girls, analyses showed positive associations between all inflammatory markers and HSCL-10, except for TRANCE. However, all associations were non-significant in crude as well as in adjusted analyses. In boys, CRP (p = 0.03) and TGF-α (p < 0.01) showed significant associations with HSCL-10, that remained significant after adjustment. Additionally, moderators were found. In boys, CRP was associated with HSCL-10 in those with high body fat and those being physical inactive, and the association between TWEAK and HSCL-10 was dependent upon sleep duration. Conclusion: There were significant prospective associations between CRP, TFG-α, and HSCL-10 in boys aged 15-18 years at baseline.

Assessment of mental health trajectories before and after myocardial infarction, atrial fibrillation or stroke: analysis of a cohort study in Tromsø, Norway (Tromsø Study, 1994-2016).

OBJECTIVES: The increased survival rate of cardiovascular disease (CVD) implies a higher proportion of individuals who live with CVD. Using data from the Tromsø Study, we aimed to investigate mental health symptom trajectories before and after myocardial infarction, atrial fibrillation or stroke in a general population and to explore factors that contribute to the association. DESIGN: Cohort study. SETTING: Sample drawn from inhabitants of the municipality of Tromsø, Norway, who participated in the Tromsø Study (1994-2016). PARTICIPANTS: A total of 18 719 participants (52.3% women) were included, and of these 2098 (32.9% women) were diagnosed with myocardial infarction, 1896 (41.9% women) with atrial fibrillation and 1263 (42.9% women) with stroke. PRIMARY OUTCOME MEASURES: Mental health symptoms were assessed using the Hopkins Symptom Checklist-10 and the Conor Mental Health Index. RESULTS: The participants who were diagnosed with either myocardial infarction or stroke had a significant monotonous increase in mental health symptoms before myocardial infarction (p=0.029) and stroke (p=0.029) that intensified at the time of diagnosis. After the event, the study found a higher prevalence of mental health symptoms with a decline in symptom levels over time for myocardial infarction (p<0.001) and stroke (p=0.004), but not for atrial fibrillation (before: p=0.180, after: p=0.410). The risk of elevated mental health symptoms with myocardial infarction, atrial fibrillation and stroke was associated with sex (p<0.001), age (p<0.01), physical activity (p<0.001), diabetes (p<0.05) and other comorbidities (p<0.001). CONCLUSION: The study indicates that mental health problems among individuals with myocardial infarction, atrial fibrillation and stroke may have started to develop several years before the cardiovascular event and suggests that successful CVD rehabilitation may need to consider previous life factors. Future research is recommended to examine whether health promotion measures in a general population also create mental health resilience after a CVD event.

Are pro-inflammatory markers associated with psychological distress in a cross-sectional study of healthy adolescents 15-17 years of age? The Fit Futures study.

BACKGROUND: Inflammatory markers have been associated with depression and anxiety disorder in adolescents. Less is known about the association between inflammation and subclinical symptoms in the form of psychological distress. We investigated prevalence of psychological distress and examined the associations between common pro-inflammatory markers and psychological distress in an adolescent population sample. METHODS: The study was based on data from 458 girls and 473 boys aged 15-17 years from the Fit Futures Study, a large-scale study on adolescent health, conducted in Northern Norway. Psychological distress was measured with the Hopkins Symptom Checklist (HSCL-10). Serum-levels of the following low-grade inflammatory markers were measured: C-reactive protein (CRP), interleukin 6 (IL-6), transforming growth factor-alpha (TGF-α), tumor necrosis factor alpha variant 1 (TRANCE) and tumor necrosis factor alpha variant 2 (TWEAK). Associations between quartiles of inflammatory markers and HSCL-10 were examined by logistic regression and adjusted for potential confounders in sex-stratified analyses. RESULTS: The proportion of psychological distress above cutoff were 26.9% and 10.8% among girls and boys, respectively. In both girls and boys, crude analysis showed positive associations between all inflammatory markers and HSCL-10, except for TWEAK and TRANCE in boys. However, none of these associations were statistically significant. Further, there were no significant findings in the adjusted analyses. CONCLUSION: There was a higher prevalence of psychological distress in girls compared to boys. Pro-inflammatory markers were not significantly associated with psychological distress in data from healthy adolescents aged 15-17 years.