Treatment of substance use disorders in adolescence and early school leaving.

OBJECTIVE: To examine early school leaving in a longitudinal cohort of all high school students treated for substance use disorder (SUD) and their demographic counterparts in Norway. METHOD: From the National Patient and National Population Registries, we extracted (a) all high school students born in 1991-1992 who received SUD treatment during 2009-2010 (N = 648; nalcohol = 95, ncannabis = 327, and nother drugs = 226) and (b) their age-and-gender matched counterparts (n = 647). From the National Educational Database, we obtained enrollment and graduation status for these two cohorts throughout the designated school period of 5 years. We estimated the hazards of early school leaving as a function of students' treatment for alcohol, cannabis, and other drug use disorders and other known risk factors. RESULTS: Nine out of 10 adolescents receiving SUD treatment left high school early (89%) compared with one in four (27%) from the matched cohort; 422 (73.5%) of these left high school during or after the treatment year. Multivariate discrete-time models revealed significant and ordered associations between receiving SUD treatment and early school leaving, HRalcohol = 3.09 [1.96, 4.89], HRcannabis = 3.83 [2.64, 5.56], HRother drugs = 5.16 [3.32, 8.03], even after accounting for individual-level (sex, immigrant background, criminal charges, and mental health treatment), family-level (family structure, parental education, and family income), and structural risk factors (municipal size, county employment, and dropout rates). CONCLUSION: Adolescents receiving SUD treatment remain especially vulnerable for early school leaving. These findings underscore the importance of improving and coordinating health and educational services for youth in SUD treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Sexting and Mental Health in Adolescence: A Longitudinal Study.

PURPOSE: Research has shown that sexting-the practice of sending, receiving, and forwarding sexual messages on digital media services-is associated with poor mental health. However, few studies have moved beyond cross-sectional designs, demonstrating that individuals who engage in sexting differ in mental health from those who do not. The purpose of our study was to investigate whether sexting was associated with increases in depression symptoms and conduct problems over time. METHODS: We analyzed data from three rounds of the longitudinal MyLife study among Norwegian adolescents (n = 3,000). The participants completed e-questionnaires containing instruments on sexting and mental health at three annual assessments. Random intercept cross-lagged panel models were estimated to examine the effect of sexting on within-person changes in mental health, measured one year later. We also examined the potential reverse order of the effects. RESULTS: In accordance with findings from cross-sectional research, the analyses showed that boys who frequently engaged in sexting also reported more depression symptoms and conduct problems. For girls, we found only a significant between-person association for sexting and depression symptoms. However, sexting was not predictive of changes in depression symptoms or conduct problems over time. On the contrary, conduct problems predicted increased sexting scores but only for girls. DISCUSSION: Our results suggest that efforts to reduce sexting may not prevent mental health problems among young people. Intervention efforts should thus redirect attention from sexting as a driver of individual mental health problems to educating adolescents on how to perform safe and responsible sexting.

Sports participation moderates the risk of family-specific negative life events on alcohol use among adolescents: Evidence from the longitudinal MyLife study.

Negative life events (NLE) have been associated with increased alcohol use (AU) during adolescence. However, whether this risk association may be modified by leisure activities such as sports participation (SP) remains poorly understood. This study examined whether accumulated family-specific NLE in particular were associated with greater AU, and if so, whether SP moderated this association to reduce AU among high-NLE adolescents. We examined five annual assessments from a nationwide cohort of 3,422 Norwegian adolescents (13-15 year-olds; 55.3 % girls at baseline) who participated in the MyLife study. At each assessment, adolescents reported their AU on the Alcohol Use Disorders Identification Test-Concise (AUDIT-C), the number of family-specific NLE in the past 12 months, SP days in the past 30 days, and multiple sociodemographic and individual-level characteristics (covariates). Changes over time in AU as a function of NLE, SP, and their interaction (NLExSP) were examined with a set of partially nested growth curve models. AU increased non-linearly over time in all models. The fully adjusted best-fitting model showed significant NLExSP interactions (estimate = -0.013, 95% CI [-0.02, -0.006]), such that the initial AUDIT-C scores were lower for high-NLE adolescents with high SP and greater for high-NLE adolescents with low SP. Further, linear increases in AU over time were marginally steeper for high-NLE adolescents with high SP (NLExSPxTime estimate = 0.034, 95% CI [-0.0002, 0.007]). Thus, SP appeared to have a protective role in reducing AU for high-NLE youth primarily during middle school years. Prevention efforts thus may utilize organized sports for youth facing family-specific NLE as a resource early on.

Attitudes Toward Cannabis Use Legalization and Openness to Legal Use Among Young Partygoers in Norway.

OBJECTIVE: The purpose of this study was to examine attitudes toward legalization of cannabis use and openness to legal use among Norwegian partygoers. METHOD: We examined a combined sample (N = 4,790; 46.2% female) of young partygoers (M age = 23.7, SD = 7.3) from three Norwegian studies on substance use in various settings: music festivals (n = 1,312), nightlife (n = 2,005), and high school graduation (n = 1,473). Through onsite surveys, the participants were asked if they thought cannabis use should be legal in Norway and whether they themselves would use the drug if legalized. These responses (yes/no/don't know) were examined in relation to participants' characteristics and cannabis use history using summary statistics and multinomial regression models. RESULTS: Although 46.1% of participants reported having used cannabis at least once, only 1/3 (32.6%) favored legalization and 1/4 (25.6%) stated they would themselves use cannabis if legalized. Yet, even among never-users, we observed non-opposition to legalization (16.4% in favor; 14.9% don't know) and openness to legal use (8.2% would use; 12.4% don't know). Histories of cannabis, tobacco, or any other drug use, sex (male), and age younger than 21 years (vs. 30 or older) were consistently associated with affirmative responses to both questions. Openness to legal use was strongly associated with favorable legalization attitudes and age younger than 21, even after accounting for lifetime cannabis use history. CONCLUSIONS: Favoring cannabis legalization and openness to legal use were relatively low in this sample of young Norwegian partygoers. Yet, prevalence of cannabis use may increase after legalization among its supporters and among those younger than 21, especially if "don't know" responses are considered.

Parental drinking, mental health and education, and extent of offspring's healthcare utilisation for anxiety/depression: A HUNT survey and registry study.

AIMS: Certain risk constellations of parental drinking, mental health and years of education are prospectively associated with offspring's risk for a diagnosis of anxiety/depression, but it remains unknown how they may relate to other aspects of offspring's mental health. We examined whether such risk constellations were also prospectively associated with the extent of offspring's utilisation of healthcare services for anxiety/depression. METHODS: The sample included 8773 adolescent offspring of 6696 two-parent families who participated in the Nord-Trøndelag Health Study in Norway. The exposures consisted of five parental risk constellations characterised by drinking frequencies and quantities, years of education and mental health previously derived based on the parental self-reports using latent profile analysis. The outcomes were the number of years in contact, and the total number of consultations/visits, with healthcare services for anxiety/depression in adolescents and young adults as recorded in healthcare registries in the period 2008-2014. Associations were examined using zero-inflated negative binomial regression models, accounting for demographics and offspring's early mental health. RESULTS: Parental risk constellations were not significantly associated with the extent of offspring's healthcare utilisation for anxiety/depression during the seven-year study period, neither in respect of number of years nor in number of contacts. CONCLUSIONS: Offspring of four risky constellations were no more likely to use healthcare services for longer time periods or have more consultations/visits than offspring of the lowest-risk constellation. Parental risk constellations appear more informative for understanding disorder aetiology than for understanding management and treatment of anxiety and depression during adolescence and early adulthood.

Norwegian adolescents' use of energy drinks and painkillers and misuse of prescription drugs prior to and during the initial COVID-19 pandemic year: Evidence from the MyLife study.

AIMS: This study aimed to examine and compare the use of energy drinks, over-the-counter (OTC) painkillers and misuse of prescription drugs in two cohorts of Norwegian adolescents entering high school (i.e. grade 11) immediately prior to and during the initial year of the COVID-19 pandemic. METHODS: Accelerated longitudinal design and multi-cohort sampling enabled identification of the two socio-demographically comparable cohorts of grade 11 students: (a) COVID-19 cohort assessed in the autumn of 2020 (n=915) and (b) pre-COVID-19 cohort assessed in the autumn of 2018/19 (n=1621). Unadjusted and adjusted logistic and Poisson models were used to estimate the proportion of (mis)users and use frequencies among (mis)users in two cohorts. RESULTS: Energy drinks use was both more common in the COVID-19 cohort (60.8% vs. 52.5%; adjusted odds ratio=1.40, 95% confidence interval (CI) 1.18-1.66, p<0.001) and more frequent among users from this cohort than among their pre-COVID-19 counterparts (9.58 vs. 7.79 days past month, adjusted incidence risk ratio (aIRR)=1.23, 95% CI 1.14-1.32, p<0.001). No cohort differences were observed in OTC painkillers use. Prescription drugs misuse was equally common in the two cohorts but was more frequent among misusers from the COVID-19 cohort than among their pre-COVID-19 counterparts (18.94 vs. 12.45 times past year, aIRR=1.52, 95% CI 1.10-2.10, p<0.001). CONCLUSIONS: Norwegian adolescents from the COVID-19 cohort were more likely to use energy drinks and, once engaged in these behaviours, to use energy drinks and misuse prescription drugs more frequently than their pre-COVID-19 counterparts.

Adolescents' Alcohol Use and Related Expectancies before and during the Early COVID-19 Pandemic: Evidence from the Nationwide MyLife Study.

INTRODUCTION: We examined a range of alcohol use indicators among Norwegian adolescents before and during the early COVID-19 pandemic. METHODS: We examined two cohorts of Norwegian 16-year-olds from the nationwide MyLife study who entered high school in fall 2020 (i.e., COVID-19 pandemic cohort; n = 915) and fall 2019/18 (i.e., prepandemic cohort; n = 1,621). Through e-surveys, adolescents reported their past year drinking frequencies and quantities (generating the Alcohol Use Disorders Identification Test-Concise; AUDIT-C scores) and completed Social Facilitation (SF) and Tension Reduction (TR) subscales of the Alcohol Outcome Expectancies Scale. Cohort differences across these outcomes were examined with linear and modified Poisson regression models. RESULTS: There were no cohort differences in the proportion of adolescents who reported drinking in the past year or in drinking/binge drinking frequencies. However, alcohol quantities consumed on a typical drinking day were 1/3 of a drink greater in the COVID-19 cohort than in the prepandemic cohort; aIRR (95% CI) = 1.13 (1.02-1.25). These consumption differences compounded into significantly greater AUDIT-C scores (aIRR [95% CI] = 1.16 [1.02-1.32]) and positive AUDIT-C screens (31.2% vs. 26.4%; aRR [95% CI] = 1.21 [1.07-1.36]) in the COVID-19 cohort. In terms of alcohol-related expectancies, there were no SF differences, but the COVID-19 cohort reported significantly greater TR expectancies; b (95% CI) = 0.11 (0.02-0.20). CONCLUSION: Despite the 2020 lockdown, Norwegian adolescents who started high school during the first pandemic year did not differ from their prepandemic peers in terms of how many of them drank, how often they drank, or in prosocial expectations they had of alcohol use. However, they consumed greater alcohol quantities per drinking day, had greater AUDIT-C scores, and reported greater tension reduction expectations of alcohol use. These results underscore the value of examining adolescents' alcohol-related behaviors during the COVID-19 pandemic above and beyond the basic drinking prevalence and frequencies.

Energy drinks and alcohol use among adolescents: A longitudinal study.

BACKGROUND: Alcohol use is a leading cause of reduced health among young people. Consumption of energy drinks might be a risk factor for alcohol use. The aim of this study was to examine if more frequent consumption of energy drinks in early adolescence was associated with higher concurrent alcohol consumption, and with stronger increase in alcohol use throughout adolescence. METHODS: The data came from MyLife, a longitudinal study where Norwegian adolescents completed e-questionnaires in the autumn of 2017, 2018, 2019, 2020, and 2021. The participants were a nationwide sample of 2916 adolescents (mean age: 14.25 [SD = 0.85], 56% girls). At baseline, adolescents self-reported how often they had consumed energy drinks over the past month, a range of family factors, individual characteristics, and substance use. Self-reports of alcohol use (frequency, usual quantity, and frequency of consuming five or more units) were collected at all five assessments and combined into continuous variables. RESULTS: The results of fully adjusted growth curve models indicate that more frequent consumption of energy drinks at baseline was associated with greater concurrent alcohol use (p < .001), and greater increase in alcohol use over time (p < .05). The effect of energy drinks on concurrent alcohol use was stronger for girls, but the effect on increase over time was stronger for boys. CONCLUSION: Consumption of energy drinks in early adolescence is associated with more alcohol use throughout adolescence, but the effect size was rather modest in this sample of Norwegian adolescents.

Time spent on social media and alcohol use among adolescents: A longitudinal study.

BACKGROUND AND AIMS: Research into the association between use of social media (SoMe) and alcohol use among adolescents is still in its infancy. The aim of the current longitudinal study was to examine if time spent on SoMe was prospectively associated with alcohol use among adolescents, and whether these associations differed for boys and girls. DESIGN: Prospective cohort study among Norwegian adolescents who completed e-questionnaires in the autumn of 2017 (t1), 2018 (t2), 2019 (t3) and 2020 (t4). SETTING: Norway. PARTICIPANTS: A nation-wide sample of N = 3096 adolescents (mean age at t1: 14.3 years (SD = 0.85), 43% boys). MEASUREMENTS: Self-report data were collected on adolescents' alcohol use, time spent on SoMe, parental monitoring, sensation-seeking, and positive and negative urgency, gender, and age. FINDINGS: Latent growth modelling adjusted for time invariant covariates (i.e., parental monitoring, sensation-seeking, and positive and negative urgency at t1) showed a positive association between time spent on SoMe and alcohol use at the start of the study; standardized b (ß) = 0.17 (95% CI: 0.09, 0.26). Time spent on SoMe at t1 was a strong positive predictor of increase in alcohol use ß = 0.31 (95% CI: 0.23, 0.40). There was also an association between degree of increase in alcohol use and increase in time on SoMe, ß = 0.14 (95% CI: 0.05, 0.24). Subsequent multigroup analysis found little evidence for gender differences (p > 0.05). CONCLUSION: The more time Norwegian adolescents aged 13-15 years spend on SoMe, the greater is their subsequent increase in alcohol use over time.

Parental binge drinking and offspring's high school non-completion: A prospective HUNT survey and educational registry study.

BACKGROUND: Alcohol-use disorders (AUD) in parents are associated with adverse outcomes in offspring. It is less known whether other forms of parental drinking such as binge drinking may also be a risk factor for offspring's outcomes -- specifically, high school non-completion. METHODS: These questions were examined in a sample of 3101 offspring (Mage = 16.1 , SD = 1.68; 49.5% girls) from 2510 2-parent families who participated in the Nord-Trøndelag Health Study in Norway (HUNT3; Young-HUNT3) in 2006-08 and were followed-up through the National Education Database (NUDB) until 2014. Associations between maternal and paternal binge drinking patterns as reported in HUNT during offspring's adolescence and offspring's subsequent high school completion were examined using logistic regression models while accounting for a comprehensive set of socio-demographic, parental, and offspring characteristics as assessed at HUNT baseline. Effect modifications of these putative associations by offspring characteristics were also explored. FINDINGS: Approximately 1 in 6 offspring (13.6% girls, 21.1% boys) failed to graduate high school within the officially designated time period, while roughly 1 in 5 mothers (20.4%) and 1 in 2 fathers (51.2%) reported any binge drinking. Weekly or more frequent binge drinking in fathers was prospectively associated with more than doubled odds of high school non-completion in offspring; OR = 2.23, 95% CI = 1.50-3.31. This effect remained substantively identical after adjustment for all covariates (aOR = 2.20, 95% CI = 1.38-3.50) and uniform across offspring characteristics such as gender, academic orientation and performance, anxiety and depression, typical alcohol consumption, and witnessing parental intoxication as assessed at HUNT baseline. CONCLUSIONS: Weekly or more frequent binge drinking in fathers negatively affected high school graduation prospects in their offspring.

Parental risk constellations and future alcohol use disorder (AUD) in offspring: A combined HUNT survey and health registries study.

OBJECTIVE: We examined the risk of developing a future alcohol use disorder (AUD) among offspring of families with different constellations of parental risk factors. METHOD: We analyzed a sample of 8,774 offspring (50.2% male) from 6,696 two-parent families who participated in the Nord-Trøndelag Health Study in Norway when offspring were 13-19 years old in 1995-1997 or 2006-2008. Based on population registry information and parental Nord-Trøndelag Health Study self-reports, families were classified via Latent Profile Analysis into fiver risk constellations reflecting parents' education, drinking quantities and frequencies, and mental health. Information about AUD-related diagnoses, treatments, and prescriptions for all offspring in the period between 2008 and 2016 was obtained from 3 national health registries and pooled to reflect any AUD. The likelihood of AUD in offspring was examined with a set of nested logistic regression models. RESULTS: Registry records yielded 186 AUD cases (2.1%). Compared with the lowest-risk constellation, offspring from two constellations were more likely to present with AUD in unadjusted analyses. After adjusting for all covariates, including offspring's alcohol consumption and witnessing parental intoxication during adolescence, AUD risk remained elevated and statistically significant (adjusted odds ratio = 2.34, 95% confidence interval = 1.14, 4.85) for offspring from the constellation characterized by at least weekly binge drinking, low education, and poor mental health in both parents. CONCLUSION: Weekly binge drinking by both parents was associated with future AUD risk among community offspring in Norway when clustered with additional parental risks such as poor mental health and low educational attainment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Fear of missing out and binge-drinking among adolescents.

INTRODUCTION: No previous studies have examined the cross-sectional association between fear of missing out (FOMO) and binge-drinking among adolescents. The aim of the present study was: (i) to estimate the magnitude of this association; (ii) to assess the impact of potential confounders (i.e. sensation-seeking, symptoms of depression and self-regulation); and (iii) determine if it is uniform across all levels of these characteristics. METHODS: Cross-sectional study of adolescents from 33 middle schools in Norway, stratified according to geographic location, urban and rural locations, and standard of living. Participants were a nation-wide sample of N = 2646 adolescents (mean age 16.2 years, 43% boys). Self-report data were collected on binge-drinking, FOMO, sensation-seeking, symptoms of depression and self-regulation. RESULTS: Overall, 21% reported binge-drinking ≤ once per month in the past 12 months, while 9% reported binge-drinking more than once per month. Multinomial logistic regression showed that the crude effect, where greater FOMO was associated with greater risk of binge-drinking, was substantial (relative-risk ratio = 1.50 [1.35, 1.66], P < 0.001), but somewhat attenuated after including all potential confounders (relative-risk ratio = 1.28 [1.14, 1.43], P < 0.001). Effect modification analyses showed that the effect of FOMO on binge-drinking ≤ once per month was stronger for adolescents with low symptom levels of depression and weaker for adolescents at high levels of depression. DISCUSSION AND CONCLUSION: Norwegian adolescents with higher FOMO have greater risk of binge-drinking.

Self-reported Mental and Physical Health Among Norwegian Adolescents Before and During the COVID-19 Pandemic.

Importance: The COVID-19 pandemic and resulting conditions may negatively affect adolescents. Objective: To examine aspects of self-reported mental and physical health among adolescents in Norway before and during the pandemic, including the role of pandemic-associated anxiety. Design, Setting, and Participants: This cohort study examined a diverse nationwide sample of grade 11 students from the longitudinal MyLife study in Norway. The original study recruitment of all 8th, 9th, and 10th graders from the same middle schools facilitated identification of 2 sociodemographically comparable cohorts assessed in October to December 2018 and 2019, before the COVID-19 pandemic, and October to December 2020, during the pandemic. School entry and enrollment in Norway is determined by the birth year, and students usually start high school (11th grade) during the fall of the year of their 16th birthday. Data were analyzed from March to June 2021. Exposures: The COVID-19 pandemic and associated conditions in Norway. Main Outcomes and Measures: In grades 10 and 11, adolescents reported their depression symptoms using the Patient Health Questionnaire-9 (cutoff scores for moderate/severe depression, ≥15), number of close friends, physical health, and organized sports participation. Cohort differences were examined with a set of nested regression models, incrementally controlling for sociodemographic covariates and grade 10 outcomes. Results: A sample of 2536 adolescents (1505 [59.4%] girls) was analyzed, including 1621 adolescents before the pandemic and 915 adolescents during the pandemic, of whom 158 adolescents (17.3%) reported high pandemic anxiety. The only significant difference in outcomes between the COVID-19 cohort and the pre-COVID-19 cohort were lower odds of organized sports participation (adjusted odds ratio [aOR], 0.69; 95% CI, 0.56-0.87). However, in subanalyses comparing adolescents with high anxiety during the COVID-19 pandemic with adolescents in the pre-COVID-19 cohort, adolescents with high pandemic anxiety were more likely to experience clinical-level depression symptoms (aOR, 2.17; 95% CI, 1.39-3.37) and poor physical health (aOR, 1.53; 95% CI, 1.01-2.31). Conclusions and Relevance: In this cohort study of Norwegian adolescents, adolescents who started high school during the pandemic year had lower odds of organized sports participation in late 2020, but were otherwise comparable in terms of self-reported mental and physical health with their pre-COVID-19 counterparts. However, adolescents in the COVID-19 cohort experiencing high pandemic-related anxiety had significantly greater odds of poorer mental and physical health than adolescents in the pre-COVID-19 cohort. Strategies aiming to mitigate the impact of COVID-19 may benefit from identifying youth disproportionally affected by the pandemic conditions.

Cannabis use among Norwegian university students: Gender differences, legalization support and use intentions, risk perceptions, and use disorder.

AIMS: We explored past-year cannabis use and associated characteristics, focusing on legalization attitudes, use intentions, risk perceptions, and possible dependence among Norwegian university/college students. METHODS: We examined a nation-wide sample of Norwegian university/college students (N = 49,688; 67% female) who participated in the Students' Health and Wellbeing Study (SHoT-study) in 2018. Participants reported past-year substance use, support for cannabis legalization, intent to use cannabis if legal, and perceived risks of weekly use. Past-year cannabis use (including use frequency) was examined in relation to these indicators. Legalization support, use intentions, and risk perceptions were examined in relation to use and gender. Potential cannabis use disorder was assessed with the Cannabis Abuse Screening Test (CAST) and examined in relation to use frequency and gender. FINDINGS: Past-year use was reported by 15.3% (11.8% women; 22.9% men). Majority of current users (roughly 90%) used no more than 50 times past year, and 6% (3.8% women; 8.5% men) met CAST use disorder criteria. Legalization support, use intentions, and no/low risk perceptions were significantly associated with greater odds of use, and greater use frequency among current users in both crude and adjusted models. Legalization support (23.0%), use intentions (14.0%), and perceptions of no/low risk (29.2%) were also relatively common even among current non-users, especially men. Male gender and more frequent use were associated with greater CAST scores and greater odds of use disorder. CONCLUSIONS: Cannabis use was relatively common in this student sample. In addition to targeting frequent use, interventions may focus on cannabis-related attitudes and risk perceptions among uncertain/uninformed students.

Adolescent income and binge drinking initiation: prospective evidence from the MyLife study.

BACKGROUND AND AIMS: No previous studies have examined the prospective association between disposable income and binge-drinking initiation among adolescents. We aimed to examine whether there is such an association and, if so, whether it is robust to confounders, uniform across individual characteristics and linear versus non-linear. DESIGN: Prospective study of adolescents from 32 middle schools, stratified according to geographic location, urban and rural locations and standard of living. Adolescents were assessed in 2017 (T1) and 1 year later (T2). SETTING: Norway. PARTICIPANTS: A nation-wide sample of 1845 adolescents (mean age 13.5 years, 44% boys) with no binge-drinking experience at T1. MEASUREMENTS: Data were collected on binge drinking at T1 and T2. Data on disposable income and on a range of demographic, individual and family factors were collected at T1. FINDINGS: Overall, 7.2% initiated binge drinking between T1 and T2. Logistic regression showed that the crude linear effect of disposable income on binge drinking initiation was substantial, and only slightly attenuated in the fully adjusted model including all putative confounders [odds ratio (OR) = 1.19, 95% confidence interval (CI) = 1.08, 1.31, P < 0.001]. However, interaction analyses showed disposable income to be negatively related to binge drinking initiation for adolescents who had experienced light drinking at T1 (OR = 0.66, 95% CI = 0.49, 0.89, P = 0.006) or who had seen their mothers intoxicated [OR = 0.62, 95% CI = 0.39, 0.99, P = 0.043). CONCLUSION: Norwegian adolescents with higher disposable income have a greater risk of subsequent binge drinking initiation than those with lower disposable income. Each additional 100 NOK (≈ €10) of weekly income increased the risk of binge drinking initiation in the following year by approximately 20%.

Monitoring young lifestyles (MyLife) - a prospective longitudinal quantitative and qualitative study of youth development and substance use in Norway.

PURPOSE: The Monitoring Young Lifestyles (MyLife) project was initiated as an integrated quantitative and qualitative prospective investigation of correlates, causes, and consequences of adolescent substance use and other addictive behaviours in Norway. PARTICIPANTS: The MyLife cohort was recruited from middle schools in Norway, which were selected from low, medium and high standard of living areas in both rural and urban regions of the country. A total of 3512 eighth, ninth and tenth graders (55% girls) from 33 schools were enrolled in the quantitative project arm (QT), while a total of 120 eighth graders (52% girls) from six schools were enrolled in the qualitative project arm (QL). FINDINGS TO DATE: QT baseline was conducted in the fall of 2017, when 2975 adolescents completed an online questionnaire at school during a regular class time. A total of 2857 adolescents participated in the first QT follow-up 1 year later. QL baseline was conducted across the fall semesters of 2014 (one class) and 2015 (five classes), when a total of 118 eighth graders completed face-to-face interviews. QL follow-ups were conducted in the spring of 2015 and fall of 2017 (n=98) for group interviews, and in the spring of 2017 and 2018 (n=95) for individual interviews. In terms of additional data sources, a total of 3035 parents consented to own participation, of which 1899 completed a brief online questionnaire at QT baseline in late 2017. School principals completed brief surveys at the same time. FUTURE PLANS: Both QT and QL arms have planned follow-ups through 2021. Consents were obtained for individual-level linkages of adolescent and parental quantitative surveys to each other, as well as to the information available in multiple national registries and databases. These supplemental data sources will provide key information on additional putative exposures as well as on the long-term health, educational, and social outcomes of the MyLife participants.

Increase in time spent on social media is associated with modest increase in depression, conduct problems, and episodic heavy drinking.

INTRODUCTION: Adolescent use of social media has been linked to a range of negative outcomes, but it is still unclear whether the associations are spurious. To address this issue, we examined if within-individual change in time spent on social media was associated with within-individual changes in depression, conduct problems, and episodic heavy drinking in a sample of adolescents using first-differencing models (FD-models). METHODS: A sample of 763 Norwegian adolescents (45.1% boys; mean age 15.22 years, standard deviation 1.44) completed two questionnaires 6-months apart. The associations between changes in time spent on social media and symptoms of depression, conduct problems, and frequency of episodic heavy drinking were estimated using FD-models, a statistical technique that effectively controls for all time-invariant individual factors. We also accounted for three time-variant putative confounders: frequency of sports practice, frequency of unsupervised leisure activities, and peer relationship problems. RESULTS: Increases in time spent on social media were associated with increases in symptoms of depression (b = 0.13 [95% CI: 0.01, 0.24], p = 0.038), increases in conduct problems (b = 0.07 [95% CI: 0.02, 0.10], p = 0.007), and increases in episodic heavy drinking (b = 0.10 [95% CI: 0.06, 0.15], p < 0.001), after adjusting for changes in the three hypothesized confounders. The effect-sizes for these relationships were, however, quite modest. CONCLUSION: Increased time spent on social media was modestly related to increases in depression, conduct problems, as well as frequency of episodic heavy drinking among adolescents.

Perceived harmfulness of various alcohol- and cannabis use modes: Secular trends, differences, and associations with actual substance use behaviors among Norwegian adolescents, 2007-2015.

BACKGROUND: How youth perceive harmfulness of risk behaviors such as substance use relates to their engagement in those behaviors. Yet, little is known about how different substance use modes (i.e., variations in amounts and use frequencies) are perceived. We investigated how adolescent perceptions of harmfulness of various alcohol- and cannabis use modes changed over time, compared to one another, and related to actual substance use behaviors. METHODS: We examined nationally-representative repeated cross-sectional samples of 16-year olds in Norway, assessed in 2007, 2011, and 2015 (NTotal = 9296) as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD). Adolescents reported their: 1) lifetime alcohol- and cannabis use, and 2) perceived harmfulness of various alcohol- and cannabis use modes. RESULTS: Prevalence estimates for perceived harmfulness: 1) remained high and stable, or increased for alcohol use modes, and 2) declined for all cannabis use modes (i.e., using 1-2 times, occasionally, and regularly) since 2007-cohort. High quantity daily drinking was more commonly perceived as harmful than minimal or occasional cannabis use. Even though culturally-relevant use modes (i.e., weekend heavy drinking and experimental cannabis use) were not most commonly endorsed as harmful, only perceptions of those use modes as harmful were inversely associated with actual substance use. CONCLUSIONS: How adolescents from Norway perceived harmfulness of alcohol- and cannabis use depended on the specific substance, its use modes, and secular cohort. Perceived harmfulness was associated with measures of actual substance use predominantly along the culturally- and adolescent-relevant modes of use.

Identification and Assessment of Drug-User Groups Among Nightlife Attendees: Self-Reports, Breathalyzer-Tests and Oral Fluid Drug Tests.

BACKGROUND AND OBJECTIVES: Even though nightlife studies with potentially intoxicated participants provide the much needed information on drug use, they face additional methodological challenges. This study aimed to explore the utility of such studies by (i) classifying nightlife attendees based on their self-reported drug use and by (ii) examining whether these classifications were meaningful when assessed against other sources of data, including oral fluid drug tests. METHODS: Self-reported questionnaires, oral fluid samples and blood alcohol concentration readings were collected in a sample of 1,085 nightlife patrons recruited outside 12 popular nightclubs in Oslo, Norway, in 2014. Patrons were classified using multiple approaches, including latent class analysis. Group differences were examined by logistic regression models. RESULTS: Participants were classified into 5 mutually exclusive groups: 2 among current non-users ("Never-users"; "Previous users"), 2 among current users ("Multiple drugs"; "Cannabis mainly") and one "Incomplete information" group. Meaningful differences across these groups were observed. For instance, positive tests for any illicit drug were more common in "Multiple drugs" group than in "Cannabis mainly" (62.7 vs. 29.1%, adjusted OR [aOR] 3.77 [2.42-5.84]) or "Incomplete information" groups (62.7 vs. 34.4%, aOR 2.46 [1.26-4.79]). Despite their self-declared non-use, illicit substances were detected in oral fluids of "Never-users" (13.1%; 95% CI 9.9-17.2) and "Previous users" (7.9%; 95% CI 5.1-12.1). CONCLUSIONS: Despite some discrepancies between self-reports and biological tests, self-reports proved both suitable and useful in identification of substantively different drug-user typologies, potentially informing targeted policy responses. Still, methodological challenges associated with onsite studies of illicit drug use should be further explored.