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).

Prospective associations between adolescent risky substance use and school dropout and the role of externalising and internalising problems.

Background: The aim of the present study was to assess to what extent risky substance use (RSU) acts as an important risk factor for school dropout from upper secondary school in a prospective study of Norwegian adolescents, and how externalising and internalising mental health problems influenced this association. Methods: We used data from a large population-based survey (the youth@hordaland-survey), which included adolescents aged 16-19 years. The predictor variables were self-reported RSU. The survey was linked with prospective data from the Norwegian Education Database, following the adolescents to 21-23 years of age. The outcome variable was registry-based school dropout within five years after starting upper secondary school. The analyses were adjusted for sex, age, socioeconomic status, and externalising and internalising problems. Results: After adjustment for sociodemographic variables, all indicators of RSU were prospectively associated with school dropout (adjusted odds ratios 1.26-2.25; all p values <.01). While internalising problems only slightly changed these estimates, the associations were substantially attenuated by externalising problems. Still, all measures of RSU, except frequent alcohol intoxication, remained positively associated with school dropout in the fully adjusted models. For the youngest students, all associations between RSU and school dropout were significant. Conclusions: Adolescent RSU is a strong predictor for school dropout, and externalising problems explained a considerable proportion of this effect. Prevention efforts to reduce student substance could improve academic outcomes among upper secondary school students, and such efforts may benefit from also targeting co-occurring externalising problems.

Mental health problems and suicidal behavior from adolescence to young adulthood in college: linking two population-based studies.

It is well established that mental health problems are highly recurrent and persistent from childhood to adolescence, but less is known to what extent mental health problems also persist from adolescence into young adulthood. The aim of the current study was therefore to examine the chronicity and risk of mental health problems and suicidality from adolescence to young adulthood. Data stem from two Norwegian population-based studies conducted 6 years apart; the youth@hordaland study from 2012 (age 16-19) and the SHoT2018 study (age 22-25). These two data sources were linked to produce a longitudinal sample of 1257 individuals. A wide range of self-reported mental health and suicidality instruments (used both continuously and categorically) were analyzed using log-link binomial regression analysis, adjusting for age, sex, parental education, and financial problems. We found that high levels of mental health problems in late adolescence were a significant risk factor for reporting poor mental health 6 years later. Internalizing and externalizing problems in adolescence were associated with a 2.8-fold and 1.9-fold increased risk, respectively, of reporting a mental disorder 6 years later. Similarly, self-harm in adolescence was associated with a 2.1-fold increased risk of suicidal thoughts 6 years later. The magnitudes of the adjusted risk ratios were generally similar across the various mental health and suicidality measures used at the two assessment points. Adjustment for confounders did not, or only slightly, attenuate the risk ratios, and all associations remained statistically significant in the adjusted analyses. This longitudinal study provides new evidence of the chronicity of mental health problems and suicidality from adolescence to adulthood in Norway. The results emphasize the importance of early identification and timely interventions to reduce the prevalence and impact of mental health problems and suicidality.

Sleep and dropout from upper secondary school: A register-linked study.

OBJECTIVE: The present study investigates the association between sleep in late adolescence and completion of upper secondary school. METHODS: The data are drawn from the youth@hordaland study, a large population-based study conducted in 2012, linked with official educational data in Norway (N = 8838). RESULTS: High school dropout was more prevalent among adolescents who had insomnia (20.6%) compared to those without insomnia (14.3%; adjusted risk ratios = 1.50; 95% confidence intervals: [2.19-2.92]). There was also a higher rate of school dropout among those who had symptoms of delayed sleep-wake phase (21%) compared to those without delayed sleep-wake phase (14.3%); adjusted risk ratios = 1.43, 95% confidence intervals: (1.28-1.59). School noncompleters were also characterized by reporting 44 minutes shorter sleep duration, longer sleep onset latency, and wake after sleep onset (both approx. 15 minutes) compared to school completers. CONCLUSION: The importance of sleep for high school dropout rates highlights the importance of including sleep as a risk indicator and a possible target for preventive interventions in late adolescence.

Trends in physical health complaints among adolescents from 2014 - 2019: Considering screen time, social media use, and physical activity.

The rising rates of physical and mental health complaints among adolescents observed in many countries have coincided with an increased time spent on screen-based devices, including social media use. We sought to document recent trends in physical health complaints (PHC) and whether co-occurring trends in screen time, social media use, and physical activity may account for these trends. To achieve these aims, we used data from the nationwide Ungdata surveys conducted annually at the municipality level in Norway, comprising 419,934 adolescents aged 13-18 from six survey years (2014-2019). Six items assessed PHC, including neck and shoulder pain, headache, and abdominal pain, during the past month. To account for the nesting structure of Ungdata, and to exploit the variation within and between municipalities, we used multilevel analyses with adolescents nested in municipality-years (n = 669), nested in municipalities (n = 345). We found a small to moderate linear increase in number of PHC among boys and girls from 2014 to 2019. Screen time and social media use moderately attenuated the trend for girls, and to a lesser extent for boys. Screen time and social media use were further positively associated with PHC across the between and within-municipality levels, and social media use was more strongly associated with PHC for girls than boys across all levels of analysis. A similar pattern emerged when considering each symptom individually. The results suggest that the prevalence of PHC rose in tandem with a group-level shift towards higher screen time and social media use. Moreover, the results indicate that higher screen time and social media use may have led to changes in the youth culture with potential consequences for adolescents' well-being.

Exposure to potentially traumatic events and PTSD symptomatology in Norwegian 11-13-year-olds: results from the Bergen Child Study.

BACKGROUND: Exposure to potentially traumatic experiences (PTEs) is common among children and adolescents, but relatively little is known about the epidemiology of trauma and trauma-related psychopathology in children and youth. The present cross- sectional epidemiological study aimed to explore factors that is associated with posttraumatic stress symptoms (PTSS) in children. METHOD: Data stem from the Bergen Child Study, a series of cross-sectional multi-phase surveys of children born between 1993 and 1995 in Bergen, Norway. The sample used is from the second wave of the Bergen Child Study (BCS) conducted in 2006, a two-phase study. The study entailed a detailed psychiatric evaluation using the Development and well-being assessment (DAWBA). The DAWBA was administered to parents or caregivers and covered diagnostic areas, child and family background, and child strengths. A total of 2043 parents participated. RESULTS: Out of the total sample, parents reported that 4.8% children had experienced PTEs at some point in their lives. The findings revealed current PTSS in 30.9% of children exposed to PTE, which was 1.5% of the total sample. None of the parents reported PTSS in their children over the threshold for diagnosing posttraumatic stress disorder (PTSD). The most common PTSS cluster was arousal reactivity (90.0%), followed by negative cognitions and mood (80%). The least frequent symptom cluster was intrusions (63.3%) and avoidance (60%). Children with PTSS were reported to live in families with significantly more family stressors (p = 0.001, d = 0.8) and had utilized significantly more sources for help relative to those without PTSS (p = 0.001, d = 0.75). CONCLUSION: The present population study on children revealed a lower prevalence rate of PTEs and PTSD than previous studies. It provided findings in the field of trauma on parent- reported PTSS and PTSD symptom clusters not restricted to the clinical level of PTSD. Lastly, it highlighted how family-life stressors and support differed between those who had PTSS and those with no PTSS.

Negative Life Events, Protective Factors, and Substance-Related Problems: A Study of Resilience in Adolescence.

BACKGROUND: There is compelling evidence for an association between negative life events (NLE) and substance-related problems (SRP) during adolescence. The literature is, however, still limited with regards to protective factors for SRP among adolescents exposed to NLE. METHODS: A large population-based survey including 9,611 Norwegian adolescents aged 16 to 19 years, comprised the dataset of this study. The main explanatory variable was NLE. The main outcome variable was SRP, assessed by the CRAFFT scale. Potential protective factors were measured with five subscales from the Resilience Scale for Adolescents (READ) questionnaire. The potential protective factors and sex were explored as moderators for the associations between NLE and SRP. RESULTS: NLE were strongly associated with SRP. Four out of five potential protective factors (i.e., Goal Orientation, Self-confidence, Family Cohesion, and Social Support) showed evidence of a protective-stabilizing effect. Even if they had protective effect across all levels of exposure to NLE, these effects were even stronger for adolescents with high exposure. For Family Cohesion a protective-stabilizing effect was only evident for boys, while a direct protective effect was found for girls. Finally, Social Competence was the only factor that did not show any evidence of promoting resilience toward SRP. CONCLUSIONS: NLE had a strong relation with SRP in this study. Protective factors buffered against SRP for all adolescents - but particularly so for adolescents who had high exposure to NLE. These findings highlight the need for preventive efforts to strengthen protective factors that may promote resilience among adolescents at risk for SRP.

Psychometric properties of a short self-report measure of rule-breaking behaviour among adolescents: findings from the Ungdata survey.

BACKGROUND: The aim of the present study was to examine the factor structure and reliability of a six-item scale of rule-breaking behaviour, and to test for measurement invariance across gender, age, survey year and geographical location. METHODS: Data were from three yearly cross-sectional and population-based collections of the Ungdata surveys (2017 to 2019) including a total of 297,102 Norwegian adolescents aged approximately 13 to 19 years. Measurements included respondent's rule-breaking behaviour, time, gender, age and geographical location. RESULTS: Confirmatory factor analyses demonstrated that a one-factor solution of the rule-breaking behaviour scale had good fit to data (comparative fit index 0.98; Tucker-Lewis index 0.96; root mean square error of approximation 0.049 (95% confidence interval 0.048, 0.050)), with factor loadings ranging from 0.60 to 0.81 for all items (mean factor loading 0.72). Similar results were found across survey years for both genders. Several multiple group confirmatory factor analyses showed indications of measurement invariance for the scale across gender, age groups, geographical locations and survey years. The ordinal alpha and omega coefficients for internal consistency of the scale were both 0.86. CONCLUSIONS: The six-item scale for self-reported rule-breaking behaviour demonstrated good psychometric properties and appears to constitute a reliable measure of adolescent rule-breaking behaviour for use in population-based surveys in a Norwegian setting.

Joint physical custody and academic achievement among youth: A population-based study with registry linkage.

Previous research has documented that youth in joint physical custody (JPC) often report fewer mental health problems than peers in other postseparation living arrangements. Whether JPC is associated with functional outcomes such as academic achievement has been less examined, and existing work has relied on self-reported school grades and pertinent controls such as parental education. Using data from the Norwegian population-based youth@hordaland study (n = 7,914), we examined the association between living arrangements and academic achievement among youth (16-19 years) using register-based information on grade point average (GPA; range: 1-6), parental education, and income. We also assessed the influence of family cohesion and coresiding biological and half/stepsiblings in explaining differences between youth in JPC and other living arrangements. Across all regression models, youth in JPC had significantly higher GPA (0.2-0.4 points) than youth living with a single mother or father. Parental education had a strong attenuating effect and reduced the magnitude of the difference with 30%-35% for youth in single-parent families and 55% for youth in stepparent families. In conclusion, we find that youth in JPC have a small but significant academic advantage compared to peers in single-parent families, which is not fully accounted for by objective measures of parental education and income, sibling composition, and family cohesion. Future longitudinal studies are needed to disentangle whether positive outcomes associated with JPC are due to inherent qualities of this living arrangement or better captured by preseparation selection mechanisms. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Extent of Alcohol-Related Problems Among College and University Students in Norway Prior to and During the COVID-19 Pandemic.

Aim: To provide estimates of the distribution of alcohol-related problems in a national sample of college and university students in 2021, i.e., during the COVID-19 pandemic, in comparison with pre-pandemic data from 2018. Design: Longitudinal data from linkage of two recent national health surveys from 2018 to 2021. Setting: Students in higher education in Norway (the SHoT-study). Participants: 8,287 fulltime students (72.5% women, 27.6% men) that were 18 years or more at the time of the first survey in 2018, and 21 years or more at the time of the second survey in 2021. Measurements: The Alcohol Use Disorders Identification Test (AUDIT) was used to assess potential alcohol-related problems. Findings: 37.0% of male students and 24.1% of female students reported either risky, harmful, or dependent alcohol use in 2021, compared with 55.0% of male students and 43.6% of female students in 2018. This decrease in alcohol-related problems was most pronounced for dependent alcohol use, where we observed a 57% relative reduction among male students (from 3.5% in 2018 to 1.5% in 2021) and a 64% relative reduction among female students (from 1.4% in 2018 to 0.5% in 2021). Conclusions: The present study demonstrated a sharp decline in alcohol-related problems among students during the COVID-19 pandemic, that were present across gender, age groups, and geographical study locations. Universal preventive measures to limit students' alcohol use should be considered when restrictions related to the pandemic is lifted.

Substance-Related Problems in Adolescents with ADHD-Diagnoses: The Importance of Self-Reported Conduct Problems.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a known risk factor for substance-related problems (SRP) during adolescence, but the nature of this relationship and the importance of co-occurring conduct problems are not fully understood. METHODS: Data stem from a linked dataset between a large population-based survey conducted in 2012 of Norwegian adolescents aged 16 to 19, and registry-based data from specialized child and adolescent mental health services (n = 9,411). RESULTS: Adolescents with "ADHD + high conduct problems" had increased risk of SRP (odds ratios = 2.37-10.14). Adolescents with "ADHD only" had very similar risk of SRP as adolescents from the general population with low symptoms of conduct problems. Relative to boys, girls with "ADHD + high conduct problems" appeared to have somewhat higher risk for SRP. CONCLUSION: The present study suggests that the risk for SRP among adolescent with ADHD is largely driven by co-existing conduct problems.

Sleep problems among adolescents within child and adolescent mental health services. An epidemiological study with registry linkage.

Sleep problems are prevalent among adolescents, especially among those diagnosed with mental health disorders. There is insufficient knowledge about sleep among adolescents within child and adolescent mental health services (CAMHS) in comparison to the general population. The data are drawn from the youth@hordaland study, a large population-based study conducted in 2012, linked to the Norwegian Patient Registry (NPR) (n = 9077). Psychiatric disorders were based on clinical diagnoses from the NPR, while insomnia, delayed sleep-wake-phase disorder (DSWPD), and other sleep problems/patterns were assessed by self-report questionnaires from youth@hordaland. The prevalence of diagnosed sleep disorders among adolescents seeking mental health services was 0.6%, yielding an estimated prevalence of 0.07% of the population. However, questionnaire-based measurement of insomnia from the youth@hordaland study indicated that insomnia was highly prevalent across disorders in comparison to a reference group of adolescents who were not within mental health care. Insomnia ranged from 29% among adolescents diagnosed with ADHD (PR = 1.79; 95% CI 1.41-2.29) to 48% among adolescents diagnosed with depression (PR = 2.53, 95% CI 2.19-2.92). All diagnostic groups had a mean sleep efficiency below (85%), indicating poor sleep quality. Insomnia, delayed sleep-phase wake disorder, and poor sleep efficiency were confirmed as transdiagnostic sleep problems across psychiatric disorders. In addition, some disorder-specific patterns emerged, such as a higher prevalence of insomnia among adolescents with depression, and DSWPS among adolescents with conduct disorder. This underscores the need for treating sleep problems in CAMHS, and transdiagnostic treatment approaches are warranted.

Sleep patterns and insomnia among adolescents receiving child welfare services: A population-based study.

OBJECTIVES: Sleep problems are common in adolescence. We aimed to investigate sleep patterns and insomnia in Norwegian adolescents who have been in contact with child welfare services (CWS), both adolescents living in foster care (FC) and adolescents receiving in-home-services (IHS). Both groups were compared to youth who reported they were not receiving child welfare interventions. DESIGN: Cross-sectional. SETTING: The population-based study youth@hordaland from 2012 in Hordaland, Norway. PARTICIPANTS: About 9421 adolescents (53.8% girls), age range 16-19 years, were divided into 3 groups; IHS group (n = 123), FC group (n = 132), and control group (n = 9166). MEASUREMENTS: Self-reported information about demographics, detailed sleep patterns, sleep problems, and adverse life events. RESULTS: Adolescents receiving IHS (vs. controls) had significantly shorter sleep duration, lower sleep efficiency, longer sleep onset latency (SOL), wake after sleep onset (WASO), and higher prevalence of insomnia. They had increased odds of insomnia (adjusted odds ratio [AOR] = 1.77, 95% confidence interval [CI] = 1.19-2.62) and SOL ≥ 30 minutes (AOR = 1.95, CI = 1.32-2.87). Adolescents in FC (vs. controls) reported lower sleep efficiency and longer WASO. When adjusting for sex and age, the associations did not substantially change. When additionally adjusting for adverse life events, the associations were considerably attenuated for both groups, and were no longer significant for the FC group. CONCLUSION: Our results indicate a higher rate of sleep problems among adolescents receiving interventions from CWS, particularly those receiving IHS. Adverse life events accounted for a substantial part of the increased risk of sleep problems.

Do Parental Education-Related Inequality Matter in Child and Adolescent Utilization of Mental Health Services: Results From a Norwegian Register Linkage Study.

Equitable access to health care point to equal access to care for those with equal needs, but pro-rich and pro-educated inequities have been documented in specialized mental health care utilization. This study aimed to investigate equity in Norwegian adolescents' use of child and adolescent mental health services (CAMHS) with regards to parental education levels, using a survey of 10 257 Norwegian 16- to 19-year-olds subsequently linked to CAMHS data from the Norwegian Patient Registry (n = 970 had been in contact with CAMHS). Analyses using concentration indices (C) suggested adolescents with parents with lower education levels had more mental health problems (ie, larger need; C = -0.032, P < .001) and were more in contact with CAMHS (C = -0.025, P < .001). Regression analysis suggested that CAMHS contact, and number of unique admissions was largely distributed according to need, but participants whose parents had basic education levels were in contact with CAMHS for slightly longer than predicted from their self-reported mental health problems, age, and sex. Results from this study suggested that contact with CAMHS was largely equitable and mostly influenced by need. There was little evidence of parental education-related inequity in access to, and use of, specialized mental health services.

Past Year Cannabis Use Among Norwegian Adolescents: Time Trends Based on the Ungdata Surveys 2010-2019.

Aims: To describe trends in cannabis use from 2010 to 2019 among Norwegian adolescents and relate these to individual- and municipal-level variables. Design: Data from nationwide repeated cross-sectional surveys collected in 2010-2013 (T1), 2014-2016 (T2), and 2017-2019 (T3) were used to describe secular trends in proportions of adolescent cannabis use. Setting: Cross-sectional surveys in 410 of the total 428 municipalities of Norway. Participants: A total of 628,678 survey responses from adolescents aged ~13-19 years of age, in which 566,912 survey responses were eligible for analyses, representing data from 340 municipalities. Measurements: Respondent's past year cannabis use, time, gender, school grade, municipality, geographical location, and municipality population. Findings: Boys reported overall higher cannabis use, with ~2:1 gender ratio for any past year cannabis use and a 3:1 gender ratio for frequent cannabis use. Adolescents in Eastern Norway reported higher cannabis use compared with other areas in the country, and adolescents from municipalities with a higher population size reported higher rates of cannabis use than smaller municipalities. A gradual increase in cannabis use from T1 to T3 was found in Eastern Norway and in the largest municipalities. More generally, proportions of past year cannabis use showed a marked increase from T2 to T3 across genders, grade/age groups, geographical location, and municipality population, with few exceptions. Conclusions: Our findings indicate that proportions of past year cannabis use have increased among Norwegian adolescents in recent years. Preventive interventions to hinder initiation of cannabis use, as well as measures to address frequent cannabis use among Norwegian adolescents, are needed.

Alcohol-related problems among college and university students in Norway: extent of the problem.

Aims: The aim of the current study was to provide estimates of the distribution of alcohol-related problems in a large sample of college and university students. We also sought to examine trends in the distribution of alcohol-related problems from 2010 to 2018. Methods: Data stem from a recent national health survey from 2018 for higher education in Norway (the SHoT study) in which 50,054 full-time students (69.1% women; 30.9% men) aged 18-35 years participated. The Alcohol Use Disorders Identification Test (AUDIT) was used to assess potential alcohol-related problems. Data on demographic characteristics were also collected. Results: More than half of the male students (52.8%) and 4 out of 10 of the female students (40.1%) reported risky, harmful or dependent alcohol use. Compared to women, men had an increased risk of risky alcohol use (relative risk ratio (RRR) = 1.57), harmful alcohol use (RRR = 2.45) and dependent alcohol use (RRR = 2.73). Younger students had higher rates of risky and harmful alcohol use compared with older students, while rates of dependent alcohol use were similar across the age span. Several demographic variables were associated with alcohol use. The trend analyses revealed that the rates of risky, harmful and dependent alcohol use, as well as mean AUDIT scores, among the students have remained relatively stable over the past 8 years. Conclusions: Alcohol use remains an important health concern among Norwegian college and university students, and the present study confirms the high rates of alcohol-related problems, and the need to address the issue within this population.

Self-Reported Illicit Drug Use Among Norwegian University and College Students. Associations With Age, Gender, and Geography.

Background and Aims: Several studies have pointed to relatively high levels of illicit drug use among students in higher education compared to the general population. The aim of the present study was to provide an updated examination of self-reported illicit drug use among Norwegian University and college students. Methods: Data stem from the SHoT study (Students' Health and Well-being Study), a nationwide cross-sectional survey for higher education in Norway including Norwegian full-time students aged 18-35. Self-reported illicit drug use across a range of specified drugs comprised the outcome variables. Information on gender, age, and study location (geographical area) was also collected and used as stratification variables. The SHoT-survey from 2018 (N = 50,054) was used for the analyses of associations between demographical variables and illicit drug use, while trends in illicit drug use were estimated by comparing the 2018-results with data from the SHoT-surveys conducted in 2010 and 2014. Results: The proportion of students reporting having ever tried illicit drugs increased from 2014 to 2018, for both males (30.8 vs. 36.7%) and females (17.5 vs. 24.0%, both p < 0.001), while only minimal changes occurred between 2010 and 2014. The most commonly used illicit drugs during the past 12 months in 2018 were cannabis (15.2%), followed by MDMA (4.0%), cocaine (3.0%), and LSD/psilocybin (2.1%). Illicit drug use showed both linear increase with age, and inverted U-shaped relationships that peaked in the age span from 23 to 28 years of age. Males reported higher illicit drug use compared with females for all drugs. Proportions of illicit drug use varied across geographical areas within the country, with the highest use being reported in the Oslo area (the largest city and capital of Norway). Conclusions: The present study reports an increase from 2010 to 2018 among Norwegian University and college students in the proportion of those reporting to have tried illicit drugs. Despite varying proportions of use across type of drug, age, gender, and geographical location, the overall high levels of illicit drug use past 12 months confirm the need to address illicit drug use in this population.

Symptoms of disordered eating and participation in individual- and team sports: A population-based study of adolescents.

AIM: This study aimed to investigate individual and team sports participation across sex, age, and levels of body mass index (BMI). We also wanted to explore how symptoms of disordered eating (DE) were associated with participation in individual and team sports, and to what extent BMI moderated this association. METHODS: Data stemmed from a large population-based survey of 10,172 Norwegian adolescents aged 16 to 19 years. Self-reported participation in organized team- and individual sports were the dependent variables. Self-reported symptoms of DE using the five-item Eating Disturbance Screening (EDS-5) questionnaire comprised the independent variable. Covariates included sex, age, socioeconomic status, and BMI. We used regression analyses for associations between DE symptoms and sports participation, including the interaction between DE and BMI. RESULTS: Boys had higher team sports participation compared with girls. Individual and team sports participation varied significantly across BMI levels for each sex. Symptoms of DE were negatively associated with team sports participation (odds ratio [OR] = 0.90, p < 0.001), and were not significantly associated with individual sports participation. BMI scores moderated the association between DE symptoms and individual sports participation (p < 0.005). DE symptoms were associated with higher individual sports participation among individuals with low BMI, and with lower participation among those with high BMI. CONCLUSIONS: DE symptoms are important correlates of sports participation among adolescents, but the direction of these associations partly differs across the weight spectrum. Promotion of factors that counteract DE is needed alongside efforts to increase physical activity and sports participation in the general adolescent population.

Trajectories of sleep problems from adolescence to adulthood. Linking two population-based studies from Norway.

STUDY OBJECTIVE: The aim of the study is to assess stability and predictors of insomnia and sleep duration from adolescence to early adulthood. METHODS: A longitudinal sample of 1257 individuals from three age cohorts were assessed from linked population-based studies, the youth@hordaland study from 2012 (age 16-18) and the SHoT2018 study (age 22-25). Identical measures of insomnia symptoms and sleep duration were analysed. RESULTS: The stability of insomnia was high from adolescence to young adulthood, 50% of those with insomnia symptoms in adolescence still had insomnia symptoms six years later (adjusted IRR = 2.01; (CI 95%; 1.5-2.44)). Short sleep duration was also stable, with 67.8% of the adolescents in the lowest sleep duration quartile still remaining in the lowest quartile six years later. The overall rate of insomnia symptoms, long wake after sleep onset (WASO), and oversleeping increased from adolescence to young adulthood. Also, we observed a reduction in sleep efficiency and later rise times. There was no significant change in sleep onset latency (SOL). CONCLUSION: Insomnia symptoms and short sleep duration are prevalent during both adolescence and young adulthood. Considerable individual stability and a rising rate of insomnia symptoms were observed over time. These findings underscore the importance of early identification and timely interventions to prevent chronic sleep problems.