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.

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.

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.

Two-year changes in sleep duration are associated with changes in psychological distress in adolescent girls and boys: the fit futures study.

Objective: Studies indicate an inverse association between sleep duration and psychological distress. We aimed to explore associations between changes in sleep duration and changes in psychological distress in girls and boys. Methods: The Fit Futures Study is a broad adolescent study providing data from 373 girls and 294 boys aged 15-18 years collected in 2010/2011 (FF1) and 2012/2013 (FF2). Psychological distress was measured by the Hopkins Symptom Checklist (HSCL-10) and sleep duration was self-reported. Change score variables were calculated as the change between baseline and follow-up for sleep duration and HSCL-10, respectively. Associations between changes in sleep duration and changes in HSCL-10 were explored by linear regressions, in gender-stratified analyses. Results: At FF1, girls and boys slept on average 6.93 (SD = 1.08) and 7.05 (SD = 1.20) hours per night respectively, and correspondingly, 6.83 (SD = 1.19) and 6.85 (SD = 1.21) at FF2. At FF1, 22.8% of the girls and 25.8% of the boys slept ≤ 6 h per night, and correspondingly 28.0% and 28.2% at FF2. In girls and boys, one unit increase (30 min) in sleep duration was associated with a decrease in HSCL-10 score of B [95% CI] = -0.090 [-0.131, -0.048], p < 0.001, and -0.054 [-0.091, -0.017], p < 0.001, respectively. The associations remained significant after adjusting for confounders. Conclusion: Our findings show that increased sleep duration was associated with decreased psychological distress during adolescence. Future studies should examine the causality between sleep duration and psychological distress.

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.].

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.

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.

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.

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.

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.

Adult attachment style and maternal-infant bonding: the indirect path of parenting stress.

BACKGROUND: The quality of maternal-infant bonding is related to important child outcomes. The literature has assumed that the ability to form relationships is a relatively stable trait, and research studies have suggested that a mother's attachment style in close adult relationships is related to mother-infant bonding. The transition to parenthood is also often stressful, and the adult attachment style may relate to parenting stress in the first year after birth. Such stress could possibly have a negative relationship with the mother-infant bond. In the present study, we examined the associations between maternal adult attachment styles and the quality of mother-infant bonding and whether this relationship is mediated by parenting stress. METHODS: The present study sample comprised 168 women (mean age 31.0 years, SD 4.23 years). Between weeks 31 and 41 of gestation, the anxious and avoidant adult attachment dimensions were measured with the Experiences in Close Relationships questionnaire (ECR). Between 5 and 15 weeks after birth mother-infant bonding and parenting stress were measured with the Maternal Postnatal Attachment Scale (MPAS) and the Parenting Stress Index-Parent Domain (PSI-PD), respectively. RESULTS: Both attachment-related avoidance and attachment-related anxiety correlated significantly and negatively with mother-infant bonding. However, a regression analysis showed that only attachment-related avoidance was a significant predictor of mother-infant bonding when controlling for demographic variables and maternal mental health history. The relationship between the adult attachment style and bonding was mediated by parenting stress. Higher scores on attachment avoidance and anxiety were related to increased stress, which was related to decreased quality of bonding. The overall parent domain and the subscale of competence in the parent-related stress dimension mediated between attachment avoidance and bonding, and the overall parent domain and the subscales of competence and role restriction mediated between attachment anxiety and bonding. There was no direct relationship between the adult attachment style and mother-infant bonding when parenting stress was included as a mediator. CONCLUSIONS: This study illustrates that maternal adult attachment style relates to mother-infant bonding. This relationship was mediated by parenting stress. The results may have implications for the early identification of mothers at risk of having bonding difficulties.

Is change in mental distress among adolescents predicted by sedentary behaviour or screen time? Results from the longitudinal population study The Tromsø Study: Fit Futures.

OBJECTIVE: There is growing interest in the relationship between sedentary behaviour and mental distress among adolescents, but the majority of studies to date have relied on self-reported measures with poor validity. Consequently, current knowledge may be affected by various biases. The aim of this study was to investigate the cross-sectional and longitudinal association between (1) objectively measured sedentary time and (2) self-reported screen time with mental distress among adolescents participating in The Tromsø Study: Fit Futures, in order to see if the association is dependent on mode of measurement of sedentary behaviour. DESIGN: Prospective study. SETTING: Sample drawn from upper secondary school students (mean age 16.3 years at baseline) from two municipalities in Northern Norway participating in The Tromsø Study: Fit Futures 1 and 2. PARTICIPANTS: 686 adolescents (54.5% female), with complete self-reported and accelerometer data after multiple imputation. PRIMARY OUTCOME MEASURES: Mental distress assessed via the Hopkins Symptom Checklist-10 (HSCL-10). RESULTS: Minutes in sedentary behaviour measured by accelerometer showed no significant relationship with mental distress in neither crude, partly adjusted nor multiple adjusted hierarchic linear regression analyses. Self-reported screen time was positively associated with mental distress in all analyses (multiple adjusted, B=0.038, p=0.008, 95% CI 0.010 to 0.066). However, the effect was small. CONCLUSIONS: Self-reported screen time was associated with slightly elevated mental distress 2 years later, whereas objectively measured minutes in sedentary behaviour was not, indicating a discrepancy in the results depending on measurement methods.

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.

High Intensity Long Interval Sets Provides Similar Enjoyment as Continuous Moderate Intensity Exercise. The Tromsø Exercise Enjoyment Study.

OBJECTIVE: High intensity interval exercise sessions with interval sets over 3 min may provide superior cardiorespiratory fitness benefits. To our knowledge, the exercise enjoyment of interval sets over 3 min is not yet elucidated. The aim of this study was to examine exercise enjoyment following one session with four intervals of 4 min high intensity exercise (HIIE) versus one session of 45 min moderate intensity continuous exercise (CE) in iso-caloric conditions using a randomized crossover design. METHODS: Seven young healthy participants were recruited to undergo two different exercise sessions in a randomized order: (1) 4 × 4 min intervals at >90% of maximum heart rate (HR max ) with 3 min of rest between interval sets, and (2) 45 min CE at 70% of HR max . Peak oxygen uptake and HR max were evaluated prior to the experiment. The participants reported their perceived exercise enjoyment using the 18-item physical activity enjoyment scale (PACES) questionnaire and their rating of perceived exertion (RPE) using Borg's 6-20 scale. RESULTS: There was no difference in the PACES score between the high intensity interval exercise session [median: 95.5 (inter-quartile range: 21.8)] and the moderate intensity CE session [91.0 (13.5), p = 0.36, r = -0.22]. The participants reported a higher RPE in the high intensity interval exercise session [16.5 (2.0)] compared with the CE session [9.0 (2.0), p = 0.01, r = -0.88]. CONCLUSION: Similar exercise enjoyment was reported following four high intensity intervals of 4 min compared with a moderate intensity CE session in this randomized crossover study with iso-caloric conditions. If enjoyment is a mediating factor for engaging in exercise, one should expect a similar probability of exercise adherence following high intensity 4 min intervals and continuous moderate intensity exercise when prescribing aerobic exercise as preventive medicine.

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.

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.

Identification of and Support for Children of Mentally Ill Parents: A 5 Year Follow-Up Study of Adult Mental Health Services.

Background: Children of parents with mental disorders are more likely to develop mental difficulties during their childhood and adulthood. Based on this knowledge, the Norwegian health legislation has been amended to better identify and protect children of parents with a mental illness. In this project, two interventions were implemented in a regional clinic for adult mental health services. These interventions were (i) Assessment Form and (ii) Child Talks. Both interventions aimed to support healthcare professionals in identifying and providing support for children of patients within adult mental health services. The process of changing relevant practice to become more family-focused was evaluated in 2010 and 2013, and the results showed some changes slowly materializing in the adult mental health services. The purpose of the current study was to investigate long-term effects of the interventions at 5 year follow-up (2015). The main aim was to investigate whether the workforce perceived that their clinical practice had changed as a result of the legislative change and the implemented interventions. Method: This longitudinal study consists of a pre-test, post-test and follow-up test. The sample (N = 219 at pre-test, N = 185 by post-test and N = 108 on follow-up test) included healthcare staff from a participating hospital, responding to an online survey about their routines for identifying children of patients, their attitudes, as well as concerns and expectations related to having a child perspective in their clinical work. Employee experiences with family conversations were also investigated, as well as their knowledge about the consequences parents' mental disorders may have for children. Results: Our findings showed a significant increase in participants identifying children of patients between pre- and post-measurement but a minor, non-significant increase at follow-up measurement. There was no significant increase of participants who reported that they had a lot of experience with family conversations. From post-test to follow-up, there was no increase in the workforce' reported positive attitudes, knowledge or expectations about the effects of the interventions. Conclusion: There have been some changes in clinical practice, but it seems that the changes required by law are a very time consuming process. It is necessary to increase the pace of the implementation process.