Social inequality in the association between life transitions into adulthood and depressed mood: a 27-year longitudinal study.

Background: Few studies have considered the life-course development of depressive symptoms in relation to life transitions in early-adulthood and whether these might affect depressive trajectories differently depending on specific indicators of parental socioeconomic status (SES). In the present work, we explore these questions using the adolescent pathway model as a guiding framework to test socially differential exposure, tracking and vulnerability of the effects of life transitions on depressed mood across different socioeconomic backgrounds. Methods: Latent growth modeling was used to estimate the associations between indicators of parental SES (parental education and household income) and depressed mood from age 13 to 40 with life transitions (leaving the parental home, leaving the educational system, beginning cohabitation, attaining employment) as pathways between the two. Our analyses were based on a 27-year longitudinal dataset (n = 1242) of a Norwegian cohort with 10 time points in total. To make socioeconomic comparisons, three groups (low, mid, and high) were made for parental education and income respectively. Results: Depressed mood decreased from age 13 to 40. The low and high parental education groups showed a stable difference in depressed mood during early adolescence, which decreased in young adulthood and then increased slightly in mid-adulthood. The low household income group showed higher depressed mood across young adulthood compared to the medium and higher household income groups. For life transitions, leaving the parental home and beginning cohabitation was associated with an added downturn of the trajectory of depressed mood when adjusting for other transitions. However, adolescents with high parental education showed a relatively stronger decrease in depressed mood when leaving the parental home. Similarly, adolescents with a high household income showed a relatively stronger decrease in depressed mood when leaving the educational system. Conclusions: Depressed mood decreased over time and developed differently depending on parental education and household income. Life transitions were generally associated with reductions in depressed mood across time, but lower SES youths were not found to be more socially vulnerable these effects.

Civic engagement and mental health trajectories in Norwegian youth.

Introduction: Applying variable-centered analytical approaches, several studies have found an association between civic engagement and youth mental health. In the present study, we used a person-centered approach to explore whether civic engagement was related to optimal trajectories of mental health compared to other trajectories. We also examined how sociodemographic factors, such as socioeconomic status (SES), gender and age were related to youth mental health trajectories. Methods: Our sample comprised 675 students (aged 16-22) who had participated in three waves of data collection (Mage = 18.85, SD = 0.55; 43% males) in the COMPLETE project, a cluster-randomized controlled trial that involved Norwegian upper secondary schools. Results: The results revealed three trajectories of mental health (reflecting a combination of mental distress and mental well-being): optimal, intermediate, and sub-optimal. Contrary to our expectations, higher levels of civic engagement were not related to the optimal trajectory of mental health vs. other trajectories. However, we found that students who reported higher levels of SES and males were more likely to follow the optimal trajectory compared to other trajectories. Discussion: While the findings on civic engagement could be due to our measurement's inability to capture the concept of "dugnad," a well-established civic activity in the Norwegian society, the findings regarding the influence of SES and gender suggest that there is still more work to be done concerning the assessment and advancement of factors that can address mental health inequalities across SES and gender.

Overall survival and causes of death in elderly patients with Hodgkin lymphoma: a Norwegian population-based case-control study.

Elderly Hodgkin Lymphoma (HL) patients are poorly characterized and underrepresented in studies. In this national population-based study, we investigated cause-specific survival using competing-risk analysis in elderly HL patients compared to the normal population. Patients ≥ 60 years diagnosed between 2000-2015 were identified by Cancer Registry of Norway, records reviewed in detail and compared to data from Norwegian Cause of Death Registry for patients and cancer-free controls. Of 492 patients, 81 (17%) were ineligible for treatment directed specifically towards HL, mostly because of an underlying other lymphoma entity, whereas 74 (15%) and 337 (69%) were treated with palliative or curative intent, respectively. Median overall survival in patients ineligible for assessment of HLdirected therapies was 0.5 years (95% confidence interval [CI] 0.4-0.6), and for palliatively and curatively treated patients 0.8 (0.4-1.2) and 9.1 (7.5-10.7) years, respectively. After correction of discrepancies in registry data, with 359 deaths, 108 (30%) died of HL, the most common cause of death. In curatively treated patients, treatment-related mortality was 6.5% and the risk-difference of dying from HL compared to controls was 28% (95% CI 23-33%) after 10 years. These numbers indicate disease control in a majority of elderly patients eligible for curative treatment, compared to risk-differences for death from HL of 59% (48-71%) and 42% (31-53%) after 10 years in the palliative and ineligible groups, respectively. There was an increased risk of dying from hematological malignancies other than HL in all groups, but not from other competing causes of death, showing no excess mortality from long-term treatment complications.

Tracking of depressed mood from adolescence into adulthood and the role of peer and parental support: A partial test of the Adolescent Pathway Model.

•Adolescent depressed mood predicts adult depressed mood.•Peer acceptance during adolescence is not associated with adult depressed mood.•Household income moderates the effect of parental closeness on adult depressed mood.

Adolescent determinants of life-course leisure-time vigorous physical activity trajectories: a 27-Year longitudinal study.

BACKGROUND: Adolescence is regarded as formative years for building the foundations for life-long health and well-being, and adolescent determinants of physical activity (PA) development is particularly interesting. Novel approaches for the study of PA development, such as group-based trajectory modelling, opens for the possibility of identifying different patterns in the relationship among several known determinants of PA. This study aimed to explore how demographic, psychological and social factors in early adolescence determine membership in four distinct leisure-time vigorous physical activity (LVPA) trajectories from 13 to 40 years. METHODS: This study is based on data from the Norwegian Longitudinal Health Behaviour Study, following a cohort born in 1977 from Western Norway. Four trajectories identified using latent class growth analysis, based on self-reposted LVPA (n = 1103, 45.5% women) measured ten times from age 13 to age 40 and 17 different adolescent determinants, were used in a multivariate multinomial logistic regression. RESULTS: We found that gender (male), VPA intentions the next year and athletic identity associated with belonging to the two trajectories reporting the highest levels of LVPA in adolescence, while VPA intentions in ten years were associated with belonging to the active trajectory compared to the decreasingly active and low active trajectories Enjoyment increased the odds of belonging to the increasingly and decreasingly active trajectories compared to the low active trajectory. In addition, two of the social determinants, mother's PA and emotional support from father, were associated with belonging to the increasingly active trajectory when compared to the low active trajectory. Higher family income increased the odds of belonging to the increasingly active compared to the decreasingly active trajectory. CONCLUSIONS: Both demographic, psychological, and social factors were identified as determinants of LVPA trajectory membership, and the findings support previous research related to the importance of intentions, but also indicate that enjoyment, role modelling and emotional support in PA can be of great importance to LVPA promotion among adolescents.

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

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

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

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

Measurement invariance of the empowering and disempowering motivational climate questionnaire-coach in youth sport.

The purpose of this study was to test the measurement invariance (across five languages, two time points, and two experimental conditions) of the empowering and disempowering motivational climate questionnaire-coach (EDMCQ-C; Appleton et al., 2016) when completed by 9256 young sport participants (M age = 11.53 years, SD = 1.39 years; 13.5% female). Exploratory Structural Equation Modeling was used to test the validity of a 2-factor (empowering and disempowering) model running a multiple group analysis without any equality constraint (configural invariance) followed by measurement invariance of factor loadings and thresholds (scalar invariance). Findings provided support for partial invariance across languages and scalar invariance across time and experimental groups. The factors were interpretable across the analyses, and items loaded as intended by theory except for item 15. This study provides further evidence regarding the psychometric properties of the EDMCQ-C and suggests this scale (minus item 15) can be used to provide meaningful latent mean comparisons (Marsh et al., 2013) of empowering and disempowering coach-created climates across athletes speaking the five targeted languages, across time, and across experimental groups.

Trends in the utilization of youth primary healthcare services and psychological distress.

BACKGROUND: Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need. METHODS: This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. RESULTS: We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 500 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16 and 66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend. CONCLUSIONS: Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

Exposure to Bullying Behaviors at Work and Depressive Tendencies: The Moderating Role of Victimization From Bullying During Adolescence.

The detrimental effects of exposure to bullying behaviors at work on employees' mental health have been thoroughly documented. However, few studies have examined whether employees' prior experiences with bullying may affect the strength of this relationship. The present study tested a model where victimization from bullying in adolescence was expected to (a) predict higher exposure to bullying behaviors at work and higher levels of depressive tendencies in adulthood and (b) strengthen the relationship between exposure to bullying behaviors at work and depressive tendencies (i.e., make employees more vulnerable). The hypotheses were tested using prospective data following a cohort of 536 Norwegian respondents over a time span of 17 years, from adolescence (age of 13) to adulthood (age of 30). Victimization from bullying in junior high school was measured at the age of 13, 14, and 15, and retrospectively at the age of 18. Exposure to bullying behaviors at work was measured at the age of 30, while depressive tendencies were measured at the age of 15 and at the age of 30. As predicted, those who had been bullied more (vs. less) in adolescence tended to have higher scores on depressive tendencies as adults and reported somewhat higher exposure to bullying behaviors at work. However, contrary to our predictions, the relationship between exposure to bullying behaviors at work and depressive tendencies in adulthood was weaker among those who had been bullied more (vs. less) in adolescence. The findings contribute to the scarce literature on the role of employees' prior victimization experiences and question the notion that prior victimization from bullying produces long-term vulnerability to future experiences of bullying.

Divorce and adolescent academic achievement: Heterogeneity in the associations by parental education.

BACKGROUND: The link between parental divorce and adolescents' academic achievement may depend on parental educational levels. However, findings have been inconsistent regarding whether the negative associations between parental divorce and adolescents' academic outcomes are greater or smaller in highly educated families. The present study aimed to investigate the possible heterogeneity in the associations between divorce and adolescents' academic achievement by parental educational levels, within the context of the elaborate Norwegian welfare state. METHODS: The population-based cross-sectional youth@hordaland study of adolescents aged 16-19 years conducted in Norway in 2012, provided information about parental divorce and was linked to national administrative registries (N = 9,166) to obtain high-quality, objective data on the adolescents' grade point average (GPA), and their parents' educational qualifications and income. RESULTS: The negative association between parental divorce and GPA was stronger among adolescents with educated or highly educated parents compared to adolescents with less educated parents. This heterogeneity was driven by maternal educational qualifications, whereby divorce was more strongly and negatively associated with GPA among adolescents with educated mothers compared to those with less educated mothers, independent of paternal educational levels and income measures. CONCLUSIONS: Among adolescents whose parents have low educational qualifications, parental divorce is not associated with their academic achievement. Educated divorced mothers appear less likely to transfer their educational advantages onto their children than nondivorced equally educated mothers, perhaps due to a "double-burden" regarding work pressure and child-rearing responsibilities. There is a need for future studies to detail the mechanisms underlying this finding.

Initial psychometric testing of the coach-adapted version of the empowering and disempowering motivational climate questionnaire: A Bayesian approach.

The present study examined the psychometric properties of the coach-adapted version of the Empowering and Disempowering Motivational Climate Questionnaire (EDMCQ) using Bayesian structural equation modelling (BSEM). The sample included 780 (Mage = 36.4; SD = 10.8; males n = 698; females n = 54; 28 participants did not report sex) youth sport coaches representing five European countries (i.e., England, France, Greece, Norway, and Spain). The results did not support a 34-item five-factor, hierarchical, a two-factor BSEM, or a bifactor BSEM model across the participating countries. However, the results supported a reduced 19-item first-order, two-factor BSEM model that largely showed approximate metric invariance, but not approximate scalar invariance across the five countries. The pool of items constituting empowering and disempowering motivational climates should be refined to further enhance the empirical operationalisation of the coach-adapted version of the EDMCQ. Advancing the quality of translation-back-translation procedures across cultures and conducting multi-national pilot testing seems warranted as well. These recommendations may help to identify the distinctive aspects of each underlying sub-dimension of the EDMCQ, where coaches are the respondents, and pave the way for further examination of the proposed hierarchical multidimensional factor structure and the cross-cultural equivalence of the EDMCQ for this population.

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

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

Associations between family structure and young people's physical activity and screen time behaviors.

BACKGROUND: Identifying factors that can influence young peoples' physical activity and sedentary behaviors is important for the development of effective interventions. The family structure in which children grow up may be one such factor. As the prevalence of single parent and reconstituted families have increased substantially over the last decades, the objective of this study was to examine whether these family structures are differentially associated with young people's MVPA, participation in organized sports and screen-time activities (screen-based passive entertainment, gaming, other screen-based activities) as compared to traditional nuclear families. METHODS: The data stem from the 2013/2014 "Health Behaviour in School- aged Children (HBSC) study". A large Norwegian sample of 11-16 years old students (n = 4509) participated. Cluster-adjusted regression models were estimated using full information maximum likelihood with robust standard errors (MLR). RESULTS: After adjusting for covariates, living with a single parent was negatively associated with days/week with 60 min MVPA (b = -.39, 95%CI: -.58, -.20), and positively associated with hours/weekday of total screen time (b = .50, 95%CI: .08, .93). Young people living with a single parent were also more likely to report no participation in organized sports (OR = 1.40, 95%CI: 1.09, 1.79). Living in a reconstituted family was negatively associated with days/week with 60 min MVPA (b = -.31, 95%CI: -.53, -.08), and positively associated with hours/weekday of total screen time (b = .85, 95%CI: .37, 1.33). For all outcomes, the interaction effects of family structure with sex, and with having siblings were not statistically significant. For material affluence, a significant interaction effect was found for participation in organized sports (χ2 [4] =13.9, p = .008). Those living in a reconstituted family with low or high material affluence had an increased risk for not participating in organized sports whereas those with medium material affluence did not. CONCLUSION: This study suggests that living with a single parent or in reconstituted families was unfavorably associated with physical activity, sport participation and screen-based behaviors among Norwegian youth. The findings indicate that family structure could be an important factor to take into account in the development and testing of interventions. More in-depth research is needed to identify the mechanisms involved.

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

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

Promoting additional activity in youth soccer: a half-longitudinal study on the influence of autonomy-supportive coaching and basic psychological need satisfaction.

This study investigated the relationships between perceptions of coach autonomy support, basic psychological need satisfaction and the frequency at which youth soccer players engage in additional soccer activity outside of team sessions. We employed structural equation modelling to test a two-wave (T1 and T2) half-longitudinal study to see if basic psychological need satisfaction mediated the relationship between coach autonomy support and additional soccer activity across a competitive season. The sample consisted of 527 youth soccer players, aged 10-15 years. Results revealed moderate to strong temporal stability for autonomy, competence, relatedness and frequency of additional soccer activity. Furthermore, no support is offered for mediation as T1 coach autonomy support was not related to any of the three basic needs at T2 when accounting for their T1 levels. However, a positive relationship between T1 autonomy and T2 additional soccer activity emerged. This suggests that those who experience high levels of autonomy in the team setting at the start of the season report an increased frequency of additional activity at the end of the season. Results are discussed in light of the Self-Determination Theory and the Trans-Contextual Model.

Changes in diet through adolescence and early adulthood: longitudinal trajectories and association with key life transitions.

BACKGROUND: Early adulthood is a period associated with poor diet and rapid weight gain. This is also an age of transition, including environmental, social and lifestyle changes which may be associated with changes in diet. We assess longitudinal associations between four early adulthood life transitions (leaving home, leaving education, entering employment, and cohabitation) and changes in consumption of fruit, vegetables, confectionery and sugar-sweetened beverages (SSBs). METHODS: Participants (n = 1100) from the Norwegian Longitudinal Health Behaviour Study, reported data on diet and life transitions on up to eight occasions from age 14 to age 30. Diet data were self-reported in response to questions on intake of fruit, vegetables, confectionery and sugar-sweetened beverages. Growth models were developed to describe changing intake of each of the four diet indicators with age. Fixed-effects regression models assessed associations between the four life transitions and within-individual changes in diet indicators, with adjustment for the remaining transitions and parenthood. RESULTS: Diet indicators showed quadratic trajectories with age: fruit and vegetable intakes declined from age 14 to ages 23 and 21 respectively, before increasing to age 30. SSB and confectionery intakes increased to age 18, before subsequently decreasing. Leaving the parental home was associated with a decrease in fruit intake of - 0.54 times/week (95% confidence interval (95%CI): -0.87;-0.22) and vegetable intake of - 0.43 times/week (95%CI: -0.70;-0.15). Leaving education was associated with increases in confectionery (0.33 times/week (95%CI: 0.04;0.62)) and SSB intakes (0.49 times/week (95%CI: 0.10;0.87). CONCLUSIONS: Leaving home and leaving education are associated with negative changes in diet and may present opportunities for effective diet and obesity intervention. Further study of these transitions is needed to understand the mechanisms mediating associations between life transitions and changes in diet.

Health-promotion research over three decades: The social-ecological model and challenges in implementation of interventions.

AIMS: This debate paper traces the development of innovative methods for undertaking health promotion research with a socialecological orientation, with a few examples drawn from 30 years of research on adolescent health promotion research at the University of Bergen. CONCLUSION: We aim to show how the social-ecological model is becoming more evident as a guide to research, using three cases that illustrate progress and potential. The first case is the Norwegian part of the European Network of Health Promoting Schools. The second case is a project just underway, The COMPLETE study, which is a community-led effort to promote students' mental health and create a good psychosocial learning environment. The third case is a developing idea for the next generation of social-ecological research on adolescent well-being, using an asset approach to foster social inclusion and sense of community in multiple settings.

Trajectories of alcohol use and association with symptoms of depression from early to late adolescence: The Norwegian Longitudinal Health Behaviour Study.

INTRODUCTION AND AIMS: Adolescence is a period in which many have an onset of alcohol use, but there is much heterogeneity in the individual development of alcohol use. Further, there is a general increase in depressive symptoms from early to late adolescence, but less is known about how different alcohol habit trajectories are associated with symptoms of depression. The aims of the present study were: to identify trajectories of alcohol consumption and drinking to intoxication during adolescence (age 13-18 years); and examine to what extent the different trajectories of alcohol use were associated with symptoms of depression over the same age span, from early to late adolescence. METHODS: Data from the Norwegian Longitudinal Health Behaviour Study were employed. Latent class growth analyses were employed to identify different trajectories of both alcohol consumption and drinking to intoxication. The resulting trajectories for each participant were used to estimate the gender-adjusted association between different development of alcohol use and symptoms of depression. RESULTS: Four trajectories of both alcohol consumption and drinking to intoxication were identified. The trajectories with an early onset of alcohol consumption or drinking to intoxication were associated with higher levels of depressive symptoms compared with late onset or stable low use trajectories. CONCLUSIONS: The findings from the present study suggest that early onset developmental trajectories of alcohol use are associated with depression. Therefore, broad assessment and interventions targeting both alcohol and depression may be indicated among early onset alcohol users, especially if they report increasing levels of consumption. [Skogen JC, Knudsen AK, Hysing M, Wold B, Sivertsen B. Trajectories of alcohol use and association with symptoms of depression from early to late adolescence: The Norwegian Longitudinal Health Behaviour Study. Drug Alcohol Rev 2016;35:307-316].

Growth Trajectories of Health Behaviors from Adolescence through Young Adulthood.

Based on nine waves of data collected during a period of 17 years (1990-2007), the present study explored different developmental trajectories of the following unhealthy behaviors: regular smoking, lack of regular exercise, lack of daily fruit intake, and drunkenness. A baseline sample of 1195 13-year-old pupils was from 22 randomly selected schools in the Hordaland County in western Norway. Latent class growth analysis revealed three developmental trajectories. The first trajectory was a conventional trajectory, comprising 36.3% of participants, who showed changes in smoking, physical exercise, fruit intake, and drunkenness consistent with the prevailing age specific norms of these behaviors in the Norwegian society at the time. The second trajectory was a passive trajectory, comprising 25.5% of participants, who reported low levels of both healthy and unhealthy behaviors during the 17-year period. The third trajectory was an unhealthy trajectory, comprising 38.2% of participants, who had high levels of unhealthy behaviors over time. Several covariates were examined, but only sex and mother's and father's educational levels were found to be significantly associated with the identified trajectories. While these findings need to be replicated in future studies, the identification of the different trajectories suggests the need to tailor intervention according to specific needs.