Reidar Jakobsen

Sleep and use of electronic devices in adolescence: results from a large population-based study

Objectives Adolescents spend increasingly more time on electronic devices, and sleep deficiency rising in adolescents constitutes a major public health concern. The aim of the present study was to investigate daytime screen use and use of electronic devices before bedtime in relation to sleep. Design A large cross-sectional population-based survey study from 2012, the youth@hordaland study, in Hordaland County in Norway. Setting Cross-sectional general community-based study. Participants 9846 adolescents from three age cohorts aged 16–19. The main independent variables were type and frequency of electronic devices at bedtime and hours of screen-time during leisure time. Outcomes Sleep variables calculated based on self-report including bedtime, rise time, time in bed, sleep duration, sleep onset latency and wake after sleep onset. Results Adolescents spent a large amount of time during the day and at bedtime using electronic devices. Daytime and bedtime use of electronic devices were both related to sleep measures, with an increased risk of short sleep duration, long sleep onset latency and increased sleep deficiency. A dose–response relationship emerged between sleep duration and use of electronic devices, exemplified by the association between PC use and risk of less than 5 h of sleep (OR=2.70, 95% CI 2.14 to 3.39), and comparable lower odds for 7–8 h of sleep (OR=1.64, 95% CI 1.38 to 1.96). Conclusions Use of electronic devices is frequent in adolescence, during the day as well as at bedtime. The results demonstrate a negative relation between use of technology and sleep, suggesting that recommendations on healthy media use could include restrictions on electronic devices.

Stages of Progression in Noncoital Sexual Interactions among Young Adolescents: An Application of the Mokken Scale Analysis

This study attempted to test empirically the tenability of the assumption of a sequential pattern of involvement in noncoital sexual interactions among white Western adolescents, by following a cohort between the ages of 13 and 16 years. The results documented that even among 13-year-old adolescents, one can already examine variations in noncoital sexual interaction, and that the various items of noncoital sexual interactions can be reliably measured. The Mokken scale analysis yielded empirical evidence of a sequential pattern of involvement in such behaviour among adolescents. Furthermore, it suggested that in early adolescence, the development of intimate sexual relationships is a slow, experimental, and cumulative process. For most adolescents, this process involves experimentation and the passage of time. The five items of noncoital sexual interactions form a strong Mokken scale, and were significant predictors of the onset of sexual intercourse.

THE EFFECT OF PARENTAL DENTAL HEALTH BEHAVIOR ON THAT OF THEIR ADOLESCENT OFFSPRING

This study was designed to investigate the effect of parental dental health behavior on that of their adolescent offspring. The data stemmed from The Norwegian Longitudinal Health Behavior Study performed in 1993 in the County of Hordaland in Norway and comprised separate questionnaires for both parents and a 16-year-old child in 436 family units. A compound measure of parental dental health behavior was applied in logistic regression analyses. The results showed that there were statistically significant associations of use of dental floss, tooth brushing, and drinking of non-sugared mineral water among parents and their adolescent offspring. No significant gender interaction in the association between same- or different-sex parent-adolescent dyads was observed. These findings indicate that parents function as social models for their offspring well into the adolescent period with regard to several dental health behaviors.

Sleep and use of alcohol and drug in adolescence. A large population-based study of Norwegian adolescents aged 16 to 19 years

BACKGROUND Changes in sleep patterns and increased substance involvement are common in adolescence, but our knowledge of the nature of their association remains limited. The aim of this study was to examine the association between several sleep problems and sleep behaviours, and use and misuse of alcohol and illicit drugs using data from a large population-based sample. METHODS A large population-based study from Norway conducted in 2012, the youth@hordaland study, surveyed 9328 adolescents aged 16-19 years (54% girls). Self-reported sleep measures provided information on sleep duration, sleep deficit, weekday bedtime and bedtime difference and insomnia. The main dependent variables were frequency and amount of alcohol consumption and illicit drug use, in addition to the presence of alcohol and drug problems as measured by CRAFFT. RESULTS The results showed that all sleep parameters were associated with substance involvement in a dose-response manner. Short sleep duration, sleep deficit, large bedtime differences and insomnia were all significantly associated with higher odds of all alcohol and drug use/misuse measures. The associations were only partly attenuated by sociodemographics factors and co-existing symptoms of depression and ADHD. CONCLUSIONS To the best of our knowledge, this is the first population-based study to examine the association between sleep, and alcohol and drug use, by employing detailed measures of sleep behaviour and problems, as well as validated measures on consumption of alcohol and illicit drug use. The findings call for increased awareness of the link between sleep problems and alcohol and drugs use/misuse as a major public health issue.

Alcohol and drug use among adolescents: and the co-occurrence of mental health problems. Ung@hordaland, a population- based study

Objectives The use of alcohol and drugs is prevalent among adolescents, but too little is known about the association between debut of alcohol and drug use, problematic use and concurrent mental health. The aim of the study was to investigate the cross-sectional association between debut of any alcohol or drug use and alcohol-related and drug-related problems and mental health. We also wanted to examine potential interactions between gender and age, and alcohol-related and drug-related variables. Design Cross-sectional study. Setting Population-based sample of Norwegian adolescents. Participants Data stem from the large population-based ung@hordaland study (N=9203), where all adolescents aged 17–19 years living in Hordaland county (Norway) were invited to participate. The main independent variables were debut of alcohol and drug use, alcohol consumption and the presence of alcohol and drug problems as measured by CRAFFT. Outcomes The dependent variables were self-reported symptoms of anxiety, depression, inattention and hyperactivity. Statistical analyses included logistic regression models. Results Debut of alcohol and drug use were associated with symptoms of depression, inattention and hyperactivity (crude ORs 1.69–2.38, p<0.001), while only debut of drug use was associated with increased symptoms of anxiety (OR=1.33, CI 95% 1.05 to 1.68, p=0.017). Alcohol-related and drug-related problems as measured by CRAFFT were associated with all mental health problems (crude ORs 1.68–3.24, p<0.001). There was little evidence of any substantial age or gender confounding on the estimated associations between alcohol-related and drug-related measures and mental health problems. Conclusions Early debut of alcohol and drug use and drug problems is consistently associated with more symptoms of mental health problems, indicating that these factors are an important general indicator of mental health in adolescence.

Mental Health Problems among Child Welfare Clients Living at Home

The great majority of children receiving intervention from child welfare and protection services (CWS) in Norway live at home. The purpose of this study was to assess mental health problems among these children. Data stem from a population-based study, the Bergen child study, conducted in 2006. Of a sample consisting of 4,162 children in the fifth to seventh grades, 82 children were CWS clients who lived at home. Compared with their peers, the CWS children had significantly higher scores on emotional problems, hyperactivity, conduct problems, peer problems, and total difficulties (child and parent reports on the Strengths and Difficulties Questionnaire). The relationship between being a CWS client and total difficulties remained significant when socio-demographic variables were controlled for. Even though the results indicate that child welfare clients have more contact with child and adolescent mental health service than earlier assumed, the results emphasise the need for strong collaboration between CWS and mental health services and the need for CWS to include other types of interventions in addition to financial support.

Mental Health Problems in Norwegian School Children Placed Out-of-home: The Importance of Family Risk Factors

The main aim of this article is to explore the association between mental health problems in children placed out-of-home and family risk factors reported as reasons for placement. The sample consisted of 109 Norwegian children aged 6–12 years. Mental health problems were assessed by the Revised Rutter scales reported by the parents and the teachers shortly after placement. On the basis of the reported reasons for placement, three risk indexes were constructed: parental risk, interactional risk, and child neglect and abuse risk. The analyses showed that 70% or more of the placed children had symptoms of mental health problems, boys more often than girls. Parental risk and interactional risk each accounted for a significant part of the variance in the childrens mental health, while child neglect and abuse did not. Our data, however, indicated that children placed out-of-home mainly due to parental risk had less mental health problems than other children, while children placed due to interactional risk or child neglect and abuse had more problems. The study indicates that family-related reasons for placement reported by the child welfare workers are important indicators for assessing mental health problems in children placed out-of-home.

Organization of HIV/AIDS related attitudes and predictors of attitudes

The purpose of this study was to investigate the psychological organization of attitudes towards public measures instituted to combat AIDS; secondly, to study the cognitive information about HIV transmission upon which these attitudes are based; and thirdly, to study whether education plans and gender also predicted negative attitudes. The study subjects were 229 students attending a Norwegian high-school (median age = 19), and the data were collected using a self-administered questionnaire. Confirmatory factor analysis confirmed the existence of two separate attitudinal dimensions: “Restrictive” and “Supportive”. The hypothesis was confirmed that beliefs about uncontrollable contact predicted “Restrictive” attitudes, while beliefs about controllable contacts did not. Educational plans, gender and “Uncontrolable contact” beliefs each predicted “Restrictive” attitudes. This suggests that beliefs and attitudes have instrumental as well as symbolic bases. Implications for public health strategies are discussed.