Sondre Aasen Nilsen

• Nilsen, Sondre Aasen; Breivik, Kyrre; Stormark, Kjell Morten & Bøe, Tormod (2026). Does Income Inequality Predict Adolescent Depressive Symptoms? Psychological Science. ISSN 0956-7976. s. 1–21. doi: 10.1177/09567976261432207. Fulltekst i vitenarkiv Vis sammendrag

  Income inequality is frequently cited as a forceful determinant of mental health and as a possible contributor to the rising trend in adolescent depressive symptoms. However, research findings often rely on low-powered cross-sectional designs. We conducted a preregistered study of the within-municipality effect of income inequality on adolescent depressive symptoms in Norway, covering ≈550,000 respondents nested within 863 municipality years and 340 municipalities. Using multilevel modeling and equivalence testing, the overall within-municipality effect of income inequality was neither statistically significant nor practically meaningful and did not significantly interact with family financial situation. A significant gender interaction showed that rising inequality predicted slightly higher depressive symptoms among females and slightly lower among males; however, the main gender effects were also probably too small to be meaningful. We conclude that changes in income inequality likely do not meaningfully predict nor help explain changes in adolescent depressive symptoms in Norway from 2010 to 2019.

• Nilsen, Sondre Aasen; Hysing, Mari & Sivertsen, Børge (2025). Parental separation and mental health problems among university students. Journal of Affective Disorders. ISSN 0165-0327. 397. doi: 10.1016/j.jad.2025.121010. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Parental separation is a risk factor for mental health problems among children and adolescents, but less is known about how parental separation relates to mental health in young adults pursuing higher education. We examined whether students with separated parents are more likely to report mental disorders and psychological distress than students without separated parents. Methods Data were drawn from the national Norwegian SHOT2022 survey (N = 52,968) of university students aged 18–35. Associations between parental separation and mental health were examined using log-link binomial regressions for self-reported disorders and ordinary least squares (OLS) regressions for psychological distress. Results Students with separated parents reported higher levels of psychological distress and were more likely to report a range of mental disorders, including depression, anxiety, and PTSD. These associations were generally modest and consistent across genders. Time since parental separation was positively and linearly associated with psychological distress, with students whose parents had separated longer ago reporting higher levels than those whose parents had separated more recently. Discussion University students with separated parents have a higher risk of self-reported mental disorders and report higher levels of psychological distress than peers. The results highlight that parental separation remains relevant for understanding variations in mental health also among university students.

• Brunborg, Geir Scott; Nilsen, Sondre Aasen; Skogen, Jens Christoffer & Bang, Lasse (2025). Possible explanations for the upward trend in mental distress among adolescents in Norway from 2011 to 2024. Social Science and Medicine. ISSN 0277-9536. 384. doi: 10.1016/j.socscimed.2025.118528. Fulltekst i vitenarkiv Vis sammendrag

  Background An upward trend in self-reported mental distress among adolescents has been documented in Norway and several other countries, yet the causes remain unclear. This study aims to identify potential explanations for this trend by testing hypothesized factors using repeated cross-sectional data. Methods We analyzed responses from 979,043 Norwegian adolescents, collected across 1417 municipality level surveys between 2011 and 2024. Eight explanatory factors with prior evidence of association with mental distress were examined: family financial difficulty, evenings spent at home, physical inactivity, bullying victimization, dissatisfaction with parents, social media use, cannabis use, and school dissatisfaction. Following a published epidemiological framework, we assessed changes in prevalence, virulence (strength of association), and the degree to which each factor statistically explained the trend in mental distress. Results Mental distress increased significantly for both sexes over time. Increased school dissatisfaction accounted for a large share of the observed trend. Time spent on social media, also explained a part of the trend. Spending more evenings at home and cannabis use contributed modestly. Other factors, including financial difficulty, bullying victimization, physical inactivity, and dissatisfaction with parents, showed limited explanatory value. Conclusions The rising trend in adolescent mental distress in Norway appears most plausibly linked to growing school dissatisfaction, with a possible contributory role of social media use. These findings underscore the need for further research into school-related factors and adolescent digital experiences, as well as preventive measures.

• Nilsen, Sondre Aasen; Radlick, Rebecca Lynn & Askeland, Kristin Gärtner (2025). Poor family finances, family-based adverse childhood experiences, and depressive and behavioral symptoms in adolescence. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 60, s. 1707–1719. doi: 10.1007/s00127-025-02824-4. Fulltekst i vitenarkiv Vis sammendrag

  Purpose Adverse childhood experiences (ACEs) are a possible pathway through which poor family finances influences adolescents’ behavioral and mental health problems. However, the interrelationship between family finances, ACEs, and behavioral and mental health outcomes in adolescence has received little attention. We aimed to (1) document exposure to family-based ACEs by perceived family finances (PFF), (2) examine how PFF relates to cumulative and pattern-based approaches to ACEs, and (3) assess the direct and interactive associations between PFF and ACEs in relation with behavioral and mental health problems. Methods Data stem from the 2017–2019 nationwide Ungdata surveys of adolescents aged 13–15 (n = 12,560). Family-based ACEs were measured by 6 items covering parental alcohol use and intoxication, and intra-familial violence and fighting. The family-based ACEs were used both as a cumulative index score and examined through latent class analysis (LCA) to identify patterns of exposures. Cluster robust linear regression analyses were used to examine additive and interactive associations between PFF, family-based ACEs, and behavioral and depressive symptoms. Results Poor (compared to not poor) PFF was significantly associated with more depressive symptoms and behavioral problems. Cumulative and pattern based approaches to family-based ACEs partially and similarly attenuated the association between PFF and mental health outcomes. Mainly, however, PFF and family-based ACEs were independently associated with mental health outcomes and did not interact. Conclusions Poor family finances and family-based ACEs co-occur, and both have strong associations with depressive symptoms and behavioral problems in adolescence.

• Nilsen, Sondre Aasen & Pettersen, Susann Dahl (2025). Måleegenskaper ved den norske versjonen av Hopkins Symptom Checklist-5 (HSCL-5). PsykTestBarn. 15(1), s. 1–18. doi: 10.7557/29.8046. Fulltekst i vitenarkiv Vis sammendrag

  Beskrivelse: Hopkins Symptom Checklist-5 (HSCL-5) er et kortfattet måleverktøy for psykiske plager. HSCL-5 består av fem spørreledd som kartlegger respondentens angst- og depresjonssymptomer i løpet av de to siste ukene. Instrumentet ble utviklet av Tambs og Moum som en kortere versjon av HSCL-25. HSCL-5 er i utgangspunktet ment for forskere som vil måle symptomer hos voksne, men måleverktøyet har også vært brukt i studier av ungdom. Hensikten med denne systematiske oversikten var å oppsummere resultater fra studier som har undersøkt måleegenskaper til HSCL-5 når instrumentet er administrert til barn og ungdom. Litteratursøk: Et systematisk litteratursøk resulterte i at 26 vitenskapelige artikler og en masteroppgave ble inkludert (fra n = 8 unike datakilder). Alle disse var basert på norske utvalg med en overveiende majoritet fra Ung-HUNT- undersøkelsene av ungdom i alderen 13–19 år. Ingen svenske eller danske publikasjoner oppfylte inklusjonskriteriene. Psykometri: Resultatene viser at HSCL-5 har tilstrekkelig til god indre konsistens (Cronbach’s alpha verdier fra 0,79-0,84) for norske ungdommer og unge voksne. Flere studier rapporterer middelverdier og standardavvik for en generell ungdomspopulasjon og noen undergrupper. Målets begrepsvaliditet er mangelfullt dokumentert, og kriterievaliditeten til instrumentet er kun undersøkt i en studentpopulasjon. Konklusjon: I ungdomsutvalg har den norske versjonen av HSCL-5 tilstrekkelig til god indre konsistens og virker å kunne skille mellom grupper som en skulle forvente har ulik grad av psykiske plager. Instrumentets begrepsvaliditet, inkludert faktorstruktur, konvergerende og kriterievaliditet, samt i hvilken grad instrumentet er måleinvariant på tvers av undergrupper som kjønn og alder, er imidlertid ikke dokumentert for barn og unge. Samlet, konkluderes det derfor med at det foreligger noe mangelfull informasjon om måleegenskapene til HSCL-5 når administrert i utvalg av ungdom, og at det ikke finnes informasjon om måleegenskapene til HSCL-5 når administrert til barn.

• Skandsen, Annika; Nilsen, Sondre Aasen; Hysing, Mari; Teicher, Martin H.; Sand, Liv & Bøe, Tormod (2024). Associations Between Distinct Trauma Classes and Mental Health Care Utilization in Norwegian Adolescents: A National Registry Study. Child Psychiatry and Human Development. ISSN 0009-398X. doi: 10.1007/s10578-024-01671-9. Fulltekst i vitenarkiv Vis sammendrag

  Adolescents who experience potentially traumatic experiences (PTEs) have an increased risk of psychopathology. PTEs often co-occur and may form interrelated patterns of exposure. This study investigated underlying classes of PTE exposure among Norwegian adolescent participants in the youth@hordaland study, and whether such classes were associated with contact with child and adolescent mental health services (CAMHS) and psychiatric diagnoses. The data stem from the population-based youth@hordaland study conducted in 2012 which was linked to the Norwegian Patient Registry (NPR, n = 8845). Exposure to PTEs was assessed by adolescent self-report whereas psychiatric disorders (Axis 1) were derived from the NPR. Latent Class Analysis was used to identify distinct classes of PTE exposure-patterns in the data. Logistic regression analyses were performed to investigate associations between classes of PTEs and contact with CAMHS and psychiatric diagnoses. Three classes of PTE exposure were identified based on model fit indices and theoretical considerations. Compared with participants in the low trauma class (88% of participants), those in the Situational-(6%) and Interpersonal trauma class (6%) had higher odds-ratios (ORs) for contact with CAMHS (OR = 2.27 (95% CI [1.78, 2.87])) and (OR = 3.26 (95% CI [2.61, 4.04])) respectively, and for being diagnosed with a psychiatric disorder in CAMHS (ORs ranged from 2.19 – 10.4) after adjusting for sex and parental education. There were more participants diagnosed with ADHD within the Interpersonal trauma class compared to the Situational trauma class when adjusting for sex and parental education (OR = 2.22 (95% CI [1.17, 4.40])). Three relatively homogeneous PTE classes, consisting of distinct patterns of trauma exposure were associated with a higher odds of contact with CAMHS and of being diagnosed with a psychiatric disorder in CAMHS. The study highlights the co-occurrence of PTEs and their impact across the diagnostic spectrum.

• Potrebny, Thomas; Nilsen, Sondre Aasen; Bakken, Anders; Soest, Tilmann von; Kvaløy, Kirsti & Samdal, Oddrun [Vis alle 9 forfattere av denne artikkelen] (2024). Secular trends in mental health problems among young people in Norway: a review and meta-analysis. European Child and Adolescent Psychiatry. ISSN 1018-8827. 34, s. 69–81. doi: 10.1007/s00787-024-02371-4. Fulltekst i vitenarkiv Vis sammendrag

  There is a growing concern that the mental health of recent generations of youth is deteriorating, yet the etiology of these secular changes is not fully understood. We aimed to review the evidence on trends in mental health problems among young people in Norway. Seven large-scale repeated cross-sectional studies were included in this study, comprising 35 cross-sectional data collections between 1992 and 2019, with a total sample of 776,606 young people. Our study found a clear increase in mental health problems among young females in Norway over the past few decades, while the trends were less marked for males. The proportion of individuals scoring above the problematic symptom score threshold increased on average by 11.2% (range 2.2% to 21.9%) for females and 5.2% (range − 0.9% to 11.1%) for males, based on data from the individual studies. The results from a meta-regression analysis showed that across all surveys, mean symptom scores increased by 17% (95% CI 12 to 21%) among females and 5% (95% CI 1 to 9%) among males from 1992 to 2019. Overall, mental health problems have increased continually since the early 1990s among young people, especially among young females. The cause of these secular changes remains unknown but likely reflect the interplay of several factors at the individual and societal level.

• Rasheed, Muneera Abdul; Nilsen, Sondre Aasen; Strand, Tor Arne; Shaheen, Fariha & Kvestad, Ingrid (2024). Is home environment associated with child fluid reasoning abilities in middle childhood in high-risk settings? findings from a cross-sectional study in Pakistan. BMC Pediatrics. 24(1). doi: 10.1186/s12887-024-05108-z. Fulltekst i vitenarkiv Vis sammendrag

  Background Evidence from low- and middle-income countries (LMIC) suggests that home environment is associated with early childhood development outcomes. However, studies from LMIC that have examined how the home environment during middle childhood is associated with intellectual abilities are scarce. The objective of the study was to explore the association between different aspects of the home environment at 7–8 years and fluid reasoning abilities in a rural, high-risk cohort in Pakistan. Methods We employed a cross-sectional research design to examine 1172 children between 7 and 8 years and their families, utilizing the Home Observation for Measurement of Environment for Middle Childhood (HOME-MC) to evaluate various aspects of the home environment and the Fluid Reasoning Index (FRI) of the Wechsler Intelligence for Children (WISC)-5th edition to assess the fluid reasoning abilities of the children. Multivariable regression analyses were used to examine the association between different components of HOME-MC (scored as indices) and FRI scores. Findings Learning materials and opportunities (β = 1.74, 95% CI = 1.15, 2.33) and Responsivity (β = 1.73, 95% CI = 1.07, 2.38) indices had the strongest association with FRI score followed by Family companionship index (β = 1.27, 95% CI = 0.63, 1.90). The eight different indices of the HOME-DC explained 22% of the total variation in FRI scores. Conclusion We conclude that concurrent learning opportunities, parental responsivity and family companionship at home are associated with fluid reasoning abilities during middle childhood which is comparable to what has been found in early childhood years.

• Heimli, Oda Marie; Kvestad, Ingrid; Bøe, Tormod; Sayyad, Nawar Mahmoud Ali; Nilsen, Sondre Aasen & Randal, Sølve Bjørn [Vis alle 7 forfattere av denne artikkelen] (2024). Protective factors associated with resilience among unaccompanied refugee minors after settling in Norway: a matched cross-sectional study. European Child and Adolescent Psychiatry. ISSN 1018-8827. 33, s. 2813–2822. doi: 10.1007/s00787-023-02364-9. Fulltekst i vitenarkiv Vis sammendrag

  This study aimed to examine protective factors associated with resilience among unaccompanied refugee minors in comparison to their Norwegian peers and to examine associations between resilience factors and characteristics related to positive outcomes among unaccompanied minors. Data stem from the Pathways to Independence study conducted in Bergen municipality, Norway in 2018–2019 where 81 unaccompanied minors aged 15–20 participated (83.3% male; 80% response rate). An age- and sex-matched control group of 324 adolescents was retrieved from the youth@hordaland study conducted in Norway in 2012. Resilience factors were assessed by the Resilience Scale for Adolescents. Unaccompanied minors reported lower scores on Goal Orientation (d = 0.4), Social Competence (d = 0.4), and Social Support (d = 0.7) compared to Norwegian adolescents. Being male was associated with lower scores on Goal Orientation (standardized mean difference [SMD] = − 0.9) and Social Support (SMD = − 0.9) among unaccompanied minors, while being in frequent contact with family in the home country was associated with higher scores on all resilience factors (SMD range = 0.6–1.1). The number of leisure activities was associated with Social Competence (SMD = 0.22). There were no significant associations between the resilience factors and amount of support in the living arrangements or contact with the child welfare services. Unaccompanied minors reported fewer resilience factors compared to Norwegian adolescents, indicating that they may have different needs compared to other adolescents. Our study also suggests that frequent contact with family in the home country may be important to bolster positive development for unaccompanied minors after settlement.

• Nilsen, Sondre Aasen; Stormark, Kjell Morten; Bang, Lasse; Brunborg, Geir Scott; Larsen, Marit Hjellset & Breivik, Kyrre (2024). Time trends in adolescent depressive symptoms from 2010 to 2019 in Norway: real increase or artifacts of measurements? Psychological Medicine. ISSN 0033-2917. 54(14), s. 3949–3961. doi: 10.1017/S0033291724002447. Fulltekst i vitenarkiv Vis sammendrag

  Background Whether the recent rise in adolescent self-reported depressive symptoms is influenced by changing reporting behavior is much debated. Most studies use observed sum scores to document trends but fail to assess whether their measures are invariant across time, a prerequisite for meaningful inferences about change. We examined whether measurement noninvariance, indicative of changing perceptions and reporting of symptoms, may influence the assessment of time trends in adolescent depressive symptoms. Methods Data stem from the nationwide repeated cross-sectional Ungdata-surveys (2010–2019) of 560 712 responses from adolescents aged 13 to 19 years. Depressive symptoms were measured with the Kandel and Davies' six-item Depressive Mood Inventory. Using structural equation modeling, we examined measurement invariance across time, gender and age, and estimated the consequences of noninvariance on cross-cohort time trends. Results Across most conditions, the instrument was found measurement invariant across time. The few noninvariant parameters detected had negligible impact on trend estimates. From 2014, latent mean depressive symptom scores increased among girls. For boys, a U shaped pattern was detected, whereby an initial decrease in symptoms was followed by an increase from 2016. Larger issues of noninvariance were found across age in girls and between genders. Conclusions From a measurement perspective, the notion that changed reporting of symptoms has been an important driver of secular trends in depressive symptoms was not supported. Thus, other causes of these trends should be considered. However, noninvariance across age (in girls) and gender highlights that depressive symptoms are not necessarily perceived equivalently from early to late adolescence and across gender.

• Askeland, Kristin Gärtner; Radlick, Rebecca Lynn; Bøe, Tormod; Hysing, Mari; Greca, Annette M. La & Nilsen, Sondre Aasen (2024). Parental unemployment and educational outcomes in late adolescence: the importance of family cohesion, parental education, and family income in a Norwegian study. Scandinavian Journal of Public Health. ISSN 1403-4948. 53. doi: 10.1177/14034948241228163. Fulltekst i vitenarkiv Vis sammendrag

  Aims: The study aimed to investigate the association between parental unemployment and grade point average and school completion in adolescence, and the importance of family cohesion, parental education, and family income in explaining these associations. Methods: Data stem from the Norwegian cross-sectional 2012 youth@hordaland-survey including 8437 adolescents (53.4% girls). Information on grade point average, school completion, parental education, and family income were retrieved from the National Education Database. Parental work status and family cohesion were assessed by adolescent self-report. Results: Adolescents with at least one unemployed parent had lower grade point averages (3.49 compared with 3.92, P<0.001) and rates of school completion (71.9% compared with 86.6%, P<0.001) compared with adolescents with two working parents. The associations between parental unemployment and both grade point average (b = −0.22, 95% confidence interval −0.32, –0.12) and school completion (odds ratio 0.59, 95% confidence interval 0.46, 0.76) partly attenuated but remained significant when taking family cohesion, parental education, and family income into account. There was a significant interaction between parental unemployment and family cohesion on grade point average, in which the positive association between family cohesion and grade point average was weaker for adolescents with unemployed parents. Conclusions: Adolescents with parents outside of the workforce are at higher risk of poorer educational outcomes than peers with working parents. Combined with the positive associations between parental education, family cohesion, family income, and educational outcomes, this underscores the importance of parents for adolescent educational outcomes, and suggests that parents and the family situation should be considered when providing academic support for adolescents who struggle in upper secondary school.

• Furuhaug, Rebekka; Markussen, Vivian; Hysing, Mari; Nilsen, Sondre Aasen; Heradstveit, Ove & Askeland, Kristin Gärtner (2024). Mental health, negative life events and resilience among adolescents in contact with the child welfare services. Children and Youth Services Review. ISSN 0190-7409. 161. doi: 10.1016/j.childyouth.2024.107625. Fulltekst i vitenarkiv Vis sammendrag

  Adolescents in contact with the child welfare services (CWS) are at increased risk of experiencing negative life events (NLE) and mental health problems compared to the general population. There is, however, limited knowledge of whether protective factors can promote resilience in the CWS population in the context of NLE. Data stem from the population-based youth@hordaland study conducted in 2012, comprising 9492 adolescents aged 16–19 years. In total, 283 youth confirmed contact with the CWS and were categorized as receiving in-home services (IHS; n = 138) or living in foster care (FC; n = 145). The youth provided self-report information on NLE, mental health problems and protective factors. The IHS- and FC groups reported significantly more NLE, mental health problems and fewer protective factors compared to the general population. Adolescents receiving IHS consistently reported the most problems compared to the general population. Approximately 30 % of the association between contact with the CWS and mental health problems was mediated by NLE. Further, higher scores on the protective factors predicted lower levels of mental health problems, independent of the number of experienced NLE. Small interaction effects were found for the protective factors Goal Orientation and Family Cohesion and NLE. The results highlight that protective factors can buffer against mental health problems among adolescents receiving CWS interventions. More research is needed to further disentangle the mechanisms leading to better outcomes in this high-risk group of adolescents.

• Schønning, Viktor; Dovran, Anders; Hysing, Mari; Hafstad, Gertrud Sofie; Nilsen, Sondre Aasen & Aarø, Leif Edvard [Vis alle 7 forfattere av denne artikkelen] (2024). Mental health in Norwegian children and adolescents exposed to childhood maltreatment: a comparison to a general population sample. Nordic Psychology. ISSN 1901-2276. doi: 10.1080/19012276.2024.2390428. Fulltekst i vitenarkiv Vis sammendrag

  The current study aimed to compare mental health outcomes of children and adolescents with maltreatment experiences to a general population sample. A secondary aim was to examine sex differences in mental health outcomes, and the association between polyvictimization and mental health. The two samples were age- and sex-matched, and data was collected from caregiver-reports and self-reports. 1378 participants aged 5 to 18 years were included in the study. Children and adolescents exposed to maltreatment had more mental health problems than the general population sample. Large effect sizes (d ≥ 0.8) were found for emotional problems (d = 1.19), hyperactivity problems (d = 0.88), peer problems (d = 0.86), and the impact score (d = 0.93). A moderate to large effect size was found on the conduct problems subscale (d = 0.68), and a small effect size was found on the prosocial subscale (d = −0.22). There was a dose-response relationship between cumulative maltreatment exposure and the severity of mental health problems. Childhood maltreatment was associated with considerably more emotional problems, hyperactivity problems, and peer problems, which in turn can impact the daily life of the exposed children and adolescents. Effective support measures for maltreated young people must be a priority.

• Girard, Lisa-Christine; Bøe, Tormod; Nilsen, Sondre Aasen; Askeland, Kristin Gärtner & Hysing, Mari (2024). Developmental trajectories of conduct problems and time-varying peer problems: the Bergen child study. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. 59, s. 2237–2246. doi: 10.1007/s00127-024-02644-y. Fulltekst i vitenarkiv Vis sammendrag

  Background: While it is increasingly acknowledged that conduct problems and peer problems often co-occur in development, less is known about the ways in which peer problems may alter the developmental course of conduct problems for distinct subgroups. Methods: Using data from a large population-based study in Norway (the Bergen Child Study/youth@hordaland; 47.4% males), we estimated group-based trajectories of conduct problems and the presence of time-varying peer problems on the developmental progression of conduct problems between seven and 19 years of age. Risk factors for group membership were also examined. Results: A 3-group model of conduct problems best fit the data (non-engagers, low-engagers, moderate-stable). The presence of peer problems increased the estimated level of conduct problems for both the low-engagers and moderate-stable groups across adolescence. No differences in conduct problems were observed when peer problems were present in childhood or preadolescence for these two groups, nor for the non-engagers group at any point. Being male, having lower perceived economic wellbeing, and lower levels of parental education predicted group membership for the moderate-stable group, whilst lower paternal education predicted membership for the low-engagers group. Conclusions: Support for developmental ‘turning points’ was found, suggesting that adolescence is a particularly salient time for those with conduct problems. In particular, the presence of peer problems can increase observed conduct problems at this stage in development.

• Karhina, Kateryna; Bøe, Tormod; Hysing, Mari & Nilsen, Sondre Aasen (2023). Parental separation, negative life events and mental health problems in adolescence. BMC Public Health. 23. doi: 10.1186/s12889-023-17307-x. Fulltekst i vitenarkiv Vis sammendrag

  Background Parental separation is associated with mental health problems in adolescence. One suggested pathway for this association is through the accumulated exposure to stress and other negative life events. This study aimed to document the distribution of negative life events among adolescents with separated compared to non-separated parents, and to assess the direct and interactive associations between parental separation, negative life events, and mental health problems in adolescence. Methods Data stem from the cross-sectional population-based youth@hordaland study of adolescents (aged 16–19) conducted in Norway in 2012, providing self-reported information about parental separation, negative life events, and depression-, anxiety-, conduct-, and ADHD symptoms. Regression analyses were used to assess the direct and interactive associations between parental separation, negative life events, and mental health problems. Results Adolescents with separated parents had more mental health problems across all symptom scales compared to peers with non-separated parents, with standardized mean differences [SMDs] ranging from 0.15 to 0.20. Negative life events moderately attenuated these differences (reduced the SMDs with about 0.04–0.08, depending on the outcome). However, none of the interactions between parental separation and negative life events on mental health problems were statistically significant. Conclusions Higher exposure to negative life events explains parts of the association between parental separation and mental health problems in adolescence. However, a parental separation does not seem to increase the vulnerability of the effects of negative life events on adolescents’ mental health. Assessing exposure to negative life events is important when providing mental health services to adolescents, particularly to those who have parents separated.

• Heradstveit, Ove; Hysing, Mari; Bøe, Tormod; Nilsen, Sondre Aasen; Sivertsen, Børge & Bretteville-Jensen, Anne Line [Vis alle 7 forfattere av denne artikkelen] (2023). Prospective associations between adolescent risky substance use and school dropout and the role of externalising and internalising problems. Nordic Studies on Alcohol and Drugs (NAD). ISSN 1455-0725. 41(1), s. 24–38. doi: 10.1177/14550725231188568. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Schønning, Viktor; Hysing, Mari; Dovran, Anders; Nilsen, Sondre Aasen; Hafstad, Gertrud Sofie & Vedaa, Øystein [Vis alle 7 forfattere av denne artikkelen] (2023). Sleep and childhood maltreatment: A matched-control study of sleep characteristics in Norwegian 16–19-year-olds. Scandinavian Journal of Psychology. ISSN 0036-5564. 65(1), s. 119–128. doi: 10.1111/sjop.12960. Fulltekst i vitenarkiv Vis sammendrag

  Sleep problems are an important but understudied health problem in adolescents exposed to childhood maltreatment. The current study aimed to examine sleep characteristics and insomnia in a population with maltreatment history and compare them to a general population sample of adolescents. Data from a sample of Norwegian 16–19-year-old adolescents with childhood maltreatment experiences (n = 62) were linked to an age- and sex-matched general population sample (n = 238). Independent samples t tests were used to compare the two groups on several detailed sleep parameters, while general linear models were used to control for mental health problems, assessed by the Strengths and Difficulties Questionnaire. Mental health was examined as a potential mediator between childhood maltreatment and sleep characteristics. Adolescents exposed to childhood maltreatment had longer sleep onset latency (1:15 h vs. 47 min, p < 0.001), longer wake after sleep onset (34 min vs. 15 min, p < 0.003), lower sleep efficiency in weekdays (77.8%, vs. 85%, p < 0.007), and lower sleep efficiency in weekends (81.8% vs. 88.9%, p < 0.001) than the reference group. Mental health problems fully mediated the association between childhood maltreatment exposure and longer sleep onset latency and wake after sleep onset. The rate of insomnia did not significantly differ between the groups. This study suggests that older adolescents exposed to childhood maltreatment have more sleep problems than the general adolescent population, and that these problems may be explained by co-existing mental health problems. These findings highlight the potential utility of assessing and providing sleep-focused treatment to adolescents with a history of childhood maltreatment and mental health problems.

• Havnen, Karen J Skaale; Kojan, Bente Heggem; Askeland, Kristin Gärtner; Nilsen, Sondre Aasen & Storhaug, Anita Skårstad (2023). Decision making in child protection emergency cases in Norway. Children and Youth Services Review. ISSN 0190-7409. 154. doi: 10.1016/j.childyouth.2023.107141. Fulltekst i vitenarkiv Vis sammendrag

  Background Research on decision-making factors in child protection emergency cases is scarce, and even less is known about factors that can avert emergency placement. Objective This study aims to explore factors that distinguish emergency cases that conclude in emergency placement (EP) from emergency cases that conclude in averted emergency placement (AEP). Participants and setting The study is based on data from an electronic survey on child protection emergency work, completed by a national sample of child protection leaders (N = 154). Method The survey included questions on external and organisational conditions of the Child Protection Service (CPS), as well as descriptions, activities and assessments related to selected emergency cases. Sixty-three of the selected cases were concluded with EP and ninety-one cases were concluded with AEP. Group differences between EP and AEP cases were analysed using descriptive statistics and logistic regression analyses. Results The findings indicate that the case factor “violence at home/child abuse” and the CPS’s activity of “considering out-of-home measures” at initial assessment phase were significantly associated with EP. Activities like “home visits” and “contact with the network” were significantly associated with AEP. Crucial factors for decision-making according to the leaders were “parents’ opinion” and “resources in the network”, which were both significantly associated with AEP. Conclusions The study has identified several potential important factors for averting emergency placements. Building averting capability in CPS is important to avoid the huge relational and social costs of errors relating to EP decisions.

• Nilsen, Sondre Aasen; Stormark, Kjell Morten; Heradstveit, Ove & Breivik, Kyrre (2023). Trends in physical health complaints among adolescents from 2014 – 2019: Considering screen time, social media use, and physical activity. SSM - Population Health. ISSN 2352-8273. 22. doi: 10.1016/j.ssmph.2023.101394. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Sivertsen, Børge; O’Connor, Rory C.; Nilsen, Sondre Aasen; Heradstveit, Ove; Askeland, Kristin Gärtner & Bøe, Tormod [Vis alle 7 forfattere av denne artikkelen] (2023). Mental health problems and suicidal behavior from adolescence to young adulthood in college: linking two population-based studies. European Child and Adolescent Psychiatry. ISSN 1018-8827. doi: 10.1007/s00787-023-02167-y. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Karhina, Kateryna; Bøe, Tormod; Hysing, Mari; Askeland, Kristin Gärtner & Nilsen, Sondre Aasen (2023). Parental separation and school dropout in adolescence. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948231164692. Fulltekst i vitenarkiv Vis sammendrag

  Aims: To document the association between parental separation and school dropout in adolescence and to examine the factors that may potentially account for this association. Methods: Data stem from the large youth@hordaland study that was linked to the Norwegian National Educational Database to obtain objective measures of educational outcomes and disposable income (N = 8323). Logistic regression analysis was used to investigate the association between parental separation and school dropout. A Fairlie post-regression decomposition was used to examine the influence of parental education, household income, health complaints, family cohesion, and peer problems in explaining the association between parental separation and school dropout. Results: Parental separation was associated with a higher odds ratio (OR) of school dropout in crude and adjusted (adjusted odds ratio (AOR)) analyses (OR=2.16, 95% confidence interval (CI) =1.90–2.45; AOR = 1.72, 95% CI = 1.50–2.00). About 31% of the higher odds of school dropout among adolescents with separated parents was explained by the covariates. The decomposition analysis suggested that parental education (43%) and disposable income (20%) accounted for most of the explained differences in school dropout. Conclusions: Adolescents with separated parents are at higher risk for not completing secondary education. Parental education and disposable income accounted for most of the explained differences in school dropout between the groups. Still, the majority of the difference in school dropout remained unaccounted for, indicating that the link between parental separation and school dropout is complex and likely influenced by multiple factors.

• Hysing, Mari; Sivertsen, Børge; Nilsen, Sondre Aasen; Heradstveit, Ove; Bøe, Tormod & Askeland, Kristin Gärtner (2023). Sleep and dropout from upper secondary school: A register-linked study. Sleep Health. ISSN 2352-7218. 9(4), s. 519–523. doi: 10.1016/j.sleh.2023.05.004. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Askeland, Kristin Gärtner; Bøe, Tormod; Sivertsen, Børge; Linton, Steven J.; Heradstveit, Ove & Nilsen, Sondre Aasen [Vis alle 7 forfattere av denne artikkelen] (2022). Association of Depressive Symptoms in Late Adolescence and School Dropout. School Mental Health. ISSN 1866-2625. 14(4), s. 1044–1056. doi: 10.1007/s12310-022-09522-5. Fulltekst i vitenarkiv Vis sammendrag

  The present study investigated the association between symptoms of depression in late adolescence and completion of upper secondary school, taking symptoms of ADHD and conduct disorder, and parental education into account. The study is based on the youth@hordaland-survey, conducted in Western Norway in 2012. A total of 9157 adolescents (aged 16–19 years, 53% girls) consented to participation and registry linkage and comprised the sample of the present study. Symptoms of depression, ADHD, and conduct disorder were based on adolescent self-report. Information on parental education, grade point average (GPA), and upper secondary school completion was retrieved from the National Education Database. In the sample, 14.8% had not completed upper secondary education within 5 years. Symptoms of depression were associated with higher odds of failure to graduate within 5 years (adjusted odds ratio (AOR) = 1.50). The association was attenuated but remained significant when adjusting for symptoms of ADHD, conduct disorder, and parental education. Adolescents reporting high levels of both depression and conduct disorder had the highest odds of dropout (AOR = 4.15). GPA partially mediated the association between symptoms of depression and dropout. The results show a consistent, but small association between symptoms of depression in late adolescence and failure to complete upper secondary education within five years. Given the high rate of depressive symptoms in the adolescent population, it is important to identify protective factors that promote school functioning and graduation for adolescents experiencing such symptoms.

• Nilsen, Sondre Aasen; Kvestad, Ingrid; Randal, Sølve Bjørn; Hysing, Mari; Sayyad, Nawar & Bøe, Tormod (2022). Mental health among unaccompanied refugee minors after settling in Norway: A matched cross-sectional study. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948221100103. Fulltekst i vitenarkiv Vis sammendrag

  Aims: To describe the mental health of unaccompanied refugee minors (URMs) settled in Norway and compare their responses to an age- and sex-matched sample of Norwegian young people. Methods: The data were from the Pathways to Independence study of URMs aged 15–20 years (n = 81; 82.7% male; response rate 80%) conducted in 2018–2019 in the Bergen municipality, Norway. The data from the URMs were linked to an age- and sex-matched group of young people from the Norwegian youth@hordaland study conducted in 2012 (n = 324). Mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ). Results: URMs were more likely to agree with most items pertaining to emotional problems, peer problems and prosocial subscales than Norwegian young people. Few differences were found for items on the conduct problems and hyperactivity-inattention problems scales. Poor psychometric properties, including weak factor loadings and low internal consistency, were detected for the SDQ subscales among URMs, except for the emotional problems subscale, indicating that the originally proposed five-factor model fitted the data poorly. Conclusions: URMs appear to have moderately more emotional problems than Norwegian young people. They are more likely to report being alone, getting along better with adults than with their peers and being bullied, but also report being more helpful and sharing with others. Studies with larger samples of URMs should determine the most appropriate factor structure of the SDQ when administered to URM samples.

• Heradstveit, Ove; Nilsen, Sondre Aasen; Breivik, Kyrre; Bakken, Anders; Haug, Thomas & Stormark, Kjell Morten (2022). Psychometric properties of a short self-report measure of rule-breaking behaviour among adolescents: findings from the Ungdata survey. Scandinavian Journal of Public Health. ISSN 1403-4948. doi: 10.1177/14034948221104650. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Nilsen, Sondre Aasen; Bergström, Malin; Sivertsen, Børge; Stormark, Kjell Morten & Hysing, Mari (2022). Sleep in adolescence: Considering family structure and family complexity. Journal of Marriage and Family. ISSN 0022-2445. 84(4), s. 1152–1174. doi: 10.1111/jomf.12844. Fulltekst i vitenarkiv Vis sammendrag

  Objectives To investigate associations between family structure, family complexity, and sleep in adolescence. Background Family structure may be associated with sleep patterns and sleep problems among adolescents. Yet, research documenting this association has not captured the complexity of modern families and used crude measures of sleep. Method The youth@hordaland study (N = 8833) of adolescents aged 16–19 conducted in 2012 in Norway provided a detailed assessment of family structure, family complexity (i.e., living with half-/stepsiblings), and multiple sleep parameters. Insomnia and delayed sleep–wake phase disorder (DSWPD) were defined in alignment with diagnostic criteria. Ordinary least squares and Poisson regression analyses were used to assess associations between family structure, family complexity, and sleep outcomes. Results Adolescents in joint physical custody (JPC) had more similar sleep parameters as peers in nuclear families than in single-and stepparent families. Adolescents in single- and stepparent families had a higher risk of short sleep duration on weekdays, long sleep onset latency, long wake after sleep onset, oversleeping, insomnia, and DSWPD than peers in nuclear families. Family complexity was also associated with a higher risk of sleep problems, but the risk attenuated when considered jointly with family structure. Socioeconomic status and depressive symptoms partly attenuated the differences between the groups. Conclusion Inequalities in sleep exist by family structure and, in part, family complexity. Despite alternating between two homes and often experiencing family complexity, sleep among adolescents in JPC was more similar to peers in nuclear families than in single- and stepparent families.

• Nilsen, Sondre Aasen; Askeland, Kristin Gärtner; Bøe, Tormod; Sivertsen, Børge; Heradstveit, Ove & Hysing, Mari (2022). Joint Physical Custody and Academic Achievement Among Youth: A Population-Based Study With Registry Linkage. Journal of Family Psychology. ISSN 0893-3200. 36(8), s. 1351–1362. doi: 10.1037/fam0001015. Fulltekst i vitenarkiv Vis sammendrag

  Previous research has documented that youth in joint physical custody (JPC) often report fewer mental health problems than peers in other post separation 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.

• Heradstveit, Ove; Nilsen, Sondre Aasen; Breivik, Kyrre; Bakken, Anders; Haug, Thomas & Hartveit, Kristian [Vis alle 7 forfattere av denne artikkelen] (2021). Past Year Cannabis Use Among Norwegian Adolescents: Time Trends Based on the Ungdata Surveys 2010–2019. Frontiers in Psychiatry. 12. doi: 10.3389/fpsyt.2021.627479. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Nilsen, Sondre Aasen; Askeland, Kristin Gärtner; Loro, Dora Poni Joseph; Iversen, Anette Christine; Havnen, Karen J Skaale & Bøe, Tormod [Vis alle 7 forfattere av denne artikkelen] (2021). Mental health, adverse life events and health service use among Norwegian youth in the child welfare system: Results from a population-based study. Child & Family Social Work. ISSN 1356-7500. 26(4), s. 601–616. doi: 10.1111/cfs.12842. Fulltekst i vitenarkiv Vis sammendrag

  Youth within the child welfare system (CWS) have often experienced adverse life events, and many need support from health services. This study aimed to compare mental health problems and health service use among adolescents receiving in-home services (IHS), living in foster care (FC) and general population youth (GP). Data stem from the youth@hordaland survey, a population-based study of adolescents (N = 10,257, age 16–19) conducted in 2012 in Hordaland County, Norway. The adolescents provided self-reported data on CWS contact, health service use, adverse life events and multiple instruments assessing mental health problems. The IHS and FC groups had significantly higher symptom scores across most mental health measures than peers from the GP. Youth receiving IHS had significantly higher scores on measures of general internalizing and externalizing problems, attention deficit hyperactivity disorder (ADHD) and depression compared with peers in FC. Those receiving IHS reported the highest health service use. Adverse life events accounted for a substantial part of the differences between the groups. Mental health problems are frequent among older adolescents within the CWS, especially among youth receiving IHS. Service providers and policymakers should be aware of the present and likely continued challenges faced by many of these youth.

• Westby, Cèline Lossius; Erlandsen, Andrea Røsberg; Nilsen, Sondre Aasen; Visted, Endre & Thimm, Jens C. (2021). Depression, anxiety, PTSD, and OCD after stillbirth: a systematic review. BMC Pregnancy and Childbirth. 21(1). doi: 10.1186/s12884-021-04254-x. Fulltekst i vitenarkiv Vis sammendrag

  Background This systematic review aimed to provide an updated summary of studies investigating depression, anxiety, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD) in parents after stillbirth (from 20 weeks gestational age until birth). Methods A literature search was conducted in the databases Web of Science and PsychINFO. Main inclusion criteria were 1) peer-reviewed, quantitative, English-language articles published from 1980; (2) studies investigating depression, anxiety, PTSD, or OCD among parents following stillbirth; and (3) studies defining stillbirth as equal to or after 20 weeks of gestation. Results Thirteen quantitative, peer-reviewed articles were eligible for inclusion. Selected articles investigated depression, anxiety, and PTSD, while no studies on OCD met our inclusion criteria. The majority of studies investigated women, while only two studies included men. The results indicated heightened short- and long-term levels of depression, anxiety, and PTSD in parents after stillbirth compared to those of parents with live birth. Studies investigating predictors found that social support, marital status, negative appraisals, and variables related to care and management after stillbirth affected levels of symptoms. Conclusions Parents who experience stillbirth have a considerably higher risk of reporting symptoms of depression, anxiety, and PTSD compared with parents with live births. More longitudinal studies are needed to increase our knowledge of how symptoms develop over time, and more research on fathers, transgender, non-binary and gender fluid individuals is needed. Research on the association between stillbirth and OCD is also warranted. Knowledge of the severity of anxiety, depression, and PTSD after stillbirth, and predictors associated with symptom severity could provide healthcare professionals with valuable information on how to provide beneficial postpartum care.

• Heradstveit, Ove; Haugland, Bente Storm Mowatt; Nilsen, Sondre Aasen; Bøe, Tormod; Sivertsen, Børge & Hysing, Mari (2021). Parental Mental Illness as a Risk Factor for Adolescent Psychiatric Disorders: A Registry-Based Study of Specialized Child and Adolescent Health Services. Child & Youth Services. ISSN 0145-935X. doi: 10.1080/0145935X.2021.1997584. Fulltekst i vitenarkiv Vis sammendrag

  Parental mental illness is a major risk factor for youth psychopathology, but few studies have used data from child and adolescent mental health services (CAMHS) to investigate this group. We used a unique linkage between a CAMHS-registry and a large population-based survey of Norwegian adolescents aged 16–19 years. Nine hundred and seventy adolescents received CAMHS, of whom 87 (9%) were registered with a parent with mental illness. These adolescents had increased odds for a range of psychiatric disorders and comorbidity compared with CAMHS-patients. These findings underscore the need to consider parental mental illness when assessing and treating adolescents with psychiatric disorders.

• Almås, Mia Amalie Jensen; Heradstveit, Ove; Askeland, Kristin Gärtner; Sivertsen, Børge; Nilsen, Sondre Aasen & Hysing, Mari (2021). Sleep patterns and insomnia among adolescents receiving child welfare services: A population-based study. Sleep Health. ISSN 2352-7218. 652. doi: 10.1016/j.sleh.2021.09.006. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Heradstveit, Ove; Gjertsen, Nathalie; Iversen, Anette Christine; Nilsen, Sondre Aasen; Askeland, Kristin Gärtner & Christiansen, Øivin [Vis alle 7 forfattere av denne artikkelen] (2020). Substance-related problems among adolescents in child welfare services: A comparison between individuals receiving in-home services and those in foster care. Children and Youth Services Review. ISSN 0190-7409. 118. doi: 10.1016/j.childyouth.2020.105344. Fulltekst i vitenarkiv Vis sammendrag

  Background and aims The literature base on substance use among adolescents who receive interventions from child welfare services (CWS) in Nordic countries is limited. The purpose of this study was to investigate whether Norwegian adolescents in contact with CWS are at higher risk for substance-related problems (SRP) compared with the general adolescent population, and to what extent those in foster care (FC) differ from those receiving in-home services (IHS). Methods The data set comprise 9785 individuals aged 16–19 years who participated in the cross-sectional, population-based youth@hordaland-survey, of whom 141 (1.4%) received IHS from the CWS, while 155 (1.6%) lived in FC. The primary outcomes were indicators of self-reported SRP. Regression analyses were used to explore the association between IHS/FC and SRP with a reference group from the general population. Potential confounding variables included age, sex, ethnicity, and internalizing- and externalizing mental health problems. Findings Compared with the general population, adolescents receiving IHS had a robust and consistent increased odds of SRP across multiple indicators compared to the general population, even after adjustment for confounding variables (adjusted odds ratios [AORs] ranging from 1.81 to 3.04, all p < 0.05; adjusted mean difference = 1.49, p < 0.01). Adolescents living in FC had a higher total degree of SRP (AOR = 1.51, p < 0.05), as well as higher illicit drug use (AOR = 1.75, p < 0.05), compared with the general adolescent population. The IHS-group had higher total degree of SRP (OR = 2.08, p < 0.01) compared with the FC-group. Conclusions Adolescents receiving IHS and adolescents in FC had a significantly heightened risk for SRP, compared with the general population. The risk for SRP was higher among adolescents receiving IHS compared with those living in FC. These findings indicate that prevention efforts of SRP in CWS-populations during adolescence are needed.

• Hysing, Mari; Heradstveit, Ove; Harvey, Allison G.; Nilsen, Sondre Aasen; Bøe, Tormod & Sivertsen, Børge (2020). Sleep problems among adolescents within child and adolescent mental health services. An epidemiological study with registry linkage. European Child and Adolescent Psychiatry. ISSN 1018-8827. s. 1–11. doi: 10.1007/s00787-020-01676-4. Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen; Breivik, Kyrre; Wold, Bente; Askeland, Kristin Gärtner; Sivertsen, Børge & Hysing, Mari [Vis alle 7 forfattere av denne artikkelen] (2020). Divorce and adolescent academic achievement: Heterogeneity in the associations by parental education. PLOS ONE. 15(3). doi: 10.1371/journal.pone.0229183. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Heradstveit, Ove; Hysing, Mari; Nilsen, Sondre Aasen & Bøe, Tormod (2020). Symptoms of disordered eating and participation in individual- and team sports: A population-based study of adolescents. Eating Behaviors. ISSN 1471-0153. 39:101434, s. 1–7. doi: 10.1016/j.eatbeh.2020.101434. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Nilsen, Sondre Aasen; Hysing, Mari; Breivik, Kyrre; Heradstveit, Ove; Sunde, Eilif Vingen & Stormark, Kjell Morten [Vis alle 7 forfattere av denne artikkelen] (2019). Complex families and health complaints among adolescents: A population-based cross-sectional study. Scandinavian Journal of Public Health. ISSN 1403-4948. s. 1–10. doi: 10.1177/1403494819893903. Fulltekst i vitenarkiv Vis sammendrag

  Aims: The structure of adolescents’ families has become more complex over the last decades in several western countries. In parallel, health complaints among adolescents appear to have risen in the Nordic countries. This study aimed to examine the association between family structure and health complaints among Norwegian adolescents while capturing biological, half-, and stepsiblings (sibship-type) in the families. Methods: Data stem from the youth@hordaland study, an epidemiological study of adolescents aged 16–19 years (N = 10,257; participation rate = 53%) conducted in 2012. This study is based on a subsample of 8808 adolescents who lived with parent(s). The adolescents provided detailed information on sociodemographics, family structure, sibship-type, and common health complaints among youth (headache, dizziness, and abdominal, neck, back, and shoulder pain). Results: Adolescents in nuclear families and joint physical custody (JPC) reported significantly lower levels of health complaints compared to peers in single- or stepparent families. Independent of family structure, biological siblings were associated with lower levels of health complaints, while stepsiblings were associated with higher levels of health complaints, but only among girls. These findings were robust to adjustments of sociodemographic variables. Conclusions: Health complaints are frequent but unequally distributed across family structures. Adolescents in nuclear families and JPC report lower levels of health complaints compared to peers in single- or stepparent families. Considering siblings appears to be relevant, as biological- and stepsiblings were related to adolescents’ symptoms, independent of family structure. In combination, knowledge about family structure and sibship-type may aid the identification of adolescents at risk of experiencing health complaints.

• Nordmo, Morten; Hagen, Julie Sofie; Pedersen, Vilde Blomhoff; Høyheim, Tea; Østby, Anna Strøm & Nilsen, Sondre Aasen (2018). How changing admission practices affect sociodemographics, satisfaction, personality, gender, and dropout of students in the professional psychologist study program in Norway :. Scandinavian Psychologist. 5:e14, s. 1–17. doi: 10.15714/scandpsychol.5.e14. Fulltekst i vitenarkiv
• Sandtorv, Lisbeth Beate; Fevang, Silje Katrine Elgen; Nilsen, Sondre Aasen; Bøe, Tormod; Gjestad, Rolf & Haugland, Siren [Vis alle 7 forfattere av denne artikkelen] (2018). Symptoms Associated With Attention Deficit/Hyperactivity Disorder and Autism Spectrum Disorders in School-Aged Children Prenatally Exposed to Substances. Substance Abuse: Research and Treatment. 12. doi: 10.1177/1178221818765773. Fulltekst i vitenarkiv Vis sammendrag

  Prenatal exposure to substances may influence a child’s neurodevelopment and impact on subsequent mental health. In a hospital-based population of school-aged children prenatally exposed to opiates and a number of illicit substances (n = 57), we evaluated mental health symptoms associated with attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) using the Swanson, Nolan, and Pelham Questionnaire, revision IV (SNAP-IV) and the Autism Spectrum Screening Questionnaire (ASSQ) and compared the scores to a reference group which comprised children from the population-based Bergen Child Study (n = 171). Prenatally exposed children had significantly higher SNAP-IV scores associated with ADHD symptoms in both areas of inattention and hyperactivity/impulsivity and also reported a higher ASSQ score related to an increased number of symptoms associated with ASD, compared with the reference group. Of tested predictors of mental health outcomes in the exposed group, the intelligence quotient was a strong predictor of most mental health outcomes, and neonatal abstinence syndrome was a predictor of inattention. In conclusion, prenatally exposed children had more mental health symptoms associated with ADHD and ASD, compared with the reference group.

• Nilsen, Sondre Aasen; Breivik, Kyrre; Wold, Bente & Bøe, Tormod (2017). Divorce and family structure in Norway: associations with adolescent mental health. Journal of Divorce and Remarriage. ISSN 1050-2556. 59(3), s. 175–194. doi: 10.1080/10502556.2017.1402655. Fulltekst i vitenarkiv
• Sandtorv, Lisbeth Beate; Hysing, Mari; Rognlid, Malin; Nilsen, Sondre Aasen & Elgen, Irene Bircow (2017). Mental Health in School-Aged Children Prenatally Exposed to Alcohol and Other Substances. Substance Abuse: Research and Treatment. 11. doi: 10.1177/1178221817718160. Fulltekst i vitenarkiv Vis sammendrag

  Prenatal exposure to substances can possibly influence a child’s neurodevelopment and may impact on subsequent mental health. We investigated the mental health status of school-aged children referred to a pediatric hospital with a history of prenatal exposure to alcohol or other substances. Mental health was assessed using the Strengths and Difficulties Questionnaire and compared with a reference group. A total of 105 of 128 (82%) eligible children prenatally exposed to substances participated in the study, with 48 children exposed to alcohol and 57 to other substances. Strengths and Difficulties Questionnaire subscale mean scores, total difficulties scores, and total impact scores were statistically significantly higher in the group of exposed children, compared with the reference group. In this hospital-based population of school-aged children prenatally exposed to alcohol or other substances, the exposed group had an increased risk of mental health problems, compared with the reference group.

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• Nilsen, Sondre Aasen; Breivik, Kyrre; Stormark, Kjell Morten & Bøe, Tormod (2026). Does income inequality predict adolescent depressive symptoms? LHRS conference. Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen (2026). Does income inequality predict adolescent depressive symptoms? CREATE-seminar. Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen (2026). Samspillet mellom familieøkonomi, negative barndomsopplevelser, og psykisk helse hos ungdommer. Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen (2025). Visualisering av pasientrapportert data: Shiny apper + kode = sant? Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen (2025). Ung i Rogaland 2025: Hva sier Ungdata om selvmordstanker, selvskading og selvmordsforsøk? Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen (2025). Hva sier Ungdata om selvmordstanker og selvmordsforsøk? Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen (2025). Psykiske plager i endring: Hva viser Ungdata, og hva mener ungdommene selv? Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen (2024). Psykisk helse hos studenter med skilte foreldre. Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen (2024). Visualisering av pasientrapporterte data. Fulltekst i vitenarkiv
• Rydland, Håvard T.; Nilsen, Sondre Aasen; Islam, Muhammad Kamrul & Kjerstad, Egil (2024). Parental divorce and mental health utilization among children. Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen (2022). Barn etter samlivsbrudd - hva er funnene? Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen (2022). Familiestress og psykisk helse hos ungdom. Fulltekst i vitenarkiv
• Nilsen, Sondre Aasen; Bøe, Tormod; Breivik, Kyrre & Wold, Bente (2020). After the Divorce: Academic Achievement, Mental Health, and Health Complaints in Adolescence : Heterogeneous associations by parental education, family structure, and siblings. Universitetet i Bergen. ISSN 9788230856932. Fulltekst i vitenarkiv Vis sammendrag

  Experiencing parental divorce or separation in childhood is associated with poorer academic achievement, and impairments in physical and mental health. Numerous studies suggest that children and youth who grow up with divorced parents get lower grades and test scores in school and have more symptoms of externalizing and internalizing problems compared to those raised in two-parent nondivorced families. Moreover, these problems are not confined to childhood but tend to persist into adulthood as well. The overall aim of the current thesis was to expand the knowledge of how parental divorce relates to adolescents’ academic achievement, mental health and health complaints, by examining heterogeneity in the outcomes of divorce by parental educational qualifications, family structure, and sibship-type (i.e., biological, half – and stepsiblings). To reach these aims, we utilized data from the large population- based youth@hordaland study of adolescents aged 16–19, that was merged with data from national registries. In Paper I, the aim was to investigate whether the association between parental divorce and adolescents’ grade point average (GPA) was related to parental educational qualifications. Overall, it was found that adolescents with divorced parents had a GPA that was 0.3 standard deviation units lower than adolescents with nondivorced parents. However, while a divorce was hardly related to GPA among adolescents with uneducated parents, divorce was linked to a lower GPA among adolescents with educated mothers, independent of paternal educational qualifications and household income measures. In Paper II, the aim was to investigate the distribution of mental health problems across six different family structures following the steep increase in parents choosing joint physical custody in Norway. It was found that adolescents living in joint physical custody (JPC) displayed significantly lower levels of both externalizing and internalizing problems than their peers living in single parent and stepparent families. Moreover, levels of mental health problems among adolescents in JPC were quite similar to and not statistically significantly different from those living in a two-parent nuclear family. In Paper III, the aims were to investigate how family structures were related to health complaints among adolescents, while capturing the complexity of the modern family by including information about sibship-type (i.e., biological, half- and stepsiblings) in the household. Corroborating the findings from Paper II, it was found that adolescents in JPC reported lower levels of health complaints than their peers in other post- divorce family structures. Moreover, independent of family structure, sharing a household with biological siblings was associated with lower levels of health complaints, while living with stepsiblings was associated with higher levels, but only among girls. Overall, the findings from this thesis suggest that adolescents with divorced parents get lower grades and report higher levels of mental health problems and health complaints than their peers in nuclear two-parent families. Furthermore, parental educational qualifications, adolescents’ post-divorce family structure, and the presence of biological and stepsiblings in the household, may influence the associations between parental divorce and adolescents’ post-divorce adjustment.

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