The Importance of Perceived Discrimination and Pre-Adoption Risk for Mental Health Problems among Young Adult Internationally Adopted Students in Norway

The research on mental health problems in adult international adoptees is limited, and while perceived discrimination has been related to increased psychological distress, less is known about its influence on more severe mental health problems. The study investigated mental health problems and the importance of pre- and post-adoption risk factors among internationally adopted students in young adulthood. Data stem from the cross-sectional SHoT study (Students’ Health and Wellbeing Study) of students in higher education in Norway where 409 (0.8%) students identified themselves as internationally adopted. The internationally adopted students reported higher levels of psychological distress and higher occurrence of self-harm, thoughts of non-suicidal self-harm (NSSH), suicide attempts and suicidal ideation compared to their non-adopted peers. Perceived discrimination was associated with increased psychological distress, and higher odds of thoughts of self-harm and suicidal ideation. Being adopted from Asia was associated with lower odds of NSSH and suicide attempts compared to other birth continents. Age at adoption was not associated with any of the mental health outcomes. The results indicate an increased risk of mental health problems for internationally adopted students and suggests that pre- and post- adoption risk factors are associated with different mental health problems.publishedVersio

Study progress, recreational activities, and loneliness in young adult carers: a national student survey

Background: Young adults (18–25 years) with informal care responsibilities have received limited attention in the research literature, and little is known on how caring responsibilities are related to functioning across different life domains. In the present study we examine associations between care responsibilities and study progress, recreational life, and loneliness in young adults in higher education. Methods: A national survey was conducted among Norwegian students in higher education (the SHoT2018-study). The response rate was 30.8%. The current sample is a subsample of the respondents, including young adults 18 to 25 years old, comprising 40.205 participants (70.2% women, mean age 22.0 years, SD = 1.7). Participants reported whether they had regular care responsibility for someone with physical or mental illness, disabilities, or substance misuse. They also answered questions on study progress, number of hours studying, physical exercise, involvement in organized volunteer student activities, number of close friends, and feelings of loneliness. Data were analyzed by Chi-square tests and logistic regression analyses, adjusting for age, sex, and chronic illness. Results: Compared to students without care responsibility, young adult carers (n = 2228, 5.5% of study sample) were more likely to report delayed study progress (OR 1.20, p < .001), higher average number of failed exams (e.g., having failed three times or more, OR 1.31, p = .002), more feelings of loneliness (OR 1.26, p < .001), and slightly fewer friends. Those with limited care responsibility (≤ 1 h daily) were more likely to participate in organized volunteer student activities, whereas students with 2 h or more of caring per day were less likely to participate in leisure student activities. Both study progress and feelings of loneliness were related to care responsibility in a response-dose pattern, with worse outcomes for those with 2 h or more of daily caring responsibility. All comparisons were adjusted for age, sex, and chronic illness. Conclusions: Study progress, recreational activities, and loneliness among young adults are associated with informal caring responsibilities. Professionals in the educational system as well as health personnel should be sensitized to the needs of young adult carers and necessary support made available.publishedVersio

Måleegenskaper ved den norske versjonen av Adult ADHD Self Report Scale, 1.1 (ASRS)

Beskrivelse. ASRS er et selvutfyllingsskjema for kartlegging ADHD-symptomene hos ungdom og voksne. Testen tar ca fem minutter å fylle ut. Originalversjonen ble gitt ut av WHO Workgroup on Adult ADHD i 2005, og den norske oversettelsen i 2008. Rettighetshaveren, Verdens helseorganisasjon, stiller ingen krav til kompetanse for administrering av testen. Tolkning og vurdering av ASRS som en del av diagnostisk utredning bør utføres av personer med diagnostisk kompetanse Litteratursøk. Vårt systematiske litteratursøk identifiserte tre publikasjoner fra én norsk studie som har brukt en annen ASRS-versjon enn den offisielle oversettelsen. Vi inkluderte likevel de tre publikasjonene, da ASRS-versjonen som ble brukt var tilstrekkelig lik den offisielle i ordlyd, og oversettelsesprosessen var korrekt. Psykometri. Ingen av de tre publikasjonene inneholdt psykometriske data. Konklusjon. Det må utøves stor varsomhet ved bruk av ASRS i klinisk praksis. Det er nødvendig å forske på måleegenskapene til dette instrumentet.publishedVersio

Trajectories of psychiatric disorders in a cohort of children with cerebral palsy across four years

Background: Risk of psychiatric disorders has been reported for children and adolescents with cerebral palsy (CP) at different ages, however little is known regarding the long-term trajectories of these disorders. Objective: The aim of this study was to assess the trajectories of psychiatric disorders in children with CP, and to explore their association to risk factors. Methods: We assessed a cohort of children with CP at age seven and again at age eleven with a child psychiatric diagnostic instrument, and parents were informants. We assessed type of CP, Gross Motor Function Classification System (GMFCS) levels, and co-occurring medical conditions in a medical examination, through the medical records, and in an interview with the parents at the onset of the study. Results: We found a significant increase in the prevalence of emotional disorders from seven to eleven years of age (p 0.01), whereas the prevalence of behavioral disorders was stable. Half of the cohort met criteria for a psychiatric disorder at both assessment points. Type of CP, spastic bilateral or unilateral, dyskinetic or ataxic, and co-occurring medical conditions were non-significant predictors of psychiatric disorders. Subthreshold psychiatric disorders at age seven were predictive of psychiatric disorders at age eleven. Conclusions: We found a persistently elevated prevalence of psychiatric disorders in children with CP. Prevalence of behavioral disorders was stable, whereas we found a significant four-fold increase in emotional disorders. Sub-threshold psychiatric disorders predicted later psychiatric disorders. Increased focus on early mental health symptoms as well as more knowledge regarding emotional disorders in children with CP seems warranted.publishedVersio

Illness perception in children with cerebral palsy, a longitudinal cohort study

Background The perception of a disorder could be of importance both in problem solving behaviors, and in the emotional approach towards a disorder. Aims In this paper, we wanted to assess changes in illness perception in children with Cerebral Palsy (CP) over a four-year interval, to compare parental and self-ratings, and to assess illness perceptions according to co-occurring medical and psychiatric disorders. Methods Parents in a cohort of children with CP (N = 36), filled in the Illness Perception Questionnaire at age seven and again at age eleven, and self-reports were gathered at age eleven. Stability across time, informant differences and scores according to motor function, intellectual disability and the prevalence of psychiatric disorders were assessed. Results We found stable parental perceptions across a four –year interval. Parents reported significantly higher impact of CP on the child, than that reported by the child itself. In children with a more severe motor disability and/or co-occurring psychiatric disorders, parents reported significantly higher median scores for perceived impact of the CP condition on symptoms, duration of the condition, and impact on leisure activities, compared to those who had less severe motor disability and/or intellectual abilities within the normal range. Conclusions We propose that illness perception should be included in the follow-up of children with CP, as it may provide a mutual understanding between the child/family and professionals involved in follow-up services, with possible impact on treatment adherence and outcome of the condition.publishedVersio

Time in bed, sleep sufficiency and emotional and behavioral problems in a general population of 10-12 year old children

Objective: To examine the relationship between time in bed, sleep sufficiency and emotional and behavioral problems in a general population of children aged 10-12 years (N=5095). Methods: Emotional and behavioral problems were assessed using The Strength and Difficulties questionnaire, which was completed by children, parents and teachers. Data on time in bed, sleep sufficiency and potential confounders (gender, pubertal development, mother&rsquo;s education and family economy) were parent reported. Results: Controlling for gender, pubertal development and socioeconomic status, childrens emotional and behavioral problems as rated by parents were related to insufficient sleep. Self-reported emotional symptoms and parent-reported conduct problems were associated with both shorter time in bed and insufficient sleep. Teacher-reported hyperactivity was associated with long time in bed. Conclusions: Children with self-reported emotional symptoms or parent-reported conduct problems seem to spend too little time in bed and to obtain insufficient sleep.publishedVersio

The Epidemiology of Insomnia and Sleep Duration Across Mental and Physical Health: The SHoT Study

Objective: Numerous epidemiological studies have been conducted to examine the prevalence and comorbidities of insomnia and document sleep duration, but a common limitation in many studies is the lack of use of agreed-upon definitions of insomnia, as well as insufficient statistical power to examine comorbid mental and physical disorders/conditions. Aim: To examine the prevalence of insomnia operationalized according to formal DSM-5 criteria and differences in mean sleep duration across a wide range of mental and physical disorders, examining men and women separately. Materials and Methods: Data stem from the SHoT study (Students’ Health and Wellbeing Study), a national survey of all college and university students in Norway. In all, 162,512 students aged 18–35 received an invitation to participate, of whom 50,054 students completed the internet-based survey (attendance rate: 30.8%). Insomnia was defined according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria and sleep duration was calculated separately for weekdays and weekends. Self-reported mental and physical disorders/conditions were assessed using a pre-defined list modified to fit this age group. Pearson chi-squared tests were used to examine the prevalence of insomnia across the various mental and physical disorders/conditions in men and women separately, and log-link binomial regression analysis were used to calculate effect-sizes, adjusting for age. Results: The prevalence of insomnia in both sexes was significantly higher across all mental disorders compared with a healthy reference group. Among females, the prevalence of insomnia ranged from 61.3% for comorbid depression (adj. RR = 2.49, 95% CI: 2.40) to 83.3% for comorbid schizophrenia (adj. RR = 3.37, 95% CI: 2.61–4.35). For males, the insomnia prevalence ranged from 32.3% for comorbid autism/Asperger (adj. RR = 2.02, 95% CI: 1.39–2.92) to 74.2% for comorbid eating disorder (adj. RR = 4.51, 95% CI: 3.87–5.27). The overall prevalence of insomnia was also significantly higher across most physical conditions compared with the healthy reference group, although generally lower compared to the mental disorders. For females, the insomnia prevalence ranged from 25% for comorbid multiple sclerosis (not significant) to 65.4% for comorbid chronic fatigue syndrome/ME (adj. RR = 2.66, 95% CI: 2.44–2.89). For males, the insomnia prevalence ranged from 20% for both comorbid cancer and diabetes (not significant) to 74.2% for comorbid fibromyalgia (adj. RR = 4.35, 95% CI: 2.96–6.39). Similar patterns were observed for sleep duration, with a significantly shorter sleep duration for across many physical disorders, but especially mental disorders. Conclusion: Insomnia and short sleep duration are strongly associated with a range of different disorders and conditions. Insomnia is most strongly associated with mental disorders, and physical conditions characterized by some level of psychological or psychosomatic properties.publishedVersio

The Association Between Self-Reported Screen Time, Social Media Addiction, and Sleep Among Norwegian University Students

The aim of this study was to assess the relationship between daily screen time and sleep, evening screen time and sleep, and between social media addiction and sleep in a student population. This cross-sectional study is based on data from a national survey of all college and university students in Norway (the SHoT2018 study; n = 49,051). The sleep outcomes were sleep duration, sleep onset latency, sleep efficiency, and insomnia operationalized according to formal DSM-5 criteria. The results show a strong negative association between time spent on screen-based devices and sleep quality and quantity, and where screen use in bed had more consistent negative associations with sleep. Furthermore, there were higher rates of insomnia among those with higher levels of addiction, and curvilinear relationships with sleep duration, sleep onset latency, and sleep efficiency. Those with higher levels of addiction also had more evening screen time. The findings suggest that screen use plays an important role in students' sleep quantity and quality, where evening screen time has a stronger relationship with sleep compared to total daily screen time. The results also suggest a role of social media addiction, and addictive social media use may be a target for intervention in order to reduce evening screen time.publishedVersio