HELSEFORSKNING-HELSEFORSKNING

Women outnumber men by 2:1 to 10:1 concerning emotional and related disorders, which are leading causes of distress and disability. Prevention and treatment efforts are therefore called for, but at present, they are only moderate to modestly effective. Such interventions should be built on knowledge of the causes of emotional disorders, which is generally lacking. To investigate potential determinants of emotional disorders and gender differences in these, we draw on the Trondheim Early Secure Study (TESS). The 2003 and 2004 birth cohorts in Trondheim have been screened with the SDQ (N=3,800), and a sample of 1,250 children (82% consent) have been drawn to participate in a more intensive study. The proposed research implies that participants will be tested biennially with similar methods over 14 years. Parents and children complete a structured diagnostic interview, and social factors are recorded during a 4-5 hour session. The 8th data collection was finalized in 2023. Selected findings: Prevalence and stability of depression and anxiety: We have identified 5 different meanings of the term “stability”. 1) Stability of form: Even though the frequency of the various symptoms of anxiety and depressive disorders changes throughout development, their implications for the underlying constructs are equally important from preschool to adolescence. Hence, emotional disorders are stable constructs. 2) At the group level: Depression increased sharply from age 12 onwards, whereas an increase in most anxiety disorders is seen already from age 8 years. 3) Relative to the group: There is a tendency for children and adolescents to keep their rank order with respect to the number of symptoms. During the early childhood years, this tendency is rather weak but increases towards adolescence. There is no continuity in emotional problems from early childhood to adolescence. 4) Relative to oneself: The stability of emotional symptoms and disorder are higher when one is compared to oneself than to peers. 5) Stability of changes: when symptom levels change, this change is carried forward in the same direction later in development. This stability in changes becomes even stronger in adolescence. Gender differences in screen time, social media use, and gaming – implications for emotional problems: Concerns have been raised that increased screen use, gaming in particular, might reduce children and youth’s social competence (which in turn may increase the risk of developing emotional problems). In one of our works, we chronicle that although boys game considerably more than girls, more time spent gaming among girls predicted reduced competence, a relationship not evident among boys. However, we later found evidence that increased symptoms of gaming disorder did not predict increased mental health problems or vice versa. Finally, we have recently documented a prospective link between other-oriented social media use (i.e., commenting and liking others’ posts, as opposed to self-oriented use, i.e., posting own material) and reduced appearance self-esteem, but this link only appeared among girls. Parental personality disorders and offspring emotional disorders: Using TESS-data, we show that Cluster A and C symptoms in parents increase the risk of anxiety in offspring, whereas increased rates of Cluster B symptoms increase the risk of depression. Gender differences in sleep disorders and reduced sleep: We document that whereas boys more often suffer from insomnia in early and middle childhood, girls outnumber boys by a 2-3 ratio when adolescence emerges. Moreover, sleeping little increases the risk of a variety of mental health problems, in particular emotional ones (anxiety and depression), but the opposite direction of influence was not found. The link between ADHD and anxiety is gender-specific: In girls, increased inattention, but not hyperactivity/impulsivity, predicted increased anxiety 2 years later across development, and increased anxiety at ages 12 and 14 predicted increased inattention but not hyperactivity-impulsivity. This was not found among boys. Non-suicidal self-harm: By age 16, we found that 17% of girls and 3% of boys had engaged in deliberate self-harm without suicidal intent. In two-thirds of the cases, parents were not aware of this self-harm. Gender differences in depression: before age 12, girls and boys are equally often depressed, but after age 12, girls more often become depressed. We tested whether two prominent risk factors for depression, negative life events, and victimization from bullying could explain this emerging gender difference, addressing two possible avenues of influence: First, girls becoming more exposed to such social stressors during early adolescence, and second, girls becoming more vulnerable to the impacts of such stressors in early adolescence. The data provided support for the latter explanation but not the first.

Virkninger på kort sikt 1. Forskergruppen og forskningsprosjektet Tidlig trygg i Trondheim a. Tildelingene har bidratt til at Tidlig trygg i Trondheim har kunnet fortsette datainnsamlingen ved gjennomføring av 14-, 16-, og 18-årsundersøkelsene. Dette har lagt grunnlaget for at 20-årsundersøkelsen kunne bli gjennomført. Denne pågår nå og vil bli avsluttet høsten 2025, hvorpå 22-årsundersøkelsen vil begynne. På tross av at foreldre ikke lenger er med og mange har flyttet, også utenlands, er oppmøteandelen meget høy. Dette gjør Tidlig trygg til den formodentlig mest intensive undersøkelsen av barn, ungdom og unge voksnes psykiske helse med kliniske intervjuer i verden. Dette gir en unik mulighet til å beskrive ulike utviklingsbaner og deres prediktorer, noe som også anerkjennes i redaktør- og kommentarartikler i de ledende tidsskriftene på feltet, for eksempel (Burke, 2024; Hawes, 2024; Papke, Klimes-Dougan, & Cullen, 2024) b. Bevilgningen til EPIONE-prosjektet har også styrket forskningen fra Tidlig trygg i Trondheim generelt og bidratt til en aktiv forskergruppe. I EPIONE-perioden er det publisert 55 vitenskapelige artikler fra Tidlig Trygg i Trondheim, og forskergruppa teller nå 28 personer inkludert forskningsassistenter som utfører datainnsamlingen. I alt 14 doktorgrader er avlevert på materialet i denne perioden. Fire av doktorandene har nå fått fast vitenskapelig stilling ved instituttet og øker seniorkompetansen i prosjektet. 2. Utdanning av psykologer: kompetanse om emosjonelle lidelser Resultatene fra EPIONE inngår som en naturlig del av kunnskapen til psykologstudenter og masterstudenter i psykologi da disse trekkes inn i undervisningen, og i alt 66 psykologstudenter har skrevet sin hovedoppgav med utgansgpunkt i dette materialet i denne perioden. 3. Forebyggings- og behandlingsmiljøet i regionen Vi har i utstrakt grad holdt foredrag om resultatene til behandlere og andre i regionen, både på kommunalt og spesialistnivå (BUP, kommunehelsetjenesten, barnevernet, familievernkontor, dommere/Tingretten), og med mulighet for at dette integreres i praksis. 4. Nasjonalt og internasjonalt forskningsmiljø Som det vil fremgå av forfatterlistene på artiklene, er det utviklet et bredt samarbeid med ledende forskere internasjonalt innen emosjonelle lidelser. I noen tilfeller har dette også skjedd ved at vi har kombinert eller kontrastert datasett på tvers av land. Dette samarbeidet er langvarig og fortsetter også etter prosjektets slutt. Mulige virkninger på lengre sikt Forebygging og behandling av emosjonelle lidelser hos unge kvinner – betydning for folkehelsen. Psykologiske og medikamentelle behandling og forebygging av emosjonelle lidelser har effekt, men denne er moderat til beskjeden, spesielt på lengre sikt. Det er derfor sterkt behov for å utvikle mer effektive tiltak. Slike bør bygges på forståelse av lidelsenes etiologi og opprettholdende faktorer. Dette prosjektet har gitt viktige bidrag til dette, men samlet sett er kunnskapen begrenset.

Women outnumber men by 2:1 to 10:1 with respect to emotional and related disorders, which are leading causes of distress and disability. Prevention and treatment efforts are therefore called for, but at present they are only moderate to modestly effective. Such interventions should be built on etiological knowledge, which is generally lacking. Emotional disorders typically have their debut in adolescence and are fairly stable into adulthood. The gender disparity is caused by a sudden increase in girls' emotional disorders during the early teenage years. The keys to unlock the etiology of young women?s emotional disorders therefore lies in the identification of (i) predictors of adolescents' emotional and related disorders and (ii) processes responsible for the gender disparity. Towards these ends, we employ a bio-psycho-social model. Despite stability in disorders, many manage or eventually overcome their problems. Since knowledge about factors responsible for such favorable long-term trajectories may be particularly important to treatment and selective/indicated prevention, we will ascertain these reasons. Even with their higher rate of disorders taken into account, women more often seek help for their problems. Combining two models of health service use we will test factors responsible for this gender gap. The 2003 & 2004 birth cohorts in Trondheim have been screened with the SDQ (N=3,800) and a stratified sample of 1,250 children (82% consent) have been drawn to participate in a more intensive study. The proposed research imply that participants will be tested biennially with similar protocols over 12 years. Parents and children complete a structured diagnostic interview. Biological (pubertal timing, body composition, genetics), psychological (e.g., personality, executive function, emotion regulation, social skills, self-esteem, attachment) and social (e.g., parent-child interaction, social exclusion, media impact) factors are recorded during a 4-5 hour session.