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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. However, 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. Hence, those who decrease in symptoms may have a further decrease later on. 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. However, more TV viewing among girls predicted a comparatively reduced understanding of others’ emotions (not found in boys) – again, a potential risk factor for developing emotional disorders. 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. 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.

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.