Annette Løvheim Kleppang

• Stea, Tonje Holte; Bertelsen, Thomas Bjerregaard; Fegran, Liv; Sejersted, Ellen; Kleppang, Annette Løvheim & Fyhn, Tonje (2024). Interventions targeting young people not in employment, education or training (NEET) for increased likelihood of return to school or employment-A systematic review. PLOS ONE. ISSN 1932-6203. 19(6). doi: 10.1371/journal.pone.0306285.
• Stea, Tonje Holte; Bonsaksen, Tore; Smith, Pierre; Kleppang, Annette Løvheim; Steigen, Anne Mari & Leonhardt, Marja [Vis alle 8 forfattere av denne artikkelen] (2024). Are social pressure, bullying and low social support associated with depressive symptoms, self-harm and self-directed violence among adolescents? A cross-sectional study using a structural equation modeling approach. BMC Psychiatry. ISSN 1471-244X. 24(1). doi: 10.1186/s12888-024-05696-1.
• Kleppang, Annette Løvheim; Abildsnes, Eirik; Haraldstad, Kristin & Stea, Tonje Holte (2024). Changes in health‑related quality of life and sleep habits after a 6‑month non‑randomised cluster‑controlled trial among children with overweight or obesity. European Child and Adolescent Psychiatry. ISSN 1018-8827. s. 1–9. doi: 10.1007/s00787-024-02375-0.
• Lien, Lars; Bonsaksen, Tore; Stea, Tonje Holte; Kleppang, Annette Løvheim; Steigen, Anne Mari & Leonhardt, Marja (2023). Time trends in self-reported depressive symptoms, prescription of antidepressants, sedatives and hypnotics and the emergence of social media among Norwegian adolescents. PLOS ONE. ISSN 1932-6203. 18(12). doi: 10.1371/journal.pone.0295384. Fulltekst i vitenarkiv Vis sammendrag

  Background Research has shown increased mental health problems and use of prescription drugs among adolescents in recent years and social media use has been linked to poorer mental health. However, trend studies concerning these topics are scarce. The purpose of this study was to analyze gender-specific trends in a) symptoms of depression and loneliness, and b) prescription of antidepressants, hypnotics and sedatives, in relation to the emergence of social media among adolescents in Norway. Methods This is an ecological study using data from the ‘Young in Oslo’ surveys from 1996 to 2021. The surveys included approximately 110 000 students, 14–17 years of age, and yielded a response rate varying from 95% in 1996 to 64% in 2021. A self-report questionnaire was used to collect information on symptoms of depression and loneliness. Information on antidepressant and sleep medication prescription was retrieved from the Norwegian Prescription Database for the age group 15 to 19 years. A graphical approach and logistic regression models were used to examine gender-specific time-trends between 1996 to 2021. Results We found a doubling in self-reported symptoms of depression and loneliness among girls between 1996 and 2021, with the steepest increase in the period from 2006 to 2012, when Facebook and other social media were introduced. A similar trend was observed in the prescription of antidepressants among girls, with the steepest increase between 2011 and 2013. Among both boys and girls, ‘worried too much about things’ and ‘had sleep problems’ were the two symptoms with the greatest changes. Conclusion A significant upward trend in self-reported depressive symptoms and medication use was observed over the past 25 years, with variations in the rate of increase, including a steeper trajectory during certain periods immediately after the introduction of social media platforms in Norway.

• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2023). Explaining variance in self-efficacy among adolescents: the association between mastery experiences, social support, and self-efficacy. BMC Public Health. ISSN 1471-2458. 23(1), s. 1–10. doi: 10.1186/s12889-023-16603-w. Fulltekst i vitenarkiv Vis sammendrag

  Background Self-efficacy has been identified as an important health-promoting factor for both physical and mental health. Previous studies have examined self-efficacy as a moderating factor between negative psychosocial influences and various outcomes, e.g., life satisfaction and stressors. There is, however, limited knowledge about factors that strengthen self-efficacy. The aim of this study is to examine the association between mastery experiences, social support, and self-efficacy among adolescents in secondary schools in Norway. Methods This study is based on cross-sectional data from the Ungdata surveys conducted in eastern part of Norway in 2021. The sample comprises 9,221 adolescents aged 13–16. Sequential multivariate linear regression was conducted to explore the association between mastery experiences, social support, and self-efficacy. Results The final model (Model 3) explains 25% of the total variance in self-efficacy. The indicators concerning mastery experiences – defined here as the personal experience of success – explain more of the observed variance in self-efficacy than the other independent variables (change in R square = 10.7%). The items ‘felt mastering things’ ‘and ‘felt useful’ make the strongest and most significant contributions to the variance in self-efficacy in the final model (β = 0.25, p < 0.001 and β = 0.16, p < 0.001, respectively), followed by the variables ‘support from friends’ and ‘parental support’ (β = 0.06, p < 0.001 an β = 0.06, p < 0.001). Conclusions Mastery experiences are potential sources for creating and strengthening self-efficacy. Awareness of the health-promoting potential in (strengthening) self-efficacy among adolescents is important. Additional research is needed to further explore these associations.

• Kleppang, Annette Løvheim; Vettore, Mario Vianna; Hartz, Ingeborg; Haugland, Siri Håvås & Stea, Tonje Holte (2023). Patterns of unhealthy behaviours during adolescence and subsequent anxiety and depression in adulthood: a prospective register linkage study of the HUNT survey and health registries. International Journal of Behavioral Nutrition and Physical Activity. ISSN 1479-5868. 20. doi: 10.1186/s12966-023-01408-2. Fulltekst i vitenarkiv Vis sammendrag

  Background There is increasing need for prospective investigations in the preventing role of health-related behaviours on mental health problems. The aim of this study is to identify patterns of health-related behaviours in adolescence, and the association between the behavioural patterns and the subsequent diagnoses and/or drug treatment for anxiety and/or depression in adulthood. Methods This prospective study consisted of 13–19-year-old participants in the Trøndelag Health Study (Young-HUNT3) in 2006–2008 (n = 2061, 1205 females and 856 males) in Norway, who also participated in HUNT4 (2017–2019). Survey data on health-related behaviours in adolescence, including low level of physical activity, low consumption of wholegrain bread, fish, fruit, vegetables and high consumption of sugar-sweetened beverages and insomnia were linked on an individual level to prospective information on drug use and diagnosis in national health registries. The different patterns of health-related behaviours were identified through latent class analysis. Subsequent anxiety or depression was defined as at least one recording in either of three registries covering recorded diagnosis in primary and specialist healthcare, or dispensed prescription drugs during 2008–2019. Additionally, self-reported psychological distress measured in young adulthood was applied as a supplemental outcome measure. Results Four patterns of health-related behaviours were identified: high risk behaviours (class 1), moderate to high risk behaviours (class 2), low to moderate risk behaviours (class 3) and low risk behaviours (class 4). Adolescents in class 3 showed higher odds of subsequent diagnoses for anxiety and/or depression in primary and specialist healthcare compared to class 4 participants. In addition, both class 1 and class 4 participants had higher odds for self-reported psychological distress than those class 4 (OR = 1.56 and OR = 1.86, respectively). Conclusions Our findings suggest that health-related behaviours are clustered among Norwegian adolescents. The patterns of unhealthy behaviours during adolescence only partly increased the risk of anxiety and depression in adulthood. Promoting healthy behaviours during adolescence may potentially reduce the burden of mental illness in adulthood, but further research is needed to clarify the nature of the relationships.

• Bonsaksen, Tore; Steigen, Anne Mari; Stea, Tonje Holte; Kleppang, Annette Løvheim; Lien, Lars & Leonhardt, Marja (2023). Negative social media-related experiences and lower general self-efficacy are associated with depressive symptoms in adolescents . Frontiers in Public Health. ISSN 2296-2565. 10, s. 1–13. doi: 10.3389/fpubh.2022.1037375. Fulltekst i vitenarkiv Vis sammendrag

  Social media are an integral part of adolescents' daily lives, and reviews have suggested an overall small association between more social media use and mental health problems. However, researchers have commonly investigated social media use in a time use perspective, rendering nuances in adolescents' social media experience less well explored. Thus, studies of relationships between social media use and mental health problems need also examine the nature of the events taking place on social media. This study aimed to examine depressive symptoms in adolescents in relationship to time spent on social media, negative social media-related experiences, and general self-efficacy. Data collected in a national survey, Ungdata 2021 (n = 139,841), was used. Multivariate linear regression analyses showed that time spent on social media was associated with depressive symptoms (β = 0.09, p < 0.001). However, negative social media-related experiences were more strongly associated with depressive symptoms (β ranging 0.09–0.22, all p < 0.001), and their inclusion weakened the initial association between time on social media and depressive symptoms. General self-efficacy was directly associated with lower symptom levels (β = −0.29, p < 0.001) but did not change the associations between social media use and depressive symptoms. The findings imply that not only time spent on social media, but in particular negative social media-related experiences, are related to depressive symptoms in Norwegian adolescents. General self-efficacy is an important resource for adolescents' mental health.

• Kleppang, Annette Løvheim & Skille, Eivind Åsrum (2022). Leisure-Time Activities in Different Contexts and Depressive Symptoms in Norwegian Adolescents: A Cross-Sectional Study. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(17). doi: 10.3390/ijerph191710769. Fulltekst i vitenarkiv
• Stea, Tonje Holte; Solaas, Susanne Aune & Kleppang, Annette Løvheim (2022). Association between physical activity, sedentary time, participation in organized activities, social support, sleep problems and mental distress among adults in Southern Norway: a cross-sectional study among 28,047 adults from the general population. BMC Public Health. ISSN 1471-2458. 22. doi: 10.1186/s12889-022-12769-x. Fulltekst i vitenarkiv Vis sammendrag

  Abstract: Background: Identifcation of modifable factors associated with poor mental health is crucial to develop targeted and efective intervention strategies for prevention of mental distress and illness in the general population. Thus, the aim of the present study was to examine the association between low level of leisure-time physical activity, high sedentary time, low participation in organized activities, low social support, sleep problems, and mental distress in a large sample of Norwegian adults. Methods: A cross-sectional study was completed by 28,047 adults (≥18 years old) in southern Norway by flling out an online self-report questionnaire. Multivariable binary logistic regression models, stratifed according to gender and adjusted for age and perceived fnancial situation, were used to examine possible associations between unhealthy lifestyle behaviors, participation in organized activities, social support, and mental distress. Results: Our results showed an increased odds of having mental distress among men reporting low leisure-time physical activity (OR: 1.18; 95%CI: 1.03–1.37), high sedentary time (1.32; 1.16–1.51), low involvement in organized activities (1.43; 1.25–1.64), low social support (2.55; 2.18–2.99), and sleep problems (7.29; 6.35–8.37) compared to the rest of the male population. For women, the results showed increased odds of mental distress among those reporting high sedentary time (1.25; 1.11–1.39), low involvement in organized activities (1.60; 1.42–1.80), low social support (2.71; 2.39–3.06), and sleep problems (5.78; 5.15–6.50) compared to the rest of the female population. For both men and women, results also indicated that mental distress was increased among younger adults and among those reporting fnancial difculties compared to the rest of the population. Conclusion: Our results showed an association between unhealthy lifestyle behaviors, low participation in organized activities, low social support and mental distress, and that the strength of the association varied substantially. These fndings provide increased knowledge about the relationship between modifable lifestyle factors and mental health which should have implications for future public health eforts.

• Steigen, Anne Mari; Finbråten, Hanne Søberg & Kleppang, Annette Løvheim (2022). Using Rasch Analysis to Assess the Psychometric Properties of a Five-Item Version of the General Self-Efficacy Scale in Adolescents. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(5). doi: 10.3390/ijerph19053082. Fulltekst i vitenarkiv Vis sammendrag

  The aim of the present study was to use Rasch analysis to assess the psychometric properties of the five-item version of the General Self-Efficacy Scale (GSES) amongst adolescents aged 13 to 19. In this cross-sectional study, 6265 adolescents responded to a web-based questionnaire. Data collected from lower and upper secondary schools in Norway, during 2018, were analysed using the partial credit parameterisation of the unidimensional Rasch model. The five-item version of the GSES was found to be unidimensional and to have acceptable reliability. The targeting of the scale could have been better. All items had ordered thresholds, indicating that the response categories worked quite well. The five-item version of the GSES has potential for measuring self-efficacy in a general population of adolescents. In surveys concerning adolescents’ mental health, it is important to include aspects of positive mental health and health-promoting factors, such as self-efficacy.

• Stea, Tonje Holte; Shatri, Herolinda; Haugland, Siri Håvås & Kleppang, Annette Løvheim (2022). Association between self-repoted childhood difficulties and obesity and health related behaviors in adulthood- a cross sectional study among 28,047 adults from the general population. . International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(3). doi: 10.3390/ijerph19031395. Vis sammendrag

  The aim of the present study was to examine the associations between self-reported childhood difficulties, weight status, and lifestyle behaviors among a representative sample of Norwegian adults. This cross-sectional study included 28,047 adults (>18 years old) living in southern Norway. A self-report questionnaire was used to assess information about the overall quality of the respondents’ childhood retrospectively in addition to current weight status and current lifestyle behaviors. Multivariable logistic regression models adjusted for gender, age, and educational level showed that evaluating childhood as difficult was associated with increased odds of obesity (OR: 1.29; 95% CI; 1.16–1.44) in adulthood. Moreover, a difficult childhood was associated with increased odds of unhealthy lifestyle behaviors in adulthood, including low consumption of fruit and berries (1.21; 1.09–1.34) and fish (1.43; 1.30–1.57), high consumption of sugar-sweetened beverages (1.30; 1.14–1.48), low level of physical activity (1.10; 1.01–1.21), smoking cigarettes (1.78; 1.61–1.97), and using smokeless tobacco (1.20; 1.07–1.36). Overall, results from the present study suggest that experiencing childhood as difficult is associated with an increased risk of obesity and a range of unhealthy lifestyle behaviors in adulthood. Thus, our findings highlight the importance of identifying and providing support to children in difficult life circumstances in addition to customized and targeted public health efforts in adulthood.

• Kleppang, Annette Løvheim; Ridder, Karin de; Haugland, Siri Håvås & Stea, Tonje Holte (2021). Physical activity, sugar‑sweetened beverages, whole grain bread and insomnia among adolescents and psychological distress in adulthood: prospective data from the population‑based HUNT study. International Journal of Behavioral Nutrition and Physical Activity. ISSN 1479-5868. 18, s. 1–11. doi: 10.1186/s12966-021-01215-7. Fulltekst i vitenarkiv
• Finbråten, Hanne Søberg; Kleppang, Annette Løvheim & Steigen, Anne Mari (2021). Using the Rasch measurement theory to assess the psychometric properties of the Hopkins Symptom Checklist-10 in adolescents. Health and Quality of Life Outcomes. ISSN 1477-7525. doi: 10.1186/s12955-021-01884-9. Fulltekst i vitenarkiv Vis sammendrag

  Background The Hopkins Symptom Checklist-10 (HSCL-10) is widely used to measure psychological distress in adolescents. To provide valid and reliable results and generate recommendations for practice and policies, instruments with sound psychometric properties are required. The purpose of this study is to use Rasch measurement theory to assess the psychometric properties of the HSCL-10 among adolescents aged 13–19. Methods In this cross-sectional study, 6445 adolescents responded to a web-based questionnaire. Data were collected from lower and upper secondary schools in Norway during 2018. The data were analysed using the partial credit parameterisation of the unidimensional Rasch model. Results HSCL-10 was found to be unidimensional and to have acceptable reliability. One pair of items showed response dependency. The targeting of the instrument could have been better. All items had ordered thresholds. Three items under-discriminated and three displayed differential item functioning regarding gender. Conclusions HSCL-10 has potential for measuring psychological distress in adolescents, though there is room for improvement. To further improve this instrument, some items should be rephrased.

• Stea, Tonje Holte; Alvsvåg, Linn & Kleppang, Annette Løvheim (2021). The Association between Dietary Habits, Substance Use, and Mental Distress among Adults in Southern Norway: A Cross-Sectional Study among 28,047 Adults from the General Population. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(18). doi: 10.3390/ijerph18189731. Fulltekst i vitenarkiv
• Kleppang, Annette Løvheim; Steigen, Anne Mari; Ma, Li; Finbråten, Hanne Søberg & Hagquist, Curt (2021). Electronic media use and symptoms of depression among adolescents in Norway. PLOS ONE. ISSN 1932-6203. doi: 10.1371/journal.pone.0254197. Fulltekst i vitenarkiv Vis sammendrag

  Background The purpose of this study was to examine the association between electronic media use, including use of social media and gaming, and symptoms of depression, and whether gender or having friends moderated these associations. Methods This study was based on self-reported cross-sectional data from the Ungdata survey, conducted in 2018 by the Norwegian Social Research (NOVA) Institute in cooperation with seven regional drug and alcohol competence centres. The target group comprised 12,353 15–16 years old adolescents. Binominal logistic regression was used to analyse the association between electronic media use and symptoms of depression. Results The odds of having symptoms of depression were higher for those who used social media more than 3 hours per day (OR: 1.60, 95% CI: 1.43–1.80), compared to those who used social media 3 hours or less per day. Additionally, the odds of having symptoms of depression was higher for those who used more than 3 hours on gaming per day (OR: 1.57, 95% CI: 1.36–1.80), compared to those who used 3 hours and less on gaming per day after adjustment for potential confounders. There were no interaction effects between social media and gaming use with symptoms of depression. Neither were the associations between social media use and gaming with symptoms of depression moderated by gender or having friends. Conclusions The odds of having symptoms of depression were significantly higher for adolescents with a more frequent use of electronic media.

• Ma, Li; Evans, Brittany; Kleppang, Annette Løvheim & Hagquist, Curt (2021). The association between screen time and reported depressive symptoms among adolescents in Sweden. Family Practice. ISSN 0263-2136. 38(6), s. 773–779. doi: 10.1093/fampra/cmab029. Fulltekst i vitenarkiv Vis sammendrag

  Background How screen use is associated with adolescents’ mental health has been widely debated in public media during the last decade, but there is still lack of information about if and how the associations vary between types of electronic media. Objective This study aimed to examine how time spent on types of screen use (social media, gaming alone, gaming in groups and watching TV) was associated with depressive symptoms among adolescents in Sweden, and whether gender moderated these associations. Methods We analysed data from the Swedish section of the Children of Immigrants: Longitudinal Survey in Four European Countries. The final sample consisted of 3556 eighth grade adolescents in 2011 (51% girls). We used logistic regression analysis to estimate the odds ratio of feeling depressed often versus less often/not at all using time spent on different types of screen use as predictor variables. Additionally, we tested interaction effects between gender and the predictor variables. Results Our results showed that spending more than 2 hours on social media was associated with higher odds of feeling depressed often compared with spending 2 hours or less. Not watching TV was associated with higher odds of feeling depressed often compared with watching TV. These patterns did not differ across genders. Gaming alone and gaming in groups were not associated with depressive symptoms. Conclusions Our findings suggest that more frequent social media use and not watching TV were associated with a higher level of depressive symptoms.

• Kleppang, Annette Løvheim; Haugland, Siri Håvås; Bakken, Anders & Stea, Tonje Holte (2021). Lifestyle habits and depressive symptoms in Norwegian adolescents: a national cross-sectional study. BMC Public Health. ISSN 1471-2458. 21. doi: 10.1186/s12889-021-10846-1. Fulltekst i vitenarkiv
• Ma, Li; Hagquist, Curt & Kleppang, Annette Løvheim (2020). Leisure time physical activity and depressive symptoms among adolescents in Sweden. BMC Public Health. ISSN 1471-2458. 20. doi: 10.1186/s12889-020-09022-8. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Background: Mental health problems have increased noticeably among adolescents. Physical activity has been identified as an important factor in the promotion of mental health. The purpose of this study was to explore how leisure time physical activity was associated with depressive symptoms among adolescents in Sweden. Methods: Using binary logistic regression we analyzed Swedish data collected as part of the Children of Immigrants: Longitudinal Survey in Four European Countries. The complete sample used for analysis consisted of 3787 adolescents (including 1855 boys and 1932 girls). Results: Adolescents who participated in physical activity during their leisure time on a daily, weekly, or monthly basis had substantially lower odds of often feeling depressed than those who were physically inactive. This pattern applied to both boys and girls. Relative to boys, girls had significantly higher odds of often feeling depressed. Conclusions: The findings of this study suggested that participation in physical activity regularly during leisure time was associated with a lower level of depressive symptoms among adolescents in Sweden. Because of the crosssectional study design conclusions about causality cannot be drawn. Future research based on longitudinal data is needed to further explore the mechanisms behind the association. This study calls for recognition of the value of physical activity in promoting mental health among adolescents. Keywords: Physical activity frequency, Depressive symptoms, Adolescents, Sweden

• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2020). Using Rasch measurement theory to assess the psychometric properties of a depressive symptoms scale in Norwegian adolescents. Health and Quality of Life Outcomes. ISSN 1477-7525. doi: 10.1186/s12955-020-01373-5. Fulltekst i vitenarkiv Vis sammendrag

  Background Scales measuring depressive symptoms in adolescents and adults are widely used for epidemiological purposes. The purpose of this study is to use Rasch measurement theory to examine the psychometric properties of a six-item scale intended to measure depressive symptoms in Norwegian adolescents. Methods The study is based on cross-sectional data from Ungdata, a survey conducted by the Norwegian Social Research Institute in cooperation with Regional Centres for Drug Rehabilitation in 2017. The target group comprised 13- to 19-years olds in Norway. Six items with four response categories, intended to measure depressive symptoms, were analysed. The analysis focused on invariance, including differential item functioning across gender and school levels. In addition, targeting, possible multidimensionality, response dependency, and the categorisation of the items were analysed. Results The scale measuring depressive symptoms shows good reliability and, on the whole, the items work well. However, one item, ‘had sleep problems’, clearly misfit and another, ‘worried too much about things’, works differently for males and females. Conclusions The scale has the potential to measure depressive symptoms in adolescents though there is room for improvement. To further improve the scale, the item concerning sleep problems should be rephrased.

• Kleppang, Annette Løvheim; Hartz, Ingeborg; Thurston, Miranda & Hagquist, Curt (2019). Leisure-time physical activity among adolescents and subsequent use of antidepressant and hypnotic drugs: a prospective register linkage study. European Child and Adolescent Psychiatry. ISSN 1018-8827. 28, s. 177–188. doi: 10.1007/s00787-018-1160-x. Fulltekst i vitenarkiv Vis sammendrag

  In this prospective study, the association between physical activity and subsequent use of antidepressant and hypnotic drug use in adolescents aged 15–16 years was examined. This study is based on information retrieved from the Norwegian Youth Health Surveys (2000–2003) and linked to prescription data from the Norwegian Prescription Database (2004–2013). In total, the study included 10711 participants with a participation rate of 87%. Adolescents were asked how many hours per week they spent on physical activity that made them sweat and/or be out of breath outside of school. Incident psychotropic drug use (outcome measure) was defined as ≥ 1 prescription of one of the following psychotropic drugs: hypnotics and antidepressants registered in the Norwegian Prescription Database. In the crude model for the time period 2004–2007, the odds of incident hypnotic use were lower for those who were physically active 1–2 h per week (OR 0.48–0.64), compared to those who were physically inactive (< 1 h per week). However, the association become non-significant 4-year post-baseline (2008–2010 and 2011–2013). In the crude model for the time periods 2004–2007, 2008–2010 and 2011–2013, the odds of incident antidepressant use were lower for physically active adolescents (2004–2007: OR 0.46–0.71, 2008–2010: OR 0.40–0.67 and 2011–2013: OR 0.37–0.58, compared to those who were physically inactive < 1 h. However, after adjustment for confounders, the association became non-significant in all time periods except in physical activity 5–7 and 8–10 h in the period 2008–2010. Physical activity does not indicate any association with later use of antidepressants, and the significant association with incident hypnotic drug use was for short-term follow-up only and disappeared on longer term follow-up periods. Given the scarcity of longitudinal studies examining the association between physical activity and mental health as well as psychotropic drug use among young people, the current study adds to previous research.

• Kleppang, Annette Løvheim; Thurston, Miranda; Hartz, Ingeborg & Hagquist, Curt (2019). Psychological distress among Norwegian adolescents: Changes between 2001 and 2009 and associations with leisure time physical activity and screen-based sedentary behaviour. Scandinavian Journal of Public Health. ISSN 1403-4948. 47(2), s. 166–173. doi: 10.1177/1403494817716374. Vis sammendrag

  Aims: The aim of this work was to examine psychological distress among Norwegian adolescents in relation to changes over time and the associations with leisure time physical activity and screen-based sedentary behaviour. Methods: This cross-sectional study was based on data retrieved from the Norwegian Youth Health Surveys in 2001 and 2009 in Hedmark County. Adolescents aged 15–16 years old completed a questionnaire regarding physical activity, sedentary behaviour, psychological distress and other health and lifestyle variables. The self-report Hopkins Symptom Checklist-10 was used to assess psychological distress. Multinomial logistic regression was used to analyse the associations between psychological distress, physical activity and sedentary behaviour. Results: Self-reported psychological distress increased significantly from 2001 to 2009 (from 19.4 to 28.2%), with the proportion of girls reporting psychological distress being twice as large as the proportion of boys. The proportion of adolescents who were physically active for ⩾11 hours per week increased significantly over the same period (from 6.0 to 10.4%). Sedentary behaviour ⩾6 hours per school day increased significantly among both sexes between 2001 and 2009. Physical activity (⩾11 hours) and sedentary behaviour (⩾6 hours) were both significantly associated with psychological distress. Conclusions: The association between physical activity, sedentary behaviour and psychological distress was weak; only high amounts of physical activity and high amounts of screen-based sedentary behaviour were associated with psychological distress. Longitudinal studies are needed to provide further insights into these associations and to understand the extent to which these variables might be causally related.

• Kleppang, Annette Løvheim; Hartz, Ingeborg; Thurston, Miranda & Hagquist, Curt (2018). The association between physical activity and symptoms of depression in different contexts – a cross-sectional study of Norwegian adolescents. BMC Public Health. ISSN 1471-2458. 18. doi: 10.1186/s12889-018-6257-0. Fulltekst i vitenarkiv Vis sammendrag

  Background The purpose was to analyse the association between physical activity taking place in different contexts (sports club, gym, exercise independently and other organized physical activities) and symptoms of depression. Methods The study was based on self-reported cross-sectional data from the Ungdata survey, conducted in 2017 by the Norwegian Social Research (NOVA) institute in cooperation with regional centres for drug rehabilitation. The target group comprised 5531 15–16 years old adolescents (Grade 10 students) and 11,655 students in grades 8 and 9 in Norway. Based on Rasch analysis, six items on depressions symptoms were used to create a composite measure of depression. Binomial logistic regression was used to analyse the association between physical activities in different contexts and symptoms of depression. Results In the crude model, the odds for symptoms of depression were lower for those who were physically active in a sports club (OR: 0.40, 95% CI: 0.30–0.53), in a sports club and gym (OR: 0.40, 95% CI: 0.28–0.56), in a sports club and exercise or keep fit independently (OR: 0.52, 95% CI: 0.38–0.72) and in a sports club, gym and exercise or keep fit independently (OR: 0.58, 95% CI: 0.41–0.81). After adjustment for potential confounders, the association became significant only for those who were physically active in a sports club (OR: 0.57, 95% CI: 0.40–0.81) and other organized physical activities, e.g. dance, martial arts (OR: 0.52, 95% CI: 0.31–0.86). Analysis for grade 8 and 9 showed the same patterns for the associations between sports club and symptoms of depression (grade 8: crude model, OR: 0.47, adjusted model, OR: 0.63, grade 9: crude model, OR: 0.44, adjusted model, OR: 0.49). Conclusions Physical activity in a sports club was associated with significantly lower odds for symptoms of depression, suggesting a possible role for social interaction in addition to physical activity per se. It is important, therefore, to consider in which types of contexts physical activities take place, not only focusing on physical activity frequency and volume when investigating the association between adolescents’ physical activity and mental health. Additional research is needed to further explore these associations as well as measures of physical activity and mental health.

• Kleppang, Annette Løvheim & Hagquist, Curt (2016). The psychometric properties of the Hopkins Symptom Checklist-10: a Rasch analysis based on adolescent data from Norway. Family Practice. ISSN 0263-2136. 33(6), s. 740–745. doi: 10.1093/fampra/cmw091. Vis sammendrag

  Abstract Background. The Hopkins Symptom Checklist (HSCL-10) is widely used for both clinical and epidemiological purposes to measure psychological distress among adolescents and adults. Objective. The purpose of this study was to investigate the psychometric properties of the HSCL-10 among adolescents in Norway using Rasch analysis. Methods. The study is based on cross-sectional data from the Norwegian Youth Health Surveys, conducted by the Norwegian Institute of Public Health in 2001 and 2009. The target group comprised of 15- to 16-year olds (Grade 10 students) in Hedmark County, Norway. Ten items with four response categories, intended to measure anxiety and depression, were analysed. The analysis focused on invariance, including differential item functioning (DIF) across genders and years of investigations. In addition, the categorization of the items, targeting, possible multidimensionality and response dependency, was analysed. Results. The HSCL-10 shows good reliability and on the whole, the items work well. However, one item, ‘Sleeping difficulties’, clearly misfit and some items work differently for boys and girls and between years of investigations. There is also need for a better targeting of the scale. Conclusions. The HSCL-10 has the potential to measure the psychological distress among adolescents but there is a room for improvement. Further judgement needs to be made as to whether the misfitting item ‘Sleeping difficulties’ should be removed or retained.

Se alle arbeider i Cristin

• Dangmann, Cecilie Ruud; Kleppang, Annette Løvheim & Leonhardt, Marja (2024). Helseundersøkelser av nyankomne barn og unge med fluktbakgrunn.
• Kleppang, Annette Løvheim; Abildsnes, Eirik; Haraldstad, Kristin & Stea, Tonje Holte (2023). Changes in Health-Related Quality of Life and Sleep Habits after a 6-Month Non-Randomised Cluster-Controlled Trial among Children with Overweight or Obesity.
• Bonsaksen, Tore; Steigen, Anne Mari; Stea, Tonje Holte; Kleppang, Annette Løvheim; Lien, Lars & Leonhardt, Marja (2023). Negative social media experiences and lower self-efficacy are associated with depressive symptoms.
• Dangmann, Cecilie Ruud; Leonhardt, Marja; Kleppang, Annette Løvheim & Lien, Lars (2022). Assessment of mental health and psychosocial support in Ukrainian refugee minors resettled in Norway .
• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2022). Explaining variance in self-efficacy among adolescents: the association between quality of life, social support, and self-efficacy.
• Kleppang, Annette Løvheim; Vettore, Mario Vianna; Hartz, Ingeborg; Haugland, Siri Håvås & Stea, Tonje Holte (2022). Patterns of unhealthy behaviours during adolescence and subsequent anxiety and depression in adulthood. A prospective register linkage study of the HUNT survey and health registries.
• Kleppang, Annette Løvheim (2021). Psykisk helse og fysisk aktivitet hos ungdom. Socialmedicinsk Tidskrift (SMT). ISSN 0037-833X.
• Steigen, Anne Mari; Finbråten, Hanne Søberg & Kleppang, Annette Løvheim (2019). The psychometric properties of a short version of the General Self-Efficacy Scale: A Rasch analysis.
• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2019). The association between screen time and psychological distress in Norwegian adolescents .
• Finbråten, Hanne Søberg; Kleppang, Annette Løvheim & Steigen, Anne Mari (2019). The necessity of applying Rasch Measurement Theory in questionnaire-based public health research.
• Ma, Li; Hagquist, Curt & Kleppang, Annette Løvheim (2019). The association between leisure time physical activity and depressive symptoms among adolescents in Sweden .
• Kleppang, Annette Løvheim (2019). Mental health and physical activity.
• Kleppang, Annette Løvheim (2018). Using Rasch modelling to explore Differential item functioning (DIF) of items in the symptoms of depression scale.
• Steigen, Anne Mari & Kleppang, Annette Løvheim (2018). Using Rasch modelling to explore targeting of the Hopkins Symptoms Checklist instrument (HSCL-10).
• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2018). Rasch(k)e stipendiater på tur. I Calogiuri, Giovanna & Knudsen, Per Egil (Red.), Institutt for Folkehelse - ÅRBOK 2017-2018. Høgskolen i Hedmark. s. 43–44.
• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2018). Rasch analysis of a scale intended to measure depressive symptoms in Norwegian adolescents.
• Finbråten, Hanne Søberg & Kleppang, Annette Løvheim (2017). Et Rasch(kt) år. I Calogiuri, Giovanna; Skille, Eivind & Knudsen, Per Egil (Red.), Institutt for Tannpleie og Folkehelse - Årbok 2016-2017. Høgskolen i Hedmark. s. 37–39.
• Kleppang, Annette Løvheim (2016). Physical activity and sedentary behaviour in relation to changes in psychological distress of adolescents from 2001 to 2009 in Norway.
• Kleppang, Annette Løvheim & Hagquist, Curt (2015). The psychometric properties of the Hopkins Symptom Checklist instrument (HSCL – 10): A Rasch analysis based on Norwegian adolescent data. Abstract number: P44 .
• Kleppang, Annette Løvheim & Hagquist, Curt (2015). The psychometric Properties of the Hopkins Symptom Checklist-10. A Rasch analysis based on Norwegian adolescent data.
• Kleppang, Annette Løvheim (2009). Mat og helse i den naturlige skolesekken.

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