Validation of the short version of Cognitive Emotion Regulation Questionnaire for adolescents in Norway.

BACKGROUND/AIM: The Cognitive Emotion Regulation Questionnaire (CERQ) is among the most popular and widely used measures of emotion regulation across age groups. This study aimed to validate the CERQ short version (CERQ-short) for use on adolescents in the Norwegian population. METHOD: A sample of 3461 adolescents (47.3% girls) aged 12-16 years was recruited through the UEVO population-based study of child maltreatment in Norway. Factor structure, reliability, measurement invariance and criterion validity were investigated. RESULTS: Confirmatory factor analysis supported the original nine-factor model including 18 items; however, not a two-factor structure nor a higher order two-factor solution. Internal consistency was adequate for all subscales, with alpha levels ranging from .73 to .84 between subscales across genders. Relationships with internalizing problems measured with the 10-item Hopkins Symptom Checklist and health-related quality of life according to KIDSCREEN-10 supported the criterion-related validity of the Norwegian CERQ-short. CONCLUSIONS: Results suggest that the CERQ-short can be used to measure cognitive emotion regulation strategies in the Norwegian adolescent population. The validation of the CERQ-short in Norway could significantly improve mental health care by facilitating better diagnosis, treatment planning, and evaluation, as well as informing public health policy and cross-cultural research.

Violence and sexual abuse rates before and during the Covid-19 pandemic: A prospective population-based study on Norwegian youth.

BACKGROUND: Considerable concern is raised as to whether the pandemic has led to an increase in violence and sexual abuse against children. OBJECTIVE: The present study objective is to provide rates of violence and sexual abuse against adolescents the year before the pandemic compared to one year into the pandemic. PARTICIPANTS AND SETTING: Two samples of Norwegian 12-16-year-olds were approached. A representative pre-pandemic sample of 9240 adolescents (M age (SD) = 14.11(0.88), and a sample recruited one year into the pandemic resulting in 3540 responses (M age (SD) = 14.5 (0.96)). METHODS: An online survey was administered during school hours including established measures of violence and sexual abuse exposure. Sociodemographic characteristics were assessed. RESULTS: There was 1.4 percentage point increase in sexual abuse by an adult, and a 3.9 percentage point decrease in psychological violence by a parent during the pandemic compared to the year before the pandemic. Otherwise, violence and sexual abuse rates remained stable across these two time periods. Risk factors for violence and sexual abuse were amplified during the pandemic. CONCLUSION: Norway, a high-income welfare state, imposed measures to counteract the burden of the pandemic mitigation actions for adolescents. This might partly explain the absence of the feared increase in violence towards adolescents. The disproportionate risk for violence and sexual abuse for some groups of adolescents is however concerning, and should be followed up over time.

The regulatory role of affective inhibitory control in somatic symptoms among adolescents exposed to child maltreatment: a population-based study.

Adolescents exposed to child maltreatment are at increased risk for various somatic symptoms, but which psychological factors that contribute to this relationship need to be further investigated. Emotion dysregulation is suggested to serve as a proximal link between child maltreatment and somatic complaints. The purpose of the present study was to investigate whether individual differences in affective inhibitory control, a central component in implicit emotion regulation, contribute to the risk of somatic symptoms in adolescents exposed to child maltreatment. Data were drawn from the UEVO study, a national population-based survey of adolescents between 12 and 16 years of age (N = 9240). For this study, we included participants who completed the emotional go/no-go task measuring affective inhibitory control (N = 7241; Mage/SD = 14 years/.87; 52% girls, 47% boys), of which N = 3349 reported at least one incident of maltreatment exposure (57% girls, 41% boys). Exposure to psychological abuse and sexual abuse were associated with somatic symptoms. Affective inhibitory control was related to somatic symptoms, both in the total sample and in adolescents exposed to child maltreatment. The strength of relationships between exposure to psychological abuse and somatic symptoms, as well as sexual abuse and somatic symptoms, were moderated by individual differences in affective inhibitory control problems. Our study suggests that psychological abuse and sexual abuse increase the risk for somatic symptoms in adolescence. Affective inhibitory control, a central component in implicit emotion regulation, was related to somatic symptoms and moderated the relationships between psychological abuse and somatic symptoms, and sexual abuse and somatic symptoms. Revealing these associations in a population-based sample indicates that treatment targeting affective inhibitory control may be beneficial and should be explored further in clinical settings.

Changes in Adolescent Mental and Somatic Health Complaints Throughout the COVID-19 Pandemic: A Three-Wave Prospective Longitudinal Study.

PURPOSE: Measures taken to limit the spread of the COVID-19 may have had unintended consequences for the mental and somatic health of children and adolescents. METHODS: A nationwide three-wave survey in a representative sample of 12-16 year olds in Norway, with baseline data collected in January 2019 (n = 9,240; 49% girls) and follow-ups in June 2020 (n = 3,564; 49% girls) and June 2021 (n = 3,540; 47% girls). Linear mixed-effects models were used to estimate change and identify predictors thereof in mental and somatic health complaints. RESULTS: Following an initial stable trend from before the pandemic to the early phase, both mental health problems (predicted value at T1 .56 [CI .55, .58], T1-T2 change -.04 [CI -.07, -.02], T2-T3 change .12 [CI .09, .14]) and somatic health complaints (predicted value at T1 .59 [95% CI .58, .61], T1-T2 difference -.09 [95% CI -.11, -.65], T2-T3 difference .18 [95% CI .15, .21]) increased significantly 15 months into the pandemic, when controlling for age in the models. When compared to boys, girls had a significantly more pronounced increase in mental health problems and somatic health; loneliness in the early stages of the pandemic significantly predicted health complaints one year later, both mental and somatic complaints. DISCUSSION: Our findings suggest that the prolonged pandemic situation and the related societal restrictions have had an impact on adolescent health in general and on the health of girls in particular. The rise in mental and somatic health complaints can in part be attributed to an increase in loneliness.

Childhood Experiences of Companion Animal Abuse and its Co-Occurrence with Domestic Abuse: Evidence from a National Youth Survey in Norway.

It is increasingly acknowledged that companion animal abuse often occurs in the same contexts as other types of abuse, particularly domestic abuse. However, the co-occurrence and strengths of these associations in the general population have not been well established in research. With data from a large representative sample of Norwegian adolescents, we aimed to determine 1) the extent to which Norwegian children are exposed to companion animal abuse in the family, 2) whether and how companion animal abuse is linked to other forms of domestic abuse that children experience, and 3) background factors associated with companion animal abuse. A total of 9240 adolescents aged 12-16 years (Mage 14.7) participated in the digital school-based survey. Four percent (n = 380) reported that they had ever witnessed a parent being violent towards a family companion animal, whereas 1% (n = 125) had experienced that an adult in the household had threatened to harm a companion animal. There was a substantial overlap between companion animal abuse and child abuse, and it most frequently co-occurred with psychological abuse and less severe forms of physical child abuse. This resonates with conceptualizations of domestic abuse as an ongoing pattern of psychological abuse and coercive control. The risk factors identified for companion animal abuse in this representative sample of adolescents were similar to known risk factors for domestic abuse. Low socioeconomic status and parents' substance abuse, parents' psychiatric illness, and parents' history of incarceration entailed a greater risk of experiencing companion animal abuse. We conclude that companion animal abuse co-occurs with other forms of domestic abuse and that it may be considered a part of the repertoire of domestic abuse that impacts children.

[Formula: see text]Unity or diversity of executive functioning in children and adolescents with post-traumatic stress symptoms? A systematic review and meta-analysis.

For some children, psychological reactions to a traumatic event develop into severe or persistent post-traumatic stress symptoms (PTSS) or the clinical condition of post-traumatic stress disorder (PTSD). Cognitive problems in children with PTSS have been reported, but it is not clear which specific functions are affected. Executive functions is a domain of particular interest, given its importance for academic performance and social and emotional functioning. A systematic literature search was performed, and 12 studies with 55 comparisons of executive functions in children with PTSS and healthy controls were eligible for meta-analysis. A subset of the studies also included a comparison group of children with traumatic experienced but without PTSS. Overall, across all tasks and measures, children with PTSS showed lower executive functioning than healthy controls (SMD = -0.57). The effect sizes between the subdomains complex tasks, verbal fluency, inhibition, shifting and working memory were not significantly different from each other, but was largest for verbal fluency (SMD = -1.45). Analyses comparing children with traumatic experiences with and without PTSS similarly showed overall lower executive functioning in the PTSS group (SMD = -0.34) and no significant differences in effect sizes between subdomains. The results have implications for assessment and clinical work with youth exposed to traumatic events. We should be aware of the poor executive functioning that may be an issue for some children with a history of trauma and subsequent development of PTSS, and the impact this could have on everyday functioning.

Adolescents' symptoms of anxiety and depression before and during the Covid-19 outbreak - A prospective population-based study of teenagers in Norway.

BACKGROUND: Lockdown policies related to the Sars-Cov-2 pandemic has potential negative consequences for mental health in youths. METHODS: Anxiety and depressive symptoms were assessed in 3 572 adolescents, age 13 to 16 using the Hopkins Symptom Checklist (HSCL-10), in a representative longitudinal survey of Norwegian youths between February 2019 (T1) and June 2020 (T2). Predictors for symptom change were analysed with linear mixed-effects models. FINDINGS: Overall, clinical levels of anxiety and depression increased slightly from 5.5% at T1 to 6.3% at T2; Chi square 224.4 (df = 1), p<.001. However, the observed change was driven by the increase in age between assessments. Being a girl, having pre-existing mental health problems, and living in a single-parent household at T1, predicted higher levels of anxiety and depressive symptoms at T2 (p<.001). Living in a single-parent household was associated with a significant increase in symptoms, also when age was controlled for (p<.001). Living in a poor family however, or having a history of maltreatment, was associated with a significantly lower increase in symptoms (p<.001). INTERPRETATION: Anxiety and depressive symptoms increased slightly in Norwegian youths between 2019 and 2020, but this change seemed to be driven by increase in age rather than pandemic-related measures. Symptom levels were unevenly distributed across demographic groups both before and during the pandemic outbreak, indicating that health disparities persist for adolescents in risk groups during a pandemic . Health inequities related to living conditions need to be addressed in future action plans, and intensified measures to mitigate inequities are needed. FUNDING: The study was funded by the Norwegian Directorate for Children, Adolescents and Family affairs (Bufdir).

Violence and abuse experiences and associated risk factors during the COVID-19 outbreak in a population-based sample of Norwegian adolescents.

BACKGROUND: The lockdowns occurring across society because of the COVID-19 pandemic have had far-reaching consequences for children and adolescents. One immediate concern was what the impact of the comprehensive disease control measures on rates of violence and abuse against children and adolescents would be. OBJECTIVE: We aimed to establish rates of child abuse and degree of family conflict during the first COVID-19 lockdown spring 2020. Additionally, we aimed to investigate associations between preexisting and concurrent risk factors and abuse during these unique times. PARTICIPANTS AND SETTING: A total of 3545 Norwegian 13- to 16-year-olds participated in this study. A total of 1944 of these had provided data 1 year before the lockdown. METHODS: We used a web survey format to assess abuse exposure and associated risk factors. The survey was administered in schools during school hours in June 2020, shortly after the reopening of schools after the first lockdown. RESULTS: In this sample 8.2% reported psychological abuse during lockdown, 2.4% had experienced physical abuse and 1.4% sexual abuse. For online sexual abuse, the rate was 5.6% during this time period. Adolescents did not report an increase in family conflict. Concurrently perceived family affluence and family risk factors were most strongly associated with physical abuse during lockdown (OR = 11.01(95% CI 5.32-22.84); OR = 5.36 (95% CI 2.69-10.67)), but also other types of child maltreatment. Analyses across assessment points suggested that prior victimization was the most accurate predictor of abuse experiences during lockdown (OR = 3.84 (95% CI 2.85-5.20)). CONCLUSIONS: The negative consequences of the COVID-19 preventative measures struck the adolescent population unevenly. The findings underscore the need for targeted measures to mitigate the negative outcomes of health-related crises for adolescents in risk groups such as those with low family affluence and prior abuse experiences.

Affective inhibitory control and risk for internalizing problems in adolescents exposed to child maltreatment: A population-based study.

Adolescents' emotion regulatory capacities modulate the relationship between child maltreatment experiences and psychopathology. Affective inhibitory control constitutes an important part of emotion regulation and involves the ability to regulate automatic or prepotent responses to irrelevant and potentially distracting emotional information. The aim of the present study was to investigate the role of affective inhibitory control in the relationship between exposure to child maltreatment and internalizing problems in adolescence. A nationally representative sample of adolescents (n = 9,240; 49% girls; Mage = 14 years; SD = 0.9), of which n = 4,261 (55% girls; Mage = 14 years; SD = 0.9) were exposed to child maltreatment, conducted an emotional go/no-go task. Participants were presented with angry facial expressions as emotional no-go stimuli in order to examine their ability to inhibit behavioral responses to threatening task-irrelevant stimuli. Affective inhibitory control problems were uniquely related to internalizing problems in maltreated adolescents. Gender effects were observed; the relationship was significant in girls but not in boys. Moreover, affective inhibitory control moderated the relationship between exposure to psychological abuse and internalizing problems in girls. We did not observe any relationship between inhibitory control and internalizing problems when neutral faces were presented as task-irrelevant information. Findings suggest that a reduced ability to inhibit threatening, but task-irrelevant, information is related to internalizing problems in maltreated adolescent girls. Results highlight the importance of affective inhibitory control as a potential moderating mechanism in individual risk for experiencing internalizing problems in abused adolescents. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cohort profile: Norwegian youth study on child maltreatment (the UEVO study).

PURPOSE: Exposure to childhood maltreatment is not uncommon, and is linked to both short-term and long-term health problems. Population-based surveys for adolescent samples provide excellent opportunities for addressing the substantial burden of early-life adversities, because collecting information close in time to exposure may increase accuracy of assessment. Still few large studies have been conducted, following individuals through adolescence. Therefore, the UEVO cohort was created with the aim of investigating prevalence of child maltreatment throughout childhood and adolescence, and its effects on health and functioning in a long-term perspective in a representative sample of Norwegian adolescents. PARTICIPANTS: The baseline for the cohort includes a representative sample of 9240 Norwegian adolescents (response rate 86.6%) aged 12-16 years, surveyed in January and February 2019. The cohort to be followed over time comprises the 5502 adolescents who agreed to be recontacted for subsequent data collection waves. FINDINGS TO DATE: The overall prevalence figures from the first wave of measurement have been published in a comprehensive national report on child maltreatment in Norway. FUTURE PLANS: A second study wave will commence in 2021, including about half of the original cohort (longitudinal), as well as a new sample starting at age 12. For participants above age 16, original survey data will be connected to national registries (pending indvidual consent), enabling the study of real-life functioning within the areas of healthcare utilisation, school drop-out, work-force participation and prescription of medication.

Adolescent abuse victims displayed physical health complaints and trauma symptoms during post disclosure interviews.

AIM: We investigated whether adolescents who had recently disclosed sexual abuse or family violence displayed more psychological trauma symptoms and physical health complaints than unaffected controls. We also investigated to what degree physical health complaints were associated with trauma symptoms in these abuse victims. METHODS: Abuse, trauma symptoms and physical health complaints were assessed during face-to-face interviews with 40 sexual abuse victims and 35 family violence victims aged 10-18 years. They had all attended forensic interviews at the Barnehus in Oslo, a specialised Norwegian police unit where evidence is gathered in adolescent-friendly surroundings, from October 2016 to November 2018. Their symptoms were compared with 41 controls from the general population. Linear regression analyses investigated associations between trauma symptoms and physical health complaints. RESULTS: Sexually abused adolescents displayed higher levels of post-traumatic stress reactions, depression, dissociation and physical health complaints than unaffected controls. Family violence victims displayed higher levels of post-traumatic stress reactions. Trauma symptoms were associated with physical health complaints, and these were most prominent in the adolescents with the highest burden of symptoms. CONCLUSION: Based on the high burden of symptoms revealed, clinical examinations of abused adolescents should include a systematic assessment of trauma symptoms and physical health complaints.

Maltreatment and trauma symptoms: Does type of maltreatment matter?

OBJECTIVE: Children frequently report a heightened experience of psychological problems such as depression, anxiety, aggression, and posttraumatic stress disorder in response to maltreatment. However, in recent years, scholars have suggested that different types of maltreatment may be associated with different symptomatology in children. METHOD: In the present study, we employ the Trauma Symptom Checklist for Young Children (TSCYC) to investigate whether children who have experienced different types of maltreatment reveal different profiles of symptomatology. Nonmaltreated (n = 101) and maltreated (n = 52) children between 3 and 12 years of age were included in the present study. Maltreatment was further categorized into the subgroups abuse and neglect. RESULTS: Findings proved the TSCYC to be successful in distinguishing nonmaltreated from maltreated children in terms of symptomatology. Furthermore, abused children showed a broader spectrum of symptoms, whereas neglected children differed on fewer symptom scales compared with their nonmaltreated peers. Lastly, abused children evinced more externalizing symptoms than the neglected children. CONCLUSION: In line with previous research, maltreated children do have more psychological symptoms, and, abused children showed enhanced psychological problems and more externalizing symptoms in particular. (PsycINFO Database Record

Behavior and inhibitory control in children with prenatal exposure to antidepressants and medically untreated depression.

PURPOSE: The present study investigates child development following prenatal exposure to maternal use of selective serotonin reuptake inhibitors (SSRIs; N = 28), versus prenatal exposure to medically untreated depression (N = 42), and no exposure (N = 33). METHODS: When the children reached 5-6 years of age, child cognitive abilities were measured using selected tests from Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-r), Neuropsychological Assessment II (NEPSY-II), and the Attention Network Test. Maternal reports of child behavioral problems were collected using the Child Behavior Checklist (CBCL). CONCLUSION: Analyses of variance revealed no effects of prenatal exposure to depression or SSRIs upon general cognition or inhibition. Regarding behavioral problems, there was a significant negative association between both SSRI and depression exposure upon externalizing, and between SSRI exposure and internalizing problems. The results are interpreted in light of theories on interactive specialization and reactivity.

Coping style and memory specificity in adolescents and adults with histories of child sexual abuse.

Individuals with histories of childhood trauma may adopt a nonspecific memory retrieval strategy to avoid unpleasant and intrusive memories. In a sample of 93 adolescents and adults with or without histories of child sexual abuse (CSA), we tested the hypothesis that nonspecific memory retrieval is related to an individual's general tendency to use avoidant (i.e., distancing) coping as a personal problem-solving or coping strategy, especially in victims of CSA. We also examined age differences and other individual differences (e.g., trauma-related psychopathology) as predictors of nonspecific memories. Distancing coping was significantly associated with less specific autobiographical memory. Younger age, lower vocabulary scores, and non-CSA childhood maltreatment (i.e., physical and emotional abuse) also uniquely predicted less autobiographical memory specificity, whereas trauma-related psychopathology was associated with more specific memory. Implications for the development of autobiographical memory retrieval in the context of coping with childhood maltreatment are discussed.

Associations between executive functions and long-term stress reactions after extreme trauma: A two-year follow-up of the Utøya survivors.

Terror attacks cause variation in everyday functioning across several domains. This paper focuses on the individual long-term costs in terms of clinical symptoms and cognitive (e.g., shifting, inhibition, and spatial working memory) difficulties associated with these symptoms in 24 survivors of a terror attack in Norway. Another 24 controls were included for comparison purposes. Participants were administered a battery of clinical and neurocognitive tests. Results showed that all clinical variables differed as a function of group, ps ≤ .001, η2 ≥ .64, but no significant differences were revealed for the neurocognitive measures. In the survivor group, shifting capacity and its interaction with gender predicted intrusion symptoms, p = .045, ηp2 = .338, and symptoms of avoidance, p = .008, ηp2 = .453. We discuss the findings in relation to theoretical models and therapeutic interventions.

Children's memory and suggestibility about a distressing event: the role of children's and parents' attachment.

Our goal was to identify individual difference predictors of children's memory and suggestibility for distressing personally experienced events. Specifically, we examined children's and parents' attachment orientations and children's observable levels of distress, as well as other individual difference factors, as predictors of children's memory and suggestibility. Children (N=91) aged 3 to 6years were interviewed about inoculations received at medical clinics. For children whose parents scored as more avoidant, higher distress levels during the inoculations predicted less accuracy, whereas for children whose parents scored as less avoidant, higher distress levels predicted greater accuracy. Children with more rather than less positive representations of parents and older rather than younger children answered memory questions more accurately. Two children provided false reports of child sexual abuse. Implications for theory, research, and practice are discussed.

The effect of emotional facial expressions on children's working memory: associations with age and behavior.

Studies on adults have revealed a disadvantageous effect of negative emotional stimuli on executive functions (EF), and it is suggested that this effect is amplified in children. The present study's aim was to assess how emotional facial expressions affected working memory in 9- to 12-year-olds, using a working memory task with emotional facial expressions as stimuli. Additionally, we explored how degree of internalizing and externalizing symptoms in typically developing children was related to performance on the same task. Before employing the working memory task with emotional facial expressions as stimuli, an independent sample of 9- to 12-year-olds was asked to recognize the facial expressions intended to serve as stimuli for the working memory task and to rate the facial expressions on the degree to which the emotion was expressed and for arousal to obtain a baseline for how children during this age recognize and react to facial expressions. The first study revealed that children rated the facial expressions with similar intensity and arousal across age. When employing the working memory task with facial expressions, results revealed that negatively valenced expressions impaired working memory more than neutral and positively valenced expressions. The ability to successfully complete the working memory task increased between 9 to 12 years of age. Children's total problems were associated with poorer performance on the working memory task with facial expressions. Results on the effect of emotion on working memory are discussed in light of recent models and empirical findings on how emotional information might interact and interfere with cognitive processes such as working memory.

Maltreatment is associated with specific impairments in executive functions: a pilot study.

Child maltreatment is associated with a host of adverse consequences. Few studies exist that map maltreated children's performance on neurocognitive tests particularly sensitive to brain and behavior associations. The aim of the present study was to investigate whether maltreated children differed in their executive functioning compared to their nonmaltreated peers, and if they did so in specific ways. Tasks aimed at measuring set shifting, spatial working memory, and inhibition were administered. Trauma-related symptomatology was further assessed to study the potential effect of maltreatment-related psychopathology on executive functioning. A univariate analysis of variance showed that maltreated children (n = 21) performed significantly poorer compared to their nonmaltreated peers (n = 22) on the Spatial Working Memory task. Symptoms of trauma-related psychopathology were not associated with performance on the executive functions tests. In conclusion, maltreatment was not associated with a global deficit in children's executive functions. Thus, when considering maltreated children's cognitive functioning, specific measures of executive functions should be applied.