Correction: Time trends in self-reported depressive symptoms, prescription of antidepressants, sedatives and hypnotics and the emergence of social media among Norwegian adolescents.

[This corrects the article DOI: 10.1371/journal.pone.0295384.].

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.

BACKGROUND: More in-depth evidence about the complex relationships between different risk factors and mental health among adolescents has been warranted. Thus, the aim of the study was to examine the direct and indirect effects of experiencing social pressure, bullying, and low social support on mental health problems in adolescence. METHODS: A school-based cross-sectional study was conducted in 2022 among 15 823 Norwegian adolescents, aged 13-19 years. Structural Equation Modelling was used to assess the relationships between socioeconomic status, social pressure, bullying, social support, depressive symptoms, self-harm and suicide thoughts. RESULTS: Poor family economy and low parental education were associated with high pressure, low parental support and depressive symptoms in males and females. Moreover, poor family economy was associated with bullying perpetration and bullying victimization among males and females, and cyberbullying victimization among females, but not males. Low parental education was associated with bullying victimization among males, but not females. Further, high social pressure was associated with depressive symptoms among males and females, whereas high social pressure was linked to self-harm and suicide thoughts among females, but not males. Bullying victimization and cyberbullying victimization were associated with depressive symptoms, self-harm, and suicide thoughts among males and females. Bullying victimization was associated with depressive symptoms among males, but not females, whereas bullying perpetration was linked to self-harm and suicide thoughts among females, but not males. Low parental support was associated with bullying perpetration, bullying victimization, depressive symptoms, self-harm and suicide thoughts among males and females, whereas low parental support was associated with high social pressure among females, but not males. Low teacher support was associated with high social pressure and depressive symptoms. Low support from friends was associated with bullying victimization, depressive symptoms and suicide thoughts among males and females, whereas low support from friends was linked to self-harm among males, but not females. Finally, results showed that depressive symptoms were associated with self-harm and suicide thoughts among males and females. CONCLUSION: Low socioeconomic status, social pressure, bullying and low social support were directly and indirectly associated with depressive symptoms and self-directed violence among Norwegian adolescents.

Sexual harassment exposure among junior high school students in Norway: prevalence and associated factors.

Background: Sexual harassment is common in most countries and cultures. Less is known about sexual harassment, its risk factors, and psychosocial outcomes among young adolescents. The aim of the study was to examine the 12-month prevalence of sexual harassment exposure, and sociodemographic and psychosocial factors associated with exposure among junior high school students in Norway. Methods: A comprehensive cross-sectional study was completed by 83,297 Norwegian adolescents in junior high school in 2021. Data on exposure to sexual harassment were used in combination with sociodemographic measures and psychosocial outcomes: depressive symptoms, loneliness, self-esteem, and well-being. Group differences were analyzed with Chi Square tests, and sociodemographic risk factors were analyzed with logistic regression. Psychosocial outcomes were assessed with multivariate and univariate ANOVAs, and dose-response relationships were assessed with linear regression. Results: Among the adolescents, 32.6% had experienced sexual harassment during the past year. Girls had higher odds of exposure (OR: 1.90, 95% CI: 1.84-1.96), whereas adolescents whose parents had higher education had lower odds (OR: 0.95, 95% CI: 0.90-0.99). Exposure was associated with higher levels of depressive symptoms (partial η2 [ES] = 0.11) and loneliness (ES = 0.07), and with lower self-esteem (ES = 0.06) and well-being (ES = 0.06). Among exposed adolescents, more frequent exposure was associated with poorer outcomes. Conclusion: Exposure to sexual harassment affects one third of junior high school students in Norway. Those who are exposed have poorer psychosocial outcomes, and there is a dose-response relationship between exposure and outcomes. Awareness of sexual harassment among young adolescents, and interventions to prevent and reduce it, are needed.

Time trends in self-reported depressive symptoms, prescription of antidepressants, sedatives and hypnotics and the emergence of social media among Norwegian adolescents.

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.

Explaining variance in self-efficacy among adolescents: the association between mastery experiences, social support, and self-efficacy.

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 (ß = 0.25, p < 0.001 and ß = 0.16, p < 0.001, respectively), followed by the variables 'support from friends' and 'parental support' (ß = 0.06, p < 0.001 an ß = 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.

Using Rasch Analysis to Assess the Psychometric Properties of a Five-Item Version of the General Self-Efficacy Scale in Adolescents.

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.

The Meaning of Social Support in Nature-Based Services for Young Adults with Mental Health Problems.

In previous studies, social context and social support have been found to be important in nature-based services. However, no studies have previously focused on the meaning of different dimensions of social support in these contexts. The aim of this study is therefore to uncover dimensions of social support in relation to mental health among young adults with mental health problems participating in nature-based services in Norway. This study applies data from a survey of 93 young adults participating in nature-based services; in addition, qualitative interview data from 20 interviews are also used. The data are analysed using qualitative content analysis, descriptive statistics, and correlation analysis. The results indicate that participants in nature-based services experience emotional, esteem, informational, and instrumental support in addition to social integration and opportunities for nurturance in these services. The service leader, other participants, and the animals are important contributors to these dimensions of social support. Nature-based services may be a helpful intervention for young adults with mental health problems. The unique context of these services, including nature and animals, adds special qualities to mental health and social work practices.

Negative social media-related experiences and lower general self-efficacy are associated with depressive symptoms in adolescents.

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 (ß = 0.09, p < 0.001). However, negative social media-related experiences were more strongly associated with depressive symptoms (ß 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 (ß = -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.

Using the Rasch measurement theory to assess the psychometric properties of the Hopkins Symptom Checklist-10 in adolescents.

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.

Electronic media use and symptoms of depression among adolescents in Norway.

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.

Using Rasch measurement theory to assess the psychometric properties of a depressive symptoms scale in Norwegian adolescents.

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.

The Social Provisions Scale: psychometric properties of the SPS-10 among participants in nature-based services.

PURPOSE: This article analyses the psychometric properties of the Social Provisions Scale 10-items version. METHODS: The Social Provisions Scale was analysed by means of the polytomous Rasch model, applied to data on 93 young adults (16-30 years) out of school or work, participating in different nature-based services, due to mental or drug-related problems. RESULTS: The psychometric analysis concludes that the original scale has difficulties related to targeting and construct validity. In order to improve the psychometric properties, the scale was modified to include eight items measuring functional support. The modification was based on theoretical and statistical considerations. CONCLUSION: After modifications the scale showed not only satisfying psychometric properties, but it also clarified uncertainties regarding construct validity of the measure. However, further analysis on larger samples are required. Implications for Rehabilitation Social support is important for a variety of rehabilitation outcomes and for different patient groups in the rehabilitation context, including people with mental health or drug-related problems. Social Provisions Scale may be used as a screening tool to assess social support of participants in rehabilitation, and the scale may also be an important instrument in rehabilitation research. There might be issues measuring structural support using a 10-items version of the Social Provisions Scale but it seemed to work well as an 8-item scale measuring functional support.