Adolescence is an important developmental period. Young people face many pressures and challenges, including growing academic expectations, changing social relationships with family and peers, and the physical and emotional changes associated with maturation. Mental health is a broad concept, including positive mental health, mental health problems and psychiatric diseases. This introductory paper addresses the issue of positive mental health, and how existing data from the Health Behaviour in School-aged Children study (HBSC) may be used to deepen our knowledge of developments in mental health among adolescents in the Nordic countries.
The Health Behaviour in School-Aged Children study is a WHO collaborative cross-national study that now includes 48 countries, collecting data every four years from 1984 to 2018 on health, well-being, health behaviour and social environments. Data collection is carried out in school classes via self-completion of questionnaires. An asset of the study is that the HBSC focuses on understanding young people’s health in their social context at family, peer, school, neighbourhood, and country levels. The investment in the HBSC study gives unique opportunities for high-quality research and monitoring in the Nordic countries.
The on-going Nordic research collaboration on positive mental health among adolescents uses the HBSC study as the research infrastructure for analysing trends as well as collecting new data on positive mental health. This special issue reports on trends when positive perspectives have been guiding the analysis of available data. The present research explores the potential of Nordic collaboration and comparative studies of school-aged children in the Nordic countries.
Life satisfaction is an important indicator when assessing positive mental health aspects in populations, including among adolescents. The aim of this study was to investigate trends over time in prevalence of high life satisfaction among adolescents from five Nordic countries: Denmark, Iceland, Finland, Norway and Sweden.
We used data from four waves of the Health Behaviour in School-Aged Children study from 2002, 2006, 2010 and 2014 (n=109,847). HBSC is a school-based study examining social circumstances, health and health behaviour among 11-, 13- and 15-years olds every four years in many European and North American countries. The Cantril Ladder, an 11-step visual analogue scale, was used as the measure of life satisfaction, and was dichotomised into two groups: high life satisfaction (scoring 9 or 10 on the scale) and medium/low life satisfaction (scoring <9).
Over the 12-year period studied, between 28.6 and 44.8% of adolescents in the five countries rated their life satisfaction as high. Relatively large changes in prevalence levels occurred at the country level over the period. Denmark and Finland showed a steady, significant decline in the prevalence of high life satisfaction over the years. Iceland showed the highest prevalence in 2010. Norway and Sweden showed similar development until 2010, followed by a clear increase for Norway and a sharp decline in adolescent high life satisfaction for Sweden up until 2014. In all countries, high life satisfaction was most prevalent in 11-year- olds and least prevalent in almost all surveys among 15-year-old girls.
Background: Excellent self-rated health (SRH) can be seen as an important component of positive health among adolescents. The aim of this paper is to examine time trends of excellent health among adolescents in five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) between 2002 and 2014, including differences between countries, gender and age. Methods: Nordic data from the Health Behaviour in School-aged Children (HBSC) survey (including 11-, 13- and 15-year-olds) from 2002 (n = 19,009), 2006 (n = 29,656), 2010 (n = 33,232) and 2014 (n = 31,540) were analysed by design-adjusted binomial logistic regression models. Results: The trend analysis of excellent SRH for Nordic adolescents indicates a small improvement between 2002 and 2006 but a stable trend in the following periods up until 2014. The time trends do, however, depend on the specific country. In general, a smaller proportion of girls compared to boys were found to rate their health as excellent. Over time, however, the proportion of boys rating their health as excellent decreased, while girls’ ratings improved. Conclusions: From a public health perspective, indications of a changing trend in adolescent health coinciding with the 2007–2008 global recession warrant further attention from researchers and policy-makers and should be closely monitored in the future.
Sleep has been found to be an important factor in adolescents’ mental and physical health. The aim of the present study was to examine trends in sleep difficulty (i.e., difficulty falling asleep more often than once a week) in the Nordic countries among 11- to 15-year-olds. We analysed Nordic data from the Health Behaviour in School-aged Children study (HBSC), which is conducted every four years, looking specifically at trends in sleep difficulty over a 12-year period from 2002 to 2014. The participants were aged 11 to 15 years. The total number of participants across these years was 113,447. A large percentage (17% to 31% in 2014) of adolescents in the Nordic countries experience sleep difficulty, and these difficulties increased from 2002 to 2014 in Denmark, Finland, Iceland, and Sweden. Only in Norway was there a decrease, mainly due to a reduction in sleep difficulty among 11-year-old boys and girls from 2010 to 2014. Sleep difficulty among boys and girls are prevalent and generally on the rise in the Nordic countries with the exception of Norway.
Adolescence is an important developmental period toward greater independence. However, the family is still very important in the life of young people. The aim of this study was to analyse changes over time in easy communication between adolescents and their parents in the Nordic countries.
The study used the Nordic part of Health Behaviour in School-aged Children, carried out in four waves from 2002–2014. It included 109,446 adolescents. The adolescents were asked how easy it was to communicate with their mother or father about things that really bothered them. The results were analysed using descriptive statistics and binomial logistic regression.
In all Nordic countries, the prevalence of easy communication between adolescents and their parents increased from 2002 to 2014. Although the positive change in parental communication was more pronounced among Nordic fathers, the data showed that mothers had markedly better communication with their adolescents than fathers did. In 2014, around three out of four adolescents found it easy to talk with their fathers, while four out of five found it easy to talk with their mothers. The results indicate that policies in the Nordic countries to support the role of both mothers and fathers in caring for their children are warranted.
Associations between school-related stress and poor health, risk behaviours and low well-being are well documented. The aim of this paper was to estimate trends of perceived school stress experienced by boys and girls of different ages in the Nordic countries, and to describe trends in school stress between the Nordic countries. Nordic data from the Health Behaviour in School-aged Children study (HBSC) between 2002 and 2014 were used. The participants were aged 11–16 years. School stress was measured by a single item; “How pressured do you feel by schoolwork?” The participants answering “some” or “a lot” were categorised as reporting school stress.
Sweden, Norway and Denmark had lower prevalence of school stress compared to Finland and Iceland. There was an increase in Iceland, Finland and Denmark, whereas adolescents from Sweden showed a decreasing trend. In Norway, the level was stable. Boys showed a marginal decline in school stress whereas girls showed an increase, and school stress increased by age for the whole period. It is a challenge for the public education systems in the Nordic countries to develop policies and practices that provide children with the necessary tools to achieve knowledge and skill, and at the same minimise stress in school.
The positive mental health and well-being perspective represents innovative public health research of first-rank priority in Europe. Good mental health is both a state and a resource for everyday life. Hence, the concept often refers to a subjective feeling (hedonic component) as well as positive functioning (eudaimonic component). Different conceptualisations of mental health-related issues are a background to this paper, which gives a brief overview of three research issues in the Nordic countries. First, the development in the occurrences of adolescent mental health-related indicators such as life satisfaction, health, sleep, and school pressure. Second, review of Nordic methodological studies reporting on different mental health-related measures. Third, the selection of measures of positive mental health employed in the 2017–2018 Health Behaviour among School-aged Children (HBSC) data collection in the Nordic countries. Using the Nordic HBSC data for 2002–2014, it was found that symptom and problem-oriented analyses of mental health can improve our understanding of the challenges adolescents face. However, there is also a need to examine positive aspects of mental health in order to enhance our understanding of different mental health-related dimensions. New measures were included in the 2017–18 HBSC data collection in the Nordic countries, enabling researchers to answer different research questions including analysing factors mediating and moderating positive mental health among school-aged children. Extending the perspective from a symptom- and problem-oriented view to a more positive and asset-based perspective adds additional value to studies of mental health.
Nordisk välfärdsforskning | Nordic Welfare Research ble etablert i 2016 og publiserer artikler innen et bredt spekter av velferdspolitiske temaer om de nordiske velferdssamfunn, som levekår og livssituasjon i befolkningen, arbeidsliv og arbeidsinkludering, sosiale tjenester, omsorg, folkehelse og funksjonshemming.
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Sven Bremberg, Karolinska Institutet, Sverige
Trine Wulf-Andersen, Roskilde Universitet, Danmark
Snæfríður Þóra Egilson, Universitetet i Island, Island
Tom Kettunen, Nordic Studies on Alcohol and Drugs, Finland
John Eriksen, OsloMet og Fafo, Norge
Design: Type-it AS, Trondheim
Sats: Tekstflyt AS
Omslagsdesign: KORD / Sissel Tjernstad
ISSN online: 2464-4161
Tidsskriftet utgis av Universitetsforlaget AS (Scandinavian University Press) på vegne av Nordens välfärdscenter.
© Universitetsforlaget 2019 / Scandinavian University Press.