Changes over time in mental health symptoms among adolescents in Tampere, Finland

Time Trends in Adolescent School Absences and Associated Bullying Involvement Between 2000 and 2019: A Nationwide Study

Education is a central determinant of adolescent health. School absences and bullying involvement jeopardize wellbeing, mental health, and educational attainment. We analyzed time trends in school absenteeism over two decades and examined the association of absenteeism with bullying involvement.We analyzed data from the nationwide School Health Promotion study, with self-reported data from Finnish middle school students in grades 8 and 9 (ages 14-17, N = 1 000 970). Questionnaires assessed frequency of illness absences (IA), truancy, frequency of bullying victimization, bullying perpetration, and involvement in both bullying perpetration and victimization. Frequent school absences were defined as occurring on more than 3 days during the prior month (2000-2015), or at least weekly (2017-2019).Frequent IA increased from 12% to 2000 to 22% in 2015. In 2017-2019, frequent IA was reported by 3.5%. Frequent truancy declined from 9% to 2000 to 4% in 2015, and remained at 4% during 2017-2019. Bully victimization was reported at least weekly by 6.9%, perpetration by 5.4% and victimization-perpetration by 1.9% of participants in total. In a logistic regression model, every type of bullying involvement increased odds for both IA and truancy.Since bullying involvement was associated with both IA and truancy, particular concern should be raised for adolescents involved in bullying, and for their social and educational functioning. The concurrent increase in IA and decrease in truancy may reflect destigmatization of mental health problems or other changes in reporting absenteeism.

Adolescent Interpersonal Behaviours and Mental Health Across Two Swedish Cohorts: 15-Year Trends and One-Year Bidirectional Associations in a Mixed-Methods Study

BACKGROUND AND AIMS

Adolescent mental health has declined in recent decades. Few studies have explored whether shifts in interpersonal behaviours- both in-person and online- can help explain this decline. Using data from two Swedish cohorts (2007-2008, 2023-2024), we examined (1) 15-year time trends (2007-2008 vs. 2023-2024) in interpersonal behaviours (victimization, aggression, prosocial behaviours) and mental health (externalizing/internalizing problems); (2) one-year bidirectional associations between them; (3) the unique role of cybervictimization/cyberaggression in relation to mental health; and (4) adolescents' accounts of online experiences that made them 'feel bad'.

METHODS

Two longitudinal school cohorts of Swedish adolescents (2007-2008: N = 911-987, Mage = 13.71-14.76 years; 2023-2024: N = 768-806, Mage = 13.89-14.89 years) completed self-report measures of interpersonal behaviours and mental health. In 2023-2024, a subset of adolescents (n = 127, 16.5%) answered open-ended questions about negative online experiences.

RESULTS

From 2007 to 2008 to 2023-2024, prosocial behaviours moderately declined for girls and boys, while internalizing problems increased moderately for girls and weakly for boys. Meanwhile, victimization, aggression, and externalizing problems increased at a weak-to-moderate level among girls. Victimization and being treated well by others showed moderate bidirectional relationships with mental health. Cybervictimization/cyberaggression had weaker associations with mental health than did in-person behaviours. According to the qualitative analysis of negative online experiences, adolescents reported harassment, social exclusion, perceived standards/expectations, time-consuming activities, and exposure to distressing content.

CONCLUSIONS

Deteriorating adolescent mental health over the past 15 years has occurred alongside rising interpersonal difficulties. The findings further suggest a reciprocal relationship between social challenges and mental health, with hostile online environments amplifying- but not primarily driving- these issues. A holistic perspective that accounts for both in-person and online experiences is essential to better understand and support adolescent well-being.

Skewed Transgender Narratives in Western Media

This essay compares representations of transgender people in Western mass and social media with data drawn from studies on transgender individuals. Three differences between the surveyed data and the media representations stand out: (1) while Western media focus on male-to-female (M-F) individuals, most transgender people in Western societies today are female-to-male (F-M). (2) Western media representations of transgender individuals highlight glamorous, successful people. Empirical data show that the socioeconomic status of transgender individuals in Western societies tends to be lower than that of nontransgender people. (3) In Western media, the transitioning process of transgender people is often portrayed as a successful soteriological journey of becoming one's "true self." Medical surveys show that transgender people suffer from psychological and physical problems both before and after transitioning. It is concluded that the disparity between the empirical data and the media narratives on transgender people is due to the persistence of neoliberal narratives in Western media.

Twenty-year changes of adolescent mental health and substance use: a Finnish population-based time-trend study

This time-trend study assesses changes in mental health and substance use among Finnish adolescents from 1998 to 2018. Representative samples of adolescents (N = 6,600) aged 13-16 years participated in school-based, almost identical cross-sectional studies in 1998 (n = 1,446), 2008 (n = 2,009), 2014 (n = 1,800) and 2018 (n = 1,345), respectively. The Strengths and Difficulties Questionnaire was used to assess mental health. When comparing mental health in the clinical range between 1998 and 2018, the main finding was the significant increase of emotional symptoms among females. The percentage of females in the clinical range increased from 17.5 to 30.1% during the twenty-year period. When psychopathology measures were analyzed as continuous variables, the finding of increased emotional problems was confirmed. The study clearly illustrates a linear trend, with a consistent increase in emotional problems among females and decrease in substance use among both genders. An alarming finding of steady increase of self-reported emotional problems indicates the importance of early detection and evidence-based interventions for adolescent with anxiety and depression to prevent adversities associated with these disorders.

Temporal changes in the associations between diagnosed psychiatric disorders and dropping out of school early

Psychiatric problems are risk markers for poor educational attainment. The number of adolescents receiving treatment has increased. We investigated whether the association between psychiatric problems in early adolescence and dropping out of school had changed. We used the register-based 1987 and 1997 Finnish Birth Cohort studies, which include all live births in Finland. Hospital districts with incomplete records were excluded, leaving 25,421 participants born in 1987 and 32,025 born in 1997. The main outcome was not having applied for secondary education by the year the cohort members turned 18. Our main predictors were psychiatric and neurodevelopmental disorders diagnosed by specialized services during 1998-2003 and 2008-2013, when the cohort members were 10-16 years old. We found that 511 (2.0) of subjects born in 1987 and 499 (1.6%) born in 1997 dropped out of school. Having any diagnosis at 10-16 of age was associated with dropping out of school early in both cohorts: 3.9% in 1987 and 4.8% in 1997. The highest proportions were in the subgroup with autism spectrum disorders (ASD), 19.4% in 1987 and 16.2% in 1997. Dropping out early increased among adolescents diagnosed with any psychiatric or neurodevelopmental disorder, from 3.9 to 4.8%, with the clearest increase for learning disabilities, from 3.4 to 9.0%. Dropping out decreased for those with depression, from 4.5 to 2.1%. Adolescents with psychiatric and especially neurodevelopmental disorders, need effective interventions to prevent them dropping out of school early. Increased detection of psychopathology did not result in decreased dropout rates.

Social anxiety in Finnish adolescents from 2013 to 2021: change from pre-COVID-19 to COVID-19 era, and mid-pandemic correlates

PURPOSE

Social anxiety disorder (SAD) is prevalent in adolescents. Increase in levels of general anxiety since 2010's has been observed in young people. Little is known of time trends in symptoms of social anxiety during 2010's, of pre- to during-COVID-19 era changes, or of associations between social anxiety symptoms and pandemic severity, distance education, and COVID-19-related experiences in young people.

METHODS

We examined social anxiety symptoms, their temporal changes, and their associations with COVID-19 related factors in a sample of 450 000 13-to-20-year-old Finns in 2013-2021. Data from nationwide School Health Promotion study was used. Social anxiety symptoms were assessed with the Mini-SPIN using cut-off score ≥ 6 as indicator of high social anxiety. Multivariate logistic regression analyses were used, controlling for gender, age, family SES, and symptoms of general anxiety and depression.

RESULTS

High-level social anxiety symptoms increased markedly from 2013/2015 to 2021 among both sexes. A steeper increase was found among females. In 2021, 47% of females self-reported high social anxiety, a two-fold increase relative to 2013/2015. No association between regional COVID-19 incidence and change in social anxiety symptoms was found. No clear associations between time spent in distance education and social anxiety symptoms were found. Fears of getting infected or transmitting coronavirus, and reports of not getting needed support for schoolwork during distance education were all associated with high social anxiety.

CONCLUSION

Prevalence of high social anxiety in young people aged 13-20 has increased considerably from 2013 to 2021, especially among girls. During COVID-19 pandemic, socially anxious young people report a need for educational support and suffer from infection-related fears.

Generalized anxiety among Finnish youth from 2013 to 2021-Trend and the impact of COVID-19

BACKGROUND

Alarming levels of emotional symptoms among youth were reported during the COVID-19 pandemic. Studies assessing these figures against the pre-pandemic developments are rare. We examined the trend of generalized anxiety (GA) in adolescents in the 2010s and the effect of the COVID-19 pandemic against this trend.

METHODS

Data from the Finnish School Health Promotion study with 750,000 participants aged 13-20 between 2013 and 2021 was analyzed using GAD-7 to measure self-reported GA (cut-off ≥10). Inquiries were made about remote learning arrangements. Effects of time and COVID-19 were analyzed with logistic regression.

RESULTS

Among females, an increasing trend in GA between 2013 and 2019 was found (OR per year 1.05), and the prevalence increased from 15.5 % to 19.7 %. Among males, the trend was decreasing (OR = 0.98), with prevalence from 6.0 % to 5.5 %. Increase in GA from 2019 to 2021 was stronger in females (19.7 % to 30.2 %) than males (5.5 % to 7.8 %), while the effect of COVID-19 on GA was equally strong (OR = 1.59 vs. OR = 1.60) against the pre-pandemic trends. Remote learning was associated with elevated levels of GA, especially among those with unmet needs for learning support.

LIMITATIONS

The design of repeated cross-sectional surveys doesn't allow analyses of within individual changes.

CONCLUSIONS

Given the pre-pandemic trends of GA, the COVID-19 effect on it appeared equal in both sexes. The increasing pre-pandemic trend among adolescent females and the strong effect of COVID-19 on GA among both sexes warrants constant monitoring of mental health of the youth in the aftermath of the COVID-19 pandemic.