P-20: Familiens betydning – en undersøkelse av hvordan helsen varierer og samsvarer mellom og innad i individer og familien

Strengthening family resources and targeting several aspects of mental wellbeing may be an important and efficient way of improving the mental wellbeing and quality of life among adolescents.

Background: The prevalence of psychological distress and loneliness is increasing among adolescents, factors which impact one’s quality of life. Previous research has shown that various health outcomes correlate within the individual, and that the family context is important for the wellbeing of adolescents. Nevertheless, studies of adolescents’ health and wellbeing often investigate health outcomes separately, disregarding the fact that the health outcomes measured are clustered within the same individual. Furthermore, few studies consider the family con- text within which these adolescents are nested. By using statistical methods that allow the inclusion of the individual level and family level, information about the relative importance of each level can be assessed. Thus the aim of the present study was to investigate the variation and covariation of psychological distress and loneliness within adolescents and between siblings within families.

Methods: The sample consisted of adolescents who participated in Young-HUNT 4 (N=8006). Psychological distress was measured by the Symptom Check List-5, and loneliness was assessed by adolescents reporting on a five-point scale on how often they felt lonely. Register data from Statistics Norway provided a unique family number used to identify adolescents belonging to the same family. Thus it was possible to create a hierarchical data structure consisting of the outcomes at level 1, adolescents at level 2 and families at level 3. The multivariate mixed models contained both psychological distress and loneliness as outcomes simultaneously, and the models were adjusted for sex, age and family education.

Results: Analyses of variability showed larger variation between adolescents than between families for both out- comes. The between-individual variance of psychological distress was 0.99 (SE=0.03) while the between-family variance was 0.22 (SE=0.03). For loneliness, the between- individual variance was 0.97 (SE=0.03) and the between- family variance was 0.15 (SE=0.03). The analyses of covariation between psychological distress and loneliness showed that the outcomes were correlated within adolescents (r=0.48) and strongly correlated within families (r=0.91).

Conclusions: Using the present statistical model, information about how psychological distress and loneliness are nested within the adolescents and within their respective families was provided. The results indicate that the promotion of mental wellbeing among adolescents should account for multiple aspects of mental well- being. Furthermore, the family context seems to be an important unit for prevention and promotion when designing and implementing public health policies, which could be important for improving the quality of life of adolescents.