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Risk and protective factors for psychological distress among adolescents: a family study in the Nord-Trøndelag Health Study



The study aimed to investigate potential adolescent and parental psychosocial risk and protective factors for psychological distress among adolescents and, in addition, to examine potential gender and age differences in the effects of risk factors on adolescent psychological distress.


Data were collected among 8,984 Norwegian adolescents (13–19 years) and their parents in the Nord-Trøndelag Health Study (HUNT). The outcome measure was psychological distress (SCL-5).


Bivariate regression analysis with generalized estimating equation (GEE) model showed that all parental self-reported variables (mental distress, substance use, social network, economic problems, unemployment and family structure) and adolescents’ self-reported variables (leisure activities, social support from friends, school-related problems and substance use) were significantly associated with psychological distress among adolescents. Results revealed that in a multiple regression analysis with a GEE model, adolescent psychosocial variables, specifically academic-related problems and being bullied at school, emerged as the strongest predictors of psychological distress among adolescents after controlling for age, gender, and all parental and adolescent variables. The following psychosocial risk factors were significantly more important for girl’s psychological distress compared to boys: problems with academic achievement, conduct problems in school, frequency of being drunk, smoking, dissatisfaction in school, living alone and seen parents being drunk.


Academic achievement and being bullied at school were the psychosocial factors most strongly associated with psychological distress among adolescents. Parental factors had an indirect effect on adolescent psychological distress, through adolescents’ psychosocial factors.

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The Nord-Trøndelag Health Study (The HUNT Study), from which the data were made available, is a collaboration between HUNT Research Centre, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Nord-Trøndelag County Council and Norwegian Institute of Public Health. This study was supported by grants from the Research Council of Norway.

Conflict of interest

The authors declare that they have no conflict of interest.

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Correspondence to Ingri Myklestad.

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Myklestad, I., Røysamb, E. & Tambs, K. Risk and protective factors for psychological distress among adolescents: a family study in the Nord-Trøndelag Health Study. Soc Psychiatry Psychiatr Epidemiol 47, 771–782 (2012).

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  • Adolescence
  • Psychological distress
  • Psychosocial factors
  • Risk factors
  • School problems