Anne Mari Steigen

• Opdal, Ida Marie; Bonsaksen, Tore; Kleppang, Annette Løvheim; Steigen, Anne Mari & Stea, Tonje Holte (2026). Screen socialising and depressive symptoms among Norwegian adolescents and the impact of the COVID-19 pandemic. Scandinavian Journal of Public Health. ISSN 1403-4948. s. 1–8. doi: 10.1177/14034948261459775. Fulltekst i vitenarkiv Vis sammendrag

  Aims: This study aimed to assess associations between online gaming with others, online socialising and depressive symptoms among adolescents, and whether these associations changed before, during and after the COVID-19 pandemic (2018, 2021 and 2023). Methods: Cross-sectional data among Norwegian adolescents aged 13–19 years in 2018, 2021 and 2023, comprising a total sample of 83,453 adolescents (Oslo: n=69,164; Møre og Romsdal: n=14,289), were used in the analyses. Multivariable binary logistic regression models, stratified by sex, were used to examine associations between online gaming with others, online socialising and depressive symptoms separately for each study year. The models were adjusted for school level, having trusted friends and perceived family economy. Results: Among girls, the results showed slightly higher odds of depressive symptoms during the pandemic than before the pandemic (odds ratio (OR)=1.1; 95% confidence interval (CI): 1.1–1.2). Frequent online gaming with others and online socialising were associated with increased odds of depressive symptoms among boys (OR=1.2; 95% CI 1.1–1.4 and OR=1.5; 95% CI 1.3–1.6) and girls (OR=1.8; 95% CI 1.6–2.0 and OR=1.7; 95% CI 1.5–1.8). Among girls, weekly online gaming with others was associated with higher odds of depressive symptoms in 2021 (OR=1.4; 95% CI 1.2–1.6). Among boys with no online socialising, frequent online gaming with others was associated with increased odds of depressive symptoms (OR=1.8; 95% CI 1.3–2.3). Conclusions: Frequent online gaming with others and online socialising were associated with higher levels of depressive symptoms among both boys and girls, with stronger associations observed among girls, particularly during the pandemic.

• Steigen, Anne Mari; Stea, Tonje Holte; Granrud, Marie Dahlen; Dangmann, Cecilie Ruud & Bonsaksen, Tore (2026). Trends in sexual harassment exposure among adolescents in Norway between 2017 and 2023 and associations with depressive symptoms. Nordic Journal of Psychiatry. ISSN 0803-9488. 80(6), s. 366–374. doi: 10.1080/08039488.2026.2694659. Fulltekst i vitenarkiv Vis sammendrag

  Purpose The aim of this study was to examine trends in sexual harassment victimization and possible changes in the association between sexual harassment victimization and depressive symptoms among adolescents (aged 16–19) in Norway between 2017 and 2023. Methods This study used cross-sectional data from the national Ungdata Survey conducted in upper secondary schools in Norway from 2017 to 2023 (total N = 229 417). Descriptive analyses and chi-square tests were used to examine changes in sexual harassment victimization across years by gender and age. Logistic regression analyses were used to study temporal trends and potential changes in the association between sexual harassment victimization and depressive symptoms. Results The prevalence of any sexual harassment victimization increased significantly among adolescents between 2017 and 2023. Girls reported a higher prevalence of all forms of sexual harassment victimization than boys. When studying the genders separately, the increase in exposure over time was statistically significant only among girls. Sexual harassment victimization was significantly associated with depressive symptoms in all years for both boys and girls. The strength of this association was generally higher among boys than among girls, and this gender difference became more pronounced between 2017 and 2023. Conclusions Our findings indicate a significant increase in sexual harassment victimization among girls between 2017 and 2023. Although girls are more frequently exposed to sexual harassment than boys, the association with depressive symptoms tends to be stronger among boys, and this difference appears to increase over time.

• Kleppang, Annette Løvheim; Hagquist, Curt; Stea, Tonje Holte; Leonhardt, Marja; Bonsaksen, Tore & Lien, Lars [Vis alle 7 forfattere av denne artikkelen] (2025). Social media use, gaming and quality of life among adolescents in Norway: results from the Young-HUNT study. Health and Quality of Life Outcomes. 23(1). doi: 10.1186/s12955-025-02428-1. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Background The use of screens, especially mobile devices like tablets and smartphones has increased over the last years and have become an integral to daily life. Adolescents today spend a lot of time using screens both at school and outside school. Identifying possible associations between gaming, social media use and quality of life (QoL) may inform the development of public health guidelines targeting adolescent behaviour. The purpose of this study is to examine the association between gaming, social media use and quality of life (QoL) among adolescents, and whether sex, spending time with friends or psychological distress moderate these associations. Methods This study was based on cross-sectional data from the Trøndelag Health study (Young-Hunt4), collected in 2017–2019. The target group comprised 8066 adolescents (13–19 years). QoL was measured with the Norwegian version of the Inventory of Life Quality (ILC). Electronic media use was measured using the two variables social media use and gaming. Multiple linear regression was used to analyse the association between social media use, gaming, and QoL. Results Results showed a negative association between gaming (> 3 h per day) after school and quality of life (b = -0.26) and social media use (> 3 h per day) after school and quality of life (b = -0.20). Similar negative associations were observed between more time spent on gaming (> 3 h per day) during weekends and quality of life (b = -0.33) and more time spent on social media (> 3 h per day) during weekends and quality of life (b = -0.16). An interaction effect was observed between sex and social media use (after school), between sex and gaming (after school and during weekends), and between psychological distress and gaming during weekends. Conclusions More than three hours spent on gaming or social media per day, both during weekdays and weekends, was negatively associated with QoL. Sex moderated these associations; however, for social media use this was shown only after school. Additional research is needed to further explore these associations.

• Thorpe, Christina; Steigen, Anne Mari; Nissen-Lie, Helene, Amundsen; Godtlund, Solveig Pettersen & Walderhaug, Espen (2025). Equine-Facilitated Psychotherapy as a Supplementary Treatment for Patients with Mental and/or Substance Use Disorders: An Observational Study on Treatment Outcome. Journal of Contemporary Psychotherapy. ISSN 0022-0116. doi: 10.1007/s10879-024-09660-8. Fulltekst i vitenarkiv Vis sammendrag

  This study examines whether adult patients (n = 105) with mental and/or substance use disorders benefit from equinefacilitated psychotherapy (EFP)—therapy with horses—in addition to regular treatment. The study used an observational pre-post-study design with two measurement points. Treatment outcomes were measured using standardized self-report instruments reflecting psychological distress (Hopkins Symptom Checklist-10), self-efficacy (General Self-Efficacy Scale-5), quality of life (Quality of Life-5), and emotion regulation (sub-scale from the Severity Indices of Personality Problems-118). All outcome measurements found statistically significant pre-post improvements after the EFP treatment program. The f indings suggest that EFP could be a beneficial supplementary treatment for a broad range of patients with mental and/or substance use disorders. However, this observational study cannot establish causation or eliminate confounding variables.

• Stea, Tonje Holte; Bonsaksen, Tore; Smith, Pierre; Kleppang, Annette Løvheim; Steigen, Anne Mari & Leonhardt, Marja [Vis alle 8 forfattere av denne artikkelen] (2024). 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. BMC Psychiatry. 24(1). doi: 10.1186/s12888-024-05696-1. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Bonsaksen, Tore; Kleppang, Annette Løvheim & Steigen, Anne Mari (2024). Cyberbullying Among Adolescents in Norway: Time Trends and Factors Associated with Perpetration and Victimization. Behavioral Sciences. 14(11), s. 1–13. doi: 10.3390/bs14111043. Fulltekst i vitenarkiv Vis sammendrag

  There is limited knowledge about time trends in cyberbullying involvement, and whereas previous studies have often focused on various mental health outcomes, possible outcomes of cyberbullying may concern a wide range of areas. A better understanding of cyberbullying development over time, as well as of the possible consequences, is needed for effective prevention and intervention efforts. The aims of this study were (i) to gain knowledge of time trends in cyberbullying among Norwegian adolescents, and (ii) to better understand how different forms of cyberbullying involvement is related to a variety of outcomes. Data from the Norwegian Ungdata surveys (2014–2016) were used to assess involvement in cyberbullying over time. Associations with cyberbullying involvement and four outcome variables (belief in a good and happy life, loneliness, school thriving, and depressive symptoms) were assessed using logistic regression analyses. Across years of study, the prevalence rates for cyberbullying involvement were 1.5% for perpetration, 3% for victimization, and 1% for perpetration-victimization. Compared with non-involvement, involvement in cyberbullying in any role was associated with poorer outcomes on all variables. Cyber-victims who were also perpetrators were less likely to have high levels of loneliness and depressive symptoms, compared to cyber-victims only. The prevalence of cyberbullying involvement among adolescents in Norway was relatively unchanged between 2014 and 2016. Cyberbullying involvement is associated with negative outcomes related to mental health, loneliness, school thriving, and beliefs in one’s personal future, and victims of cyberbullying appear to be the most vulnerable group.

• Bonsaksen, Tore; Steigen, Anne Mari; Granrud, Marie Dahlen; Dangmann, Cecilie Ruud & Stea, Tonje Holte (2024). Sexual harassment exposure among junior high school students in Norway: prevalence and associated factors. Frontiers in Public Health. 12. doi: 10.3389/fpubh.2024.1307605. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2023). Explaining variance in self-efficacy among adolescents: the association between mastery experiences, social support, and self-efficacy. BMC Public Health. 23(1), s. 1–10. doi: 10.1186/s12889-023-16603-w. Fulltekst i vitenarkiv Vis sammendrag

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

• Bonsaksen, Tore; Steigen, Anne Mari; Stea, Tonje Holte; Kleppang, Annette Løvheim; Lien, Lars & Leonhardt, Marja (2023). Negative social media-related experiences and lower general self-efficacy are associated with depressive symptoms in adolescents. Frontiers in Public Health. 10, s. 1–13. doi: 10.3389/fpubh.2022.1037375. Fulltekst i vitenarkiv Vis sammendrag

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

• Stea, Tonje Holte; Steigen, Anne Mari; Dangmann, Cecilie Ruud; Granrud, Marie Dahlen & Bonsaksen, Tore (2023). Associations between exposure to sexual abuse, substance use, adverse health outcomes, and use of youth health services among Norwegian adolescents. BMC Public Health. 23(1). doi: 10.1186/s12889-023-16261-y. Fulltekst i vitenarkiv Vis sammendrag

  Background A strong association between sexual abuse and adverse health outcomes has been reported among adolescents. The present study aimed to provide more information about adverse health outcomes associated with sexual abuse and substance use, and to examine the use of youth health services among Norwegian adolescents. Methods National representative cross-sectional study among 16–19-year-old Norwegian adolescents (n = 9784). Multivariable regression analyses, adjusted for socioeconomic status and age, were used to examine the association between exposure to sexual abuse, substance use and health risk factors, and the use of youth health services. Results Adolescents exposed to sexual abuse had higher odds of depressive symptoms (males: OR:3.8; 95% CI:2.5–5.8, females: 2.9;2.4–3.5), daily headache (males: 5.3;2.8–10.1, females:1.9; 1.5–2.4), high medication use (males: 3.2;1.7-6.0, females: 2.0;1.6–2.6), self-harm (males: 3.8;2.4-6.0, females:3.2; 2.6–3.9), suicidal thoughts (males: 3.3; 2.2-5.0, females:3.0; 2.5–3.6) and suicide attempts (males: 9.5;5.6–16.0, females:3.6;2.7–4.9). Furthermore, exposure to sexual abuse was associated with higher odds of using school health services (males: 3.9;2.6–5.9, females: 1.6;1.3–1.9) and health services for youth (males: 4.8;3.1–7.6, females: 2.1;1.7–2.5). In general, substance use was associated with increased odds of adverse health related outcomes and use of youth health services, but the strength of the relationships varied according to sex. Finally, results indicated a significant interaction between sexual abuse and smoking that was associated with increased odds of having suicidal thoughts for males (2.6;1.1–6.5) but a decreased odds of having suicidal thoughts and have conducted suicide attempts once or more for females (0.6;0.4-1.0 and 0.5;0.3–0.9, respectively). Conclusions The present study confirmed a strong relationship between exposure to sexual abuse and health risks, especially among males. Moreover, males exposed to sexual abuse were much more likely to use youth health services compared to sexually abused females. Substance use was also associated with adverse health outcomes and use of youth health services, and interactions between sexual abuse and smoking seemed to influence risk of suicidal thoughts and attempts differently according to sex. Results from this study increase knowledge about possible health related effects of sexual abuse which should be used to identify victims and provide targeted treatment by youth health services.

• Lien, Lars; Bonsaksen, Tore; Stea, Tonje Holte; Kleppang, Annette Løvheim; Steigen, Anne Mari & Leonhardt, Marja (2023). Time trends in self-reported depressive symptoms, prescription of antidepressants, sedatives and hypnotics and the emergence of social media among Norwegian adolescents. PLOS ONE. 18(12). doi: 10.1371/journal.pone.0295384. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Steigen, Anne Mari; Eriksson, Bengt G.; Kogstad, Ragnfrid Eline & Bergh, Daniel (2022). The Meaning of Social Support in Nature-Based Services for Young Adults with Mental Health Problems. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(3). doi: 10.3390/ijerph19031638. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Steigen, Anne Mari; Finbråten, Hanne Søberg & Kleppang, Annette Løvheim (2022). Using Rasch Analysis to Assess the Psychometric Properties of a Five-Item Version of the General Self-Efficacy Scale in Adolescents. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(5). doi: 10.3390/ijerph19053082. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Finbråten, Hanne Søberg; Kleppang, Annette Løvheim & Steigen, Anne Mari (2021). Using the Rasch measurement theory to assess the psychometric properties of the Hopkins Symptom Checklist-10 in adolescents. Health and Quality of Life Outcomes. doi: 10.1186/s12955-021-01884-9. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Kleppang, Annette Løvheim; Steigen, Anne Mari; Ma, Li; Finbråten, Hanne Søberg & Hagquist, Curt (2021). Electronic media use and symptoms of depression among adolescents in Norway. PLOS ONE. doi: 10.1371/journal.pone.0254197. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2020). Using Rasch measurement theory to assess the psychometric properties of a depressive symptoms scale in Norwegian adolescents. Health and Quality of Life Outcomes. doi: 10.1186/s12955-020-01373-5. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Steigen, Anne Mari; Eriksson, Bengt G.; Kogstad, Ragnfrid Eline; Toft, Helge Prytz & Bergh, Daniel (2018). Young Adults in Nature-Based Services in Norway—In-Group and Between-Group Variations Related to Mental Health Problems. Nordic Journal of Social Research. 9, s. 110–133. doi: 10.7577/njsr.2301. Fulltekst i vitenarkiv Vis sammendrag

  Young adults with mental health problems who do not attend school or work constitute a significant welfare challenge in Norway. The welfare services available to these individuals include nature-based services, which are primarily located on farms and integrate the natural and agricultural environment into their daily activities. The aim of this study is to examine young adults (16–30 years old) not attending school or work who participated in nature-based services in Norway. In particular, the study analyses mental health problems among the participants and in-group variations regarding their symptoms of mental health problems using the Hopkins Symptoms Checklist (HSCL-10). This paper compares symptoms of mental health problems among participants in nature-based services with those of a sample from the general population and a sample of those receiving clinical in-patient mental healthcare. A questionnaire was developed for the study and was completed by 93 participants in nature-based services. The majority of these participants were recruited from the Norwegian Labour and Welfare Administration (NAV), local mental health services, and school authorities. Results indicate that just more than half of the respondents exhibited symptoms of mental health problems based on their HSCL-10 scores. In general, they reported fewer symptoms than the clinical in-patient sample (18–30 years old) and more symptoms than the general population sample (18–19 years old). Among the participants in nature-based services, those recruited through NAV and local mental health services exhibited no differences in symptoms. Half of the participants older than 23 years in nature-based services had not completed upper secondary school. The participants, including those with symptoms of mental health problems and low expectations at the outset of their participation, generally expressed high satisfaction with the services.

• Steigen, Anne Mari & Bergh, Daniel (2018). The Social Provisions Scale: psychometric properties of the SPS-10 among participants in nature-based services. Disability and Rehabilitation. ISSN 0963-8288. doi: 10.1080/09638288.2018.1434689. Fulltekst i vitenarkiv Vis sammendrag

  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.

• Steigen, Anne Mari; Kogstad, Ragnfrid Eline & Hummelvoll, Jan Kåre (2016). Green Care services in the Nordic countries: an integrative literature review (Grønn omsorg i de nordiske landene: en integrativ litteraturgjennomgang). European Journal of Social Work. ISSN 1369-1457. 19(5), s. 692–715. doi: 10.1080/13691457.2015.1082983. Fulltekst i vitenarkiv Vis sammendrag

  This article reviews Nordic literature on Green Care for people out of work or school, or with mental health- and/or drug-related problems, published from 1995 to April 2014. Green Care is a well-established international concept that uses animals, plants and nature in an active process to offer health-promoting activities for people. Reports, evaluations and scientific articles are included. The main finding was that the Green Care services described in the literature provided positive activities for our target group. Seven main categories emerged during the analysis: mastery and coping, positive effects on mental health, physical activity, structure and meaningfulness, the feeling of dignity produced by performing a decent ordinary job, social gains, animals and nature experienced as being supportive. Essential intervention factors identified can be described as: (i) contact with animals, (ii) supportive natural environments, (iii) the service leader as a significant important other, (iv) social acceptance and fellowship with other participants and (v) meaningful and individually adapted activities in which mastery can be experienced. These five components interact in a holistic way; the synergetic effects extend the sum of the single factors

• Kogstad, Ragnfrid Eline & Steigen, Anne Mari (2012). Mental Health Promotion by Recovery-Oriented Green Care Services. I Berget, Bente; Lidfors, Lena; Pálsdóttir, Anna María; Soini, Katriina & Thodberg, Karen (Red.), Green Care in the Nordic countries - a research field in progress. Report from the Nordic research workshop on Green Care in Trondheim, June 2012. The Norwegian University of Life Sciences. s. 35–36. Fulltekst i vitenarkiv Vis sammendrag

  In the last decade an increasing number of persons with mental, physical and social problems participate in different Green Care services in the Nordic countries and other European countries. Despite that it is much practical experiences with the utilization of agricultural farms and its nature surroundings as a basis for promoting human health, the research is still scarce. The main goal for this first Nordic workshop on Green Care was to provide a status of research on Green Care, and how these services are organized in the Nordic countries. Furthermore the aim was to identify research goals on Green Care in a Nordic context. Finally, we also aimed to facilitate the potential development of a Nordic research network within Green Care.

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• Kleppang, Annette Løvheim; Finbråten, Hanne Søberg; Hagquist, Curt & Steigen, Anne Mari (2025). The psychometric properties of the SDQ: a Rasch analysis based on data from the Young-HUNT study. Fulltekst i vitenarkiv
• Steigen, Anne Mari; Kleppang, Annette Løvheim; Stea, Tonje Holte; Opdal, Ida Marie & Bonsaksen, Tore (2025). In-person and online socialization among Norwegian adolescents in relation to the COVID-19 pandemic. Fulltekst i vitenarkiv
• Bonsaksen, Tore; Kleppang, Annette Løvheim & Steigen, Anne Mari (2025). Cyberbullying among adolescents in Norway 2014-2016: time trends and factors associated with perpetration and victimization. Fulltekst i vitenarkiv
• Sandsdalen, Tuva; Steigen, Anne Mari & Finbråten, Hanne Søberg (2024). Skjermbruk fra vugge til grav – digitalisering og helse i et livsløpsperspektiv. Fulltekst i vitenarkiv
• Steigen, Anne Mari (2024). The association between screen use, psychological distress and sleep among adolescents in Norway. Fulltekst i vitenarkiv
• Steigen, Anne Mari (2024). Young people's mental health in the wake of the COVID-19 pandemic. Fulltekst i vitenarkiv
• Steigen, Anne Mari; Bonsaksen, Tore; Granrud, Marie Dahlen; Dangmann, Cecilie Ruud & Stea, Tonje Holte (2023). Time trends in sexual harassment exposure among adolescents in Norway between 2017 and 2021. Fulltekst i vitenarkiv
• Bonsaksen, Tore; Steigen, Anne Mari; Stea, Tonje Holte; Kleppang, Annette Løvheim; Lien, Lars & Leonhardt, Marja (2023). Negative social media experiences and lower self-efficacy are associated with depressive symptoms. Fulltekst i vitenarkiv
• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2022). Explaining variance in self-efficacy among adolescents: the association between quality of life, social support, and self-efficacy. Fulltekst i vitenarkiv
• Steigen, Anne Mari (2021). Folkehelsearbeid i et livsløpsperspektiv - hva kan det helsefremmende og forebyggende arbeidet bidra med. Fulltekst i vitenarkiv
• Finbråten, Hanne Søberg; Kleppang, Annette Løvheim & Steigen, Anne Mari (2019). The necessity of applying Rasch Measurement Theory in questionnaire-based public health research. Fulltekst i vitenarkiv
• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2019). The association between screen time and psychological distress in Norwegian adolescents. Fulltekst i vitenarkiv
• Steigen, Anne Mari; Finbråten, Hanne Søberg & Kleppang, Annette Løvheim (2019). The psychometric properties of a short version of the General Self-Efficacy Scale: A Rasch analysis. Fulltekst i vitenarkiv
• Steigen, Anne Mari (2019). Sosial støtte i naturbaserte tjenester for unge voksne med psykiske problemer. Fulltekst i vitenarkiv
• Steigen, Anne Mari & Kleppang, Annette Løvheim (2018). Using Rasch modelling to explore targeting of the Hopkins Symptoms Checklist instrument (HSCL-10). Fulltekst i vitenarkiv
• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2018). Rasch analysis of a scale intended to measure depressive symptoms in Norwegian adolescents. Fulltekst i vitenarkiv
• Kogstad, Ragnfrid Eline; Steigen, Anne Mari & Baklien, Børge (2018). Beyond Labeling Building relational, supportive and dialogical resources in Green care services. Fulltekst i vitenarkiv
• Kleppang, Annette Løvheim; Steigen, Anne Mari & Finbråten, Hanne Søberg (2018). Rasch(k)e stipendiater på tur. I Calogiuri, Giovanna & Knudsen, Per Egil (Red.), Institutt for Folkehelse - ÅRBOK 2017-2018. Høgskolen i Hedmark. s. 43–44. Fulltekst i vitenarkiv
• Steigen, Anne Mari (2017). Care farming and Young adults at risk of marginalization. Fulltekst i vitenarkiv
• Steigen, Anne Mari & Bergh, Daniel (2015). The social provisions scale-an anlysis of the psychometric Properties, using Norwegian data on young adults participating in Green Care services. Fulltekst i vitenarkiv
• Steigen, Anne Mari & Kogstad, Ragnfrid Eline (2014). Jobbfokus og Grønt arbeid. Grønt arbeid og andre tiltak i skjermet sektor som virkemiddel for å motvirke marginalisering og sosial ulikhet blant ungdom. Fulltekst i vitenarkiv
• Steigen, Anne Mari (2014). Grønn omsorg i de nordiske landene: en litteraturreview. Fulltekst i vitenarkiv
• Steigen, Anne Mari (2013). Grön omsorg i ett nordiskt perspektiv – vad säger forskningen? Fulltekst i vitenarkiv
• Kogstad, Ragnfrid Eline & Steigen, Anne Mari (2012). Green Care Entrepreneurs. Video presentation. Fulltekst i vitenarkiv
• Dalskau, Lina Harvold; Steigen, Anne Mari & Ihlebæk, Camilla (2012). Metodiske utfordringer i feltet - forskning på grønn omsorg. Fulltekst i vitenarkiv
• Steigen, Anne Mari & Kogstad, Ragnfrid Eline (2012). Green Care, Entrepreneurs and Public Health. Fulltekst i vitenarkiv
• Qvortrup, Lars; Wistoft, Karen; Christensen, Jacob Højgaard; Lavy, Shiri; Christensen, Anders Astrup & Rimpelä, Arja [Vis alle 10 forfattere av denne artikkelen] (2026). Recovering from the covid-19 pandemic | NordForsk. NordForsk. doi: https:/www.nordforsk.org/2026/recovering-covid-19-pandemic. Fulltekst i vitenarkiv Vis sammendrag

  The relationship between governance cultures and learning, wellbeing and democratic participation among Nordic schoolchildren.

• Steigen, Anne Mari (2018). Social support in nature-based services for young adults with mental health problems. Karlstad University Press. Fulltekst i vitenarkiv

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