Changes in family and school environment during the Covid-19 pandemic and their relationship with changes in psychological distress and loneliness among Norwegian adolescents: The HUNT study

Bodil Elisabeth Valstad Aasan; Monica Lillefjell; Věra Skalická; Steinar Krokstad; Kirsti Kvaløy; Erik R Sund

doi:10.1016/j.ssmph.2025.101767

Changes in family and school environment during the Covid-19 pandemic and their relationship with changes in psychological distress and loneliness among Norwegian adolescents: The HUNT study

SSM Popul Health. 2025 Feb 21:29:101767. doi: 10.1016/j.ssmph.2025.101767. eCollection 2025 Mar.

Authors

Bodil Elisabeth Valstad Aasan¹, Monica Lillefjell^{2

3}, Věra Skalická⁴, Steinar Krokstad^{1

5}, Kirsti Kvaløy^{1

5

6}, Erik R Sund^{1

5}

Affiliations

¹ HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Levanger, Norway.
² Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.
³ Department of Public Health, Faculty of Health Sciences, UiS - University of Stavanger, Stavanger, Norway.
⁴ Department of Psychology, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.
⁵ Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
⁶ Centre for Sami Health Research, Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.

Abstract

In this follow-up study, we investigated how levels of psychological distress, loneliness, family cohesion, teacher support, and peer support changed from before to during the Covid-19 pandemic among Norwegian adolescents (ages 13-19), and whether these changes were predicted by parental education. Additionally, we investigated whether changes in family cohesion, teacher support, and peer support were associated with changes in psychological distress and loneliness, and whether these change-to-change associations were moderated by parental education. Data from the Young-HUNT4 (2017-2019, T1) and Young-HUNT COVID (May-June 2021, T2) surveys were used, in which 1565 adolescents participated in both (response rate = 45%). We specified univariate and multivariate two-wave latent change score models to investigate the aims of this study. Results indicated that levels of psychological distress, loneliness, family cohesion, teacher support, and peer support worsened from T1 to T2. None of these changes were significantly predicted by parental level of education. Deteriorations in family cohesion, teacher support, and peer support were weakly related to increases in psychological distress (β = 0.17, 95% confidence interval (CI) 0.11 to 0.23; β = 0.10, 95% CI 0.04 to 0.16; β = 0.09, 95% CI 0.02 to 0.15), and loneliness (β = 0.10, 95% CI 0.05 to 0.15; β = 0.08, 95% CI 0.02 to 0.13; β = 0.12, 95% CI 0.06 to 0.18). Although largely similar, deteriorations in family cohesion were somewhat more strongly associated with increases in psychological distress among adolescents with parents of lower levels of education.

Keywords: Adolescents; Covid-19; Family; Loneliness; Psychological distress; School; Young-HUNT study.