International studies indicate that 10-16 per cent of children and adolescents have mental health problems that negatively affect their daily life. Approximately half of these (5-8 per cent of all children and adolescents) are assumed to have diagnosable psychological disorders that require treatment. More knowledge is needed about the early stages, development trajectories and risk and protective factors of psychological disorders and distress, both to prevent negative development and to promote well-being and good mental health.
The purpose of the study
The aim of the TOPP study is to gain knowledge about Norwegian children, adolescents and their families to help identify the predictors of both good and difficult developmental trajectories.
The research team examines why some children and adolescents are satisfied with their quality of life and which factors contribute to some children developing significant mental disorders such as anxiety, depression and behavioural problems. In addition, they are studying mothers’ and fathers’ psychological distress, life satisfaction sickness absence, and burnout related to the challenges of parenthood, family relationships and other life strains. Understanding children’s and adolescents’ developmental trajectories as well as their parents health is essential for promoting optimal growth conditions. Such knowledge forms the foundation for health promotion, prevention and treatment measures.
Both nationally and internationally, there are few studies that have accumulated such extensive information from a large number of families since the children were 18 months old up to the age of 18-19 years. This makes the data unique and of a very high value.
The TOPP study was established in 1992 and has been based at various centres before arriving at its current home, the Norwegian Institute of Public Health. The NIPH is the Data Controller and the project is based in the Department of Childhood, Development and Cultural Diversity.
The effects of health promotion and preventive measures are usually greatest if they begin early, before problems become chronic. Knowledge about the development of social skills and anti-social behaviour in young children, before school age, is limited. Just 10-15 years ago little was known about whether the behaviour observed in one-year-olds remained stable both before and during school age, and we knew very little about the child-rearing conditions which were associated with changes in positive and negative child outcomes. Such knowledge can best be obtained from longitudinal studies of large population groups which start to collect data when the children are very young. These studies should incorporate information on factors in the child-rearing environment as well as characteristics of each child. Both sets of factors can increase the child's risk of developing psychological distress or protect him/her from being affected by unfortunate circumstances. The TOPP study is collecting information about these factors, which makes this data set unique. The data are well-suited to contribute to knowledge about how preventive work with children, adolescents and their families should be organised.
Eight data collections
The TOPP study has collected questionnaire data on conditions in the home environment and the characteristics of children and mothers in eight waves.
In 1993, the first questionnaire was completed by 929 parents, i.e. 87 percent of a cohort of users of 19 health centres from eight municipalities in Eastern Norway. The families received the first questionnaire when they attended the health check for their 18-month old child. Since then they have received questionnaires when the children were ages 2.5, 4.5, between 8 and 9 years, between 12 and 13 years, between 14 and 15 years, and between 16 and 17. The last questionnaire round was in 2011 when the participants were between 18 and 19 years old.
In the first four waves, it was mainly the mothers who filled out the forms. Children / adolescents completed their own questionnaires from 12-13 years of age onwards. Separate forms for the fathers were included from the sixth wave of data collection (14-15 years). In addition, further information has been collected from a sub-sample of families through qualitative interviews.
The response rate usually drops in longitudinal studies and this has been the case in the TOPP study. Almost 80 per cent of the mothers who filled out the first form also answered questions in the next two waves, while between 48 and 57 per cent of those who answered the questions in the first wave submitted questionnaires in the last wave.
The value of the data increases for each new wave of questionnaires as we track the children from early in life into late adolescence. In addition, the forms include questions on a wide range of themes, more respondents have begun to fill out the forms and they are very conscientiously filled out. The data are particularly well-suited to studying the early stages, developmental trajectories and causes of a variety of conditions. Not many other studies have these qualities, whether in Norway or overseas.
Voluntary and anonymous
The TOPP study is subject to the ethical guidelines and rules of confidentiality that apply in the National Committee for Research Ethics in the Social Sciences and the Humanities. This means that the information provided by the participants in the TOPP study cannot be traced back to an individual. All participants in the study can withdraw from the study at any time without giving a reason. So far, the majority of participants have chosen to continue in the study. Having so many families still involved is very important, and helps to increase our knowledge of a range of topics with high relevance for health promotion and preventive measures.
Thanks to the participants
We would like to take this opportunity to thank all the families who have participated! The TOPP study is under completion, but new rounds of data collection are currently being planned.