Browsing by department "Medicinska fakulteten"

There are many individual or social underlying factors that affect the performance in world-class team sports. Many studies of the subject concentrate on individual sports and there are less findings about the underlying factors that affect precisely teams’ performance. Every known factor affecting the performance can be determinant for success, so any information about them may help the athlete and the team to develop. In this review, the existing research results of both individual and social factors affecting teams’ performance is being analyzed. According to studies, the most significant individual underlying factors of a great performance are motivation, psychophysical well-being, psychical skills and mental toughness, which means the ability to cope better than your opponents with the many demands of sports, to remain in control under pressure and to be confident and determined. Especially confidence as a characteristic of mental toughness, appears to be strongly linked to the sports performance. There are also many social underlying factors of which the most remarkable ones are open interaction within the team, team cohesion, the actions of an athlete leader and coaches’ behavior and feedback. Some of the social factors, such as the actions of an athlete leader and the coaches´ behavior may affect the performance through the individual factors, such as athletes´ confident or motivation. Many of the studies in this review compare several different sports to get more information but it would also be beneficial to research even more, for example by making a longitudinal study of the subject or by having more representative samples. It would also be reasonable to study more the development of mental toughness by observing the training and performances of world-class athletes. The information in this review is useful for the athletics and coaches in world-class sport teams, for the developers of competitive sports and for the researchers of the field. This review raises awareness of the factors that affect the sports performance which may improve chances of successful performances. Also, the projects developing safety in world-class sports probably benefit from the knowledge of the factors affecting the sports performance.

Objectives. Online communication has become central for adolescents’ everyday lives during the last two decades. Because friendships are vital for psychosocial development in adolescence, it is important to know how online communication affects adolescents’ friendships. The topic has been researched via four hypotheses. The Displacement hypothesis suggests that online communication is harmful for real-life friendships, whereas the Stimulation hypothesis claims that the internet is a useful environment to maintain real-life friendships. The Rich Get Richer hypothesis suggests that people who already have good existing friendships, will benefit most from online communication. The Social Compensation hypothesis suggests that internet gives possibility for socially inhibited people to make friends. Methods. Articles were searched with terms adolescent + online communication + friendship and adolescent + online communication + well-being. The topic narrowed down to 10-20-year-old adolescents and their friendships. Online communication was defined primarily as instant messaging but also some research that included other ways of online communication in addition to instant messaging were included. Results and Conclusions. The research so far has shown support mostly to the Stimulation and the Rich Get Richer hypothesis, but also some support to the Social Compensation hypothesis. Online communication increased the quality of existing friendships and these effects were stronger among social adolescents compared to socially inhibited adolescents. Socially anxious and lonely adolescents seem to find online communication easier to approach than face-to-face communication. Moreover, the online communication might increase self-esteem for lonely adolescents, which in part can make it easier to form real-life friendships. These results are important to be considered when attempting to help socially inhibited adolescents, but research should also consider the findings that these adolescents might also compensate face-to-face communication with online communication. The research overall has limitations, since most of the studies are cross-sectional and measurements rely on self-evaluation. Also, the trends of online communication devices are changing constantly, and the research has not had a unified measure for online communication. In future studies, it would be important to pay more attention to the definition of online communication, and to consider the effects of communication via mobile phone and the emerging popularity of more visually oriented online communication devices.

Tavoitteet. Imetyksellä tiedetään olevan lyhyt- ja pitkäaikaisia suotuisia terveysvaikutuksia. Imetykseen liittyvissä suosituksissa asetetaan tavoitteeksi täysimetys kuuden kuukauden ikään saakka, mutta tämä ei toteudu Suomessa. Keinoja imetyksen tukemiseksi tulisi kehittää ja huomioida myös erityistä tukea tarvitsevat vauvat ja perheet. Downin syndrooma on yksi yleisimmistä kromosomihäiriöistä ja sitä on tutkittu suhteellisen paljon. Downin syndroomaan tiedetään liittyvän erilaisia rakenteellisia ja kehityksellisiä tekijöitä, jotka voivat vaikeuttaa imetystä. Tämän tutkimuksen tarkoitus on selvittää imetykseen liittyviä vaikeuksia vauvoilla, joilla on Downin syndrooma. Samalla on tarkoitus selvittää sitä, miten vanhempia voitaisiin tukea imetyksen onnistumiseksi. Menetelmät. Tutkimus on integroiva kirjallisuuskatsaus. Tiedonhaut tehtiin Scopus ja Pub-Med-tietokantoihin hakulausekkeella (”down syndrome”) AND breastfeeding. Tutkimusaineistoksi valikoitui kahdeksan vertaisarvioitua artikkelia. Tutkimusartikkeleista etsittiin vastauksia molempiin tai jompaankumpaan tutkimuskysymyksistä. Tutkimuskysymys 1: Millaisia imetykseen liittyviä vaikeuksia tyypillisesti esiintyy vauvoilla, joilla on Downin syndrooma? Tutkimuskysymys 2: Miten vanhempia voidaan tukea imetyksen onnistumiseksi? Tulokset ja johtopäätökset. Tutkimusartikkeleista nousi esille kolme pääteemaa, joihin imetyksessä esiintyvät vaikeudet jakautuivat. Nämä teemat olivat äitiin liittyvät imetyksen vaikeudet (terveydentila, kokemukset, elämäntilanne, maidonerityksen puute/pelko), vauvaan liittyvät imetyksen vaikeudet (imemisen vaikeudet, väsymys/unisuus) ja olosuhteisiin liittyvät imetyksen vaikeudet (erillään olo vauvasta). Suurimmat vauvaan liittyvät imetyksen vaikeudet olivat 0-3 kuukauden iässä ja oli viitteitä siitä, että vaikeudet helpottivat 6-9 kuukauden iässä. Tärkeimpinä vanhempien tukemisen keinoina imetyksen onnistumiseksi esille nousivat ohjaus, tuki ja tietotaito (tiedon saannin merkitys, vanhempien väsymys). Vanhemmat tarvitse-vat tukea uudessa elämäntilanteessa imetyksen onnistumiseksi, jos lapsen terveydentila sallii imetyksen. Terveydenhuollon henkilökunnalla on merkittävä rooli tiedon jakamisessa ja vanhempien tukemisessa imetyksen onnistumiseksi. Vanhempien imettämisen vaikeuksien kohtaamiseen liittyviä kokemuksia selvittämällä voidaan mahdollisesti kehittää entistä parempia käytänteitä vanhempien tukemiseen imetyksessä.

The treatment of social anxiety disorder with internet delivered cognitive-behavior therapy has been studied for the past two decades, but still reviews of studies on the subject could not been found in the databases used in this study. The goal of this review was to examine the efficacy of iCBT in treating social anxiety disorder and to review the treatment protocols used in the efficacy studies. A systematic literature search was conducted in the databases available through EBSCOhost (ia. CINAHL, MEDLINE, eBook Collection (EBSCOhost) & eBook Academic Collection (EBSCOhost)) with the search term ”((((internet OR web) AND (cognitive behav* therapy)) OR iCBT) AND (social phobia OR social anxiety disorder)))”. Studies which examined the efficacy of iCBT in treating social anxiety disorder with an RCT trial comparing it to waiting list or treatment as usual conditions were included in the review. The search revealed 11 studies filling these requirements, in which three separately developed treatment protocols were studied. Guided iCBT significantly reduces the symptoms of social anxiety disorder and it was significantly more efficacious in reducing symptoms than waiting list, also clinically significant improvement was considerably more common in people receiving the treatment. Only a few studies comparing iCBT to live therapies were found, and even though they had promising results, conclusions could not be made based on two studies. The treatment protocols were similar to each other and there were no substantial differences noted in the efficacies of the different treatments. Treatment satisfaction was high which supports the role of iCBT as an acceptable treatment option. There was variation between the studies in the time therapists used per patient, but even the longest average time therapists used indicated that the therapists used their time more efficiently compared to live treatments. There was a lot of variation between the studies in adherence and completion rates, and the maintenance of adherence should be attended to also in future treatment protocols.

There are now internet-based interventions for most of the common mental health disorders, and the evidence for their effectiveness indicates that these treatments are a promising way to improve the availability of mental health services. Given that there are, however, only few interventions for psychotic disorders, the objective of this review was to describe the content of these interventions and to assess their effectiveness. The reviewed web-based interventions for psychotic disorders consist of psychoeducation, social support and therapeutic exercises. Multimedia content was utilized in psychoeducation, and moderated internet forums were an essential part of interventions that offered social support. The therapeutic sessions consisted of independent exercises, which emphasized ways to recognize harmful thoughts and develop coping skills. The interventions were considered feasible and helpful for the most part. There is also promising evidence for treatment effects, especially with regard to depression and psychosocial functioning. Due to methodological deficiencies, however, the evidence is scarce. In the future researchers should focus on systematic research with strong methodological quality. It is also important that the development of these interventions is user-centered. In addition, there is remarkable variation as far as effectiveness is concerned, and the underlying causes should be unraveled.

Irony is a way of communicating a message in which words and their meaning is in conflict. People with autism spectrum disorder (ASD) have a tendency to interpret words literally which is a result of their problems in social interaction. It has been reported that people with ASD have difficulties to react to irony in a proper manner which leads to the assumption that they do not understand irony. In my Bachelors thesis I will review studies on irony comprehension of individuals with ASD. The aim of my review is to find from the literature if the assumption that individuals with ASD cannot detect irony is correct and what kind of explanations there are on the underlying issues of their difficulties in irony comprehension. Studies are quite contradictory on how well people with ASD can detect irony. Some suggest that individuals with ASD can detect irony as well as typically developed and others propose that people with ASD cannot detect irony even closely as well as typically developing. But studies are unanimous that people with ASD have great difficulties in the comprehension of irony compared to typically developing. There are many explanations why people with ASD might have difficulties with irony. One is that children with ASD lack the theory of mind, so they have problems in understanding that the speaker has his or her independent intentions that they might want to transmit to the listener when using irony. According to another explanation the disturbance in language development might influence irony perception. Sometimes tasks testing irony perception require the ability to produce difficult verbal outcomes which are difficult for people with ASD. They have also difficulties to perceive prosodic cues overall and irony has a wide variety of possible prosodic cues. In addition to the specific difficulties in, for example prosody and language, people with ASD also have hard time in integrating these multiple different cues automatically. However, there are compensatory mechanisms that help them to overcome these difficulties. They just do not automatically use them when processing language but if they are explicitly told to take in account that there might be irony individuals with ASD are doing better in irony tasks. For future research it would be important to study how well people with ASD detect irony in more natural situations. Furthermore, it should be studied how much they understand irony even when they recognize it because it has been shown that people with ASD do not enjoy irony as much as typically developing.

Borderline personality disorder is a mental disorder which is associated with high levels of subjective suffering and severe decline in everyday functioning. It is considered quite difficult to treat and it has been linked to substantially increased risks of self-injurious behaviour and morbidity due to suicides. The psychopathology and core symptomology of borderline personality disorder can be conceptualized through the feelings of chronic shame and having a shameful self-image. Shame is a highly aversive affect, which has many different unadaptive behavioural and cognitive consequences. Borderline personality disorder has been linked to many abnormalities in emotional processing of shame and in susceptibilies to experiencing affects of shame. Self-compassion is a theme adopted to western psychology from Buddhist traditions. Self-compassion has recently seen an increase of attention in the field of modern psychology. It has been linked to many positive psychological correlates and to reduced general psychopathology. Self-compassion constitutes of an attitude to oneself in which one accepts his/herself subjective difficulties with mindfulness and as an essential part of the common human experience. Self-compassionate attitude toward oneself, also includes the desire to alleviate ones subjective suffering. Based on intuition self-compassion seems to target the main difficulties behind the problems that are faced by people with borderline personality disorder and chronic feelings shame. The objective of this paper was to examine the empirical and theoretical data of the role of shame in explaining the symptomology of borderline personality disorder and the applicability of self-compassion in treatment of psychopathology stemming from intense feelings of shame. Randomized controlled trials, pilot studies of self-compassion based interventions, meta-analyses and systematic reviews were searched from common psychological databases and Google Scholar. Additionally articles were included in this paper after manual scanning of the lists of reference of the selected literature. Even though the information obtained from research on the applicability of self-compassion in treatment of borderline personality disorder and transdiagnostic shame has its limitations, self-compassion may have its unique additional offerings to the treatment of borderline personality disorder. Future research on the mechanisms of change in self-compassion and their neural substrates would be highly useful in order to understand the potential mediating effect of transdiagnostic shame in reduced psychopathology associated with developing a self-compassionate attitude.

Aims. Research on positive impacts of self-compassion has increased during 21th century. Previous studies have shown that self-compassion is associated with more adaptive coping strategies, more effective emotion regulation and better readiness to face up personal weaknesses and life challenges. Furthermore, self-compassion is consistently associated with less psychopathology, especially depression. Chronic pain is a globally significant cause of burden, often existing with comorbid depression. The aim of this bachelor’s thesis was to examine the associations between self-compassion and typical psychopathology in people living with chronic pain as well as to examine how self-compassion is related to close psychological processes in this population. Methods. Literature search was carried out in Scopus and PubMed -databases using keywords self-compassion, selfcompassion and chronic pain. Keywords were limited to exist only in the article title. Intervention studies were excluded from review. Results and conclusions. Studies on positive impacts of self-compassion in people with chronic pain have so far been mainly cross-sectional which does not allow causal implications. Still, the evidence is fairly impressive. Self-compassion is shown to have negative and strong associations with typical psychopathology, especially with depression- and stress-symptoms. There is also tentative indication that self-compassion is a prospective predictor of depressive symptoms. Self-compassion is associated with close psychological processes, particularly acceptance of pain, healthier coping strategies and less experiential avoidance in people living with chronic pain. Together these processes seem to lead to better mental health, better social functioning and less pain disability. Findings suggest that one key element of self-compassion is its motivational impact on action. Enhancing self-compassion is an interesting and potential way to promote health and quality of life in people living with chronic pain. It would also be worth to take into consideration when developing psychological interventions for people suffering from chronic pain.

Publication bias is one of the central threats to the validity of scientific research. In research of mindfulness-based interventions publication bias has been examined mostly in meta-analyses with statistical methods that have several limitations. This study examined how meta-analyses and systematic reviews that have examined publication bias have succeeded in their assessments. A rough estimate of publication bias and suggestions for further meta-analyses were made based on the examination. The study was conducted in the form of a literature review. It was found that there are significant limitations in examinations of publication bias, the most central of which being limited sample sizes, strong heterogeneity of studies and suboptimal method choices in meta-analyses and systematic reviews. The conclusions about publication bias also seemed overly optimistic in some cases. These limitations made it difficult to estimate the magnitude of publication bias. Regardless of that, there was evidence for the existence of publication bias, although in general it did not seem to lower the effect sizes of mindfulness-based interventions to zero. In future, publication bias should be assessed with methods less sensitive to the issues raised in this study. In addition, there is a need for pre-registered, good-quality replication studies of mindfulness-based interventions.

Aims. Previously psychopathy has been regarded as a homogenous and categorical personality disorder that cannot be treated. However, recent findings have suggested that psychopathy may be both a heterogenous and dimensional phenomenon. Several studies have found at least two subtypes, out of which primary and secondary psychopathy are the most prevalent. These two subtypes seem to manifest on their own, partly overlapping dimensions. The aim of this review was to evaluate the reliability of the evidence on heterogeneity of psychopathy and the model of two different subtypes, the core traits of psychopathy, and the differences in traits and etiology between the subtypes. Methods. The review is based on literature found from the Google Scholar database by searching for the term ”psychopathy” in connection with the words ”subtypes”, ”primary”, ” secondary”, ”heterogeneity”, ”variants” and ”treatment”. Conclusions. The evidence on the heterogeneity of psychopathy and the model of two different subtypes is strong. The reviewed studies suggest that callousness and lack of empathy are the core traits of psychopathy. Additional core traits of the primary subtype were low negative affect, high positive affect, few internalizing symptoms, higher control and high trait boldness and fearlessness. The distinctive traits of the secondary subtype were high negative affect, low positive affect, high impulsivity, lack of self-control, high internalizing symptoms and neuroticism. As both subtypes seem to have very distinct traits, the treatability of psychopathy may depend on the subtype which should be taken into consideration when developing and researching treatment methods. Research on psychopathy has mostly been conducted on samples of Western white men and therefore it is uncertain if psychopathy manifests in a similar way in different populations. Hence psychopathy and its subtypes require more research on differing populations.