Browsing by master's degree program "Magisterprogrammet i psykologi"

Aims: The aim of this study was to test the feasibility of a new phonemic awareness test to study children who have potential problems in their reading skills. The children were second graders whose reading skills either had or had not caused worry at home or school. The phonemic awareness test was developed for investigating and providing intervention on phonemic awareness. This new method includes ten different ways to change phonemes in a word. We determined if some of these phonemic changes are better at separating the groups from each other and whether there are differences between the tasks in the degree of difficulty. In addition, the children were also tested with standardized neuropsychological tests that measure reading-related skills. The study was done completely remotely and one of its aims was also to get additional information on feasibility of neuropsychological testing in remote environments. Methods: 16 participants took part in the study. Eight of them were children whose reading skills had caused worry and other eight whose reading skills had not caused such worry. The study was done remotely using Zoom and the experiment took about 1-1,5 hours depending on how quickly the child completed the tasks. There were 11 tasks altogether, which assessed the child’s reading and writing skills and skills that can affect these, such as phonological skills, working memory and rapid naming. Results: The groups differed from each other almost in every standardized test and also in the new phonemic awareness test. In the new phonemic awareness test children who had caused worry on their reading skills got less points in every part, but the groups differed statistically significantly in five of them only. These five included changing the beginning or the ending of the word, diphthong, diphthong to long vowel and changing a vowel to a consonant. The degree of difficulty varied between the subtests of the phonemic awareness task, the pattern of performance being comparable in the two groups. Detecting differences between word beginnings and syllables was the easiest and detecting diphthong and vowel to consonant or consonant to vowel changes were the most difficult. These results are promising, suggesting that the phonemic awareness test could serve to identify problems in phonemic awareness in children whose reading skills are suspected to be poor. This study also suggested the feasibility of carrying out neuropsychological tests remotely.

Objectives. Anxiety causes significant suffering in different life domains, and its prevalence rates are high already in childhood and adolescence. Often symptoms develop into a disorder which is why identifying factors associated with anxiety is important. Anxiety disorders run in families but only few studies have examined the association between maternal and child anxiety on a symptom level. It’s possible that this association is mediated by parenting competence but, as far as is known, this has never been studied. The aim of this study was to examine the associations of maternal anxiety with child anxiety and fears both cross-sectionally and longitudinally. It was also examined whether this association is mediated by parenting competence. Methods. The sample of this study was part of the Finnish Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) cohort. The sample consisted of 992 mothers who evaluated their own anxiety symptoms (Beck Anxiety Inventory) first when children were 2–5 years old and again when they were 7–11 years old. In the latter follow-up mothers also evaluated their parenting competence (Parenting Sense of Competence) as well as children’s anxiety (Spence Children’s Anxiety Scale for Parents) and fears (The Short Form of the Fear Survey Schedule for Children – Revised). The association of maternal anxiety with child anxiety and fears was examined with linear regression analysis. The mediating effect of parenting competence was examined with mediation analysis. Results and conclusions. Child anxiety and fears were associated with both current and previous maternal anxiety. Children of more anxious mothers showed more anxiety and fear-related symptoms and the association with mother’s former symptoms was as strong as with mother’s current symptoms. The associations of maternal anxiety with children’s later anxiety and fears were partially mediated by parenting competence. These results support previous findings that even low maternal anxiety is associated with child development and elaborates them by showing that it is associated specifically with child anxiety and fear-related symptoms. The current findings also extend existing knowledge about this association by showing that it is partially mediated by parenting competence. These findings can be utilized in prevention and treatment of childhood anxiety.

Äidin perinataalimasennuksen eli raskaudenaikaisen ja synnytyksen jälkeisen masennuksen on todettu olevan yhteydessä moniin lapsen kasvun ja kehityksen ongelmiin. Aiemmissa tutkimuksissa on löydetty äidin perinataalimasennusoireilun yhteys lapsen ADHD-oireisiin ja heikompaan toiminnanohjaukseen. Aihetta on kuitenkin tutkittu toistaiseksi melko vähän, ja ADHD-oireita käsitelleiden tutkimusten kohteina ovat olleet pääasiassa alle kouluikäiset lapset. Tämän tutkimuksen tavoitteena on selvittää, onko äidin perinataalimasennusoireilu yhteydessä kouluikäisen lapsen ADHD-oireisiin ja toiminnanohjaukseen. Tutkimuksessa selvitetään lisäksi, vaikuttaako sukupuoli äidin perinataalimasennusoireilun ja kouluikäisen lapsen ADHD-oireiden väliseen yhteyteen sekä äidin perinataalimasennusoireilun ja lapsen toiminnanohjauksen väliseen yhteyteen. Tutkimukseen osallistui 2 002 äiti-lapsiparia, jotka kuuluivat suomalaiseen The Prediction and Prevention of Pre‐eclampsia and Intrauterine Growth Restriction (PREDO) -kohorttitutkimukseen. Äidit vastasivat masennusoirekyselyyn 14 kertaa raskausaikana alkaen raskausviikolla 120/7–136/7 ja päättyen raskausviikolle 380/7–396/7 tai synnytykseen sekä kaksi viikkoa ja kuusi kuukautta synnytyksen jälkeen. Äidit arvioivat lastensa ADHD-oireita sekä ADHD Rating Scale että Conners’ 10-item Scale -kyselylomakkeilla ja toiminnanohjausta Behavior Rating Inventory of Executive Function (BRIEF) -kyselylomakkeella. Äidin perinataalimasennusoireilun yhteyttä lapsen ADHD-oireisiin ja toiminnanohjaukseen tutkittiin lineaarisella regressioanalyysillä, jossa huomioitiin useita äitiin ja lapseen liittyviä taustamuuttujia. Sukupuolen vaikutusta äidin perinataalimasennusoireilun ja lapsen ADHD-oireiden sekä äidin perinataalimasennusoireilun ja lapsen toiminnanohjauksen välisiin yhteyksiin tutkittiin moderaatioanalyysillä. Lineaarisella regressioanalyysillä tutkittiin, onko sukupuolen ja äidin perinataalimasennuksen välillä yhdysvaikutusta ennustettaessa lapsen ADHD-oireita ja toiminnanohjausta. Tutkimuksen tuloksista ilmeni, että äidin masennusoireilu sekä raskausaikana että synnytyksen jälkeen oli yhteydessä lapsen voimakkaampiin ADHD-oireisiin ja heikompaan toiminnanohjaukseen. Tulosten perusteella lapsen sukupuoli moderoi äidin ensimmäisen raskauskolmanneksen masennusoireilun ja kouluikäisen lapsen yliaktiivisuus-impulsiivisuusoireiden välistä yhteyttä. Sukupuoli ei kuitenkaan moderoinut muita äidin perinataalimasennusoireilun ja lapsen ADHD-oireiden välillä löytyneitä yhteyksiä eikä vaikuttanut äidin perinataalimasennusoireilun ja lapsen toiminnanohjauksen väliseen yhteyteen. Tutkimus lisäsi tietoa siitä, kuinka äidin masennusoireilu jokaisena raskauskolmanneksena ja synnytyksen jälkeen on yhteydessä kouluikäisen lapsen voimakkaampiin ADHD-oireisiin ja heikompaan toiminnanohjaukseen. Tässä tutkimuksessa sukupuoli moderoi äidin ensimmäisen raskauskolmanneksen masennusoireilun ja kouluikäisen lapsen yliaktiivisuus-impulsiivisuusoireiden välistä yhteyttä, mutta kyseessä saattaa olla satunnainen löydös. Sukupuolen mahdollisesta vaikutuksesta äidin perinataalimasennusoireilun ja lapsen ADHD-oireiden väliseen yhteyteen tarvitaan lisää tutkimuksia.

The aim of the study. Maternal depression during pregnancy occurs in up to one in four women. It is a serious condition that can have long-term negative effects on the development of the foetus and the child through a harmful intrauterine environment. Maternal depression during pregnancy is for instance associated with internalizing mental health symptoms and temperament in children. However, there is little research evidence on the association of maternal depression during pregnancy with anxiety symptoms in school-aged children. Childhood anxiety symptoms can have serious and long-term consequences for an individual in terms of psychosocial, academic and professional functioning. This study examines whether maternal depressive symptoms during pregnancy increases the risk of anxiety symptoms in school-age children. I also investigate whether infant negative emotionality mediates the association between maternal depression symptoms during pregnancy and anxiety symptoms in school-age children. Methods. The sample of this study, which consists of 1625 mother-child pairs, was part of a larger PREDO (The Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction) follow-up study. Data from 3-12 months infancy follow-up and follow-up at the age of 7 to 11 years were used in this study. Mothers rated depressive symptoms during pregnancy using a self-assessment questionnaire (Center for Epidemiologic Studies Depression Scale). Mothers assessed their children's negative emotionality (Revised Infant Behavior Questionnaire) in the infant follow-up and their children's anxiety symptoms (Spence Children's Anxiety Scale, parent report version & The Short Form of the Fear Survey Schedule for Children-Revised) in the school-age follow-up. The associations between maternal depressive symptoms during pregnancy and anxiety symptoms in school-age children were examined with linear regression analysis. Negative emotionality in infancy as a mediator of this relationship was examined with mediation analysis. Results and conclusions. According to this study, maternal depressive symptoms during pregnancy increased the risk of anxiety symptoms in school-age children. The observed associations between maternal depressive symptoms and anxiety symptoms in children were independent of all the covariates selected for this study, such as maternal depression symptoms during follow-up at the age of 7 to 11. Preliminary research findings were also obtained on negative emotionality in infancy as partly mediating the association between maternal depressive symptoms during pregnancy and anxiety symptoms in school-age children. This study helps to increase understanding of the early risk factors of anxiety symptoms in children and the importance of preventive measures during pregnancy. High negative emotionality in early childhood is also a justified target for interventions.

Background: Parenting stress, romantic relationship satisfaction and their associations have been studied extensively, mostly with cross-sectional studies and in different clinical groups. However, parents of young children in non-clinical groups are less studied, especially with longitudinal settings. The aim of this master’s thesis is to investigate the change in maternal parenting stress over time, associations with romantic relationship satisfaction and if romantic relationship satisfaction modifies the change in parenting stress. Methods: Our sample (n = 361) is drawn from the prospective cohort study “The InTraUterine sampling in early pregnancy” (ITU). Participating mothers took part in two follow-up assessments: first at the child’s age of 1–2-years and second at 3 years. Parenting stress was assessed at the first and second follow-ups with the “Parenting Stress Index-Short Form” (PSI-SF) questionnaire with three subscales: parental distress, parent-child dysfunctional interaction and difficult child. Romantic relationship satisfaction was assessed at the first follow-up with the satisfaction subscale form the “Dyadic Adjustment Scale” (DAS) questionnaire. Data were analyzed using linear regression models and mixed models. Child’s age, sex, daycare, and siblings, as well as mother’s education and mental health disorders were controlled for in the analyses. Results: Higher parenting stress at the first follow-up was associated with higher parenting stress at the second follow-up. Higher romantic relationship satisfaction was associated with lower parenting stress at the first follow-up in all the subscales, and at the second follow-up in parental distress and difficult child subscales. Parenting stress related to difficult child’s subscale appeared to increase over time in the entire sample, but in the closer examination the changes in parenting stress were partly different in the groups of high and low romantic relationship satisfaction. Controlling for background variables did not affect the results. Conclusions: The results of this thesis fill the previous gaps in longitudinal settings and studies carried out with mothers of young children in non-clinical groups. It seems that romantic relationship satisfaction may be connected to parenting stress and its change in the early childhood. A broader understanding of these phenomena in the family context may be beneficial for applications, for example in health care, in preventing problems and promoting wellbeing of families with children.

Objective: The aim of the study was to investigate whether alexithymia and its subscales (difficulty in identifying and describing emotions and externalizing thinking) are related to exhaustion symptoms. Alexithymia reflects difficulty in identifying and describing emotions and has been found to be associated with a number of health and mental health problems. In turn, exhaustion is a problem that causes significant harm to individuals and society. This paper is the first to examine the association of alexithymia subscales with exhaustion symptoms. Methods: the study used the Young Finns Study follow-up data, from which data on alexithymia was examined in 1980 and exhaustion symptoms in the follow-up survey in 2012. The size of the sample was 1230. The research questions were explored using generalized linear gamma regression models controlling for different background variables (socioeconomic factors of adulthood and childhood family environment factors and depressive symptoms). Results: Higher alexithymia scores were found to be associated with more severe exhaustion symptoms. In addition, higher difficulties in identifying and describing emotions were associated with more intense exhaustion symptoms and higher levels of externalizing thinking were associated with lower intense exhaustion symptoms. Conclusion: Overall, alexithymic traits contribute to the intensity of exhaustion symptoms. However, controlling for depressive symptomatology weakened the association of the total alexithymia score with exhaustion symptomatology. This study raised the need to further investigate the significance of the alexithymia subscales in the future.

Aims: Schizophrenia is characterized by cognitive impairment that associates with many problems in everyday life and functioning. Earlier research has hypothesized that antidepressant medication may associate with better cognitive functioning among schizophrenia patients, but empirical results are mixed. This study explored the profile of schizophrenia patients that use antidepressants and asked whether there is an association between antidepressant use and cognitive performance in a clinical patient sample. Because of effects on the central nervous system, benzodiazepines and anticholinergic medications were also considered. Methods: Study participants were drawn from the SUPER-Finland cohort, which was collected among patients with psychotic illnesses in 2016–2018 from all university hospital districts across Finland (n=10474). The analysis included working-age (18–70) patients with a schizophrenia diagnosis (F20) and complete results from the brief cognitive assessment (n=3411). Information about regular medications and psychosocial factors were gathered through questionnaire and interview. Cognition was assessed with CANTAB (Cambridge Neuropsychological Test Automated Battery), out of which the subtests measuring reaction time (RTI) and visual learning (PAL) were included. The association of antidepressants on cognition was examined using both pooled antidepressants and various antidepressant groups as predictors in linear regression models. Gender, age, age of diagnosis, living status, relationship, education, and psychological distress were controlled in the models. Results: Over 35% of schizophrenia patients regularly used at least one antidepressant. On average, schizophrenia patients using antidepressants experienced lower well-being and more psychological distress than patients without antidepressants. The use of antidepressants was not generally associated with better or poorer cognitive performance. However, the use of SNRI antidepressants was associated with a significantly faster reaction time. The use of benzodiazepines was associated with poorer cognitive performance in both reaction time and visual learning. Conclusions: The results support the conclusion that there is generally no meaningful association between antidepressants and better cognitive performance in schizophrenia. However, the association of SNRI-medicines with a slightly faster reaction time is promising and warrants further research. Several psychosocial factors were associated with the cognitive performance of schizophrenia patients, which underlines the need for supporting psychosocial well-being in cognitive rehabilitation.

Aims: The transdiagnostic cognitive-behavioral model of eating disorders (ED) views EDs as a single disorder with different clinical manifestations, but the CBT effectiveness research thus far has mostly only pooled results within individual ED categories. A panoramic meta-analysis (PMA) synthesizes evidence across indications, and here the aim is to explore whether a PMA in the context of CBT for EDs provides an unbiased and precise effect estimate when pooling across the ED diagnoses. Methods: Reviews that synthesize RCTs of CBT for EDs were searched, and reviews that met inclusion criteria and included meta-analytic data or valid data from a single RCT were included in the PMA. Two PMAs (CBT vs active controls, CBT vs inactive controls) were performed. The outcome most commonly employed in the meta-analyses identified in the search was chosen as the outcome of interest. Findings: Of the n=24 meta-analyses, only n=7 were eligible for the PMA. The analysis provided support for the effectiveness of CBT vs inactive controls ((SMD: 0.32, 95% CI: 0.05 to 0.59, I2= 38.1%) but results were inconclusive when CBT was compared to active controls (SMD: 0.01, 95% CI: -0.35 to 0.36, I2=75.2%). Conclusions: Due to the methodological limitations of this thesis, several central comprehensive meta-analyses had to be excluded from the PMA. Thus, this PMA failed to provide a precise and unbiased synthesis of existing data of the effectiveness of CBT for EDs across the diagnoses.

The aim of this thesis was to examine the test-retest reliability of three outcome-based behavioural tasks - the reversal learning task, the weather prediction task, and the working memory task - with three measuring sessions. In addition, the aim was to determine the more reliable of the two learning tasks: the reversal learning task and the weather prediction task. Test-retest reliability refers to a task’s ability to produce reliable results when repeated. The repetition of a task has been found to cause a so-called retest effect which means the changing of test scores when the participants is exposed to an identical or similar test in the past. The magnitude of this retest effect depends, for example, on the temporal interval of the measurements, the design of the task, and the age and intelligence of the participant. The reversal learning task, the weather prediction task, and the working memory task are all utilized in health care and their test-retest reliability may have clinical implications. The participants were 40 healthy adults aged 18 to 35, and all of them were subjected to two of the behavioural tasks in three sessions with 4 to 14 day intervals. The data was analyzed with an intraclass correlation coefficient suitable for the determining of test-retest reliability and analyses of variance. The results of the analyses of variance were further analyzed with pairwise comparisons. The intraclass correlation coefficients of the behavioural tasks ranged from moderate to good. The reversal learning task’s analysis of variance revealed statistically significant variance in the outcome variables between sessions. Similarly, the reaction times of the weather prediction task had statistically significant variance between the sessions. The working memory task’s accuracy, on the other hand, had statistically significant variance between trial types. Reaction times of the working memory task had statistically significant variance between both the sessions and the trial types. Test-retest reliability is a complex issue which cannot be determined in a single study. That being said, the results of this study support the repeated clinical use of these instruments among healthy adults of 18 to 45 years of age and with the 4 to 14 day interval. When it comes to the learning tasks, the weather prediction task seemed to be the more reliable one, but the differences were small.

Objectives: Associations between family socioeconomic status and child and adolescent mental health have garnered increasing research interest in the last few decades. Parental mental health has also been shown to affect these associations. The aim of this study was to investigate whether changes in household income are associated with changes in adolescent mental health, and whether parental psychological distress affects these possible associations. Methods: The sample of this study was derived from the UK Household Longitudinal Study, and consisted of 9233 British adolescents aged 10 to 15 years and their biological mothers, stepmothers, or adopted mothers. The data of this study was gathered in four separate study waves. Adolescent mental health was measured with the self-completed Strengths and Difficulties Questionnaire total difficulties score. Parental psychological distress was measured with the 12-item version of the General Health Questionnaire. Household income was equivalised to account for family size and composition. The data was analysed using fixed effects and random effects panel models. Adolescent sex, adolescent age, and parent age were included in the models as potential confounding variables. Results and conclusions: Greater household income was associated with less self-reported mental health symptoms in adolescents, but changes in household income were not associated with changes in adolescent mental health. Increases in parental psychological distress were associated with increases in adolescent mental health symptoms. The sex of the adolescent was not associated with adolescent mental health, while results regarding adolescent and parent age were mixed. The findings of this study suggest that there is an association between household income and adolescent mental health, but this association may not be causal in nature. The results also corroborate the status of parental mental health as an important determinant of adolescent mental health.