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(2017)Anorexia nervosa is a severe and chronic mental disorder with high relapse and mortality rate. It still has relatively poor prognosis and the rates of recovery vary a lot largely depending on the way recovery is defined and specific criteria used. Studies show that recovery of anorexia nervosa is composed of changes in different areas of life and in this review I study physical, psychological, behavioral, social and functional components of recovery. I also study different definitions of recovery and how these definitions and emphasis on certain components affect treatment and research. Physical and behavioral symptoms of anorexia nervosa are clearly observable and considering this fact, it is interesting to know how psychological factors receive attention in treatment process. Within the eating disorder literature most studies focus on weight gain and improvement in eating disorder symptomatology. And in treatment those areas are the first priority. Because of life-threatening nature of the illness and the positive effect of early treatment response on prognosis this emphasis is most important. However, considering the high relapse rate of anorexia nervosa, physical condition and behavioral changes do not indicate complete recovery and other components should also be included in the definition of recovery and paid attention to in treatment. Besides, there is evidence that certain mental changes and insight into the illness allow for recovery in other components. And although physical factors are usually stressed, anorexia nervosa can alternatively be seen as a disorder of impaired identity development and disturbed sense of self. Assessment of psychological changes is challenging and information is usually derived from qualitative studies and patient’s own experiences. While qualitative approach usually is more time consuming, the detailed information they provide could be used to enrich data of empiricist methods. Nowadays, there is a lot of knowledge about risk and predisposing factors of anorexia nervosa, but limiting understanding of mechanisms of change and recovery. In order to develop more effective treatment in the future, understanding of key processes of recovery should be increased and at the same time in treatment, all components of recovery should be taken in to consideration to achieve full recovery.
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Lapsen käytöshäiriöiden ja vanhemmuuden välinen yhteys - tunnekylmät piirteet moderoivana tekijänä (2020)Objectives. Parenting is known to be associated with children’s conduct problems. Parenting can be divided into negative and positive parenting dimensions, both of which have independent effects on conduct problems. The strength of the association between parenting and a child’s conduct problems is also influenced by the child’s individual traits. One approach focuses on callous unemotional traits that can be defined as lack of guilt and empathy as well as callous use of others. The quality of parenting may affect children differently depending on the level of their callous unemotional traits. In this review it will be examined whether callous unemotional traits work as a moderating factor on the association between conduct problems and parenting. Methods. The literature search was conducted with PubMed -database using search terms parent* and callous unemotional. In addition, the reference lists from articles already found were manually searched. The articles that examined the moderating effect of callous unemotional traits of 4 to 13-year-old children on the association between conduct problems and parenting were selected in the review. Seven articles were picked to the final review. Results and conclusions. The quality of parenting and conduct problems are associated with each other, but the strength of the association is influenced by the child’s callous unemotional traits. Parenting affects children differently based on the level of callous unemotional traits. Parenting had little effect on children high on callous unemotional traits, which is attributed to them being less responsive to punishment and other people’s distress. However, parental warmth affected these children and it is seen as an important protective factor from conduct problems. The negative dimension of parenting was consistently associated with more conduct problem symptoms and positive dimension of parenting with less symptoms on children low on callous unemotional traits. Considering callous unemotional traits in the treatment of conduct problems would be important to better suit interventions for children based on their individual traits.
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(2019)Intrusive thoughts concerning intentionally harming one’s infant are common in new parents, as much as half of new mothers report having them after childbirth. Most parents experience thoughts as passing but more distressing than other types of postpartum intrusive thoughts. Thoughts concerning child harm can be experienced distressing also by other family members and clinicians which may lead to secrecy or overestimation of risk of child abuse. According to current research, intrusive thoughts do not seem to predict child abuse. More research is needed to normalize intrusive thoughts and find out connection between intrusive thoughts and child abuse.
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(2020)Purpose of the Review: Climate change is not a new thing. Global warming and climate change pose environmental problems and increasing risks for mental health of individuals as well as generally among people. Children and adolescents are at risk of a range of climate-related mental health stressors due to their limited adaptive capacity and still developing understanding of the climate change. They are exposed to the negative effects of climate change for their whole lifetime. In this study, I reviewed the latest research on the psychological effects of climate change on children and adolescents. This study included research that addressed children and adolescents' awareness of climate change, their emotions and anxiety towards climate change and future. Methods: Literature searches were made in PubMed with mixed words 1) climate change or global warming, 2) mental health, anxiety, eco-anxiety, distress or fear and 3) children, child or adolescent. Language was English. In addition, the bibliographies of the selected articles were manually browsed and some of the literature was selected from there. 19 articles covering the effects of climate change for children and adolescents were selected for this study. Findings and summary: Children and adolescent of all ages are aware of climate change. They are worried and afraid of climate change and the future all around the world. Awareness of climate change arose emotions and eco-anxiety. Children and adolescents will be the future decision-makers, so they need skills and the capacity to adapt to the climate change. More research is needed on mental health and adaptation effects of climate change for children, adolescents and adults.
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(2023)Lapset voivat toimia oikeudellisessa kontekstissa todistajina niin uhrin asemassa kuin silminnäkijöinäkin. Yleisimpiä rikoksia, joissa lapsia kuullaan todistajina ovat lapseen kohdistuvat väkivalta- ja seksuaalirikokset. Lisäksi lapsen todistajanlausunto voi olla keskeisessä asemassa perheväkivaltaepäilyä selvitettäessä. Koska lapset ovat enenevissä määrin osallisina oikeudellisessa kontekstissa, lisääntyy myös tarve ymmärtää lasten muistiin ja todistajanlausuntoon vaikuttavia tekijöitä. Tämän katsauksen tavoitteena on esitellä keskeisimmät tällaiset tekijät ja lisätä ymmärrystä siitä, voiko lapsi olla luotettava todistaja. Katsauksessa käytettiin lähteinä keskeisiä kansainvälisiä tutkimusartikkeleita lasten muistista oikeuspsykologisesta näkökulmasta. Tutkimukset yhtenäisesti osoittavat, että vanhemmilta lapsilta voidaan odottaa parempia ja eheämpiä muistikuvia ja kertomuksia tapahtumista kuin nuoremmilta lapsilta. Kuitenkin laadukkailla haastatteluilla, joissa huomioidaan lapsen kehitystaso ja muistiin ja todisteluun vaikuttavat tekijät, voidaan nuoriltakin lapsilta saada luotettavaa ja laadukasta tietoa. Tutkimusten mukaan saman kysymyksen esittäminen lapselle haastattelun aikana saattaa johtaa lapsen vastauksen ja jopa muistikuvan muuttumiseen, mikä heikentää lapsen kertomuksen luotettavuutta. Toistetut haastattelut puolestaan lisäävät tavoitetun olennaisen tiedon määrää, koska lapsi pystyy täydentää aiempaa kertomustaan. Olennaista on käyttää avoimia kysymyksiä, joihin lapsi pystyy vapaasti kertoa tapahtumista muistamansa yksityiskohdat. Lasten muistikuvia tapahtumista heikentää tutkimusten mukaan viive tapahtumien ja niistä kertomisen välillä, sekä keskenään samanlaisina toistuvat tapahtumat, jolloin lapsi herkästi sekoittaa eri tapahtumakertoja toisiinsa. Lisäksi lapsilla voi olla vaikeuksia myös muistikuvan lähteen tunnistamisessa, eli he saattavat sekoittaa todellisuudessa tapahtuneet asiat kuviteltuihin, mikä vääristää muistikuvia. Lisäksi lapsen kielellisillä taidoilla on suuri merkitys siihen, mitä lapsi tapahtumahetkellä painaa mieleensä, miten hän myöhemmin muistaa tapahtumat ja miten hän osaa muistikuvansa sanoittaa. Lapsen muistikuvien määrään ja tarkkuuteen vaikuttaa myös lapsen osallisuus tapahtumiin. Tutkimukset osoittavat, että lapsi muistaa yleisesti paremmin sellaiset tapahtumat, joissa hän on itse ollut aktiivisena osallisena. Kuitenkin jos lapsi seuraa itselleen tutun henkilön toimintaa, voidaan se muistaa yhtä hyvin kuin oma toiminta. Tämä antaa viitteitä siitä, että lapsi voi olla yhtä hyvä todistaja niin uhrina kuin silminnäkijänäkin. Haasteena tutkimuksissa on se, miten saadaan eettisesti jäljiteltyä rikoksen luonnetta, jotta tutkimustulokset olisivat suoremmin sovellettavissa oikeudelliseen kontekstiin. Jotkin tutkimukset ovat onnistuneet hyödyntämään todellisia tapauksia, joissa on epäily seksuaalisesta hyväksikäytöstä, tai yhdistämään tutkimusasetelmaan sellaisia piirteitä, jotka voisivat liittyä esimerkiksi seksuaalirikokseen. Joka tapauksessa oikeudellisessa kontekstissa tulee olla tietoisia näistä tutkimuslöydöksistä, ja lapsia tulee haastatella ja heidän antamiaan lausuntoja arvioida lapsen kehitystaso ja muistiin ja todisteluun vaikuttavat tekijät huomioiden.
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(2019)Incarcerated mothers of small children are a group in need of special attention. The first year of a child is thought as significantly important when the child is developing an attachment bond to their mother. During this period of time, a long lasting separation from the primary caregiver can be damaging to the child. In many countries, mothers are separated from their children during their prison sentence, but in special units, some are given the chance to live together with their child. The aim of my thesis is to examine how living in prison will affect the child, the future development of the child, and the attachment bond between the mother and the child. I will also study the effects of incarceration on the mothers' mental health and parenting. My data consists of peer-reviewed articles, searched with Google Scholar. In my data, I included studies in which the sample consisted of mothers and children living in prison, or of mothers who were separated from their small children because of their prison stay. The chosen articles used quantitative methods to measure variables related to the well-being of the children or the mothers, or the attachment between the children and the mothers. Nine studies were included, all of which were carried out in the USA or in England, and published during the years 2000-2018. In two of the studies, most of the children who were living in a mother and baby unit in prison were securely attached to their mothers. In another study, preschool-aged children who had lived in prison as babies had less depression and anxiety symptoms than the children who had been separated from their mothers as babies. In follow-up, the mothers in the first group were more likely to have the custody of their children than the mothers in the comparison group. Connections to other variables, such as maternal interaction, depression and reflective functioning were weaker: there are results that support the effectiveness of prison interventions, but also results that are against the interventions. Prison nurseries did not have a statistically significant effect on the variables in the studies, but no study that was explored here reported any negative effects to the children either. In the light of these results, alternatives for a separation should be guaranteed to as many mothers and children as possible. Research has also shown that various incarcerated mothers have a lot of mental health problems, a history of traumatic experiences and and an insecure attachment bond. More research is needed to define effective interventions and treatments targeted to this risk group.
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(2019)Background and aim of the study. Antisocial behavior is a complex phenotype describing combinations of criminal or aggressive behavior opposing the social rules and symptoms of antisocial personality disorder. Antisocial behavior seems to be highly heritable, but the mechanisms of heritability remain poorly understood. One of the best studied risk factors is maltreatment in childhood, but it seems that biological factors can create higher vulnerability to harmful experiences and so heighten the risk for antisocial behavior. Differences in levels of MAOA enzyme, caused by MAOA gene variants, has been proposed to be one possible biological factor moderating the interaction between childhood maltreatment and antisocial behavior. Especially the low activity variant, MAOA-L-genotype, has been proposed to increase the risk as the complete ineffectiveness of MAOA enzyme has been shown to led to impulsive aggression. The aim of this review is to examine how childhood maltreatment and MAOA genotype can heighten risk for antisocial behavior across the lifespan. Research methods. A search for relevant studies was made using terms ”MAOA” or ”Monoamine oxidase A” in connection with ”antisociality”, ”antisocial behavior”, ”antisocial lifespan”, ”violence” and ”childhood maltreatment” or ”childhood adversities”. The databases used were Google Scholar, PubMed, Scopus and Helka. Results and conclusions. The MAOA gene variants did not create a risk for antisocial behavior, but when a MAOA-L-carrier is exposed to childhood maltreatment, the risk became remarkably higher. MAOA-H genotype seems to improve resilience against harms of maltreatment. Research on topic has resulted in quite mixed results, especially in populations other than white males. The reasons behind the high heredity of antisocial behavior remain unknown, but it seems that biological factors and childhood experiences are equally crucial in development of antisocial behavior.
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(2018)Childhood sexual abuse has long been seen as a major predisposing factor for the transition from victim to offender. Research results from this theory called the cycle of abuse are partly contradictory. In the light of new research, the association between childhood sexual abuse and subsequent sexual offending can be seen in a way that childhood sexual abuse serves as a predisposing factor but does not alone predict future sexual offending as the effect of experienced abuse depends on many other factors affecting the child’s development. This thesis summarizes what is currently known about the psychological factors mediating and moderating the association between childhood sexual abuse and subsequent sexual offending. Research literature suggests several different factors related to caregiving environment, emotional regulation, social learning and sexual development of the child. The most important conclusion is, however, that there is an urgent need for further research, as most of the discussed factors are mainly based on theories and hypotheses that haven’t been tested empirically. It is important to identify the factors mediating and moderating the association between childhood sexual abuse and subsequent sexual offending as that is how they can be taken into account in working with abused children, for instance, which can be considered as an effective way to break the intergenerational cycle of sexual offending.
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(2023)Tavoitteet: Dissosiaatio on mielen puolustusmekanismi, joka ilmenee usein trauman yhteydessä tai sen jälkeen. Se voi vaikuttaa moniin mielen toimintoihin, kuten muistiin, havainnointiin, tietoisuuteen ja identiteettiin, sekä ilmetä irrallisuutena omista ajatuksista, tunteista tai ympäristöstä. Etenkin lapsuudessa ilmenevän dissosiaation vaikutuksista mielenterveyteen tiedetään kuitenkin vähän. Kirjallisuuskatsauksen tavoitteena oli tarkastella lapsuudessa ilmenevää dissosiaatiota ja dissosiaation vaikutuksia myöhempään mielenterveyteen. Menetelmät: Tutkimuskirjallisuutta varten hain tutkimuksia PubMed ja Google Scholar -tietokannoista yhdistelemällä hakusanoja ”dissociation”, ”children”, ”adolescents”, ”mental health”, ”outcomes” ja ”role” syksyn 2023 aikana. Lisäksi hyödynsin aiheeni kannalta merkityksellisten artikkeleiden lähdeluetteloita. Tulokset ja johtopäätökset: Tutkimustulosten perusteella dissosiaatio vaikuttaa olevan erityisesti kytköksissä itsetuhoisuuteen ja saattaa toimia välittäjänä kaltoinkohtelun ja mielenterveyshäiriön kehittymisen välillä. Erityisesti lasten ja nuorten kohdalla tutkimusta on kuitenkin rajallisesti, ja lisätutkimuksen tarve on ilmeinen. Täydentävää tutkimusta tarvitaan laajentamaan ymmärrystä dissosiaatiohäiriöistä ja niiden vaikutuksista, jotta voidaan kehittää tehokkaampia interventioita.
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Lapsuuden ja nuoruuden aikaisten emootioiden säätelyvaikeuksien yhteys syömishäiriön kehittymiseen (2021)The purpose of this review is to describe the relation between emotional dysregulation during childhood and adolescence and development of eating disorders. Childhood emotional issues relate broadly to later psychopathology, and, on the other hand, eating disorders are often associated with emotional dysregulation. Therefore, it is essential to examine the connection between emotional dysregulation during childhood and adolescence and development of later eating disorders. The studies selected for this review are a systematic review and eleven prospective longitudinal studies, three of which are also included in the systematic review. According to these studies difficulties with emotion regulation (such as anxiety, depression, impulsivity) during late childhood and adolescence often precede symptoms of eating disorder and predispose the individual to development of eating disorder. Risk groups that stand out are children and adolescents with emotional issues of anxiety and depression, as well as children and adolescents who have symptoms of anxiety or depression alongside body dissatisfaction or drive for thinness. Additionally, a strong risk factor is simultaneous expression of several emotional difficulties, such as impulsivity and affect reactivity. In conclusion, the study results support the significance of emotional skills both in prevention and recognition of eating disorders as well as in their treatment.
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(2024)Tavoitteet: Nuorisorikolliset ovat yhteiskunnan erityinen ryhmä, johon liittyy paljon riskitekijöitä. Nuorisorikollisilla on tavanomaista enemmän lapsuuden kaltoinkohteluhistoriaa ja tunnekylmiä piirteitä. Lapsuuden kaltoinkohtelulla on kielteisiä vaikutuksia lapsen kehitykseen ja se voi johtaa rikollisuuteen myöhemmin elämässä. Tunnekylmät nuoret eivät tunne empatiaa ja syyllisyyttä kuten muut, joten myös heillä on suuri rikollisuuden riski. Tutkimustieto näiden kahden riskitekijän keskinäisistä yhteyksistä on kuitenkin hajanaista. Tutkielman tavoitteena onkin tutkia, miten lapsuuden kaltoinkohtelun eri muodot ja tunnekylmät piirteet ovat yhteydessä toisiinsa nuorisorikollisilla. Menetelmät: Vertaisarvioitu, englanninkielinen ja alkuperäistutkimuksista koostuva tutkimuskirjallisuus haettiin helmikuussa 2024 PubMed-tietokannasta yhdistelemällä hakusanoja ”callous-unemotional traits”, ”child maltreatment”, ”juvenile delinquency”, “psychopathy”, ”criminality”, “ICU”, ”recidivism”, “aggression”, “violence”, “empathy”, and “parenting” sekä artikkelien lähdeluetteloita tarkastelemalla. Tulokset ja johtopäätökset: 10 tutkimusartikkelin perusteella lapsuuden kaltoinkohtelu voi ennustaa tunnekylmiä piirteitä nuorisorikollisilla. Varsinkin emotionaalinen laiminlyönti ennustaa tunnekylmyyttä. Eri kaltoinkohtelumuotojen yhteyksistä tunnekylmyyteen löytyi kuitenkin kulttuurillisia eroja. Yhteyttä vahvisti tunteiden puuduttaminen ja äidin matala lämpö. Yhteyden sukupuolieroja ei oltu tutkittu suoraan, mutta paljastui, että nuorisorikollispojilla on vähemmän kaltoinkohtelun kokemuksia ja enemmän tunnekylmiä piirteitä, kuin nuorisorikollistytöillä. Jatkossa olisi tärkeää tutkia sukupuolieroja tarkemmin sekä tutkimustietoa hyödyntäen kehittää rikollisuuden uusimista ehkäiseviä interventiota ja auttaa nuorisorikollisia jatkamaan rikollisuudesta vapaata elämää.
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(2017)Traumatic childhood experiences predispose psychiatric symptoms in adulthood. Sexually abused children have more behavioral problems, depressive symptoms, feel more shame and have lower self-esteems compared to other children. Borderline personality disorder (BPD) is characterized by fear of abandonment, aggression towards self and others, difficulty of controlling feelings and behavior, instability of identity and self-destructive behavior, and these traits could hypothetically stem from shameful and traumatic childhood experiences. BPD has a relatively strong genetic component, but the specific etiological factors are still unclear. In this review, the aim is to see whether there is a connection between child sexual abuse and BPD, how specific forms of abuse correlate with BPD and ultimately, to show whether child sexual abuse is a relevant factor in the etiology of BPD. Studies show that childhood sexual abuse was significantly common in the histories of people with BPD. People suffering from BPD had experienced childhood sexual abuse more often than people with depression, schizophrenia or healthy controls had. However, there was no difference in the prevalence of sexual abuse between BPD and other personality disorders. In these studies, there was no difference in the familiarity of the perpetrator, but on average people with BPD had experienced sexual abuse slightly earlier in childhood. Reliable conclusions could not be made about duration, frequency, seeking help, nature of abuse or use of force due to scarcity and narrow focus of previous research on the subject. The results presented in this review suggest that childhood sexual abuse does not play a part in the development of BPD as an independent causative factor. However, the lack of uniform usage of the term ”sexual abuse” and the interrelatedness of sexual abuse, other forms of abuse and family environmental factors all pose challenges for interpreting the results. The observed connection between BPD and childhood sexual abuse could be explained by the cumulative problems associated with underprivileged families, which can result in neglect and thus being more vulnerable to abuse. Additional longitudinal and meta-analytical research is needed to clarify the connections.
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(2019)Psychotic disorders are quite rare but severe mental disorders. For example, the life time prevalence for schizophrenia is only 0.5 %, whereas the life time prevalence for psychotic symptoms is approximately 5 - 6 %. Psychotic symptoms can predict problems with mental health and they are often considered to be early signs of the beginning of a psychotic disorder. Psychotic disorders can cause impairments in a person’s ability to handle daily tasks and they are known to have a negative impact on the general quality of life. Therefore, it is extremely important to recognize factors that may cause psychotic disorders in order to prevent their development. It is known, that psychotic symptoms and psychotic disorders can be explained by multiple different factors, but it has been suggested that childhood sexual abuse is one of these explaining factors. However, victims of sexual abuse will not always develop a psychotic disorder. Therefore, it is especially important to understand, which of the underlying factors could possibly transmit or moderate the link between childhood sexual abuse and psychotic symptoms. When the association is known, victims of sexual abuse can be supported properly. For the literature selection of my thesis, I chose studies which discussed psychotic symptoms of persons with sexual abuse history in childhood as well as studies, which examined traumatic childhood experiences retrospectively of patients with first-episode psychosis. In addition, the literature selection included population based studies, which examined both sexual abuse history in childhood and psychotic symptoms from randomly selected sample. Many of the studies used retrospective self-report questionnaires in the collection of data, while there were also some studies where data was based on medical records. In my thesis I examine the link between childhood sexual abuse and psychotic symptoms and especially that which factors have an impact on such link and which moderate it. The symptoms of general psychopathology, such as anxiety, are essential factors transmitting the link. Additionally, other childhood trauma experiences also have an impact on the link: emotional and physical abuse transmit the path to the positive psychotic symptoms whereas physical neglect mediates the path to the negative symptoms. It is also known, that the link between sexual abuse and psychotic symptoms is stronger with females than males. Childhood sexual abuse is strongly associated with psychotic symptoms. Therefore, psychotic symptoms increase the risk of developing psychotic disorder and hence, it is important to take notice for the showing symptoms as soon as possible.
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(2017)Studies have shown that significant proportion of people with eating disorders have reported childhood sexual abuse. However, the link between childhood sexual abuse and eating disorders is still unclear. Eating disorder is a severe condition, and therefore it is important to find out the mechanisms underlying it. The purpose of current thesis is to examine whether there is an association between childhood sexual abuse and eating disorders later in life. Studies on this subject are mostly cross-sectional – therefore, the existence of causal links remains unclear. The few longitudinal studies evaluating the link between childhood sexual abuse and eating disorders have produced mixed results. From a biological point of view, the link between childhood sexual abuse and eating disorders could stem from the dysregulation of the hypothalamic-pituitary-adrenal axis. Alternatively, the link could result from traumatization, as the trauma model posits. It is probable that the link is a complicated one, with many mediators and moderators influencing it. According to the existing literature, it seems that sexual abuse is a risk factor for developing an eating disorder, especially bulimia nervosa and binge-eating disorder. According to studies, treatment outcomes for eating disorder patients with a history of childhood sexual abuse have been poor. Thus, early intervention of child sexual abuse is important to prevent the development of eating disorders. In future, there is a need for more, prospective longitudinal studies on this subject that help to understand the link between child sexual abuse and eating disorder.
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(2019)The present thesis reviews studies on the relationship between a childhood trauma and a psychosis, and psychological factors that may mediate this relationship. Recent studies have connected childhood traumas to the psychosis and to the risk for psychosis. The studies are correlational and some of them have explored psychological factors that may mediate relation between childhood trauma and psychosis. Among these, studies have explored attachment, dissociation, emotion regulation, and cognitive schema as potential mediators. The data was collected in October 2019 from the PsycInfo, Google Scholar and PubMed databases. Nine studies were selected for this review, with the emphasis on quality of methods and recent publication. Three of these studies focused on the attachment quality and one of them also on dissociation. Dissociation alone was focused on three studies. One study focused on emotion regulation and two studies on cognitive schemas but one of them included also dissociation. The studies supported a view that anxiety and fearful attachment styles, emotion regulation, negative self-schemas and dissociation functioned as mediators between childhood traumatic experiences and psychosis. Dissociation has particularly a strong role. It was repeated as a mediator in several studies, sometimes even when the comorbid symptoms were controlled for. However, the results should be interpreted critically. All the studies, except one, were cross-sectional precluding any causal conclusions. Further studies need to be done. Future research should include longitudinal studies and there should be paid more attention to research methods.
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(2019)Objectives: Psychotic symptoms are often seen as a sign of severe psychopathology. However, the high prevalence of symptoms in relation to the low prevalence of psychosis raises the question of the clinical significance of childhood psychotic symptoms. In this thesis, I examine the clinical significance of psychotic symptoms in childhood. I review results on the prevalence and persistence of psychotic symptoms in childhood and associations between childhood psychotic symptoms and later psychotic and non-psychotic psychopathology. Methods: The thesis was made as a literature review. Literature was collected from the PubMed and Google Scholar databases using the following keywords and their various combinations: psychotic, psychosis, psychotic symptom, psychotic-like, schizophrenia, hallucination, delusion, and childhood, children, child, pediatric or young. In addition, some of the literature was found in the reference lists of other research reports. The choice of literature was made according to the relevance of the topic. Results and conclusions: Childhood psychotic symptoms are associated with later psychotic disorders, but the majority of children having psychotic symptoms do not suffer from later psychotic disorder. Symptoms have also been shown to be associated with non-psychotic disorders, poorer global functioning and suicidal behavior. Studies show that the prevalence of psychotic symptoms is quite high in childhood, but the majority of symptoms disappear over time. The high prevalence and transience rates of psychotic symptoms in childhood suggest that symptoms also occur in non-clinical populations. It’s possible that the psychotic symptoms reported by a child reflects immature thinking patterns or imagination instead of being psychotic. The methods used in the studies and thus the results are variable, which makes it difficult to draw clear conclusions.
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(2018)Adult psychopathy is typically included under the umbrella term of antisocial personality disorder, but the two constructs do not entirely overlap. The central features of psychopathic personality are a lack of empathy and blunted affect, whereas antisocial behaviour is more strongly related to impulsivity and a lack of self-control. In children, the developmentally analogous counterpart to psychopathic personality traits are generally considered to be callous-unemotional traits, while antisocial personality disorder corresponds to conduct disorder. This paper aims to examine whether children with behavioural problems differ in terms of callous-unemotional traits, as the target of interest are the genetic and psychophysiological determinants as well as the developmental idiosyncrasies. Research indicates that callous-unemotional traits in children are linked to a presentation of conduct disorder that is more stable and more severe. Callous-unemotional children with behavioural problems are less empathic and have more blunted affect than other children, whereas non-callous children with behavioural problems are exceptionally reactive emotionally. In addition, callous-unemotional traits predict more negative life experiences, as well as more conduct problems in the context of negative life experiences. Callous-unemotional traits may therefore, for example, significantly influence the effectiveness of intervention and prevention practices. Central areas of future research may thus be other potential factors between callous-unemotional traits and conduct problems, as well as the possibilities for intervention concerning both callous-unemotional traits and conduct problems.
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(2018)Tutkimuksen tarkoitus oli selvittää, millaisia asenteita lapsilla ja nuorilla on ikätovereitaan kohtaan, ja miten heidän asenteitaan voitaisiin parantaa. Änkyttävän lapsen puhe poikkeaa sujuvasti puhuvan lapsen puheesta ja hän saattaa kokea turhautumista ja häpeää änkytyksensä vuoksi. Tutkimusten mukaan änkyttäviä lapsia ja nuoria kiusataan keskimäärin enemmän kuin sujuvasti puhuvia lapsia ja nuoria. Myös kommunikoinnin pelkoa esiintyy keskimäärin enemmän änkyttävillä lapsilla ja nuorilla kuin heidän sujuvasti puhuvilla ikätovereillaan. Änkyttävän lapsen ja nuoren hyvinvointia lisäisi se, että hänen ikätoverinsa suhtautuisivat änkytykseen neutraalisti tai myönteisesti, ja siksi asenteita olisi mielekästä parantaa, mikäli ne ovat kielteisiä. Tutkimus on integroiva kirjallisuuskatsaus. Tutkimusaineisto kerättiin neljästä eri tietokannasta käyttäen hakulauseketta (stutter* OR stammer*) AND attention*. Aineistoon valittiin sellaiset artikkelit, joissa tutkittiin lasten ja nuorten asenteita änkyttäviä ikätovereitaan kohtaan tai joissa tehtiin interventio asenteiden parantamiseksi. Sopivia artikkeleita löytyi kahdeksan. Lasten ja nuorten asenteet änkyttäviä ikätovereitaan kohtaan olivat melko kielteiset. Viidesosalla lapsista oli jokseenkin kielteinen tai hyvin kielteinen asenne. Mitä enemmän lapsi änkytti, sitä kielteisemmät havainnot ikätovereilla oli hänen puheestaan. Kouluopetukseen yhdistetyillä interventioilla oli myönteisiä vaikutuksia lasten ja nuorten asenteisiin. Myös yksittäisen änkytysaiheisen esitelmän kuuntelu tai videon katsominen muutti nuorten asenteita myönteisemmiksi. Tapaustutkimuksessa änkyttävän lapsen kiusaaminen väheni, kun hän osallistui puheterapeutin toteuttamaan interventioon. Hän harjoitteli puheterapiassa roolileikin avulla kiusaamisen kohtaamista ja sen lisäksi piti luokalleen esitelmän änkyttämisestä puheterapeutin kanssa.
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(2017)Tavoitteet. Puheen ja musiikin äänet käsitellään aivoissa osittain yhteisesti. Molempien virtaa pilkotaan pienemmiksi yksiköiksi rytmin, painon, ajoituksen ja sävelkulun avulla. Nämä puheen prosodiset ominaisuudet muistuttavat sen laulun kaltaisuudesta ja läheisestä yhteydestä musiikkiin. Onkin päätelty, että musiikki voisi toimia tehokkaana kanavana kielellisten häiriöiden kuntoutuksessa. Tämän tutkimuksen tavoitteena oli selvittää, miten musiikin soveltuvuutta dysleksian ja kielellisen erityisvaikeuden kuntoutuksessa on tutkittu vuosina 2014 – 2017. Kiinnostus kohdistuu siihen, mitä musiikin ja prosodian havaitsemiseen liittyviä akustisia ominaisuuksia aineistossa on tutkittu ja hyötyvätkö tutkittavat musiikin käytöstä kuntoutuksessa. Menetelmät. Tämän tutkimuksen menetelmänä toimi kuvaileva kirjallisuuskatsaus. Aineistoa haettiin käsitteiden dyslexia, prosody, music-based auditory training, music ja musical intervention avulla.Termi specific language impairment jätettiin hakulausekkeen ulkopuolelle, koska se vei fokuksen pois pääasiasta, dysleksiasta. Aineistoa haettiin Scopus-, Pubmed- ja Web of Science-tietokannoista ja myös Google Scholar-hakukoneen avulla. Lopullinen aineisto sisältää 4 tutkimusartikkelia. Tulokset ja johtopäätökset. Musiikin ja prosodian havaitsemiseen liittyvien akustisten ominaisuuksien tutkimus on dysleksian kohdalla pidemmällä kuin SLI:n. Molempien kohdalla tutkittiin rytmiä, sanan tai tavun painotusta, kestoa, musiikillista pulssia ja äänen nousuaikaa. Dysleksiatutkimuksessa tutkittiin erillisesti kategorista havaitsemista ja SLI:n kohdalla äänen- tai sävelkorkeuden ja rytmin samanaikaista havaitsemista. Habibilla ja ryhmällä (2016) oli ainoana musiikillisen intervention (CMT) vaikuttavuutta dysleksian kuntoutuksessa koskeva tutkimus, jonka tuloksena lukemistulokset paranivat melkein yhden standardipoikkeaman verran sekä myös auditiivinen tarkkaavuus 20 % mittausten 1 ja 2 välillä ja vielä 6 vk CMT:n jälkeenkin. SLI-lasten heikko musiikillisen pulssin havaitseminen ennakoi selvästi sekä puheen ymmärtämistä että ilmaisua. Heidän kohdallaan musiikillinen kuntoutus edellyttää dysleksialapsiin verrattuna tarkempaa suunnittelua, jossa musiikillinen pulssi tukee ilmauksen prosodista fraseerausta. Tutkimusta tarvitaan lisää. Avainsanat - Nyckelord Dysleksia, prosodia, lapset, musiikkiin pohjautuva auditiivinen harjoittelu, musiikki, musiikillinen interventio
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(2019)Tavoitteet. Lukemisen vaikeus on yleinen oppimisvaikeus, jolla on vaikutusta monen lapsen ja nuoren elämään niin Suomessa kuin muuallakin maailmassa. Lukemiseen liittyvillä vaikeuksilla saattaa olla vaikutusta myös lapsen tai nuoren yleiseen hyvinvointiin, johon puolestaan on olennaisesti kytköksissä itsetunto. Tämän tutkielman tavoitteena oli selvittää, minkälaisia vaikutuksia lukemisen vaikeuksilla on 2000-luvun puolella julkaistuissa tutkimuksissa itsetuntoon ja sen eri osa-alueisiin. Tämän lisäksi haluttiin tarkastella lukemisen vaikeuden rinnalla itsetuntoa heikentäviä tai kohentavia tekijöitä, jotta saataisiin tietoa itsetuntoon liittyvän kohdennetun tuen tarpeessa olevista lapsista ja nuorista. Menetelmä. Tutkimusmenetelmänä käytettiin integroivaa kirjallisuuskatsausta. Tieteellisiä tutkimusartikkeleita haettiin maaliskuussa 2019 kolmesta tietokannasta: Scopuksesta, Ovid Medlinesta ja Web of Sciencesta. Lopullisessa hakulausekkeessa yhdisteltiin lukemisen vaikeuksiin, itsetuntoon sekä lapsuuteen ja nuoruuteen liittyviä englanninkielisiä termejä. Lopullinen tutkimusaineisto koostui seitsemästä Scopuksesta löytyneestä tutkimusartikkelista, jotka vastasivat tämän kandidaatintutkielman tutkimuskysymyksiin. Tutkielman tulokset saatiin kerättyä tutkimusaineistoa analysoimalla. Tulokset ja johtopäätökset. Aineistosta nousi esiin, että lasten ja nuorten lukemisen vaikeuksilla on yhteys alentuneeseen itsetuntoon, mutta ei kuitenkaan kaikilla itsetunnon osa-alueilla. Yleisen itsetunnon osalta tulokset olivat ristiriitaisia, sillä osassa tutkimuksista yleinen itsetunto oli alentunut ja osassa normaali. Aineiston vertailun perusteella itsetunnon osa-alueista useimmiten tilastollisesti merkitsevästi heikentynyt oli kouluun sidonnainen tai akateeminen itsetunto. Itsetuntoa heikentäväksi tekijöiksi todettiin lukemisen vaikeuden rinnalla esiintyvät tarkkaavuuden ja puheen tuoton vaikeudet sekä naissukupuoli ja siihen liittyvät emotionaaliset ja välttelyyn perustuvat selviytymismekanismit. Itsetuntoa kohentavaksi tekijäksi todettiin puolestaan dysleksiadiagnoosi. Näiden tulosten perusteella lukemisen vaikeudet altistavat lapsen tai nuoren etenkin kouluun sidonnaisen itsetunnon heikentymiselle, mutta erityisesti mahdollisimman varhaisessa vaiheessa annettu diagnoosi voi suojata lasta itsetunto-ongelmilta.
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