Browsing by discipline "Psykologia"

The purpose of this review was to examine the association between language skills and emotion regulation in preschool children. The association has been shown with several different methods, three of which were reviewed here. First, studies have shown that difficulties and delays in language development often co-occur with emotional difficulties and conduct disorders. Second, inner speech can be used in guiding one's thoughts and actions and third, conversation-based interventions can affect emotional competence including regulation skills. In addition, it was examined which aspects of language are most significant in regard to emotion regulation and it was also considered what might be the mediating mechanisms between language and emotion regulation in light of current research. Children with specific language impairment were twice as likely to have emotional difficulties relative to typically developed children and difficulties were more frequently clinical or disorder level. Children with better language skills used more internalized private speech. Using more internalized private speech was associated with less anger expression and made it possible for those children to use better regulation strategies. Conversation-based interventions had an effect to children's emotional competence including regulation skills and prosocial behaviour. Studies showed that vocabulary size was a significant predictor of regulation skills.

Pain is a common symptom among cancer patients, and its occurrence may result from cancer itself, cancer treatment and/or other non-cancer health problems. Cancer pain is usually treated medically. After the development of the biopsychosocial model of pain it was understood that psychological factors affect the pain experience. Nonpharmacologic interventions are generally the basis of pain management, and psychological interventions significantly contributes to the management of cancer pain. This review examines evidence for psychological interventions that can be used to reveal adults’ cancer pain. The literature search was conducted in one database, PubMed, and the search was limited to years 2010-2019. The search was made using two keyword combinations: 1) psycholog* and oncological pain, and 2) psychological intervention and oncological pain. Articles were chosen by reviewing titles and abstracts. In addition, reference lists of the chosen articles were reviewed to identify additional relevant articles. Articles addressing examination or operation related pain were excluded as well as studies that included children or adolescents. Psychological interventions used in cancer pain management can be divided into skill based and education-based interventions. In skill-based interventions the patient learns concrete coping strategies. In addition, they aim at changing the way the patient interprets pain. In education based interventions the patient acquires information about the disease, analgesic medications, and effective communication regarding pain with health care providers. According to meta-analyses psychological interventions were effective in managing cancer pain. They affected both pain severity and inconvenience. Studies focusing only one intervention type showed partially similar results. Mindfulness-based programs were the most promising of the skill-based interventions. The evidence for hypnosis and yoga was weak, so more research is needed before any clear conclusions can be made. All education-based interventions were effective in managing cancer pain. Thus, pain education seems to be beneficial regardless the way it is implemented.

Chronic pain is a disabling condition with remarkable economic costs and great resistance to treatment. Therefore, it is important to find new methods to recognize patients with high risk of developing chronic pain and to prevent the transition to chronicity. The purpose of this review is to present and evaluate the evidence of cognitive–behavioral interventions as preventive care for chronic pain. The fear–avoidance model of pain suggests that a minority of people with acute pain develop a persistent disability through avoidance behavior thriven by cognitive factors such as pain catastrophizing, fear of movement and false fear–avoidance beliefs. Indeed, psychological factors have been shown to predict the development of chronic pain even better than biomedical factors. Cognitive–behavioral interventions targeting these risk factors appear to be useful in preventing chronic pain and especially in pain-related work absenteeism. It is however unclear whether the positive effects of cognitive–behavioral interventions are mediated through the change in psychological risk factors or rather some other factors, such as therapeutic rapport or peer support that positively affect commitment to treatment. It is important to develop standardized treatment protocols in the future. The effect of intervention timing and the level of psychological risk on the preventive efficacy of cognitive–behavioral interventions should also be further studied. Developing more accurate screening tools to recognize patients with elevated risk of chronic pain in primary care is also crucial for efficient preventive care of pain conditions. In addition to work absenteeism, more attention should be paid to the effects of these early interventions on pain symptoms and patients’ quality of life.

Objectives: Schizophrenia and other psychotic disorders are serious mental illnesses characterized by positive, negative and disorganized symptoms. In addition to the aforementioned symptom types, psychotic disorders are associated with a wide array of cognitive deficits. Cognitive functioning has been found to deteriorate already during the prodromal phase preceding the onset of a psychotic disorder. In schizophrenia, the level of severity of cognitive deficits has been found to become settled fairly quickly after the onset of illness. During the last few decades, a form of neuropsychological rehabilitation called cognitive remediation therapy has been developed for the alleviation of cognitive deficits associated with psychotic disorders. The aim of this review is to examine whether cognitive remediation therapy is an effective form of rehabilitation for people at risk for psychosis, patients with first episode psychosis and patients in the early course of schizophrenia or other psychotic disorders. The effectiveness of cognitive remediation therapy is evaluated in terms of its capabilities to alleviate cognitive deficits and enhance functioning. Methods: The material for this review consists of research articles retrieved from Scopus. The article searches were conducted using various combinations of the following search terms: cognitive remediation, schizophrenia, psychosis, first episode, early course, high risk, prodrom* and premorbid. Two systematic reviews, one combined meta-analysis and systematic review and three original research reports were included in this review. Results: Cognitive remediation therapy has been shown to enhance the cognitive functioning of patients in the early course of psychotic disorders and patients with recent onset psychosis. Positive effects on patients’ functioning have also been found, and alleviation of other symptoms of psychotic disorders due to cognitive remediation therapy has been reported in some studies. Few studies have examined the effectiveness of cognitive remediation therapy for people at risk for psychosis, but current evidence tentatively suggests that this population could also benefit from the treatment. Future studies should investigate how different kinds of cognitive remediation therapy affect different aspects of cognition and functioning, what kinds of factors explain the effects of the treatment and how cognitive remediation therapy could be tailored to the needs of different groups and individuals.

Tavoitteet. Väestön ikääntymisen myötä monet sairaudet, mukaan lukien muistisairaudet tulevat lisääntymään. Alzheimerin tauti on merkittävin dementiaa aiheuttava sairaus, johon riski sairastua kasvaa voimakkaasti iän myötä. Väestön ikääntyminen asettaa haasteita Alzheimerin taudin interventio-, diagnoosi- ja hoitomenetelmille. Ymmärrys sairauden riskitekijöistä ja suojaavista tekijöistä sekä sen etenemisestä niin neuropatologian kuin kliinisen oireiston suhteen auttaa tuleviin haasteisiin vastaamisessa. Kognitiivisen reservin teoria lisää osaltaan tätä ymmärrystä, toisaalta sairastumisriskiä pienentävistä tekijöistä, toisaalta sairauden neuropatologian ja kliinisen ilmentymisen välisestä suhteesta. Kognitiivisen reservin tiedetään antavan yksilölle suojaa Alzheimerin taudin dementiaoireita vastaan ja hidastavan toimintakyvyn laskua. Tämän katsauksen tavoitteena oli selvittää, voiko kognitiivinen reservi suojata yksilöä myös Alzheimerin taudin patologian kehittymiseltä. Menetelmät. Kirjallisuushaku suoritettiin käyttämällä Helka, PubMed ja Scopus tietokantoja. Hakutermeinä käytettiin Cognitive reserve AND Alzheimer’s disease, Alzheimer’s disease biomarkers, Alzheimer’s disease pathology ja Cognitive reserve measurement. Varhaisella iällä (<65v) alkavaa Alzheimerin tautia koskevat tutkimukset jätettiin huomiotta. Muita ehtoja tutkimusajankohdan tai -menetelmien suhteen ei asetettu. Tutkimuskysymyksen kannalta katsaukseen löytyi neljä ’ydintutkimusta’, joista kolme käsitteli kognitiivisen reservin yhteyttä Alzheimerin taudin keskeisimpien biomarkkereiden kehittymiseen. Yksi tutkimuksista käsitteli Alzheimerin taudin tunnetuimman geneettisen riskitekijän, apolipoproteiini E4 alleelin vaikutusta yksilön koulutustaustan ja hippokampuksen rakenteen väliseen suhteeseen. Tulokset ja johtopäätökset. Kognitiivisen reservin ja alzheimerin taudin biomarkkereiden välistä yhteyttä käsitelleet tutkimukset antavat viitteitä siitä, että korkeampi reservi saattaa ehkäistä Beta-amyloidiplakkien muodostumista aivoihin. Tutkimukset sisälsivät tiettyjä rajoitteita, ja olemassa olevat tulokset perustuvat yksittäisiin mittareihin ja pieneen määrään koehenkilöitä. Aiheesta tarvitaan lisää pitkittäistutkimusta. APOE4 alleelin vaikutusta koulutuksen ja hippokampuksen rakenteen väliseen yhteyteen selvittänyt tutkimus osoitti, että riskigeenin kantajilla mediaalisen ohimolohkon tiettyjen alueiden kortikaalinen paksuus lisääntyi suhteessa opiskeluvuosien määrään. Vastaavaa ei havaittu matalan riskin ryhmässä. Havainto kaipaa lisätutkimusta.

My thesis is a scientific review written for psychology students and researchers, wherein I assess factors affecting attitude certainty. Research on persuasion and attitude change has political, commercial, educational, therapeutic and everyday value. The most popular model describing attitude change is the elaboration likelihood model, according to which attitudes shift either through the central route, where people think though the pertinent issue carefully, or through the peripheral route, where environmental cues lead to a shift in the attitude. A large proportion of the research on persuasion and attitude change has been conducted with an emphasis on marketing with relatively homogeneous populations and low-stakes research frames. Therefore, the generalizability of these results warrants skepticism. People have differing cognitive styles and ways of processing information, one of which is the need for cognition. It reflects individual differences in the extent to which people enjoy cognitive tasks. The elaboration likelihood model has been studied through this construct, which has been linked to attitude permanence. However, the need for cognitive closure, which reflects the tendency to form opinions quickly and to hold on to them steadfastly, has been found to have a similar effect. Also, intellectual humility might moderate the connection between elaboration and attitude certainty. In this review I critique the elaboration likelihood model through these contradicting research results. I also reflect on the effects of the thoughtfulness heuristic (which refers to the tendency to feel as if one has thought about a certain issue more than one has) and the type of information assessed (e.g. is the issue familiar or new) on attitude certainty. The material referred to in this review was searched using Scopus and Google Scholar. Keywords used were, among others, ”elaboration likelihood model”, ”attitude change”, ”attitude certainty” and “persuasion”. The material spanned the years 1980–2017. The focus was on articles concerning the elaboration likelihood model, attitude change and differing cognitive styles, many of which were published in the journals ”Journal of Personality and Social Psychology” and ”Personality and Social Psychology”. The elaboration likelihood model’s 7th postulate, according to which attitudes formed through the central route are stronger than the ones formed through the peripheral route, ought to be questioned. Also, the research results on the thoughtfulness heuristic blur the distinction between the model’s central and the peripheral routes. The generalizability of the model is limited, because the variance in cognitive styles is greater than the one in the population used in the creation of the model. Different cognitive styles ought to be compared using longitudinal settings in order to gather more information about the true permanence of attitudes.

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.

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.

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.

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.