Browsing by Subject "Adolescents"

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  • Suomalainen, L.; Haravuori, H.; Berg, N.; Kiviruusu, O.; Marttunen, M. (2011)
    Background: In November 2007, a student shot eight people and himself at Jokela High School, Finland. This study aims to evaluate the long-term effects of exposure to a school shooting among adolescents. Method: Associations between psychological outcomes and background factors were analysed and compared with "comparison students" four months after the incident. A questionnaire including Impact of Event Scale (IES) and General Health Questionnaire (GHQ-36) was used. Results: Half of the females and a third of the males suffered from posttraumatic distress. High level of posttraumatic distress (IES >= 35), predicting PTSD, was observed in 27% of the females and 7% of the males. The odds ratio was 6.4 (95% confidence interval 3.5-10.5) for having high levels of posttraumatic distress. Severe or extreme exposure and female gender were found to increase the risk. Forty-two percent of the females and 16% of the males had psychiatric disturbance (GHQ >= 9). Severe or extreme exposure, older age and female gender increased the risk. Perceived support from family and friends was found to be protective. Conclusions: The observed risk and protective factors were similar to earlier studies. Follow-up will be essential in identifying factors predicting persisting trauma-related symptoms in adolescence. (C) 2010 Elsevier Masson SAS. All rights reserved.
  • Holm, Marja; Björn, Piia Maria; Laine, Anu; Korhonen, Johan; Hannula, Markku S. (2020)
    This study investigated mathematics-related achievement emotions among Finnish adolescents (N = 1379) receiving special education support (SEdS) in self-contained and general mathematics classrooms and receiving no mathematics SEdS through multilevel modeling. Mathematics performance, gender, and classroom size were controlled for. Adolescents receiving SEdS in general classrooms reported less enjoyment and pride and more anger, anxiety, shame, hopelessness, and boredom than those receiving SEdS in self-contained classrooms and those receiving no SEdS. In contrast, adolescents receiving SEdS in self-contained classrooms reported more enjoyment and pride and less anger, anxiety, and hopelessness than those receiving no SEdS. Furthermore, adolescents receiving no SEdS reported more anxiety, hopelessness, and boredom in general classrooms when the proportion of classmates receiving SEdS was higher. We discuss the practical implications for developing SEdS in relation to achievement emotions.
  • Katainen, Anu; Heikkilä, Riie (2020)
    Critical discussions on the focus group method have highlighted the importance of considering the forms of interaction generated in groups. In this empirical paper we argue that these forms of interaction are intimately linked to the ways participants interpret the study setting, and these interpretations are likely to differ significantly depending on participants' social backgrounds. In the light of our data consisting of 18 focus groups with 15-year-old school pupils from both affluent and deprived neighbourhoods of Helsinki discussing film clips about young people drinking alcohol, we ask what kinds of modes of participation are mobilised in focus group discussions in order to mark the social position of participants. We further analyse these modes in relation to situated identity performances, arguing that contextual factors of the study setting become especially important to consider when researching vulnerable groups and heterogeneous populations. The analysis yields three modes of participation: these are active/engaged, resistant/passive and dominant/transformative. We argue that these modes can be viewed as actively taken positions that reveal what kinds of identities and competences participants are able and willing to mobilise in the study setting, and that recognising these modes is important in all interview settings.
  • Castren, Sari; Grainger, Marjut; Lahti, Tuuli; Alho, Hannu; Salonen, Anne H. (2015)
    Background: Adolescent gambling and substance use are viewed as a public health concern internationally. The early onset age of gambling is a known risk factor for developing gambling problems later in life. The aims of this study are: to evaluate the internal consistency reliability, factorial validity and classification accuracy of the Finnish version of DSM-IV-Multiple Response-Juvenile (DSM-IV-MR-J) criteria measuring at-risk/problem gambling (ARPG); to examine gender differences in gambling participation, ARPG and substance use among first-year junior high school students; and to investigate the association of gambling and gaming (video game playing) participation, substance use and social variables with ARPG. Methods: This study examined 988 adolescents (mean age 13.4 years) at 11 public schools in Finland between October-December 2013. The response rate was 91.6%. Chi-squared test and binary logistic regression analysis were used. Results: 'Illegal acts' was the most endorsed and sensitive, but the least specific criteria identifying ARPG. During the past year, 51.6% of the respondents had gambled, 7.9% were identified as at-risk/problem gamblers (DSM-IV-MR-J score >= 2), 8.0% had smoked and 8.9% had been drinking for intoxication, and the first three were significantly more common among boys than girls. The odds ratio of being a male past-year at-risk/problem gambler was 2.27, 5.78 for gambling often or sometimes, 2.42 for video game playing weekly or more often and 6.23 for having peer gamblers. Conclusions: Overall, the Finnish version of the DSM-IV-MR-J had acceptable internal consistency reliability and factorial validity. None of the DSM-IV-MR-J criteria were accurate enough to screen ARPG per se. ARPG past-year prevalence was relatively high with males gambling more than females. ARPG was as common as drinking alcohol for intoxication and smoking. Peer gambling was strongly associated with ARPG. Efficient strategies to minimise the risks of gambling problems, tools for prevention and identification of ARPG among the underage are needed.
  • Liskola, Joni; Haravuori, Henna; Lindberg, Nina; Niemelä, Solja; Karlsson, Linnea; Kiviruusu, Olli; Marttunen, Mauri (2018)
    Background: The Alcohol Use Disorders Identification Test (AUDIT) is commonly used in adults to screen for harmful alcohol consumption but few studies exist on its use among adolescents. Our aim was to validate the AUDIT and its derivative consumption questionnaire (AUDIT-C) as screening instruments for the detection of problem use of alcohol in adolescents. Methods: 621 adolescents (age-range, 12-19 years) were drawn from clinical and population samples who completed the AUDIT questionnaire. Psychiatric diagnoses were assessed using K-SADS-PL. A rating based on the K-SADS-PL was used to assess alcohol use habits, alcohol use disorders, screening and symptom criteria questions. Screening performance of the AUDIT and AUDIT-C sum scores and Receiver Operating Characteristic (ROC) curves were calculated. The diagnostic odds ratios (dOR) were calculated to express the overall discrimination between cut-offs. Results: Comparisons of ROC between the AUDIT and AUDIT-C pairs indicated a slightly better test performance by AUDIT for the whole sample and in a proportion of the subsamples. Optimal cut-off value for the AUDIT was >= 5 (sensitivity 0.931, specificity 0.772, dOR 45.22; 95% CI: 24.72-83.57) for detecting alcohol problem use. The corresponding optimal cut-off value for the AUDIT-C was >= 3 in detecting alcohol problem use (sensitivity 0.952, specificity 0.663, dOR 39.31; 95% CI: 19.46-78.97). Agreement between the AUDIT and AUDIT-C using these cut-off scores was high at 91.9%. Conclusions: Our results for the cut-off scores for the early detection of alcohol problem use in adolescents are >= 5 for AUDIT, and >= 3 for AUDIT-C.
  • Mustelin, Linda; Kaprio, Jaakko; Keski-Rahkonen, Anna (2018)
    Objective: Binge eating disorder (BED) is a clinical eating disorder that is strongly and bidirectionally related to overweight and obesity. Little is known about how subclinical features of BED relate to weight development in adolescence and young adulthood. Method: Women (n=2825) and men (n=2423) from the community-based longitudinal FinnTwin16 cohort participated. Seven eating-related cognitions and behaviors similar to the defining features of BED were extracted from the Eating Disorder Inventory-2 and were assessed at a mean age of 24. We used linear mixed models to assess the association of features of BED with BMI trajectories across four waves of data collection (mean ages 16, 17, 18, and 24). Results: The number of features of BED at wave 4 (age 24) was significantly associated with BMI from age 16 years onwards. Those reporting more features of BED had gained more weight throughout adolescence and into their twenties. Conclusions: Features of BED in young adulthood were preceded by steeper BMI trajectories in adolescence. A higher number of features were consistently associated with higher BMI and more weight gain.
  • Holm, Marja Eliisa; Korhonen, Johan; Laine, Anu; Björn, Piia Maria; Hannula, Markku Sakari (2020)
    This study investigated the big-fish-little-pond effect (BFLPE) on mathematics-related achievement emotions (enjoyment, pride, anger, anxiety, shame, hopelessness, and boredom) among adolescents (N = 1322) using multilevel modeling, controlling for the effects of gender and classroom size. The results indicated that only pride was influenced by the BFLPE. Hence, adolescents reported less pride in mathematically higher-performing classrooms (higher class average). The cross-level interaction effects indicated that the BFLPE varies across mathematics performance levels and gender. In mathematically higher-performing classrooms, adolescents with lower mathematics performance reported less pride and more shame, whereas adolescents with higher mathematics performance reported less enjoyment and more boredom. Additionally, males reported more shame in higher-performing classrooms. We discuss the practical implications of supporting achievement emotions in higher-performing classrooms.
  • Lommi, Sohvi; Viljakainen, Heli T.; Weiderpass, Elisabete; de Oliveira Figueiredo, Rejane Augusta (2020)
    Purpose To validate the Children's Eating Attitudes Test (ChEAT) in the Finnish population. Materials and methods In total 339 children (age 10-15 years) from primary schools in Southern Finland were evaluated at two time points. They answered the ChEAT and SCOFF test questions, and had their weight, height and waist circumference measured. Retesting was performed 4-6 weeks later. Test-retest reliability was evaluated using intra-class correlation (ICC), and internal consistency was examined using Cronbach's alpha coefficient (C-alpha). ChEAT was cross-calibrated against SCOFF and background variables. Factor analysis was performed to examine the factor structure of ChEAT. Results The 26-item ChEAT showed high internal consistency (C-alpha 0.79), however, a 24-item ChEAT showed even better internal consistency (C-alpha 0.84) and test-retest reliability (ICC 0.794). ChEAT scores demonstrated agreement with SCOFF scores (p <0.01). The mean ChEAT score was higher in overweight children than normal weight (p <0.001). Exploratory factor analysis yielded four factors (concerns about weight, limiting food intake, pressure to eat, and concerns about food), explaining 57.8% of the variance. Conclusions ChEAT is a valid and reliable tool for measuring eating attitudes in Finnish children. The 24-item ChEAT showed higher reliability than the 26-item ChEAT.
  • Lallukka, Tea; Mekuria, Gashaw B.; Nummi, Tapio; Virtanen, Pekka; Virtanen, Marianna; Hammarström, Anne (2019)
    BackgroundCo-occurrence of mental and somatic symptoms is common, and recent longitudinal studies have identified single trajectories of these symptoms, but it is poorly known whether the symptom trajectories can also co-occur and change across the lifespan. We aimed to examine co-occurring symptoms and their joint trajectories from adolescence to midlife.MethodsLongitudinal data were derived from Northern Sweden, where 506 girls and 577 boys aged 16years participated at baseline in 1981 (99.7% of those initially invited), and have been followed up in four waves until the age of 43. Survey data were collected about depressive, anxiety, and somatic symptoms. Potential joint development of this three-component symptom set was examined with multiple response trajectory analysis, a method that has not been previously used to study co-occurrence of these symptoms.ResultsWe identified a five trajectory solution as the best: very low (19%), low (31%), high (22%), late sharply increasing (16%) and a very high increasing (12%). In the late sharply increasing and very high increasing groups the scores tended to increase with age, while in the other groups the levels were more stable. Overall, the results indicated that depressive, anxiety, and somatic symptoms co-exist from adolescence to midlife.ConclusionsThe multiple response trajectory analysis confirmed high stability in the co-occurrence of depressive, anxiety, and somatic symptoms from adolescence to midlife. Clinicians should consider these findings to detect symptoms in their earliest phase in order to prevent the development of co-occurring high levels of symptoms.
  • Lallukka, Tea; Mekuria, Gashaw B; Nummi, Tapio; Virtanen, Pekka; Virtanen, Marianna; Hammarström, Anne (BioMed Central, 2019)
    Abstract Background Co-occurrence of mental and somatic symptoms is common, and recent longitudinal studies have identified single trajectories of these symptoms, but it is poorly known whether the symptom trajectories can also co-occur and change across the lifespan. We aimed to examine co-occurring symptoms and their joint trajectories from adolescence to midlife. Methods Longitudinal data were derived from Northern Sweden, where 506 girls and 577 boys aged 16 years participated at baseline in 1981 (99.7% of those initially invited), and have been followed up in four waves until the age of 43. Survey data were collected about depressive, anxiety, and somatic symptoms. Potential joint development of this three-component symptom set was examined with multiple response trajectory analysis, a method that has not been previously used to study co-occurrence of these symptoms. Results We identified a five trajectory solution as the best: “very low” (19%), “low” (31%), “high” (22%), “late sharply increasing” (16%) and a “very high increasing” (12%). In the “late sharply increasing” and “very high increasing” groups the scores tended to increase with age, while in the other groups the levels were more stable. Overall, the results indicated that depressive, anxiety, and somatic symptoms co-exist from adolescence to midlife. Conclusions The multiple response trajectory analysis confirmed high stability in the co-occurrence of depressive, anxiety, and somatic symptoms from adolescence to midlife. Clinicians should consider these findings to detect symptoms in their earliest phase in order to prevent the development of co-occurring high levels of symptoms.
  • Castaneda, Anu E.; Tuulio-Henriksson, Annamari; Aronen, Eeva T.; Marttunen, Mauri; Kolho, Kaija-Leena (2013)
  • Hagquist, Curt; Valimaa, Raili; Simonsen, Nina; Suominen, Sakari (2017)
    Although there is an increasing focus on trend analyses of adolescent mental health, yet too little attention is paid to the methodological challenges and pitfalls inherent in this type of analyses. The purpose of the study is to analyse the psychometric properties of a Finnish instrument on psychosomatic problems, with a major focus on Differential Item Functioning (DIF) across time. Questionnaire data collected in 1994, 1998, 2006 and 2014 among Finnish schoolchildren in grade 9 (15-year-olds) as part of the Health Behaviour in School-aged Children (HBSC) study were utilised. The polytomous Rasch model was used to examine the psychometric properties of a composite measure of psychosomatic problems. The results clearly indicate that the composite measure on psychosomatic problems consisting of nine items does not work invariantly over time. In particular, the item depressed shows DIF across years of investigations. This item works quite differently at the first year of investigation compared to the last year showing higher expected values 2014 (=less frequent problems) than 1994. This DIF affects the person measure of change in psychosomatic problems between 1994 and 2014. Resolving the item depressed for year of investigation DIF, or removing it, increases the difference in person mean values between the two years, implying increasing psychosomatic problems over time. Since the DIF affects the trend results, different options to address the problems need to be considered. Removing the item depressed would bring the Finnish measure of psychosomatic problems in better accordance with the content of the questions on psychosomatic problems in the international HBSC protocol in which the item depressed is not included.
  • Wiegman, Albert; Gidding, Samuel S.; Watts, Gerald F.; Chapman, M. John; Ginsberg, Henry N.; Cuchel, Marina; Ose, Leiv; Averna, Maurizio; Boileau, Catherine; Boren, Jan; Bruckert, Eric; Catapano, Alberico L.; Defesche, Joep C.; Descamps, Olivier S.; Hegele, Robert A.; Hovingh, G. Kees; Humphries, Steve E.; Kovanen, Petri T.; Kuivenhoven, Jan Albert; Masana, Luis; Nordestgaard, Borge G.; Pajukanta, Paevi; Parhofer, Klaus G.; Raal, Frederick J.; Ray, Kausik K.; Santos, Raul D.; Stalenhoef, Anton F. H.; Steinhagen-Thiessen, Elisabeth; Stroes, Erik S.; Taskinen, Marja-Riitta; Tybjaerg-Hansen, Anne; Wiklund, Olov; European Atherosclerosis Soc Conse (2015)
    Familial hypercholesterolaemia (FH) is a common genetic cause of premature coronary heart disease (CHD). Globally, one baby is born with FH every minute. If diagnosed and treated early in childhood, individuals with FH can have normal life expectancy. This consensus paper aims to improve awareness of the need for early detection and management of FH children. Familial hypercholesterolaemia is diagnosed either on phenotypic criteria, i.e. an elevated low-density lipoprotein cholesterol (LDL-C) level plus a family history of elevated LDL-C, premature coronary artery disease and/or genetic diagnosis, or positive genetic testing. Childhood is the optimal period for discrimination between FH and non-FH using LDL-C screening. An LDL-C a parts per thousand yen5 mmol/L (190 mg/dL), or an LDL-C a parts per thousand yen4 mmol/L (160 mg/dL) with family history of premature CHD and/or high baseline cholesterol in one parent, make the phenotypic diagnosis. If a parent has a genetic defect, the LDL-C cut-off for the child is a parts per thousand yen3.5 mmol/L (130 mg/dL). We recommend cascade screening of families using a combined phenotypic and genotypic strategy. In children, testing is recommended from age 5 years, or earlier if homozygous FH is suspected. A healthy lifestyle and statin treatment (from age 8 to 10 years) are the cornerstones of management of heterozygous FH. Target LDL-C is <3.5 mmol/L (130 mg/dL) if > 10 years, or ideally 50% reduction from baseline if 8-10 years, especially with very high LDL-C, elevated lipoprotein(a), a family history of premature CHD or other cardiovascular risk factors, balanced against the long-term risk of treatment side effects. Identifying FH early and optimally lowering LDL-C over the lifespan reduces cumulative LDL-C burden and offers health and socioeconomic benefits. To drive policy change for timely detection and management, we call for further studies in the young. Increased awareness, early identification, and optimal treatment from childhood are critical to adding decades of healthy life for children and adolescents with FH.
  • Lindfors, Pirjo; Minkkinen, Jaana; Rimpelä, Arja; Hotulainen, Risto (2018)
    Research on the associations between family and school social capital, school burnout and academic achievement in adolescence is scarce and the results are inconclusive. We examined if family and school social capital at the age of 13 predicts lower school burnout and better academic achievement when graduating at the age of 16. Using data from 4467 Finnish adolescents from 117 schools and 444 classes a three-level multilevel analysis was executed. School social capital, the positive and supportive relationships between students and teachers, predicted lower school burnout and better academic achievement among students. Classmates' family social capital had also significance for students' academic achievement. Our results suggest that building school social capital is an important aspect of school health and education policies and practices.
  • Silventoinen, Karri; Su, Jinni; Pulkkinen, Lea; Barr, Peter; Rose, Richard J.; Dick, Danielle M.; Kaprio, Jaakko (2019)
    We analyzed how the effects of genetic and environmental factors on the perceptions of family interaction change from early to late adolescence. The data were collected by postal surveys on Finnish twins (N=4808) at 12, 14 and 17years of age and analyzed using genetic twin modeling. Additive genetic factors explained a modest share of the variation in perceived relational support (a(2)=0.30 in boys and 0.18 in girls) and relational tensions (a(2)=0.13 and 0.14, respectively) at 12years of age, with the proportions becoming larger through 17years of age (a(2)=0.53 in boys and 0.49 in girls for relational support; a(2)=0.35 in boys and 0.33 in girls for relational tensions). Simultaneously, the role of environment shared by co-twins decreased. These findings suggest that the associations between perceived family interaction and other factors in adulthood should be interpreted with caution, because they partly reflect genetic background, whereas in childhood, they may provide more reliable information on parental characteristics.
  • Dobewall, Henrik; Lindfors, Pirjo; Karvonen, Sakari; Koivusilta, Leena; Vainikainen, Mari-Pauliina; Hotulainen, Risto; Rimpelä, Arja (BioMed Central, 2019)
    Abstract Background The health selection hypothesis suggests that poor health leads to low educational attainment during the life course. Adolescence is an important period as poor health might prevent students from making the best educational choices. We test if health in adolescence is associated with educational aspirations and whether these associations persist over and above sociodemographic background and academic achievement. Methods Using classroom surveys, a cohort of students (n = 5.614) from the Helsinki Metropolitan Region was followed from the 7th (12–13 years,) up to the 9th grade (15–16 years) when the choice between the academic and the vocational track is made in Finland. Health factors (Strengths and Difficulties Questionnaire (SDQ), self-rated health, daily health complaints, and long-term illness and medicine prescribed) and sociodemographic background were self-reported by the students. Students’ educational aspirations (applying for academic versus vocational track, or both) and their academic achievement were obtained from the Joint Application Registry held by the Finnish National Agency for Education. We conducted multilevel multinomial logistic regression analyses, taking into account that students are clustered within schools. Results All studied health factors were associated with adolescents’ educational aspirations. For the SDQ, daily health complaints, and self-rated health these associations persisted over and above sociodemographic background and academic achievement. Students with better health in adolescence were more likely to apply for the academic track, and those who were less healthy were more likely to apply for the vocational track. The health in the group of those students who had applied for both educational tracks was in between. Inconsistent results were observed for long-term illness. We also found robust associations between educational aspirations and worsening health from grade 7 to grade 9. Conclusions Our findings show that selection by health factors to different educational trajectories takes place at early teenage much before adolescents choose their educational track, thus supporting the health selection hypothesis in the creation of socioeconomic health inequalities. Our findings also show the importance of adolescence in this process. More studies are needed to reveal which measures would be effective in helping students with poor health to achieve their full educational potential.
  • Dobewall, Henrik; Lindfors, Pirjo; Karvonen, Sakari; Koivusilta, Leena; Vainikainen, Mari-Pauliina; Hotulainen, Risto; Rimpelä, Arja (2019)
  • Engberg, Elina; Figueiredo, Rejane A.O.; Rounge, Trine B.; Weiderpass, Elisabete; Viljakainen, Heli (2020)
    Purpose We aimed to examine whether sedentary screen time changes when transitioning from childhood to adolescence and whether children's screen time, separately for school days and weekends, affects body mass index (BMI) in adolescents. Methods This prospective 3-year follow-up study included 5,084 children with a mean (standard deviation) age of 11 (1) years at baseline and 14 (1) years at follow-up. Children reported screen time, more specifically, time spent viewing TV programs and using a computer outside school while sitting. We categorized children into light, medium, and heavy TV viewers and computer users separately for school days and weekends. We also calculated the age- and gender-specific BMI z-score (BMIz). Results Time spent viewing TV changed from baseline to follow-up on school days and on weekends (p <.001 for both); the proportion of heavy TV viewers on school days (≥3 h/d) increased from 16% to 23% and on weekends (≥4 h/d) from 19% to 30%. Heavy TV viewers and computer users on both school days and on weekends had a higher BMIz 3 years later (p <.001 for all). After adjusting for age, gender, language, baseline BMIz, sleep duration, eating habits, exercise, and the other screen-time variables, heavy TV viewing on weekends remained significantly associated with an increased BMIz at follow-up (B = .078; p = .013). Conclusions The proportion of heavy screen users increases when transitioning from childhood to adolescence. Moreover, heavy screen use, especially on weekends in 11-year-old children, is associated with an increased BMI 3 years later.
  • Laakso, Saila; Valta, Helena; Verkasalo, Matti; Toiviainen-Salo, Sanna-Maria; Viljakainen, Heli; Mäkitie, Outi (2012)
  • Parhiala, P.; Ranta, K.; Gergov, Vera; Kontunen, J.; Law, R.; La Greca, A. M.; Torppa, M.; Marttunen, M. (2020)
    In order to offer early and accessible treatment for adolescents with depression, brief and effective treatments in adolescents' everyday surroundings are needed. This randomized controlled trial studied the preliminary effectiveness, feasibility, and acceptability of interpersonal counseling (IPC) and brief psychosocial support (BPS) in school health and welfare services. The study was conducted in the 28 lower secondary schools of a large city in Southern Finland, randomized to provide either IPC or BPS. Help-seeking 12-16-year-old adolescents with mild-to-moderate depression, with and without comorbid anxiety, were included in the study. Fifty-five adolescents received either 6 weekly sessions of IPC or BPS and two follow-up sessions. Outcome measures included self- and clinician-rated measures of depression, global functioning, and psychological distress/well-being. To assess feasibility and acceptability of the treatments, adolescents' and counselors' treatment compliance and satisfaction with treatment were assessed. Both treatments were effective in reducing depressive disorders and improving adolescents' overall functioning and well-being. At post-treatment, in both groups, over 50% of adolescents achieved recovery based on self-report and over 70% based on observer report. Effect sizes for change were medium or large in both groups at post-treatment and increased at 6-month follow-up. A trend indicating greater baseline symptom severity among adolescents treated in the IPC-providing schools was observed. Adolescents and counselors in both groups were satisfied with the treatment, and 89% of the adolescents completed the treatments and follow-ups. This trial suggests that both IPC and BPS are feasible, acceptable, and effective treatments for mild-to-moderate depression in the school setting. In addition, IPC seems effective even if comorbid anxiety exists. Our study shows that brief, structured interventions, such as IPC and BPS, are beneficial in treating mild-to-moderate depression in school settings and can be administered by professionals working at school.