Browsing by Subject "psykologi"

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  • Haavisto, Anu (Helsingin yliopisto, 2013)
    Organ transplantation (Tx) is a life-saving procedure for patients with end-stage organ failure. Survival rates have improved in recent decades, but the prevalence of neurological and psychiatric morbidities remain high. This is the first study to comprehensively assess cognitive and behavioral outcomes in a national sample of Finnish children who have undergone heart, kidney, or liver Tx. It presents data on 87 children who received transplants between 1993 and 2008. The first aim of this thesis was to assess both global intelligence and a specific neuropsychological profile of pediatric heart, kidney, and liver Tx recipients. The second aim was to compare health-related quality of life and psychosocial adjustment between the Tx groups. Within the cognitive outcome variables, a generalized effect on intelligence was observed, on a group level, in children who underwent heart or kidney Tx, particularly in children with neurological abnormality. Liver Tx children had age-appropriate intelligence. All Tx groups tended to have more problems in nonverbal than in verbal intelligence. In neuropsychological functions, specific visuomotor and visuoconstructive impairment emerged in all Tx groups. In children without neurological comorbidity, few problems emerged in attention, language, or memory and learning. Of the risk factors, early onset and longer disease duration prior to Tx were associated with poorer cognitive outcome, particularly in nonverbal functions. Also, poorer graft function at the time of assessment was associated with lower verbal functions, attention, and memory in kidney Tx children. Within the behavioral outcome variables, no significant differences were observed between heart, kidney, and liver Tx recipients. Parents and teachers reported an increase in internalizing and in the total number of psychiatric symptoms, but these were attributable mainly to a significant increase in somatic complaints. The Tx children themselves found that their health made it more difficult to be with friends, for example, and attend school or hobbies. Of the risk factors, shorter follow-up time after Tx was associated with poorer behavioral outcome. Neurological comorbidity was associated with both self- and proxy-reported behavioral outcome, yet family structure (child not living with both biological parents) and poorer parental health-related quality of life were also negatively associated with the child s adjustment. The outcomes of the majority of school-aged children who have undergone an organ Tx are reassuring. However, a significant minority exhibit considerable global cognitive delay. Additionally, the cognitive profile suggests that Tx children may be susceptible to negative effects in the posterior cortex with associated visuospatial difficulties. Thus, follow-up evaluations of children who have undergone Tx need to include assessment of both intelligence and of other neuropsychological functions, particularly in the domains of visuomotor, visuoconstructive, and visuospatial functions. Further, Tx children and their families should be offered psychosocial support. During cognitive and socioemotional development, new issues may arise; consequently, counseling as a routine part of treatment throughout childhood and adolescence is essential.
  • Ritola, Ville (Helsingfors universitet, 2016)
    Background. Knowing what a psychological test measures and if it works the same way in different contexts, i.e. has measurement invariance (MI), is crucial for its valid and reliable use. The Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV) was published in Finland in 2012. However, recent research suggests that the factor model given in the WAIS-IV test manual and the information regarding MI between different age groups and levels of education are lacking. Methods. This study employed the normative sample of the Finnish WAIS-IV. First, the factor model in the manual was examined and improved using confirmatory factor analysis with a mixed data-theory approach. Second, the new model was tested for strict residual MI for different age groups and levels of education, in order to study if the test reaches an acceptable level of MI. Results and conclusions. The results indicated that the normative data is best modeled by an oblique non-g model. The study also replicated a Spatial Visualization factor with loadings from Block Design, Visual Puzzles and Picture Completion, and Quantitative Reasoning factor with Figure Weights and Arithmetic. A previously unmentioned link in factor analytic literature on WAIS-IV was found between Block Design and Processing Speed factors. The results questioned the link between Arithmetic and Verbal Comprehension factor and found the underlying source of shared variance to be links between Information and Arithmetic, which was interpreted as Educational Achievement. WAIS-IV reached strict residual MI for both different age groups and levels of education. The study offers a more accurate factor model of WAIS-IV and gives confidence that psychologists can reliably apply it over different ages and levels of education in the normal population of Finland.
  • Lilius, Albert (Helsingfors, 1921)