Eila Laukkanen

The prevalence of alexithymia and its relationship with Youth Self-Report problem scales among Finnish adolescents.

This study investigated the relationship between alexithymia, depressive symptoms, and Youth Self-Report (YSR) self-image profiles among 13 to 18-year-old adolescents (n = 7087) attending school in Kuopio, Finland. The final sample consisted of 3936 adolescents (1801 boys, 2135 girls) who completed structured self-rating questionnaires (Toronto Alexithymia Scale [TAS] 20, Beck Depression Inventory [BDI], and YSR) during class periods at school. The overall prevalence of alexithymia was 7.3%. However, girls in all age groups were more frequently alexithymic than boys. Regardless of sex, alexithymic youths reported more depressive symptoms as well as internalizing and externalizing problems than the others. A YSR total score of more than 70 was recorded among 33.4% of alexithymic compared with 3.7% of nonalexithymic adolescents. The TAS-20 correlated significantly with the BDI score, YSR total score, and with internalizing problems. This study revealed alexithymia among adolescents to be associated with various complications such as depressive symptoms, high scores in YSR problem scales, and difficulties in social relationships. Our findings indicate that these adolescents are at high risk of mental disorders and require treatment interventions.

Heavy drinking is associated with more severe psychosocial dysfunction among girls than boys in Finland.

PURPOSE To investigate social, psychological, and environmental factors related to heavy drinking by 15-year-old Finnish school pupils. METHODS Each of 240 pupils completed a questionnaire about alcohol use, smoking, and illicit drug use; an Offer Self-Image Questionnaire; an Inventory of Parent and Peer Attachment; and a Psychosomatic Symptoms Questionnaire. Teachers assessed each pupil according to a Social Skills Rating Scale. Academic achievement was assessed on the basis of report grades. RESULTS Heavy drinking was associated with smoking, trial of drugs, poor social skills in class, and poor school achievement in both boys and girls. In girls, heavy drinking was associated with psychosomatic symptoms and a negative social self-image. Girls who drank heavily also had more difficulty with concentration and externalizing problems and more problems with teachers than those who were abstinent or consumed alcohol moderately. The self-images of boys who drank heavily were more negative than those of alcohol-abstinent boys. In boys, heavy drinking was associated with higher numbers of peer relationships. CONCLUSIONS Heavy drinking is associated with more severe psychosocial dysfunction among girls than boys. It may be possible to identify girls at school who drink heavily and guide them toward treatment.

Mental Disorders in Self-Cutting Adolescents

PURPOSE Self-cutting as a form of self-harm is common in general population adolescents. The aim of this study was to investigate the prevalence of mental disorders and associated factors among self-cutting community-dwelling adolescents. METHODS A sample of adolescents who reported current self-cutting (n = 80) was drawn from a large sample of community adolescents (n = 4205). Of these 80 individuals, 44 consented to further detailed assessment. An age- and gender-matched control subject was selected for each study subject. Data collection included Structured Clinical Interviews for DSM-IV-TR, the Beck Depression Inventory, the Alcohol Use Disorders Identification Test (AUDIT), and the Youth Self-Report for adolescents aged 11-18 years (YSR). RESULTS Major depressive disorder (63% vs. 5%), anxiety disorders (37% vs. 12%), and eating disorders (15% vs. 0%) were more common among self-cutting girls (n = 41) than among controls. None of the self-cutting boys (n = 3) had a DSM-IV-TR Axis I mental disorder. In multivariate model, the presence of major depressive disorder, the AUDIT score and the YSR internalizing subscale score were the factors that were independently associated with the presence of self-cutting in girls. CONCLUSIONS Major depressive disorder, signs of alcohol misuse, and internalizing behavior strongly associate with self-cutting in community-dwelling adolescents, especially in girls.

Spatial Span in Very Prematurely Born Adolescents

The working memory functions and processing speed of 35 adolescents born preterm (≤ 32 weeks of gestation) and those of 31 control adolescents were assessed at the age of 16 years. All study participants were free from major disabilities. There were no statistically significant differences in verbal IQ between the study groups. Adolescents born preterm performed less well in complex spatial span compared to their peers born full term, even when verbal IQ and processing speed were allowed to covary. Both groups performed equally well in other working memory tasks and processing speed. Gestational age was the primary contributor to spatial span performance. These results indicate a minor spatial working memory deficit in preterm born adolescents without major disability and with normal cognitive capacity. Our results are encouraging and indicate only minor neuropsychological consequences due to very preterm birth.

Associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood

This longitudinal study explored associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood. The baseline data were collected in 1996 from 14-year-old pupils (n = 235; 116 girls, 119 boys) at schools using a structured questionnaire that included a 14-item scale of psychosomatic symptoms. The follow-up data were collected in 2006 from the same persons at the age of 24 using the Symptom Checklist-90. Follow-up questionnaires were returned by 149 (63.4%) young adults (88 women and 61 men). Young adults who had many psychosomatic symptoms in adolescence suffered more often than the others from somatization and anxiety symptoms in early adulthood. In addition, women had more symptoms of depression and paranoid ideation, and men had more interpersonal sensitivity and psychotic symptoms. Psychosomatic symptoms in adolescence might be important signals of mental health and this should be taken seriously in school health and in general primary care.

Dissociation in a general population of Finnish adolescents.

Only a few studies have been published concerning dissociation in general population adolescents. We assessed dissociation using the Adolescent Dissociative Experiences Scale (A-DES) in a sample of Finnish adolescents aged 13 to 18 years (n = 4019). The A-DES had good internal reliability and factor analysis suggested a 1-factor solution to be optimal. The younger participants had somewhat higher A-DES scores, but there were no differences between the genders. The mean A-DES score of 0.88 in the whole sample was lower than that in previous studies in other countries. A high level of dissociation was associated with an age of 15 or less, daily smoking, frequent use of alcohol, abuse of legal drugs, cannabis use, social isolation, and poor school performance in mathematics.

Descriptions of Help by Finnish Adolescents Who Self‐Mutilate

PURPOSE The purpose of this study is to describe help from the viewpoint of self-mutilating Finnish adolescents. METHODS Methodological triangulation was used in data collection. Written descriptions were provided by 62 self-mutilating adolescents (aged 12-21 years) of the help they received and wished to receive, and individual interviews were conducted with 10 self-mutilating adolescents (aged 15-22 years). Qualitative content analysis was applied. FINDINGS Three groups of people that can be of help were identified by the self-mutilating adolescents: age-mates, including peers and fellow self-mutilating adolescents; loved ones; and adults, including unknown adults, health and social care professionals, teachers and school counsellors, and parents. Factors contributing and hindering to help were identified. CONCLUSIONS Self-mutilating adolescents want to be helped and, in their opinion, adults are duty-bound to help and care for them.

Dissociation, self-cutting, and other self-harm behavior in a general population of Finnish adolescents

A few studies on adult clinical samples have demonstrated that dissociation predicts self-harm behavior without intent to die. Furthermore, a similar association has been found from selected adolescent populations. However, no studies have been published on the association between dissociation and self-harm behavior in general populations of either adults or adolescents. We investigated whether a high level of dissociation predicts self-cutting or other self-harm behavior in a Finnish general population sample of 4019 adolescents aged between 13 and 18 years. Those with a high level of dissociation measured with the Adolescent Dissociative Experiences Scale had a higher risk of current self-cutting and other self-harm behavior, even when adjusted for several possible confounding factors. Self-cutting adolescents had higher Adolescent Dissociative Experiences Scale scores than those displaying other kinds of self-harm behavior. These results indicate that a high level of dissociation is an independent risk factor for self-harm behavior in adolescents, and may have value both in clinical work and further research.

Helping adolescents who self‐mutilate: parental descriptions

AIM The purpose of this qualitative descriptive study was to explore parental views on how to help adolescents who self-mutilate. BACKGROUND Self-harm, including self-mutilation, is common among adolescents. However, parental conceptions of helping adolescents who self-mutilate have rarely been investigated in nursing science. DESIGN Qualitative descriptive design. METHOD Four parents of self-mutilating adolescents were interviewed in depth. Qualitative content analysis was applied. RESULTS Three main categories emerged: a description of an adolescent who self-mutilates and descriptions of ways to help self-mutilating adolescents and ways to help their parents and family. An adolescent who self-mutilates appears externally to feel very well, but inside feels lonely and inferior to others. Help may include an adolescent helping herself by performing some activities alone or in relation to other people and an adolescent receiving help from a safe and trusting human relationship. Such a relationship can be with anyone who knows about the self-mutilation and is of utmost importance, but a caring attitude is particularly expected from adults. Factors that facilitate helping were identified as well as those considered help-hindering or helpful. Help that had been provided to parents and the family included factors considered helpful and unhelpful. CONCLUSION Adolescents who self-mutilate try to help themselves, but are in need of external, probably professional help. Parents are in need of information about self-mutilation as a phenomenon to be able to help their children. Help for self-mutilating adolescents as perceived by their parents also includes help for the whole family. RELEVANCE TO CLINICAL PRACTICE The findings of this study could assist health care professionals in approaching and helping both self-mutilating adolescents and their parents.

The Association of Parental Alcohol Abuse and Depression with Severe Emotional and Behavioural Problems in Adolescents: A Clinical Study:

Background: Earlier studies have indicated associations between parental psychiatric problems, such as depression, and substance abuse and adolescent problems. Aims: This study aimed to determine whether parental psychiatric problems are associated with problems and problem behaviour in adolescents in a clinical sample. Methods: The study subjects were 70 outpatient adolescents (age 13–18 years, boys 30%) and their parents. The adolescents were assessed using the structural clinical interview for DSM-III-R (SCID) and a semi-structured questionnaire, and the parents were interviewed using a semi-structured questionnaire. Results: Maternal alcohol abuse and depression were associated with serious problems, especially among girls, and paternal alcohol abuse was associated with adolescent health-compromising behaviour. Maternal depression and alcohol abuse had no association with adolescent health-compromising behaviour. Maternal depression without alcohol abuse was associated with the diagnosis of major depressive disorder in adolescents, but not with other adolescent problems, while paternal depression without alcohol abuse was not associated with any adolescent problems. Conclusions: Despite the small study sample, these findings indicate that parental psychiatric problems and alcohol abuse are correlated with adolescent psychological problems and should be considered and assessed when assessing adolescents.