Leena Joskitt

Comorbid Psychiatric Disorders Associated with Asperger Syndrome/High-functioning Autism: A Community- and Clinic-based Study

The present study identifies the prevalence and types of comorbid psychiatric disorders associated with Asperger syndrome (AS)/high-functioning autism (HFA) in a combined community- and clinic-based sample of fifty 9- to 16-year-old subjects using the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version. The level of functioning was estimated using the Children’s Global Assessment Scale. The results support common (prevalence 74%) and often multiple comorbid psychiatric disorders in AS/HFA; behavioral disorders were shown in 44%, anxiety disorders in 42% and tic disorders in 26%. Oppositional defiant disorder, major depressive disorder and anxiety disorders as comorbid conditions indicated significantly lower levels of functioning. To target interventions, routine evaluation of psychiatric comorbidity in subjects with AS/HFA is emphasized.

Multi-informant reports of psychiatric symptoms among high-functioning adolescents with Asperger syndrome or autism

The aim of the study was to examine psychiatric symptoms in high-functioning adolescents with autism spectrum disorders reported by multiple informants. Forty-three 11- to 17-year-old adolescents with Asperger syndrome (AS) or high-functioning autism (HFA) and 217 typically developed adolescents completed the Youth Self-Report (YSR), while their parents completed the Child Behavior Checklist (CBCL). Teachers of adolescents with AS/HFA completed the Teacher Report Form (TRF). The informants reported significantly more psychiatric symptoms, especially withdrawn, anxious/depressed, social and attention problems, in adolescents with AS/HFA than in controls. In contrast to findings in the general population, the psychiatric problems of adolescents with AS/HFA are well acknowledged by multiple informants, including self-reports. However, anxiety and depressive symptoms were more commonly reported by adolescents with AS/HFA and their teachers than their parents, indicating that some emotional distress may be hidden from their parents.

Psychometric evaluation of social phobia and anxiety inventory for children (SPAI-C) and social anxiety scale for children-revised (SASC-R)

The study evaluated the psychometric properties of Finnish versions of the Social Phobia and Anxiety Inventory for Children (SPAI-C) and the Social Anxiety Scale for Children-Revised (SASC-R). 352 students (M = 12.2 years) participated in the study and completed the SPAI-C and SASC-R. In addition, 68 participants (M = 12.2 years) and their parents were interviewed with the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS-PL). The SPAI-C was more sensitive for identifying youth meeting criteria for social phobia (SP), whereas the SASC-R demonstrated greater specificity. The youth in this sample had lower mean total scores on the self-report questionnaires than did those in the original validitation studies of the SPAI-C and SASC-R conducted in America. These findings question whether cross-cultural differences in the expression of SP influence the clinical cut-off scores used in translated versions of social anxiety questionnaires.The study evaluated the psychometric properties of Finnish versions of the Social Phobia and Anxiety Inventory for Children (SPAI-C) and the Social Anxiety Scale for Children-Revised (SASC-R). 352 students (M = 12.2 years) participated in the study and completed the SPAI-C and SASC-R. In addition, 68 participants (M = 12.2 years) and their parents were interviewed with the Schedule for Affective Disorders and Schizophrenia for School Aged Children (K-SADS-PL). The SPAI-C was more sensitive for identifying youth meeting criteria for social phobia (SP), whereas the SASC-R demonstrated greater specificity. The youth in this sample had lower mean total scores on the self-report questionnaires than did those in the original validitation studies of the SPAI-C and SASC-R conducted in America. These findings question whether cross-cultural differences in the expression of SP influence the clinical cut-off scores used in translated versions of social anxiety questionnaires.

Screening infants with social and emotional problems: A pilot study on the brief infant oddler social and emotional assessment (Bitsea) in northern Finland

Abstract Objectives. To compare 3 questionnaires used to evaluate early developmental problems, emotionaldisturbances and competence in 18-month-old infants. Study design. A follow-up study with parents of infants 8 to 36 months of age who responded to adevelopmental questionnaire. Methods. Fifty infants (18 months of age) were evaluated through 3 questionnaires: (1) the BriefInfant and Toddler Social and Emotional Assessment (BITSEA), (2) the Child Behavior Checklist(CBCL) and (3) the MacArthur Communicative Development Inventories (MCDI). Results. The BITSEA-questionnaire results (total problem scores) had a strong correlation with themost CBCL subscales and the MCDI (total scores) and gave more precise information concerningthe infants’ developmental problems. Conclusions. The BITSEA questionnaire identifies developmental problems in the early stages andscreens infants’ social-emotional competence.

A pilot longitudinal follow-up study of the Brief Infant Toddler Social-Emotional Assessment (BITSEA) in Northern Finland: examining toddlers' social-emotional, behavioural and communicative development

Developmental needs should be assessed in early infancy and followed longitudinally to improve identification, prevention and intervention efforts.The objective was to examine the relationship between competencies and areas of need in toddlers’ development, and to describe the properties and utility of the Brief Infant Toddler Social–Emotional Assessment (BITSEA) in a pilot study in Northern Finland. Parents (N = 50) evaluated toddler development at 18 and 36 months. Assessments included the BITSEA, the Child Behavior Checklist and the MacArthur Communicative Development Inventories. Lower communicative skills were associated with an increase in toddler behavioural problems. Social–emotional competence (S-EC) was associated with better communication development. Parents reporting enhanced communication skills and S-EC in their toddlers also reported fewer behavioural problems in their young children; however, further research employing the BITSEA in a larger and heterogeneous sample of Finnish children is needed to determine appropriate cut-off scores and reliability especially for the unique subscales of BITSEA.

The association between parental images and satisfaction in intimate relationships in a Northern Finland sample

Objectives. Experiences in one’s family of origin, especially the relationship to one’s parents, supposedly form the basis of relationships in adulthood. The connection between traumatic childhood events and later life has been studied intensively, whereas average childhood growth experiences have been given less attention. The aim of this study was to find out the association between images of the mother and father and the psychosocial well-being of young adults from the perspective of satisfaction in intimate relationships. Study design. Cross-sectional study. Methods. The research is a part of the Oulu University Hospital “Mother-Child Follow-up Study 1971– 1972’’. The follow-up data were collected from the young adults (n=337) in 2000 by way of mailed questionnaires, which included 17 questions about the participants’ images of their parents and 18 questions about their intimate relationship satisfaction. In this study we used attachment theory as a theoretical frame of reference. Results. Mental images of dominating parents were associated with quarrelsome intimate relationships, and the image of a dominating father, with repressive/submissive and less balanced relationships. Mental images of diligent and sociable parents were associated with a loving and balanced relationship, and the image of supportive parents, with a balanced relationship. Parental diligence was associated with a less quarrelsome relationship. Conclusion. The young adults’ mental images of their parents were associated with their intimate relationship satisfaction. Positive mental images of the father, in particular, seemed to protect young adults from a quarrelsome and repressive/submissive intimate relationship.

Twinship as a protective factor against behavioural and emotional problems at preschool age

Early attachment has both protective and risk factors as regards later mental health. In Finland, insecure-avoidant-type attachment is overrepresented. Does this indicate a risk for emotional and behavioural problems at preschool age? In this study, we examined and compared the association between attachment and mental health in Finnish singletons and twins. The attachment of 27 singletons and 58 twins with both parents had previously been examined at the age of 18 months using Preschool Assessment of Attachment criteria. At the age of 4, the childrens emotional and behavioural symptoms were assessed using Child Behavior Checklist questionnaires reported by parents. The mothers and fathers reported significantly more behavioural and emotional problems at preschool age in singletons than in twins. Insecure-avoidant-type attachment to the mother was significantly associated with higher scores concerning withdrawal, somatic problems and total internalising symptoms among singleton preschoolers, whereas among twins, no such correlations were observed. The results thus suggest that twinship is a protective factor in the trajectory from toddler avoidant attachment to internalising problems at preschool age.