Papers by Mauri Marttunen
Journal of Child and Adolescent Behavior, 2016
Background: Associations between psychopathic traits and other forms of psychopathology among you... more Background: Associations between psychopathic traits and other forms of psychopathology among youth in the community, as well as gender differences in these associations have been scarcely studied yet. The present study aimed to explore this relationship in a sample of Finnish mid-adolescent girls and boys. Methods: The sample comprised 370 secondary school ninth-graders with the mean age of 15.1 years (SD 0.28). The Youth Psychopathic traits Inventory (YPI) and the Youth Self Report (YSR) served as self-assessments. Results: Boys showed significantly higher traits of psychopathy, but girls scored significantly higher on the Total Problems as well as on the majority of the syndrome scales on the YSR. In both genders, psychopathic traits correlated highly with rule-breaking and aggressive behavior, moderately with attention and thought complaints, and modestly with depression, anxiety, withdrawal and social problems. The correlations between psychopathic traits and somatic problems were moderate in boys, but modest in girls. The correlations showed only a few statistically significant gender differences: the correlation between the Affective dimension of the YPI and the rule-breaking behavior syndrome scale of the YSR, as well as the correlation between the Interpersonal dimension of the YPI and somatic problems were stronger in boys than in girls. Conclusions: Even though boys show higher traits of psychopathy and girls exhibit more general psychopathology, the correlations between psychopathic traits and other forms of psychopathology closely resemble each other. In both genders, psychopathic traits correlate positively with both externalizing and internalizing problems. The callous-unemotional traits correlate more strongly with rule-breaking behavior in boys than in girls. Screening for psychopathic traits among adolescents with psychosocial adjustment problems seems relevant.
Health Education & Behavior, Aug 7, 2012
Schools are among the most important setting for preventive interventions among adolescents. Ther... more Schools are among the most important setting for preventive interventions among adolescents. There are evidence-based intervention programs for adolescents at risk for and with early signs of mental health problems but one demanding task is to detect the ones who are in need of an intervention. The aim of the present study was to analyze associations between self-esteem, depressive symptoms, and social anxiety in order to determine clinically relevant cut-points for male and female adolescents’ self-esteem as measured with the Rosenberg Self-Esteem Scale (RSES). The participants of the present prospective study, started in 2002-2003, were 2070 adolescents aged 15 years (1,167 girls and 903 boys) at two study sites in Finland who participated at both baseline and 2-year follow-up. Self-esteem was related to depressive symptoms and social anxiety, and the RSES was able to discriminate between cases of depression and social phobia. The present study suggests a cutoff of 25 points to classify low self-esteem in both girls and boys. Low self-esteem may function as an indicator of various forms of internalizing psychopathology. The RSES is worth further examination as a potential screening tool for adolescents in risk of psychopathology.
BMJ Open, Dec 1, 2021
Purpose This cohort profile describes the Stress, development and mental health study (TAM), whic... more Purpose This cohort profile describes the Stress, development and mental health study (TAM), which is a cohort study investigating risk and protective factors as well as longitudinal associations regarding mental health and well-being from adolescence to midlife. This interdisciplinary cohort study operates, for example, in the fields of public health, social medicine, psychiatry and the life course perspective. Participants In 1981 (n=2242, 98.0% of the target population), 1982 (n=2191, 95.6%) and 1983 (n=2194, 96.7%) during school classes, surveys were conducted to all Finnish-speaking pupils (mostly born 1967) in the Tampere region in Finland. Participants of the school study at age 16 in 1983 (n=2194) comprised the base population for the longitudinal data and were followedup using postal questionnaires in the years 1989, 1999, 2009 and 2019 at ages 22 (n=1656, 75.5% of the age 16 participants), 32 (n=1471, 67.0%), 42 (n=1334, 60.8%) and 52 (n=1160, 52.9%). Findings to date The self-reported questionnaires include information on physical and mental health (eg, depression and mood disorders, anxiety disorders), health behaviour and substance misuse (eg, alcohol, tobacco and exercise), socioeconomic conditions, psychosocial resources (eg, self-esteem), social relationships and support, life events, etc. The numerous studies published to date have examined mental health and various factors from several perspectives such as risk and protective factors, individual developmental paths (eg, trajectories) and pathway models (mediation and moderation). Future plans Current and future research areas include, for example, longitudinal associations between mental health (eg, depressive symptoms, self-esteem) and (1) substance use (alcohol and tobacco), (2) family transitions (eg, parenthood, relationship status) and (3) retirement. Next follow-up is planned to be conducted at the latest at age 62 in 2029. Before that it is possible to link the data with cause-of-death register. ► This cohort covers almost completely one age cohort of one city at baseline and has a long follow-up time covering several life phases from adolescence to midlife in a 36-year follow-up. ► These data have been collected using a holistic perspective and it includes information on physical and mental health, health behaviours, socioeconomic conditions, psychosocial resources, social relationships and support, life events, etc. ► The response rates at follow-ups (52.9%-75.5%) are reasonably good compared with postal surveys in general and 89% of the participants have participated in at least one follow-up. ► The limitations of the cohort include rather long gaps between the follow-ups (6-10 years) and the data confining nearly only to self-reported measures.
BMC Psychiatry, May 12, 2016
Background: The proposed posttraumatic stress disorder (PTSD) criteria for the International Clas... more Background: The proposed posttraumatic stress disorder (PTSD) criteria for the International Classification of Diseases (ICD) 11th revision are simpler than the criteria in ICD-10, DSM-IV or DSM-5. The aim of this study was to evaluate the ICD-11 PTSD factor structure in samples of young people, and to compare PTSD prevalence rates and diagnostic agreement between the different diagnostic systems. Possible differences in clinical characteristics of the PTSD cases identified by ICD-11, ICD-10 and DSM-IV are explored. Methods: Two samples of adolescents and young adults were followed after exposure to similar mass shooting incidents in their schools. Semi-structured diagnostic interviews were performed to assess psychiatric diagnoses and PTSD symptom scores (N = 228, mean age 17.6 years). PTSD symptom item scores were used to compose diagnoses according to the different classification systems. Results: Confirmatory factor analyses indicated that the proposed ICD-11 PTSD symptoms represented two rather than three factors; re-experiencing and avoidance symptoms comprised one factor and hyperarousal symptoms the other factor. In the studied samples, the three-factor ICD-11 criteria identified 51 (22.4 %) PTSD cases, the two-factor ICD-11 identified 56 (24.6 %) cases and the DSM-IV identified 43 (18.9 %) cases, while the number of cases identified by ICD-10 was larger, being 85 (37.3 %) cases. Diagnostic agreement of the ICD-11 PTSD criteria with ICD-10 and DSM-IV was moderate, yet the diagnostic agreement turned to be good when an impairment criterion was imposed on ICD-10. Compared to ICD-11, ICD-10 identified cases with less severe trauma exposure and posttraumatic symptoms and DSM-IV identified cases with less severe trauma exposure. Conclusions: The findings suggest that the two-factor model of ICD-11 PTSD is preferable to the three-factor model. The proposed ICD-11 criteria are more restrictive compared to the ICD-10 criteria. There were some differences in the clinical characteristics of the PTSD cases identified by ICD-11, when compared to ICD-10 and DSM-IV.
Child Abuse & Neglect, Jun 1, 2016
Sexual harassment has been studies as a mechanism reproducing inequality between sexes, as gender... more Sexual harassment has been studies as a mechanism reproducing inequality between sexes, as gender based discrimination, and more recently, as a public health problem. The role of family-related factors for subjection to sexual harassment in adolescent has been little studied. Our aim was to study the role of socio-demographic family factors and parental involvement in adolescent's persona life for experiences of sexual harassment among 14-18-year-old population girls and boys. An anonymous cross-sectional classroom survey was carried out in comprehensive and secondary schools in Finland. 90 953 boys and 91 746 girls aged 14-18 participated. Sexual harassment was elicited with five questions. Family structure, parental education, parental unemployment and parental involvement as perceived by the adolescent were elicited. The data were analyzed using cross-tabulations with chi-square statistics and logistic regressions. All types of sexual harassment experiences elicited were more common among girls than among boys. Parental unemployment, not living with both parents and low parental education were associated with higher likelihood of reporting experiences of sexual harassment, and parental involvement in the adolescent's personal life was associated with less reported sexual harassment. Parental involvement in an adolescent's life may be protective of perceived sexual harassment. Adolescents from socioeconomically disadvantaged families are more vulnerable to sexual harassment than their more advantaged peers.
European Journal of Psychiatry, Jun 1, 2013
Background and Objectives: Several large-scale studies on adolescent mental health have used ques... more Background and Objectives: Several large-scale studies on adolescent mental health have used questionnaire items derived from DSM-IV criteria to assess eating disorders. The aim of the present brief report was to analyse the capacity of self-reported eating disorder symptoms to capture clinically significant eating disorders. Methods: All pupils in the ninth grade (N = 606, response rate 98.2%, mean age = 15.4) of comprehensive school in a defined area were invited to participate in the study. Adolescents who reported some form of eating pathology (n = 126) were invited to an interview (RAB). Results: Anorexia based on the self-report resulted in a positive predictive value of 60.0% for lifetime and 20% for current eating disorder, when compared to the results in the RAB. No case of BN was detected by the RAB, but self-reported BN symptoms were predictive of both EDNOS and subclinical eating pathology. Conclusions: Self-reported eating disorder symptoms seem to be relatively good predictors of broadly defined eating pathology, but may result in overestimation of clinical conditions.
Schizophrenia Bulletin, 2004
In a double-blind, controlled study, we examined the therapeutic effects of high-frequency left p... more In a double-blind, controlled study, we examined the therapeutic effects of high-frequency left prefrontal repetitive transcranial magnetic stimulation (rTMS) on schizophrenia symptoms. A total of 22 chronic hospitalized schizophrenia patients were randomly assigned to 2 weeks (10 sessions) of real or sham rTMS. rTMS was given with the following parameters: 20 trains of 5-second 10-ELz stimulation at 100 percent motor threshold, 30 seconds apart Effects on positive and negative symptoms, self-reported symptoms, rough neuropsychological functioning, and hormones were assessed. Although there was a significant improvement in both groups in most of the symptom measures, no real differences were found between the groups. A decrease of more than 20 percent in the total PANSS score was found in 7 control subjects but only 1 subject from the real rTMS group. There was no change in hormone levels or neuropsychological functioning, measured by the MMSE, in either group. Left prefrontal rTMS (with the used parameters) seems to produce a significant nonspecific effect of the treatment procedure but no therapeutic effect in the most chronic and severely ill schizophrenia patients.
Tässä raportissa tuotetaan tietoa mielenterveys-ja päihdepalvelujen järjestämisestä sekä mielente... more Tässä raportissa tuotetaan tietoa mielenterveys-ja päihdepalvelujen järjestämisestä sekä mielenterveysja päihdetyön menetelmistä ja yhteistyöstä opiskeluterveydenhuollossa toisen asteen oppilaitoksissa ja ammattikorkeakouluissa. Raportti on osa Vaikuttavat mielenterveysinterventiot osana opiskeluterveydenhuoltoa-hanketta, joka toteutetaan Terveyden ja hyvinvoinnin laitoksen sekä sosiaali-ja terveysministeriön yhteistyönä. Raportin tuottamaa tietoa hyödynnetään toimivien mielenterveys-ja päihdetyön menetelmien ja toimintamallien sekä mielenterveys-ja päihdetyön osaamis-ja kehittämistarpeiden tunnistamisessa. Opiskeluterveydenhuollon terveyden-ja sairaanhoitopalveluja ei järjestetä kaikissa kunnissa valtioneuvoston asetuksen edellyttämänä yhtenäisenä kokonaisuutena. Terveydenhuoltolain mukaisia ehkäiseviä mielenterveys-ja päihdepalveluja on järjestetty suurimmassa osassa kunnista, mutta puutteita on erityisesti sairaanhoidollisten mielenterveys-ja päihdepalvelujen järjestämisessä sekä niiden saatavuudessa opiskeluterveydenhuollosta. Riittämättömyyttä on myös opiskeluterveydenhuollon tai terveyskeskuksen ja opiskeluhuollon psykologipalveluissa sekä lääkäripalveluissa ja mielenterveyspalvelujen verkostossa. Ehkäisevä mielenterveys-ja päihdetyö sekä lievien ja keskivaikeiden (komplisoitumattomien) mielenterveyden häiriöiden hoitaminen kuuluu jokaisen terveydenhuollon ammattilaisen työhön opiskeluterveydenhuollossa. Mielenterveys-ja päihdetyö edellyttää osaamista, perusmenetelmiä ja joustavia yhteistyön mahdollisuuksia opiskelijoiden tukemiseksi. Erilaiset yhdessä tekemisen työmuodot koetaan hyödyllisiksi ja tavoiteltaviksi. Tällaisia ovat muun muassa työparityöskentely, yhteisvastaanotto, moniammatilliset työryhmät, opiskelijan saattaen siirtäminen työntekijältä toiselle, nopea konsultaatiomahdollisuus sekä liikkuvat matalan kynnyksen ja erikoistason palvelut. Kunnissa kaivataan selkeää kansallista ohjausta opiskeluterveydenhuoltoa ohjaavan lainsäädännön toimeenpanoon ja nuorten palvelujen järjestämiseen. Lisäksi toivotaan toimivia yhteistyökäytäntöjä, selkeää vastuunjakoa, riittävää resursointia ja johdon tukea sekä toiminnan systemaattista seurantaa. Opiskeluterveydenhuollossa nähdään tärkeiksi ehkäisevän mielenterveys-ja päihdetyön tehostaminen, keinot varhaiseen puuttumiseen, erilaiset puheeksioton ja neuvonpidon toimintamallit sekä lievien ja keskivaikeiden häiriöiden hoitomenetelmät. Opiskeluterveydenhuollon mielenterveys-ja päihdetyöhön tarvitaan strukturoituja interventioita ja työmenetelmiä, riittävästi aikaa kohdata opiskelijat sekä vahvaa osaamista ja aitoa kiinnostusta mielenterveys-ja päihdetyöhön. Haluamme kiittää vastaava lääkäri Noora Seiloa Tampereen kaupungin opiskeluterveydenhuollosta asiantuntemuksesta ja palautteesta, joka on parantanut raportin laatua ja luettavuutta. Raportin tuottamaa tietoa voidaan käyttää valtakunnallisesti opiskeluterveydenhuollon, opiskeluhuollon sekä nuorten mielenterveys-ja päihdepalvelujen kehittämisessä niin kunnissa kuin oppilaitoksissakin.
Nordic Journal of Psychiatry, 2017
Abstract Background: Studies have emphasized screening for psychiatric disorders, especially suic... more Abstract Background: Studies have emphasized screening for psychiatric disorders, especially suicide risk in emergency departments. Psychiatric disorders and experimentation with alcohol increase in adolescence and intoxications among patients challenge the staff in emergency departments. Aims: This study examined the degree of suicidal ideation (SI) and suicidal behavior in adolescents, and the extent to which they differed from non-suicidal patients in terms of alcohol use, psychological distress, self-esteem, and perceived social support. Methods: The study comprised 120 adolescents, a mean age of 14.2 years. Of them 60% were females. We collected data on the clinical characteristics and assessed the patient’s psychiatric status using self-report scales and analyzed blood samples for alcohol. A consulting psychiatrist interviewed each patient before discharge to evaluate potential SI or suicide attempt (SA) using structured and semi-structured scales. Results: Of the 120 patients 20% had SI or had made a SA. High psychological distress in girls, low blood alcohol levels (BALs), as well as low scores on self-esteem, on social support and on familial support were associated with patients with SI/SA. Logistic regression showed that the most significant variables with suicidal patients included low BAL and low self-esteem and high alcohol consumption. Psychological distress had a direct and mediational role in the suicidal patients. Conclusions: Adolescents referred to the pediatric emergency department with intoxication displaying high psychological distress and low self-esteem represent a high-risk group of teens. In this group, careful assessment of mental health status, screening for suicidal ideation, and SAs seems warranted.
Bipolar Disorders, 2020
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, 2019
Background:Scientific literature suggests that the prevalence of delinquency amongst adolescents ... more Background:Scientific literature suggests that the prevalence of delinquency amongst adolescents has decreased internationally in past decades. However, whether this change is consistent across all socioeconomic groups has not yet been studied. Objective:The aim of this study was to examine changes in delinquency amongst Finnish adolescents according to socioeconomic status between 2000 and 2015. Method:A population-based school survey was conducted biennially amongst 14-16-year-old Finns between 2000 and 2015 (n= 761,278). Distributions for delinquency and socioeconomic adversities (low parental education, not living with both parents and parental unemployment in the past year) were calculated using crosstabs. Associations between delinquency, time, and socioeconomic adversities were studied using binomial logistic regression results shown by odds ratios with 95 % confidence intervals. Results:Delinquency was positively associated with all three socioeconomic adversities studied an...
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Papers by Mauri Marttunen