The traits of Autism Spectrum Disorder and bullying victimization in an epidemiological population.

Autistic children (Autism Spectrum Disorder, ASD) show an increased risk of bullying victimization and often face challenges in communication and peer relationships. However, it is unclear to what extent the amount and quality of ASD traits are associated with bullying victimization. This study examined the association of bullying victimization and ASD traits in an epidemiological population of 8-year-old children (n = 4408) using parent and teacher completed Autism Spectrum Screening Questionnaires (ASSQs), both separately and combined. The ASSQ items relating to loneliness and social isolation, lack of co-operating skills, clumsiness and lack of common sense were associated with victimization in the study population. The higher the ASSQ scores, the more the children were victimized: the ASSQ scores increased in parallel with victimization from 0 (0% victimized) to 45 (64% victimized). The victimization rate was 46% in ASD sample, 2% in the total population sample and 2% in the non-ASD population sample. The results enable more targeted means for recognizing potential victimization.

Longitudinal associations between childhood and adulthood externalizing and internalizing psychopathology and adolescent substance use.

BACKGROUND: Emotional and behavioral problems are commonly associated with substance use in adolescence but it is unclear whether substance use precedes or follows mental health problems. The aim was to investigate longitudinal associations between externalizing and internalizing psychopathology and substance use in a prospective population study design. METHOD: The sample was the Northern Finland Birth Cohort 1986 Study (NFBC 1986; n = 6349; 3103 males). Externalizing and internalizing mental health problems were assessed at age 8 years (Rutter scales), substance use and externalizing and internalizing problems [Youth Self-Report (YSR)] at age 15-16 years, and hospital diagnoses for internalizing disorders (age 25) and criminal offences (age 20) from nationwide registers in adulthood. RESULTS: Externalizing problems at age 8 were associated with later substance use. After adjustment for sociodemographic factors, parental alcohol use and psychiatric disorders, and earlier externalizing and internalizing problems, substance use predicted criminality, especially among males, with the highest odds ratio (OR) for cannabis use [adjusted OR 6.2, 95% confidence interval (CI) 3.1-12.7]. Early internalizing problems were not a risk for later substance use. Female adolescent cannabis (OR 3.2, 95% CI 1.4-7.3) and alcohol (OR 2.1, 95% CI 1.1-4.2) use predicted internalizing disorders in adulthood. CONCLUSIONS: Externalizing problems precede adolescent substance use in both genders, whereas, among boys, substance use also precedes criminal offences. Internalizing problems may follow substance use in females. These associations were robust even when taking into account previous mental health problems.

Disruptive behaviour disorder with and without attention deficit hyperactivity disorder is a risk of psychiatric hospitalization.

AIM: To evaluate the psychiatric hospitalization among adolescents diagnosed with disruptive behaviour disorders (DBD) and/or attention deficit hyperactivity disorder (ADHD). METHODS: The sample (N = 457) was drawn from the Northern Finland Birth Cohort 1986. Four groups were formed, based on the K-SADS-PL diagnostic interview procedure: adolescents with DBD (n = 44), ADHD (n = 91), comorbid DBD and ADHD (n = 72) and without either DBD or ADHD (n = 250). Information from the Finnish Hospital Discharge Register (FHDR) was used to evaluate the psychiatric hospitalization among the study subjects. RESULTS: When compared with no diagnosis group, the adolescents with behavioural disorders had an increased risk (adjusted odds ratios: DBD = 4.4, ADHD = 2.2, comorbid DBD & ADHD = 5.6) of having also psychiatric disorder in the FHDR. The onset age of the psychiatric disorders in the FHDR (medians: DBD = 14.9, ADHD = 7.5 and DBD & ADHD = 15.3 years) and the combined length of hospitalization (medians: 25, 50 and 26 days, respectively) differed among adolescents with behavioural disorders compared with those with no diagnosis (median age 12.1 years and length of hospitalization 4 days). CONCLUSION: Adolescents diagnosed with DBD (with and without ADHD) are at high risk of undergoing psychiatric hospitalization during their life.

Physical activity, emotional and behavioural problems, maternal education and self-reported educational performance of adolescents.

This study examined whether physical activity, mental health and socio-economic position were associated with the overall academic performance and future educational plans of adolescents aged 15-16 years. We used a sample of 7002 boys and girls from the Northern Finland Birth Cohort 1986. Data were collected by a postal enquiry in 2001-02. Multivariable logistic regression models were estimated and adjusted for family structure and all variables in the models. In the fully adjusted models, higher levels of physical activity and high parental socio-economic position were associated with higher overall academic performance and future plans for higher education. High scoring on behavioural problems was related to lower overall academic performance and poorer future academic plans. In summary, a higher level of physical activity, fewer behavioural problems and higher socio-economic position were independently associated with high self-perceived overall academic performance and plans for higher education among adolescents. The interrelations of these factors and the positive relationship between physical activity, mental health and school outcomes provide a context of critical importance for future research, intervention programming and policy directed at improving the educational attainment of adolescents.

Sensory Abnormality and Quantitative Autism Traits in Children With and Without Autism Spectrum Disorder in an Epidemiological Population.

Sensory abnormalities (SAs) are recognized features in Autism Spectrum Disorder (ASD), and a relationship between SAs and ASD traits is also suggested in general population. Our aims were to estimate the prevalence of SAs in three different settings, and to study the association between SAs and quantitative autism traits (QAT) using the Autism Spectrum Screening Questionnaire (ASSQ) and a parental questionnaire. In an epidemiological population of 8-year-old children (n = 4397), the prevalence of SAs was 8.3%, in an ASD sample (n = 28), 53.6%, and in a non-ASD sample (n = 4369), 8.0%, respectively. Tactile and auditory hypersensitivity predicted an ASD diagnosis. The ASSQ was able to differentiate children with and without SA. In conclusion, QAT level and SAs were associated in all study samples.

Prevalence of Autism Spectrum Disorder in 7-9-Year-Old Children in Denmark, Finland, France and Iceland: A Population-Based Registries Approach Within the ASDEU Project.

We estimated autism spectrum disorder (ASD) prevalence in 7-9 year-old children in 2015 using data from three nationwide health registry systems (Denmark, Finland, Iceland) and two French population-based regional registries. Prevalence ranged from 0.48% in South-East France to 3.13% in Iceland (South-West France: 0.73%, Finland: 0.77%, Denmark: 1.26%). Male/female ratios ranged from 3.3 in Finland to 5.4 in South-West France. Between 12% (Denmark) and 39% (South-West France) of cases were diagnosed with intellectual disability. The variations in population-based ASD prevalence across four European countries with universal health care practices likely reflect variation in detection, referral and diagnosis practices and autism awareness across these areas. Using established population-based data systems is an efficient approach to monitor ASD prevalence trends over time.

Is prenatal alcohol exposure related to inattention and hyperactivity symptoms in children? Disentangling the effects of social adversity.

BACKGROUND: Studies concerning whether exposure to low levels of maternal alcohol consumption during fetal development is related to child inattention and hyperactivity symptoms have shown conflicting results. We examine the contribution of covariates related to social adversity to resolve some inconsistencies in the extant research by conducting parallel analyses of three cohorts with varying alcohol consumption and attitudes towards alcohol use. METHODS: We compare three population-based pregnancy-offspring cohorts within the Nordic Network on ADHD from Denmark and Finland. Prenatal data were gathered via self-report during pregnancy and birth outcomes were abstracted from medical charts. A total of 21,678 reports concerning inattention and hyperactivity symptoms in children were available from the Strengths and Difficulties Questionnaire or the Rutter Scale completed by parents and/or teachers. RESULTS: Drinking patterns differed cross-nationally. Women who had at least some social adversity (young, low education, or being single) were more likely to drink than those better off in the Finnish cohort, but the opposite was true for the Danish cohorts. Prenatal alcohol exposure was not related to risk for a high inattention-hyperactivity symptom score in children across cohorts after adjustment for covariates. In contrast, maternal smoking and social adversity during pregnancy were independently and consistently associated with an increase in risk of child symptoms. CONCLUSIONS: Low doses of alcohol consumption during pregnancy were not related to child inattention/hyperactivity symptoms once social adversity and smoking were taken into account.

Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts.

OBJECTIVES: We examine whether pregnancy weight (pre-pregnancy body mass index (BMI) and/or weight gain) is related to core symptoms of attention deficit hyperactivity disorder (ADHD) in school-age offspring. DESIGN: Follow-up of prospective pregnancy cohorts from Sweden, Denmark and Finland within the Nordic Network on ADHD. METHODS: Maternal pregnancy and delivery data were collected prospectively. Teachers rated inattention and hyperactivity symptoms in offspring. High scores were defined as at least one core symptom rated as 'severe' and two as 'present' (approximately 10% of children scored in this range). Logistic regression and latent class analyses were used to examine maternal pregnancy weight in relation to children's ADHD core symptoms. RESULTS: Teacher rated 12 556 school-aged children. Gestational weight gain outside of the Institute of Medicine guidelines was not related to ADHD symptoms (below recommendations: odds ratio (OR): 0.96; 95% confidence interval (CI): 0.81, 1.14; above recommendations: OR: 0.98; 95% CI: 0.82, 1.16). To examine various patterns of pre-pregnancy BMI and weight gain, we used latent class analysis and found significant associations between classes that included pre-pregnancy overweight or obesity and a high ADHD symptom score in offspring, ORs ranged between 1.37 (95% CI: 1.07, 1.75) and 1.89 (95% CI: 1.13, 3.15) adjusted for gestational age, birth weight, weight gain, pregnancy smoking, maternal age, maternal education, child gender, family structure and cohort country of origin. Children of women who were both overweight and gained a large amount of weight during gestation had a 2-fold risk of ADHD symptoms (OR: 2.10, 95% CI: 1.19, 3.72) compared to normal-weight women. CONCLUSIONS: We show for the first time that pre-pregnancy BMI is associated with ADHD symptoms in children. Our results are of public health significance if the associations are causal and will then add ADHD symptoms in offspring to the list of deleterious outcomes related to overweight and obesity in the prenatal period.

To be born as a twin--risks and sequelae.

About 2.5% of infants born in Finland are twins. Twins have long been objects for genetic studies, which nowadays have large study groups, e.g. twin registers from a whole country. Twins can also be studied from another point of view: the special situation of being a twin, and its consequences on development and mental health. Perinatal mortality and morbidity are higher in twins than in singletons, and accordingly cumulative incidences of various handicaps are higher in twins. The human relationships of twins have their special features from the early beginning. Twins have to share the attention from the parents, and some parents resolve the situation by sharing the twins: "mother's child" and "father's child" may develop. Twins may be dependent on each other, and the inter-twin relationship can also be characterized by dominance-submissiveness. In adolescence, the time of getting independence from the parents, twins have also another task of development: they have to grow up from the co-twin dependence in order to become autonomous adults. In comparison to much bigger twin materials of genetic studies, follow-up studies in birth cohorts have their benefits, too. They give us a good opportunity to research the development of human relationships in twin families and their consequences on both somatic and mental health.

Long-term outcome of migration in childhood and adolescence.

The effect of migration on the family and on the individual can be divided into three groups: cultural, changes in social environment and changes in the interpersonal relations. When successful adaptation is not achieved, acculturative stress may arise and somatic or mental disorders may develop. The finding of individual differences in people's responses to environmental conditions has led to search for vulnerability factors that increase people's susceptibility to stressors and for buffering influences that serve a protecting function under the same circumstances. The studies on migration should focus on somatic and mental health of the migrants, on achievements at school and at work, on protecting factors at different ages of migration and on the role of language acquisition and of social network on the adaptational process. The focus on this review is in childhood, adolescence and young adulthood.

Targeting a company's real core competencies.

By recognizing its core competencies, a company can clearly define organizational boundaries and focus resources for maximum advantage. The authors outline an approach for identifying those competencies that can provide a company with the best chance to achieve long-term competitive advantage.

Mental health promotion in comprehensive schools.

The purpose of this paper is to describe a participatory action research process on the development of a professional practice model of mental health nurses in mental health promotion in a comprehensive school environment in the city of Oulu, Finland. The developed model is a new method of mental health promotion for mental health nurses working in comprehensive schools. The professional practice model has been developed in workshops together with school staff, interest groups, parents and students. Information gathered from the workshops was analysed using action research methods. Mental health promotion interventions are delivered at three levels: universal, which is an intervention that affects the whole school or community; selective, which is an intervention focusing on a certain group of students; and indicated, which is an individually focused intervention. All interventions are delivered within the school setting, which is a universal setting for all school-aged children. The interventions share the goal of promoting mental health. The purposes of the interventions are enhancing protective factors, reducing risk factors relating to mental health problems and early identification of mental health problems as well as rapid delivery of support or referral to specialized services. The common effect of the interventions on all levels is the increase in the experience of positive mental health.

[Kinetic immunological-turbidimetric determination of C-3 protein with a fast analyzer (author's transl)]. / Kinetische immunologisch-turbidimetrische C3-Bestimmung mit einem Fast Analyzer.

A new immunological-turbidimetric method is described for the quantitative determination of individual proteins. It is based on initial rate analysis with fixed time kinetics. The optimal conditions for the analysis of C-3 protein are described, with respect to buffer composition, reaction time, the time interval for measurement of the initial rate, and the concentrations of antigen and antibody. With these optimised, standardised conditions, it is possible to obtain results for 29 samples in 20 seconds, using a reaction time of deltaA/15 seconds. The method is relatively accurate with a day to day variation coefficient of 4.3 for C-3 concentrations of 217.5 mg/l, and 6.4 for concentrations of 435 mg/l. It is therefore suitable for the clinical chemical laboratory. A detailed comparison of this with other methods, and its use in the measurement of patients' sera will be presented elsewhere.

[The enzymic and immunological determination of coeruloplasmin: sex- and method-dependent differences during the administration of oestrogens (author's transl)]. / Enzymatisch und immunologisch bestimmtes Coeruloplasmin: Geschlechts- und Methodenunterschiede unter Ostrogeneinnahme

After 14 days of 1 mug ethinyloestradiol per kg body weight per day, both sexes show highly significant increases in serum coeruloplasmin which are independent of the determination method. Expressed on a percentage basis, the concentrations of coeruloplasmin under oestrogen medication determined by the p-phenylendiamine oxidase reaction are significantly higher than those determined by the immunological-nephelometric method. This is because several coeruloplasmin components, mainly C and DO, take part in the determination with p-phenylendiamine oxidase, whereas the immunological method measures chiefly the coeruloplasmin DO component. The significant sex differences under oestrogen medication shown by the determination with p-phenylendiamine oxidase, can therefore be explained by the presence of C- and D-coeruloplasmins in women, while the serum of men contains almost exclusively D-coeruloplasmins. Under oestrogen medication, the increase occurs primarily in the DO- coeruloplasmin component, and women also show an increase in coeruloplasmin-C. The significant higher enzymatic concentrations in the serum of the women in contrast to the men are thus plausibly explained. With the immunological assay, the sex differences were only probably significant.

PIP: Ceruloplasmin levels were determined enzymatically and immunologically in 8 healthy men and 9 healthy women treated with 1 mcg ethinyl estradiol for 14 days. Concentrations of ceruloplasmin during estrogen administration measured by the p-phenylendiamine oxidase reaction are significantly higher than those determined by the immunological-nephelometric method, because several ceruloplasmin components, mainly C and Do, are included in the enzymatic measurement. The significant sex differences shown by the enzymatic determination can be explained by the presence of C- and D-ceruloplasmins in women, while men have almost exclusively D-ceruloplasmin. Under estrogen medication, the increase occurs primarily in the Do ceruloplasmin component, but women also show and increase in ceruloplasmin C.

[A rapid and precise determination of fibrinogen and its cleavage products (author transl)]. / Eine schnelle und exakte Fibrinogen-Bestimmungsmethode unter Berücksichtigung von Spaltprodukten

A method is described for the quantitative determination of fibrinogen equivalents in citrated blood before and after removal of the fibrinogen by coagulation. The method employs an immunological reaction, which is measured by mechanized nephelometry. Thus the sum of all the fibrinogen equivalents can be compared with the concentration of "cleavage products". The difference between the two readings represents the concentration of coagulable fibrinogen. For the fibrinogen concentration of 11.15 mg/l, variation coefficients of 2.81% in series and 3.31% for day to day were obtained. The accuracy of a new method was tested under conditions of fibrinogenolysis, and in the presence of heparin, by comparison with simple radial immunodiffusion, and with the "coagulation physiological rapid method for the determination of fibrinogen" after Clauss ((1957), Acta-Haematol, 17, 237-246). In addition 180 citrated blood samples of different patients were compared with the simple radial immunodiffusion, the method of Clauss and the new method. Only the new rapid method appears to measure plausible fibrinogen values, and permits a clear differentiation between coagulable and non-coagulable fibrinogen equivalents. It can be recommended for clinical practice.

[Quantitative plasma protein determination as an aid to diagnosis (author's transl)]. / Diagnostik mit Hilfe quantitativer Plasmaprotein-Bestimmungen.

The lack of internationally comparable reference standards for plasma proteins causes problems. For this reason, it is only possible to evaluate the "accuracy" of measurements by comparison of methods. Differences in results which may sometimes be based on technical procedure, physical chemistry or biology are gone into with reference to diagnostically important examples such as albumin, transferrin, ceruloplasmin, fibrinogen and complement 3. It is shown which plasma protein constellations may frequently be expected in certain reactions and what protein patterns have principal importance in clinical practice, e.g. in acute and chronic inflammatory diseases, protein depletion diseases and in liver diseases.

[Comparison of conventional methods for the determination of albumin, transferrin and ceruloplasmin in serum with immunological reference methods (author's transl)]. / Vergleiche konventioneller Methoden zur Albumin-, Transferrin- und Coeruloplasmin-Bestimmung im Serum mit immunologischen Referenzmethoden

Radial immunodiffusion, which is a presently accepted reference method, was compared with the mechanized immunoprecipitation. Each of these specific methods was compared with two normal clinical-chemical methods for the determination of albumin and transferrin, and an enzymic method for the determination of ceruloplasmin. The correlation coefficients, the mean slope for regression, and the percentage variation of the average values from those of the average values of the reference methods are presented. In the determination of albumin and ceruloplasmin, radial immunodiffusion and mechanized immunoprecipitation give the same results. Surprisingly, these two specific methods give different results in the determination of transferrin. In as far as there is no doubt concerning the accuracy of the mechanized immunoprecipitation, this method is recommended, since it also has the advantage of being less demanding in cost and time.

Somatically expressed psychological distress and alexithymia in adolescence--reflecting unbearable emotions?

The characteristics of five 11- to 15-year-old patients with somatic symptoms and alexithymia in conjunction with psychological distress are reported. The findings are compared with the existing literature. Preceding somatic disorders and difficulties at school and in peer relationships were found. Family violence was evident in two cases. We postulate that the developmental tasks of adolescence were complicated by the threat of disability, disease, and death. The parents were incapable of expressing their feelings either in general or because of their recent traumatic experiences. Our findings suggest that unbearable emotions often precede the combination of preadolescent and adolescent alexithymia and somatization in clinically relevant cases.