Mother's marital satisfaction associated with the quality of mother-father-child triadic interaction.

Low marital satisfaction has been shown to be a risk factor for early parenthood and parent-child relationship problems (Erel & Burman, ; McHale, ). The aim of this study was to assess how parental reports of marital satisfaction related to family alliance and coordination in the observed triadic interaction. The study group included 120 families. Marital satisfaction was evaluated during pregnancy, at 4 months, and at 18 months using the Revised Dyadic Adjustment Scale (RDAS; Busby, Christensen, Crane & Larsson, ) for both parents. Mother-father-child interaction was analyzed in the Lausanne Triadic Play setting and coded using the Family Alliance Assessment Scale (Favez, Lavanchy Scaiola, Tissot, Darwiche & Frascarolo, ) when the child reached 18 months of age. The mother's higher marital satisfaction at every measuring point was associated with a cooperative family alliance and/or higher family coordination at 18 months. The father's experience of marital satisfaction was not related to family interaction at any assessment point. Our study suggests that a mother's experience of lower marital satisfaction during pregnancy may be an early sign of later problems in family relationships.

Intercorrelations and developmental pathways of mothers' and fathers' loneliness during pregnancy, infancy and toddlerhood--STEPS study.

Our aim was to study the inter-correlations and developmental pathways of mothers' and fathers' social and emotional loneliness during pregnancy (20th pregnancy week), infancy (child aged 8 months), and early childhood (child aged 18 months). Moreover, we aimed to study whether mothers and fathers who have different developmental profiles (identified by latent growth curve mixture models) differ in their experiences of marital dissatisfaction (RDAS), social phobia (SPIN) and depression (BDI) during pregnancy. Both mothers' social and emotional loneliness and fathers' social and emotional loneliness were highly stable, and within individuals these loneliness factors were strongly correlated. However, the correlations between mothers' loneliness experiences and fathers' loneliness experiences were weaker than expected. Separate latent growth curve groups were identified, which differed in feelings of marital dissatisfaction, social phobia, and depression. These groupings revealed that the higher the loneliness was, the more the parents experience these other psychosocial problems.

Parents' psychological well-being and parental self-efficacy in relation to the family's triadic interaction.

The aim of the study was to assess whether a parent's psychological well-being and/or self-efficacy relate to interaction within the family. This study is part of a Finnish follow-up study called Steps to the Healthy Development and Well-Being of Children (STEPS;). The study group included 120 families. Mother's and father's social anxiety and depression were assessed during pregnancy and at 18 months of the child's age using self-report questionnaires; the mother's and father's self-efficacy were assessed at 18 months using a parental self-efficacy scale validated within the STEPS study. Mother-father-child triadic interaction was studied at 18 months within a Lausanne Triadic Play setting. Results showed that maternal symptoms of depression during pregnancy and maternal social anxiety at 18 months were related to triadic interaction within the family. There was no relation between father's psychological well-being and triadic interaction within the family. Father's self-efficacy in teaching tasks and the Mother's self-efficacy in emotional support were associated with family interaction. The findings suggest that maternal psychological well-being and self-efficacy in emotional support may be important components of family triadic interaction whereas paternal self-efficacy in teaching tasks seems to support family coordination in triadic interaction.

Do headache and abdominal pain in childhood predict suicides and severe suicide attempts? Finnish nationwide 1981 birth cohort study.

This study investigated associations between pain symptoms in mid-childhood and severe suicidality in adolescence and early adulthood. Severe suicidality was defined as completed suicide or suicidal attempt requiring hospital admission. In a nationwide prospective population-based study (n = 6,017), parents and children were asked about the child's headache and abdominal pain at age eight. The outcome was register-based data on suicide or suicidal attempt requiring hospital treatment by age 24. Family composition, parental educational level, and the child's psychiatric symptoms reported by the child, parents and teacher at baseline were included as covariates in statistical analyses. Boys' abdominal pain reported by the parents was associated with later severe suicidality after adjusting for family composition, parental educational level, and childhood psychiatric symptoms at baseline. In addition, the association between boys' own report of headache and later severe suicidality reached borderline significance in unadjusted analysis. Girls' pain symptoms did not predict later severe suicidality.

[Update in Current Care guidelines. Evaluation of a suspected child sexual abuse]. / Lapsen seksuaalisen hyväiksikäytön epäilyn tutkiminen.

According to Finnish Child Welfare Law, the authorities are obligated to report suspicions of child sexual abuse immediately to the police and to social services to ensure the well being of the child. The investigating police may request assistance for forensic interviews and medical assessments from specialized units. The child's disclosure is often the most important part of the evaluation. The timing of medical examination is crucial to obtain biological trace of evidence and to document evidence of acute injury or infection. The need for crisis support must be evaluated.

Childhood predictors of antipsychotic use among young people in Finland.

OBJECTIVE: Information on who uses antipsychotic medication is limited to cross-sectional data. The objective of this study was to study the patterns of psychopathology at age 8 years and antipsychotic use between the ages of 12 and 25 years. METHODS: A total of 5525 subjects from the Finnish Nationwide 1981 birth cohort were linked to the National Prescription Register and the Hospital Discharge Register between 1994 and 2005. Information about parent-reported and teacher-reported conduct, hyperkinetic and emotional symptoms, and self-reported depressive symptoms was gathered at age 8 years. Information about antipsychotic use and about psychiatric disorders treated in hospitals between the ages of 12 and 25 years was register based. Diagnostic classes of hospital treatment included non-affective psychoses, affective disorders, and other psychiatric disorders. RESULTS: The cumulative incidence of antipsychotic use by age 25 years was 2.8% among men (n = 69) and 2.1% among women (n = 55). In both sexes, living with other than two biological parents at age 8 years was associated with antipsychotic use, and three fourths of antipsychotic users had been treated for psychiatric disorders in a hospital. Among men, the most common hospital diagnosis was non-affective psychoses (44% of all antipsychotic users), and antipsychotic use was associated with childhood conduct problems. Among women, the most common hospital diagnosis was affective disorders (38% of all antipsychotic users), and antipsychotic use was associated with emotional problems and self-reported depressive symptoms in childhood. CONCLUSIONS: Antipsychotic use in adolescence and young adulthood is different among men versus women both with regard to hospital diagnoses and childhood psychiatric problems.

Childhood predictors of becoming a teenage mother among Finnish girls.

OBJECTIVE: To study predictive associations between psychosocial factors at age 8 and becoming a mother under the age of 20. DESIGN: Prospective follow-up study. SETTING: Finland. POPULATION: 2867 girls born in 1981. METHODS: Information on family background and psychiatric symptoms was collected at age 8. The associations between these factors and becoming a teenage mother were analyzed using logistic regression analysis. MAIN OUTCOME MEASURES: Data on births by the age of 20 collected from the hospital discharge register. RESULTS: 128 girls (4.8%) had given birth at the age of 15-19 years. Childhood conduct problems and hyperactive problems, having young mother and family structure other than two biological parents had an independent association with becoming a teenage mother. CONCLUSIONS: Girls with externalizing type of problems in childhood have an increased risk of becoming teenage mothers. These problems may also complicate their motherhood.

What is the long-term outcome of boys who steal at age eight? Findings from the Finnish nationwide "From A Boy To A Man" birth cohort study.

OBJECTIVE: The aim was to study predictive associations between childhood stealing behavior at the of age 8 years with later psychiatric disorders, criminality or suicide attempts and completed suicides up to the age 25 years in a large representative population-based birth cohort. METHOD: The sample includes 2,592 Finnish males born in 1981 with information about stealing from both parents and teachers. Information about psychiatric disorders, criminality, suicide attempts requiring hospital admission and completed suicides was gathered from four different Finnish nationwide registries until the study participants were 25 years old. RESULTS: One out of ten boys had stealing behavior during the previous 12 months. After adjusting for parental education level and conduct problems or hyperactivity (i.e. potential confounds), stealing at eight independently predicted substance use and antisocial personality disorders, and high level of crimes. Stealing was also associated with completed suicide or severe suicide attempt requiring hospital admission. Comorbid stealing and frequent aggression had the strongest predictive association with any psychiatric diagnosis, crime and completed suicide or severe suicide attempt, while stealing without aggression was not associated with any of the negative outcomes. CONCLUSIONS: Stealing accompanied with aggressivity at age eight is predictive of wide range of adversities. However, no increased risk was observed among the group with stealing behaviors but without aggression.

Childhood bullying and becoming a young father in a national cohort of Finnish boys.

Childhood bullying is known to be associated with various adverse psychosocial outcomes in later life. No studies exist on its association with becoming a young father. The study is based on a national cohort, which included 2,946 Finnish boys at baseline in 1989. Information on bullying was collected from children, their parents and their teachers. Follow-up data on becoming a father under the age of 22 were collected from a nationwide register. The follow-up sample included 2,721 boys. Bullying other children frequently was significantly associated with becoming a young father independently of being victimized, childhood psychiatric symptoms and parental educational level. Being a victim of bullying was not associated with becoming a young father when adjusted for possible confounders. When the co-occurrence of bullying and victimization was studied, it was found that being a bully-victim, but not a pure bully or a pure victim, is significantly associated with becoming a young father. This study adds to other studies, which have shown that the risk profile and relational patterns of bully-victims differ from those of other children, and it emphasizes the importance of including peer relationships when studying young fathers.

Factors associated with reported childhood depressive symptoms at age 8 and later self-reported depressive symptoms among boys at age 18.

AIMS: This study aimed to study conditions associated with depressive symptoms at ages 8 and 18 in a representative birth cohort of Finnish males. METHODS: The participants in this community-based 10-year follow-up study consisted of 2,348 boys born in 1981. At age 8, three informant sources were used: parents, teachers, and the children themselves. Depressive symptoms were established using the Children's Depression Inventory (CDI). At age 18, self-report questionnaires were used to study the boys' family factors, life events, adaptive functioning, and substance use. Depressive symptoms at age 18 were established using Beck's Depression Inventory (BDI). RESULTS: Poor adaptive functioning at age 18 was independently associated with both child and late adolescent depressive symptoms. Use of illicit drugs and somatic health problems were independently associated with later depressive symptoms. Parental divorce in early childhood independently predicted depressive symptoms both in childhood and in late adolescence. Teacher reports of child's total problems at age 8 independently predicted depressive symptoms at age 18. CONCLUSIONS: Depression in males at ages 8 and 18 is particularly associated with stressful life events in childhood, whereas late depression is associated with somatic health problems and substance use. Further population-based studies comparing conditions associated with childhood and adolescent depression are needed.

Bullying at age eight and criminality in adulthood: findings from the Finnish Nationwide 1981 Birth Cohort Study.

CONTEXT: There are no prospective population-based studies examining predictive associations between childhood bullying behavior and adult criminality. OBJECTIVE: To study predictive associations between bullying and victimization at age eight and adult criminal offenses. DESIGN: Nationwide birth cohort study from age 8 to 26 years. PARTICIPANTS: The sample consists of 5,351 Finnish children born in 1981 with information about bullying and victimization at age eight from parents, teachers, and the children themselves. MAIN OUTCOME MEASURES: National police register information about criminal offenses at age 23-26 years. RESULTS: When controlled for the parental education level and psychopathology score, bullying sometimes and frequently independently predicted violent (OR 3.9, 95% CI 1.9-7.9, p < 0.001; OR 2.5, 95% CI 1.6-4.1, p < 0.001, respectively), property (OR 2.3, 95% CI 1.2-4.7, p < 0.05; OR 1.7, 95% CI 1.1-2.7, p < 0.05), and traffic (OR 2.8, 95% CI 1.8-4.4, p < 0.001; OR 1.6, 95% CI 1.3-2.1, p < 0.001) offenses. The strongest predictive association was between bullying frequently and more than five crimes during the 4-year period (OR 6.6, 95% CI 2.8-15.3, p < 0.001) in adjusted analyses. When different informants were compared, teacher reports of bullying were the strongest predictor of adult criminality. In adjusted analyses, male victimization did not independently predict adult crime. Among girls, bullying or victimization at age eight were not associated with adult criminality. CONCLUSIONS: Bullying among boys signals an elevated risk of adult criminality.

Childhood bullying as a predictor for becoming a teenage mother in Finland.

The aim of this study is to examine the association between bullying behaviour at the age of 8 and becoming a mother under the age of 20. This birth cohort study included 2,867 Finnish girls at baseline in 1989. Register-based follow-up data on births was collected until the end of 2001. Information, both on the main exposure and outcome, was available for 2,507 girls. Both bullies and victims had an increased risk of becoming a teenage mother independent of family-related risk factors. When controlled for childhood psychopathology, however, the association remained significant for bullies (OR 2.2, 95% CI 1.2-4.1) and bully-victims (OR 1.8, 95% CI 1.05-3.2), but not for pure victims. Reports of bullying and victimisation from the girls themselves, their parents and their teachers were all associated with becoming a teenage mother independent of each other. There is a predictive association between being a bully in childhood and becoming a mother in adolescence. It may be useful to target bullies for teenage pregnancy prevention.

Child mental health problems and obesity in early adulthood.

OBJECTIVE: To examine whether mental health problems in childhood increase the likelihood of overweight or obesity during early adulthood among male subjects. STUDY DESIGN: In a national prospective population-based study conducted in Finland, child mental health, including depression, emotional problems, conduct problems, and hyperactivity (determined on the basis of child, parent, and teacher information), was assessed at age 8 years. Body mass index (BMI) was obtained from military examination records (n = 2209) conducted in early adulthood (age range, 18-23 years). RESULTS: Both moderate (50th-90th percentile) and high (>90th percentile) levels of conduct problems at age 8 years were prospectively associated with a young adult being obese (BMI > or = 30; odds ratio [OR], 2.0; 95% CI, 1.2-3.2; and OR, 2.9; 95% Confidence interval [CI], 1.5-5.9; respectively). Conduct problems were also prospectively associated with a young adult being overweight (25 < or = BMI < 30; OR, 1.5; 95% CI, 1.1-1.9 for moderate levels of conduct problems, and OR, 1.9; 95% CI, 1.2-2.8 for high levels), after controlling for hyperactive problems and sociodemographic factors. CONCLUSIONS: Conduct problems in childhood are prospectively associated with overweight and obese in young adulthood. Future studies should address the potential for interventions to reduce obesity risk in young adulthood for boys who manifest conduct problems early in life.

Childhood predictors of later psychiatric hospital treatment: findings from the Finnish 1981 birth cohort study.

Psychiatric hospital treatment (PHT) is expensive and indicates a severe disorder. Investigation of the early identification of this small patient group has though been hindered by small samples or unsatisfactory assessment in childhood. The present study aims to study the predictive association between psychopathology at age 8 using multi-informant assessment and later PHT. A nationwide birth cohort of Finnish children (n = 5,346) was assessed at age 8 to obtain information about psychopathology using the Rutter parent and teacher reports and self-reports of depressive symptoms. The main outcome was admission to any hospital with a primary diagnosis of any psychiatric disorder according to the Finnish National Hospital Discharge Register between age 13 and 24. Between age 13 and 24, 6.2% of the males and 4.1% of the females had been admitted for PHT. Among males, PHT was independently predicted by non-intact family and adult reports of conduct and of emotional symptoms, while among females by self-reported depressive symptoms. However, the combination of conduct and emotional problems was the strongest predictor for PHT in both sexes. Admission due to psychosis among males was associated with childhood conduct, attention, and emotional problems, but with emotional problems among females. Psychopathology at age 8 can be seen as a long-lasting increased risk of severe psychiatric disorders requiring hospital treatment in adolescence or early adulthood. Attention should be paid to self-reports among females and of comorbid conduct and emotional problems in both sexes in the early identification of this patient group.

Cancer during pregnancy: Two case studies.

When a pregnant woman develops cancer, death and life are competing in her body and in her mind. In this article, two cases of pregnant cancer patients are described. The pregnant women were accompanied through their journey toward delivery and during the first months with their newborn. The process of being in intensive cancer treatment during pregnancy, of giving birth, and of building an early relationship with the infant is explored.

Motherhood and early interaction in a schizoaffective patient: the story of a long-term psychotherapy.

This paper focused on motherhood in a patient with a schizoaffective disorder. The core of the treatment was to build a strong therapeutic alliance in which compliance with medication and elaboration of mental processes could be achieved. Pregnancy and motherhood are a time of crisis in the life of women. For the schizoaffective patient this crisis threatens the deepest level of functioning and challenges attachment patterns. Comprehensive treatment including psychosocial support, medication and psychotherapy is able to protect the baby to be, the early relationship between mother and baby, and the development of the child over time in this high-risk family. However, the commitment over years of the same psychotherapist also seems one of the most powerful tools.

Childhood antecedents of being a cigarette smoker in early adulthood. The Finnish 'From a Boy to a Man' Study.

OBJECTIVE: To identify childhood psychiatric symptoms as antecedents of cigarette smoking at age 18. METHODS: In 1989, a general population sample of 2946 8-year-old boys born in Finland in 1981 was assessed using the Rutter's parent and teacher questionnaires, and the Child Depression Inventory. This birth cohort was followed up in 1999, when the subjects reported for their obligatory military service at age 18. Information about cigarette smoking frequency was obtained from 78% (n = 2307) of the boys attending the study in 1989. RESULTS: Childhood hyperactivity and self-reported depressive symptoms correlated with moderate daily (1-10 cigarettes), and heavy daily (>10 cigarettes) smoking at age 18. Conduct problems correlated with heavy daily smoking. A high level of childhood depressive symptoms, particularly in conjunction with a low educational level of the father, increased the risk of daily smoking. Emotional problems decreased the risk of smoking at age 18. In general, teacher reports had a better predictive power than parent reports for subsequent smoking. CONCLUSION: Future developmental studies with special focus on interaction between individual and environmental factors are warranted to reveal the mechanisms underlying the association between childhood psychopathology and adult smoking. In particular, the associations between childhood depression and future smoking need more clarification.

Childhood psychopathology and sense of coherence at age 18: findings from the Finnish from a boy to a man study.

OBJECTIVE: To examine associations between childhood psychopathology and family factors at age 8, and sense of coherence (SOC) at age 18. METHODS: The sample includes 2,314 Finnish boys born 1981 with information about psychopathology from parents and teachers using Rutter scales, and self-reports of depressive symptoms using Child Depression Inventory (CDI), and self-reports of SOC at age 18. RESULTS: Low parental education level and living in other than two biological parent family at age 8 were associated with low SOC 10 years later. Boys with internalizing symptoms based on parent/teacher reports, and depressive symptoms based on self-reports at age 8 were at risk for lower SOC at follow-up. Comorbidity of internalizing and conduct problems had the strongest association with low SOC. CONCLUSION: The study shows that internalizing symptoms, comorbid conduct and emotional problems, low parental education level and nonintact family at age 8 predict low SOC at age 18. Future research whether universal, selective or indicated early interventions targeted on risk factors of childhood mental health problems may result in promotion of well-being (including good SOC) in early adulthood is warranted.

Changes in psychiatric problems and service use among 8-year-old children: a 16-year population-based time-trend study.

OBJECTIVE: To study differences in children's psychiatric symptoms and child mental health service use at three time points: 1989, 1999, and 2005. METHOD: Three cross-sectional representative samples of 8-year-old children were compared from southern Finland. The sampling, procedure, and methods were similar at all three time points. Information was gathered from parents and teachers using Rutter questionnaires and other related determinants of service use and from children using the Children's Depression Inventory. The participation rate at the three time points was 96% in 1989, 86% in 1999, and 84% in 2005. RESULTS: Overall, parent and teacher reports of children's problems did not show a significant increase during the 16-year period. Parent reports of boys' conduct symptoms decreased from 1989 to 1999. However, self-reported depressive symptoms among girls increased from 1989 to 2005. Low parental education level, broken family, and negative life events were associated with depressive symptoms among girls. Although 4% of boys and 1% of girls had used child mental health services in 1989, the respective figures in 2005 were 12% and 4%. The majority of children who were screen positive on either parent or teacher ratings of emotional and behavioral problems using Rutter scales had received some educational support from school in 2005. CONCLUSIONS: Reports of depressive symptoms increased among girls, and this finding merits further studies. Use of services has continuously increased. School services play an important role in providing support and early detection of children who need to be referred to child mental health services.

Childhood bullying as a risk for later depression and suicidal ideation among Finnish males.

BACKGROUND: Little is known about the predictive association between childhood bullying behavior with depression and suicidal ideation at age 18. METHODS: The sample included 2348 boys born in 1981. Information about bullying was gathered at the age of 8 from self, parent and teacher's reports. Depression and suicidal ideation were assessed during the Finnish military call-up examination. RESULTS: Based on regression models, boys who were bullies frequently, but not merely sometimes, were more likely to be severely depressed and to report suicidal ideation compared to boys who were not bullies. When controlling for depression at age 8 the association between frequent bullying and severe depression was maintained but the association with suicidal ideation became non-significant. Boys who were only victimized were not more likely to be depressed or to report suicidal ideation at age 18. Boys who were frequently both bullies and victims were found to be at risk for later depression. LIMITATIONS: Our finding can only be generalized to boys who were involved in bullying at elementary school age. Data at age 18 was based only on self-reports and the bullying/victimization questions were very general. CONCLUSIONS: Childhood bullying behavior is a risk factor for later depression. Screening and intervention for bullying behavior in the early school years is recommended to avoid subsequent internalizing problem in late adolescence.