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Biomedical subjects

Hanna Ebeling

Publications and source records attributed to Hanna Ebeling.

17 recordsLinked to original sources
PubMed2007

Use of context in pragmatic language comprehension by children with Asperger syndrome or high-functioning autism.

Utilizing relevance theory, this study investigated the ability of children with Asperger syndrome (AS) and high-functioning autism (HFA) to use context when answering questions and when giving explanations for their correct answers. Three groups participated in this study: younger AS/HFA group (age 7-9, n=16), older AS/HFA group (age 10-12, n=23) and a normally functioning control group (age 7-9, n=23). The results indicated that the younger AS/HFA group did less well when answering contextually demanding questions compared to the control group, and the performance of the older AS/HFA group fell in between the younger AS/HFA group and the control group. Both AS/HFA groups had difficulties explaining their correct answers, suggesting that they are not always aware of how they have derived answers from the context.

Aptitude↗
PubMed2006

Answering contextually demanding questions: pragmatic errors produced by children with Asperger syndrome or high-functioning autism.

UNLABELLED: This study examined irrelevant/incorrect answers produced by children with Asperger syndrome or high-functioning autism (7-9-year-olds and 10-12-year-olds) and normally developing children (7-9-year-olds). The errors produced were divided into three types: in Type 1, the child answered the original question incorrectly, in Type 2, the child gave a correct answer, but when asked a follow-up question, he/she explained the answer incorrectly, and in Type 3, the child first gave a correct answer or explanation, but continued answering, which ultimately led to an irrelevant answer. Analyses of Type 1 and 2 errors indicated that all the children tried to utilize contextual information, albeit incorrectly. Analyses of Type 3 errors showed that topic drifts were almost non-existent in the control group, but common in the clinical group, suggesting that these children had difficulties in stopping processing after deriving a relevant answer. LEARNING OUTCOMES: The reader becomes aware of the different instances which may lead to the irrelevance of answers and get knowledge about features of answers of children with AS/HFA.

Aptitude↗
PubMed2006

Recurrent and transient depressive symptoms around delivery and maternal sensitivity.

In this study, the continuity, timing and severity of depressive symptoms around delivery was compared to maternal sensitivity in a community-based sample of 78 first-time mothers. Maternal mood was assessed before delivery (an interview and the General Health Questionnaire), 2 weeks and 4 months after delivery (the Edinburgh Postnatal Depression Scale), and maternal sensitivity 6-8 weeks after delivery (the CARE-Index). Nearly half (46%) of the mothers reported having depressive symptoms at least once, and half of these (23%) reported having such symptoms recurrently. Depressive mothers were significantly lower in sensitivity than non-depressive ones. Both pre- and postnatal, as well as recurrent and transient symptoms, affected the maternal interactive style, and both major and minor depressive symptoms were in most cases part of depressive continuity. Most (76%) mothers who reported depressive symptoms 2 weeks after delivery also reported recurrent symptoms. The most significant finding is considered to be that most (75%) mothers who were assessed to be at the risk level in sensitivity reported depressive symptoms. The public health nurses in the well-baby clinics identified only a few depressive mothers with recurrent symptoms. The conclusion of our study was that depressive symptoms at any time point around delivery constitute a risk of maternal interactive functioning, and identification of these problems is essential for well-timed and focused interventions.

Adult↗
PubMed2006

A comparative assessment of the factor structures and psychometric properties of the GHQ-12 and the GHQ-20 based on data from a Finnish population-based sample.

The General Health Questionnaire (GHQ) is a self-report questionnaire designed to identify psychological distress. Psychometric properties of two versions of GHQ-12 and GHQ-20 were assessed in a large population-based sample of Finnish twins, ages 22 to 27 (n= 4580). Participants were randomized into two subgroups, namely Twin1 (n= 2294) and Twin2 (n= 2286). The GHQ-12 data were assessed using Confirmatory Factor Analysis (CFA). The factor structure of the GHQ-20 was first assessed with Exploratory Factor Analysis (EFA) in the Twin1 dataset, and the results obtained were then subjected to CFA in Twin1 and Twin2 datasets. The CFA of the GHQ-12 indicated that the best fit and the simplest solution were provided by the three-factor solution in both subpopulations. Analyses of the GHQ-20 suggested that the four-factor structure was superior to the three-factor model. This result is also theoretically justifiable. Compared to the 12-item version, GHQ-20 provides additional fourth factor of anhedonia, suggesting some discriminative power.

Adult↗
PubMed2005

Attention and behavioural problems of Finnish adolescents may be related to the family environment.

BACKGROUND: Adolescents' attention and behavioural problems in relation to the family environment were studied in the Northern Finland 1986 Birth Cohort. METHOD: Fifteen-year-old adolescents (N=6888) completed the Youth Self-Report (YSR) questionnaire and their parents (N=6643) completed the Strengths and Weaknesses in ADHD and Normal Behaviours (SWAN) questionnaire. The ratings were compared in relation to gender and family characteristics. RESULTS: Girls scored higher than boys on the YSR attention problems subscale (means 4.61 vs. 3.41), the rule-breaking behaviour subscale (means 4.25 vs. 3.69) and the aggressive behaviour subscale (means 7.18 vs. 5.63). Parents reported more SWAN attention problems in their sons than in their daughters. Living in an other than intact family increased YSR and SWAN attention problems and YSR behavioural problems in both genders. Adolescents living in very large families (11-19 children) had least attention and behavioural problems. CONCLUSIONS: Attention and behavioural problems seem to be common among adolescents in Finland. For both genders, living in other than intact families increases especially behavioural problems. Additionally, a very large family seems to be a protective factor against those problems.

Adolescent↗
PubMed2004

Seasonal variation in postnatal depression.

BACKGROUND: We evaluated the occurrence of postnatal depression in general and during different seasons as part of a larger longitudinal mother-child follow-up study. METHOD: One hundred and eighty-five mothers, from the maternity wards of University Hospital of Oulu, Finland, completed a self-rating depression scale, the Edinburgh Postnatal Depression Scale (EPDS) twice: first at hospital 2-7 days after delivery and the second time at home 4 months after the delivery. Different psychosocial variables were mapped out to avoid any confounding factors. The year was divided in two separate ways: first, three different time periods were selected by the amount of sunlight: dark (October-January), intermediate (February, March, August, September) and light (April-July), and second, the year was divided by seasons. The results were analysed by the chi(2)-test for multinomials. RESULTS: Sixteen percent (16.2) of mothers were scored as being depressed using 13 as a cut-off point immediately after the infant was born. Thirteen percent (13.0) were depressed measured 4 months postpartum. There was more mild depression in the autumn (ratio observed/expected 1,62; 95% confidence interval 1.05-2.19) immediately after delivery, using 10 as a cut-off, and less depression in the spring (0.27; 0.00-0.62) measured at home later, using 13 as a cut-off. When using classification by the amount of light there was more depression during the dark time (1.58; 1.05-2.11) immediately postpartum. LIMITATIONS: The group sizes and the amount of sample sizes collected within each month are quite small. CONCLUSIONS: It should be borne in mind that seasonal changes and alterations in the amount of light might influence the occurrence of postnatal depression.

Depression, Postpartum↗
PubMed2004

Does pain relief during delivery decrease the risk of postnatal depression?

BACKGROUND: To test the hypothesis that sufficient pain relief during delivery decreases the risk of postnatal depression. METHODS: As part of a prospective follow-up study of the risk factors for postnatal depression and its impact on the mother-infant interaction and child development, 185 parturients filled in the Edinburgh Postnatal Depression Scale (EPDS), first during the first postpartum week and again (n = 162) 4 months later. The incidence and the risk of high EPDS scores was calculated according to the mode of delivery and the mode of pain relief during vaginal delivery, also after adjusting for the length of labor. RESULTS: Mothers who received epidural/paracervical blockade during their delivery spent less time in the delivery room than mothers in the nitrous oxide/acupuncture group (p = 0.033) or mothers with no pain relief (p = 0.026) and had shorter length of labor than mothers without pain relief (p = 0.04). The adjusted risk of depressive scores at the first postnatal week was decreased in the epidural/paracervical group when compared with no analgesia group (OR: 0.25, 95% CI: 0.09-0.72). This difference was not shown at 4 months postpartum. Elective or emergency cesarean section did not increase the risk of high EPDS scores at the first week or at 4 months postpartum. CONCLUSION: The mode of pain relief during vaginal delivery seems to be associated with the incidence of postpartum depression, especially immediately after delivery.

Adult↗
PubMed2004

Videoconferencing in child and adolescent telepsychiatry: a systematic review of the literature.

A systematic review of child and adolescent telepsychiatry was conducted. It was based on a search of the electronic databases MEDLINE and PsycINFO covering the period 1966 to June 2003. Studies were selected for review if they concerned videoconferencing for patient care or consultation, evaluated a clinical service or education, or assessed satisfaction with videoconferences. Twenty-seven articles were identified that fulfilled the selection criteria. These comprised two reports of randomized controlled experiments, 10 of descriptive questionnaire studies or observational surveys, seven case studies and eight other reports. Only three of the studies presented some calculations of cost-effectiveness. When classified by 'Quality of Evidence' criteria, only two studies were in category I (the highest), one was in II-2 and the rest fell into category III (the lowest). Most studies of child and adolescent telepsychiatry examined satisfaction with videoconferencing or described programmes or care regimens. Videoconferencing seemed to improve the accessibility of services and served an educational function. Some papers also mentioned savings in time, costs and travel. Problems with non-verbal communication and the audiovisual quality of the videoconference were mentioned as drawbacks. Telepsychiatry therefore seems to offer several benefits, at least in sparsely populated regions. Well designed and properly controlled trials are required to evaluate the clinical value of this promising method in child psychiatry, where there is a constantly increasing need for services.

Adolescent↗
PubMed2003

A practice guideline for treatment of eating disorders in children and adolescents.

Eating disorders are diseases of both the body and the psyche. Early treatment focuses on restoration of nutritional status and somatic health, including psycho-educational counselling and support offered to the patient and his/her family. Diagnosis and treatment require a multidisciplinary approach. Psychological factors related to the condition should be assessed. The most severe weight loss should be reversed before psychotherapeutic treatment. Nutritional counselling is recommended, and the benefits of individual and/or family therapy are considered in accordance with the patient's age, development, symptomatology and comorbid psychiatric disorders. Medication is useful in the treatment of bulimia nervosa and certain comorbid symptoms of anorexia nervosa. Early admission to treatment and active therapy are associated with a more favourable prognosis.

Adolescent↗
PubMed2003

Traumatic injuries of children and adolescents--are they associated with psychiatric contacts?

Our aim was to investigate whether a large number of hospital visits by children and adolescents because of injuries are associated with psychiatric treatments and subsequent suicides. We examined the case records of 250 randomly chosen patients, 156 (62%) boys and 94 (38%) girls, out of 2306 outpatients who were 0-16 years old and had been treated because of traumatic injuries in Oulu University Hospital in 1984 and were alive in 1997. Boys with seven or more accidents had had psychiatric treatments more commonly than did boys with fewer accidents (39% vs. 8%). In addition, the case records of the patients who had died before the end of 1997 out of the 2306 patients were examined. Twenty-one (0.9%) patients (20 males and one female) had died, and seven (0.3%) of them had committed suicide. The traumatically injured male patients had a twofold suicide rate compared to the national average. The researchers also re-coded the causes of death from the death certificates. There seems to be a tendency to interpret adolescent suicides as accidental, as one of the seven registered suicides (14%), but six of the seven re-coded suicides (86%) had occurred before the age of 20.

Accidents, Traffic↗
PubMed2003

Maternal smoking and hyperactivity in 8-year-old children.

OBJECTIVE: To investigate the association between maternal smoking during pregnancy and hyperactivity in 8-year-old children. METHOD: The study population consisted of children from the Northern Finland 1985/86 Birth Cohort. At 8-year follow-up 9,357 children were alive. Mothers provided information both during pregnancy and at age 8. Teachers assessed children's behavior by the Children's Behavior Questionnaire (Rutter B2). Unadjusted analyses and stratification were used to study associations and confounding variables. A multivariate logistic regression model was fitted to assess the independent association between smoking and outcome. RESULTS: Maternal smoking was associated with hyperactivity even after adjustment for sex, family structure, socioeconomic status, maternal age, and maternal alcohol use (odds ratio 1.30; 1.08-1.58). The association was particularly notable among children of young mothers with low social standing. A positive dose-response relationship was seen between maternal smoking and hyperactivity. CONCLUSION: This study, the largest population-based prospective follow-up on fetal nicotine exposure and later behavioral disorders, confirms earlier descriptions of the link between maternal smoking during gestation and childhood hyperactivity. Discontinuation or decreased use of cigarettes during pregnancy might improve behavioral outcome of children.

Adult↗
PubMed2003

Inter-twin relationships and mental health.

We evaluated dominance-submissiveness between co-twins and its relationship to mental health in a cohort study of 419 twins followed from pregnancy to 22-30 years of age. Dominance-submissiveness between co-twins was assessed from three separate perspectives: physical dominance, psychological dominance, and verbal dominance. Depressive, nervous, and psychosomatic symptoms were analyzed in different twin groups. In the physical domain, males were more commonly dominant than females at school age and in adulthood. Before and at school age, girls were more dominant than boys in the psychological and verbal domains, as well as in total dominance. These differences disappeared in adulthood, and 81% of adult twins felt themselves equal to their co-twin in total dominance. Submissiveness in the psychological domain seemed to be associated with increased depressiveness, nervous complaints and psychosomatic symptoms in males of male-female twin pairs. Verbally submissive males in same-sex twin pairs had more depression and psychosomatic symptoms. Among females of same-sex twin pairs, submissiveness in the psychological domain was most clearly associated with depressive symptoms, whereas psychological or verbal dominance-submissiveness among females from male-female twin pairs was not associated with symptoms. Psychologically dominant males and females of same-sex twin pairs expressed greater nervousness than did their co-twins. We conclude that being submissive, especially in the psychological domain, to a female twin partner seems to be stressful, whereas it is easier, especially for females, to be submissive to a male twin partner.

Adult↗
PubMed2003

Special school teachers require more goal-oriented collaboration with psychiatric professionals in Northern Finland.

BACKGROUND: The problems of children and adolescents have increased in number and severity during the last years. OBJECTIVE: The purpose of this study was to elicit the views of special school teachers in the Oulu Province in Finland concerning their pupils' problems and the need, use and adequacy of relevant psychiatric services. METHODS: The information was collected from the Northern Ostrobothnia Hospital District in 1998 in Finland and responses were obtained from the 37 (97.4%) special schools. The data were analysed using the content analysis method. RESULTS: Special-needs pupils had various behavioural and emotional problems that made it difficult for them to learn and for the teachers to teach. According to the teachers, the major obstacles in the process of helping special-needs pupils were the delayed admission for treatment and the lack of information necessary for the pupils' school work and goal-oriented aftercare, although there were also favourable experiences of functional co-operation and availability of useful information. Some schools lacked a reliable network for helping pupilsand supporting teachers. The Finnish legislation on basic education obliges the providers of education to provide rehabilitation in connection with special education and to arrange relevant development, counselling and support services. CONCLUSION: The rehabilitation of special-need pupils and the collaboration between school and mental health authorities is not optimally realised in spite of the legislation.

Adolescent↗
PubMed2002

Children and adolescents with developmental disorders and violence.

OBJECTIVES: The aim of this preliminary study was to investigate how commonly child-psychiatric inpatients have experienced and seen violence, and whether children with developmental disorders are at an increased risk for such traumatic events. METHODS: The sample consisted of 41 patients, 29 boys and 12 girls, with a mean (SD) age of 11.8 (3.2) years. Ten children had a developmental disorder, 19 an emotional disorder, 9 a behavioural disorder and 3 a psychotic disorder. The study was performed as part of the normal clinical examinations by paying special attention to violence in the lives of these patients. RESULTS: 88% of the patients had experienced some form of violence. 49% had experienced active physical violence and 49% active psychological violence. If suspected violence was also taken into account, active physical violence was more common among the patients with developmental disorders (90%) or behavioural disorders (78%) than among those with emotional disorders (37%) or psychotic disorders (67%). On the other hand, passive physical violence without active physical violence had been experienced by 37% of the patients with emotional disorders but not by the other patients. CONCLUSIONS: Violence was common among all groups of child-psychiatric inpatients. These individuals may be vulnerable to violence, as interaction with them may be especially demanding for peers and adults.

Adolescent↗
PubMed2002

Psychiatric disorders of children and adolescents--a growing problem at school.

The purpose is to present the views of comprehensive school and senior secondary school teachers working in the Oulu province in Northern Finland concerning the behavioural and emotional disorders of their pupils, the actions taken by teachers to refer pupils for consultation, and the functionality of mental health services. The data were collected by questionnaires in 1998 and 2000. According to the teachers' estimates, the behavioural and emotional disorders of pupils have both increased in number and become more severe at all levels of primary and secondary education. The teachers of comprehensive schools and special schools mostly contacted the parents when a pupil was found to have psychiatric symptoms. At the early stages of referral the teachers often also consulted with the pupil welfare team for support. The teachers of senior secondary schools contacted primarily the school nurse and secondarily the parents. Teachers were content with the psychiatric health care services if their pupils benefited from them, but the availability of services and the flow of information were problems. It was also difficult to decide when to refer a pupil for consultation and treatment. The responsibilities and obligations for the availability and functionality of mental health services for children and adolescents were re-defined and specified in a statute enforced as of January 2001. The question is how can we convert responsibilities and obligations into practical action?

Adolescent↗