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This large, international dataset contains survey responses from N = 12,570 students from 100 universities in 35 countries, collected in 21 languages. We measured anxieties (statistics, mathematics, test, trait, social interaction, performance, creativity, intolerance of uncertainty, and fear of negative evaluation), self-efficacy, persistence, and the cognitive reflection test, and collected demographics, previous mathematics grades, self-reported and official statistics grades, and statistics module details. Data reuse potential is broad, including testing links between anxieties and statistics/mathematics education factors, and examining instruments’ psychometric properties across different languages and contexts. Data and metadata are stored on the Open Science Framework website [https://osf.io/mhg94/].

In this study, we explored whether satisfaction with government management, perception of risk, and gratitude influenced public anxiety during the COVID-19 pandemic in China. Using a cross-sectional, anonymous and confidential online survey, a nationwide sample of Chinese adults (N = 876) was targeted between March 25–March 30, 2020, a period in which newly confirmed cases significantly declined in China. The anxiety level was decreased as compared to that assessed during the peak period. Multiple parallel mediation modeling demonstrated that risk perception and gratitude partially mediated the relationship between satisfaction with government management and public anxiety. Increasing satisfaction and gratitude, as well as reducing risk perception contribute to the public’s mental health. The results may shed light on the positive factors for psychological well-being during the COVID-19 pandemic and may aid potential strategies for the policy maker, the public, and the clinic to regulate negative emotions or future emerging infectious diseases.

Despite the prominence of fitness testing in school physical education (PE), there is a sparsity of research examining the antecedents of students’ affective experiences during fitness testing lessons. This study aimed to investigate the associations among task- and ego-involving motivational climates, perceived physical competence, physical performance, enjoyment, and anxiety during two different types of PE fitness testing lessons. Altogether, 645 Finnish students from Grade 5 (50% boys, Mage = 11.2, SD = 0.36) and Grade 8 (47% boys, Mage = 14.2, SD = 0.35) participated in two fitness testing lessons with different content (lesson 1: 20-meter shuttle run test and a test of flexibility; lesson 2: curl-ups, push-ups, 5-leaps, and a catching-throwing combination test). Students’ experiences were collected using short questionnaires immediately after the lessons. Structural equation modeling was applied to examine the direct and indirect associations among study variables. Results indicated that task-involving climate and perceived competence increased students’ enjoyment and decreased their anxiety levels whereas ego-involving climate had no effect on students’ enjoyment but increased their anxiety levels. In addition, students’ actual physical performance as a mediator between motivational climate and affects, or as a direct predictor of affects, was limited. Strategies advancing task-involving motivational climate and students’ perception of competence should be employed to increase enjoyment and decrease anxiety during PE fitness testing lessons.

This article discusses the results of a reception study of three environmental films with a focus on emotional reactions and the films’ influence on the respondents’ environmental awareness. The short experimental film Valtakunnat/Realms (Finland, 2018) envisions post-human life, and the potential destruction that the planet is being driven towards. To Teach a Bird to Fly (Finland, 2020), a short documentary fiction film about a woman raising critically endangered birds, imagines a future where the effects of climate change have been reversed. The documentary film The Biggest Little Farm (USA, 2018) follows a couple who buy a barren farm with the aim of restoring its biodiversity. Through thematic analysis two interconnected responses – hope and anxiety – were identified. The article discusses the connection between viewers’ emotional responses, the films’ different styles, their utopian and dystopian elements, and the impact of the films on viewers’ environmental awareness. The article concludes that both gloomy and hopeful films can help viewers reflect on their own relationship to nature and consider their role in preventing an environmental catastrophe. peerReviewed

Good aerobic fitness associates positively with cognitive performance and brain health and conversely, low aerobic fitness predisposes to neurodegenerative diseases. To study how genotype together with exercise, started at older age, affects brain and behavior, we utilized rats that differ in inherited aerobic fitness. Rats bred for Low Capacity for Running (LCR) are shown to display less synaptic plasticity and more inflammation in the hippocampus and perform worse than rats bred for a High Capacity for Running (HCR) in tasks requiring flexible cognition. Here we used middle-aged (∼ 16 months) HCR and LCR rats to study how genotype and sex associate with anxiety and neural information filtering, termed sensory gating. Further, we assessed how inherited aerobic capacity associates with hippocampus-dependent learning, measured with contextual fear conditioning task. In females, we also investigated the effects of voluntary wheel running (5 weeks) on these characteristics. Our results indicate that independent of sex or voluntary running, HCR rats were more anxious in open-field tasks, exhibited lower sensory gating and learned more efficiently in contextual fear conditioning task than LCR rats. Voluntary running did not markedly affect innate behavior but slightly decreased the differences between female LCR and HCR rats in fear learning. In conclusion, inherited fitness seems to determine cognitive and behavioral traits independent of sex. Although the traits proved to be rather resistant to change at adult age, learning was slightly improved following exercise in LCR females, prone to obesity and poor fitness. peerReviewed

Sosiaalisissa tilanteissa koettu ahdistuneisuus on ilmiönä yleinen, mutta ahdistuneisuuden ollessa voimakasta ja yksilön toimintaa haittaavaa on kyse kliinisestä sosiaalisten tilanteiden pelosta. Sosiaalisten tilanteiden pelko puhkeaa useimmiten nuoruudessa, jolloin yksilön itsetietoisuus kasvaa, sosiaalisen kognition kyvyt kehittyvät ja sosiaalinen ympäristö on muutoksessa. Sosiaalisten tilanteiden pelon (STP) on havaittu olevan tytöillä yleisempää kuin pojilla, ja olevan yhteydessä nuorten kokemaan sosiaaliseen tukeen, ystävyyssuhteiden inhibointiin ja ystävyyssuhteiden laatuun. Vuonna 2019 alkunsa saanut COVID-19-pandemia on tutkimusten mukaan vaikuttanut monilla tavoin yksilöiden hyvinvointiin ja mielenterveyteen, mutta sen vaikutuksia nuorten sosiaaliseen ahdistuneisuuteen on tutkittu vasta vähän. Tämän tutkimuksen tavoitteena oli tarkastella nuorten STP:n oireiden voimakkuutta ja muutosta vuosina 2013, 2015, 2021, ja selvittää samalla sukupuolten välistä eroa ja läheisten ystävyyssuhteiden merkitystä STP:n oireiden voimakkuuteen ennen COVID-19-pandemiaa sekä sen aikana. Tutkimus on osa laajempaa valtakunnallista kouluterveyskyselytutkimusta, joka toteutetaan joka toinen vuosi. Aineisto (n= 451 478) koostui peruskoulun 8. ja 9. luokan oppilaista sekä lukiokoulutuksen ja ammatillisten oppilaitosten 1. ja 2. vuoden opiskelijoista vuosina 2013, 2015 ja 2021. Kouluterveyskysely toteutetaan koulupäivän aikana opiskelijoiden itsearvioina, ja kyselylomake oli vuosina 2013 ja 2015 paperinen ja vuonna 2021 sähköinen. Sosiaalista ahdistuneisuutta tarkasteltiin tutkimuksessa sosiaalisten tilanteiden pelon oireita kartoittavalla Mini-SPIN-mittarilla. Läheisten ystävyyssuhteiden merkitystä tarkasteltiin kysymällä, onko osallistujilla sellaisia läheisiä ystäviä, joiden kanssa he pystyvät juttelemaan lähes mistä vain asioista. Tutkimuksen tulokset vahvistivat aikaisempaa käsitystä siitä, että COVID-19-pandemia on vaikuttanut nuorten mielenterveyteen negatiivisesti, ja nuorten sosiaalisten tilanteiden pelon oireet olivat vuonna 2021 merkittävästi voimakkaampia, kuin vuosina 2013 ja 2015. Tulokset osoittivat tyttöjen STP:n oireiden yleistyneen enemmän kuin pojilla kyselyvuosien välillä, ja että tytöt kokivat huomattavasti enemmän STP:n oireita kuin pojat. STP:n oireiden havaittiin olevan koko aineistossa yhteydessä myös läheisten ystävyyssuhteiden puutteeseen. Oletuksen vastaisesti STP:n oireet olivat kasvaneet vuosien 2013, 2015 ja 2021 välillä enemmän niillä nuorilla, joilla oli yksi tai useampi läheinen ystävä verrattuna niihin nuoriin, jotka raportoivat, että heillä ei ollut yhtäkään läheistä ystävää. Tulevissa tutkimuksissa on syytä tarkastella lähemmin mahdollisia syy- tai riskitekijöitä nuorten STP:n oireiden kasvuun sekä siihen, millä tavoin nuorten läheiset ystävyyssuhteet vaikuttavat koettuun sosiaaliseen ahdistuneisuuteen poikkeusaikana, kuten sosiaalisia rajoittamistoimia edellyttäneen pandemian kuluessa.

The aim of the study was to investigate the effect of a 360° virtual counselling environment (360°VCE) on reducing people’s anxiety levels and improving computed tomography angiography (CCTA) process time. The anxiety during CCTA can reduce patient safety, the quality of the imaging experience, and the image quality, as well as increase the radiation dose. In the intervention planning phase (phase I) the systematic review identified and synthesized the effectiveness of digital counseling environments (n=26) at reducing anxiety, depression, and adherence to treatment among patients who are chronically ill. In phase II the 360°VCE was developed using spherical panoramic images and non-immersive 360° technology. A qualitative study was then conducted to describe patients’ (n=10), radiographers’ (n=10) and radiography students’ (n=10) experiences of the developed 360°VCE for the CCTA. In the pilot study the 360°VCE relieved patients’ fear, increased knowledge and senses of patient safety and self-efficacy. In phase III the effect of a 360°VCE on patient anxiety and CCTA process time were evaluated in a randomised controlled trial. A total of 86 CCTA patients were randomly assigned to intervention (n=41) and control (n=45) groups. The primary outcome, anxiety, was measured using the State-Trait Anxiety Inventory (STAI). The secondary outcome was CCTA process time. Pre-scan anxiety was lower among patients in the 360°VCE group right before CCTA in comparison to patients in the control group (p=0.015). The change in the state anxiety was -7.34 (95% CI -9.83 to -4.86, p

Background Family caregivers often report high levels of distress, including depressive symptoms, anxiety, and reduced quality of life. There is a need for a greater understanding of the factors influencing, explaining, and maintaining psychological distress in family caregivers. Aim The aim of this study was to examine whether avoidance strategies such as thought suppression (WBSI), psychological inflexibility (AAQ-II), and, and caregiver experiential avoidance (EACQ) predict psychological distress (BDI-II, GAD-7) and quality of life (WHOQOL) in family caregivers aged 60 and over. We hypothesized that these avoidance strategies would explain elevated levels of psychological symptoms and lower quality of life. Method Altogether, 149 family caregivers completed self-report measures of depressive symptoms, anxiety, quality of life, thought suppression, psychological inflexibility and caregiver experiential avoidance. We conducted correlation and regression analyses to assess the associations and the predictive ability of these constructs. Results Together, psychological inflexibility and thought suppression accounted for between 40 and 46% of the variance in the depression and anxiety outcomes and 15% of the variance in the physical domain of quality of life. Unwanted thoughts, the subcomponent of thought suppression, was strongly associated with symptoms of depression and anxiety, and with physical and psychological quality of life. Conclusion Thought suppression and psychological inflexibility played a significant role in explaining family caregivers’ symptoms of depression and anxiety. In addition, psychological inflexibility was significantly related to quality of life. This suggests the need for acceptance-based strategies to handle thought suppression and psychological inflexibility.

One of the most important factors in a child’s growth environment is the emotional atmosphere of the family. Childhood experiences and perceptions of interaction with parents can be reflected in the offspring’s later life course. This study explored, i) the connections between parental images and the quality of the offspring’s current intimate relationships; ii) differences between females and males in relation to their parental images and the quality of their relationships; and iii) whether the mother’s self-reported assessment of her strictness and the adult offspring’s recollections of the disciplinary methods of their parents are associated in the adult offspring’s recalled parental images and current emotional distress, anxiety and depression as assessed by the Hopkins Symptom Check List (HSCL-25); and whether their parental images are associated with their emotional distress. The data is a part of the Oulu University Hospital “Mother-Child Follow-up Study 1971–1972”. The mothers responded to a 1st follow-up questionnaire (the assessment of her strictness) when the children were 7 years old (N = 354). The offspring responded to a 2nd follow-up questionnaire concerning experienced discipline methods, their parental images and current intimate relationship quality and HSCL-25-scores in the year 2000 (N = 337). A supportive mother image was associated with the daughters’ and sons’ — and a supportive paternal image only with the daughters’ — balanced relationships. A dominant father image was associated with both the daughters’ and sons’ submissive/repressive relationships. A supportive image of the opposite sex parent was associated with the offspring’s loving relationships and protected them from quarrelsome relationships. A supportive image of the father also protected the female offspring from a submissive/repressive relationship. A recollection of dialogic discipline of both parents was positively associated with the corresponding parent’s supportive and sociable images, and correspondingly recalled restriction and corporal punishment with dominating parental images. Dialogic discipline protected from dominating parental images. Dominating images of both parents, maternal strictness, and lack of recalled paternal dialogic discipline were associated with the offspring’s emotional distress (HSCL-25), anxiety, and depression symptoms. Parental images may act as mediators between childhood experiences and current well-being. The perceptions of the father were emphasized in this study. Tiivistelmä Kasvuympäristön tärkeimpiä tekijöitä on lapsuudenperheen tunneilmapiiri. Lapsuudenkokemukset ja käsitykset vuorovaikutuksesta vanhempien kanssa voivat heijastua jälkeläisten myöhempiin ihmissuhteisiin ja hyvinvointiin aikuisiässä. Tämän tutkimuksen tarkoituksena oli selvittää i) nuorten aikuisten vanhempimielikuvien ja nykyisen parisuhteen laadun välistä yhteyttä, ii) naisten ja miesten välisiä eroja liittyen vanhempimielikuviin ja parisuhteen laatuun, iii) liittyvätkö äidin ilmoittama arvio hänen omasta ankaruudestaan ja aikuisten jälkeläisten muistamat vanhempiensa käyttämät kasvatusmenetelmät jälkeläisten vanhempimielikuviin ja tämän hetkiseen emotionaaliseen stressiin, ahdistukseen ja masennukseen Hopkinsin menetelmällä (HSCL-25) mitattuna, sekä liittyvätkö jälkeläisten vanhempimielikuvat heidän HSCL-25-oireisiinsa. Aineisto on osa Oulun yliopistollisen sairaalan ”Äiti-lapsi-seurantatutkimusta 1971–1972”. Äidit vastasivat ensimmäiseen seurantakyselyyn ja arvoivat omaa ankaruuttaan kasvattajina lapsen ollessa seitsemänvuotias (N = 354). Jälkeläiset vastasivat vuonna 2000 (N = 337) toiseen seurantakyselyyn, joka koski heidän kokemaansa kasvatusta ja muistiin palautettuja vanhempimielikuviaan sekä tämänhetkistä parisuhteensa laatua ja HSCL-25–menetelmällä mitattuja oireitaan. Kannustava äitimielikuva liittyi sekä tyttären että pojan tasapainoiseen parisuhteeseen, mutta kannustava mielikuva isästä heijastui vain tyttären tasapainoiseen suhteeseen, ja se myös suojasi tyttäriä alistavalta/alistuvalta suhteelta. Dominoiva isämielikuva liittyi sekä tyttären että pojan alistavaan/ alistuvaan suhteeseen. Kannustava mielikuva vastakkaista sukupuolta olevasta vanhemmasta liittyi sekä naisilla että miehillä rakastavaan parisuhteeseen ja suojeli riitaisalta suhteelta. Muistikuva äidin ja isän dialogisesta kurista liittyi kannustavaan ja sosiaaliseen mielikuvaan vastaavasta vanhemmasta. Rajoittava ja ruumiillisesti rankaiseva kuri liittyi dominoivaan vanhempimielikuvaan, kun taas dialoginen kasvatus suojasi siltä. Mielikuva dominoivasta vanhemmasta, isän dialogisen kasvatuksen ja kurin vähäisyys sekä äidin tiukkuus hänen itsensä arvioimana liittyivät jälkeläisten HSCL-25-, ahdistuneisuus- ja masennusoireisiin. Vanhempimielikuvat näyttäisivät toimivan lapsuuden kokemusten ja nykyisen hyvinvoinnin välittäjinä. Tässä tutkimuksessa isämielikuvien merkitys korostui. Isyyden merkitys kaipaa lisätutkimuksia.

Introduction: Preterm birth may disturb the typical development of the mother– infant relationship, when physical separation and emotional distress in the neonatal intensive care unit may increase maternal anxiety and create challenges for early interaction. This cluster-randomized controlled trial examined the effects of maternal singing during kangaroo care on mothers’ anxiety, wellbeing, and the early mother– infant relationship after preterm birth. Method: In the singing intervention group, a certified music therapist guided the mothers (n = 24) to sing or hum during daily kangaroo care during 33–40 gestational weeks (GW). In the control group, the mothers (n = 12) conducted daily kangaroo care without specific encouragement to sing. Using a convergent mixed methods design, the quantitative outcomes included the State-Trait Anxiety Inventory (STAI) at 35 GW and 40 GW to assess the change in maternal-state anxiety levels and parent diaries to examine intervention length. Post-intervention, the singing intervention mothers completed a self-report questionnaire consisting of quantitative and qualitative questions about their singing experiences. Results: The mothers in the singing intervention group showed a statistically significant decrease in STAI anxiety levels compared to the control group mothers. According to the self-report questionnaire results, maternal singing relaxed both mothers and infants and supported their relationship by promoting emotional closeness and creating early interaction moments. Discussion: Maternal singing can be used during neonatal hospitalization to support maternal wellbeing and early mother–infant relationship after preterm birth. However, mothers may need information, support, and privacy for singing. peerReviewed

Background: Fitness testing is a commonly applied learning and teaching practice implemented in both secondary and elementary school physical education (PE). Many teachers believe that by using a variety of different tests, they are able to provide students with feedback regarding their fitness status, and furthermore, increase students’ willingness to be physically active later in their lives. However, empirical evidence concerning students’ affective responses during fitness testing classes is limited. Purpose: The primary aim of the study was to investigate whether students’ perceptions of enjoyment and anxiety differed between two different types of fitness testing classes and PE in general. In addition, the measurement invariances over time and between Grade 5 (aged 11–12) and Grade 8 (aged 14–15) groups were determined. Method: A total sample of 645 Finnish Grade 5 (N = 328, 50% boys, mean age = 11.2, SD = 0.36) and Grade 8 students (N = 317, 47% boys, mean age = 14.2, SD = 0.35) participated in the study. Series of multi-group confirmatory factor analyses were conducted to test the level of measurement invariance between general PE and fitness testing classes, and between age groups. Strict factorial invariance was supported for both enjoyment and anxiety scales allowing for latent mean comparisons. Latent mean differences were studied using z-tests. Results: Grade 5 students perceived significantly lower levels of enjoyment and cognitive processes and a higher level of somatic anxiety in fitness testing classes compared to general PE. Additionally, for Grade 8 students, levels of enjoyment and cognitive processes were significantly lower and somatic anxiety and worry higher in fitness testing classes than in general PE. Furthermore, enjoyment was significantly higher, and cognitive processes, somatic anxiety and worry lower among Grade 5 students compared with Grade 8 students in both contextual PE and during fitness testing class. Conclusion: Results of this study indicate that students’ perceptions of enjoyment were lower in fitness testing classes compared to PE in general. Additionally, students perceived lower levels of cognitive anxiety and higher levels of somatic anxiety in fitness testing classes than in general PE. It is noteworthy that students might not significantly dislike fitness testing per se but instead have significantly more positive affects towards PE in general. Generally, practitioners conducting fitness testing lessons are encouraged to embrace different strategies such as fostering basic psychological needs or promoting mastery climate to facilitate enjoyment and diminish anxiety. peerReviewed

Background Although some adolescents managed to cope well with the challenges brought on by the COVID-19 pandemic, the well-being of many was adversely affected due to school closures, distance education, restrictions on gathering with friends, and limited access to mental health services. Many adolescents reported increased anxiety and depression as well as decreased psychological wellbeing due to the pandemic. Consequently, there is a need for psychological support that exceeds the strained resources available to schools to support young people during times of crisis and societal pressure. Objective The present study aimed to explore the effects of an online-delivered ACT intervention to promote adolescent psychological flexibility and self-compassion and decrease psychological distress during the second wave of COVID-19 in the fall of 2020. Methods A total of 348 adolescents aged 15–16 were randomly divided into three equal groups: 1) the iACT student coach + virtual coach group, n = 116; 2) the iACT virtual coach group, n = 116; and 3) the control group with no intervention, n = 116). Among these adolescents, 234 participated in a pre-measurement (iACT, n = 154; control, n = 80; intent-to-treat) and completed measures of psychological flexibility, self-compassion, anxiety, and depression. Results An investigation of all the adolescents who participated in the pre-measurement (intent-to-treat analysis, n = 234) revealed no significant differences between the three groups with regard to psychological flexibility, self-compassion, and symptoms of anxiety and depression. However, upon combining the two intervention groups and examining the adolescents who completed at least 30% of the Youth Compass program (per-protocol analysis, n = 137), small but significant differences between the iACT intervention and control groups were found regarding the psychological flexibility subscale valued action, self-compassion, and anxiety in favor of the intervention group. Conclusions Active use of an ACT-based online intervention under adverse circumstances may decrease symptoms of anxiety and increase psychological flexibility skills in adolescents. publishedVersion

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Artikkeli selvittää COVID-19-pandemian ajallisia ja intersubjektiivisia ulottuvuuksia eksistentiaalisen fenomenologian näkökulmasta. Teoreettisena lähtökohtana ovat erityisesti Martin Heideggerin ja Jean-Paul Sartren ajallisuuden ja autenttisuuden analyysit sekä Edmund Husserlin kuvaus uskomuksista pidättäytymisestä (epokhē). Esitän, että pandemian alkuvaiheen erityislaatuinen ajallinen ulottuvuus liittyy maailmavarmuuden järkkymiseen ja elämän haurauden kohtaamiseen. Kun kuoleman mahdollisuus hallitsee inhimillistä kanssakäymistä, olemassaoloa alkaa luonnehtia odotus ”normaaliin” palaamisesta ja nykyisyyden todellisuus hämärtyy. Analysoin tätä problematiikkaa ennen kaikkea epokhēn, autenttisuuden, Hingehaltenheitin ja välitilan käsitteiden avulla. Lisäksi kuvaan, miten pandemia, joka toi esiin yksilöiden erilaiset tavat kohdata uusi tilanne, kyseenalaisti myös käsitykset jaetusta rationaalisuudesta. peerReviewed

Background: The uncertain and stressful global situation caused by the COVID-19 pandemic has the potential to cause anxiety and impact people's mental health. Simultaneously, social distancing policies have isolated people from their normal social interactions. These societal changes have inevitably influenced gambling and gaming practices, and many people may have turned to betting or gaming as a means of social exchange. This study examined the influence of COVID-19 anxiety on increased mental health problems and their relationship to gambling and gaming problems. The mediating role of social motives for gambling and gaming was also investigated. Material and methods: Finnish adults (N = 1530; Mage = 46.67; 50.33% male) were recruited from a volunteer participant panel to participate in a survey study. COVID-19 anxiety was assessed using a scale adapted from the Spielberger State–Trait Anxiety Inventory. Mental health problems were evaluated with the five-item Mental Health Inventory. Gambling problems were measured using the Problem Gambling Severity Index, and gaming problems were measured with the Internet Gaming Disorder Test. Social motives for gaming were evaluated using a single-item measure. Analyses used generalised structural equation modelling. Results: COVID-19 anxiety predicted increased mental health problems, which were associated with heightened gambling and gaming problems. Social motives for gambling and gaming were a significant mediator, suggesting that gambling and gaming problems are emphasized markedly among those who are socially motivated by and involved in such games. Conclusions: Mental health problems experienced during the pandemic and the social properties of games might accentuate gambling and gaming problems. publishedVersion

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Suomessa ulkomaalaistaustaisen väestön osuus koko väestöstä on kasvanut tasaisesti viimeisen kolmen vuosikymmenen aikana ja osuus tulee kasvamaan maahanmuuton yhä yleistyessä sekä uusien maahanmuuttajasukupolvien syntyessä. Ulkomaalaistaustainen väestö on heterogeeninen väestöryhmä, johon kuuluvat eroavat toisistaan esimerkiksi taustamaan, maahanmuuton syyn, sosioekonomisen aseman ja kielitaidon osalta. Tämä pro gradu -tutkielma koostuu kirjallisuuskatsauksesta sekä artikkelikäsikirjoituksesta. Kirjallisuuskatsauksessa systemaattisen tiedonhaun avulla vertailtiin ulkomaalaistaustaisen väestön psyykkistä kuormittuneisuutta koko väestöön tai tutkittavan maan syntyperäiseen väestöön sekä selvitettiin psyykkiseen kuormittuneisuuteen yhteydessä olevia tekijöitä aiempien eurooppalaisten tutkimusten pohjalta. Tulosten mukaan ulkomaalaistaustainen väestö oli muuta väestöä kuormittuneempaa, joskin myös poikkeavia tuloksia löydettiin. Ulkomaalaistaustaisten psyykkiseen kuormittuneisuuteen yhteydessä olevista tekijöistä esiin nousivat erityisesti naissukupuoli, heikko sosioekonominen asema, pakolaistausta, sosiaalisen tuen puute, koettu syrjintä sekä maahanmuuttajien yhteiskunnallinen asema liittyen esimerkiksi maahanmuuttopolitiikkaan. Artikkelikäsikirjoitus perustuu THL:n vuosina 2018–2019 toteuttamaan väestötasoiseen Ulkomaalaistaustaisten terveys ja hyvinvointi Suomessa (FinMonik) -tutkimukseen. Artikkelikäsikirjoituksessa tarkoituksena oli verrata ulkomailla syntyneen Suomessa asuvan väestön psyykkistä kuormittuneisuutta koko väestöön sekä vertailla sen yleisyyttä eri taustamaaryhmissä. Lisäksi tavoitteena oli selvittää ulkomailla syntyneen väestön psyykkiseen kuormittuneisuuteen yhteydessä olevia tekijöitä. Aineisto analysoitiin SAS 9.4 ja SUDAAN 11.0.3 ohjelmilla. Analyysimenetelminä käytettiin Taylor Linearization -testiä, logistista regressioanalyysiä, predicted marginals -testiä sekä Satterthwaiten f-testiä. Tutkimuksessa osoitettiin Suomessa asuvan ulkomaalaistaustaisen väestön psyykkisen kuormittuneisuuden olevan koko väestöä yleisempää (17.4 % vs. 12.9 %). Erityisesti Lähi-Idästä ja Pohjois-Afrikasta muuttaneiden kuormittuneisuus oli merkittävästi yleisempää kuin koko väestöllä (29.7 %). Lisäksi pakolaistausta, työttömyys tai taloudellinen inaktiivisuus sekä heikko kielitaito lisäsivät todennäköisyyttä kuormittuneisuudelle. Sekä kirjallisuuskatsauksen että tutkimuksen tulokset osoittavat tarpeen kiinnittää tarkempaa huomiota ulkomaalaistaustaisen väestön psyykkiseen hyvinvointiin Suomessa. Ulkomaalaistaustaisten psyykkisen hyvinvoinnin riskitekijät ovat osin samoja kuin muulla väestöllä, minkä lisäksi siihen vaikuttavat kokemukset aiemmassa kotimaassa sekä uuteen kotimaahan sopeutumisen aiheuttamat haasteet. Ulkomaalaistaustaisten kotoutumiseen tulisi kiinnittää entistä enemmän huomiota ja kohdentaa toimenpiteitä esimerkiksi työllistymiseen, kouluttautumiseen, kielen oppimiseen sekä sosiaaliseen tukeen. In Finland, the percentage of foreign-background population has grown constantly in recent decades and will continue to grow in the future. Foreign-background population is a heterogeneous subpopulation that differs in terms of, for example, country of origin, reason for migration, socio-economic status, and language skills. This thesis consists of a literature review and an article manuscript. With a systematic approach in the literature review, the aims were to compare the psychological distress prevalence rates between foreign-background and general or native populations in European countries and to identify factors related to psychological distress among foreign-background population. The results showed that foreign-background population was more often psychologically distressed compared to general or native populations. Factors associated with psychological distress were female gender, low socio-economic status, refugee-background, inadequate social support, perceived discrimination, and the societal status of migrants related to, for example, migration policies. The article manuscript is based on the Survey on Well-Being among Foreign Born Population (FinMonik) which is a population-based survey of foreign-born population living in Finland conducted by the Finnish Institute for Health and Welfare. The aims were to compare the prevalence rates of psychological distress in foreign-born and general Finnish population, to investigate the prevalence rates between different regions of origin, and to examine which socio-demographic and migration-related factors are associated with psychological distress among foreign-born population. The analysis was carried out using SAS 9.4 and SUDAAN 11.0.3 statistical softwares. The data were analyzed by Taylor linearization method, logistic regression analysis, predicted marginals and Satterthwaite-adjusted F-value. According to the study, psychological distress was more prevalent among foreign-born population than among general population. In particular, migrants from Middle East and North-Africa were significantly more often distressed than migrants from other countries of origin. Additionally, unemployment or economic inactivity, international protection as a reason for migration and beginner-level language proficiency were the main factors increasing the odds for distress among foreign-born population. Based on the results of the literature review and the study, it can be concluded that there is a need to pay more attention to the mental well-being of the foreign-background population. The risk factors for mental well-being are partly the same as for the general population. In addition, experiences prior to migration and challenges faced after migration affect their mental well-being. Attention should be paid to the integration of foreign-background population and interventions should be diverse and targeted at, for example, employment, education, language learning, and social support.

Studies have found math anxiety and achievement to be related from the beginning of formal schooling, but the knowledge regarding the direction of the relationship is vague. The purpose of the present study was to study this relationship. We investigated math anxiety from two points of view: trait and state anxiety. In the first substudy, we investigated the longitudinal relationship between math anxiety and performance from sixth to seventh grade (n = 848) with cross-lagged modeling. In the second substudy, we investigated the situational relationship of anxiety and performance by giving the participants (n = 149) challenging and nonchallenging math tasks adapted to their skill level, and then examining the association between anxiety and the performance. The results suggest that math anxiety has a small longitudinal effect on performance: High anxiety in sixth grade predicted low performance in seventh grade. Anxiety also had a situational association with performance: when anxiety was aroused, the participants performed more poorly compared to their skill level. The results adduce the two-fold effect of anxiety on achievement: math anxiety seems to have both a real-time association with performance and a long-term effect on the development of basic arithmetic skills. peerReviewed

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A massive shift towards remote work practices has presented many organizations and employees with acute challenges associated with multi-locational work. This shift underscores the need to reconsider isolation as one of the focal challenges of organizations in an era of increasingly dispersed and mediated work practices. This study relies on a three-wave survey among Finnish workers to investigate how remote work practices and the use of information and communication technology (ICT) have impacted perceptions of isolation during the global health pandemic, and whether these relationships have an effect on psychological distress. The findings indicate that facilitating the use of ICTs may help organizations and employees combat isolation, while simultaneous increases in remote work practices lead employees to feel more isolated. In addition, the findings highlight a reciprocal effect between psychological distress and isolation, suggesting that strain may both increase perceptions of isolation and be a result of being isolated. peerReviewed

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Many studies in recent years focused on the efficiency of bilingual education in different school settings. If a school pursues a regular implementation of CLIL modules instead of the establishment of proper CLIL streams, the student group that is affected by this teaching approach is much more diverse when compared to the preselected CLIL stream groups. In this regard, also students with high English anxiety and low self-efficacy will have to participate in the modules and it is particularly interesting to see how these student types deal with teaching units held in a foreign language. The study at hand presents results from an intervention at German schools with two biology units taught in English. Students aged 15 to 16 rated the affective effects of these modules by filling in a pre-post-follow up questionnaire. Results show that English anxiety can indeed be lowered, while students’ self-efficacy increases due to this intervention. Obviously, more research has to confirm whether this is the case for other age groups and subjects as well. Nonetheless, it is a good start to recommend employing CLIL modules on a greater scale since the effects are substantial even if students do not willingly choose to take part in CLIL.

This study examines how individuals’ engagement in bullying at school and at university relates to the anxiety they feel in general and in various learning situations in which students interact during their higher education. It was predicted that, of the individuals who have experiences of bullying (in the role of bully, victim, or in a dual role as bully-victim), those who have been subjected to bullying experience more anxiety than do those who have no experience with bullying. A nationally representative sample of Finnish university students (N = 5086) participated in the study by responding to survey questions assessing their experiences of (a) anxiety syndrome, (b) context-specific social anxiety, and (c) situation-specific social anxiety in university learning settings. The findings revealed that victims differed from those with no experience of bullying in that they reported more of having current diagnosis of anxiety syndrome and higher levels of context-specific social anxiety in university learning contexts. This held true for both victims of school bullying and those who were bullied at university. The particular learning situations in which victims reported significantly higher levels of social anxiety were seminars, discussions with their teacher, and taking tests and exams. Implications for educational practices at university, student health services, and future directions for research are discussed. peerReviewed

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women. It affects 9–18% of the female population, but often remains undiagnosed. In addition to the common somatic comorbidities of the syndrome, including decreased fertility and hormonal and metabolic issues, there is emerging evidence showing higher risk for psychological distress, especially depression and anxiety, in PCOS. Furthermore, the latest studies indicate an increased prevalence of more severe psychiatric diseases, e.g., schizophrenia, in females with PCOS. Thus, PCOS exerts a severe health burden which decreases the health-related quality of life (HRQoL). Despite increasing interest and research, it is still unclear how the psychological and psychiatric health and HRQoL of women with PCOS are affected through aging up to menopause, as most studies have been conducted on reproductive-aged women. The main aim of this work was to assess the risk for psychological distress and decreased HRQoL in PCOS during two different time points, at age 31 and 46, using data from the prospective longitudinal Northern Finland Birth Cohort 1966 (NFBC66). Additionally, the long-term psychosis risk in women with PCOS was assessed by linking the NFBC66 data with the national registers. The results showed a higher prevalence of anxiety and/or depression symptoms in women with PCOS at both ages. The lifetime risk for depression was nearly 2-fold higher up to age 46. PCOS was also associated with a 3-fold higher risk for psychosis until age 50, even after adjusting for parental history of psychosis, which is the most common risk factor. The affected women showed a lower HRQoL up to age 46, in addition to a decreased health status and life satisfaction. The analyses indicated that the findings could not be explained by overweight, obesity, hyperandrogenism, or infertility. Overall, the findings suggest that PCOS is an independent risk factor for psychological distress up to a late reproductive age. The study showed that women with PCOS have an increased risk for psychosis and that they experience a long-term decrease in their HRQoL. These observations highlight the need to recognize the long-term health impacts of PCOS beyond metabolic and fertility issues, especially regarding psychological distress and quality of life. Tiivistelmä Monirakkulainen munasarjaoireyhtymä (PCOS) on lisääntymisikäisten naisten yleisin hormonaalinen häiriö. Sen esiintyvyys on 9–18 % naisväestössä, mutta se on yleisesti kuitenkin alidiagnosoitu. Tavallisten somaattisten liitännäisongelmien, kuten alentuneen hedelmällisyyden sekä metabolisten vaikutusten lisäksi PCOS on näyttänyt lisääntyvässä määrin olevan yhteydessä myös psyykkisten ongelmien riskiin, esimerkiksi masennukseen ja ahdistuneisuuteen. Tämän lisäksi viimeisimmät tutkimustulokset ovat osoittaneet, että myös vakavampien mielenterveyden sairauksien, kuten skitsofrenian, esiintyvyys on kasvanut PCOS-naisilla. PCOS aiheuttaakin merkittävän terveysriskin naisille, mikä johtaa terveyteen liittyvän elämänlaadun laskuun. Lisääntyneestä kiinnostuksesta ja tutkimuksista huolimatta on edelleen epäselvää, miten PCOS:n vaikutukset psyykkiseen terveyteen ja elämänlaatuun mahdollisesti muuttuvat lähestyttäessä vaihdevuosia, sillä aiemmat tutkimukset ovat pääasiassa käsitelleet lisääntymisikäisiä naisia. Tämän työn päätavoite oli tutkia PCOS-naisten psyykkistä terveyttä ja elämänlaatua 31- ja 46-vuotiaina käyttäen tutkimusaineistona Pohjois-Suomen syntymäkohorttia 1966. Lisäksi PCOS-naisten pitkäaikaista psykoosiriskiä tutkittiin hyödyntämällä syntymäkohortin lisäksi kansallisia rekisteritietoja. Tutkimuksen tulokset osoittivat ahdistus- ja/tai masennusoireiden lisääntyneen PCOS-naisilla molemmissa aikapisteissä. Masennusriski oli lähes kaksinkertainen ikävuoteen 46 mennessä kontrolleihin verrattuna. Psykoosiriski 50 vuoden ikään mennessä oli kolminkertainen, vaikka huomioon otettiin vanhempien psykoosihistoria. Oireisilla naisilla myös elämänlaatu sekä itsearvioidut elämäntyytyväisyys ja terveydentila olivat heikentyneet 46-vuotiaaksi saakka. Analyysit osoittivat myös sen, etteivät ylipaino, hypernadrogenismi tai infertiliteetti selittäneet löydöksiä. Tutkimuksen tulokset osoittivat PCOS:n olevan itsenäinen riskitekijä psyykkisen terveyden heikentymiselle ja elämänlaadun laskulle vaihdevuosiin saakka. Tutkimus osoitti myös psykoosiriskin olevan kohonnut. Tutkimustulokset korostavat tarvetta tunnistaa PCOS:n pitkäaikaisvaikutuksia myös metaboliaan ja lisääntymiseen liittyvien seikkojen ulkopuolelta, erityisesti koskien psyykkistä terveyttä ja elämänlaatua.

Introduction: There is evidence from earlier trials for the efficacy of music therapy in the treatment of depression among working-age people. Starting therapy sessions with relaxation and revisiting therapeutic themes outside therapy have been deemed promising for outcome enhancement. However, previous music therapy trials have not investigated this issue.Objective: To investigate the efficacy of two enhancers, resonance frequency breathing (RFB) and listening homework (LH), when combined with an established music therapy model (trial registration number ISRCTN11618310).Methods: In a 2 × 2 factorial randomised controlled trial, working-age individuals with depression were allocated into groups based on four conditions derived from either the presence or absence of two enhancers (RFB and LH). All received music therapy over 6 weeks. Outcomes were observed at 6 weeks and 6 months. The primary outcome was the Montgomery Åsberg Depression Rating Scale (MADRS) score.Results: There was a significant overall effect of treatment for the primary outcome favouring the breathing group (d = 0.50, 95% CI 0.07 to 0.93, p = 0.02). The effect was larger after adjustment for potential confounders (d = 0.62, 95% CI 0.16 to 1.08, p = 0.009). Treatment effects for secondary outcomes, including anxiety (anxiety scale of Hospital Anxiety and Depression Scale) and quality of life (RAND-36), were also significant, favouring the breathing group. The homework enhancer did not reach significant treatment effects.Conclusion: We found that the addition of RFB to a music therapy intervention resulted in enhanced therapeutic outcome for clients with depression.

Although music is known to be a part of everyday life and a resource for mood and emotion management, everyday life has changed significantly for many due to the global coronavirus pandemic, making the role of music in everyday life less certain. An online survey in which participants responded to Likert scale questions as well as providing free text responses was used to explore how participants were engaging with music during the first wave of the pandemic, whether and how they were using music for mood regulation, and how their engagement with music related to their experiences of worry and anxiety resulting from the pandemic. Results indicated that, for the majority of participants, while many felt their use of music had changed since the beginning of the pandemic, the amount of their music listening behaviors were either unaffected by the pandemic or increased. This was especially true of listening to self-selected music and watching live streamed concerts. Analysis revealed correlations between participants’ use of mood for music regulation, their musical engagement, and their levels of anxiety and worry. A small number of participants described having negative emotional responses to music, the majority of whom also reported severe levels of anxiety.

Haitallinen huolehtiminen ja ajatusten tukahduttaminen ovat yleisiä mielen prosesseja, joilla on havaittu olevan yhteyksiä moniin mielenterveyden ongelmiin. Tämän tutkimuksen tarkoituksena oli selvittää haitallisen huolehtimisen ja ajatusten tukahduttamisen keskinäisiä yhteyksiä sekä näiden yhteyksiä masennus- ja ahdistusoireisiin. Tutkimuksen aineisto koostui 33 korkeakouluopiskelijasta. Osallistujat täyttivät itsearviointilomakkeet huolehtimisesta (PSWQ), ajatusten tukahduttamisesta (WBSI) sekä masennus- ja ahdistusoireista (DASS). Huolehtimisen ja ajatusten tukahduttamisen keskinäisiä yhteyksiä sekä näiden yhteyksiä masennus- ja ahdistusoireisiin tarkasteltiin korrelaatioilla. Muuttujien välisiä yhteyksiä tarkasteltiin myös ryhmäjakojen sekä sirontakuvioiden ja niihin sovitettujen käyrien avulla. Lopuksi haitallisen huolehtimisen ja runsaan ajatusten tukahduttamisen yhteisiä yhteyksiä masennus- ja ahdistusoireisiin tarkasteltiin ryhmävertailuilla. Tulokset vahvistivat aiempia havaintoja ajatusten tukahduttamisen yhteyksistä masennus- ja ahdistusoireisiin. Huolehtimisen osalta yhteys vahvistui ainoastaan ahdistusoireisiin. Tämä on yhdenmukainen aiempiin havaintoihin, joissa huolehtimisen on havaittu omaavan vahvemman yhteyden ahdistukseen verrattuna masennukseen. Yhteyksien laatua koskevat tulokset vahvistivat ajatusta huolehtimisen muuttumisesta haitalliseksi vasta huolehtimisen määrän kasvaessa tarpeeksi suureksi. Samankaltainen yhteys löytyi myös ajatusten tukahduttamiselle, jota aikaisemmat tutkimukset ovat pääsääntöisesti kohdelleet jatkuvana muuttujana. Vastoin aiempia havaintoja huolehtimisen ja ajatusten tukahduttamisen väliltä ei löytynyt tilastollisesti merkitsevää yhteyttä. Myöskään kokemuksellisen välttämisen näkökulmasta tuotettu oletus siitä, että haitallinen huolehtiminen ja runsas ajatusten tukahduttaminen omaisivat yhdessä vahvemmat yhteydet masennus- ja ahdistusoireisiin kuin erikseen, ei saanut tukea.

The aim of the study was to assess associations between dimensions of mental skills, psychological readiness and predictors of career longevity among current athletes. Mental skills dimensions were measured with the Ottawa Mental Skills Assessment Tool (OMSAT). The psychological predictors of athletic career longevity were measured with the Athletic Coping Skills Scale-28 (the ACSI-28) producing scores for seven coping skills and with the Competitive State Anxiety Inventory-2 (CSAI-2) which produced scores for confidence in competition. Overall, 253 current athletes (average age 22 years) of various competitive levels (classified to 5 groups according to the national sport classification system) participated in the study. The results showed that coping skills and confidence in competition positively associated with various range of mental skills dimensions. The competitive level was related to stress reactions, fear control, focusing, refocusing and imagery coping skills. The results suggest that some mental skills may came with experience, while the development of other mental skills may require interventions to reduce the likelihood of early termination of the professional career and achieve career longevity. The results also discussed in terms of a holistic perception of sports psychology and focuses not only on performance, but also on the well-being and sustainable development of the athletes.

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This follow-up study investigated the associations of childhood learning disabilities (LDs) with adult-age anxiety, depression, and unemployment. Psychosocial problems in childhood and psychiatric diagnoses and lack of education in adolescence were studied as potential mediators, and gender and mother’s education as potential moderators of these associations. Data on childhood clinical neuropsychological assessments and lifelong register data on individuals with childhood LD (n = 430; 301 [70%] males; 20–39 years of age) and matched controls (n = 2,149) were applied. Mediation analyses were performed using structural equation modeling. Childhood LDs exerted a significant, but relatively small effect on psychiatric diagnoses in adolescence, which predicted adult-age depression and anxiety. LDs were related to unemployment both directly and via psychiatric diagnoses in adolescence. Examination of differences in the effects on adult-age outcomes of subtypes of LDs revealed mathematical disability to be more strongly associated with psychosocial problems in childhood and psychiatric problems in adolescence and adulthood than reading disability. Our findings show that LD has small and mostly indirect effects on the risk for later well-being problems. The findings emphasize the importance of adolescence in predicting adult-age psychiatric and employment problems and call for more holistic support for individuals with LDs. peerReviewed

Previous research indicates that excessive fear is a critical feature in anxiety disorders; however, recent studies suggest that disgust may also contribute to the etiology and maintenance of some anxiety disorders. It remains unclear if differences exist between these two threat-related emotions in conditioning and generalization. Evaluating different patterns of fear and disgust learning would facilitate a deeper understanding of how anxiety disorders develop. In this study, 32 college students completed threat conditioning tasks, including conditioned stimuli paired with frightening or disgusting images. Fear and disgust were divided into two randomly ordered blocks to examine differences by recording subjective US expectancy ratings and eye movements in the conditioning and generalization process. During conditioning, differing US expectancy ratings (fear vs. disgust) were found only on CS-, which may demonstrated that fear is associated with inferior discrimination learning. During the generalization test, participants exhibited greater US expectancy ratings to fear-related GS1 (generalized stimulus) and GS2 relative to disgust GS1 and GS2. Fear led to longer reaction times than disgust in both phases, and the pupil size and fixation duration for fear stimuli were larger than for disgust stimuli, suggesting that disgust generalization has a steeper gradient than fear generalization. These findings provide preliminary evidence for differences between fear- and disgust-related stimuli in conditioning and generalization, and suggest insights into treatment for anxiety and other fear- or disgust-related disorders.

Better therapeutic alliances are known to predict better treatment outcomes, but little knowledge still exists on the patient characteristics that lead to better alliances. In a sample of 128 outpatients assigned to long-term psychodynamic psychotherapy and suffering from mood and/or anxiety disorder, this study evaluated how the alliance, measured using the Working Alliance Inventory (WAI), is predicted by three different measures for assessing psychological resources and vulnerabilities: the Wechsler Adult Intelligence Scale—Revised (WAIS–R), the Defense Style Questionnaire (DSQ), and the Rorschach-based Ego Impairment Index (EII-2). All the three measures showed some ability to predict the development of the alliance during long-term therapy. The WAIS–R was found to be the strongest independent predictor, with higher intelligence scores predicting favorable development of both the patient- and therapist-rated alliance. Lower DSQ values, indicating less use of immature defenses, predicted greater improvement in the patient- but not the therapist-rated alliance. Higher EII-2 values, indicating more problematic ego functioning, predicted likewise greater patient-rated alliance improvement over the course of treatment. These findings support the value of pretreatment multimethod psychological assessment when tailoring treatment to the individual needs of patients. peerReviewed

Public speaking is an important skill for university students to learn and practice as they progress through education and into their careers. However, individuals often avoid facing public speaking, as they lack the skills to cope with the anxiety that arises when speaking in front of others. The current study aimed to investigate the relationship between public speaking anxiety, distress tolerance, and psychological flexibility. A sample of 95 college students completed psychological flexibility measures and self-ratings of public speaking anxiety before and after a public speaking challenge. A behavioral index of public speaking distress tolerance (i.e., speech duration) was also recorded. The results showed that self-reported public speaking anxiety correlates significantly with a number of aspects of psychological flexibility (i.e., openness to experiences, self-perspective skills, and cognitive fusion). These findings suggest that openness to experiences is a key factors in developing interventions to cope with self-reported public speaking anxiety for undergraduate students. However, if we want to increase speech duration as a behavioral index of distress tolerance, training skills related to behavioral awareness and valued actions might be more relevant. The results are discussed in terms of their relevance to the development of public speaking interventions for university students. peerReviewed

Tyypin 2 diabeteksen on havaittu olevan yhteydessä kohonneeseen masennuksen, ahdistuksen ja fatiikin kokemiseen. Aiempaa tutkimusta on kuitenkin syytä täydentää. Tyypin 2 diabetekseen liittyvien masennus-, ahdistus- ja fatiikkioireiden ymmärtäminen on tärkeää, sillä niillä voi olla vaikutusta potilaiden terveyteen ja laajemmin myös terveydenhuollon kustannuksiin. Masennus-, ahdistus- ja fatiikkioireiden terveyttä heikentävät vaikutukset saattavat välittyä diabeteksen hoitotasapainon heikentymisen kautta. Tulokset masennus- ahdistus- ja fatiikkioireiden yhteydestä tyypin 2 diabetespotilaiden hoitotasapainoon ovat kuitenkin ristiriitaisia. Tämän tutkimuksen tarkoituksena on tarkastella tyypin 2 diabeteksen yhteyttä masennus-, ahdistus- ja fatiikkioireiden esiintymiseen sekä oireiden yhteyttä tyypin 2 diabeteksen hoitotasapainoon työikäisillä. Tutkimuksen aineisto koostui 10 tyypin 2 diabetespotilaasta ja 10 verrokista, joista muodostettiin vertaistetut parit (engl. matched pairs). Verrokit oli valittu vastaamaan mahdollisimman hyvin diabetespotilaita iän ja koulutustaustan perusteella. Tutkitut olivat iältään 38–63-vuotiaita. Masennusoireita kartoitettiin Beck Depression Inventoryn (BDI-II), ahdistusoireita Beck Anxiety Inventoryn (BAI) ja fatiikkioireita Fatigue Impact Scalen (FIS) avulla. Tutkimuksen aikana ilmennyttä väsymistä arvioitiin Visual Analogue Scale (VAS) -janan avulla. Potilaiden hoitotasapainoa arvioitiin pitkäaikaista verensokeritasoa kuvaavan sokerihemoglobiinin (HbA1c) avulla. Tässä tutkimuksessa tyypin 2 diabetespotilaiden havaittiin kokevan enemmän ahdistusoireita verrokkeihin nähden. Masennus- ja fatiikkioireiden yhteyttä tyypin 2 diabetekseen ei löydetty. Lisäksi verrokit väsyivät odotusten vastaisesti tutkimuksen aikana tyypin 2 diabetespotilaita enemmän. Masennus-, ahdistus- tai fatiikkioireiden ja hoitotasapainon yhteydelle ei saatu tukea. Tutkimuksen tulokset tukevat aiempia havaintoja tyypin 2 diabetespotilaiden kohonneista ahdistusoireista. Pienen aineiston vuoksi tulokset eivät kuitenkaan ole yleistettävissä, ja tarvitaan lisää tutkimusta masennus-, ahdistus- ja fatiikkioireiden sekä tyypin 2 diabeteksen hoitotasapainon yhteydestä suuremmalla aineistolla. Masennus-, ahdistus- ja fatiikkioireiden synnyn ja vaikutusten ymmärtäminen tyypin 2 diabetekseen liittyen vaatii tulevaisuudessa lisää tutkimusta. Tyypin 2 diabetekseen liittyvät masennus-, ahdistus- ja fatiikkioireet on syytä huomioida myös terveydenhuollossa niiden terveyttä heikentävien vaikutusten lievittämiseksi.

Chronic pain is a widespread issue accompanied commonly by depression and anxiety. Chronic pain has been shown to alter brain processing within the emotional and reward circuits, pointing towards a possible link between pain and comorbid mood disorders. Pain relief may be achieved by alleviating depressive and anxious symptoms. Relaxation is important for pain relief and eliciting relaxation through music listening is shown to relieve pain, depression, anxiety, and discomfort among others. In addition to auditory stimuli, Vibroacoustic treatment – the tactile application of low frequency sinusoidal sound vibration, plus music listening and therapeutic interaction – has been shown to be beneficial for relieving these symptoms. Although the combination of music listening and low frequencies has been previously explored, the role of the music listening within the vibroacoustic treatment context is unknown. A single-case, mixed method crossover study was conducted with a client suffering from chronic pain and comorbid mood disorders, four sessions with music listening, and four sessions without. Quantitative outcomes showed the client was more relaxed, less anxious, and had less pain after the music sessions. Qualitative findings showed that the client at first could not relax without the music listening because of her severe anxiety, but learned to use music as a distractor from her thoughts to relax, but also that silence was equally important for her; these hinged on her making the choice based on her needs, which had previously been difficult for her.

This study aimed at evaluating the possible benefits of starting Integrative Improvisational Music Therapy (IIMT) sessions with 10 min of Resonance Frequency Breathing (RFB), a type of slow breathing known to be beneficial for stress reduction and emotional regulation. A client diagnosed with anxiety disorder and social phobia attended 12 IIMT sessions. Using an alternating treatments design, RFB was systematically alternated with a control intervention (vibroacoustic therapy, VAT). Therapy processes were assessed through the Session Evaluation Questionnaire (SEQ) and the continuous measurement of heart rate variability (HRV), a biomarker of autonomic nervous system response. RFB was consistently accompanied by higher HRV and followed by lower Arousal, when compared to VAT. The music psychotherapy process displayed two phases, with the first being emotionally more challenging than the second. In the first phase, the high frequency HRV component (HFnu) during music improvisations and Positivity scores were comparatively higher in sessions starting with RFB, whereas in the second phase, post-session Smoothness and Positivity were comparatively lower after RFB. The therapy outcome was positive, with marked symptom improvements. RFB appeared to have functioned as an adaptive intervention, modulating the emotional difficulty of the sessions according to the therapy phase and the client’s current needs. peerReviewed

Anxiety and claustrophobic reactions in MRI examinations cause unintentional movements, and such motion artifacts lead to interpretation problems. Furthermore, requested anesthesia makes the process costly. A total of 60 outpatients were examined in the Diagnostic Centre of Pécs, Hungary, to test whether synchronizing recorded music to the gradient pulsation of the MRI device can improve the sedative effect of the music. The patients were assigned to three groups: a nonmusic (control), an original tempo (random) and a synchronized music (synchronous) group. Results showed a significantly decreased state anxiety level after the MRI examination in the random and synchronous groups as compared with the control group. However, there was no difference in the effectiveness of either music conditions regarding state anxiety level after the examination. Participants in the music groups found the examination significantly more pleasant compared with the control group. In conclusion, the present study provides support for the notion that listening to music during an MRI examination significantly reduces patient anxiety, whereas noise attenuating devices do not provide the same effect. peerReviewed

Background Depression is among the leading causes of disability worldwide. Not all people with depression respond adequately to standard treatments. An innovative therapy that has shown promising results in controlled trials is music therapy. Based on a previous trial that suggested beneficial effects of integrative improvisational music therapy (IIMT) on short and medium-term depression symptoms as well as anxiety and functioning, this trial aims to determine potential mechanisms of and improvements in its effects by examining specific variations of IIMT. Methods/design A 2 × 2 factorial randomised controlled trial will be carried out at a single centre in Finland involving 68 adults with a diagnosis of depression (F32 or F33 in International Statistical Classification of Diseases and Related Health Problems 10th revision). All participants will receive 6 weeks of bi-weekly IIMT, where they are invited to improvise music and reflect on those improvisations with a music therapist in a one-to-one setting. Potential enhancements to IIMT will include: home-based listening to recorded improvisations (LH) from IIMT sessions to facilitate integration of therapeutic processing into daily life; and resonance frequency breathing (RFB), a breathing exercise at the beginning of each session to facilitate emotional expression and processing. Participants will be randomised in a 1:1:1:1 ratio into each combination (IIMT alone or with one or both enhancements). The primary outcome is depressive symptoms measured by the Montgomery–Åsberg Depression Rating Scale (MADRS) at 6 weeks. Secondary outcomes are depressive symptoms at 6 months; anxiety, quality of life, and functioning at 6 weeks and 6 months; and adverse events. Secondary underlying mechanisms/process variables are self-rated momentary depression level before every IIMT session; and homework compliance in IIMT + LH. Statistical analyses involve an intention-to-treat approach, using a linear mixed-effects model examining the main effects (LH vs no LH; RFB vs no RFB) and interaction effects (LH × RFB). Discussion This trial will contribute to understanding the mechanisms of IIMT and may further enhance the effectiveness of an intervention that was previously shown to be superior to standard care alone for adults with depression. Trial registration ISRCTN11618310. Registered on 26 January 2018.