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This study investigated whether an internet-based intervention aimed at enhancing the psychological well-being of female soccer players before the competitive season could be effective approach to meet the needs of the players. Players (n= 43; 17–26 years old)on the four separated teams in Finland’shighest league were assigned to either a guided six-week online Acceptance and Commitment Therapy intervention (ACTi) or to a control condition (CON). A between-groups pre–post (ACTi vs. CON) design was implemented before the competitive season. Players in the ACTi were offered three group sessions, performed internet-based tasks, and were individually supported by a guide. The results demonstrated that the ACTi players maintained their sports-related well-being (between-group, d = 0.72), while the sports-related well-being of the CON players, especially emotional and social well-being, had declined. In addition, ACTi players’perceived stress (d = 0.60) and depression (d = 0.88) declined, while their psychological flexibility in sports (d = 0.41) increased compared to the CON players. These results suggest that before the competitive season, players’ sports-related well-being decreases. The ACT intervention seemed to prevent this decrease and provide players with the skills to cope with emotional and social stressors related to the competitive season.

This narrative review brings together the findings regarding the differences in the auditory event-related potentials (ERPs) between patients with depressive disorder and non-depressed control subjects. These studies' results can inform us of the possible alterations in sensory-cognitive processing in depressive disorders and the potential of using these ERPs in clinical applications. Auditory P3, mismatch negativity (MMN) and loudness dependence of auditory evoked potentials (LDAEP) were the subjects of the investigation. A search in PubMed yielded 84 studies. The findings of the reviewed studies were not highly consistent, but some patterns could be identified. For auditory P3b, the common findings were attenuated amplitude and prolonged latency among depressed patients. Regarding auditory MMN, especially the amplitude of duration deviance MMN was commonly attenuated, and the amplitude of frequency deviance MMN was increased in depressed patients. In LDAEP studies, generally, no differences between depressed patients and non-depressed controls were reported, although some group differences concerning specific depression subtypes were found. This review posits that future research should investigate whether certain stimulus conditions are particularly efficient at separating depressed and non-depressed participant groups. Future studies should contrast responses in different subpopulations of depressed patients, as well as different clinical groups (e.g., depressive disorder and anxiety disorder patients), to investigate the specificity of the auditory ERP alterations for depressive disorders. peerReviewed

Dysconnectivity of large-scale brain networks has been linked to major depression disorder (MDD) during resting state. Recent researches show that the temporal evolution of brain networks regulated by oscillations reveals novel mechanisms and neural characteristics of MDD. Our study applied a novel coupled tensor decomposition model to investigate the dysconnectivity networks characterized by spatio-temporal-spectral modes of covariation in MDD using resting electroencephalography. The phase lag index is used to calculate the functional connectivity within each time window at each frequency bin. Then, two adjacency tensors with the dimension of time frequency connectivity subject are constructed for the healthy group and the major depression group. We assume that the two groups share the same features for group similarity and retain individual characteristics for group differences. Considering that the constructed tensors are nonnegative and the components in spectral and adjacency modes are partially consistent among the two groups, we formulate a double-coupled nonnegative tensor decomposition model. To reduce computational complexity, we introduce the lowrank approximation. Then, the fast hierarchical alternative least squares algorithm is applied for model optimization. After clustering analysis, we summarize four oscillatory networks characterizing the healthy group and four oscillatory networks characterizing the major depression group, respectively. The proposed model may reveal novel mechanisms of pathoconnectomics in MDD during rest, and it can be easily extended to other psychiatric disorders. peerReviewed

• Yleisimpiä raskaus- ja vauva-ajan mielenterveyshäiriöitä ovat masennus ja ahdistuneisuus. • Sekä naiset että miehet voivat sairastua perinataaliaikana eli raskaus- ja vauva-aikana masennukseen ja ahdistuneisuuteen. • Lievän ja keskivaikean masennuksen sekä ahdistuneisuuden hoito perusterveydenhuollossa on todettu kustannusvaikuttavaksi. • Perinataaliajan masennuksen ja ahdistuneisuuden ehkäisystä, tunnistamisesta ja varhaisesta hoidosta on paljon uutta tutkimustietoa. • Raskaus- ja vauva-ajan masennuksesta ja ahdistuneisuudesta on tekeillä Hotus-hoitosuositus erityisesti neuvoloissa toimiville terveydenhoitajille.

10 paginas, 15 fguras, Psychedelics produce fast and persistent antidepressant effects and induce neuroplasticity resembling the effects of clinically approved antidepressants. We recently reported that pharmacologically diverse antidepressants, including fluoxetine and ketamine, act by binding to TrkB, the receptor for BDNF. Here we show that lysergic acid diethylamide (LSD) and psilocin directly bind to TrkB with affinities 1,000-fold higher than those for other antidepressants, and that psychedelics and antidepressants bind to distinct but partially overlapping sites within the transmembrane domain of TrkB dimers. The effects of psychedelics on neurotrophic signaling, plasticity and antidepressant-like behavior in mice depend on TrkB binding and promotion of endogenous BDNF signaling but are independent of serotonin 2A receptor (5-HT2A) activation, whereas LSD-induced head twitching is dependent on 5-HT2A and independent of TrkB binding. Our data confirm TrkB as a common primary target for antidepressants and suggest that high-affinity TrkB positive allosteric modulators lacking 5-HT2A activity may retain the antidepressant potential of psychedelics without hallucinogenic effects, Open access funding provided by University of Helsinki including Helsinki University Central Hospital. The group of E.C. was supported by the Academy of Finland (294710, 303124, 307416 and 327192), Sigrid Jusélius Foundation and Jane and Aatos Erkko Foundation. The group of I.V. was supported by the Helsinki Institute of Life Science (HiLIFE) Fellow Program, Human Frontier Science Program (RGP0059/2019), Sigrid Juselius Foundation, Academy of Finland (331349, 335527 and 346135) and Cancer Foundation Finland. We also acknowledge CSC–IT Center for Science for providing computing resources and the HiLIFE NMR unit at the University of Helsinki, Instruct-ERIC Finland, FINStruct and Biocenter Finland for providing facilities and expertise. The group of M.S. was supported by the Jane and Aatos Erkko Foundation. The group of K.S.M. was supported by the Russian Science Foundation (22-14-00130 issued to G.S.A.). The group of P.P. was supported by the Jane and Aatos Erkko foundation and the Academy of Finland (323435). The group of E.R.K. was supported by the Academy of Finland (317399) and the Finnish Foundation for Alcohol Studies. The group of M.Va. was supported by the Academy of Finland (288475 and 294173), Sigrid Juselius Foundation, Finnish Cancer Foundation and Biocentrum Finland. R.M. was supported by the Brain & Mind Doctoral Programme (University of Helsinki) and received a grant from the Boehringer Ingelheim Foundation for methodological training. C.C. was supported by the Finnish Cultural Foundation (002100254). L.V.E. was supported by the Finnish Cultural Foundation (00180226) and the Finnish Foundation for Alcohol Studies. The authors dedicate this manuscript to the memory of Tomasz Róg.

Successful emotional processing is pivotal for the therapeutic change, and music can support emotional processing. However, we know little on how music-based emotional processing actually predicts clinical outcomes. This study investigated music therapeutic emotional processing (MEP) as a predictor of therapeutic outcome in treatment for depression. Data consisted of self-reports of 64 clients (age range 19–57, 74% female) from a clinical trial (12 sessions) of integrative improvisational music therapy (IIMT). A 19-item MEP questionnaire was developed for assessing clients’ experiences after sessions. Emergent MEP factors were correlated with clients’ perceptions of the therapeutic value of the sessions (Session Evaluation Questionnaire [SEQ]) and with recovery from depression (Montgomery–Åsberg Depression Rating Scale [MADRS]). MEP emerged as a constitution of three factors: expression, awareness, and pain. Expression and awareness increased across the process and correlated positively with session value and MADRS change. Pain demonstrated a more complex inverted u-shaped temporal curve and correlated with roughness of session experience. The presence of pain during the late part of the therapy predicted lower recovery. The findings support MEP factors as predictors of therapeutic outcome and provide conceptual insight into the mechanisms of change in art therapies. Knowledge on music-based emotional processing holds relevance also beyond therapy context for everyday music engagement.

Introduction: Relatively little is known about individual differences in adolescent psychological flexibility and its associations with symptoms of stress and depression. This study examined different profiles of adolescent stress and depressive symptoms and their associations with developing psychological flexibility before the critical educational transition. Methods: The data were derived from a general sample of 740 Finnish ninth-grade adolescents (Mage = 15.7 years, 57% female) who were assessed twice during the final grade of their basic education. The data were analyzed using growth mixture modeling. Results: Four profiles of stress and depressive symptoms were identified during a school year: 1) no stress and no depressive symptoms (None; 69%); 2) mild and decreasing stress and depressive symptoms (Decreasing; 15%); 3) low but increasing stress and depressive symptoms (Increasing; 6%); and 4) high and stable levels of stress and depressive symptoms (High; 10%). The adolescents in these profiles differed from each other in their initial levels and changes of psychological flexibility. The initial level of psychological flexibility was highest in the no-symptom profile group. We observed simultaneous change trends in symptoms and psychological flexibility during a school year. When symptoms decreased, psychological flexibility increased, and when symptoms increased, psychological flexibility decreased. Conclusions: A bidirectional pattern of relationships between psychological flexibility and psychological symptoms was found. Despite initially high level of skills in psychological flexibility, some adolescents, unexpectedly, experienced increased symptoms of stress and depression during the school year. The results call for further studies to explore in-depth the developmental diversity in adolescents’ well-being and its antecedents. peerReviewed

Objectives To examine birth cohort differences in depressive symptoms and life satisfaction in older men and women and the mechanisms underpinning the possible cohort differences. Methods Two independent cohorts of Finnish men and women aged 75 and 80 were assessed in 1989–1990 ( n = 617) and 2017–2018 ( n = 794). They reported their depressive symptoms (CES-D), current life satisfaction, and evaluation of life until now. Results The later-born cohort reported fewer depressive symptoms (8.6 ± 7.1 vs. 13.9 ± 8.3) and the differences were similar for the subdomains of depressive symptoms. The later-born cohort was more often mostly satisfied with life until now (90 vs. 70%) but not with the current life than the earlier-born cohort. Better self-rated health and education of the later-born cohort partly explain the cohort differences. Discussion Older people in Finland report fewer depressive symptoms and they are more satisfied with their past life compared to their counterparts assessed 28 years ago.

Task-irrelevant threatening faces (e.g., fearful) are difficult to filter from visual working memory (VWM), but the difficulty in filtering non-threatening negative faces (e.g., sad) is not known. Depressive symptoms could also potentially affect the ability to filter different emotional faces. We tested the filtering of task-irrelevant sad and fearful faces by depressed and control participants performing a color-change detection task. The VWM storage of distractors was indicated by contralateral delay activity, a specific event-related potential index for the number of objects stored in VWM during the maintenance phase. The control group did not store sad face distractors, but they automatically stored fearful face distractors, suggesting that threatening faces are specifically difficult to filter from VWM in non-depressed individuals. By contrast, depressed participants showed no additional consumption of VWM resources for either the distractor condition or the non-distractor condition, possibly suggesting that neither fearful nor sad face distractors were maintained in VWM. Our control group results confirm previous findings of a threat-related filtering difficulty in the normal population while also suggesting that task-irrelevant non-threatening negative faces do not automatically load into VWM. The novel finding of the lack of negative distractors within VWM storage in participants with depressive symptoms may reflect a decreased overall responsiveness to negative facial stimuli. Future studies should investigate the mechanisms underlying distractor filtering in depressed populations. publishedVersion

Background Individuals with depression and depressive symptoms have a higher mortality rate than non-depressed individuals. The increased comorbidity and mortality associated with depression has remained largely unexplained. The underlying pathophysiological differences between depressive subtypes, melancholic and non-melancholic, may provide some explanation to this phenomenon. Methods 1995 participants (mean age 61 years) from the Helsinki Birth Cohort Study were recruited for this prospective study and followed up for a mean of 14.1 years. Information regarding medical history, lifestyle, and biochemical parameters were obtained. Depressive symptoms were assessed using the Beck Depression Inventory. Standardized mortality ratios were calculated. Results Participants were followed up for a total of 28 044 person-years. The melancholic depressive group had an increased adjusted risk of mortality [HR 1.49 (95% CI: 1.02-2.20)] when compared to the non-depressive group. Comparing mortality to the whole population of Finland using standardized mortality ratios (SMR) both the non-melancholic [1.11 (95% CI: 0.85-1.44)] and melancholic depressive [1.26 (95% CI: 0.87-1.81)] groups had higher mortality than the non-depressive group [ 0.82 (95% CI: 0.73-0.93)]. Conclusions Melancholic depressive symptoms are most strongly related to a higher mortality risk. peerReviewed

Since parental burnout can have detrimental consequences for parents, couples, and children, easy-to-use, reliable, and valid practical tools for the early detection of parental burnout are required. We developed and validated a brief scale to identify burned-out parents and parents at burnout risk. In Study 1, we developed the 5-item Brief Parental Burnout scale (BPBs) based on the gold standard measure of parental burnout, the Parental Burnout Assessment (PBA). We applied Item Response Theory Graded Response Model (GRM) analyses on the data of 1,725 Finnish parents. Compared against the PBA total score, the five selected items showed both high sensitivity and specificity in screening parental burnout. As expected, burned-out parents and those at burnout risk according to the BPBs displayed higher depressive symptoms, lower self-esteem, and more frequent sleep disruptions than non-burned-out parents. In Study 2, we tested the sensitivity and specificity of the BPBs by using both the BPBs and the PBA as independent assessment tools in a sample of 1,088 Finnish parents. In Study 3, the high sensitivity and specificity of the BPBs found in Study 2 were replicated in an independent sample of 104 Belgian parents. We further demonstrated the concurrent validity of the BPBs test score interpretations by showing that burned-out parents, or those at burnout risk, reported higher child neglect and parental violence than non-burned-out parents. Because of its user-friendliness and the strong psychometric properties of its test score, the BPBs is a good candidate to use as a screening tool for parental burnout. (PsycInfo Database Record (c) 2021 APA, all rights reserved). peerReviewed

SummaryBackgroundTraumatic brain injury is associated with the future risk of depression and suicide, and this raises the possibility that former participants in sports characterised by low intensity repetitive head impact may also subsequently experience an increased burden of these mental health outcomes. Using new data from a cohort study integrated into a meta-analysis of the current evidence, we compared the occurrence of depression and suicide in former contact sports athletes against general population controls.MethodsThe cohort study comprised 2004 retired male athletes who had competed internationally on an amateur basis for Finland between 1920 and 1965, and 1385 age-equivalent male general population controls. Former contact sports participants were drawn from soccer, boxing, or Olympic-style (non-professional) wrestling. During follow-up, cases of major depressive disorder and suicide were captured via linkage to mortality and hospitalisation registries. In a PROSPERO-registered (CRD42022352780) systematic review, we searched PubMed and Embase from their inception to October 31 2022 for reports of cohort studies of contact sports participation and later risk of depression and suicide that were published in English and reported standard estimates of association and variance. Study-specific estimates were aggregated using random-effect meta-analysis. The Newcastle-Ottawa Scale was used to appraise the quality of each study.FindingsIn analyses of the Finnish cohort data, up to 45 years of health surveillance gave rise to 131 hospitalisations for major depressive disorder and 61 suicides. In survival analyses (hazard ratio [95% confidence interval]) adjusted for age and socioeconomic status, former boxers (depression: 1.43 [0.73, 2.78]; suicide: 1.75 [0.64, 4.38]), wrestlers (depression: 0.94 [0.44, 2.00]; suicide: 1.60 [0.64, 3.99]), and soccer players (depression: 0.62 [0.26, 1.48]); suicide: 0.50 [0.11, 2.16]) did not have statistically significantly different rates of major depressive disorder or suicide relative to general population controls. The systematic review identified 463 potentially eligible published articles, of which 7 met inclusion criteria. All studies sampled men and 3 were evaluated as being of high quality. After aggregating results from these retrieved studies with new data from the cohort study, we found that retired soccer players appeared to have a somewhat lower risk of depression (summary risk ratio: 0.71 [95% 0.54, 0.93]) relative to general population controls, while the rate of suicide was essentially the same (0.70 [0.40, 1.23]). Past participation in American football was associated with some protection against suicide (0.58 [0.43, 0.80]) but there were insufficient studies of depression for aggregation. All studies showed directionally consistent relationships and there was no indication of inter-study heterogeneity (I2=0%).InterpretationBased on a small cluster of studies exclusively comprising men, retired soccer players had a lower rate of later depression, and former American football players had a lower risk of suicide. Whether these findings are generalisable to women requires testing.FundingNone.Research in contextEvidence before this studyA series of cohort studies suggest that brain injury serious enough to necessitate hospitalisation is associated with elevated rates of later depression and suicide. This raises the possibility that former participants in sports characterised by low intensity repetitive head impact, who have an increased risk of other mental health disorders in later life such as dementia, may also experience an increased burden of depression and suicide. Searching PubMed and Embase using terms for specific contact sports (e.g., ‘boxing’, ‘martial’, ‘wrestling’, ‘football’, ‘soccer’, ‘hockey’, ‘rugby’), depression and suicide (e.g., depression, dysthymic; suicide) revealed relevant studies in former athletes from American football, soccer, and rugby union but no evidence for boxing, wrestling, or other contact sports. Overall, there was a suggestion of mixed results and an absence of a quantitative synthesis of findings for depression.Added value of this studyIn the first cohort study to simultaneously examine the risk of depression and suicide across multiple contact sports, there was no convincing evidence that retired boxers, wrestlers, or soccer player had a different rate of these health outcomes than the general population. After incorporating these new results into a meta-analysis, former soccer players had a lower risk of depression but there was no clear link with suicide. Retired American footballers appeared to experience lower suicide rates at follow-up.Implications of all the available evidenceCounter to the apparent impact of traumatic brain injury, a background in contact sports was not associated with elevated rates of depression or suicide. Indeed, former soccer athletes (depression) and American football players (suicide) seemed to experience some protection against these health outcomes. The existing evidence base is, however, hampered by an absence of studies of women, and is modest in scale and narrow in scope, currently not including several popular contact sports.

Background To investigate whether physical performance is independently of physical activity (PA) associated with positive and negative dimensions of mental well-being in middle-aged women. Methods Data were drawn from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study in which women 47 to 55 years were randomly selected from the Finnish National Registry. They (n = 909) participated in measurements of physical performance (handgrip force, knee extension force, vertical jumping height, maximal walking speed, and six-minute walking distance). Both mental well-being (the Centre for Epidemiologic Studies Depression Scale, the International Positive and Negative Affect Schedule Short Form and the Satisfaction with Life Scale) and PA were self-reported. Associations between variables were analysed using multivariate linear regression modelling adjusted for body height, fat mass %, menopausal status and symptoms, marital status, parity, employment status, self-reported mental disorders, and use of psycholeptics and psychoanaleptics. PA was then entered into a separate model to explore its role in the associations. Results In the adjusted models, significant positive associations of six-minute walking distance with positive affectivity (B = 0.12, p = 0.002) and life satisfaction (B = 0.15, p = 0.033) were observed. No significant associations were observed between physical performance and depressive symptoms or negative affectivity. PA was positively associated with positive affectivity and life satisfaction and negatively with depressive symptoms across all the physical performance variables. Conclusions Of the physical performance dimensions, aerobic component was associated with positive mental well-being independently of PA level. In relation to other physical performance components, the results point to the benefits of physical activity for mental well-being.

Emotional reactions to movies are typically similar between people. However, depressive symptoms decrease synchrony in brain responses. Less is known about the effect of depressive symptoms on intersubject synchrony in conscious stimulus-related processing. In this study, we presented amusing, sad and fearful movie clips to dysphoric individuals (those with elevated depressive symptoms) and control participants to dynamically rate the clips’ valences (positive vs. negative). We analysed both the valence ratings’ mean values and intersubject correlation (ISC). We used electrodermal activity (EDA) to complement the measurement in a separate session. There were no group differences in either the EDA or mean valence rating values for each movie type. As expected, the valence ratings’ ISC was lower in the dysphoric than the control group, specifically for the sad movie clips. In addition, there was a negative relationship between the valence ratings’ ISC and depressive symptoms for sad movie clips in the full sample. The results are discussed in the context of the negative attentional bias in depression. The findings extend previous brain activity results of ISC by showing that depressive symptoms also increase variance in conscious ratings of valence of stimuli in a mood-congruent manner. publishedVersion

Tutkimuksessa tarkasteltiin teknologiavälitteisesti videoneuvottelusovelluksella toteutettavaa ryhmäinterventiota, eDepressiokoulua, masennuksesta toipumisen näkökulmasta. Masennus on kokonaisvaltainen ilmiö sosiaalisine kytkentöineen. Laaja-alainen toipuminen on identiteettiin, osallisuuteen ja yhteiskunnalliseen asemaan heijastuva muutosprosessi, jonka tavoitteena on toipujan hyväksi kokema arki. Tapausesimerkkinä toimivat yhdessä sairaanhoitopiirissä toteutetut kaksi eDepressiokoulupilottia. Tutkimuksessa kysyttiin, miten eDepressiokoulu heijastuu toipumiseen ja millainen merkitys eDepressiokoulun eri elementeillä, kuten teknologiavälitteisyydellä, ryhmämuotoisuudella ja strukturoidulla rakenteella, on toipumisessa. Asiakkaiden ja työntekijöiden haastatteluin ja kirjallisesti tuottama kokemuksellinen tutkimusaineisto analysoitiin teoriaohjaavalla sisällönanalyysilla. Tulosten perusteella eDepressiokoulu on lupaava interventio masennuksesta toipumisen tukemisessa. Perinteisen depressiokoulun tavoin eDepressiokoulu vahvistaa identiteettiä, tarjoaa uutta tietoa ja uusia taitoja, rohkaisua ja vertaistukea sekä vahvistaa myönteistä ajattelua ja toiveikkuutta. Osa asiakkaista koki myös teknologisten taitojensa parantuneen sekä suhtautumisensa etäpalveluihin muuttuneen myönteisemmäksi. Myös osa ammattilaisista kuvasi ennakkoluulojensa karisseen havaittuaan eDepressiokoulussa etuja. eDepressiokoulun koettiin tarjoavan mahdollisuuden matalankynnyksen palveluun tilanteissa, joissa pitkien välimatkojen tai vallinneen koronapandemian vuoksi olisi muutoin jääty ilman palvelua. Tilannekuvan asiakkaan arjesta koettiin täydentyvän asiakkaiden kotoa käsin kameran välityksellä osallistuessa. Teknologiavälitteinen eDepressiokoulu tukee arjessa toipumista.

In this study, we examined whether maternal perceived job insecurity (JI) affected depressive symptoms in their adolescent children. Specifically, we tested a mediator-moderator model in which we hypothesized that maternal JI was related to adolescent depressive symptoms indirectly via maternal depressive symptoms. Most importantly, we also explored whether this indirect path was moderated by two buffering resources, i.e., maternal off-job recovery and adolescent self-esteem. There is little research on the effects of parental JI on adolescent children from the viewpoint of buffering moderators. Due to growing insecurity in the labor markets we need more information about resources that mitigate the harmful effects of JI within families. We tested the model via structural equation modeling among Finnish mother-adolescent dyads (N = 601, mothers aged 32–60 years; adolescents aged 14–18 years). Our results showed that mothers’ depressive symptoms did not mediate the relationship between mothers’ JI and adolescents’ depressive symptoms, but mothers’ JI was directly related to increased depressive symptoms among both adolescents and their mothers. Mothers’ off-job recovery and adolescents’ self-esteem buffered against mothers’ JI in relation to depressive symptoms. When off-job recovery (in mothers) and self-esteem (in adolescents) were high, the higher level of JI was not associated with increased depressive symptoms. Off-job recovery among working mothers should be improved as it has potential to protect against JI. Moreover, adolescents’ self-esteem should be boosted as it mitigates the effects of mothers’ job stress (e.g., JI) on adolescents’ well-being.

Depressed individuals exhibit an attentional bias towards mood-congruent stimuli, yet evidence for biased processing of threat-related information in human interaction remains scarce. Here, we tested whether an attentional bias towards interpersonally aggressive pictures over interpersonally neutral pictures could be observed to a greater extent in depressed participants than in control participants. Eye movements were recorded while the participants freely viewed visually matched interpersonally aggressive and neutral pictures, which were presented in pairs. Across the groups, participants spent more time looking at neutral pictures than at aggressive pictures, probably reflecting avoidance behaviour. When the participants could anticipate the stimulus valence, depressed participants – but not controls – showed an early attentional bias towards interpersonally aggressive pictures, as indexed by their longer first fixation durations on aggressive pictures than on neutral pictures. Our results thus preliminarily suggest both an early attentional bias towards interpersonal aggression, which is present, in depressed participants, also when aggression contents are anticipated, and a later attentional avoidance of aggression. The early depression-related bias in information processing may have maladaptive effects on the way depressed individuals perceive and function in social interaction and can therefore maintain depressed mood. peerReviewed

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.

Background Early appearing temperamental differences and the psychological flexibility skills of individuals are proposed factors influencing stress and depression among adolescents. We test the theoretical assumption that temperament may form a basis for facing the outer world, while the development of psychological flexibility being another such basis and a mediator in well-being outcomes. Methods Using data on 740 adolescents (Mage = 15.7 years, 57% female) assessed at the beginning and end of the final grade of basic education, structural equation modeling (SEM) with mediation analysis was conducted to examine the associations between the key temperament dimensions, changes in psychological flexibility, and changes in symptoms of stress and depression. Results The results indicate that both temperament and psychological flexibility had unique, direct associations with changes in symptoms of stress and depression. There were also indirect links between temperament and changes in symptoms achieved via psychological flexibility: adolescents with negative affectivity (NA) showed an increase in symptoms of stress and depression mediated by lower psychological flexibility, while adolescents with effortful control (EC) and extraversion (EX) showed a decrease in symptoms, mediated by higher psychological flexibility. Limitations More research with longer-term follow-up study designs is needed to explore these associations thoroughly. Conclusions Temperamental patterns play a significant role in the development of psychological symptoms. However, these associations are modified by psychological flexibility. Together, temperamental dimensions and psychological flexibility form cumulative patterns influencing psychological symptoms. The practical implications of the findings are discussed in this study. peerReviewed

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.

Research on the predictors of outcome for early, community-based, and time-limited interventions targeted for clinical depression in adolescents is still scarce. We examined the role of demographic, psychosocial, and clinical variables as predictors of outcome in a trial conducted in Finnish school health and welfare services to identify factors associating to symptom reduction and remission after a brief depression treatment. A total of 55 12–16-year-olds with mild to moderate depression received six sessions of either interpersonal counseling for adolescents (IPC-A) or brief psychosocial support (BPS). Both interventions resulted in clinical improvement at end of treatment and 3- and 6-month follow-ups. Main outcome measures were self-rated BDI-21 and clinician-rated Adolescent Depression Rating Scale (ADRSc). Latent change score (LCS) models were used to identify predictors of change in depressive symptom scores and clinical remission at end of treatment and 3- and 6-month follow-ups over the combined brief intervention group. Symptom improvement was predicted by younger age and having a close relationship with parents. Both symptom improvement and clinical remission were predicted by male gender, not having comorbid anxiety disorder, and not having sleep difficulties. Our results add to knowledge on factors associating with good treatment outcome after a brief community intervention for adolescent depression. Brief depression interventions may be useful and feasible especially for treatment of mild and moderate depression among younger adolescents and boys, on the other hand clinicians may need to cautiously examine sleep problems and anxiety comorbidity as markers of the need for longer treatment. publishedVersion

There is an existing link between two of the most common diseases, obesity and depression. These are both of great public health concern, but little is known about the relationships between the subtypes of these conditions. We hypothesized that non-melancholic depressive symptoms have a stronger relationship with both body composition (lean mass and fat mass) and dysfunctional glucose metabolism than melancholic depression. For this cross-sectional study 1510 participants from the Helsinki Birth Cohort Study had their body composition evaluated as lean mass and fat mass (Lean Mass Index [LMI, kg/m2] + Fat Mass Index [FMI kg/m2] = Body Mass Index). Participants were evaluated for depressive symptoms utilizing the Beck depression inventory, and had laboratory assessments including an oral glucose tolerance test. Higher than average FMI was associated with a higher percentage (mean [%], 95% CI) of participants scoring in the depressive range of the Beck depression inventory (20.2, 17.2–23.2) compared to those with low FMI (16.3, 13.8–18.9; p = 0.048) when adjusted for age, sex, education, and fasting plasma glucose concentration. Higher FMI was associated with a higher likelihood of having depressive symptoms (OR per 1-SD FMI = 1.37, 95% CI 1.13–1.65), whereas higher LMI was associated with a lower likelihood of having depressive symptoms (OR per 1-SD LMI = 0.76, 95% CI 0.64–0.91). Participants with an above average FMI more frequently (mean [%], 95% CI) had non-melancholic depressive symptoms (14.7, 11.8–17.7) as compared to those with low FMI (9.7, 7.6–11.9; p = 0.008) regardless of LMI levels. There was no difference between the body composition groups in the likelihood of having melancholic depressive symptoms. The non-melancholic group had higher (mean [kg/m2], SD) FMI (9.6, 4.1) than either of the other groups (BDI p p = 0.005). As hypothesized, non-melancholic depressive symptoms are most closely related to high fat mass index and dysfunctional glucose metabolism.

OBJECTIVE To examine the relationship between menopausal status and mental well-being, and whether this relationship varies as a function of physical activity (PA). METHODS Based on a hormonal analysis and bleeding diary, women aged 47 to 55 were categorized as pre (n = 304), early peri (n = 198), late peri (n = 209), or postmenopausal (n = 387). Mental well-being was assessed using the Centre for Epidemiologic Studies Depression Scale, the International Positive and Negative Affect Schedule Short Form, and the Satisfaction with Life Scale. PA was self-reported and categorized as low, medium, and high. Associations between variables were analyzed using multivariate linear regression adjusted for age, marital and employment status, parity, self-reported mental disorder, use of psycholeptics and psychoanaleptics, and menopausal symptoms. RESULTS Depressive symptoms were lower amongst the pre than postmenopausal women (B = 0.07, confidence interval 0.01-0.13). Menopausal symptoms attenuated these associations. Menopausal status showed no associations with life satisfaction, or with positive or negative affectivity.Women with high PA scored higher on positive affectivity, and the pre, early peri, and postmenopausal women scored higher on life satisfaction (B = 0.79, P

This study examined Flow with Nature (FWN) treatment, which is an integrative intervention (rehabilitation) based on eco and environmental psychology, psychotherapeutic theories and professional psychological practice. FWN is intended for depression rehabilitation with the help of social support, nature environments and FWN exercises. Exercises encourage sensing the environment, mindful awareness, psychological processing and focusing on the future. The FWN treatment proceeds in separate stages (horizon, growth and path), which emphasise nature, group (social support) and FWN exercises differently. This study focused on the experiences of the participants in the FWN treatment. Finnish adults who had been diagnosed with clinical depression took part in the FWN treatment (N = 82) and answered feedback questions (by paper, electronic questionnaire or phone discussion). Answers were analysed using theory-based content analysis. Data were collected between spring 2019 and spring 2020. The majority of the participants were women (82%) and on average 44 years old. Content analysis revealed that the participant feedback answers were in agreement with the central theoretical themes of FWN. The participants emphasised the significance of nature, social support and exercises differently. Moreover, the significance of these ingredients differed according to the stages of treatment: in the horizon stage restorative (e.g., fascination) and comprehensive nature experiences (e.g., connectedness with nature), in the growth stage social support (e.g., peer support) and in the path stage environmental self-regulation (e.g., nature as a part of life) were emphasised. These results are in accordance with the objectives of the stages and seem to support the phase-based rationale. The participants’ experiences of the key elements of the intervention, social support and nature environment were experienced mainly positively, which supports their inclusion in future intervention versions. In the future, FWN exercises should be developed to better enable participants’ possibilities for concentration and being present in the moment (mindfulness). Exercises should also be simplified to match the target group’s cognitive abilities.

OBJECTIVE: This study investigates the association between depressive symptoms and multisite pain and health-related quality of life and work ability in currently employed health care workers with recurrent low back pain (LBP). METHODS: Multisite pain, depressive symptoms, quality of life, and work ability were assessed by validated questionnaires. A generalized linear model was used for statistical analysis. RESULTS: Notably, 28% of female health care workers with LBP had at least moderate levels of depressive symptoms. Depressive symptoms were significantly associated with decreased health-related quality of life and work ability. Multisite pain was not significantly associated with work ability. CONCLUSIONS: Depressive symptoms are relatively common in female health care workers with LBP, and treatment of these symptoms may be crucial to improve their work ability. publishedVersion

Music listening is a great resource for mental well-being, pleasure, and self-regulation, but it may also be maladaptive. Depression, for instance, has been shown to relate to music use that is characterized by rumination, avoidance, and mood worsening. However, we know little of the role of individual differences in such maladaptive music use. Hence, this study focused on examining the role of personality, empathic traits, emotional contagion, and the types of musical reward as predictors of maladaptive music listening. Participants ( N = 318) answered an online survey comprising measures for the abovementioned traits in addition to the Healthy-Unhealthy Music Scale (HUMS) as a measure of maladaptive music use. Results demonstrated that Unhealthy musical engagement was predicted by a variety of traits representing general negative emotionality (e.g., Neuroticism, Personal Distress, contagion for negative emotions). Structural equation modeling highlighted the importance of the empathic trait Personal Distress in mediating Unhealthy musical engagement. Finally, we deliberate if maladaptive strategies are indeed “maladaptive” for such individuals or merely a coping mechanism, which is indeed adaptive for them, aiding to combat depressive and anxious states thereby preventing them from “tipping over” into depression.

Tämän pro gradu -tutkielman tarkoituksena oli tutkia suomalaisten äitien vanhemmuuden uupumusta COVID-19-pandemiasta aiheutuneen poikkeustilan aikana 18.3.-14.5.2020. Tutkielmassa tarkastellaan äitien vanhemmuuden uupumuksen varhaisia ennustavia tekijöitä sekä näitä yhteyksiä muokkaavia tekijöitä. Vanhemmuuden uupumus on vanhemmuuden kontekstissa ilmenevä pitkittyneen stressin aiheuttama oireyhtymä. Se koskettaa vanhemman lisäksi koko perhettä, sillä sen on todettu vaikuttavan haitallisesti myös toiseen vanhempaan, lapsiin sekä vanhempien ja lasten välisiin suhteisiin. Tutkimuksen teoreettisena viitekehyksenä käytettiin BR2-mallia, jonka mukaan vanhemmuuden uupumuksen synnylle keskeisiä ovat vanhempien vanhemmuudessaan kokemat vaatimukset ja voimavarat. Mallin mukaan vanhemmuuden uupumus syntyy, kun vanhempi kokee vanhemmuudessaan jatkuvasti enemmän vanhemmuuden vaatimuksia kuin voimavaroja. Tässä tutkimuksessa äidin vanhemmuuden vaatimuksina ja vanhemmuuden uupumuksen varhaisina riskitekijöinä tutkittiin äidin masennusoireilua sekä lapsen negatiivista emotionaalisuutta lapsen ollessa 2-vuotias. Äitien vanhemmuuden uupumusta puolestaan tarkasteltiin poikkeustilan aikana, kun lapsi oli 6/7-vuotias. Poikkeustilan voidaan ajatella samanaikaisesti äkillisesti lisänneen vanhemmuuden vaatimuksia ja vähentäneen vanhemmuuden voimavaroja, kun yhteiskunnan sulkeutuessa esikoulut ja koulut sulkeutuivat, sosiaalisia kontakteja vältettiin ja työntekijöitä kehotettiin mahdollisuuksien mukaan siirtymään etätyöhön. Äidin varhaisen masennusoireilun ja lapsen varhaisen negatiivisen emotionaalisuuden sekä äidin myöhemmän vanhemmuuden uupumuksen välisiä yhteyksiä muokkaavina tekijöinä tarkasteltiin äitien poikkeustilan aikaista työtilannetta ja lapsen hoitotilannetta. Kiinnostuksen kohteena oli se, olivatko etätyötä tai kodin ulkopuolella työtä tehneet äidit erityisen alttiita vanhemmuuden uupumukselle sekä se, altistiko lapsen hoito kotona tai kodin ulkopuolella äidit vanhemmuuden uupumukselle. Koska äidin masennusoireilu ja lapsen negatiivinen emotionaalisuus on aiemmin yhdistetty vanhempien matalampaan hyvinvointiin, oletettiin, että nämä muuttujat selittävät äitien myöhempää uupumusta vanhemmuuteen. Työtilanteen ja lapsen hoitotilanteen osalta ei asetettu hypoteeseja aiemman puuttuvan kirjallisuuden vuoksi. Tutkimusaineisto on kerätty osana Helsingin yliopiston Lasten D-vitamiinitutkimusta (VIDI). Tämän tutkimuksen tutkimusjoukko käsitti yhteensä 257 äitiä. Aineiston analyysi suoritettiin lineaarisella regressioanalyysilla. Tutkimuksen oletusten mukaisesti äidin masennusoireilu lapsen ollessa 2-vuotias oli yhteydessä äidin myöhempään vanhemmuuden uupumukseen poikkeustilan aikana, kun lapsi oli 6/7-vuotias. Sen sijaan 2-vuotiaan lapsen negatiivinen emotionaalisuus ei ollut yhteydessä äidin myöhempään vanhemmuuden uupumukseen paitsi niillä äideillä, jotka olivat kokeneet masennusoireilua lapsen ollessa 2-vuotias. Äidin poikkeustilan aikaisella työtilanteella tai lapsen hoitotilanteella ei havaittu olevan muokkaavia vaikutuksia äidin varhaisen masennusoireilun sekä lapsen varhaisen negatiivisen emotionaalisuuden ja myöhemmän vanhemmuuden uupumuksen välisiin yhteyksiin. Tämä tutkimus tuotti uutta tietoa suomalaisten äitien poikkeustilan aikaista vanhemmuuden uupumusta ennakoivista tekijöistä. Lapsen negatiivisen emotionaalisuuden ja äidin masennusoireilun yhdysvaikutusta tai lapsen negatiivisen emotionaalisuuden erillistä vaikutusta ei ole ennen tutkittu vanhemmuuden vaatimustekijöinä, joten tutkimus tarjosi lisätietoa niiden roolista vanhemmuuden uupumuksen synnyssä. Tuloksia voidaan hyödyntää, kun halutaan tunnistaa uupumiselle erityisen alttiita vanhempia. Jatkossa tärkeää olisi tutkia äitien lisäksi myös isiä sekä työelämän ulkopuolella olevia äitejä. Myös vanhemmuuden voimavarojen tutkiminen vastaisuudessa antaisi lisätietoa vanhemmuuden uupumukselta suojaavista tekijöistä.

Tämä pro gradu -tutkielma käsittelee masennuksen värittämää arkea ja arjen voimavaratekijöitä masennuksen keskellä. Masennusta on harvoin tutkittu arjen näkökulmasta, vaikka henkilökohtaisia masennuksen kuvauksia on tutkittu kasvavissa määrin. Masentuneena ihmisen suhde arkielämään muuttuu, mikä tekee arjen näkökulmasta tärkeän tutkimusaiheen. Tutkimustehtävänä on selvittää, kuinka arkea masennuksen kanssa merkityksellistetään ja millaisia voimavaratekijöitä masentuneen arjessa jäsennetään. Ensimmäistä tutkimuskysymystä lähestyn Rita Felskin (2000) arjen ulottuvuuksien kautta. Toista tutkimuskysymystä lähestyn aineistolähtöisesti. Tutkielman teoreettisena näkökulmana on narratiivinen tutkimusote ja tutkimusmenetelmänä narratiivien analyysi. Taustalla vaikuttaa konstruktionistinen tulkintatapa, jonka mukaan todellisuus rakentuu jatkuvasti puheen ja toiminnan kautta. Tutkielman aineistona on Pauliina Vanhatalon kaunokirjallinen elämäkertateos Keskivaikea vuosi, joka kuvailee keskivaikean masennusdiagnoosin saamista ja siitä seuraavaa vuotta Pauliinan elämässä. Masentuneen arjen ajallisuutta merkityksellistetään tässä tutkielmassa sekä toistuvuuden rikkoutumisena että uudelleenmuotoutumisena. Toistuvuuden rikkoutuminen ilmenee esimerkiksi siten, että työ- ja toimintakyky ovat vaakalaudalla, kun tavallisia arjen askareitakaan ei enää jakseta suorittaa. Arjen toistuvuuden uudelleenmuotoutumiseen kuuluvat esimerkiksi elämänrytmin hidastaminen ja masennuksen itsehoitokeinot, kuten kuntoilu, avantouinti ja tietoiseen läsnäoloon perustuvat meditaatioharjoitukset. Masentuneen arjen paikallisuus merkityksellistetään tässä tutkielmassa elinpiirin kaventumisena. Arjen voimavaratekijäkategorioiksi nousevat aineiston pohjalta lähisuvun emotionaalinen ja arkinen tuki, ammatillinen tuki, uudenlaisten ajatusmallien omaksuminen ja arjen uudelleen jäsentäminen. Voimavaratekijöiden moninaisuus kuvaa vaihtelevia ja erilaisia keinoja selvitä arjessa masennuksen kanssa. Masentuneiden arjen tutkimukselle on oma tärkeä paikkansa, sillä masentuneiden kohtaaminen auttamistyössä edellyttää laaja-alaista ymmärrystä masentuneiden arjesta, sen haasteista ja voimavaroista.

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.

Objectives: The objective of the present study was to investigate whether an acceptance and commitment therapy (ACT)-based web-intervention (Group 1, CareACT), or a standardized rehabilitation in a rehabilitation center (Group 2) was effective in enhancing the psychological well-being of family caregivers aged 60 and over compared to support provided by voluntary caregiver associations (Group 3). Methods: Altogether, 149 family caregivers participated in this quasi-experimental study. Primary outcome measure was depression. Secondary outcomes included anxiety, sense of coherence, quality of life, psychological flexibility, experiential avoidance, and thought suppression. The questionnaires were administered at baseline, and four, and 10 months post-measurement. We investigated differences in the changes between the groups using Mplus modeling techniques. Results: Regarding the main outcome of depression, the results suggest that the CareACT intervention was superior to standardized rehabilitation and to the support given by caregiver associations at four months, both showing a medium-sized difference between the groups. However, the change from four to 10 months post-intervention was not significantly different between these groups (d = 0.32–0.36). Thought suppression showed a significantly different change between the three groups from baseline to four months and to 10 months post-measurement (p = .038). Conclusions: Web-based ACT may have beneficial effects on depressive symptoms and thought suppression in older caregivers. Clinical implications: Web-based ACT could be a feasible alternative to institutional rehabilitation and support provided by voluntary caregiver associations. Web-based ACT responds flexibly to the needs of caregivers and provides them an opportunity for learning new skills to promote well-being. peerReviewed

Objective This study examined the predictive ability of the Rorschach-based Ego Impairment Index (EII-2) on outcome of psychotherapy in different types and durations of therapy. Method A total of 326 outpatients suffering from depressive or anxiety disorders were randomized into receiving solution-focused (n = 97), short-term psychodynamic (n = 101), or long-term psychodynamic psychotherapy (n = 128). Psychotherapy outcome assessments during the 5-year follow-up period covered psychiatric symptoms, social functioning, and work ability. Results Lower EII-2 values, which indicate less problematic ego functioning, were found to predict faster improvement in both short-term therapies as compared to long-term psychotherapy. Conclusion The results provide preliminary support for the utility of EII-2 as a complementary measure to interview-based methods for selecting between short- and long-term therapies. peerReviewed