Alexithymic traits and early parenting - parental reflective functioning, postpartum bonding and caregiving behaviour: FinnBrain Birth Cohort Study

Alexithymic traits with characteristics of difficulties in identifying and describing feelings and externally oriented thinking may potentially affect emotion-linked domains of parenting such as parental reflective functioning, postpartum bonding and caregiving behaviour. Studies on parental alexithymic traits are still scarce. Especially knowledge concerning parental alexithymic traits and their influence on parenting during the first year of a child’s life, as well as studies including fathers are lacking. This dissertation is part of the FinnBrain Birth Cohort Study. The aim of this thesis was to explore the associations between parental alexithymic traits and emotion-linked parenting abilities, i.e., parental reflective functioning and postpartum bonding by self-report questionnaires as well as maternal alexithymic traits and caregiving behaviour by observational method. The main findings showed that higher levels of parental alexithymic traits were associated with weaker parental reflective functioning and more problems in postpartum bonding in both mothers and fathers. Furthermore, maternal alexithymic traits were shown to associate with less sensitivity and more hostility in caregiving behaviour. The three dimensions of alexithymic traits were differentially associated with the studied dimensions of parenting. Further, the associations varied by parental sex. These findings support for the idea of dimensionality of alexithymic traits. The results imply that alexithymic traits may influence parenting but future studies are needed to establish the causality of the associations, as well as the underlying mechanisms. Alexithymic traits, as a relatively common personality construct, could be considered as potential risk factors for sub-optimal parenting among the general population. Screening for alexithymic traits could be considered a possible route for detecting families that would benefit from more support in their emotional skills e.g., in maternity clinics and primary health care. Vanhemman aleksityymiset piirteet ja varhainen vanhemmuus – vanhemman reflektiokyky, varhaisen kiintymisen kokemus ja hoivakäyttäytyminen. FinnBrain syntymäkohorttitutkimus. Aleksityymiset piirteet, joihin liittyy vaikeus tunnistaa ja kuvata tunteita sekä ulkokohtainen ajattelutapa, voivat olla yhteydessä tunteisiin liittyviin vanhemmuuden osa-alueisiin, kuten vanhemman reflektiokykyyn, varhaiseen kiintymisen kokemukseen ja hoivakäyttäytymiseen. Vanhemman aleksityymisiä piirteitä koskevaa tutkimusta on kuitenkin varsin vähän, ja erityisesti tietoa vanhemman aleksityymisten piirteiden merkityksestä vauvavuoden aikana ei ole juuri lainkaan. Lisäksi tähänastinen aleksitymiaan liittyvä vanhemmuustutkimus on keskittynyt pitkälti äiteihin, minkä vuoksi isien aleksityymisten piirteiden yhteyksistä heidän vanhemmuuteensa ei tiedetä juuri mitään. Tämä tutkimus on osa FinnBrain-syntymäkohorttitutkimusta. Tämän väitöskirjatyön tavoitteena oli tutkia vanhempien aleksityymisten piirteiden ja vanhempien reflektiokyvyn sekä varhaisen kiintymisen kokemuksen välisiä yhteyksiä kyselylomakkeilla. Lisäksi tavoitteena oli tutkia äitien aleksityymisten piirteiden yhteyttä hoivakäyttäytymiseen havainnointitutkimuksen menetelmin. Tutkimuksen keskeinen tulos oli, että sekä äitien että isien aleksityymiset piirteet olivat yhteydessä heikompaan vanhemman reflektiokykyyn sekä ongelmallisempaan varhaisen kiintymisen kokemukseen. Lisäksi äitien aleksityymiset piirteet olivat yhteydessä heikompaan sensitiivisyyteen ja voimakkaampaan vihamieliseen käyttäytymiseen osana hoivakäyttäytymistä. Eri aleksitymian osa-alueet olivat yhteydessä eri vanhemmuuden osa-alueisiin ja äitien ja isien välillä havaittiin eroja siinä, mikä aleksitymian osa-alue selitti kutakin yhteyttä vahvimmin. Tämä tukee aiempaa tutkimustietoa aleksitymian moniulotteisuudesta. Tutkimustulokset viittaavat siihen, että vanhemman aleksityymiset piirteet saattavat olla yhteydessä vanhemmuuden laatuun, mutta yhteyden kausaliteettia tai sitä selittäviä mekanismeja ei vielä tunneta. Näin ollen, aleksitymian ja vanhemmuuden välisiä yhteyksiä tulee tutkia lisää. Jatkossa on hyvä arvioida, olisiko vanhempien aleksityymisten piirteiden seulonta mahdollisesti hyödyllistä osana ns. riskiperheiden tunnistamista esimerkiksi neuvolajärjestelmän kontekstissa

”Minä yksin itken meitä.” : Surutyön tunnevaikutukset Selja Ahavan teoksissa

Pro gradu -tutkielmassani tarkastelen Selja Ahavan (s. 1974) romaaneissa Eksyneen muistikirja (2010), Taivaalta tippuvat asiat (2015) ja Ennen kuin mieheni katoaa (2017) esiintyvää surutyön ja siihen liittyvien tunnevaikutusten kuvausta kerronnan retoriikan näkökulmasta. Kaikissa kolmessa teoksessa yllättävän menetyksen aiheuttama suru kuvautuu teosten kantavana teemana ja tarinan muuttumattomana ytimenä. Tutkielmani tavoitteena on tutkia, esiintyykö teoksissa klassisen surutyön vaiheet ja miten surutyötä ja siihen liittyviä tunnevaikutuksia on kerronnallisin keinoin korostettu. Analyysissäni yhdistän surututkimuksen kentältä surutyön vaiheteorioiden tarkastelun ja kirjallisuudentutkimuksen kentältä emootioiden ja affektien sekä kerronnallisen empatian tutkimuksen elementtejä. Teoreettisina lähtökohtina hyödynnän tutkielmassani Aristoteleen Retoriikkaa ja Runousoppia sekä emootioiden ja affektien tutkimuksesta Suzanne Keenin teoreettisia näkökulmia kerronnan tekniikoista ja keinoista kerronnallisen empatian (narrative empathy) herättäjänä lukijassa. Lisäksi tutkin sitä, miten Ahava on teoksissaan käyttänyt kyseisiä keinoja herättääkseen empatiaa teoksen henkilöhahmoja kohtaan. Tutkielmani analyysissä nousee esiin, että Ahavan teokset sisältävät monitasoista tunnevaikuttamista niin suoran emootioiden kuvauksen kuin tiedostamattomampien affektienkin myötä. Suru on universaali ilmiö ja siihen liittyvät surutyön vaiheet esiintyvät selkeimmin teoksissa Taivaalta tippuvat asiat ja Ennen kuin mieheni katoaa. Niin kutsuttua pitkittynyttä, patologista surua kuvataan teoksessa Eksyneen muistikirja. Surutyön vaiheiden kuvausta korostetaan välittämällä surutyön emootioita ja affekteja lukijalle retorisin keinoin erityisesti naispäähenkilöiden näkökulmasta. Tämän fokalisaation myötä myös ensisijaiseksi empatian kohteeksi muotoutuvat nimenomaan naispäähenkilöt, vaikka empatiaa pyritään herättämään muitakin keskeisiä henkilöhahmoja kohtaan. Retorisista keinoista surutyön kuvauksessa nousevat merkityksellisinä esiin temporaalinen vaihtelu, lyyriset keinot ja fragmentaarisuus, rinnakkaiskertomus sekä lohtuhahmot henkilöhahmojen tietoisuuden kuvaajina. Aristoteelinen ’katharsis’ tragedian tunnevaikutusten tuottamana puhdistavan elementtinä kuvautuu teoksissa Taivaalta tippuvat asiat sekä Ennen kuin mieheni katoaa, mutta teoksessa Eksyneen muistikirja pitkittynyt surutyö näyttäytyy ’katharsiksen’ toteutumisen estäjänä. Ahavan teokset jatkavat osaltaan erityisesti naisille perinteistä huolilaulujen traditiota ja edustavat täten taiteen ja terapian yhdistelmää ylisukupolvisessa surukokemusten jakamisessa

Association between parental alexithymic traits and self-reported postnatal reflective functioning in a birth cohort population Findings from the FinnBrain Birth Cohort Study

Parental reflective functioning (PRF) refers to a parent's effort to see his/her child as a separate individual person from early on, and to be curious of the child's own thoughts and feelings. Parenting abilities are affected by the parent's emotion regulation and emotional availability. Alexithymia as a personality construct with emotional deficits and poor imagination could potentially affect also PRF, but studies on parental alexithymia are still scarce. The aim of the present study was to examine the association between parental alexithymic traits and PRF, which to date has not been explored. As most of the parenting research concern only mothers, an additional aim was to study also fathers. The 20-item Toronto Alexithymia Scale (TAS-20) and the 14-item Parental Reflective Functioning Questionnaire (PRFQ-Fi) were filled by 1882 mothers and 994 fathers at six months postpartum as part of the FinnBrain Birth Cohort Study. A significant negative association between TAS-20 total score and PRFQ-Fi total score among both genders was found. The main alexithymia dimension responsible for this association was Externally Oriented Thinking. The results suggest that alexithymic traits indeed are related to parental reflective functioning, but more studies are needed to explore the direction of this relation

Gender-specific associations between the dimensions of alexithymia personality trait and dental anxiety in parents of the FinnBrain Birth Cohort Study

We evaluated gender-specific associations of two dimensions of dental anxiety (anticipatory and treatment-related dental anxiety) with three dimensions of alexithymia: difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking. The sample comprised 2558 parents from the general population participating in the FinnBrain Birth Cohort Study. Dental anxiety was measured with the Modified Dental Anxiety Scale and alexithymia with the 20-item Toronto Alexithymia Scale. Associations between dental anxiety and alexithymia dimensions were modelled using linear regression analysis adjusting for general anxiety and depressive symptoms, age, and education. Structural equation modeling assessed their interrelationships. In women, anticipatory dental anxiety was associated only with difficulty in identifying feelings, but treatment-related dental anxiety was associated with difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking. In men, anticipatory dental anxiety was associated with only externally oriented thinking, whereas treatment-related dental anxiety was associated with difficulty in describing feelings, and with externally oriented thinking. Structural equation modelling showed that difficulty in identifying feelings was associated with anticipatory and treatment-related dental anxiety in women, whereas in men, only difficulty in describing feelings was associated with both types of dental anxiety. Anticipatory and treatment-related dental anxiety have different associations with alexithymia dimensions

Maternal Alexithymic Traits Are Related to Lower Maternal Sensitivity and Higher Hostility in Maternal Caregiving Behavior-The FinnBrain Birth Cohort Study

Background: The quality of parental caregiving behavior with their child plays a key role in optimal mother-infant interaction and in supporting child adaptive development. Sensitive caregiving behavior, in turn, requires the ability to identify and understand emotions. Maternal alexithymia, with difficulties in identifying and describing feelings or emotions, as well as a concrete way of thinking, could potentially complicate the quality of caregiving. In this study, we aim to explore the possible association between maternal alexithymic traits and the quality of maternal caregiving behavior. Methods: The study sample consisted of 158 mother-infant dyads within the FinnBrain Birth Cohort Study population with an available report of maternal alexithymic traits at 6 months postpartum and observational data on maternal caregiving behavior at 8 months postpartum. Alexithymia was measured using the 20-item Toronto Alexithymia Scale (TAS-20) including three alexithymia dimensions-Difficulty Identifying Feelings, Difficulty Describing Feelings (DDF), and Externally Oriented Thinking (EOT). Maternal caregiving behavior was assessed using the Emotional Availability Scale and in this study, all four parent dimensions (Sensitivity, Structuring, Non-intrusiveness and Non-hostility) were included. Maternal depressive and anxiety symptoms at 6 months postpartum were controlled for as potential confounders. In addition, background factors of mother's age and gestational weeks at the time of child birth, maternal educational level, monthly income and parity, as well as relationship status and the gender of the baby were assessed. Results: Maternal TAS-20 total score correlated negatively with Sensitivity (r = -0.169, p = 0.034) and with non-intrusiveness (r = -0.182, p = 0.022). In addition, maternal DDF correlated negatively with Sensitivity (r = -0.168, p = 0.035) and EOT with Non-hostility (r = -0.159, p = 0.047). Furthermore, in regression analyses with controlling for the associated background factors, maternal total score of alexithymic traits (p = 0.034, eta(2)p = 0.029) and higher DDF (p = 0.044, eta(2)p = 0.026) remained significantly associated with lower Sensitivity and higher EOT remained significantly associated with lower Non-hostility (p = 0.030, eta(2)p = 0.030). Conclusions: In this explorative study we found preliminary evidence for the hypothesis that higher maternal alexithymic traits associate with lower maternal sensitivity and more hostile maternal caregiving behavior. Further studies are needed to explore these hypotheses and to investigate their possible implications for child development.</p

Determinants of positive mental health in adolescents : a cross-sectional study on relationships between positive mental health, self-esteem, character strengths and social inclusion

Adolescence is a crucial time period with especial vulnerability for development of mental health problems. Growing interest is focusing on the determinants of positive mental health in order to find the key concepts that could be influenced in the promotion of mental well-being of adolescents. In this study we aim to explore the relations between self-esteem, character strengths and experience of social inclusion as determinants of adolescents’ positive mental health controlled for selected sociodemographic background factors. The study population (n = 195) consisted of comprehensive school students who filled in an electronic questionnaire of adolescent’s mental well-being in Fall 2019. The questionnaire included measures of Warwick-Edinburgh Mental Well-being Scale (WEMWBS), VIA Youth-measure 96, Rosenberg Self-Esteem Scale and Experience of Social Inclusion Scale. The methods included group comparisons and General Linear Model computed by SPSS 24.0. The strongest association was found between positive mental health and self-esteem (β = 0.789, p < 0.001), followed by character strengths of hope and kindness and experience of social inclusion. Interestingly, family’s socioeconomic factors did not associate significantly with positive mental health in the final statistical model. In terms of our results, it seems that self-esteem, character strengths and experience of social inclusion might have stronger association with adolescents’ mental well-being than family’s socioeconomic determinants. Therefore, it should be discussed whether psychological determinants overcome the individual effect of poor socioeconomic status as factors that influence positive mental health. Further studies are needed to establish these results more firmly.publishedVersionPeer reviewe

Alexithymia, body mass index and gestational diabetes in pregnant women — FinnBrain birth cohort study

ObjectiveOverweight, obesity, and associated problems in metabolic health are an increasing public health concern. Personality traits and emotional processing styles may play a role in the regulation of food intake and reward. Alexithymia is a personality construct involving difficulties in identifying and expressing emotions and has been previously associated with eating disorders and metabolic problems. We examined associations between alexithymia dimensions, Body Mass Index (BMI) and gestational diabetes in pregnant women.MethodsThe participants were 1660 pregnant women living in Finland from the FinnBrain Birth Cohort Study. We investigated the associations between alexithymia and its dimensions as measured by the Toronto Alexithymia Scale (TAS-20), overweight, and gestational diabetes. The effects of age, education, and depressive symptoms were controlled for using hierarchical regression analysis.ResultsAlexithymic individuals had a higher prevalence of overweight compared to those with low or moderate levels of alexithymia (66.0% vs. 34.8%, OR 3.6, adjusted OR 3.6, CI95% 1.9–6.8, p p p = .005].ConclusionsAlexithymia, and especially its dimension of EOT is associated with overweight and gestational diabetes in pregnant women. Future studies should clarify causality and examine potential mechanisms and associations with pregnancy outcomes and fetal health.</div