Riittakerttu Kaltiala

Riittakerttu Kaltiala
Tampere University | UTA · Faculty of Medicine and Health Technology

MD, PhD, BSc Professor of Adolescent Psychiatry

About

222
Publications
48,600
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
7,957
Citations
Introduction
My research interests comprise adolescent mental health epidemiology; sexuality, gender identity and mental health in adolescence; violent behaviour and mental disorders in adolescence; and adolescent psychiatric health services research
Additional affiliations
January 2013 - present
January 2006 - present
January 2004 - December 2011
University of Turku

Publications

Publications (222)
Article
Full-text available
Adolescence is an important period for identity formation and identity consolidation is one of the main developmental tasks. Gender identity is an essential aspect of identity but so far little is known about its development. Neither has the identity development of adolescents with features of gender dysphoria (GD) been extensively studied so far....
Article
Full-text available
Background: Some mental disorders have been associated with increased likelihood of sexual offending in adolescents (and adults), but relevant studies tend to be of established sex offenders. Aims: To examine relationships between adolescent mental disorders and subsequent involvement in sex offending and to explore any predictive value of prima...
Article
Full-text available
Purpose of the study: School absenteeism and school dropout jeopardize the future health and wellbeing of students. Reports on the participation of school health care in absenteeism reduction are infrequent, although physical and mental health problems are the most common causes of school absenteeism. Our aim was to explore what reasons different...
Article
Gender‐diverse adolescents have reported excessive experiences of sexual harassment, but studies on this are few and suffer from methodological problems. Our aim was to compare experiences of sexual harassment between adolescents belonging to different gender‐identity groups. A nationally representative cross‐sectional survey of 127,210 adolescents...
Article
Objective To examine secular trends and sociodemographic determinants of thinness, overweight, and obesity among Malaysian children and adolescents in 2006-2015. Design We used cross-sectional data from the National Health and Morbidity Surveys 2006, 2011, and 2015. Individuals were classified into pre- (6-9 years), early (10-13 years) and mid (14...
Article
Full-text available
Purpose This register-based study aimed to evaluate trends in adolescent psychiatric inpatient care using nationwide data from three consecutive decades. Methods The study population (N 17,112) comprised all Finnish citizens aged 13–17 receiving their first-ever psychiatric inpatient treatment between 1980 and 2010 in Finland. Information on inpat...
Article
Full-text available
Background: Mental health problems are common in adolescence and seeking help for them is becoming more common. Referrals to adolescent mental healthcare have recently increased in Finland. Objective: To examine time trends in internalizing and externalizing mental health symptoms among Finnish adolescents. Method: A time-trend school survey w...
Article
Objectives Emerging evidence reveals disparities in suicidal behaviour and ideation exist between transgender and cisgender youth. It has been hypothesized that certain gender minority specific risk factors, such as experiences of victimization, could partially explain the mental health disparities between transgender and cisgender youth. We set ou...
Article
Full-text available
Adolescents brought before court suffer excessively of mental disorders. Less is known about subsequent criminal participation of adolescent psychiatric inpatients. Our register study comprised all subjects that had between 1980 and 2010 been admitted to psychiatric inpatient care in Finland for the first time in their lives at ages 13–17 (n = 16 8...
Article
Full-text available
Background During adolescence, bullying often has a sexual content. Involvement in bullying as a bully, victim or both has been associated with a range of negative health outcomes. Transgender youth appear to face elevated rates of bullying in comparison to their mainstream peers. However, the involvement of transgender youth as perpetrators of bul...
Article
Full-text available
Mentalization, emotion regulation, and identity diffusion are theoretically and clinically important transdiagnostic psychological constructs that contribute to mental health. In order to advance meaningful empirical research on these constructs, we need measures that are well tested. In this study, we used confirmatory factor analysis to assess th...
Article
Full-text available
Background Despite reduced sanctions and more permissive attitudes toward cannabis use in the USA and Europe, the prevalences of adolescent cannabis use have remained rather stable in the twenty-first century. However, whether trends in adolescent cannabis use differ between socioeconomic groups is not known. The aim of this study was to examine tr...
Article
Full-text available
Background: Sexuality is a major facet of development during adolescence. Apace with normal sexual development, sexual experiences become more common and intimate. Recent research reports mixed results as to whether this is the case among transgender identifying adolescents. Recent research also suggests that trans youth experience negative sexual...
Article
Full-text available
BACKGROUND: Ignorance, misconceptions and fear hinder the implementation of young children's age-appropriate sexuality education (SE) globally. Methods to promote the SE of young children are needed. AIM: We aimed to evaluate why parents and professionals resist the concept of childhood SE and to test whether a child-centred term could reduce this...
Article
Background Serious long-term diseases like asthma, diabetes or epilepsy in adolescence means extra efforts to cope everyday life in school, hobbies or at home. These also set extra challenges on adolescents to go through the developmental tasks of that age. We study here, if adolescents with a long-term disease have lower chances for an academic ed...
Article
Importance The association between income and mental health has long been a question of interest. Nationwide register data provide means to examine trends and patterns of these associations. Objectives To compare income-specific trends in the incidence rates of first psychiatric hospital admissions and to evaluate whether an income gradient exists...
Article
Full-text available
All over Europe youth delinquency is decreasing; our understanding of the factors related to juvenile delinquency and the characteristics of effective forensic youth care has increased substantially. However, effective prevention and intervention strategies are not always employed due to financial, demographical and socio-political challenges count...
Article
Purpose: To assess how adolescent development progresses and psychiatric symptoms develop among transsexual adolescents after starting cross-sex hormone treatment. Materials and methods: Retrospective chart review among 52 adolescents who came into gender identity assessment before age 18, were diagnosed with transsexualism and started hormonal gen...
Article
We investigated whether the associations between involvement in bullying and emotional and behavioral symptoms among adolescents differ according to sexual orientation. Respondents were 25 147 boys and 25 257 girls in comprehensive school (Mage 15.4, SD 0.6), and 33 231 males and 36 765 females in upper secondary education (Mage 17.4, SD 0.8) in Fi...
Article
Full-text available
Purpose: To explore whether the increase observed in referrals to child and adolescent gender identity services (GIDSs) has been similar in four Nordic countries and in the UK. Materials and methods: Numbers of referrals per year in 2011–2017 were obtained from all GIDS in Denmark, Finland, Norway, Sweden and the UK and related to population aged <...
Article
Full-text available
Background: Scientific literature suggests that the prevalence of delinquency amongst adolescents has decreased internationally in past decades. However, whether this change is consistent across all socioeconomic groups has not yet been studied. Objective: The aim of this study was to examine changes in delinquency amongst Finnish adolescents acco...
Article
Objective: To review research on emotional, cognitive, and behavioral levels of sexual development in children and adolescents, and, based on that, to propose a model of sexual development from infancy to early adulthood, the Steps of Sexuality. Methods: Literature review. Results: We present a model of sexual development from infancy to early adul...
Article
Introduction: Subjection to sexual harassment among adolescents have been associated with negative mental health outcomes, such as depression and social anxiety. Self-esteem and social support may modify these associations. Methods: The Adolescent Mental Health Cohort 10-year replication data were used. It is a cross-sectional classroom survey invo...
Article
Purpose: Smoking is a significant cause of morbidity and mortality worldwide. In the past decades, the prevalence of adolescent smoking has decreased in industrial countries. However, whether the decreasing trend can be seen across all socioeconomic groups is unknown. The aim of this study was to examine time trends in adolescent smoking according...
Article
Gender dysphoria in adolescence could be expected to be associated with delayed sexual development because of the distress related to the sexual characteristics of the body. However, identity challenges may also increase early and risk-taking sexual behaviours among adolescents with gender dysphoria. We studied sexual experiences among 101 adolesce...
Article
The aim of this study was to explore whether there has been an increase in prevalence and changes in sex ratio in feelings of gender dysphoria (GD) in an adolescent population in Northern Europe, and to study the impact of invalid responding on this topic. We replicated an earlier survey among junior high school students in Tampere, Finland. All fi...
Article
Full-text available
Purpose: To explore whether sexual harassment experiences are more common among adolescents reporting romantic and erotic interests in the same sex and both sexes, when sociodemographic and mental health confounding are controlled for, and whether the associations are similar in both sexes and in different phases of adolescence. Methods: A cross-se...
Article
Background: Increasing numbers of adolescents are seeking treatment from gender identity services, particularly natal girls. It is known from survey studies some adolescents exaggerate their belonging to minorities, thereby distorting prevalence estimates and findings on related problems. The aim of the present study was to explore the susceptibil...
Article
Symptoms of generalized anxiety disorder (GAD) are common among adolescents and can lead to severe psychosocial impairment, yet there is a lack of a good quality scale to measure symptoms of generalized anxiety in young people. The 7-item Generalized Anxiety Disorder Scale (GAD-7) is a self-report scale used to measure GAD symptoms and has been val...
Article
Manifold factors connect with adolescent sexual behavior, but studies on their reciprocal associations are scarce. This study seeks to find the ways in which parental involvement, family characteristics, depression, and delinquency are connected to adolescent early/risky sexual behavior, and to what extent they modify each other. A population-based...
Article
Bullying at school has far-reaching impacts on adolescent well-being and health. The aim of this study was to examine trends in bullying at school according to socioeconomic adversities among Finnish adolescents from 2000 to 2015. A population-based school survey was conducted biennially among 14-16-year-old Finns between 2000 and 2015 (n = 761,278...
Article
Full-text available
We analyzed the associations between sexual orientation and subjection to/perpetration of bullying at school, taking into account confounding by psychiatric symptom dimensions and involvement in the other role. Survey data among 25,147 boys and 25,257 girls in comprehensive school, and 33,231 boys and 36,765 girls in upper secondary education in Fi...
Article
Full-text available
Riittakerttu Kaltiala-Heino,1–3 Hannah Bergman,4 Marja Työläjärvi,2 Louise Frisén4 1Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland; 2Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland; 3Vanha Vaasa Hospital, Vaasa, Finland; 4Department of Clinical Neuroscience, Karolinska Institutet, S...
Article
Subjection to sexual harassment is associated with a number of negative outcomes, such as internalizing and externalizing symptoms and a disinclination to attend school. Among adolescents, sexual harassment may increase with both their emerging sexual desires and increased socializing in mixed-gender peer groups during early adolescence. We set out...
Article
Background: Overweight and perceived overweight are common among adolescents. The nature of the relationship between overweight/perceived overweight and mental health problems is still unclear. Aims: The aim of this study was to examine whether actual overweight, perceived overweight or both are associated with internalizing and externalizing disor...
Article
Purpose: To elucidate a possible connection between delinquency and adolescent sexual behaviours in different age groups from 14 to 20 and the role of depression therein. Materials and methods: Data were gathered from the cross-sectional Finnish School Health Promotion Study 2010 and 2011 with 186,632 respondents. We first examined the bivariate re...
Article
Full-text available
Background: Longitudinal associations between social phobia (SP), depression and eating disorders (EDs), and the impact of antecedent SP and depression on subsequent treatment seeking for EDs have rarely been explored in prospective adolescent population studies. Aim: We aimed to examine these associations in a large-scale follow-up study among mid...
Article
Full-text available
Background The mortality rate of young offenders is high. Furthermore, mortality in young offenders is associated with psychiatric and substance use disorders. The primary aim of this national register-based follow-up study was to investigate the mortality rate of Finnish delinquents who underwent a forensic psychiatric examination between 1980 and...
Article
Background: Aggressive and disruptive behaviors often precede the onset of schizophrenia. In this register-based follow-up study with a case-control design, we wanted to investigate if serious delinquency was associated with future diagnoses of schizophrenia or schizoaffective disorder (here, broadly defined schizophrenia) among a nationwide conse...
Article
We studied current (GIDYQ-A) and recalled (RCGI) childhood gender identity among 719 upper secondary school students 401 girls, mean age 17.0 (SD = 0.88) years old and 318 boys, mean age 17.2 (SD = 0.86 years old in Finland. We also compared these dimensions of identity in community youth to same dimensions among adolescent sex reassignment (SR) ap...
Article
Full-text available
Background: Early sexual activity and multiple sexual partners are deemed risky sexual behaviors and connected to mental disorders such as depression. Parent–adolescent relationship is connected both to risky sexual behaviors and depression. Objective: To ascertain if there is a connection between parental involvement and adolescent sexual behavior...
Article
Background: Psychopathy research has thus far focused mostly on child, male, and delinquent samples, but the results are most likely non-generalizable to adolescent girls with mental health disorders. Aim: The present study aimed to compare self-rated psychopathic traits between female psychiatric outpatients and girls in the community, and to inve...
Article
Full-text available
Background More research is needed to improve our understanding of the manifestation of psychopathic traits in violently offending girls. Our aim here was to assess psychopathic traits and psychopathy-related background variables in a Finnish nationwide consecutive sample of girls charged with violent crimes and referred to a pretrial forensic psyc...
Article
Background: Mental health profiles differ between boys and girls from puberty onwards. It is not known whether differences also extend to symptom presentation in schizophrenia spectrum disorders. It may be that girls and boys are not treated entirely equally by the professionals. Aims: To study gender differences in symptom profiles, family adversi...
Article
Background: In DSM 5, conduct disorder was expanded with the new specifier ‘with limited prosocial emotions (LPE)’. These callous-unemotional traits have been emphasized as the ‘core’ of psychopathy syndrome providing greater information about current and future impairment. Individuals with callous-unemotional traits have shown elevated levels of i...
Article
Objectives: The aim of our study was to explore whether gender dysphoria in adolescent girls is associated with early pubertal timing. Methods: We compared menarcheal timing among 52 adolescent girl-to-boy sex reassignment (SR) applicants with that of 644 adolescent girls who participated in an adolescent population mental health survey. Results: O...
Article
Background: A debate concerns whether eating disorders are increasing in prevalence. The role of socio-economic status (SES) for adolescent eating disorders (ED) is another matter of debate. Aims: To ascertain whether self-reported eating disorders or their symptoms have increased in prevalence in adolescent population from the early 2000s to early...
Article
Aims To assess temporal trends of adolescent alcohol use in Finland from 2000 to 2011, according to socio-economic status and depression. Methods Classroom self-administered questionnaires concerning health, health behaviours and school experiences were administered biennially from 2000–2001 to 2010–2011 to nationwide samples of 14- to 16-year-old...
Article
Full-text available
We examined longitudinal associations between social phobia (SP) and educational and interper-sonal impairments among Finnish adolescents. Participants were 3278 adolescents (9th grade; M age = 15.5 years) who completed measures of SP and depressive symptoms; 2070 participated in follow-up two years later. Indicators for educational and interperson...
Article
Full-text available
Purpose To study the associations between subjection to sexual harassment and emotional (depression) and behavioural (delinquency) symptoms among 14-to-18-year-old adolescents, and gender differences within these associations. Methods 90,953 boys and 91,746 girls aged 14–18 participated in the School Health Promotion Study (SHPS), a school-based su...
Article
Full-text available
Objective: Proeating disorder (pro-ED) communities online encourage harmful weight-loss and weight-control practices. This study examined the association between exposure to pro-ED content online and subjective well-being (SWB) among adolescents and young adults in four countries. Method: Cross-national data were collected in the US, Germany, th...
Article
Sexual harassment has been studies as a mechanism reproducing inequality between sexes, as gender based discrimination, and more recently, as a public health problem. The role of family-related factors for subjection to sexual harassment in adolescent has been little studied. Our aim was to study the role of socio-demographic family factors and par...
Article
Overweight is reportedly a risk factor for being bullied, and body image may mediate this association. Research on associations between overweight and bullying has so far only focused on children and early adolescents. We explored associations between actual and perceived overweight at age 15 and involvement in bullying at ages 15 and 17. A total o...
Article
Schizophrenia (SCH) and pervasive developmental disorders (PDDs) belong to different diagnostic categories. There is, however, overlap between these 2 diagnostic groups. The aim of this preliminary study was to evaluate some aspects of neurocognitions and social cognitions in adolescents with SCH (n = 10, 2 boys and 8 girls; age range = 13.3-17.7 y...
Article
Full-text available
Background: Culture‑related differences in psychopathic traits have been reported for adults, but for adolescents such knowledge is lacking. The aim of this cross‑national study was to compare self‑reported psychopathic traits between Finnish and Dutch samples of mid‑adolescent community youth. Methods: The Youth Psychopathic traits Inventory (YPI)...
Article
Full-text available
Background: Associations between psychopathic traits and other forms of psychopathology among youth in the community, as well as gender differences in these associations have been scarcely studied yet. The present study aimed to explore this relationship in a sample of Finnish mid-adolescent girls and boys. Methods: The sample comprised 370 seconda...
Article
Full-text available
In aftermath of the school shootings in Finland (2007 and 2008), hundreds of schools were threatened with similar acts. These threats of homicidal violence occupied both police and psychiatrists, but little is known about the potential threat these cases posed. Our study compared the threats of homicidal violence communicated by pupils aged 12–18 u...
Article
Sexually offending behavior by adolescents may be directed towards children, age-mates and adults. Neurocognitive and psychiatric disorders and the associated inability to age-related interpersonal relationships and inability to control the sexual desires activated during adolescence may lead a young person to seek inappropriate sexual satisfaction...
Article
Ethical challenges in child and adolescent forensic psychiatry arise, on the one hand, from the dilemmas commonly faced in forensic psychiatry with adult patients, such as the dual role of the forensic psychiatrist, questions of criminal responsibility, autonomy and competence and involuntary treatment, and, on the other, from the immaturity and de...
Article
Full-text available
In general psychiatric services, cost-benefit screening instruments for psychopathic traits in adolescents are needed. The aim of the present study was to study the psychometric properties of the Finnish versions of the Youth Psychopathic traits Inventory (YPI) and the Antisocial Process Screening Device (APSD-SR) in community youth. As gender-spec...
Article
Full-text available
Increasing numbers of adolescents present in adolescent gender identity services, desiring sex reassignment (SR). The aim of this study is to describe the adolescent applicants for legal and medical sex reassignment during the first two years of adolescent gender identity team in Finland, in terms of sociodemographic, psychiatric and gender identit...
Article
Transsexualism and other variations of gender identity are based on a stable sense of identity. The aetiology of this phenomenon is not fully known. Suffering caused by gender dysphoria is alleviated with sex reassignment. The psychiatric assessment of both adolescents and adults has been centralized in Finland to two university hospitals, the Hels...
Article
Objective: To study associations between emotional and behavioural symptoms and later engagement in sexual behaviours in middle adolescence. Materials and methods: All ninth graders in two Finnish cities were recruited to respond to a questionnaire focusing on mental health and disorders, health behaviours and risk and protective factors (T1), and...
Article
Full-text available
Purpose: Adolescents engaging in early sexual intercourse are at elevated risk for depression, but it is not clear at what point of adolescent development this connection ceases to be significant. Depression is a highly prevalent mental health problem in adolescence compared to childhood, especially among girls. This study examines the association...
Article
Full-text available
Group-based modeling techniques are increasingly used in developmental studies to explore the patterns and co-occurrence of internalizing and externalizing problems. Social competence has been found to reciprocally influence internalizing and externalizing problems, but studies on its associations with different patterns of these problems are scarc...
Article
Background: Most research on violent perpetrators is based on male samples. Aims: To compare girls and boys admitted to an adolescent forensic unit due to physically violent and/or sexually coercive behavior. Methods: On an adolescent forensic ward, demographics, family, treatment, crime and victimization histories, diagnose, psychiatric symptoms a...
Article
Background Structured violence risk assessment is an essential part of treatment planning for violent young people. The Structured Assessment of Violence Risk in Youth (SAVRY) has been shown to have good reliability and validity in a range of settings but has hardly been studied in adolescent mental health services.AimsThis study aimed to evaluate...
Article
Unlabelled: The Clark and Wells' cognitive model of social phobia suggests that self-focused attention, negative observer-perspective images of oneself and safety behaviours maintain anxiety in subjects with SP. Empirical research among adults supports the model, but limited evidence for it has been obtained in other age groups or in the general p...
Article
Full-text available
Adolescent depression is more common in lower socio-economic groups. Whether this pattern has changed over time, is not known.We examined the prevalence of self-reported depression and its changes in socio-economic groups from 2000 to 2011 among Finnish adolescents. Data were based on classroom surveys every second year from 2000[box drawings light...
Article
Full-text available
Social phobia and depression are common, highly comorbid disorders in middle adolescence. The mechanism underlying this comorbidity, however, is unclear. Decrease in self-esteem caused by the initial disorder might play a decisive role in the development of the subsequent disorder. The present study aimed to determine whether the association betwee...