Neurocognitive Impairment in Early Adolescence Following Prenatal Alcohol Exposure of Varying Duration

The aims of the study were, first, to perform a comprehensive assessment of neurocognitive status in early adolescence of children exposed to alcohol prenatally; and, second, to examine whether duration of exposure continues to be predictive of outcome at this age. Twenty-seven exposed 12-14-year-olds and 39 nonexposed 13-14-year-olds underwent neuropsychological assessments (WISC-III, NEPSY subtests) of attention and executive functions, language, visuomotor functions, and memory. The group of non-exposed children was used to develop preliminary test norms for the 13-14-year-old exposed children whereas published test norms could be used for the 12-year-olds. The results demonstrated neurocognitive impairment across all types of tasks. Impairment varied in degree according to the duration of alcohol exposure. Children exposed throughout pregnancy, most of who had diagnoses of Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE), performed well below the average range. It was concluded that the neurocognitive effects of alcohol exposure tend to be widespread and generalized. Attention and executive functions do not seem to be selectively affected. Further, the relationship between duration of prenatal alcohol exposure and neurocognitive development continues to be significant in early adolescence.     

Neurocognitive impairment in early adolescence following prenatal alcohol exposure of varying duration.

The aims of the study were, first, to perform a comprehensive assessment of neurocognitive status in early adolescence of children exposed to alcohol prenatally; and, second, to examine whether duration of exposure continues to be predictive of outcome at this age. Twenty-seven exposed 12-14-year-olds and 39 non-exposed 13-14-year-olds underwent neuropsychological assessments (WISC-III, NEPSY subtests) of attention and executive functions, language, visuomotor functions, and memory. The group of non-exposed children was used to develop preliminary test norms for the 13-14-year-old exposed children whereas published test norms could be used for the 12-year-olds. The results demonstrated neurocognitive impairment across all types of tasks. Impairment varied in degree according to the duration of alcohol exposure. Children exposed throughout pregnancy, most of who had diagnoses of Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE), performed well below the average range. It was concluded that the neurocognitive effects of alcohol exposure tend to be widespread and generalized. Attention and executive functions do not seem to be selectively affected. Further, the relationship between duration of prenatal alcohol exposure and neurocognitive development continues to be significant in early adolescence.     

Response Style Differences in the Inattentive and Combined Subtypes of Attention-Deficit/Hyperactivity Disorder

This study examined potential differences between the inattentive and combined ADHD subtypes using laboratory tasks assessing behavioral inhibitory processes. Seventy-five children completed two tasks of behavioral inhibition believed to isolate different processes: the cued reaction time task (CRT), a basic inhibition task, and the go/no-go task (GNG), a complex inhibition task that incorporates motivational contingencies. Three groups of participants were identified, including ADHD/Inattentive (n = 17), ADHD/Combined (n = 37), and comparison (n = 21). Results indicated that rather than showing behavioral inhibition deficits, the ADHD/I children appeared overly inhibited, as evidenced by slower reaction times across the two tasks and significantly higher errors of omission in the GNG task. Additionally, the ADHD/I children did not demonstrate cue dependency effects on the CRT task, suggesting that they were failing to incorporate relevant information before making a response. The sluggish and inhibited performance of the ADHD/I group challenges the idea that it is a subtype of ADHD.     

Prenatal Exposure to Maternal Smoking and Childhood Behavioural Problems: A Quasi-experimental Approach

This retrospective cross-sectional paper examines the relationship between maternal smoking during pregnancy and children’s behavioural problems at 9?years of age independent of a wide range of possible confounders. The final sample comprised 7,505 nine-year-old school children participating in the first wave of the Growing Up in Ireland study. The children were selected through the Irish national school system using a 2-stage sampling method and were representative of the nine-year population. Information on maternal smoking during pregnancy was obtained retrospectively at 9?years of age via parental recall and children’s behavioural problems were assessed using the Strengths and Difficulties Questionnaire across separate parent and teacher-report instruments. A quasi-experimental approach using propensity score matching was used to create treatment (smoking) and control (non-smoking) groups which did not differ significantly in their propensity to smoke in terms of 16 observed characteristics. After matching on the propensity score, children whose mothers smoked during pregnancy were 3.5?% (p?<?0.001) and 3.4?% (p?<?0.001) more likely to score in the problematic range on the SDQ total difficulties index according to parent and teacher-report respectively. Maternal smoking during pregnancy was more strongly associated with externalising than internalising behavioural problems. Analysis of the dose–response relationship showed that the differential between matched treatment and control groups increased with level of maternal smoking. Given that smoking is a modifiable risk factor, the promotion of successful cessation in pregnancy may prevent potentially adverse long-term consequences.     

Violence Exposure and Early Adolescent Alcohol Use: An Exploratory Study of Family Risk and Protective Factors

In this short-term longitudinal exploratory interview study, the relations between exposure to community violence and subsequent alcohol use were examined, with a focus on caregiver and family variables as moderators. Maternal caregivers and their children (N =101 families; 98% African American; M child age = 11.2 yrs) were interviewed separately and completed measures of violence exposure, caregiver and child adjustment, including substance use, and family functioning. Family interaction was also videotaped and coded. Child alcohol use at Time 2 was positively associated with all forms of violence exposure, and was negatively related to felt acceptance from caregiver, but was not associated with caregiver-rated family competence, observer-rated family interaction, maternal problems with alcohol, or maternal psychopathology. Logistic regression analyses predicting child alcohol use at Time 2 indicated that exposure to community violence increased risk of alcohol use, and felt acceptance from the caregiver decreased the likelihood of alcohol use, but did not buffer the effects of violence exposure on alcohol use. Implications and future directions are discussed.     

Food preferences before and during treatment for a pediatric feeding disorder

Little is known about the food preferences of children with a feeding disorder and medical diagnoses. Therefore, we conducted repeated paired-stimulus-preference assessments with foods to which we either exposed or did not expose 3 children with a feeding disorder and medical diagnoses during clinical treatment. Responding was relatively equivalent for exposure and nonexposure foods throughout the preference assessments, suggesting that preferences for foods did not change due to exposure during treatment.     

Numerical and arithmetical cognition: a longitudinal study of process and concept deficits in children with learning disability

Based on the stability and level of performance on standard achievement tests in first and second grade (mean age in first grade = 82 months), children with IQ scores in the low-average to high-average range were classified as learning disabled (LD) in mathematics (MD), reading (RD), or both (MD/RD). These children (n = 42), a group of children who showed variable achievement test performance across grades (n = 16), and a control group of academically normal peers (n = 35) were administered a series of experimental and psychometric tasks. The tasks assessed number comprehension and production skills, counting knowledge, arithmetic skills, working memory, the ease of activation of phonetic representations of words and numbers, and spatial abilities. The children with variable achievement test performance did not differ from the academically normal children in any cognitive domain, whereas the children in the LD groups showed specific patterns of cognitive deficit, above and beyond the influence of IQ. Discussion focuses on the similarities and differences across the groups of LD children.     

Sex-Typed Responses in the Rorschach Protocols of Children With Gender Identity Disorder

A coding system was developed to measure sex-typed responses in the Rorschach protocols of children with gender identity disorder (n = 79). Their responses were compared to that of sibling (n = 25), psychiatric (n = 26), and normal (n = 28) controls. Results show that children with gender identity disorder gave significantly more cross-sex responses than same-sex responses, whereas the psychiatric and normal controls gave significantly more same-sex responses than cross-sex responses. The siblings did not differ in the number of same-sex and cross-sex responses. Results are discussed with regard to various assessment issues in the study of children with gender identity disorder.     

Sex-typed responses in the Rorschach protocols of children with gender identity disorder.

A coding system was developed to measure sex-typed responses in the Rorschach protocols of children with gender identity disorder (n = 79). Their responses were compared to that of sibling (n = 25), psychiatric (n = 26), and normal (n = 28) controls. Results show that children with gender identity disorder gave significantly more cross-sex responses than same-sex responses, whereas the psychiatric and normal controls gave significantly more same-sex responses than cross-sex responses. The siblings did not differ in the number of same-sex and cross-sex responses. Results are discussed with regard to various assessment issues in the study of children with gender identity disorder.     

Attaining and maintaining preparation: A comparison of attention in hyperactive,normal, and disturbed control children

The hypothesis that hyperactive children have a deficit in sustained attention was investigated. Eighteen children who had attention deficit disorder with hyperactivity (ADDH), aged 7 to 11 years, were compared with children who had conduct disorder (n = 15), mixed conduct disorder and ADDH (n = 26), emotional disorder (n = 18), or learning disability (n = 22), and with normal controls (n = 15). The subjects were tested on three versions of the Continuous Performance Task. Sustained attention was assessed from performance with increasing time on task and from ability to prepare attention in response to a warning. Performance of all subjects deteriorated with increasing time and improved with the opportunity to prepare attention. Hyperactive subjects were not more adversely affected by increasing time, nor did they benefit less than controls from the opportunity to prepare attention. Data reanalysis after rediagnosis according to ICD-9 criteria did not change the results. This study did not confirm the hypothesis that hyperactive children have a unique sustained attention deficit.     

The Effects of Prenatal Alcohol Exposure on Behavior: Rodent and Primate Studies

The use of alcohol by women during pregnancy is a continuing problem. In this review the behavioral effects of prenatal alcohol from animal models are described and related to studies of children and adults with FASD. Studies with monkeys and rodents show that prenatal alcohol exposure adversely affects neonatal orienting, attention and motor maturity, as well as activity level, executive function, response inhibition, and sensory processing later in life. The primate moderate dose behavioral findings fill an important gap between human correlational data and rodent mechanistic research. These animal findings are directly translatable to human findings. Moreover, primate studies that manipulated prenatal alcohol exposure and prenatal stress independently show that prenatal stress exacerbates prenatal alcohol-induced behavioral impairments, underscoring the need to consider stress-induced effects in fetal alcohol research. Studies in rodents and primates show long-term effects of prenatal and developmental alcohol exposure on dopamine system functioning, which could underpin the behavioral effects.     

Formula: see text]Substance exposure in utero and developmental consequences in adolescence: A systematic review

Background: The impacts of maternal substance use have been observed in both research and clinical experience. Several studies have shown that preschool children are at heightened risk of developing various cognitive, behavioral, and socioemotional difficulties. Most knowledge has been generated concerning alcohol consumption during pregnancy and the postnatal effects thereof. Less is known about substance use other than alcohol (for instance, opiates, marijuana, and cocaine) during pregnancy and the long-term developmental consequences. Objective: The aims of this review are to identify relevant published data on adolescents who have been exposed in utero to alcohol and/or other substances and to examine developmental consequences across functions and mental health at this point in life. Methods: PubMed, Embase, and PsychInfo were searched for publications during the period of 1980-2011 and titles and abstracts selected according to prespecified broad criteria. Results: Twenty-five studies fulfilled all of the specific requirements and were included in this review. Most research covered prenatal alcohol exposure. Other substances, however, included cocaine, marijuana, opiates, and poly-substances. Results showed that prenatal exposure to alcohol has long-term cognitive, behavioral, social, and emotional developmental consequences depending on amount and timing of exposure in utero. Less evidence exists for long-term consequences of exposure in utero to other substances than alcohol. However, recent brain-imaging studies have provided important evidence of serious effects of other substance exposure on the developing brain and recent follow-up studies have found an association with deficits in language, attention, areas of cognitive performance and delinquent behavior in adolescence.     

Testosterone,aggressiveness, and antisocial personality

Testosterone levels were examined in prisoners convicted of violent crimes (n = 13), in men previously convicted of violent crimes but currently not in prison (n = 15), in nonviolent alcoholics (n = 15), and in randomly selected control males (n = 16). Morning, afternoon, and evening testosterone levels were assessed after a minimum alcohol abstinence period of 24 hr. Violent and nonviolent men did not differ in plasma total testosterone level on any sampling occasion. In violent men, however, testosterone levels were significantly correlated with hostility, as measured by the Derogatis Symptom Check List. Most violent men were diagnosed with Antisocial Personality Disorder (ASP) [DSM‐III‐R; 301.70], and the unweighted ASP symptom count also correlated significantly with testosterone levels in these subjects. We suggest that individuals whose life histories involve numerous antisocial behaviors tend to have high testosterone levels even when interpersonal violence is excluded. This, however, does not eliminate the possibility that males who are characterized by high hostility may also have elevated testosterone levels. Violent predisposition and antisocial conduct beginning in early adolescence predict adult aggressive behaviors, which are augmented by power‐related alcohol expectancies and alcohol abuse. Aggr. Behav. 25:113–123, 1999. © 1999 Wiley‐Liss, Inc.     

The association between maternal smoking and secondhand exposure and autonomic functioning at 2-4 weeks of age

This study examined the association between maternal smoking and exposure to environmental tobacco smoke (ETS) during pregnancy and infant heart rate. Participants were 62 mother-infant dyads where mother smoked during pregnancy, 47 dyads where mother did not smoke during pregnancy but was exposed to ETS and 47 dyads where mother did not smoke and was not exposed to ETS. Average heart rate (HR) and respiratory sinus arrhythmia (RSA) were assessed at 2-4 weeks of age during sleep. Infants in both exposure groups had higher HR and lower RSA than nonexposed infants. Furthermore, boys in both exposure groups had higher HR and lower RSA than girls. These results highlight the importance of considering prenatal ETS exposure and infant gender when assessing infant outcomes.     

Everyday Marital Conflict and Child Aggression

Children's immediate aggressive responding to exposure to marital conflict was examined. Participants were 108 families with 8- to 16-year-old children (53 boys, 55 girls), with diary records of children's reactions to marital conflict in the home completed by 103 mothers (n = 578 records) and 95 fathers (n = 377 records) during a 15-day period. Child responses to analog presentations of marital conflict tactics were also obtained. Exposure to destructive conflict tactics and negative parental emotionality increased the likelihood of aggressive behavior in children when they witnessed marital conflict, whereas constructive conflict tactics and positive parental emotionality decreased the probability of aggression. Conflict topics presumed to be threatening to the child (child- or marital-related) also heightened the likelihood of aggression. Aggressive responding to conflict in both home and laboratory predicted externalizing behavior problems. Fathers' and mothers' separate diary reports, and child responses to analog presentation of conflict, provided generally consistent findings. An exposure hypothesis for marital conflict as an influence on child aggression is discussed.     

Does war beget child aggression? Military violence,gender, age and aggressive behavior in two Palestinian samples

We examined, first, the relations between children's exposure to military violence and their aggressive behavior and the role of age and gender in that relation in two Palestinian samples. Second, we tested parenting practices as a moderator of the relation between exposure to military violence and aggressive behavior, and third, whether exposure to military violence of different nature (direct victimization versus witnessing) has specific associations with different forms of aggression (reactive, proactive and aggression-enjoyment). Study I was conducted in a relatively calm military-political atmosphere in Palestine-Gaza, and included 640 children, aged 6-16 years whose parents (N=622) and teachers (N=457) provided reports. Older children (> or =12 years) provided self-reports (N=211). Study II included 225 Palestinian children aged 10-14-year, who participated during a high-violence period of the Al Aqsa Intifada characterized by air raids, killing and destruction. Results showed that witnessing severe military violence was associated with children's aggressive and antisocial behavior (parent-reported) in study I, and with proactive, reactive and aggression-enjoyment (child-reported) in the study II. As hypothesized, good and supporting parenting practices could moderate the link between exposure to military violence and aggressive behavior. Aggr.     

Co-regulation of movement speed and accuracy by children with heavy prenatal alcohol exposure

The study investigated how children with heavy prenatal alcohol exposure regulate movement speed and accuracy during goal-directed movements. 16 children ages 7 to 17 years with confirmed histories of heavy in utero alcohol exposure, and 21 nonalcohol-exposed control children completed a series of reciprocal tapping movements between two spatial targets. 5 different targets sets were presented, representing a range of task difficulty between 2 and 6 bits of information. Estimates of percent error rate, movement time, slope, and linear fit of the resulting curve confirmed that for goal-directed, reciprocal tapping responses, performance of the group with prenatal alcohol exposure was described by a linear function, as predicted by Fitts' law, by sacrificing movement accuracy. The index of performance was the same for the two groups: it initially increased, then leveled off for more difficult movements.     

Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD

Children diagnosed with attention-deficit/hyperactivity disorder (ADHD; n = 142) were prospectively monitored into adolescence (13-18 years old) to evaluate their risk for elevated substance use relative to same-aged adolescents without ADHD (n = 100). Probands reported higher levels of alcohol, tobacco, and illicit drug use than did controls. Group differences were apparent for alcohol symptom scores but not for alcohol or marijuana disorder diagnoses. Within probands, severity of childhood inattention symptoms predicted multiple substance use outcomes: childhood oppositional defiant disorder/conduct disorder (ODD/CD) symptoms predicted illicit drug use and CD symptoms. Persistence of ADHD and adolescent CD were each associated with elevated substance use behaviors relative to controls. Further study of the mediating mechanisms that explain risk for early substance use and abuse in children with ADHD is warranted.     

Personality disorders associated with substance use among American and Greek adolescents

A study was conducted to investigate the association between personality disorder (PD) symptomatology and substance use among adolescents in community settings in the United States and Greece. The Structured Clinical Interview for DSM-IV Personality Disorders and the Adolescent Health Behavior Survey were completed by 37 male and 84 female adolescents, ages 15 to 18, who were recruited from an adolescent medical clinic and schools in and near New York City (n = 71) and Heraklion, Greece (n = 50). Results indicated that: (1) adolescents with PDs reported more frequent alcohol consumption during the past year than did those without PDs; (2) adolescents with borderline PD reported more cigarette smoking and heavy alcohol consumption than did those without borderline PD; (3) adolescents with antisocial PD symptomatology reported greater alcohol, cigarette, and illicit drug use than did those without antisocial PD symptomatology; and (4) although more American (30%) than Greek (4%) adolescents reported illicit substance use, differences were not observed in the prevalence of alcohol use, cigarette use, or personality disorders as a function of nationality.     

Some effects of alcohol on eyewitness memory

Male volunteers (N = 120) in small groups of 5 to 10 watched a staged theft involving live actors. Some (n = 47) were under the influence of alcohol (average blood alcohol level of .10) at the time. Some subjects (n = 58) were interviewed immediately after the event, and all were interviewed 1 week later. The delayed interview included the presentation of a photospread that either did or did not contain the picture of the "thief." Alcohol suppressed the amount recalled during the immediate interview and both the amount and accuracy of recall after the 1-week delay. Alcohol had no influence on the ability of witnesses to recognize the thief's picture. When the thief's picture was not present in the photospread, however, alcohol increased the rate of false identifications. An immediate interview substantially improved the amount of information subjects were able to recall 1 week later.