Functional Disability in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Accumulating evidence suggests that the pre-dementia syndrome mild cognitive impairment (MCI) is characterized by decrements in instrumental activities of daily living (IADL). The current review was a quantitative synthesis of the available literature to objectively characterize IADL disability in MCI while clarifying inconsistencies in findings across studies. It was hypothesized that individuals with MCI would display significantly greater functional impairment relative to cognitively intact controls. Candidate moderators specified a priori included functional assessment approach, MCI subtype, depressive symptoms, and language conducted. Online databases (PubMed/MEDLINE and PsycINFO) and reference lists were searched to identify peer-reviewed publications assessing IADL in MCI compared to normal aging. A total of 151 effect sizes derived from 106 studies met inclusionary criteria (N?=?62,260). Random effects models yielded a large overall summary effect size (Hedges’ g?=?0.76, 95 % confidence interval: 0.68???0.83, p?<?.001) confirmed in multi-level analyses adjusted for nesting of effect sizes within studies (g?=?0.78, 95 % confidence interval: 0.69???0.87). Functional assessment strategy and MCI subtype were significant moderators of effect size, whereas depressive symptoms and language were not. Results convincingly demonstrate that MCI is associated with significant difficulties in the performance of complex everyday tasks. It appears that functional decline, like cognitive decline, exists on a continuum from healthy aging to dementia onset. Implications for clinical practice and research priorities are discussed.     

Examining the Validity of ADHD as a Diagnosis for Adolescents with Intellectual Disabilities: Clinical Presentation

Children with intellectual and developmental disabilities are at heightened risk for mental disorders. Using current diagnostic criteria, disruptive behavior disorders, specifically Attention-Deficit/Hyperactivity Disorder (ADHD), appear to be the most prevalent co-occurring disorders. However, the validity of ADHD as a diagnosis for children and adolescents with intellectual disabilities remains unclear. The present study examined the clinical presentation of ADHD (prevalence, sex differences, and comorbidity) among adolescents with and without intellectual disability (ID) as well as investigated the validity of ADHD for adolescents with ID by examining similarities in terms of symptom presentation, developmental course, and associated functional impairment. The sample included 142 adolescents and their families, about a third of whom were classified in the ID group and the remaining were in the typically developing (TD) group. Findings indicated that adolescents with ID continue to be at elevated risk for ADHD (risk ratio: 3.38:1) compared to their typically developing peers. Additionally, the presentation of ADHD appeared similar among adolescents with and without ID, supporting the validity of an ADHD diagnosis for this population of adolescents. Implications for public policy and intervention are discussed.     

The Early Presentation of Dementia in People with Down Syndrome: a Systematic Review of Longitudinal Studies

Adults with Down syndrome (DS) are at a very high risk of developing early onset Alzheimer’s disease (AD) due to trisomy of chromosome 21. AD is preceded by a prolonged prodromal “pre-clinical” phase presenting with clinical features that do not fulfil the diagnostic criteria for AD. It is important to clinically characterise this prodromal stage to help early detection of the disease as neuropathology of AD is almost universal by the fifth decade in DS. There is a lack of knowledge of the trajectory of decline associated with the onset of dementia in this population and early signs may be overlooked or misdiagnosed, negatively affecting the quality of life of those affected and the use of early pharmacological or psychosocial interventions. The objective of this systematic review is to evaluate the published literature on longitudinal data in order to identify the cognitive and behavioural changes occurring during the prodromal and early stages of AD in this population. Fifteen peer-reviewed articles met the inclusion criteria, including a total number of 831 participants, with the duration between baseline and follow up varying from 1 year to 47 years. Results suggest that, compared to the general population for which short-term (episodic) memory loss is the most common indicator associated with the onset of AD, in people with DS, executive dysfunction and Behavioural and Psychological Symptoms of Dementia (BPSD) are commonly observed during pre-clinical and early stages and may precede memory loss. The review highlights the importance of using a broad spectrum of assessments in the context of heterogeneity of symptoms. Theoretical and practical implications are discussed, as well as the need for further research.     

The Logic of Deferral: Educational Aims and Intellectual Disability

The educational aims described by educational philosophers rarely embrace the full range of differences in intellectual ability, adaptive behavior, or communication that children exhibit. Because envisioned educational aims have significant consequences for how educational practices, pedagogy, and curricula are conceptualized, the failure to acknowledge and embrace differences in ability leaves open the question of the extent to which students with intellectual disabilities are subject to the same aims as their “typically-developing” peers. In articulating and defending valued aims of education, educational philosophers tacitly or expressly concede that particular aims will be ill suited to many children with intellectual disabilities, and that separate aims will therefore apply to them. This paper evaluates the philosophical reasoning behind this conclusion that some people, by necessity, must be governed by separate educational aims, to be decided separately and secondarily. The author calls this the “deferral stance.” First, the paper outlines concerns about a particular ability-biased social and epistemic context in which theorizing about educational aims takes place. The author then examines assumptions that underpin the logic of deferral, arguing that the logic proves flawed when subjected to conceptual and empirical scrutiny. The paper concludes by outlining an inclusive approach—the affirmative stance—to theorizing about educational aims that resists the logic of exclusion and deferral.     

Authoritative Parenting of Chinese Mothers of Children with and without Intellectual Disability

The present study examined authoritative parenting and associations with parenting sense of competence and social support in Chinese mothers of children with intellectual disability and mothers of typically developing children. One hundred and sixty-seven mothers of children with intellectual disability with a mean age of 10.89 years (SD?=?1.74) and 119 mothers of typically developing children with a mean age of 10.55 years (SD?=?1.10) participated in a survey. Mothers of children with intellectual disability reported similar levels of parental warmth, and less use of reasoning and autonomy support compared with mothers of typically developing children. Parenting efficacy contributed uniquely to three dimensions of authoritative parenting for mothers of children with intellectual disability. By comparison, parenting efficacy did not contribute to use of reasoning and autonomy support for mothers of typically developing children. Social support made a unique but small contribution to parental warmth but not to parental reasoning and autonomy support for mothers of children with intellectual disability. For mothers of typically developing children, social support was associated with both parental warmth and autonomy support. This study suggests that child disability status is related to maternal authoritative parenting, and additionally, parenting efficacy plays a more critical role in predicting authoritative parenting of Chinese mothers of children with intellectual disability than mothers of typically developing children.     

精神分裂症病人来源记忆研究的回顾与展望

精神分裂症病人的来源记忆研究是颇受关注的认识心理学课题之一。本文围绕该类病人的来源记忆研究状况从如下几方面做出简要回顾和总结：一是精神分裂症病人的来源记忆较项目记忆更困难;二是精神分裂症病人的来源记忆成绩与其阳性症状和阴性症状之间存在一定的关联;三是智商、注意和药物等因素对精神分裂症病人的来源记忆成绩存在一定的影响;四是精神分裂症病人来源记忆的脑机制研究受到高度重视。文章最后对未来研究和临床应用进行了思考和展望。     

An Ecological Approach to Reducing the Social Isolation of People With an Intellectual Disability

An ecological approach to understanding insecure attachments and social isolation among people with an intellectual disability is constructed using Gibson's (1979/1986) affordance-based theory. Although environmental affordances and individual limitations interact to limit the development of social competence, we believe that by focusing on the immediate environment, community-based approaches to helping people with an intellectual disability are often ignored, which increases the burden on individual caregivers. A more comprehensive strategy, which extends Gibson's theory of affordances, allows us to consider how higher level social systems influence the immediate environment and provides the context for understanding why successful change occurs when a multifaceted, holistic approach that works on several levels is adopted. Examining these systems within an ecological framework fundamentally redefines our thinking by shifting the focus from a person's disability to a more nuanced understanding of a person's abilities within the context of appropriate environmental supports in which the person's disability becomes less salient.     

Impact of Neurologic Deficits on Motor Imagery: A Systematic Review of Clinical Evaluations

Motor imagery (MI, the mental representation of an action without engaging in its actual execution) is a therapeutically relevant technique to promote motor recovery after neurologic disorders. MI shares common neural and psychological bases with physical practice. Interestingly, both acute and progressive neurologic disorders impact brain motor networks, hence potentially eliciting changes in MI capacities. How experimental neuroscientists and medical practitioners should assess and take into account these changes in order to design fruitful interventions is largely unresolved. Understanding how the psychometric, behavioral and neurophysiological correlates of MI are impacted by neurologic disorders is required. To address this brain-behavior issue, we conducted a systematic review of MI data in stroke, Parkinson’s disease, spinal cord injury, and amputee participants. MI evaluation methods are presented. Redundant MI profiles, primarily based on psychometric and behavioral evaluations, emerged in each clinical population. When present, changes in the psychometric and behavioral correlates of MI were highly congruent with the corresponding motor impairments. Neurophysiological recordings yielded specific changes in cerebral activations during MI, which mirrored structural and functional reorganizations due to neuroplasticity. In this view, MI capacities may not be deteriorated per se by neurologic diseases resulting in chronic motor incapacities, but adjusted to the current state of the motor system. Literature-driven orientations for future clinical research are provided.     

Neuropsychological Measures in the Arab World: A Systematic Review

Although Arabic is one of the most widely used languages in the world, little is known on the availability of standardized neuropsychological tests in Arabic. We review the literature published before 2016, using the keywords Arab*, cogniti*, and neuropsycholo*, as well as keywords for each Arab country. PubMed, PsycINFO, Education Source, Academic Search Complete, Education Resources Information Center, Shamaa, and Arabpsynet databases were searched, in addition to a selected number of Arabic medical and educational journals. After excluding case reports, studies conducted on Arab groups residing outside the Arab world or Israel, and studies that employed intelligence scales or cognitive screens without standardization, 384 studies were eventually reviewed. Tests with most extensive use, adaptation, validation and norming were identified. The Raven Matrices, with its variants, was the most normed cognitive test for Arab individuals (normed in 16 countries). The rate of neuropsychology publications from the Arab countries combined, per year, was less than half of that of each American journal (top 10 journals pertaining to cognition). Nonetheless, the rate in Arab countries has increased after 2010. Publications were mostly from Egypt and Saudi Arabia, but the ratio of test adaptation-to-publication was the largest in Jordan and Lebanon. Approximately half of these publications did not employ cognitive tests that were developed, translated, adapted, or standardized according to international guidelines of psychological measurement. We provide recommendations on improving clinical neuropsychology to better serve Arab patients.     

A Systematic Review of Propensity Score Methods in the Social Sciences

The use of propensity scores in psychological and educational research has been steadily increasing in the last 2 to 3 years. However, there are some common misconceptions about the use of different estimation techniques and conditioning choices in the context of propensity score analysis. In addition, reporting practices for propensity score analyses often lack important details that allow other researchers to confidently judge the appropriateness of reported analyses and potentially to replicate published findings. In this article we conduct a systematic literature review of a large number of published articles in major areas of social science that used propensity scores up until the fall of 2009. We identify common errors in estimation, conditioning, and reporting of propensity score analyses and suggest possible solutions.     

A Systematic Review of Cognition in Chiari I Malformation

Displacement of the cerebellar tonsils in Chiari type I malformation (CMI) can affect functions controlled by the cerebellum and brainstem. While playing an integral role in the control of movement, the cerebellum also has widespread cortical connections, influencing a range of cognitive process. A systematic literature review was conducted to examine the relationship between cognition and CMI, assessing evidence for general or domain-specific cognitive change. The search protocol examined the AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, and Scopus databases. Articles meeting the following criteria were included in this review (i) examined children or adults with a clinically defined diagnosis of CMI, (ii) assessed cognitive function with a prospective examination, (iii) included at least one standardized instrument designed to measure general or specific domains of cognitive function, and (iv) were published in English in a peer-reviewed journal. Twelve articles were identified, including 783 cases aged 3 months to 64 years. General cognition, processing speed, and learning and memory appeared less affected, while language deficits appeared to diminish with age. Executive dysfunction was the most commonly reported cognitive impairment, while attention and working memory, and visuospatial and perceptual skills also appeared vulnerable. Numerous methodological limitations were identified that should be considered in interpreting the impact of CMI and planning future investigations. Overall, there is currently insufficient evidence to describe a valid and reliable profile of cognitive impairment in CMI. Further research is required to confirm these preliminary psychometric results and integrate them with pathophysiological models     

Parenting Stress through the Lens of Different Clinical Groups: a Systematic Review &amp; Meta-Analysis

Research has demonstrated an association between parenting stress and child behavior problems, and suggested levels of parenting stress are higher among parents of children at risk for behavior problems, such as those with autism and developmental delay (ASD/DD). The goal of the present study was to conduct a systematic review of parenting stress and child behavior problems among different clinical groups (i.e., ASD/DD, chronic illness, with or at-risk for behavioral and/or mood disorders). We also examined demographic and methodological variables as moderators and differences in overall levels of parenting stress between the clinical groups. This systematic review documents a link between parenting stress and child behavior problems with an emphasis on externalizing behavior. One-hundred thirty-three studies were included for quantitative analysis. Parenting stress was more strongly related to child externalizing (weighted ES r = 0.57, d = 1.39) than internalizing (weighted ES r = 0.37, d = 0.79) problems. Moderation analyses indicated that the association between parenting stress and behavior problems was stronger among studies which had mostly male and clinic-recruited samples. Overall, parenting stress levels were higher for parents of children with ASD/DD compared to parents of children from other clinical groups. Findings document the association between parenting stress and child behavior problems and highlight the importance of assessing parenting stress as part of routine care and throughout behavioral intervention programs, especially for groups of children at high risk for behavior problems, such as children with ASD/DD, in order to identify support for both the parent(s) and child.     

Genetic Disorders of Intellectual Disability: Expanding our Concepts of Phenotypes and of Family Outcomes

Over the past two decades, great strides have been made in our understandings of how genetic conditions influence behavior and how such so-called “behavioral phenotypes” influence parent and family stress and coping. In this paper, we call for expansions in two directions. First, as a field we need to go beyond behavior in our concepts of phenotypes, to also include the many medical, physical, and other “non-behavioral” phenotypes that influence children’s everyday lives. Second, in examining how etiology-related phenotypes affect others, we need to go beyond the outcome of parental stress. In this regard, we focus on parental health, well-being, and various life choices, as well as how parenting children with specific genetic disorders can often lead to positive perceptions and outcomes. We end by discussing remaining research issues and how these two expansions relate to clinical practice.     

正确认识心理因素在颞颌关节紊乱病中的作用

颞颌关节紊乱病(temporomndibular disprder,TMD)是口腔颌面部常见的疾病之一.TMD病因比较复杂,目前认为是多种因素作用的结果,主要为心理因素、牙合因素等.但是目前对于心理因素在TMD的发生、发展、治疗和转归方面,很多学者尚持有异议.运用系统论中的整体性原则、动态性原则、系统涨落理论、综合性原则和最佳化原则等阐明如何才能获得对心理因素在TMD中的作用的全面认识,并指出重视心理因素在TMD中的作用也是顺应医学模式转变,体现人文关怀的需要.     

Overlapping and Distinct Cognitive Impairments in Attention-Deficit/Hyperactivity and Autism Spectrum Disorder without Intellectual Disability

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are commonly comorbid, share genetic liability, and often exhibit overlapping cognitive impairments. Clarification of shared and distinct cognitive effects while considering comorbid symptoms across disorders has been lacking. In the current study, children ages 7–15 years assigned to three diagnostic groups:ADHD (n?=?509), ASD (n?=?97), and controls (n?=?301) completed measures spanning the cognitive domains of attention/arousal, working memory, set-shifting, inhibition, and response variability. Specific processes contributing to response variability were examined using a drift diffusion model, which separately quantified drift rate (i.e., efficiency of information processing), boundary separation (i.e., speed-accuracy trade-offs), and non-decision time. Children with ADHD and ASD were impaired on attention/arousal, processing speed, working memory, and response inhibition, but did not differ from controls on measures of delayed reward discounting, set-shifting, or interference control. Overall, impairments in the ASD group were not attributable to ADHD symptoms using either continuous symptom measures or latent categorical grouping approaches. Similarly, impairments in the ADHD group were not attributable to ASD symptoms. When specific RT parameters were considered, children with ADHD and ASD shared impairments in drift rate. However, children with ASD were uniquely characterized by a wider boundary separation. Findings suggest a combination of overlapping and unique patterns of cognitive impairment for children with ASD as compared to those with ADHD, particularly when the processes underlying reaction time measures are considered separately.     

Military and Crime: A Systematic Review of the Literature

ABSTRACT

This study systematically analyzed the literature on the effects of military participation on later criminal behavior. When all studies were analyzed as a whole, the findings did not indicate a clear effect. However, a focus upon specific offense types revealed that the military experience decreased non-violent crime but increased violent crime. Active military personnel tended to be less likely to commit crime. Some evidence demonstrated that male and non-white veterans committed more crime than their civilian counterparts, but future research is needed to replicate these subgroup differences. Theoretical implications and future research directions are also discussed.     

学习不良儿童家庭资源的元分析

对过去20年关于学习不良儿童家庭资源的研究结果进行的元分析显示,儿童各种家庭资源的效应值变异程度不大。总体来说,学习不良儿童和一般儿童的家庭资源差异显著。一般儿童的父母文化程度和教养方式优于学习不良儿童的父母文化程度和教养方式。但是,两类儿童的父母期望没有显著差异。