Neuropsychological Functioning in Children with Medium Chain Acyl Coenzyme A Dehydrogenase Deficiency (MCADD): The Impact of Early Diagnosis and Screening on Outcome

Children with medium chain acyl coenzyme A dehydrogenase deficiency (MCADD) have been reported to be at high risk for neurocognitive deficits. However this has not been systematically studied and little is known about the exact nature of neuropsychological sequelae or of the impact of early diagnosis and screening on outcome. We examined cognitive and adaptive outcome in children with MCADD (N?=?38, age range: 2 years, 2 months – 10 years, 3 months) diagnosed either through a newborn screening program (tandem mass spectrometry/MSMS) or upon clinical presentation. There was no evidence of overall intellectual impairment in either groups but there was some suggestion of poorer verbal and specific executive functioning (i.e., planning) abilities in the unscreened cohorts. Adaptive functioning was relatively intact with the exception of reduced Daily Living Skills in both our screened and unscreened groups. Early diagnosis and greater number of hospitalizations were related to higher verbal, communication, and socialization skills. Overall, our results highlight the importance of early diagnosis and management for children with MCADD.     

The role of attention in subitizing: Is the magical number 1?

Subitizing, the fast and accurate enumeration of up to about 3 or 4 objects, has often been thought to be dependent on limited-capacity preattentive mechanisms. We used an attentional blink paradigm to investigate the extent to which subitizing requires attentional resources. On each trial, subjects identified a target letter in an RSVP stream and then enumerated dots presented in the stream that were either simultaneous with the target letter or followed it by up to 400 ms. For numerosities from 2 to 9, evidence of an attentional blink was observed; only enumeration of 0 or 1 elements was independent of lag. Thus, even enumeration of 2–3 objects, which is within the traditional subitizing range, appears to require attentional resources. The relation of this work to studies on the attentional requirements of detecting a unique item among distractors, a supposedly preattentive discrimination, is briefly discussed.     

Internal health locus of control predicts willingness to track health behaviors online and with smartphone applications

Given rising technology use across all demographic groups, digital interventions offer a potential strategy for increasing access to health information and care. Research is lacking on identifying individual differences that impact willingness to use digital interventions, which may affect patient engagement. Health locus of control, the amount of control an individual believes they have over their own health, may predict willingness to use mobile health (mHealth) applications (‘apps’) and online trackers. A cross-sectional study (n = 276) was conducted to assess college students’ health locus of control beliefs and willingness to use health apps and online trackers. Internal and powerful other health locus of control beliefs predicted willingness to use health apps and online trackers while chance health locus of control beliefs did not. Individuals with internal and powerful other health locus of control beliefs are more willing than those with chance health locus of control beliefs to utilize a form of technology to monitor or change health behaviors. Health locus of control is an easy-to-assess patient characteristic providers can measure to identify which patients are more likely to utilize mHealth apps and online trackers.     

Experience of a Lifetime: Study Abroad,Trauma, and Institutional Betrayal

This study is the first to expand the investigation of study-abroad risks to include a range of traumatic experiences for male and female students and to examine effects of institutional betrayal (i.e., an institution’s failure to prevent trauma or support survivors). In an online survey of 173 university students who had studied abroad, many respondents (45.44%, n = 79) reported exposure to at least 1 traumatic experience while abroad, most frequently natural disasters, sexual assault, and unwanted sexual experiences. Of students exposed to potentially traumatic events, more than one third (35.44%, n = 28) also reported at least 1 form of related institutional betrayal, which uniquely correlated with posttraumatic distress in some participants, when controlling for lifetime trauma history.     

Suppression of overt attentional capture by salient-but-irrelevant color singletons

For more than 2 decades, researchers have debated the nature of cognitive control in the guidance of visual attention. Stimulus-driven theories claim that salient stimuli automatically capture attention, whereas goal-driven theories propose that an individual’s attentional control settings determine whether salient stimuli capture attention. In the current study, we tested a hybrid account called the signal suppression hypothesis, which claims that all stimuli automatically generate a salience signal but that this signal can be actively suppressed by top-down attentional mechanisms. Previous behavioral and electrophysiological research has shown that participants can suppress covert shifts of attention to salient-but-irrelevant color singletons. In this study, we used eye-tracking methods to determine whether participants can also suppress overt shifts of attention to irrelevant singletons. We found that under conditions that promote active suppression of the irrelevant singletons, overt attention was less likely to be directed toward the salient distractors than toward nonsalient distractors. This result provides direct evidence that people can suppress salient-but-irrelevant singletons below baseline levels.     

The role of behavior analysis in the rehabilitation of persons with dementia

With the rapidly aging population, it is expected that increases in cases of dementia will double over the next 20 years. Currently, there is no cure for diseases such as Alzheimer's disease or frontotemporal dementia (FTD) that cause progressive dementia, and only a few pharmacological interventions that slow the progression of the decline exist. Given that there is no cure available, a rehabilitation approach that emphasizes maintaining existing abilities and removing excess disability (as opposed to emphasizing cure or recovery) for as long as possible is warranted. The current paper proposes that nonpharmacological rehabilitation efforts need to target 5 broad areas/targets: memory enhancement, altering social contingencies and communication styles, improving self-care skills, the arrangement of physical environments to maintain and improve functioning, and increasing physical fitness/physical activity. The purpose of this paper is to review specific behaviorally oriented interventions that target these 5 areas and show promise for inclusion in comprehensive rehabilitation efforts for individuals with dementia.     

A comparison of blindpulling and blindwalking as measures of perceived absolute distance

Blindwalking has become a common measure of perceived absolute distance and location, but it requires a relatively large testing space and cannot be used with people for whom walking is difficult or impossible. In the present article, we describe an alternative response type that is closely matched to blindwalking in several important respects but is less resource intensive. In the blindpulling technique, participants view a target, then close their eyes and pull a length of tape or rope between the hands to indicate the remembered target distance. As with blindwalking, this response requires integration of cyclical, bilateral limb movements over time. Blind-pulling and blindwalking responses are tightly linked across a range of viewing conditions, and blind-pulling is accurate when prior exposure to visually guided pulling is provided. Thus, blindpulling shows promise as a measure of perceived distance that may be used in nonambulatory populations and when the space available for testing is limited.     

The stigma of widowhood in war and disaster affected communities of Sri Lanka: Contextual paths between trauma exposure and mental health distress

To add to the dialogue regarding the long-term recovery and wellbeing of war and tsunami-affected women in Sri Lanka, we utilised the Conservation of Resources Theory (COR, Hobfoll, 2009) to inform an investigation of direct and indirect effects. The study was specifically designed to assess how traumatic exposure may represent a form of loss which may associate with related losses in the form of external and internal stigma which may then associate with poor mental health outcomes. The data for this study were collected in 2016 from a sample of 379 widowed women in Eastern Sri Lanka; participant spouses died in the civil war, in the tsunami, or from health or other problems. Our analyses yielded a model suggesting associations between remembered trauma event exposure from war and disaster, external stigma, internalised stigma and mental health symptom distress. Results further yielded direct and indirect effects suggesting that trauma may represent a form of loss, and potentially lead to distress through the weight and challenges of stigma.