Neuropsychological deficits in preschool as predictors of ADHD symptoms and academic achievement in late adolescence

High levels of ADHD symptoms are related to severe negative outcomes, which underscore the importance of identifying early markers of these behavior problems. The main aim of the present study was therefore to investigate whether neuropsychological deficits in preschool are related to later ADHD symptoms and academic achievement, over and above the influence of early ADHD symptom levels. The present study is unique because it includes a broader range of predictors compared to previous studies and the participants are followed over time for as long as 13 years (i.e., ages 5–18 years). Preschool data included measures of executive functioning and reaction time variability as well as emotional reactivity and emotion regulation of both positive and negative emotions. When controlling for early ADHD symptom levels, working memory, reaction time variability, and regulation of happiness/exuberance were significantly related to inattention whereas regulation of happiness/exuberance and anger reactivity were significantly related to hyperactivity/impulsivity. Furthermore, working memory and reaction time variability in preschool were significantly related to academic achievement in late adolescence beyond the influence of early ADHD symptoms. These findings could suggest that it is possible to screen for early neuropsychological deficits and thereby identify children who are at risk of negative outcomes. Furthermore, our results suggest that interventions need to look beyond executive functioning deficits in ADHD and also target the role of emotional functioning and reaction time variability. The importance of including both the positive and negative aspects of emotional functioning and distinguishing between emotion regulation and emotional reactivity was also demonstrated.     

Consistency in physiological stress responses and electromyographic activity during induced stress exposure in women and men

Physiological responses serve the role as objective indicators of stress as well as a link between psychosocial stress and various health outcomes. The aim of the present exposure session was to compare different physiological stress responses (systolic and diastolic blood pressure, heart rate, urinary epinephrine and norepinephrine, salivary cortisol) as well as trapezius muscle activity, measured by surface electromyography, during mental and physical stress in 11 women and ten men. The results show significantly increased activity in all measures but cortisol and significant associations between sympathetic arousal and EMG activity. The association between sympathetic arousal and muscle activity is of importance for understanding the high prevalence of musculoskeletal disorders in mentally stressful but physically light work tasks. Men had higher blood pressure and a more pronounced increase in epinephrine output than women, whereas women had higher heart rate. It was concluded that sympathetic activity is more sensitive to moderately intense stress exposure than pituitary adrenocortical (cortisol) activity and that men respond to performance stress with more epinephrine output than women. Although the correlations between the different indicators of sympathetic arousal were high, together they could still only explain 30–70% of the inter-individual variance. Thus, several parameters are needed in order to obtain a reliable measure of sympathetic activity.     

Consistency in Physiological Stress Responses and Electromyographic Activity during Induced Stress Exposure in Women and Men

Physiological responses serve the role as objective indicators of stress as well as a link between psychosocial stress and various health outcomes. The aim of the present exposure session was to compare different physiological stress responses (systolic and diastolic blood pressure, heart rate, urinary epinephrine and norepinephrine, salivary cortisol) as well as trapezius muscle activity, measured by surface electromyography, during mental and physical stress in 11 women and ten men. The results show significantly increased activity in all measures but cortisol and significant associations between sympathetic arousal and EMG activity. The association between sympathetic arousal and muscle activity is of importance for understanding the high prevalence of musculoskeletal disorders in mentally stressful but physically light work tasks. Men had higher blood pressure and a more pronounced increase in epinephrine output than women, whereas women had higher heart rate. It was concluded that sympathetic activity is more sensitive to moderately intense stress exposure than pituitary adrenocortical (cortisol) activity and that men respond to performance stress with more epinephrine output than women. Although the correlations between the different indicators of sympathetic arousal were high, together they could still only explain 30-70% of the inter-individual variance. Thus, several parameters are needed in order to obtain a reliable measure of sympathetic activity.     

Living with Multiple Endocrine Neoplasia Type 1: Decent Care-Insufficient Medical and Genetic Information A Qualitative Study of MEN 1 Patients in a Swedish Hospital

This qualitative study explores how 29 Swedish patients with Multiple Endocrine Neoplasia type 1 (MEN1) experience living with the condition, appraisal of the clinical follow-up program, and surveys their future expectations. The aim of this study is to build knowledge about this patient group in order to provide optimal care. The participants describe physical, psychological, and social limitations in their daily activities and how these limitations influence quality of life. Our findings indicate that a majority of patients have adjusted to their situation, describing themselves as being healthy despite physical symptoms and treatment. The participants received decent care in the clinical follow-up program, - however, greater effort should be put into patient information. These patients might benefit from genetic counseling. Health professionals involved should recognize their potential impact and influence on a patient’s ability to adjust to these circumstances. Antonovsky`s Sense of Coherence theory is used to discuss these findings.     

The Influence of Cancer-related Distress and Sense of Coherence on Anxiety and Depression in Patients with Hereditary Cancer

This study examines the association between Sense of Coherence and anxiety and depression amongst patients at risk of hereditary cancer receiving genetic counseling. When writing this article, 144 patients referred for genetic counseling due to a suspicion of hereditary cancer in the family were recruited for this multicentered longitudinal study on the psychosocial aspects of genetic counseling in Norway. A total of 96 (66%) patients responded to the follow-up survey distributed 6 months after genetic counseling. This survey included the Sense of Coherence-29 Scale, Impact of Event Scale, and Hospital Anxiety and Depression Scale. Multiple regression analyses were applied. Our results show association between cancer-related distress and symptoms of anxiety and depression. Sense of Coherence is significantly associated with both anxiety and depression. The hypothesis of Sense of Coherence buffering cancer-related distress and the possible impact of these findings for genetic counseling are discussed.     

Training and transfer effects of executive functions in preschool children

Executive functions, including working memory and inhibition, are of central importance to much of human behavior. Interventions intended to improve executive functions might therefore serve an important purpose. Previous studies show that working memory can be improved by training, but it is unknown if this also holds for inhibition, and whether it is possible to train executive functions in preschoolers. In the present study, preschool children received computerized training of either visuo‐spatial working memory or inhibition for 5 weeks. An active control group played commercially available computer games, and a passive control group took part in only pre‐ and posttesting. Children trained on working memory improved significantly on trained tasks; they showed training effects on non‐trained tests of spatial and verbal working memory, as well as transfer effects to attention. Children trained on inhibition showed a significant improvement over time on two out of three trained task paradigms, but no significant improvements relative to the control groups on tasks measuring working memory or attention. In neither of the two interventions were there effects on non‐trained inhibitory tasks. The results suggest that working memory training can have significant effects also among preschool children. The finding that inhibition could not be improved by either one of the two training programs might be due to the particular training program used in the present study or possibly indicate that executive functions differ in how easily they can be improved by training, which in turn might relate to differences in their underlying psychological and neural processes.     

Decomposing coronary-prone behavior: Dimensions of type a behavior in the Videotaped Structured Interview

This study examined the factorial structure of data generated in the Videotaped Structured Interview for assessment of Type A behavior. Based on the literature, it was argued that there are at least three distinct concepts of Type A behavior, focused on competitiveness and pressured drive, speech characteristics, and hostility, respectively. These three concepts were clearly represented among the factors from factor analyses based on data from 282 subjects. Three factors represented speech and psychomotor characteristics, where the first reflected interactions between subject and interviewer (e.g., response latency, interruptions), the second tempo of speech (accelerating, dysrhythmic and rapid speech), and the third oral gestures (e.g., expiratory sighs). Hostility was reflected in two factors, one defined by emotional intensity (e.g., anger when recalling paat event) and the other hostility expressed towards the interviewer. Pressured drive dominated a content factor reflecting self-awareness of Type A behavior. Finally, there was one factor related to psychomotor tension. Through further factor and item analyses, it was possible to combine these factors into three homogeneous and moderately intercorrelated subscales of Type A behavior reflecting Hostility, Speech Characteristics, and Self-Awareness of Type A behavior. These scales showed good interrater agreement and stability over two years. The Self-Awareness Scale was highly correlated with self-report measures of Type A behavior. The Hostility Scale, on the other hand, was moderately related to measures of Type A behavior, anger and hostility, but was unrelated to anxiety. The Speech Characteristic Scale, finally, was virtually unrelated to psychometric measures.     

THE STRUCTURE OF ABILITIES IN THE RETARDED

The ability structure in retarded women was studied on the same lines as with men (Kebbon, 1965). The women, 89 in number, were between 17 and 54, their IQ's between 40 and 90. Factor analysis was done of their scores on 16 tests measuring four factors—verbal, spatial-inductive, numerical and psychomotor. Comparison with the corresponding scores from 89 matched men and 92 normal men indicated that, in terms of these factors, retarded women have the same ability structure as retarded men, and that both have a similar structure to that of persons of average and superior intelligence.     

Psychosocial Factors Associated with Quality of Life Among Individuals Attending Genetic Counseling for Hereditary Cancer

The aim of this multicenter study was to explore associations between psychosocial factors (general self-efficacy, perceived availability of social support, cancer-related distress) and health-related quality of life, among individuals at risk for hereditary cancer. One-hundred and twenty one participants with a family history of breast-cancer or colorectal cancer answered a questionnaire 2-4 weeks prior to genetic counseling. The two dimensions of the health-related quality of life measure, mental and physical health were both used as outcome variables. Multiple regression (linear) analyses revealed that increasing degrees of cancer-related distress was related to decreasing degrees of mental health whereas increasing degrees of self-efficacy and social support were related to increasing degrees of this outcome variable. Self-efficacy, self-esteem support and tangible aid seemed to moderate the relationship between cancer-related distress and mental health. These results suggest that self-efficacy and certain resources of social support buffer the negative association between cancer-related distress and mental health, and might be suitable for interventional efforts. Implications for genetic counseling practice are discussed.     

Prenatal androgens and gender-typed behavior: a study of girls with mild and severe forms of congenital adrenal hyperplasia

Gender-typed behaviors and interests were investigated in 26 girls, aged 2-10 years, affected with congenital adrenal hyperplasia (CAH) and in 26 unaffected girls matched for age. Girls with CAH were more interested in masculine toys and less interested in feminine toys and were more likely to report having male playmates and to wish for masculine careers. Parents of girls with CAH rated their daughters' behaviors as more boylike than did parents of unaffected girls. A relation was found between disease severity and behavior indicating that more severely affected CAH girls were more interested in masculine toys and careers. No parental influence could be demonstrated on play behavior, nor did the comparison of parents' ratings of wished for behavior versus perceived behavior in their daughters indicate an effect of parental expectations. The results are interpreted as supporting a biological contribution to differences in play behavior between girls with and without CAH.