Neurodevelopmental consequences of pediatric cancer and its treatment: applying an early adversity framework to understanding cognitive,behavioral, and emotional outcomes

Today, children are surviving pediatric cancer at unprecedented rates, making it one of modern medicine’s true success stories. However, we are increasingly becoming aware of several deleterious effects of cancer and the subsequent “cure” that extend beyond physical sequelae. Indeed, survivors of childhood cancer commonly report cognitive, emotional, and psychological difficulties, including attentional difficulties, anxiety, and posttraumatic stress symptoms (PTSS). Cognitive late- and long-term effects have been largely attributed to neurotoxic effects of cancer treatments (e.g., chemotherapy, cranial irradiation, surgery) on brain development. The role of childhood adversity in pediatric cancer – namely, the presence of a life-threatening disease and endurance of invasive medical procedures – has been largely ignored in the existing neuroscientific literature, despite compelling research by our group and others showing that exposure to more commonly studied adverse childhood experiences (i.e., domestic and community violence, physical, sexual, and emotional abuse) strongly imprints on neural development. While these adverse childhood experiences are different in many ways from the experience of childhood cancer (e.g., context, nature, source), they do share a common element of exposure to threat (i.e., threat to life or physical integrity). Therefore, we argue that the double hit of early threat and cancer treatments likely alters neural development, and ultimately, cognitive, behavioral, and emotional outcomes. In this paper, we (1) review the existing neuroimaging research on child, adolescent, and adult survivors of childhood cancer, (2) summarize gaps in our current understanding, (3) propose a novel neurobiological framework that characterizes childhood cancer as a type of childhood adversity, particularly a form of early threat, focusing on development of the hippocampus and the salience and emotion network (SEN), and (4) outline future directions for research.     

Choice with initial and terminal link reinforcement: an alternative self-control paradigm

Self-control is demonstrated when a less desirable immediate outcome is chosen to ensure a substantially better future. In a novel animal analogue of this situation, primary reinforcement was delivered in both the initial and terminal links of a concurrent chain schedule. Rats made initial link choices between equal amounts of ethanol-free or ethanol-containing milk. Choosing the ethanol-free reinforcer resulted in delivery of the larger terminal link reinforcer and was thus analogous to self-control. Self-control decreased as the delay between initial and terminal links increased. The results have implications for human choice situations where decisions are made between two immediately available reinforcement alternatives each associated with a different delayed outcome.     

Oppression and discrimination among lesbian,gay, bisexual,and Transgendered people and communities: a challenge for community psychology

Lesbian, gay, bisexual, and transgendered (LGBT) people continue to experience various forms of oppression and discrimination in North America and throughout the world, despite the social, legal, and political advances that have been launched in an attempt to grant LGBT people basic human rights. Even though LGBT people and communities have been actively engaged in community organizing and social action efforts since the early twentieth century, research on LGBT issues has been, for the most part, conspicuously absent within the very field of psychology that is explicitly focused on community research and action–Community Psychology. The psychological and social impact of oppression, rejection, discrimination, harassment, and violence on LGBT people is reviewed, and recent advances in the areas of LGBT health, public policy, and research are detailed. Recent advances within the field of Community Psychology with regard to LGBT research and action are highlighted, and a call to action is offered to integrate the knowledge and skills within LGBT communities with Community Psychology's models of intervention, prevention, and social change in order to build better theory and intervention for LGBT people and communities.     

Sex differences in perceived attributes of computer-mediated communication

Researchers have pointed to the influence of sex with respect to the attributes of the computer medium. The author elaborates upon possible sex differences in reference to perceived attributes of the computer medium, i.e., Richness, Accessibility, Velocity, Interactivity, Plasticity, and Immediacy. Data from both a pilot and main study are reported and interpreted. The pilot study included 78 participants, while the main study involved 211. The independent samples were composed of Communication Studies students enrolled at two Mid-Atlantic universities. Nine items with anchors of 1: strongly disagree and 7: strongly agree were taken from the 2000 Computer Mediated Communication Competence Scale of Spitzberg to assess the attributes of computer-mediated interaction. The results indicate that women scored higher than men on perceptions of Accessibility, Velocity, Interactivity, and Immediacy.     

Temporal constraints on visual learning: a computational model

Given a constant stream of perceptual stimuli, how can the underlying invariances associated with a given input be learned? One approach consists of using generic truths about the spatiotemporal structure of the physical world as constraints on the types of quantities learned. The learning methodology employed here embodies one such truth: that perceptually salient properties (such as stereo disparity) tend to vary smoothly over time. Unfortunately, the units of an artificial neural network tend to encode superficial image properties, such as individual grey-level pixel values, which vary rapidly over time. However, if the states of units are constrained to vary slowly, then the network is forced to learn a smoothly varying function of the training data. We implemented this temporal-smoothness constraint in a backpropagation network which learned stereo disparity from random-dot stereograms. Temporal smoothness was formalized with the use of regularization theory by modifying the standard cost function minimised during training of a network. Temporal smoothness was found to be similar to other techniques for improving generalisation, such as early stopping and weight decay. However, in contrast to these, the theoretical underpinnings of temporal smoothing are intimately related to fundamental characteristics of the physical world. Results are discussed in terms of regularization theory and the physically realistic assumptions upon which temporal smoothing is based.     

Psychometric properties of the Wolpe-Lazarus assertiveness scale

The psychometric properties of the Wolpe-Lazarus Assertiveness Scale (WLAS) were evaluated with a sample of 100 male and 157 female psychiatric patients. There were no significant differences with regard to males and females for total WLAS scores. The WLAS seems to be internally consistent and has acceptable split-half and test-retest reliabilities. A factor analysis performed separately for males and females indicates that the 10 most prominent factors account for about 60% of the accumulated variance. The primary factor, shared by males and females, was labeled General Expressiveness. There was little evidence for the external validity of the WLAS when total scores were correlated with performance on a role play test. However, when WLAS factor scores were evaluated in light of role played performance, somewhat better evidence of the external validity of the WLAS was found in two of the factors for the females.     

School adjustment of children with observable disabilities

This study investigated school behavior and achievement of children with mild degrees of observable physical disability. Children from two different disability types (cleft palate and cerebral palsy) were compared with each other and to a control group in order to determine potential similarities across disability types. Children (N=78) from each of the two disability groups were individually matched to each other and to a normal control group (N=39) by sex, IQ, socioeconomic status, age, and grade. They were compared on the basis of teachers' behavioral ratings and achievement test scores. All children attended regular public school classrooms. The two disability groups displayed significantly greater inhibition of impulse and lower educational achievement than did the controls. The implication of similar school adjustment across mild but observable subtypes is discussed.Parts of this article were presented at the meeting of the American Psychological Association, Washington, D.C., September 1976. The study was supported in part by PHS Grant DE-00853, the National Institute of Dental Research.     

Reducing risk of head injury in youth soccer: An extension of behavioral skills training for heading

Recently, concerns regarding sport-related concussions have increased within the research literature, the media, and popular culture. One potential source of soccer-related concussions involves the purposeful striking of the ball with one's head (i.e., heading). There is currently limited research on an effective teaching method to improve safe heading technique. In the current study, Behavior Skills Training (BST) was evaluated as a method to teach correct heading techniques to youth soccer players. BST increased the percentage of correct steps for each player based on a task analysis of heading. Based on social validity questionnaires administered to players and the coach, BST was rated as an acceptable form of training. After the final training session, experienced coaches rated each player as having improved from baseline to training.