Neurocognitive outcomes in children with chronic kidney disease: Current findings and contemporary endeavors

Given the rise in chronic kidney disease (CKD) in both children and adults, CKD has recently been targeted as a public health priority. Childhood onset kidney disease is generally a noncurable and progressive condition that leads to kidney failure by early adulthood. Fortunately, improved identification of kidney problems allows for early intervention, which is thought to slow progression toward end-stage renal disease. In addition, medical interventions for pediatric end-stage renal disease have also improved, allowing children to take advantage of lifesaving renal replacement treatments such as dialysis and kidney transplantation. In spite of improvements in identification and treatment, CKD causes both direct and indirect insults to a variety of organ systems. This paper reviews recently published studies pertaining to the neurocognitive and psychosocial impact of CKD on children of various ages and at various stages of kidney failure. Specific attention is focused on summarizing peer reviewed research that describes associations between kidney functioning and cognitive functioning, language acquisition, visual spatial abilities, memory, and executive functioning. In addition, peer reviewed research describing psychosocial outcomes associated with CKD related to academic achievement, social-behavioral functioning, and quality of life are summarized. The authors also identified disease-specific factors that likely mediate neurocognitive outcomes (e.g., anemia, hypertension, cardiovascular) and endorse the importance of continued interdisciplinary research collaborations that will provide a better understanding of the mechanisms responsible for improved neurocognitive functioning after transplantation. The authors conclude this review by describing a multicenter, prospective, longitudinal, National Institutes of Health funded study that is currently examining the developmental outcomes of children with mild to moderate CKD. The authors speculate that the Chronic Kidney Disease in Children Prospective Cohort Study (CKiD) findings will provide additional evidence-based guidance for clinicians and researchers working with children and adolescents with deteriorating kidney function to improve medical and developmental outcomes.     

Evaluating the Parentification Questionnaire: Psychometric Properties and Psychopathology Correlates

The Parentification questionniare (PQ; Jurkovic and Thirkield in Parentification questionnaire, University Plaza, Atlanta, GA, 1998), developed to assess various levels of parentification retrospectively, is one of the most widely used instruments in the clinical and research literature base. Yet, despite its frequent use, no studies of which we are aware have examined the psychometric properties of this instrument. Thus, this study fills a gap in the literature by examining the psychometric properties of the PQ with a sample of 143 racially diverse college students. The data were subjected to exploratory analysis using principal component analysis. Varimax orthogonal rotations were applied to the analyses. The final results supported a three-component solution (although with fewer items), consistent with Jurkovic’s three-factor multidimensional clinical framework for understanding parentification. We also examined the relations between the resultant scores of the PQ and scores from the Brief Symptom Inventory (BSI; Derogatis in Derogatis Brief symptom inventory: Administration, scoring, and procedures manual, National Computer Systems, Inc., Minneapolis, MN, 1993), which captures mental health symptomatology. These results reflected significant correlations in theoretically expected directions. However, taken together, the three PQ factors significantly accounted for the variance in psychopathology scores in only two of the four regression models. The preliminary results from this study support the reliability and multidimensional nature of the PQ scores. Implications for family therapy and suggestions for future family systems research are discussed.     

Should I trust you? Autistic traits predict reduced appearance‐based trust decisions

Facial impressions of trustworthiness guide social decisions in the general population, as shown by financial lending in economic Trust Games. As an exception, autistic boys fail to use facial impressions to guide trust decisions, despite forming typical facial trustworthiness impressions (Autism, 19, 2015a, 1002). Here, we tested whether this dissociation between forming and using facial impressions of trustworthiness extends to neurotypical men with high levels of autistic traits. Forty‐six Caucasian men completed a multi‐turn Trust Game, a facial trustworthiness impressions task, the Autism‐Spectrum Quotient, and two Theory of Mind tasks. As hypothesized, participants’ levels of autistic traits had no observed effect on the impressions formed, but negatively predicted the use of those impressions in trust decisions. Thus, the dissociation between forming and using facial impressions of trustworthiness extends to the broader autism phenotype. More broadly, our results identify autistic traits as an important source of individual variation in the use of facial impressions to guide behaviour. Interestingly, failure to use these impressions could potentially represent rational behaviour, given their limited validity.     

An Investigation of a Polish Version of the Parentification Inventory

Journal of Child and Family Studies - Parentification is defined as a pattern of family interactions in which children and adolescents are required to engage in adult-like roles and...     

Infants show enhanced neural responses to musical meter frequencies beyond low-level features

Music listening often entails spontaneous perception and body movement to a periodic pulse-like meter. There is increasing evidence that this cross-cultural ability relates to neural processes that selectively enhance metric periodicities, even when these periodicities are not prominent in the acoustic stimulus. However, whether these neural processes emerge early in development remains largely unknown. Here, we recorded the electroencephalogram (EEG) of 20 healthy 5- to 6-month-old infants, while they were exposed to two rhythms known to induce the perception of meter consistently across Western adults. One rhythm contained prominent acoustic periodicities corresponding to the meter, whereas the other rhythm did not. Infants showed significantly enhanced representations of meter periodicities in their EEG responses to both rhythms. This effect is unlikely to reflect the tracking of salient acoustic features in the stimulus, as it was observed irrespective of the prominence of meter periodicities in the audio signals. Moreover, as previously observed in adults, the neural enhancement of meter was greater when the rhythm was delivered by low-pitched sounds. Together, these findings indicate that the endogenous enhancement of metric periodicities beyond low-level acoustic features is a neural property that is already present soon after birth. These high-level neural processes could set the stage for internal representations of musical meter that are critical for human movement coordination during rhythmic musical behavior.

Research Highlights

• 5- to 6-month-old infants were presented with auditory rhythms that induce the perception of a periodic pulse-like meter in adults.
• Infants showed selective enhancement of EEG activity at meter-related frequencies irrespective of the prominence of these frequencies in the stimulus.
• Responses at meter-related frequencies were boosted when the rhythm was conveyed by bass sounds.
• High-level neural processes that transform rhythmic auditory stimuli into internal meter templates emerge early after birth.

     

Parentification and mental health symptoms: mediator effects of perceived unfairness and differentiation of self

Existing research indicates that parentification can result in positive and negative outcomes for individuals; however, little is known about the mechanisms that account for the variability. This study tested a theoretical model of the relation between parentification tasks and mental health symptoms, with perceived unfairness and differentiation of self (DoS) as mediators. The results supported the proposed model in a sample of 783 college students. A significant total indirect effect existed between the latent construct of parentification and that of mental health symptoms. Significant specific indirect effects were observed between parentification and mental health symptoms with perceived unfairness as a mediator; between parentification and DoS with perceived unfairness as a mediator and between perceived unfairness and mental health symptoms mediated by DoS. Implications for clinical work with adult clients who have experienced parentification in their family of origin are addressed.