Applying a traumatic stress approach to understanding PCS following pediatric mild TBI

Pediatric traumatic brain injury is a significant public health concern affecting hundreds of thousands of children each year. The majority of children who sustain traumatic brain injuries are classified as having a mild traumatic brain injury, and a subset of these children go on to experience persistent physical, cognitive, and emotional symptoms. These symptoms, known as postconcussive symptoms, can endure for months and even years after injury. The outcomes of mild traumatic brain injury are variable and not well understood for a small percentage of children who experience persistent symptoms. The current article explores the potential influence of children’s posttraumatic stress symptoms on persistent postconcussive symptoms. Despite the high incidence of posttraumatic stress symptoms after pediatric accidental injury, they have not yet been identified as an important factor for consideration in the understanding of pediatric postconcussive outcomes. The article will review the literature on posttraumatic stress and postconcussive symptoms after pediatric injury and consider neurobiological and cognitive factors to propose a model explaining a pathway through which posttraumatic stress reactions may serve as the mechanism for the expression and maintenance of postconcussive symptoms after mild traumatic brain injury. The clinical implications for the proposed relationship between posttraumatic stress symptoms and postconcussive symptoms are considered prior to the conclusion of the article, which acknowledges limitations in the current literature and provides suggestions for future research.     

The self‐regulatory role of anticipated group‐based shame and guilt in inhibiting in‐group favoritism

In three studies, we examined whether the anticipation of group‐based guilt and shame inhibits in‐group favoritism. In Studies 1 and 2, anticipated group‐based shame negatively predicted in‐group favoritism; in neither study did anticipated group‐based guilt uniquely predict in‐group favoritism. In Study 3, we orthogonally manipulated anticipated group‐based shame and guilt. Here, we found that the shame (but not the guilt) manipulation had a significant inhibitory effect on in‐group favoritism. Anticipated group‐based shame (but not guilt) promotes egalitarian intergroup behavior. Copyright © 2013 John Wiley & Sons, Ltd.     

Evidence for a Multi-Dimensional Latent Structural Model of Externalizing Disorders

Strong associations between conduct disorder (CD), antisocial personality disorder (ASPD) and substance use disorders (SUD) seem to reflect a general vulnerability to externalizing behaviors. Recent studies have characterized this vulnerability on a continuous scale, rather than as distinct categories, suggesting that the revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) take into account the underlying continuum of externalizing behaviors. However, most of this research has not included measures of disorders that appear in childhood [e.g., attention-deficit/hyperactivity disorder (ADHD) or oppositional defiant disorder (ODD)], nor has it considered the full range of possibilities for the latent structure of externalizing behaviors, particularly factor mixture models, which allow for a latent factor to have both continuous and categorical dimensions. Finally, the majority of prior studies have not tested multidimensional models. Using lifetime diagnoses of externalizing disorders from participants in the Fast Track Project (n?=?715), we analyzed a series of latent variable models ranging from fully continuous factor models to fully categorical mixture models. Continuous models provided the best fit to the observed data and also suggested that a two-factor model of externalizing behavior, defined as (1) ODD+ADHD+CD and (2) SUD with adult antisocial behavior sharing common variance with both factors, was necessary to explain the covariation in externalizing disorders. The two-factor model of externalizing behavior was then replicated using a nationally representative sample drawn from the National Comorbidity Survey-Replication data (n?=?5,692). These results have important implications for the conceptualization of externalizing disorders in DSM-5.     

Parkinson’s disease disrupts both automatic and controlled processing of action verbs

The problem of how word meaning is processed in the brain has been a topic of intense investigation in cognitive neuroscience. While considerable correlational evidence exists for the involvement of sensory-motor systems in conceptual processing, it is still unclear whether they play a causal role. We investigated this issue by comparing the performance of patients with Parkinson’s disease (PD) with that of age-matched controls when processing action and abstract verbs. To examine the effects of task demands, we used tasks in which semantic demands were either implicit (lexical decision and priming) or explicit (semantic similarity judgment). In both tasks, PD patients’ performance was selectively impaired for action verbs (relative to controls), indicating that the motor system plays a more central role in the processing of action verbs than in the processing of abstract verbs. These results argue for a causal role of sensory-motor systems in semantic processing.     

Impaired artificial grammar learning in agrammatism

It is often assumed that language is supported by domain-specific neural mechanisms, in part based on neuropsychological data from aphasia. If, however, language relies on domain-general mechanisms, it would be expected that deficits in non-linguistic cognitive processing should co-occur with aphasia. In this paper, we report a study of sequential learning by agrammatic aphasic patients and control participants matched for age, socio-economic status and non-verbal intelligence. Participants were first exposed to strings derived from an artificial grammar after which they were asked to classify a set of new strings, some of which were generated by the same grammar whereas others were not. Although both groups of participants performed well in the training phase of the experiment, only the control participants were able to classify novel test items better than chance. The results show that breakdown of language in agrammatic aphasia is associated with an impairment in artificial grammar learning, indicating damage to domain-general neural mechanisms subserving both language and sequential learning.     

Predictive validity of callous-unemotional traits measured in early adolescence with respect to multiple antisocial outcomes

This study investigated the predictive validity of youth callous-unemotional (CU) traits, as measured in early adolescence (Grade 7) by the Antisocial Process Screening Device (APSD; Frick & Hare, 2001), in a longitudinal sample (N = 754). Antisocial outcomes, assessed in adolescence and early adulthood, included self-reported general delinquency from 7th grade through 2 years post-high school, self-reported serious crimes through 2 years post-high school, juvenile and adult arrest records through 1 year post-high school, and antisocial personality disorder symptoms and diagnosis at 2 years post-high school. CU traits measured in 7th grade were highly predictive of 5 of the 6 antisocial outcomes-general delinquency, juvenile and adult arrests, and early adult antisocial personality disorder criterion count and diagnosis-over and above prior and concurrent conduct problem behavior (i.e., criterion counts of oppositional defiant disorder and conduct disorder) and attention-deficit/hyperactivity disorder (criterion count). Incorporating a CU traits specifier for those with a diagnosis of conduct disorder improved the positive prediction of antisocial outcomes, with a very low false-positive rate. There was minimal evidence of moderation by sex, race, or urban/rural status. Urban/rural status moderated one finding, with being from an urban area associated with stronger relations between CU traits and adult arrests. Findings clearly support the inclusion of CU traits as a specifier for the diagnosis of conduct disorder, at least with respect to predictive validity.     

An evaluation of advance notice to increase compliance among preschoolers

Advance notice of an upcoming instruction was evaluated to increase compliance among 3 children (4 to 5 years old) who exhibited noncompliance. Results show that the procedure was ineffective for all 3 participants. Advance notice plus physical guidance or physical guidance alone was necessary to increase compliance.     

Influence of assessment setting on the results of functional analyses of problem behavior

Analogue functional analyses are widely used to identify the operant function of problem behavior in individuals with developmental disabilities. Because problem behavior often occurs across multiple settings (e.g., homes, schools, outpatient clinics), it is important to determine whether the results of functional analyses vary across settings. This brief review covers 3 recent studies that examined the influence of different settings on the results of functional analyses and identifies directions for future research.     

Further evaluation of antecedent interventions on compliance: the effects of rationales to increase compliance among preschoolers

Functional analyses were conducted to identify reinforcers for noncompliance exhibited by 6 young children. Next, the effects of rationales (statements that describe why a child should comply with a caregiver-delivered instruction) were evaluated. In Experiment 1, 3 participants received the rationales immediately after the therapist's instruction. In Experiment 2, 3 additional participants received more practical rationales immediately before the therapist's instruction. The results indicate that rationales were ineffective for all 6 children. A guided compliance procedure increased compliance for 1 child; contingent access to preferred items with or without response cost increased compliance for the other participants. Although levels of problem behavior varied within and across participants, they were often higher in the rationale and guided compliance conditions.     

“Who I Am Depends on How Fairly I'm Treated”: Effects of Justice on Self‐Identity and Regulatory Focus

Across 2 experiments, we examined motivational processes elicited by justice‐related experiences. Specifically, we examined the effects of justice on recipients' self‐identity and regulatory focus. As predicted, those who experienced unfairness had a strong individual identity and prevention focus owing to the threats of social rejection and economic exploitation communicated by unfairness. Conversely, individuals exposed to fairness had strong interdependent identities and promotion focus owing to the favorable economic and socioemotional information communicated by fairness. These effects were accentuated among participants who reported high sensitivity to injustice and internal loci of control. Our findings are important because they highlight causal associations between justice and key motivation constructs.