“Social Separation” Among Women Under 40 Years of Age Diagnosed with Breast Cancer and Carrying a BRCA1 or BRCA2 Mutation

We conducted an exploratory, qualitative study investigating experiences of women who had developed breast cancer under the age of 40 and who were identified as BRCA1 or BRCA2 mutation carriers. These germline mutation carriers face an increased lifetime risk of a second primary breast cancer and an increased risk for a primary ovarian cancer. Thirteen women who fit this criteria participated in three focus groups conducted at a major cancer center in the UK during Spring 2003. We asked broad, open-ended questions that allowed for a wide range of responses about their cancer and genetic testing experiences, physical and psycho-social concerns, family and partner reactions and their need for social support. The women expressed feelings of devastation, loneliness, feeling different and isolation, ambivalence about having to support family members, worries about partner’s anxiety and depression, and anxiety about talking to family members, especially children. These feelings were stronger after the cancer diagnosis and compounded by the genetic test results that occurred at a later time. We also found that, at least temporarily, the women experienced what we call “social separation”—emotional distance from, or dissonance with groups they interact with or are part of, e.g., family and friends, frequently leading to a reduction in communication or a change in previously unstated, but accepted normal interaction. We concentrate on a few characteristics of social separation—feelings of aloneness, isolation and separation, use of silence and verbal discretion, the relationship between estrangement and kinship interaction and norm disruption, and are looking at social patterns of interpersonal relationships that may occur when risk and illness statuses are new and framing and feeling rules have not as yet been clearly developed due to a cultural lag.     

Neonatal encephalopathy in the term infant: neuroimaging and inflammatory cytokines

The interrelationship between inflammation and ischemia is complex and poorly understood in the developing nervous system. In the preterm newborn, maternal infection may predispose to white matter injury and may be associated with cytokine elevation. In the term infant, few studies exist linking elevation of cytokines with encephalopathy and poor neurodevelopmental outcome. This review discusses the interplay among inflammatory cytokines, neonatal encephalopathy, and neuroimaging parameters.     

Longitudinal study of perception of structured optic flow and random visual motion in infants using high‐density EEG

Electroencephalogram (EEG) was used in infants at 3–4 months and 11–12 months to longitudinally study brain electrical activity as the infants were exposed to structured forwards and reversed optic flow, and non‐structured random visual motion. Analyses of visual evoked potential (VEP) and temporal spectral evolution (TSE, time‐dependent amplitude changes) were performed on EEG data recorded with a 128‐channel sensor array. VEP results showed infants to significantly differentiate between the radial motion conditions, but only at 11–12 months where they showed shortest latency for forwards optic flow and longest latency for random visual motion. When the TSE results of the motion conditions were compared with those of a static non‐flow dot pattern, infants at 3–4 and 11–12 months both showed significant differences in induced activity. A decrease in amplitudes at 5–7 Hz was observed as desynchronized theta‐band activity at both 3–4 and 11–12 months, while an increase in amplitudes at 9–13 Hz was observed as synchronized alpha‐band activity only at 11–12 months. It was concluded that brain electrical activities related to visual motion perception change during the first year of life, and these changes can be observed both in the VEP and induced activities of EEG. With adequate neurobiological development and locomotor experience infants around 1 year of age rely, more so than when they were younger, on structured optic flow and show a more adult‐like specialization for motion where faster oscillating cell assemblies have fewer but more specialized neurons, resulting in improved visual motion perception.     

Reproductive Decision-Making in MMR Mutation Carriers After Results Disclosure: Impact of Psychological Status in Childbearing Options

Reproductive techniques such as prenatal diagnosis (PND) or preimplantation genetic diagnosis (PGD), although debated, are legally forbidden in France in case of Lynch syndrome. The preference of mutation carriers about their reproductive options is not systematically considered in France. We aimed to prospectively assess the reproductive preferences of mismatch repair mutation carriers consulting in our institution (2003–2010, n?=?100). We also considered the short- and long-term post-disclosure psychological impact using the Impact of Events Scale-Revised questionnaire to measure the prevalence of posttraumatic stress disorder (PTSD) in those patients. Complete data were obtained for 34 respondents (17 males, 17 females, median age of 33.5 years [22–59]). Seventeen respondents (57 %) preferred spontaneous natural conception versus 28 % and 35 % choosing PND and PGD, respectively. At results disclosure, respondents mainly explained their distress by fear of premature death (43 %) and transmitting mutated genes (42 %). One year later, this last fear remained predominant in 55 % of subjects. None of the main socio-demographical, psychological or medical variables (including fear of transmitting mutations) was significantly associated with the reproductive preferences. Results disclosure had a real and time-decreasing psychological impact on mutation carriers. Reproductive techniques, expected to decrease the hereditary risk, were not significantly preferred to natural conception.     

Medial prefrontal cortex supports source memory for self-referenced materials in young and older adults

Behavioral evidence suggests that young and older adults show a benefit in source memory accuracy when processing materials in reference to the self. In the young, activity within the medial prefrontal cortex supports this source memory benefit at study. In this investigation, we examined whether the same neural regions support this memory benefit in both age groups. Using fMRI, we scanned participants while they studied and retrieved pictures of objects paired with one of three scenes (source) under self-reference and other-reference conditions. At the time of study, half of the items were presented once and half twice, allowing us to match behavioral performance between the groups. Both groups showed equivalent source accuracy benefits for objects encoded self-referentially. Activity in the left dorsal medial prefrontal cortex supported subsequent source memory in both age groups for the self-referenced relative to the other-referenced items. At the time of test, source accuracy for both the self- and other-referenced items was supported by a network of regions including the precuneus in both age groups. At both study and test, little in the way of age differences emerged, suggesting that when they are matched on behavioral performance, young and older adults engage similar regions in support of source memory when processing materials in reference to the self; however, when we did not match performance, age differences in functional recruitment were prevalent. These results suggest that by capitalizing on preserved processes (self-referential encoding), older adults can show improvement in memory for source details that they would typically not remember well, relative to the young.     

The Influence of Clinical Experience and Assessment Method on the Evaluation of Child Behavior Change

This research examined how people’s ability to detect behavior change in simulated child targets is affected by their clinical experience and the assessment method they use. When using summary assessment methods that are widely employed in research and clinical practice, both inexperienced and experienced clinical staff detected changes in the overall frequency of targets’ aggressive behavior, but were not uniquely influenced by changes in targets’ reactions to social events. When using contextualized assessment methods that focused on conditional reactions, experienced staff showed greater sensitivity than novices to context-specific changes in targets’ aggressive and prosocial reactions to aversive events. Experienced staff also showed greater sensitivity to context-specific changes in their overall impressions of change, but only for aggression. The findings show how clinically experienced judges become more attuned to if…then… contingencies in children’s social behavior, and how summary assessment methods may hamper the detection of change processes.     

SOCIOEMOTIONAL AND BEHAVIORAL PROBLEMS IN TODDLERS WITH LANGUAGE DELAY

Toddlers with language delay are at risk for persistent developmental and behavioral difficulties; however, the association between socioemotional/behavior problems and language in young children is not well understood. This study explored socioemotional/behavior problems in a unique sample of toddlers with language delays using a measure developed explicitly for this age group. Toddlers identified by 18 months with receptive and expressive language delay (LD; n = 30) or typical development (TD; n = 61) were evaluated at 18 and 24 months of age using the Infant‐Toddler Social and Emotional Assessment (ITSEA) and the Mullen Scales of Early Learning. Compared to toddlers who had TD, toddlers with LD had significantly more concerning scores at 18 and 24 months on all ITSEA domains. The rate of “clinical concern” on most domains was not high in either group, except that >60% of LD toddlers were in the clinical concern range on the Competence domain. Socioemotional/behavioral problems were dimensionally related to receptive and expressive language, with greater language delay associated with more concerning ITSEA scores. Socioemotional and behavioral problems are related to receptive and expressive language abilities in 18‐ and 24‐month‐olds, indicating the need for screening of both types of concerns in toddlers identified with potential language delays.