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.     

The Assessment of Preterm Infants' Behavior (APIB): furthering the understanding and measurement of neurodevelopmental competence in preterm and full-term infants

The Assessment of Preterm Infants' Behavior (APIB) is a newborn neurobehavioral assessment appropriate for preterm, at risk, and full-term newborns, from birth to 1 month after expected due date. The APIB is based in ethological-evolutionary thought and focuses on the assessment of mutually interacting behavioral subsystems in simultaneous interaction with the environment. The subsystems of functioning assessed include the autonomic (respiration, digestion, color), motor (tone, movement, postures), state organization (range, robustness, transition patterns), attention (robustness, transitions), and self-regulation (effort, success) systems as well as the degree of facilitation required to support reorganization and subsystem balance. The environment is represented by a sequence of distal, proximal, tactile, and vestibular challenges, derived from the BNBAS. The APIB conceptualizes infant competence as the degree of differentiation of subsystem function and degree of modulation of subsystem balance at any stage in infant development. Infants are understood as actively seeking their next differentiation, while counting on good enough environments to assure progressing developmental competence. In the case of interference such as premature birth, the mismatch of expectation and actual experience causes misalignment, which may become developmentally costly. The assessment is a finely tuned dialogue between examiner and infant, which requires training, skill and self-knowledge. The APIB has well established inter-rater-reliability, concurrent and construct validity, and is clinically relevant for behavioral intervention and individually appropriate and supportive care.     

How to launch a national Internet-based panel study quickly: lessons from studying how American are coping with the tragedy of September 11, 2001?

This article reports on the planning, development, and implementation of a large national Internet-based panel study of how Americans are coping with the terrorist attacks of September 11, 2001. The study was designed to determine predictors and correlates of risk and resilience, both cross-sectionally and longitudinally. In order to acquire timely and meaningful data, we developed/adapted an extensive set of measures, obtained human subjects approval, and posted a research Web site just 17 days after the attacks. This article describes the major hurdles we confronted and the guidelines we recommend regarding these topics, including the methodological trade-offs inherent in Internet-based research, information technology requirements and tribulations, human subjects issues, selection of measures and securing permission for their use, and the challenges of participant recruitment. We also discuss issues that we did not anticipate, including the survey intervention. We focus not on findings, but on the concrete procedural, administrative, technical, and scientific challenges we encountered and the solutions we devised under considerable time and resource pressures.     

A limit on retrieval-induced forgetting

Retrieving some members of a memory set impairs later recall of semantically related but not unrelated members (M. C. Anderson, R. A. Bjork, & E. L. Bjork, 1994; M. C. Anderson & B. A. Spellman, 1995). The authors investigated whether this retrieval-induced forgetting effect would generalize to testing procedures other than category-cued recall. Although the authors demonstrated a retrieval-induced forgetting effect using a category-cued recall task, they failed to show retrieval-induced forgetting on several different memory tests that used item-specific cues, including a category-plus-stem-cued recall test, a category-plus-fragment-cued recall test, a fragment-cued recall test, and a fragment completion task.     

Intrinsic vs. Extrinsic Religious Motivation and the Marital Relationship

Research suggests a strong positive relationship between religiosity and marital satisfaction. Neglected, however, are differences in satisfaction based on nominal religious motivation. The influence of religiosity on marital satisfaction was examined for 74 couples. Results indicate the higher the husband's intrinsic religiosity, the higher the satisfaction for both partners. Wives' satisfaction increased as they became more extrinsically motivated. Differences in religiosity significantly decreased satisfaction for husbands. Findings are discussed from the perspective of gender-based interaction patterns, gender demographics of religious devotion and activity, and power dynamics. We recommend therapists understand these findings and integrate them into the clinical dialogue.     

Self-report schedules for use in assessing the marital adjustment of abusive and nonabusive parents

Abstract

Abusive parents and nonabusive parents were compared on three self-report behavioral marital questionnaires. The questionnaires—the Marital Status Inventory, the Locke-Wallace Marital Adjustment Test, and the Areas of Change Questionnaire—have been used in pre-post evaluations of treatment and in the discrimination of distressed from nondistressed marriages. The results indicated that both groups reported having only mildly distressed marital relationships. The report presents initial normative data on the questionnaires for abusive parents and nonabusive parents who were seeking help with child management problems.     

Emotion regulation and the temporal dynamics of emotions: Effects of cognitive reappraisal and expressive suppression on emotional inertia

The tendency for emotions to be predictable over time, labelled emotional inertia, has been linked to low well-being and is thought to reflect impaired emotion regulation. However, almost no studies have examined how emotion regulation relates to emotional inertia. We examined the effects of cognitive reappraisal and expressive suppression on the inertia of behavioural, subjective and physiological measures of emotion. In Study 1 (N = 111), trait suppression was associated with higher inertia of negative behaviours. We replicated this finding experimentally in Study 2 (N = 186). Furthermore, in Study 2, instructed suppressors and reappraisers both showed higher inertia of positive behaviours, and reappraisers displayed higher inertia of heart rate. Neither suppression nor reappraisal were associated with the inertia of subjective feelings in either study. Thus, the effects of suppression and reappraisal on the temporal dynamics of emotions depend on the valence and emotional response component in question.     

Examination of the Eyberg Child Behavior Inventory Discrepancy Hypothesis

ABSTRACT

This study examined the Eyberg Child Behavior Inventory (ECBI) discrepancy hypothesis, which asserts that a discrepancy in score elevations on the ECBI Intensity and Problem Scales is related to problematic parenting styles. The Intensity Scale measures the frequency of child disruptive behavior, and the Problem Scale measures parent perception of their child's behavior as problematic. In a sample of 216 female caregivers of 3-to7-year-old children, the magnitude of discrepancy between T scores on the two ECBI scales was found to predict parental tolerance for child misbehavior. A one-standard-deviation difference in ECBI T scores identified (a) parents intolerant of their child's misbehavior when the Problem score was highest and (b) overly permissive parents when the Intensity score was highest.     

Treatment Outcome for Low Socioeconomic Status African American Families in Parent-Child Interaction Therapy: A Pilot Study

The course and efficacy of parent-child interaction therapy (PCIT) were examined in 18 socioeconomically disadvantaged African American families of preschoolers with disruptive behavior disorders. Mothers reported significant improvements in child disruptive behavior but not in maternal depressive symptoms or parenting stress. Attrition was 56%, most often occurring after pre-treatment assessment but before treatment began. Results suggest that PCIT may lead to positive behavior changes for disadvantaged young African American children when families complete treatment. Recruitment, engagement, and retention remain significant problems requiring further study. Reduction of parenting stress also requires study in this population.     

Authoritarianism and fear responses to pictures: The role of social differences

Authoritarianism can be defined as the covariation of authoritarian submission, authoritarian aggression, and conventionalism (Altemeyer, 1981). All three of these tendencies involve adherence to specific standards of behavior: standards that could be exposed to threat and disruption. This study is an investigation of the self‐reported fear of authoritarians in response to threats. A sample of 126 university students was exposed to a series of pictures of potentially threatening people and situations. In general, participants with high scores on authoritarianism were more fearful than participants with low scores. This result was found for both social threats (i.e., social differences, social disorder) and personal threats (i.e., animals, dangerous situations). The strongest association between authoritarianism and fear involved cases of social differences, defined as elements of a person's appearance or behavior that involve diversity or deviance from common social norms. Regression analyses also indicated that variation in authoritarianism could be best predicted by fear of social differences. Thus, these data suggest that authoritarians are relatively sensitive to threat, and particularly to threats involving the “outsider” who does not fit authoritarian standards of uniformity and order. The data are also consistent with recent research and theory that right‐wing ideology is at least partly motivated by threat and fear.