Parent reports of children’s working memory,coping, and emotional/behavioral adjustment in pediatric brain tumor patients: A pilot study

Neurocognitive problems in childhood survivors of brain tumors are well documented. Further, research has shown that problems in cognitive functioning may be associated with impairment in the use of complex strategies needed to cope with stress, including secondary control coping strategies (e.g., acceptance and cognitive reappraisal) which have been associated with fewer adjustment problems. The present study measured cognitive function, coping strategies, and adjustment in children ages 6–16 years at the time of brain tumor diagnosis and at two follow-up time-points up to 1 year post-diagnosis. In a prospective design, working memory was assessed in a total of 29 pediatric brain tumor patients prior to undergoing surgery, child self-reported coping was assessed at 6 months post-diagnosis, and parent-reported child adjustment was assessed at 12 months post-diagnosis. Significant correlations were found between working memory difficulties and secondary control coping. Secondary control coping was also negatively correlated with child attention and total problems. Regression analyses did not support secondary control coping mediating the association between working memory difficulties and child attention or total problems. These findings represent the first longitudinal assessment of the association between working memory, coping, and adjustment across the first year of a child’s brain tumor diagnosis and suggest a possible role for early interventions addressing both working memory difficulties and coping in children with brain tumors.     

A Clinical Decision Support Tool to Predict Cancer Risk for Commonly Tested Cancer-Related Germline Mutations

The rapid drop in the cost of DNA sequencing led to the availability of multi-gene panels, which test 25 or more cancer susceptibility genes for a low cost. Clinicians and genetic counselors need a tool to interpret results, understand risk of various cancers, and advise on a management strategy. This is challenging as there are multiple studies regarding each gene, and it is not possible for clinicians and genetic counselors to be aware of all publications, nor to appreciate the relative accuracy and importance of each. Through an extensive literature review, we have identified reliable studies and derived estimates of absolute risk. We have also developed a systematic mechanism and informatics tools for (1) data curation, (2) the evaluation of quality of studies, and (3) the statistical analysis necessary to obtain risk. We produced the risk prediction clinical decision support tool ASK2ME (All Syndromes Known to Man Evaluator). It provides absolute cancer risk predictions for various hereditary cancer susceptibility genes. These predictions are specific to patients’ gene carrier status, age, and history of relevant prophylactic surgery. By allowing clinicians to enter patient information and receive patient-specific cancer risks, this tool aims to have a significant impact on the quality of precision cancer prevention and disease management activities relying on panel testing. It is important to note that this tool is dynamic and constantly being updated, and currently, some of its limitations include (1) for many gene-cancer associations risk estimates are based on one study rather than meta-analysis, (2) strong assumptions on prior cancers, (3) lack of uncertainty measures, and (4) risk estimates for a growing set of gene-cancer associations which are not always variant specific. All of these concerns are being addressed on an ongoing basis, aiming to make the tool even more accurate.     

Sluggish Cognitive Tempo Symptoms Contribute to Heterogeneity in Adult Attention-Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) persists into adulthood in over 50% of cases, although its associated symptom profiles, comorbid problems, and neuropsychological deficits change substantially across development. Sluggish cognitive tempo (SCT) symptoms may contribute to associations between ADHD and comorbid problems and may partially explain the substantial heterogeneity observed in its correlates. 349 adults aged 18–38 years (M = 23.2, SD = 4.5, 54.7% male, 61.03% with ADHD) completed a multi-informant diagnostic procedure and a comprehensive neuropsychological battery. Adults with ADHD (n = 213) were retained for analyses. Latent class analyses (LCA) revealed three profiles of SCT symptoms among those with ADHD, which we classified as minimal, moderate, or severe SCT. Multiple analysis of covariance (MANCOVA) revealed significant differences among these profiles, which remained when controlling for persistence of ADHD symptoms and sex. In general, adults with ADHD combined with SCT symptoms (moderate and severe) had significantly more symptoms of anxiety, depression, and persistent inattention, and had more severe professional and relational impairment compared to ADHD adults without SCT. Compared to those with moderate or minimal SCT symptoms, the severe SCT group had the most symptoms of depression and internalizing disorders, and the most impairment in the domain of daily responsibility. No significant differences based on externalizing symptoms emerged when controlling for sex and persistence of inattention symptoms, suggesting the moderate and severe SCT groups do not simply reflect more symptoms. Moreover, follow-up mediation analyses revealed that SCT might at least partially explain the heterogeneity in ADHD. Findings have implications for refinement of etiological conceptualization, assessment methods, and intervention strategies.     

Factors Influencing Clinical Correlates of Chronic Traumatic Encephalopathy (CTE): a Review

Chronic traumatic encephalopathy (CTE) is a neuropathologically defined disease reportedly linked to a history of repetitive brain trauma. As such, retired collision sport athletes are likely at heightened risk for developing CTE. Researchers have described distinct pathological features of CTE as well a wide range of clinical symptom presentations, recently termed traumatic encephalopathy syndrome (TES). These clinical symptoms are highly variable, non-specific to individuals described as having CTE pathology in case reports, and are often associated with many other factors. This review describes the cognitive, emotional, and behavioral changes associated with 1) developmental and demographic factors, 2) neurodevelopmental disorders, 3) normal aging, 4) adjusting to retirement, 5) drug and alcohol abuse, 6) surgeries and anesthesia, and 7) sleep difficulties, as well as the relationship between these factors and risk for developing dementia-related neurodegenerative disease. We discuss why some professional athletes may be particularly susceptible to many of these effects and the importance of choosing appropriate controls groups when designing research protocols. We conclude that these factors should be considered as modifiers predominantly of the clinical outcomes associated with repetitive brain trauma within a broader biopsychosocial framework when interpreting and attributing symptom development, though also note potential effects on neuropathological outcomes. Importantly, this could have significant treatment implications for improving quality of life.     

Beneficence and procreation

Consider a duty of beneficence towards a particular individual, S, and call a reason that is grounded in that duty a “beneficence reason towards S.” Call a person who will be brought into existence by an act of procreation the “resultant person.” Is there ever a beneficence reason towards the resultant person for an agent to procreate? In this paper, I argue for such a reason by appealing to two main premises. First, we owe a pro tanto duty of beneficence to future persons; and second, some of us can benefit some of those persons by procreating. In support of the first premise I reject the presentist account of time in favor of the view that future persons are just as real as presently existing persons. I then argue that future persons are like us in all the morally relevant ways, and since we owe duties of beneficence to each other, we also owe duties of beneficence to future persons. In support of the second premise I offer an account of benefiting according to which an individual can be benefited by an action even if it makes her no better off than she would have been, had the action not been performed. This account of benefiting solves what I call the “non-identity benefit problem.” Finally, I argue that having a life worth living is a benefit, and some of us can cause some persons that benefit by causing them to exist.     

Does Child Temperament Play a Role in the Association Between Parenting Practices and Child Attention Deficit/Hyperactivity Disorder?

Ineffective parenting practices may maintain or exacerbate attention deficit/hyperactivity disorder (ADHD) symptoms and shape subsequent development of disruptive behavior disorders (DBD’s) in youth with ADHD. Recent theoretical models have suggested that parenting may exert effects on ADHD via its role in child temperament. The current study aimed to evaluate the indirect effects of parenting dimensions on child ADHD symptoms via child temperament. Youth ages 6–17 years (N?=?498; 50.4 % ADHD, 55 % male) completed a multi-stage, multi-informant assessment that included parent, child, and teacher report measures of parenting practices, child temperament, and ADHD symptoms. Statistical models examined the direct and indirect effects of maternal and paternal involvement, poor supervision, and inconsistent discipline on inattention and hyperactivity-impulsivity via child temperament and personality traits. Results indicated differential patterns of effect for negative and positive parenting dimensions. First, inconsistent discipline exerted indirect effects on both ADHD symptom dimensions via child conscientiousness, such that higher levels of inconsistency predicted lower levels of conscientiousness, which in turn, predicted greater ADHD symptomatology. Similarly, poor supervision also exerted indirect effects on inattention via child conscientiousness as well as significant indirect effects on hyperactivity-impulsivity via its impact on both child reactive control and conscientiousness. In contrast, primarily direct effects of positive parenting (i.e., involvement) on ADHD emerged. Secondary checks revealed that similar pathways may also emerge for comorbid disruptive behavior disorders. Current findings extend upon past work by examining how parenting practices influence child ADHD via with-in child mechanisms and provide support for multi-pathway models accounting for heterogeneity in the disorder.     

Phonetic Symbolism and Memory for Advertisements

This study investigated whether phonetic symbolism within brand names influences the memory of advertisements. Participants both saw and heard brand names with front vs. back vowels paired with small vs. large products in a congruent vs. incongruent fashion. When later given several unexpected memory tasks, it was found that congruent (vs. incongruent) pairings led to enhanced brand name and product recall as well as the efficiency of both brand name and paired recognition. These findings are consistent with a theory of cross‐modal processing involving perceptual unification. Copyright © 2016 John Wiley & Sons, Ltd.     

Beery VMI performance in autism spectrum disorder

Few studies have examined the visuomotor integration (VMI) abilities of individuals with autism spectrum disorder (ASD). An all-male sample consisting of 56 ASD participants (ages 3–23 years) and 36 typically developing (TD) participants (ages 4–26 years) completed the Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI) as part of a larger neuropsychological battery. Participants were also administered standardized measures of intellectual functioning and the Social Responsiveness Scale (SRS), which assesses autism and autism-like traits. The ASD group performed significantly lower on the Beery VMI and on all IQ measures compared to the TD group. VMI performance was significantly correlated with full scale IQ (FSIQ), performance IQ (PIQ), and verbal IQ (VIQ) in the TD group only. However, when FSIQ was taken into account, no significant Beery VMI differences between groups were observed. Only one TD participant scored 1.5 standard deviations (SDs) below the Beery VMI normative sample mean, in comparison to 21% of the ASD sample. As expected, the ASD group was rated as having significantly higher levels of social impairment on the SRS compared to the TD group across all major domains. However, level of functioning on the SRS was not associated with Berry VMI performance. These findings demonstrate that a substantial number of individuals with ASD experience difficulties compared to TD in performing VMI-related tasks, and that VMI is likely affected by general cognitive ability. The fact that lowered Beery VMI performance occurred only within a subset of individuals with ASD and did not correlate with SRS would indicate that visuomotor deficits are not a core feature of ASD, even though they present at a higher rate of impairment than observed in TD participants.