Executive functions in extremely low birth weight and late-preterm preschoolers: Effects on working memory and response inhibition

Executive function (EF) refers to fundamental capacities that underlie more complex cognition and have ecological relevance across the individual's lifespan. However, emerging executive functions have rarely been studied in young preterm children (age 3) whose critical final stages of fetal development are interrupted by their early birth. We administered four novel touch-screen computerized measures of working memory and inhibition to 369 participants born between 2004 and 2006 (52 Extremely Low Birth Weight [ELBW]; 196 late preterm; 121 term-born). ELBW performed worse than term-born on simple and complex working memory and inhibition tasks and had the highest percentage of incomplete performance on a continuous performance test. The latter finding indicates developmental immaturity and the ELBW group's most at-risk preterm status. Additionally, late-preterm participants performed worse compared with term-born on measures of complex working memory but did not differ from those term-born on response inhibition measures. These results are consistent with a recent literature that identifies often subtle but detectable neurocognitive deficits in late-preterm children. Our results support the development and standardization of computerized touch-screen measures to assess EF subcomponent abilities during the formative preschool period. Such measures may be useful to monitor the developmental trajectory of critical executive function abilities in preterm children, and their use is necessary for timely recognition of deficit and application of appropriate interventional strategies.     

Understanding suicidal behaviour in young people referred to specialist CAMHS: a qualitative psychoanalytic clinical research project

A qualitative psychoanalytic clinical research project using a post-Kleinian contemporary approach was undertaken by a team of seven qualified and experienced child psychotherapists working in community Tier 3 Child and Adolescent Mental Health Services (CAMHS). A number of referred young people who deliberately harmed themselves or attempted suicide, who fulfilled the inclusion criteria and consented to participate, were offered an extended individual and family assessment. Grounded Theory analysis of the qualitative data led to the formulation of the Truth Danger Theory. Typical situations in which suicidal behaviour occurred were identified, including intergenerational confusion, neglect, physical and/or sexual abuse within the family, Oedipal conflict, maternal depression and families in which there was a chronically ill sibling. We found that there was a marked disparity between the young person's experience of relationships in the family and the family's own account of their situation, a fractured reality. This can be reflected in an incongruence in the young person's presentation, which may be misleading when assessing risk. The young person feels him/herself to be in a dead end from which there seems to be no escape. Self-harm, for some, contains this impossible dilemma (albeit pathologically) but when it does not, suicide may seem the only option. The Truth Danger Theory provides explanations and predictions for suicidal behaviour and has implications for clinical practice.     

Pure reason and contemporary philosophy of religion: the rational striving in and for truth

This essay urges contemporary philosophers of religion to rethink the role that Kant’s critical philosophy has played both in establishing the analytic nature of modern philosophy and in developing a critique of reason’s drive for the unconditioned. In particular, the essay demonstrates the contribution that Kant and other modern rationalists such as Spinoza can still make today to our rational striving in and for truth. This demonstration focuses on a recent group of analytic philosophers of religion who have labelled their own work ‘analytic theology’ and have generated new debates, including new arguments about Kant bridging philosophy and theology. Cultivation of a reflective critical openness is encouraged here; this is a practice for checking reason’s overly ambitious claims about God.     

Extremely Preterm Birth Outcome: A Review of Four Decades of Cognitive Research

Premature birth incidence and survival rates are increasing steadily due to advances in obstetric and neonatal intensive care. Those born at the limits of viability are highly at-risk of adverse neurocognitive function over their lifespan, leading to current controversy regarding aggressive resuscitation efforts for these extremely preterm children. However, data from earlier generation cohorts who were born in substantially different eras of neonatal intensive care cannot be relied on to predict outcome of today’s newborn. Our review by the crucial variable of birth cohort year shows a changing developmental trajectory in which today’s extremely preterm survivor is likely to have fewer severe medical complications, better neurological outcomes, and fewer adverse cognitive late effects. Such data further underscore the importance of concurrently considering medical, familial, socioenvironmental, and neurobiological factors in combination with individual neonatal intensive care center protocols when studying outcomes of the preterm child. This complex, interrelated range of factors directly affects the immature, rapidly developing premature brain. However, ongoing surveillance to detect subsequent delay or impairment and to apply interventional strategies early in the developmental course holds promise for further enhancement of functional outcome.     

Emotional inhibition of effective contraception

Negative emotional responses to sex such as anxiety, guilt and fear tend to inhibit sexual behavior. When they are not sufficient to inhibit sexual intercourse, however, they frequently interfere with the ability to plan for, or cope with the consequences of sexual activity. More specifically, these emotional responses to sex frequently interfere with the ability to apply thoughtful and careful logic to contraceptive decision making, and thereby inhibit the use of effective methods of birth control. The current article is a review of the empirical support for emotional inhibition of contraception, and an examination of the psychological mechanisms by which these responses to sex mediate birth control behavior.     

Real-World Knowledge Facilitates Interpretation of Paintings by Naive Art Observers

It is often assumed that women kill themselves because of love and men because of achievement problems. The authors evaluated the suicide notes of 56 U.S. adult women and men with regard to love and achievement motives. Love themes were significantly more common than achievement themes, independent of sex and age. This suggests that, at least for U.S. adults who leave suicide notes, relationship concerns may be a dominant component of the motivation for suicide.