Intercontinental telehealth coaching of therapists to improve verbalizations by children with autism

This study examined the effects of intercontinental telehealth coaching on the mastery of therapists’ skills and improvements in verbalizations by children with autism, testing whether telehealth can be a solution for underserved communities in developing countries such as Georgia‐Sakartvelo in Eastern Europe. Three therapists delivering and three children with autism receiving early‐intervention services from the nongovernmental organization Children of Georgia in Tbilisi participated. Experimenters provided coaching from Virginia, USA to therapists in Georgia‐Sakartvelo. Observers in Georgia‐Sakartvelo and in Virginia conducted the behavioral observations. We used inexpensive communications technology to provide the coaching and a multiple‐baseline design across participants to evaluate the effects of the intervention. Therapists demonstrated improvements in two classes of behaviors: correct command sequences and positive consequences. The children demonstrated improvements with echoics and mands. The study demonstrated that telehealth can be a good model for delivering early‐intervention services to children with autism in underserved and distant regions of the world.     

Hot and Cool Executive Function and its Relation to Theory of Mind in Children with and without Autism Spectrum Disorder

Previous research has clearly demonstrated that autism spectrum disorder (ASD) involves deficits in multiple neuropsychological functions, such as executive function (EF) and theory of mind (ToM). A conceptual distinction is commonly made between cool and hot EF. In ASD, continued attention has been paid to the cool areas of executive dysfunction. Cool EF has been strongly related to ToM, but research has not taken into account the association between hot EF and ToM in ASD. The present study investigated the associations between hot and cool EF and ToM in 56 school-aged children with ASD and 69 controls on tasks tapping cool EF (i.e., working memory, inhibition, planning), hot EF (i.e., affective decision making, delay discounting), and ToM (i.e., mental state/emotion recognition and false belief). Significant group differences in each EF measure support an executive dysfunction in both domains in ASD. Strong associations between delay discounting and ToM mental state/emotion recognition were found, suggesting that hot EF makes a unique contribution to ToM above and beyond cool EF in typical development and ASD. This study improves understanding of the profile of higher-order cognitive deficits in children with ASD, which may inform diagnosis and intervention.     

Serotoninergic regulation of emotional and behavioural control processes

5-Hydroxytryptamine (5-HT, serotonin) has long been implicated in a wide variety of emotional, cognitive and behavioural control processes. However, its precise contribution is still not well understood. Depletion of 5-HT enhances behavioural and brain responsiveness to punishment or other aversive signals, while disinhibiting previously rewarded but now punished behaviours. Findings suggest that 5-HT modulates the impact of punishment-related signals on learning and emotion (aversion), but also promotes response inhibition. Exaggerated aversive processing and deficient response inhibition could underlie distinct symptoms of a range of affective disorders, namely stress- or threat-vulnerability and compulsive behaviour, respectively. We review evidence from studies with human volunteers and experimental animals that begins to elucidate the neurobiological systems underlying these different effects.     

Effects of guided immune-imagery: The moderating influence of openness to experience

It is widely believed that personality has an important role in determining the effectiveness of guided imagery (GI) interventions. The primary aim of the current study was to examine whether the effect of GI on several outcome measures was dependent upon openness to experience, a theoretically relevant variable previously unexplored as a potential moderator. Thirty-five healthy participants were randomised to an animated imagery, verbal imagery or no-intervention control group, with imagery groups receiving 10 × 20 min sessions. Pre/post-assessments of cortisol, sleep, stress and creativity were administered along with the openness to experience scale. Regression analysis indicated a significant increase in cortisol and decrease in tiredness following verbal GI, but only for those high in openness. The efficacy of GI interventions may be dependent upon openness to experience and this variable should be accounted for in future studies.     

Epidemiological considerations in transgender health: A systematic review with focus on higher quality data

Abstract

Background: High quality data pertaining to the size of the transgender and gender diverse (TGD) population are scant, however, several recently published studies may provide more reliable contemporary estimates.

Aims: To summarize the estimated number and proportion of TGD individuals overall and across age groups, based on most accurate data.

Methods: This systematic review focused on recent studies (published from 2009 through 2019) that utilized sound methodology in assessing the proportion of TGD people in the general population. Publications were included if they used clear definitions of TGD status, and calculated proportions based on a well-defined sampling frame. Nineteen eligible publications represented two broad categories of studies: those that used data from large health care systems; and those that identified TGD individuals from population surveys.

Results: Among health system-based studies, TGD persons were identified using relevant diagnostic codes or clinical notes. The proportions of individuals with a TGD-relevant diagnosis or other recorded evidence ranged between 17 and 33 per 100,000 enrollees. In population surveys TGD status was ascertained based on self-report with either narrow or broad definitions. The survey-based estimates were orders of magnitude higher and consistent across studies using similar definitions. When the surveys specifically inquired about ‘transgender’ identity, the estimates ranged from 0.3% to 0.5% among adults, and from 1.2% to 2.7% among children and adolescents. When the definition was expanded to include broader manifestations of ‘gender diversity’, the corresponding proportions increased to 0.5-4.5% among adults and 2.5-8.4% among children and adolescents. Upward temporal trends in the proportion of TGD people were consistently observed.

Conclusions: Current data indicate that people who self-identify as TGD represent a sizable and increasing proportion of the general population. This proportion may differ, depending on inclusion criteria, age, and geographic location, but well-conducted studies of similar type and design tend to produce comparable results.     

Strong body,clear mind: Physical activity diminishes the effects of supervisor interpersonal injustice

We integrate exercise physiology tenets with self-regulation theory to explain how physical activity diminishes the effects of supervisor interpersonal injustice. We posit that individuals can help prevent self-regulation depletion from interpersonal injustice when they engage in physical activity. In Study 1, we manipulated physical activity and interpersonal injustice in a laboratory setting, and in Study 2, utilizing a two-week experience sampling method we examined how employees reacted differently to daily interpersonal injustice as a function of their general level of physical activity engagement. Our results demonstrate that both acute and chronic levels of physical activity attenuate the effects of supervisor interpersonal injustice episodes on self-regulation depletion, which subsequently reduces social undermining directed toward the supervisor. Our findings highlight the theoretical and practical significance of physical activity for interpersonal injustice and for organizations in general.