Subjective social status, objective socioeconomic status, and cardiovascular risk in women.

OBJECTIVE: Subjective perceptions of personal social status may relate to health beyond the effects of objective socioeconomic status (SES). The authors examined the relationship between subjective social status (SSS) and psychosocial, behavioral, and physical cardiovascular risk factors in middle-aged women. DESIGN: Ninety-two women (90.2% White) completed ladder-based, pictorial self-report measures of SSS relative to others in their community and in the United States. Psychosocial measures of depression, anxiety, pessimism, stress, and social support and behavioral risk factors of fruit and vegetable consumption, leisure physical activity, and body-mass index were obtained. In addition, women underwent measurement of clinic blood pressure and assessment of daytime ambulatory systolic and diastolic blood pressure (SBP; DBP) over 2 consecutive days. RESULTS: Community SSS was significantly inversely related to anxiety, pessimism, stress, and daytime ambulatory DBP after controlling for objective SES and U.S. SSS. Women with lower U.S. SSS showed less healthy dietary and exercise behaviors and, contrary to predictions, lower clinic and ambulatory DBP. CONCLUSION: This study provides additional evidence that perceptions of one's position in the social hierarchy could have important health implications beyond the impact of objective SES. Further, the cardiovascular risk implications of perceived community versus U.S. social status appear to be distinct.     

Exploring the Impact of Parental Military Deployment/Field Posting on Adolescents in Indian Military Families

The purpose of this study was to explore the consequences of parental deployment for adolescents and to identify the risk and protective factors which may affect their well- being. The study being exploratory in nature, focus group was chosen for data collection. Three focus groups were held with boys and girls in the age group 12–18 years who were experiencing the deployment of their father for more than six months. Each group consisted of 6–8 participants. A semi structured interview schedule was prepared for the focus group interviews. Each focus group was audio taped and then transcribed for further analysis. Response themes indicate relocation in the absence of the father, changes in roles and responsibilities, routine changes, not having the parent to help with the homework, participate in activities and provide guidance as major sources of stress. While the relaxation in family rules and discipline is cherished by all, there are reintegration problems when the parent returns. Some adolescents expressed concern about the health and worries of the at-home parent, for most of them the mother or the at home parent is the central figure who helps steer through the multiple deployments.     

The role of parenting and dopamine D4 receptor gene polymorphisms in children's inhibitory control

Temperamental effortful control has important implications for children's development. Although genetic factors and parenting may influence effortful control, few studies have examined interplay between the two in predicting its development. The current study investigated associations between parenting and a facet of children's effortful control, inhibitory control (IC), and whether these associations were moderated by whether children had a 7‐repeat variant of the DRD4 exon III VNTR. A community sample of 409 3‐year‐olds completed behavioural tasks to assess IC, and observational measures of parenting were also collected. Negative parenting was associated with lower child IC. The association between children's IC and positive parenting was moderated by children's DRD4 7‐repeat status, such that children with at least one 7‐repeat allele displayed lower IC than children without this allele when positive parenting was lower. These effects appeared to be primarily influenced by parent support and engagement. Results extend recent findings suggesting that some genetic polymorphisms may increase vulnerability to contextual influences.     

Heterogeneity of auditory verbal working memory in schizophrenia

The heterogeneity of schizophrenia remains an obstacle for understanding its pathophysiology. Studies using a tone discrimination screening test to classify patients have found evidence for 2 subgroups having either a specific deficit in verbal working memory (WM) or deficits in both verbal and nonverbal memory. This study aimed to (a) replicate in larger samples differences between these subgroups in auditory verbal WM; (b) evaluate their performance on tests of explicit memory and sustained attention; (c) determine the relation of verbal WM deficits to auditory hallucinations and other symptoms; and (d) examine medication effects. The verbal WM and tone discrimination performance did not differ between medicated (n = 45) and unmedicated (n = 38) patients. Patients with schizophrenia who passed the tone screening test (discriminators; n = 60) were compared with those who did not (nondiscriminators; n = 23) and healthy controls (n = 47). The discriminator subgroup showed poorer verbal WM than did controls and a deficit in verbal but not visual memory on the Wechsler Memory Scale-Revised (Wechsler, 1987), whereas the nondiscriminator subgroup showed overall poorer performance on both verbal and nonverbal tests and a marked deficit in sustained attention. Verbal WM deficits in discriminators were correlated with auditory hallucinations but not with negative symptoms. The results are consistent with a verbal memory deficit in a subgroup of schizophrenia having intact auditory perception, which may stem from dysfunction of language-related cortical regions, and a more generalized cognitive deficit in a subgroup having auditory perceptual and attentional dysfunction.     

The role of brain-derived neurotrophic factor genotype, parental depression, and relationship discord in predicting early-emerging negative emotionality

The brain-derived neurotrophic factor (BDNF) gene is a plausible candidate for early-emerging negative emotionality (NE), and evidence suggests that the effects of this gene may be especially salient in the context of familial risk for child maladjustment. We therefore examined whether the single-nucleotide polymorphism producing a valine-to-methionine substitution at codon 66 (val66met) of the BDNF gene was associated with childhood NE, in the context of parental depression and relationship discord. A sample of 413 three-year-old children was assessed for NE using standardized laboratory measures. The children's parents completed clinical interviews as well as a measure of marital satisfaction. Children with at least one BDNF methionine (met) allele exhibited elevated NE when a parent had a history of depressive disorder or when relationship discord was reported by a parent. In contrast, this allele was associated with especially low NE when parental depression was absent and when the parental relationship was not discordant. Our findings suggest that the BDNF met allele confers increased child sensitivity to both positive and negative familial influences.     

Limitations in verbal fluency following heavy burdens of early childhood diarrhea in Brazilian shantytown children.

The effects of heavy burdens of diarrhea in the first 2 years of life on specific executive control function like verbal fluency are not well understood. In previous studies, we have shown associations of early childhood diarrhea (ECD) with nonverbal intelligence and school functioning. Therefore, we postulated that ECD might affect early neuropsychological development leading to long-term deficits in normal cognitive development. Based on our extensive 14-year prospective cohort studies of early childhood diarrheal illnesses in a Brazilian shantytown community, we examined ECD correlations between specific impairments of higher mental function and executive skills in shantytown children 5-10 years later (now at 6-12) years of age. Specifically we examined whether heavy diarrheal illnesses correlate with reduced performance on selected tests of executive function. Our study, for the first time, suggests a disproportional impairment in semantic but not phonetic fluency in a subset of children with heavy burdens of diarrhea in their first 2 years of life even when controlling for maternal education, breastfeeding, and child schooling. Similar semantic decrements have been associated with impaired recovery from brain injury. These exploratory studies suggest the importance of verbal fluency tests to assess executive functioning in children challenged by poor nutrition and diarrhea in early life. In addition, our unique findings show the potential influences of early childhood diarrhea on language development that is so critical to productive adulthood and potentially set a foundation for new neuropsychological approaches, which assess early burdens of enteric illnesses on childhood development.     

Not the End of the Odyssey: Parental Perceptions of Whole Exome Sequencing (WES) in Pediatric Undiagnosed Disorders

Due to the lack of empirical information on parental perceptions of primary results of whole exome sequencing (WES), we conducted a retrospective semi-structured interview with 19 parents of children who had undergone WES. Perceptions explored during the interview included factors that would contribute to parental empowerment such as: parental expectations, understanding of the WES and results, utilization of the WES information, and communication of findings to health/educational professionals and family members. Results of the WES had previously been communicated to families within a novel framework of clinical diagnostic categories: 5/19 had Definite diagnoses, 6/19 had Likely diagnoses, 3/19 had Possible diagnosis and 5/19 had No diagnosis. All parents interviewed expressed a sense of duty to pursue the WES in search of a diagnosis; however, their expectations were tempered by previous experiences with negative genetic testing results. Approximately half the parents worried that a primary diagnosis that would be lethal might be identified; however, the hope of a diagnosis outweighed this concern. Parents were accurately able to summarize their child’s WES findings, understood the implications for recurrence risks, and were able to communicate these findings to family and medical/educational providers. The majority of those with a Definite/Likely diagnosis felt that their child’s medical care was more focused, or there was a reduction in worry, despite the lack of a specific treatment. Irrespective of diagnostic outcome, parents recommended that follow-up visits be built into the process. Several parents expressed a desire to have all variants of unknown significance (VUS) reported to them so that they could investigate these themselves. Finally, for some families whose children had a Definite/Likely diagnosis, there was remaining frustration and a sense of isolation, due to the limited information that was available about the diagnosed rare disorders and the inability to connect to other families, suggesting that for families with rare genetic disorders, the diagnostic odyssey does not necessarily end with a diagnosis. Qualitative interviewing served a meaningful role in eliciting new information about parental motivations, expectations, and knowledge of WES. Our findings highlight a need for continued communication with families as we navigate the new landscape of genomic sequencing.