Developmental coordination disorder and internalizing problems in children: The environmental stress hypothesis elaborated

There is a growing literature connecting poor motor coordination to physical and mental health outcomes in children and adolescents. These studies suggest that children with disorders such as developmental coordination disorder (DCD) are at greater risk for depression and anxiety, as well as obesity, and poor physical fitness. With regard to internalizing problems (symptoms of depression and anxiety), there is also evidence to suggest that the environment may play an important role in the etiology of psychological distress in this population. Cairney, Veldhuizen, & Szatmari, 2010 used the phrase “environmental stress hypothesis” to highlight the role that negative exposure to personal and interpersonal stressors might play in accounting for higher rates of internalizing symptoms in children with DCD. In this paper, we elaborate further on this basic premise, offering a model linking DCD to internalizing problems based on Pearlin’s stress process framework. In addition to stressors (risk) and protective factors, we incorporate both physical activity and obesity into our stress model. Next, we review the existing literature to see if there is evidence supporting specific components (pathways) of the model. In doing so, areas in need of further research are identified. Implications for intervention are also provided.     

Predictors of willingness to register as an organ donor among dutch adolescents

Abstract

In order to identify relevant determinants of organ donor registration among Dutch adolescents, a school-based cross-sectional survey was conducted among 145 high school students. Fifty-one percent of respondents indicated they were willing to register as organ donors and 80% reported a positive general attitude towards registration. Various misconceptions about the registration and donation procedure were identified. On average only moderate knowledge levels related to organ donation were found. In order of strongest association, negative outcome expectancies, past behaviour and experience, positive outcome expectancies, and social outcome expectancies proved to be significant predictors of willingness to register as organ donors. Self-efficacy was indirectly associated with willingness via outcome expectancies. Knowledge about organ donation was not significantly associated with willingness. The results suggest that in order to persuade adolescents to register as organ donors, refutational messages will have to be developed to counterargue the prevailing negative outcome expectancies related to organ donation and registration as an organ donor.     

Affective and health-related outcome expectancies for physical activity in older adults

This study tests the effects of affective and health-related outcome expectancies on physical exercise, assuming stronger direct and indirect (via intention) effects from affective outcome expectancy to physical exercise than from health-related outcome expectancy to exercise. Physical exercise and social cognitive variables were assessed at baseline, and 6- and 12-month follow-up in 335 older adults (60–95 years of age). Applying structural equation modelling, there was a direct effect from affective, but not from health-related outcome expectancy on intentions and behaviour. Also, the indirect effect from self-efficacy on physical exercise via affective outcome expectancy was significant, whereas the mediation via health-related outcome expectancy was not. These findings emphasise the relative importance of affective versus health-related outcome expectancies in predicting intentions and physical exercise in older adults and highlight the importance to separate these facets at a conceptual level to enhance both theory development and health promotion.     

Neuropsychological Functioning in Children with Medium Chain Acyl Coenzyme A Dehydrogenase Deficiency (MCADD): The Impact of Early Diagnosis and Screening on Outcome

Children with medium chain acyl coenzyme A dehydrogenase deficiency (MCADD) have been reported to be at high risk for neurocognitive deficits. However this has not been systematically studied and little is known about the exact nature of neuropsychological sequelae or of the impact of early diagnosis and screening on outcome. We examined cognitive and adaptive outcome in children with MCADD (N?=?38, age range: 2 years, 2 months – 10 years, 3 months) diagnosed either through a newborn screening program (tandem mass spectrometry/MSMS) or upon clinical presentation. There was no evidence of overall intellectual impairment in either groups but there was some suggestion of poorer verbal and specific executive functioning (i.e., planning) abilities in the unscreened cohorts. Adaptive functioning was relatively intact with the exception of reduced Daily Living Skills in both our screened and unscreened groups. Early diagnosis and greater number of hospitalizations were related to higher verbal, communication, and socialization skills. Overall, our results highlight the importance of early diagnosis and management for children with MCADD.     

The Nature of the Automatization Deficit in Chinese Children with Dyslexia

Clarifying whether automatization deficits constitute the primary causes or symptoms of developmental dyslexia, we focused on three critical issues of the dyslexic automatization deficit, namely universality, domain specificity, and severity. Thirty Chinese dyslexic children (mean age 10 years and 5 months), 30 chronological-age-, and 30 reading-level-matched children were tested in 4 areas of automaticity: motor, visual search, Stroop facilitation effects, and automatic word recognition. The results showed that the dyslexic children performed significantly worse than the CA-controls but not the RL-controls in all the tasks except for Stroop congruent-color words, on which they performed worse than children in both control groups. The deficits reflect a lag in reading experiences rather than a persistent cognitive deficit.     

Charting the Developmental Trajectories of Attention and Executive Function in Chinese School-Aged Children

Attention is a complex domain that has reawakened research interest in recent years. There are relatively few studies that have examined age-related changes across different attention subcomponents, such as selection, maintenance, and control, using large samples covering a wide age range. The present study assessed performance in 466 participants in order to identify the ages at which mature performance was reached across differing attention subcomponents. Furthermore, we investigated whether the nature of the attentional demands or task difficulty predicted the age at which stable levels of performance were reached. The results supported the former rather than the latter alternative.     

Implementation of Cognitive Therapy for PTSD in routine clinical care: Effectiveness and moderators of outcome in a consecutive sample

ObjectiveTrauma-focused psychological treatments are recommended as first-line treatments for Posttraumatic Stress Disorder (PTSD), but clinicians may be concerned that the good outcomes observed in randomized controlled trials (RCTs) may not generalize to the wide range of traumas and presentations seen in clinical practice. This study investigated whether Cognitive Therapy for PTSD (CT-PTSD) can be effectively implemented into a UK National Health Service Outpatient Clinic serving a defined ethnically mixed urban catchment area.MethodA consecutive sample of 330 patients with PTSD (age 17–83) following a wide range of traumas were treated by 34 therapists, who received training and supervision in CT-PTSD. Pre and post treatment data (PTSD symptoms, anxiety, depression) were collected for all patients, including dropouts. Hierarchical linear modeling investigated candidate moderators of outcome and therapist effects.ResultsCT-PTSD was well tolerated and led to very large improvement in PTSD symptoms, depression and anxiety. The majority of patients showed reliable improvement/clinically significant change: intent-to-treat: 78.8%/57.3%; completer: 84.5%/65.1%. Dropouts and unreliable attenders had worse outcome. Statistically reliable symptom exacerbation with treatment was observed in only 1.2% of patients. Treatment gains were maintained during follow-up (M = 280 days, n = 220). Few of the selection criteria used in some RCTs, demographic, diagnostic and trauma characteristics moderated treatment outcome, and only social problems and needing treatment for multiple traumas showed unique moderation effects. There were no random effects of therapist on symptom improvement, but therapists who were inexperienced in CT-PTSD had more dropouts than those with greater experience.ConclusionsThe results support the effectiveness of CT-PTSD and suggest that trauma-focused cognitive behavior therapy can be successfully implemented in routine clinical services treating patients with a wide range of traumas.     

An Evaluation of the Effects of Diagnostic Composition on Individual Treatment Outcome Within Transdiagnostic Cognitive–Behavioral Group Therapy for Anxiety

Recently, studies have supported the efficacy of treating anxiety disorders utilizing a transdiagnostic, or non-diagnosis-specific, framework (Erickson, D. H. (2003). Group cognitive behavioural therapy for heterogeneous anxiety disorders. Cognitive Behaviour Therapy, 32, 179–186; Garcia, M. S. (2004). Effectiveness of cognitive-behavioural group therapy in patients with anxiety disorders. Psychology in Spain, 8, 89–97; Norton, P. J., & Hope, D. A. (2005). Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 36, 79–97). Transdiagnostic group treatment packages focus on the common aspects inherent across the anxiety disorders such as behavioral and cognitive avoidance, and faulty cognitive appraisals of threat potential or meaning (Barlow, D. H., Allen, L. B., & Choate, M. L. (2004). Toward a unified treatment for emotional disorders. Behavior Therapy, 35, 205–230). Although research supports the overall efficacy of transdiagnostic cognitive behavior therapy (CBT) for anxiety disorders (Norton, P. J., & Philipp, L. M. (2008). Transdiagnostic approaches to the treatment of anxiety disorders: A quantitative review. Psychotherapy: Theory, Research, Practice and Training, 45, 214–226), the effect of diagnostically mixed group composition on individual outcomes is less clear. This study investigated the relationship between group composition and treatment outcome within diagnostically heterogeneous groups with the purpose of determining if diagnostic heterogeneity differentially impacted treatment outcome for 84 individuals during a 12-week transdiagnostic cognitive–behavioral group anxiety treatment program (Norton, P. J. (2012a). Group cognitive-behavioral therapy of anxiety: A transdiagnostic treatment manual. New York: Guilford). The diagnostic makeup of the treatment group was examined at the beginning of treatment and at the end of treatment, and the results indicated that the diagnostic makeup of the treatment group had no significant impact on individual treatment outcome. These findings have direct implications for the delivery of transdiagnostic treatments, and are discussed in terms of their global implications for the transdiagnostic approach to the treatment of anxiety disorders.     

Face gender recognition in developmental prosopagnosia: Evidence for holistic processing and use of configural information

Face identification deficits in developmental prosopagnosics (DPs) have been thought to be due to general difficulties with processing configural face information and integrating configural and parts information into a coherent whole (holistic processing). Gender recognition provides a further opportunity to more fully examine this issue as this ability may be intact in DPs and it has been shown to depend on processing configural information and holistic processing in neurotypical individuals. In the present study we first determined that, indeed, gender discrimination performance was similar in DPs and controls. Second, we found that inversion and scrambling (which we propose measures holistic processing and sensitivity to configural information, respectively) produced comparable deficits in DPs and controls, suggesting that both groups use holistic processing and configural information to recognize gender. This indicates that holistic processing and using configural face information are not general impairments in DP and may be more specific to face identity.