Fatigue,emotional functioning,and executive dysfunction in pediatric multiple sclerosis

Objective: Fatigue, depression, anxiety, and executive dysfunction are associated with multiple sclerosis (MS) in adults. Existing research suggests similar problems in pediatric MS, but relationships between these variables have not been investigated. This study investigates the associations between executive functioning and fatigue, emotional functioning, age of onset, and disease duration in pediatric MS.

Methods: Twenty-six MS or Clinically Isolated Syndrome (CIS) patients, ages 7 to 18, were evaluated through a multidisciplinary demyelinating diseases clinic. Participants completed neuropsychological screening including Verbal Fluency, Digit Span, and Trail-Making Test. Parents completed rating forms of behavioral, emotional, and executive functioning. Patients and parents completed questionnaires related to the patient’s quality of life and fatigue. Pearson’s correlation coefficients were calculated to investigate relationships between fatigue, emotional functioning, and executive functioning, as well as to examine correlations between parent and child reports of fatigue.

Results: Rates of parent-reported anxiety, depression, fatigue, and executive dysfunction varied widely. Means were below average on the Trail-Making Test and average on Verbal Fluency and Digit Span, though scores varied widely. Various fatigue and emotional functioning indices—but not age of onset or disease duration—significantly correlated with various performance-based measures of executive functioning.

Conclusion: Results indicate pediatric MS is associated with some degree of fatigue, emotional difficulties, and executive dysfunction, the latter of which is associated with the two former. Notably, age of onset and disease duration did not significantly correlate with executive functioning. Results advance understanding of psychological and clinical variables related to neurocognitive outcomes in pediatric MS.     

Which modality is best for presenting navigation instructions?

Three experiments involved college students receiving and following instructions of various lengths for navigating in a three-dimensional space displayed on a computer screen. The purpose was to evaluate which is the best modality for presenting navigation instructions so that they can be executed successfully. Single modalities (read, hear, and see) were considered along with dual modalities presented simultaneously or successively. It was found that when there were differences between single modalities, generally execution accuracy was best for see and worst for read. Information presented in two modalities did not yield better accuracy than information presented twice in a single modality. Also, the ordering of modalities depended on the extent of practice. Thus, presentation modality does not have a consistently large effect on receiving and following navigation instructions. Repetition and the amount of practice are much more important variables than is presentation modality in determining how well navigation instructions are followed.     

The Effects of a Multiple Family Therapy on Adolescents with Eating Disorders: An Outcome Study

Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders and many programs have been developed over the past decade. Still, there is little evidence in the literature on the effectiveness on MFT for treating eating disorders. The present study examines the effects of a particular model of Multiple Family Therapy on eating disorder symptoms, quality of life, and percentage of Expected Body Weight (%EBW) in adolescents with eating disorders (ED). Eighty‐two adolescents with ED, aged between 11 and 19 years, were assessed before and after treatment using the Eating Disorders Inventory 2 (EDI‐2), the Outcome Questionnaire 45 (OQ‐45) and %EBW. Results showed a significant increase in %EBW between the beginning and end of treatment, with a large effect size. 52.4% of patients achieved an EBW above 85%. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of patients had a total OQ‐45 score below clinical significance. This study suggests that Multiple Family Therapy may benefit adolescents with eating disorders, with improvement on several outcome measures (%EBW, ED symptoms, and quality of life). However, the lack of a comparison group entails caution when drawing conclusions.     

Differences in multiple‐target visual search performance between non‐professional and professional searchers due to decision‐making criteria

Professional visual searches, such as those conducted by airport security personnel, often demand highly accurate performance. As many factors can hinder accuracy, it is critical to understand the potential influences. Here, we examined how explicit decision‐making criteria might affect multiple‐target search performance. Non‐professional searchers (college undergraduates) and professional searchers (airport security officers) classified trials as ‘safe’ or ‘dangerous’, in one of two conditions. Those in the ‘one = dangerous’ condition classified trials as dangerous if they found one or two targets, and those in the ‘one = safe’ condition only classified trials as dangerous if they found two targets. The data suggest an important role of context that may be mediated by experience; non‐professional searchers were more likely to miss a second target in the one = dangerous condition (i.e., when finding a second found target did not change the classification), whereas professional searchers were more likely to miss a second in the one = safe condition.     

How facial attractiveness affects sustained attention

The present study investigated whether and how facial attractiveness affects sustained attention. We adopted a multiple‐identity tracking paradigm, using attractive and unattractive faces as stimuli. Participants were required to track moving target faces amid distractor faces and report the final location of each target. In Experiment 1, the attractive and unattractive faces differed in both the low‐level properties (i.e., luminance, contrast, and color saturation) and high‐level properties (i.e., physical beauty and age). The results showed that the attractiveness of both the target and distractor faces affected the tracking performance: The attractive target faces were tracked better than the unattractive target faces; when the targets and distractors were both unattractive male faces, the tracking performance was poorer than when they were of different attractiveness. In Experiment 2, the low‐level properties of the facial images were equalized. The results showed that the attractive target faces were still tracked better than unattractive targets while the effects related to distractor attractiveness ceased to exist. Taken together, the results indicate that during attentional tracking the high‐level properties related to the attractiveness of the target faces can be automatically processed, and then they can facilitate the sustained attention on the attractive targets, either with or without the supplement of low‐level properties. On the other hand, only low‐level properties of the distractor faces can be processed. When the distractors share similar low‐level properties with the targets, they can be grouped together, so that it would be more difficult to sustain attention on the individual targets.     

Parallel associative processing in the dorsal striatum: segregation of stimulus-response and cognitive control subregions

Although evidence suggests that the dorsal striatum contributes to multiple learning and memory functions, there nevertheless remains considerable disagreement on the specific associative roles of different neuroanatomical subregions. We review evidence indicating that the dorsolateral striatum (DLS) is a substrate for stimulus–response habit formation – incremental strengthening of simple S–R bonds – via input from sensorimotor neocortex while the dorsomedial striatum (DMS) contributes to behavioral flexibility – the cognitive control of behavior – via prefrontal and limbic circuits engaged in relational and spatial information processing. The parallel circuits through dorsal striatum interact with incentive/affective motivational processing in the ventral striatum and portions of the prefrontal cortex leading to overt responding under specific testing conditions. Converging evidence obtained through a detailed task analysis and neurobehavioral assessment is beginning to illuminate striatal subregional interactions and relations to the rest of the mammalian brain.     

Preference for gamma-hydroxybutyrate (GHB) in current users

Gamma-hydroxybutyrate (GHB) is a drug with significant abuse potential. The present study aimed to assess the relative value of escalating doses of GHB to current GHB users via the Multiple Choice Procedure (MCP), and to validate that the dose rated highest with the MCP would be self-administered at a greater rate than placebo. Participants were 5 current GHB users who were not currently trying to stop using GHB. To examine the value of escalating doses of GHB, the following doses of GHB were used: 0 (placebo), 12.5, 25, 37.5, and 50 mg/kg. Participants typically assigned higher doses of GHB had higher crossover points on the MCP. During choice sessions, participants made repeated choices between administering GHB, placebo or nothing. All participants selected GHB exclusively (5 out of 5 instances) except for one participant who selected GHB on 4 out of 5 instances, thus 96% (i.e., 24/25) of choices were for active GHB. Based on these data, GHB appears likely to function as a dose-dependent reinforcer for humans based on our sample.     

Mindfulness-based cognitive therapy to treat multiple chemical sensitivities: a randomized pilot trial

Skovbjerg, S., Hauge, C. R., Rasmussen, A., Winkel, P. & Elberling, J. (2012). Mindfulness‐based cognitive therapy to treat multiple chemical sensitivities: A randomized pilot trial. Scandinavian Journal of Psychology 53, 233–238. Multiple chemical sensitivities (MCS) is a medically unexplained and socially disabling disorder characterized by negative health effects attributed to exposure to common airborne chemicals. Currently, there is no evidence‐based treatment. The objectives of the study were to assess the feasibility of an 8‐week mindfulness‐based cognitive therapy program (MBCT) for adults with MCS and to evaluate possible effects on psychological distress and illness perception. The study design was a randomized clinical trial. The MBCT programme comprised 8 weekly sessions of 2½ hours. Forty‐two adults were screened for eligibility and 37 were included. Mean age of the participants was 51.6 years, 35 (94.6%) were female and 21 (56.8%) were unemployed. Measures of psychological distress and illness perceptions were assessed at baseline, 4 weeks, 8 weeks and at 3 months follow‐up. No significant differences in effect measures were found between the groups. However, those who completed the MBCT program generally reported benefiting in terms of improved coping strategies and sleep quality. The positive verbal feedback from the participants in the MBCT group suggests that a larger randomized clinical trial on the effect of MBCT for MCS could be considered.