What do pre-adolescents and adolescents understand about HIV/AIDS?

Abstract

Pre-adolescents and adolescents (N= 80, aged 10, 12, 15, and 18 years) were tested on their knowledge of HIV/AIDS. Knowledge was assessed using a self-report questionnaire (examining levels of factual knowledge) and a semi-structured interview (examining cognitive developmental levels of understanding). Examination of the developmental shifts in understanding of HIV/AIDS revealed an increase in conceptual complexity on causal and prevention dimensions. The main conceptual changes included a shift from single cause to multiple cause solutions and a shift from identifying surface or immediate features to implicating less salient features. Additionally, with age, concepts about HIV/AIDS were increasingly organised around internal, physiological principles. Questionnaire responses yielded significant age-related increases in knowledge. Level of knowledge, as measured by the questionnaire, was higher than that assessed by the interview for the three youngest age groups. Thus, factual information acquired about HIV/AIDS is not automatically accompanied by understanding. In light of these findings the past conclusion that adolescents have high levels of knowledge of HIV/AIDS is questioned.     

Binge-Drinking: A Test of the Role of Group Norms in the Theory of Planned Behaviour

A study was undertaken to assess the utility of the theory of planned behaviour in the prediction of students' binge-drinking. Additionally, a perspective was utilised to address the usually weak contribution of subjective norms in predicting behavioural intentions. Respondents were 289 undergraduate students. The study employed a longitudinal design, with the predictors of performing the behaviour under consideration assessed prior to the measure of reported behaviour. Support was found for the application of the theory of planned behaviour to binge-drinking. A reconceptualisation of norms in the theory of planned behaviour, from a social identity theory/self-categorization theory perspective, was also supported; consistent with expectations, the norms of a behaviourally relevant reference group predicted intentions to binge-drink, especially for participants who identified strongly with the reference group. The results are discussed in relation to measures which may help to reduce the incidence of binge-drinking by university students.     

Intention to Participate in Predictive Genetic Testing for Hereditary Cancer: The Role of Attitude toward Uncertainty

This study aimed to identify factors predictive of intentions to participate in genetic testing for hereditary cancer. Measures of the psychosocial influences on intention were based on the theories of reasoned action (TRA) and planned behaviour (TPB) and a new measure of Attitude toward Uncertainty. The participants (the breast cancer sample, n = 124; the colon cancer sample, n = 168) were recruited via a general practitioner's patient database and asked to complete postal questionnaires. The overall response rate was 57.4% (54.7% in the colon cancer sample, 61.4% in the breast cancer sample). In the colon cancer sample, 72% of respondents stated that they would choose to participate in genetic testing for colon cancer susceptibility. In the breast cancer sample, 77% of respondents stated that they would choose to participate in genetic testing for breast cancer susceptibility. The TRA components (attitudes and subjective norms) and Attitude toward Uncertainty emerged as the strongest predictors of intention. The Attitude toward Uncertainty appears to moderate intention in that participants with more negative attitudes toward uncertainty are more likely to undergo the test than those seeking more certainty.     

Book Review

Performance-based measures and ratings of executive functions were examined in a sample of adolescents with attention deficit/hyperactivity disorder (ADHD) and comparison controls. Performance-based measures of executive function included inhibition, working memory, set shifting, and planning, and ratings of these same executive functions were completed by parents and teachers. Adolescents with ADHD demonstrated lower executive function performance than controls and displayed elevated ratings on the executive function ratings by parents and teachers. Significant associations were obtained between the performance-based measures and the parent and teacher ratings, but each measure was not uniquely associated with its respective scale on the rating scales. When performance-based measures and ratings were examined as predictors of ADHD status, the parent and teacher ratings entered as significant predictors of ADHD status. Further commonality analyses indicated that performance-based measures accounted for little unique variance in predicting ADHD status and also displayed little overlap with the behavioral ratings. These findings highlight the diagnostic utility of behavioral ratings of executive function in predicting ADHD status; however, behavioral ratings should not be assumed to be a proxy for performance on measures of executive function in clinical practice.     

Relationship between reaction time variability and motor skill development in ADHD

Slower and more variable reaction times to computerized tasks have been documented in children diagnosed with attention deficit/hyperactivity disorder (ADHD). Recent research supports a role for attentional lapses in generating abnormally variable and slow responses. However, given the association between ADHD and impairments in motor control, we hypothesized that slower or more variable reaction times might also correlate with motor development. The aim of this case-control study was to explore the relationship between motor function, reaction speed and variability, and ADHD. After comprehensive educational and clinical assessments, motor skill development was evaluated in 35 children ages 9 to 14 (19 with ADHD) using the Physical and Neurological Examination for Subtle Signs (PANESS) test battery. Finger-sequencing speed and variability were quantified with goniometers. Reaction times were measured with 20 trials each of computerized simple and choice (binary) tasks. Compared to healthy controls, children with ADHD had slower and more variable reaction times, and these findings correlated with impaired motor development (PANESS) and slow and variable finger sequencing (goniometers). Further studies of motor development in ADHD may identify factors influencing speed and variability of reaction times.     

An Examination of Lexical and Sublexical Reading Skills in Children with Neurofibromatosis Type 1

Neurofibromatosis type 1 (NF1) is an inherited neurocutaneous disorder associated with a high frequency of cognitive and learning difficulties. Based on discrepancies between IQ and academic achievement, approximately 17% of children with NF1 have been classified as having reading impairments. In this study, the lexical and sublexical reading skills of children with NF1 (n = 30) were examined using the Castles' Word/Non-Word Test (modified version), together with measures of neuropsychological functioning and academic achievement. Twenty children (67%) demonstrated deficits in one or more reading subskills, with 75% of these meeting criteria for phonological dyslexia and 20% classified with mixed dyslexia. These findings indicate that a large proportion of children with NF1 may be characterized by a specific difficulty with the sublexical procedure, suggesting a difficulty employing spelling-to-sound rules to assemble a pronunciation when reading. In line with previous studies, the present findings also suggest that discrepancy-based methods may not be sufficiently sensitive to identify children who experience reading difficulties.     

Deficit in Response Inhibition in Children with Attention Deficit/Hyperactivity Disorder (ADHD): Impact of Motivation?

To date, neuropsychological and psycho-physiological studies have revealed inconsistent results regarding an executive or motivational deficit explaining the response inhibition deficit in children with attention deficit/hyperactivity disorder (ADHD). Research on differentiating neuropsychological processes in ADHD subtypes is still scarce. Therefore, the motivational impact on response inhibition among boys with ADHD was examined in this study. In the first study, 19 boys with ADHD-combined type (ADHD-C) and 19 age-matched healthy control subjects performed a modified Go/No-Go task with the following experimental conditions: neutral, auditory feedback, reward, response cost, and reward/response cost. Performance and physiological data (heart rate and skin conductance responses) were recorded. In a second study with the modified Go/No-Go task, data for six children with ADHD-C, six with ADHD-inattentive subtype (ADHD-I), and six healthy control subjects were compared. Neither of the two studies revealed group by condition interactions. In study 1, boys with ADHD-C generally made more commissions and omissions compared to the control group. However, feedback significantly improved the response inhibition in all children. The heart rate of all children was increased in the two conditions of reward and reward/response cost. Study 2 revealed that children with ADHD-I responded more slowly and showed increased reaction time variability compared to both other groups. The present study supports an executive rather than a motivational deficit in the response inhibition among children with ADHD-C, though further results also indicate the role of auditory feedback on response inhibition. Additionally, the findings support the differentiation of ADHD-C and ADHD-I, suggesting that ADHD-I children are characterized by a sluggish cognitive tempo.     

Processing Speed Weakness in Children and Adolescents with Non-Hyperactive but Inattentive ADHD (ADD)

DSM-IV-TR defines ADHD-Predominantly Inattentive as allowing up to five symptoms of hyperactivity/impulsivity, while theories of the inattentive type usually assume a group that is hypoactive and characterized by processing speed and cognitive interference deficits. In a community-recruited sample of 572 children and adolescents, a pure inattentive subtype of ADHD (ADD) was defined as those who met DSM-IV-TR criteria for ADHD-PI but had two or fewer hyperactive/impulsive symptoms. Processing and output speeds of those with ADD were compared to those identified with DSM-IV-TR ADHD combined type and non-ADHD controls. These results were then contrasted with those found when DSM-IV-TR defined ADHD-PI was compared with ADHD-C and controls. Processing and output speed were assessed with the Trailmaking A and B and the Stroop Naming Tests. Cognitive interference control was assessed with the interference score from the Stroop Task. Slower cognitive interference speed was found in the ADD vs. ADHD-C and controls comparisons, but not the ADHD-PI versus ADHD-C and controls comparisons. On output speed measures, ADD exhibited the slowest performance, significantly different from controls and the effect size for the set-shifting speed contrast (Trailmaking B) was double that of the ADHD-PI vs. control comparison. ADHD-Inattentive type as defined by the DSM-IV-TR is a heterogeneous condition with a meaningful proportion of those affected exhibiting virtually no hyperactive/impulsive symptoms. This subgroup may represent a distinct inattentive condition characterized by poor cognitive interference control and slow processing or output speed.     

Inattention,working memory,and academic achievement in adolescents referred for attention deficit/hyperactivity disorder (ADHD)

This study investigated the role of inattention and working memory in predicting academic achievement in 145 adolescents aged 13 to 18 referred for attention deficit/hyperactivity disorder (ADHD). Path analysis was used to examine whether auditory-verbal and visual-spatial working memory would mediate the relationships between classroom inattention symptoms and achievement outcomes. Results provide support for the mediational model. Behavioral inattention significantly predicted both auditory-verbal and visual-spatial working memory performance. Auditory-verbal working memory was strongly associated with adolescents' achievement in reading and mathematics, while visual-spatial working memory was only associated with achievement in mathematics. The path from inattention symptoms to reading was partially mediated by the working memory variables, but the path from inattention to mathematics was not mediated by working memory. The proposed model demonstrated a good fit to the data and explained a substantial amount of variance in the adolescents' achievement outcomes. These findings imply that working memory is a risk factor for academic failure for adolescents with attentional problems.     

Assessment of children's receptive vocabulary using event-related brain potentials: Development of a clinically valid test

The combined verbal and motor impairments characteristic of children with disorders such as Cerebral Palsy (CP) frequently compromise the accuracy of standard psychometric assessments. What is needed is a test to measure language that does not require verbal or motor responses. This study was designed to determine whether single-word receptive vocabulary could be assessed in young children without CP, using an ERP-compatible test based on Form M of the Peabody Picture Vocabulary Test-Revised (PPVT-R). Fifteen 10-year-old children with normal levels of psychometric intelligence participated. Ninety pictures were selected from the PPVT-R (Form M), representing three levels of single-word receptive vocabulary (Preschool, Child-Adolescent, Adult). Each picture was presented twice (pseudo-random), once paired with a spoken word that was semantically congruent with the picture and once paired with a semantically incongruent word. The children's N400 was significantly larger to incongruent than to congruent pairs, but only when the vocabulary was within their repertoire. The results are discussed in terms of electrophysiologic correlates of acquired language and the clinical use of this ERP test as an adjunct to assessing patients with moderate to severe communication and/or motor impairments (e.g., cerebral palsy, autism, head injury).