Agreement between Parents and Children on Ratings of Post-Concussive Symptoms Following Mild Traumatic Brain Injury

The level of parent-child agreement on post-concussive symptoms (PCS) was examined in children following mild traumatic brain injuries (TBI). As part of a larger longitudinal study, 186 children with mild TBI and 99 with orthopedic injuries (OI), from 8 to 15 years of age, were recruited prospectively. Parents and children completed the PCS Interview (PCS-I) and the Health and Behavior Inventory (HBI) at 2 weeks, 1 month, 3 months, and 12 months postinjury. Item-level correlations between child and parent ratings on both measures of PCS were significant but modest in both groups. Parent-child correlations for composite scales on the HBI and the total score on the PCS-I were significant in both groups, but somewhat higher in the OI group than in the mild TBI group. Mean symptom ratings tended to be significantly higher for children as compared to parents, especially for somatic symptoms. Parents and children display modest agreement when reporting PCS; their ratings correlate significantly, but children report higher mean levels of symptoms than parents.     

The specificity of the Stroop interference score of errors to ADHD in boys

The Stroop Interference Test is widely used to assess the inhibition function; however, divergent results have emerged from meta-analyses in children with ADHD. This has led to conflicting results as to whether the Stroop test detects the level of inhibition in these children. We hypothesized that the general approach to include interference scores depending on response time causes conflicting results, whereas recordings of errors may prove a superior measure of the inhibition function in children with ADHD. In the present study, 39 children with an ADHD diagnosis, two subgroups with and without another comorbid mental health disorder, were compared with respect to their interference scores of response time and errors with two subgroups of children with no ADHD. The two subgroups comprised 33 children with another mental health disorder other than ADHD and 56 children with no psychiatric disorder. The between-group analyses detected a multivariate, marginal main effect of an ADHD diagnosis on the Stroop interference scores, and a univariate main effect of an ADHD diagnosis on the interference score of errors. Further, only the interference score of errors predicted significantly the parent reported scores on the Inhibit scale from the Behavior Rating Inventory of Executive Function. These findings support that a Stroop interference score of errors is sensitive for inhibition problems in children with ADHD and encourages the use of Stroop versions including error recordings independent of response time.     

Parenting and the dysregulation profile predict executive functioning in children with acquired brain injury

Background: Children with acquired brain injury (ABI) present with high rates of psychological disorders commonly accompanied by deficits in hot and cold executive functions (EFs). Impairments in EFs have been reported to precede mental health problems. Moreover, children who are vulnerable to developing mental health problems in adulthood frequently present with a dysregulation profile in childhood, characterized by impairments in cognitive, behavioral and emotional regulation. Objective: To identify profiles of behaviors associated with impairment in hot and cold EFs and compare injury factors, environmental stressors and dysregulation profile between them. Methods: A latent profile analysis was conducted with 77 children with ABI aged between 6 and 12. Injury factors, child IQ, environmental stressors and the dysregulation profile were compared between these behavioral profiles. Logistic regressions were conducted to predict profile membership. Results: Two profiles were identified: Profile M, with mild deficits (1–2 SD above the mean) in working memory and social skills, and profile C, presenting clinically significant deficits (2–3 SD above the mean) in shift, initiate, working memory, planning and social skills and mild deficits in inhibit, emotional control and task monitor. Proximal environmental stressors (dysfunctional parenting practices, parental stress, parent’s executive dysfunction, anxiety-trait, and depressive symptoms) and dysregulation symptoms predicted profile membership, whereas injury factors, child IQ and distal environmental stressors did not. Conclusion: Following ABI, children with profile C are at risk of mental health problems and present with more proximal stressors. The dysregulation profile may be useful as a proxy for risk for later mental health problems in children with ABI.     

Using Medical Family Therapy with Parents of an Adult Child with Traumatic Brain Injury

Abstract

Acquired traumatic brain injury (ATBI) is a public health concern causing approximately 2.5 million emergency room visits in the United States annually. Medical family therapy (MedFT) displays how biological issues impact each area of a client’s life. This paper highlights how MedFT can be utilized with parents of an adult child with ATBI; the case is presented as treatment occurred with benefits of the inclusion of MedFT. Researchers propose a call to the field of marriage and family therapy to increase access of MedFT to afford more opportunities to help families who experience medical conditions.     

Positive affectivity and attentional control moderate the link between negative affectivity and depressed mood

Research and theory suggest that deficits in trait positive affectivity (PA) and in capacity for executive control of attention (i.e., attentional control or AC) may each intensify risk for depressive symptoms associated with high trait negative affectivity (NA). In contrast, high levels of PA and AC should protect against that risk. However, prospective tests of such predictions are rare. Furthermore, if PA and AC both modulate NA-related risk, it remains to be seen if those effects are independent and complementary or if they operate in an overlapping manner. This study assessed baseline temperament and change in depressed mood across one month in a sample of 125 adolescents. Results supported both PA and AC as modulators of NA’s association with changes in depressed mood. Furthermore, results suggested that these modulating effects are largely non-overlapping and complementary, such that when both PA and AC are low, high NA predicts increases in depressed mood. In contrast, high NA predicts decreases in depressed mood when both PA and AC are high. Limitations of these findings, directions for future research, and implications for prevention are discussed.     

Predicting internalizing symptoms over a two year period by BIS,FFFS and attentional control

Identifying risk factors for the development of internalizing disorders is of major importance. In this context, behavioral inhibition (BIS), the fight-flight-freeze-system (FFFS), and attentional control (AC) have been proposed as being possible risk factors for both anxiety disorders and depression. Even though related cross-sectionally, it is still unclear whether these factors are precursors for internalizing disorders. In this longitudinal study, 1811 participants (aged 12–15) completed questionnaires on BIS/FFFS, AC, and internalizing symptoms at pretest and at two year follow-up. Supporting the alleged importance of BIS/FFFS and AC in the development of internalizing symptoms, BIS/FFFS and AC showed predictive value for anxiety and depression symptoms at two year follow-up. For anxiety symptoms this predictive value was not independent of the level of symptoms at pretest. For depression symptoms, AC showed predictive value over and above pretest level of depression symptoms. In the context of early detection of at risk adolescents, results suggest that screening of current anxiety and depression symptoms is most relevant in addition to a focus on AC for the screening of depression. However, it cannot be ruled out that at a further extended follow-up also BIS/FFFS might show independent predictive value for symptoms of anxiety and/or depression.     

Un nuevo enfoque sobre la esquizofrenia

RESUMEN

El entrenamiento en habilidades sociales y el programa de terapia familiar están siendo evaluados en un proyecto de investigación que incluye un tratamiento comparativo con terapia de movilización. En este tipo de terapia los pacientes, asignados al azar y con una esquizofrenia documentada, practican relajación, footing, reducción del estrés estrés, actividades manuales y terapia creativa. Se ha intentado en este artículo hacer una primera aproximación a un enfoque de tratamiento psicosocial de la esquizofrenia con base empírica. Bajo la optimista pretensión teórica de que los pacientes esquizofrénicos tratados tienen capacidad para aprender; que las actitudes y sentimientos familiares pueden cambiar en forma positiva y el ambiente donde se desenvuelven puede diseñarse para suspender la diátesis, mediatizada biológicamente.     

Hacia las máquinas conscientes

Resumen

Se propone un bosquejo de teoría para el estudio del fenómeno de la consciencia desde un punto de vista unificador—natural y artificial—basado en el análisis de la mente como un fenómeno de control. Se incluye una justificación de la investigación en consciencia artificial no como imitación mecánica de la consciencia natural, sino por las propiedades de que puede dotar a un sistema técnico. Se describe la evolución no biomimética de las estructuras básicas de control y se analizan las estrategias más actuales para el desarrollo de máquinas conscientes.     

Aprendizaje implícito: tres aproximaciones a la cuestión del aprendizaje sin conciencia

Resumen

Los tres paradigmas más importantes desarrollados en el área del aprendizaje implícito son revisados a la luz de la definición recientemente planteada por Reber (1993) d este conocimiento como aquél que se produce independientemente de los intentos conscientes por aprender, y en ausencia de un reconocimiento explícito de sus resultados. Se repasan los estudios empíricos más relevantes llevados a cabo siguiendo cada uno de estos tres paradigmas, y se discute el grado en que podría asumirse para cada uno de ellos el cumplimiento de estos requisitos, concluyendo que sería el paradigma de aprendizaje secuencial el único en el que se habría demostrado suficientemente la existencia de un proceso implícito de aprendizaje. Los recientes intentos de elaborar modelos computacionales de los mecanismos responsables de estos aprendizajes se señalan, por último, como un enfoque alternativo a este mismo problema de delimitación de los procesos de aprendizaje asociativo no consciente, que podrían ayudar a comprender su naturaleza y limitaciones, analizando el modo como la complejidad podría derivarse, en el sistema cognitivo humano, a partir de procesos computacionales más simples, inferiores al nivel de elaboración de la conciencia.