Cognitive Functioning,Behavior, and Quality of Life After Stroke in Childhood

Rationale: To provide a better understanding of cognitive functioning, motor outcome, behavior and quality of life after childhood stroke and to study the relationship between variables expected to influence rehabilitation and outcome (age at stroke, time elapsed since stroke, lateralization, location and size of lesion).

Methods: Children who suffered from stroke between birth and their eighteenth year of life underwent an assessment consisting of cognitive tests (WISC-III, WAIS-R, K-ABC, TAP, Rey-Figure, German Version of the CVLT) and questionnaires (Conner's Scales, KIDSCREEN).

Results: Twenty-one patients after stroke in childhood (15 males, mean 11;11 years, SD 4;3, range 6;10–21;2) participated in the study. Mean Intelligence Quotients (IQ) were situated within the normal range (mean Full Scale IQ 96.5, range IQ 79–129). However, significantly more patients showed deficits in various cognitive domains than expected from a healthy population (Performance IQ p?=?.000; Digit Span p?=?.000, Arithmetic's p?=?.007, Divided Attention p?=?.028, Alertness p?=?.002). Verbal IQ was significantly better than Performance IQ in 13 of 17 patients, independent of the hemispheric side of lesion. Symptoms of ADHD occurred more often in the patients' sample than in a healthy population (learning difficulties/inattention p?=?.000; impulsivity/hyperactivity p?=?.006; psychosomatics p?=?.006). Certain aspects of quality of life were reduced (autonomy p?=?.003; parents' relation p?=?.003; social acceptance p?=?.037). Three patients had a right-sided hemiparesis, mean values of motor functions of the other patients were slightly impaired (sequential finger movements p?=?.000, hand alternation p?=?.001, foot tapping p?=?.043). In patients without hemiparesis, there was no relation between the lateralization of lesion and motor outcome. Lesion that occurred in the midst of childhood (5–10 years) led to better cognitive outcome than lesion in the very early (0–5 years) or late childhood (10–18 years). Other variables such as presence of seizure, elapsed time since stroke and size of lesion had a small to no impact on prognosis.

Conclusion: Moderate cognitive and motor deficits, behavioral problems, and impairment in some aspects of quality of life frequently remain after stroke in childhood. Visuospatial functions are more often reduced than verbal functions, independent of the hemispheric side of lesion. This indicates a functional superiority of verbal skills compared to visuospatial skills in the process of recovery after brain injury. Compared to the cognitive outcome following stroke in adults, cognitive sequelae after childhood stroke do indicate neither the lateralization nor the location of the lesion focus. Age at stroke seems to be the only determining factor influencing cognitive outcome.     

Neuropsychological Functioning in Children with Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) has been associated with deficits in the areas of verbal memory and learning, executive functioning, working memory, and attention in adults. Findings have been less consistent in the few studies examining neuropsychological functioning in childhood PTSD, which are often limited by comparing children with PTSD to children without trauma histories, making it unclear whether observed neuropsychological deficits are related to trauma exposure or to PTSD symptomatology. In an ethnically diverse sample of 62 children who witnessed intimate partner violence (n = 27 PTSD+ and 35 PTSD?), children with PTSD exhibited slower and less effective learning, heightened sensitivity to interference, and impaired effect of rehearsal on memory acquisition on the California Verbal Learning Test – Children's Version, a word list learning task. Both groups performed in the below average range on measures of executive functioning, attention, and intellectual ability.     

Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD

We followed an ethnically and socioeconomically diverse sample of preadolescent girls with ADHD (n = 140) and matched comparison girls (n = 88) over a period of 5 years, from middle childhood through early/midadolescence, with the aim of determining whether childhood levels of executive function (EF) would predict adolescent multi-informant outcomes of social functioning and psychopathology, including comorbidity between externalizing and internalizing symptomatology. Predictors were well-established measures of planning, response inhibition, and working memory, along with a control measure of fine motor control. Independent of ADHD versus comparison group status, (a) childhood planning and response inhibition predicted adolescent social functioning and (b) childhood planning predicted comorbid internalizing/externalizing disorders in adolescence. Subgroup status (ADHD-Combined, ADHD-Inattentive, and comparison) moderated the relationship between childhood planning and adolescent internalizing/externalizing comorbidity, with the combined type revealing particularly strong associations between baseline planning and adolescent comorbidity. Mediation analyses indicated that adolescent social functioning mediated the prediction from childhood EF to comorbidity at follow-up; in turn, in the girls with ADHD, adolescent comorbidity mediated the prediction from childhood EF to social functioning at follow-up. We conclude that childhood interventions should target EF impairments in addition to behavioral symptoms.     

Social support as a mediator of religious involvement and physical and emotional functioning in a national sample of African-Americans

Researchers propose social support as one of the factors that may explain the positive relationship often observed between religious involvement and health outcomes. African-Americans are a population that tends to have higher than average levels of religious involvement and are also disproportionately impacted by most health conditions. The present study sought to determine whether social support mediates the role of religious involvement in physical and emotional functioning and depressive symptoms, among a national probability sample of African-Americans (N = 803). Study participants completed telephone interviews. We used structural equation modelling to test hypotheses based on the theoretical model. Findings suggest evidence for a mediating role of belonging and tangible support in the association between religious behaviours and physical functioning as well as depression. There was no mediational role played by appraisal support, or for emotional functioning. Implications for faith-based health promotion interventions are discussed.     

Factor structure of the construct of adaptive behavior in children with and without intellectual disability

Although the presence of significant limitations in adaptive behavior constitutes one of the three necessary criteria for diagnosing intellectual disability, adaptive behavior structure has always been the subject of considerable controversy among researchers. The main goal of this study is to extend previous research results that provide further support to a multidimensional structure of conceptual, social, and practical skills compared to the unidimensional structure. One-factor and 3-correlated factors models as measured by 15 observable indicators were analyzed by means of confirmatory factor analysis (CFA), as well as their relationships with one second-order factor (i.e., adaptive behavior). To that end, 388 children with and without intellectual disabilities were assessed with the Diagnostic Adaptive Behavior Scale (DABS). Results of CFA indicated that the 3 first-order factors solution provides the best fit to the data. Reliability and validity of the multidimensional model were also analyzed through different methods such as the composite reliability and the average variance extracted. Finally, implications of these findings and possible directions for future research are discussed.     

Measuring moral reasoning using moral dilemmas: evaluating reliability,validity, and differential item functioning of the behavioural defining issues test (bDIT)

ABSTRACT

We evaluated the reliability, validity, and differential item functioning (DIF) of a shorter version of the Defining Issues Test-1 (DIT-1), the behavioural DIT (bDIT), measuring the development of moral reasoning. About 353 college students (81 males, 271 females, 1 not reported; age M = 18.64 years, SD = 1.20 years) who were taking introductory psychology classes at a public University in a suburb area in the Southern United States participated in the present study. First, we examined the reliability of the bDIT using Cronbach’s α and its concurrent validity with the original DIT-1 using disattenuated correlation. Second, we compared the test duration between the two measures. Third, we tested the DIF of each question between males and females. Findings reported that first, the bDIT showed acceptable reliability and good concurrent validity. Second, the test duration could be significantly shortened by employing the bDIT. Third, DIF results indicated that the bDIT items did not favour any gender. Practical implications of the present study based on the reported findings are discussed.     

Invariance on a reading comprehension test in European Portuguese: A differential item functioning analysis between students from rural and urban areas

The aim of this study was to determine whether the items from a reading comprehension test in European Portuguese function differently across students from rural and urban areas, which biases the test validity and the equity in assessment. The sample was composed of 653 students from second, third and fourth grades. The presence of differential item functioning (DIF) was analysed using logistic regression and the Mantel–Haenszel procedure. Although 17 items were flagged with DIF, only five items showed non-negligible DIF in all effect-size measures. The evidence of invariance across students with rural or urban backgrounds for most of the items supports the validity of the test though the five identified items should be further investigated.     

Developmetrics A balanced and short Best Friend Index for children and young adolescents

This study evaluated a short friendship questionnaire providing a balanced assessment of positive (e.g., support) and negative (e.g., jealousy) friendship features. In addition, associations with indices of adaptive functioning versus psychopathology were tested. The friendship questionnaire was presented to 548 typically developing children and young adolescents (M _age = 11;01 years). Results confirmed validity and independence of the two friendship features, and showed that negative friendship features were uniquely associated with symptoms of psychopathology, whereas both positive and negative features were, in opposite directions, uniquely associated with aspects of socioemotional functioning.     

Meaning in life,emotional distress,suicidal ideation,and life functioning in an active duty military sample

The present study examined the relationship of meaning in life with emotional distress, suicidal ideation, and life functioning in a sample of 273 active duty Security Forces personnel assigned to two US Air Force bases. Results of regression analyses indicated that stronger meaning in life was significantly associated with less severe emotional distress (p?<?0.001, ΔR ²?=?0.047) and suicidal ideation (p?=?0.043, ΔR ²?=?0.017), and better functioning at work and in intimate relationships, nonfamily relationships, and recreational activities (p?<?0.001, ΔR ²?=?0.073). Meaning in life showed stronger associations with outcomes relative to other predictors and covariates and explained the relationship between belonging and life functioning. Findings suggest that meaning in life is associated with less emotional distress and suicide risk, and greater success and performance across multiple domains in life among military personnel.     

Parent-Adolescent Relationship and Adolescent Psychological Functioning among African-American Female Adolescents: Self-Esteem as a Mediator

African-American female adolescents living in urban areas are at increased risk for adverse adjustment outcomes. The present study accomplished two goals. First, the quality of the parent-adolescent relationship across age groups was examined for differences among younger (i.e., 12'14) versus mid-range (i.e., 15'16) versus older (i.e., 17'18) adolescents. Second, self-esteem was examined as a possible mediator of the relationship between the quality of the parent-adolescent relationship and adolescent psychological functioning in a sample of 608 African-American urban adolescent females. With regard to developmental shifts in the quality of the parent-adolescent relationship, midrange adolescents reported a significantly poorer relationship with their mother than older adolescents. Results also indicated that self-esteem partially mediated the relationship between parent-child relationship and adolescent psychological functioning. Mental health professionals can broaden their interventions that aim to improve adolescent psychological functioning by either focusing on the quality of the parent-adolescent relationship or adolescent self-esteem.