Sleep EEG changes during adolescence: An index of a fundamental brain reorganization

Delta (1–4 Hz) EEG power in non-rapid eye movement (NREM) sleep declines massively during adolescence. This observation stimulated the hypothesis that during adolescence the human brain undergoes an extensive reorganization driven by synaptic elimination. The parallel declines in synaptic density, delta wave amplitude and cortical metabolic rate during adolescence further support this model. These late brain changes probably represent the final ontogenetic manifestation of nature’s strategy for constructing nervous systems: an initial overproduction of neural elements followed by elimination. Errors in adolescent brain reorganization may cause mental illness; this could explain the typical age of onset of schizophrenia. Longitudinal studies of sleep EEG are enhancing our knowledge of adolescent brain maturation. Our longitudinal study of sleep EEG changes in adolescence showed that delta power, which may reflect frontal cortex maturation, begins its decline between ages 11 and 12 years and falls by 65% by age 17 years. In contrast, NREM theta power begins its decline much earlier. Delta and theta EEG frequencies are important to sleep theory because they behave homeostatically. Surprisingly, these brain changes are unrelated to pubertal maturation but are strongly linked to age. In addition to these (and other) maturational EEG changes, sleep schedules in adolescence change in response to a complex interaction of circadian, social and other influences. Our data demonstrate that the daytime sleepiness that emerges in adolescence is related to the decline in NREM delta as well as to altered sleep schedules. These longitudinal sleep data provide guideposts for studying cognitive and behavioral correlates of adolescent brain reorganization.     

Impaired awareness of movement disorders in Parkinson’s disease

Background

This study analyzed the presence of awareness of movement disorders (dyskinesias and hypokinesias) in 25 patients with Parkinson’s disease (PD) and motor fluctuations (dyskinesias, wearing off, on–off fluctuations). Of the few studies that have dealt with this topic, none have analyzed the differences in the awareness of motor deficits by comparing the on and off states using motor scales and an extensive battery of tests to assess cognitive and behavioral functioning.

Methods

PD patients were compared on three different scales that we have devised to measure awareness of movement disorders: Global Awareness of Movement (GAM) Disorders, dyskinesia/hypo-bradykinesia rating scales.

Results

Data showed that PD patients had greater awareness and psychological suffering in the off state than in the on state. In particular, they were troubled by motor disabilities related to hypokinesias and had mood-related symptoms and a perception of disability in activities of daily living. Interestingly, patients only showed a selective reduction of awareness of movement disorders associated with executive functions and related to dyskinesias in the on state, compared to a preserved awareness of hypokinesias in the off state. On the contrary, no association with executive functions was found in the off state.

Conclusion

Our findings suggest that the dopaminergic overstimulation of mesocorticolimbic pathways may cause a dysfunction of prefrontal–subcortical connections related to the impaired insight.     

压力反应、压力应对与睡眠质量关系述评

压力反应是个体应对应激源作用时所产生的非特异性表现, 而压力应对是个体社会生活中一种综合的压力适应过程。压力反应及其应对是压力与睡眠质量之间的重要变量。生理、认知、情绪和行为等方面的压力反应与睡眠质量有直接的交互作用, 而认知调节、情绪调节、应对方式、社会支持和人格倾向等压力应对因素则能够改变压力与睡眠之间相互作用的强度、持续时间以及最终结果。     

注意缺陷多动症与犯罪的关系及其司法启示

注意缺陷多动症(Attention deficit hyperactivity disorder, ADHD) 是一种常见于儿童期的精神障碍, 也可能持续到青少年及成年阶段, 其症状表现为难于集中注意力、难于控制其行为及活动过度等, 这些缺陷可能会增加患者犯罪的几率。轻微脑功能障碍、自我调节学说、强化敏感性理论、相关人格特质等在一定程度上可解释ADHD与犯罪的关系。ADHD作用于犯罪存在三种不同的可能路径, 即独立作用、间接作用和无作用。文中特别指出ADHD患者在刑事司法过程中表现的特点及其司法启示。未来研究应从基因、神经心理机制及其与环境的交互作用上进一步探讨ADHD与犯罪的关系, 并提示在犯罪预防、审讯、法庭审判以及罪犯矫治中需要考量ADHD的可能影响。     

A Longitudinal Analysis of Psychiatric Severity upon Outcomes Among Substance Abusers Residing in Self-Help Settings

A longitudinal analysis of psychiatric severity was conducted with a national sample of recovering substance abusers living in Oxford Houses, which are self-run, self-help settings. Outcomes related to residents' psychiatric severity were examined at three follow-up intervals over one year. Over time, Oxford House residents with high versus low baseline psychiatric severity reported significantly more days using psychiatric medication, decreased outpatient psychiatric treatment, yet no significant differences for number of days abstinent and time living in an Oxford House. These findings suggest that a high level of psychiatric severity is not an impediment to residing in self-run, self-help settings such as Oxford House among persons with psychiatric comorbid substance use disorders.     

Peer Perceptions and Liking of Children with Anxiety Disorders

Examined three aspects of childhood anxiety and peer liking: (1) whether or not children can detect anxiety in age-mates, (2) the degree to which peer-reported anxiety, self-reported anxiety, and presence of anxiety disorders are associated with peer liking, and (3) whether or not self-reported anxiety and presence of anxiety disorders are associated with peer liking after controlling for peer-reported anxiety. Peer raters (9.5–12.5 years) rated videotaped speech samples of target children with anxiety disorders (AD; 9.5–13 years) and target children without anxiety disorders (NAD; 9.5–13 years). Peer-rated anxiety was positively correlated with target children’s self-reported anxiety and was higher among children with AD and children with social phobia (SP). Peer liking was inversely related to peer-reported anxiety and was lower for target children with SP. Target children with SP were liked less regardless of how anxious peers perceived them to be. Peer rater and target child demographics did not moderate the relationship between peer-rated anxiety and peer liking.     

Common and Unique Factors Associated with DSM-IV-TR Internalizing Disorders in Children

With the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-IV Fourth Edition-Text Revision. Author, Washington, DC. 2000) ahead, decisions will be made about the future of taxonomic conceptualizations. This study examined the factor structure of items from three internalizing disorders (Social Phobia, Generalized Anxiety Disorder, and Depression) on the Anxiety Disorders Interview Schedule for DSM-IV-Child Version (Silverman, W. K., & Albano, A. M. Anxiety disorders interview schedule for children for DSM-IV, child and parent versions. Psychological Corporation, San Antonio, 1996). Two-, three-, and four-factor models emerged in an exploratory factor analysis. Confirmatory factor analysis provided additional empirical support for the four-factor model over the two- or three-factor models. Implications for the structure of the DSM-V taxonomy in children and adolescents are discussed.     

Perceived agency in retirement and retiree drinking behavior: Job satisfaction as a moderator

Based on recent findings that post-retirement adjustment may be influenced by the conditions leading up to the decision to retire, we examine the impact of individual agency in the retirement decision on problematic drinking behavior, as well as the extent to which such an effect may itself depend upon the valence of the pre-retirement work experience. Using a sample of 304 blue-collar retirees, our findings indicate that, when controlling for pre-retirement drinking behavior, perceptions of retirement as the result of a more forced or involuntary decision are associated with greater alcohol consumption, while perceptions of retirement as the result of a more volitional or voluntary process are associated with lower levels of alcohol consumption and a lower risk of problematic drinking behavior. Our results also indicate that pre-retirement job satisfaction amplifies the former relationship, while attenuating the latter one.     

Implicit theories of intelligence and IQ test performance in adolescents with Generalized Anxiety Disorder

During the past decade, several studies have reported positive effects of cognitive-behavioral therapy (CBT) in the treatment of children and adolescents with mental disorders. One of the most important CBT interventions is to teach children and adolescents to challenge negative thoughts that lead to maladjusted behaviors. Based on the implicit theories of intelligence framework, the main purpose of this study was to test whether an incremental theory manipulation could be used to affect IQ test performance in adolescents with Generalized Anxiety Disorder (GAD). Results showed that patients demonstrated enhanced IQ performance and experienced less state anxiety when they were exposed to an incremental theory of intelligence manipulation. Our findings suggest that incremental theory manipulation provides a useful cognitive strategy for addressing school-related anxiety in adolescents with mental disorders such as GAD.     

Threat interpretation bias as a vulnerability factor in childhood anxiety disorders

The present study examined threat interpretation biases in children 7-12 years of age with separation, social and generalised anxiety disorders (N=15), non-anxious offspring at risk due to parental anxiety (N=16) and non-anxious controls of non-anxious parents (N=14). Children provided interpretations of ambiguous situations to assess cognitive, emotional and behavioural responses. In comparison with non-anxious control children and at-risk children who did not differ from each other, anxious children reported stronger negative emotion and less ability to influence ambiguous situations. These results suggest that threat interpretation bias may be a cognitive factor associated with ongoing childhood anxiety but not a vulnerability factor associated with parental anxiety.