New insights into factors influencing adult height in short SGA children: Results of a large multicentre growth hormone trial

BACKGROUND

Growth hormone (GH) treatment is effective in improving adult height (AH) in short children born SGA. However, there is a wide variation in height gain, even after adjustment for predictive variables. It is therefore important to investigate new factors which can influence the response to GH.

OBJECTIVE

To investigate the efficacy of GH treatment (1 mg/m(2/) day) in short SGA children on AH. To assess the relation between spontaneous catch-up growth after birth and growth during puberty on the total height gain SDS to AH.

PATIENTS

Longitudinal GH trial in 170 children.

RESULTS

Median age at start of GH was 7·1 years and height -3·0 SDS. AH was -1·8 SDS (TH-corrected AH -1·1 SDS) in boys and -1·9 SDS (TH-corrected AH -1·3 SDS) in girls. Spontaneous catch-up growth after birth was ≥0·5 SDS in 42% of children. In contrast to expectation, spontaneous catch-up growth was negatively correlated with total height gain SDS during GH (P = 0·009). During puberty, height SDS declined (-0·4 SDS in boys and -0·5 SDS in girls) resulting in a lower total height gain SDS than expected. Pubertal height gain was 25·5 cm in boys and 15·3 cm in girls, significantly lower compared to AGA children (P < 0·001). At onset of puberty, BA for boys and girls was moderately advanced (P = 0·02 and P < 0·001, respectively). Growth velocity was comparable to AGA children during the first two years of puberty, but thereafter significantly lower until reaching AH (P < 0·001).

CONCLUSION

In contrast to our hypothesis, children with greater spontaneous catch-up growth after birth show a lower total height gain SDS during GH. Height SDS declines from mid-puberty, due to a marked early deceleration of growth velocity.

[Scientific and practical contribution of G.M. Zarakovskiy to domestic psychophysiology development (to the 90th anniversary)]

This article presents the main directions and outcomes of G.M. Zarakovskiy researches of psychophysiological characteristics and human capabilities for them accounting in designing and defining the conditions and organization of human operator activity in order to improve the performance and reliability of professional labour. The article contains the main dates of his life and work at the Military Medical Academy, Institute of Aviation and Space Medicine, and in the all-Russian Research Institute of Technical Aesthetics and conceptual views and approaches of G.M. Zarakovskiy to solving actual problems of psychology and psychophysiology of labour as a condition for improving the quality of life of the population and the innovative development of the economy of the country.

Coping styles: longitudinal development from ages 17 to 33 and associations with psychiatric disorders

Relationships of coping styles to maturation, sex, and psychiatric diagnoses are not well defined. Accordingly, we examined their development from late-adolescence into adulthood, and their associations with psychiatric disorders. We assessed coping styles in 970 subjects prospectively, at mean ages 17, 24, 29, and 33, using the Coping Inventory for Stressful Situations. Selected DSM-IV-TR lifetime psychiatric disorders were assessed at age 24. We found that reliance on adaptive task-oriented coping (TOC) increased sharply from ages 17 to 24, (effect size [ES]=0.94), and stabilized thereafter; less adaptive emotion-oriented coping (EOC) declined continuously over time. Men and women had similar TOC scores from ages 17 to 33, but women had moderately higher EOC scores at age 17 (ES=0.53). Greater reliance on EOC at age 24 was associated with more major depressive or anxiety disorders, adjusted for stressors and sex. Greater use of TOC at age 17 was associated with less risk for drug or alcohol abuse/dependence by age 24 after adjusting for sex and stressors. In conclusion, coping styles generally became more adaptive with maturation, though women used EOC more than men. Additionally, greater reliance on TOC in late-adolescence may reduce risks for substance use disorders.

Childhood adversity, midlife generativity, and later life well-being

OBJECTIVES

Prior studies confirm that after experiencing childhood adversity, resilient adults can recover and engage in generative growth. This study explored the long-term effects of childhood adversity (assessed as harsh parenting and/or childhood poverty) on successful aging for individuals who either achieved or failed to achieve Erikson's psychosocial developmental stage of generativity in midlife.

METHOD

The study utilized a sample of 636 men from the Harvard Sample and Inner City Cohort of the 73-year longitudinal Study of Adult Development. Nested ordinary least squares regression models were used to test the mediating and moderating effects of midlife generativity on later life health and adjustment to aging.

RESULTS

Men who experienced childhood adversity were less likely than men with no childhood adversity to achieve generativity in midlife. Although achievement of generativity was associated with better later life health and adjustment to aging, it neither mediated nor moderated the negative relation between childhood poverty and later life health outcomes. However, for men who experienced an adversarial childhood, achievement of generativity mediated and moderated adjustment to aging.

DISCUSSION

Results suggest that psychosocial growth in adulthood can compensate for the long-term negative effects of an adversarial childhood on adjustment to aging, but not for later life health.

Early development, stress and depression across the life course: pathways to depression in a national British birth cohort

BACKGROUND

The aetiology of depression is multifactorial, with biological, cognitive and environmental factors across the life course influencing risk of a depressive episode. There is inconsistent evidence linking early life development and later depression. The aim of this study was to investigate relationships between low birthweight (LBW), infant neurodevelopment, and acute and chronic stress as components in pathways to depression in adulthood.

METHOD

The sample included 4627 members of the National Survey of Health and Development (NSHD; the 1946 British birth cohort). Weight at birth, age of developmental milestones, economic deprivation in early childhood, acute stressors in childhood and adulthood, and socio-economic status (SES) in adulthood were assessed for their direct and indirect effects on adolescent (ages 13 and 15 years) and adult (ages 36, 43 and 53 years) measures of depressive symptoms in a structural equation modelling (SEM) framework. A structural equation model developed to incorporate all variables exhibited excellent model fit according to several indices.

RESULTS

The path of prediction from birthweight to age of developmental milestones to adolescent depression/anxiety to adult depression/anxiety was significant (p < 0.001). Notably, direct paths from birthweight (p = 0.25) and age of developmental milestones (p = 0.23) to adult depression were not significant. Childhood deprivation and stressors had important direct and indirect effects on depression. Stressors in adulthood were strongly associated with adult depression.

CONCLUSIONS

Depression in adulthood is influenced by an accumulation of stressors across the life course, including many that originate in the first years of life. Effects of early-life development on mental health appear by adolescence.

Personality change associated with chronic diseases: pooled analysis of four prospective cohort studies

BACKGROUND

Common chronic conditions, such as heart disease and cancer, are associated with increased psychological distress, functional limitations and shortened life expectancy, but whether these diseases alter aspects of personality remains unclear.

METHOD

To examine whether the onset of heart disease, stroke, diabetes, cancer, hypertension, arthritis and respiratory disease is associated with subsequent changes in personality traits of the five-factor model, we pooled data from the Health and Retirement Study, the Midlife in the United States Survey, and the graduate and sibling samples of the Wisconsin Longitudinal Study for an individual-participant meta-analysis (total n=17,493; mean age at baseline 55.8 years).

RESULTS

After adjustment for age, we observed consistent decreases in extraversion [-0.25 T-scores per one disease; 95% confidence interval (CI) -0.40 to -0.10], emotional stability (-0.40, 95% CI -0.61 to -0.19), conscientiousness (-0.44, 95% CI -0.57 to -0.30) and openness to experience (-0.25, 95% CI -0.37 to -0.13) but not in agreeableness (-0.05, 95% CI -0.19 to 0.08) after the onset of chronic diseases. The onset of each additional chronic disease accelerated the average age-related personality change by 2.5 years in decreasing extraversion, 5.5 years in decreasing conscientiousness, and 1.6 years in decreasing openness to experience, and attenuated the increasing levels of emotional stability by 1.9 years. Co-morbid conditions were associated with larger changes than single diseases, suggesting a dose-response association between morbidity and personality change.

CONCLUSIONS

These results support the hypothesis that chronic diseases influence personality development in adulthood.

Correlates of cognitive change

Although there has been considerable interest in identifying potential correlates of cognitive change, results of past studies have been inconsistent. The present study incorporated a number of methodological features intended to maximize sensitivity to detect characteristics of individuals with different amounts of cognitive change. Cognitive change in 5 cognitive abilities was analyzed with 2nd-order latent growth curve models applied to data from a moderately large sample of healthy adults ranging from 18 to 99 years of age (Ns of 4,802 with 1 occasion, 2,265 with 2 occasions, and 1,128 with 3 occasions). There was significant individual difference variance in the longitudinal changes in several cognitive abilities, even in separate analyses of individuals between 18 years of age and 39, between 40 and 64, and 65 and over. Potential correlates of change included measures of self-rated health, vision, mood, personality, and lifestyle. Most of the potential correlates of change had high reliability, and several analyses were based on even more reliable factors determined by the variance common to multiple measures. Despite favorable conditions for detecting correlates of change, there was little evidence that cognitive change was moderated by any of the variables examined. Possible reasons for the inconsistent results regarding correlates of cognitive change are discussed.

Heritability of brain volume change and its relation to intelligence

Human brain volumes change throughout life, are highly heritable, and have been associated with general cognitive functioning. Cross-sectionally, this association between volume and cognition can largely be attributed to the same genes influencing both traits. We address the question whether longitudinal changes in brain volume or in surface area in young adults are under genetic control and whether these changes are also related to general cognitive functioning. We measured change in brain volume and surface area over a 5-year interval in 176 monozygotic and dizygotic twins and their non-twin siblings aged 19 to 56, using magnetic resonance imaging. Results show that changes in volumes of total brain (mean = -6.4 ml; 0.5% loss), cerebellum (1.4 ml, 1.0% increase), cerebral white matter (4.4 ml, 0.9% increase), lateral ventricles (0.6 ml; 4.8% increase) and in surface area (-19.7 cm(2),1.1% contraction) are heritable (h(2) = 43%; 52%; 29%; 31%; and 33%, respectively). An association between IQ (available for 91 participants) and brain volume change was observed, which was attributed to genes involved in both the variation in change in brain volume and in intelligence. Thus, dynamic changes in brain structure are heritable and may have cognitive significance in adulthood.

Reflections on widowhood and its effects on the self

Widowhood has not been written about extensively. Recent books in the mainstream press have focused on the experience of the acute loss. This paper describes the experience of widowhood of the author and of several other women after long marriages. It considers issues around the acute loss but also on the effects on the "self" over many years and on the adaptations and developmental changes that can occur in later years. These are related to previous aspects of the personality of each person. Psychological development can take place at the same time as the process of mourning. Implications of this experience for clinical work are discussed.

Maturation of the human dorsolateral prefrontal cortex coincides with a dynamic shift in microRNA expression

MicroRNA are small RNAs that provide specificity for the RNA induced silencing complex, which forms the basis of an exquisite combinatorial system for posttranscriptional regulation. This system, essential for complex metazoans, is exemplified in the development of the cerebral cortex. To explore the complexity of human cortical miRNA expression in detail, we analyzed RNA from postmortem prefrontal cortex from 97 subjects aged 2 months to 78 years using miRNA microarray. Global miRNA expression was highest in the early years before declining significantly after adolescence (n = 140 decreased, n = 32 increased). Late adolescence was also marked by an inflection point between miRNA on an upward trajectory vs the majority going down. Functional annotation of target genes displaying inverse mRNA expression patterns in the same tissue were overrepresented in neurodevelopmentally significant pathways including neurological disease (most significantly schizophrenia), nervous system development, and cell-to-cell signaling. As mature miRNA expression is largely posttranscriptionally regulated, miRNA biogenesis gene expression was also examined. Dicer and Exportin-5 displayed significant associations with age; however, neither correlated with global miRNA expression across the lifespan. This investigation of cortical miRNA expression provides a framework for understanding the complex posttranscriptional regulatory environment during development and aging that may form a substrate for changes observed in neurodevelopmental disorders.

Mixture modeling methods for the assessment of normal and abnormal personality, part II: longitudinal models

Studying personality and its pathology as it changes, develops, or remains stable over time offers exciting insight into the nature of individual differences. Researchers interested in examining personal characteristics over time have a number of time-honored analytic approaches at their disposal. In recent years there have also been considerable advances in person-oriented analytic approaches, particularly longitudinal mixture models. In this methodological primer we focus on mixture modeling approaches to the study of normative and individual change in the form of growth mixture models and ipsative change in the form of latent transition analysis. We describe the conceptual underpinnings of each of these models, outline approaches for their implementation, and provide accessible examples for researchers studying personality and its assessment.

The trajectory of depressive symptoms across the adult life span

IMPORTANCE

Long-term longitudinal studies are needed to delineate the trajectory of depressive symptoms across adulthood and to individuate factors that may contribute to increases in depressive symptoms in older adulthood.

OBJECTIVES

To estimate the trajectory of depressive symptoms across the adult life span; to test whether this trajectory varies by demographic factors (sex, ethnicity, and educational level) and antidepressant medication use; and to test whether disease burden, functional limitations, and proximity to death explain the increase in depressive symptoms in old age.

DESIGN

Longitudinal study.

SETTING

Community.

PARTICIPANTS

The study included 2320 participants (47.0% female; mean [SD] age at baseline, 58.1 [17.0] years; range, 19-95 years) from the Baltimore Longitudinal Study of Aging.

MAIN OUTCOMES AND MEASURES

Estimated trajectory of depressive symptoms modeled from 10, 982 assessments (mean [SD] assessments per participant, 4.7 [3.6]; range, 1-21) based on the Center for Epidemiologic Studies Depression scale and 3 subscales (depressed affect, somatic complaints, and interpersonal problems).

RESULTS

The linear (γ10 = 0.52; P < .01) and quadratic (γ20 = 0.43; P < .01) terms were significant, which indicated that depressive symptoms were highest in young adulthood, decreased across middle adulthood, and increased again in older adulthood. The subscales followed a similar pattern. Women reported more depressed affect at younger ages, but an interaction with age suggested that this gap disappeared in old age. Accounting for comorbidity, functional limitations, and impending death slightly reduced but did not eliminate the uptick in depressive symptoms in old age.

CONCLUSIONS AND RELEVANCE

Symptoms of depression follow a U-shaped pattern across adulthood. Older adults experience an increase in distress that is not due solely to declines in physical health or approaching death.

Identity dimensions and related processes in emerging adulthood: helpful or harmful?

OBJECTIVES

The current study evaluated the mediational role of well-being in the relationship between identity development and psychosocial functioning.

METHOD

A sample of 7,649 undergraduate students (73% female; mean age = 19.95, standard deviation = 1.98; 62% Caucasian) completed measures of personal identity, well-being, internalizing symptoms, externalizing problems, and health-risk behaviors.

RESULTS

Results revealed that (a) identity exploration and commitment were negatively associated with internalizing symptoms, health-risk behaviors, and externalizing problems through well-being, (b) ruminative exploration was negatively associated with well-being and positively associated with externalizing problems, and (c) increased levels of ruminative exploration appear more detrimental for men than for women.

CONCLUSION

The study shed light on the mechanisms through which identity processes are related to internalizing symptoms, externalizing problems, and health-risk behaviors. The role of well-being in these associations, and the potentially deleterious "side effects" of exploration and commitment appear to suggest new and important directions for identity research.

The effect of birth cohort on well-being: the legacy of economic hard times

In the present research, we examined the effects of age, cohort, and time of measurement on well-being across adulthood. Cross-sectional and longitudinal analyses of two independent samples-one with more than 10,000 repeated assessments across 30 years (mean assessments per participant = 4.44, SD = 3.47) and one with nationally representative data-suggested that well-being declines with age. This decline, however, reversed when we controlled for birth cohort. That is, once we accounted for the fact that older cohorts had lower levels of well-being, all cohorts increased in well-being with age relative to their own baseline. Participants tested more recently had higher well-being, but time of measurement, unlike cohort, did not change the shape of the trajectory. Although well-being increased with age for everyone, cohorts that lived through the economic challenges of the early 20th century had lower well-being than those born during more prosperous times.

Effect of obesity on linear growth

PURPOSE OF REVIEW

To describe our current understanding of the mechanisms involved in the regulation of linear growth in childhood obesity.

RECENT FINDINGS

The developmental origins hypothesis has focused on low birth weight individuals with subsequent obesity, identifying a cascade of neuroendocrine regulatory factors involved in the progressive increase in body fat and metabolic risk. Yet, tall stature is the common clinical outcome of childhood obesity. Recent data have expanded our understanding of environmental influences on developing systems. Here, we review the elements of neuroendocrine systems contributing to the integration of metabolic controls involved in growth regulation in the obese child with particular emphasis on growth hormone, ghrelin, insulin-like growth factors and insulin.

SUMMARY

Growth patterns of obesity during childhood are well described, documenting increased linear growth in early childhood associated with accelerated pubertal maturation resulting in normal adult height. Despite recent data suggesting that ghrelin and the growth hormone secretagogue receptor, as well as the insulin-like growth factors, their binding proteins and insulin have potential to be mediators of nutrient exposure and linear growth, it remains to be determined how these systems interrelate and determine growth. This is an area of ongoing investigation.

Economic drivers and consequences of stunting

This paper reviews evidence addressing four questions pertinent to the understanding of the economic returns to investing in nutrition: (a) Where are the promising areas of interface between economics and nutrition? (b) What is the contribution of income growth to improving nutrition? (c) Is adult chronic disease being given too little consideration in nutrition programs? (d) More generally, are we using the right outcome measures to assess nutrition interventions?

Visual perceptual strengths and weaknesses in adults with intellectual disabilities compared with a birth year-matched norm

BACKGROUND

The ventral and dorsal streams are considered to be the brain substrates of vision for perception and action, respectively. Using the Developmental Test of Visual Perception (DTVP), the current study examined whether visual perceptual strengths and weaknesses in adults with intellectual disabilities (ID) were attributable to the dichotomy of the visual streams.

METHOD

In study 1, DTVP performance was compared among mild, moderate and severe adult ID groups; study 2 contrasted adult ID groups with and without Down syndrome (DS). To prevent possible contamination by the Flynn effect, participants were matched by birth year with the norm of the DTVP original edition.

RESULTS

Independent of the extent of ID among the three groups in study 1 and the aetiological group difference in study 2, relative strength was found for two DTVP tasks: eye-hand coordination and distinguishing target figures from interference background. Relative weakness was obtained in identifying a figural category. Participants with DS demonstrated exceptional weakness in discerning a target from either mirror-imaged or rotated alternatives, in addition to figural-category detection.

CONCLUSIONS

Visual perceptual strengths and weaknesses in persons with ID were difficult to explain on the basis of two visual streams. An interpretation originating in a different research context (e.g. frontal-lobe dysfunction) appears to be required for explaining visual perceptual weaknesses in persons with ID. For persons with DS, strong frontal-lobe dysfunction with atypical lateralisation might be the pathological determinant of visual perceptual weaknesses.

A four-stage model explaining the higher risk of Type 2 diabetes mellitus in South Asians compared with European populations

With approximately 1.5 billion people at risk, the staggeringly high risk of Type 2 diabetes in South Asians comprises a global problem. The causes of this high risk are complex, with 23 major risk factors identified in a Lancet seminar. This paper proposes a four-stage explanatory model: (1) the birth of a small, adipose, lowlean mass South Asian baby--the phenotype tracking through life; (2) in childhood and early adulthood, the deposition of any excess energy intake preferentially in upper body and ectopic fat stores rather than in the lower body or superficial subcutaneous fat stores; (3) as a consequence of points 1 and 2, and exacerbated by an environment of low physical activity and excess calories, the accelerated appearance of high levels of plasma insulin, triglycerides and glucose, and the fatty-liver vicious cycle; (4) β-cell failure as a result of fewer β-cells at birth, exposure to apoptotic triggers such as fat in the pancreas, and high demand from insulin resistance, which causes diabetes. Other risk factors--especially energy-dense hyperglycaemic diet and low physical activity--play into this pathway. The recommended behavioural changes fit with this model, which brings clarity to guide future research, policy, practice and health promotion.

Fetal programming effects of testosterone on the reward system and behavioral approach tendencies in humans

BACKGROUND

Sex differences are present in many neuropsychiatric conditions that affect emotion and approach-avoidance behavior. One potential mechanism underlying such observations is testosterone in early development. Although much is known about the effects of testosterone in adolescence and adulthood, little is known in humans about how testosterone in fetal development influences later neural sensitivity to valenced facial cues and approach-avoidance behavioral tendencies.

METHODS

With functional magnetic resonance imaging we scanned 25 8-11-year-old children while viewing happy, fear, neutral, or scrambled faces. Fetal testosterone (FT) was measured via amniotic fluid sampled between 13 and 20 weeks gestation. Behavioral approach-avoidance tendencies were measured via parental report on the Sensitivity to Punishment and Sensitivity to Rewards questionnaire.

RESULTS

Increasing FT predicted enhanced selectivity for positive compared with negatively valenced facial cues in reward-related regions such as caudate, putamen, and nucleus accumbens but not the amygdala. Statistical mediation analyses showed that increasing FT predicts increased behavioral approach tendencies by biasing caudate, putamen, and nucleus accumbens but not amygdala to be more responsive to positive compared with negatively valenced cues. In contrast, FT was not predictive of behavioral avoidance tendencies, either through direct or neurally mediated paths.

CONCLUSIONS

This work suggests that testosterone in humans acts as a fetal programming mechanism on the reward system and influences behavioral approach tendencies later in life. As a mechanism influencing atypical development, FT might be important across a range of neuropsychiatric conditions that asymmetrically affect the sexes, the reward system, emotion processing, and approach behavior.