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Hocking MC, Schultz RT, Yerys BE, Minturn JE, Fantozzi P, Herrington JD. White matter connectivity and social functioning in survivors of pediatric brain tumor. J Neurooncol 2024:10.1007/s11060-024-04724-0. [PMID: 38837018 DOI: 10.1007/s11060-024-04724-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 05/25/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE Survivors of pediatric brain tumors (SPBT) are at risk for social deficits, fewer friendships, and poor peer relations. SPBT also experience reduced brain connectivity via microstructural disruptions to white matter from neurological insults. Research with other populations implicates white matter connectivity as a key contributor to poor social functioning. This case-controlled diffusion-weighted imaging study evaluated structural connectivity in SPBT and typically developing controls (TDC) and associations between metrics of connectivity and social functioning. METHODS Diffusion weighted-imaging results from 19 SPBT and 19 TDC were analyzed using probabilistic white matter tractography. Survivors were at least 5 years post-diagnosis and 2 years off treatment. Graph theory statistics measured group differences across several connectivity metrics, including average strength, global efficiency, assortativity, clustering coefficient, modularity, and betweenness centrality. Analyses also evaluated the effects of neurological risk on connectivity among SPBT. Correlational analyses evaluated associations between connectivity and indices of social behavior. RESULTS SPBT demonstrated reduced global connectivity compared to TDC. Several medical factors (e.g., chemotherapy, recurrence, multimodal therapy) were related to decreased connectivity across metrics of integration (e.g., average strength, global efficiency) in SPBT. Connectivity metrics were related to peer relationship quality and social challenges in the SPBT group and to social challenges in the total sample. CONCLUSIONS Microstructural white matter connectivity is diminished in SPBT and related to neurological risk and peer relationship quality. Additional neuroimaging research is needed to evaluate associations between brain connectivity metrics and social functioning in SPBT.
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Affiliation(s)
- Matthew C Hocking
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- The University of Pennsylvania, Philadelphia, PA, USA.
| | - Robert T Schultz
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- The University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin E Yerys
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- The University of Pennsylvania, Philadelphia, PA, USA
| | - Jane E Minturn
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- The University of Pennsylvania, Philadelphia, PA, USA
| | - Peter Fantozzi
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - John D Herrington
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- The University of Pennsylvania, Philadelphia, PA, USA
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2
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Remaud J, Besnard J, Barbarot S, Roy A. Social cognition in children with neurofibromatosis type 1. J Clin Exp Neuropsychol 2024; 46:374-381. [PMID: 38678397 DOI: 10.1080/13803395.2024.2348214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 04/21/2024] [Indexed: 04/30/2024]
Abstract
INTRODUCTION Neurofibromatosis type 1 (NF1) is a genetic pathology that can lead to impaired social functioning that has a negative impact on patients' quality of life. To date, although the hypothesis of impaired social cognition has been proposed as a potential explanation for these difficulties, very few studies have focused on theory of mind in children with NF1. Furthermore, other complex sociocognitive abilities have never been investigated. The aim of the present study was to assess theory of mind, moral reasoning, and social information processing in children with NF1 compared with a control group. METHOD We administered the Paediatric Evaluation of Emotions, Relationships and Socialization® to 38 children with NF1 aged between 8 years and 16 years 11 months (mean = 11.4, SD = 2.3) and 43 control children with comparable sociodemographic characteristics. RESULTS Patients performed significantly worse than controls on moral reasoning and social information processing tests, but there was no significant difference on theory of mind. CONCLUSIONS These results seem to confirm the presence of social cognition difficulties in NF1 that could explain, at least in part, their social difficulties, although not all dimensions are concerned. The differences between the processes we assessed are discussed in relation to the methodologies used to measure them, and raises questions about the complementarity of traditional tools and more ecological assessments.
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Affiliation(s)
- Julie Remaud
- Pays de la Loire Psychology Laboratory (LPPL), SFR Confluences, Universities of Angers & Nantes, Angers, France
| | - Jérémy Besnard
- Pays de la Loire Psychology Laboratory (LPPL), SFR Confluences, Universities of Angers & Nantes, Angers, France
| | - Sébastien Barbarot
- Nantes Neurofibromatosis Expert Center, Nantes University Hospital, Nantes, France
| | - Arnaud Roy
- Pays de la Loire Psychology Laboratory (LPPL), SFR Confluences, Universities of Angers & Nantes, Angers, France
- Nantes Neurofibromatosis Expert Center, Nantes University Hospital, Nantes, France
- Reference Center for Learning Disabilities, Nantes University Hospital, Nantes, France
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3
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Brænden A, Coldevin M, Zeiner P, Stubberud J, Melinder A. Neuropsychological mechanisms of social difficulties in disruptive mood dysregulation disorder versus oppositional defiant disorder. Child Neuropsychol 2024; 30:402-424. [PMID: 37106502 DOI: 10.1080/09297049.2023.2205632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
Children with Disruptive Mood Dysregulation Disorder (DMDD) or Oppositional Defiant Disorder (ODD) are characterized by irritability and social difficulties. However, the mechanisms underlying these disorders could be different. This study explores differences in social cognition and executive function (EF) across DMDD and ODD and the influence of these factors and their interaction on social problems in both groups. Children with DMDD (n = 53, Mage = 9.3) or ODD (n = 39, Mage = 9.6) completed neuropsychological tasks measuring social cognition (Theory of Mind and Face-Emotion Recognition) and EF (cognitive flexibility, inhibition, and working memory). Parents reported social problems. More than one-third of the children with DMDD and almost two-thirds of those with ODD showed clear difficulties with Theory of Mind. Most children with DMDD (51-64%) or ODD (67-83%) showed difficulties with EF. In children with DMDD, worse EF (β = -.36) was associated with more social problems, whereas in children with ODD, better EF (β = .44) was associated with more social problems. In those with ODD, but not in those with DMDD, the interaction between social cognition and EF contributed to the explained variance of social problems (β = -1.97). Based on the observed interaction pattern, enhanced EF may lead to increased social problems among children with ODD who also exhibit social cognition difficulties. This study suggests the existence of distinct neuropsychological mechanisms underlying the social issues observed in children with DMDD versus those with ODD.
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Affiliation(s)
- Astrid Brænden
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marit Coldevin
- Lovisenberg Diaconal Hospital, Nic Waals Institute, Oslo, Norway
| | - Pål Zeiner
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jan Stubberud
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Annika Melinder
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
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Khan N, Anderson V, Crossley L, Hearps S, Catroppa C, Ryan NP. Nature and correlates of self-esteem in young adult survivors of childhood traumatic brain injury. Neuropsychol Rehabil 2024:1-17. [PMID: 38466215 DOI: 10.1080/09602011.2024.2326428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/23/2024] [Indexed: 03/12/2024]
Abstract
Despite growing research linking childhood traumatic brain injury (TBI) with reduced wellbeing, self-esteem, and psycho-social health, very few studies have examined self-esteem and its correlates in young adult survivors of childhood TBI. This very-long-term follow-up study evaluated self-esteem in 29 young adults with a history of childhood TBI (M time since injury = 13.84 years; SD = 0.74), and 10 typically developing controls (TDCs). All participants were originally recruited into a larger, longitudinal case-control study between 2007 and 2010. In the current follow-up study, both groups completed well-validated measures of self-esteem and mental health in young adulthood. Although group means for self-esteem did not significantly differ between TBI and TDC groups, a higher proportion of TBI participants rated their self-esteem in the clinical range (TBI group = 17%; TDC group = 0%). While self-esteem was not significantly associated with injury or pre-injury child or family characteristics, lower self-esteem was significantly correlated with greater concurrent feelings of loneliness (p = 0.007) and higher concurrent mood symptoms (p < 0.001).Our results suggest that social isolation and low mood may represent meaningful targets for psycho-social interventions to address poor self-worth in young adults with a history of childhood TBI.
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Affiliation(s)
- Noor Khan
- Brain and Mind, Murdoch Children's Research Institute, Parkville, Australia
- Psychological Sciences, University of Melbourne, Parkville, Australia
| | - Vicki Anderson
- Brain and Mind, Murdoch Children's Research Institute, Parkville, Australia
- Psychological Sciences, University of Melbourne, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
- Department of Psychology, Royal Children's Hospital, Parkville, Australia
| | - Louise Crossley
- Brain and Mind, Murdoch Children's Research Institute, Parkville, Australia
| | - Stephen Hearps
- Brain and Mind, Murdoch Children's Research Institute, Parkville, Australia
| | - Cathy Catroppa
- Brain and Mind, Murdoch Children's Research Institute, Parkville, Australia
- Psychological Sciences, University of Melbourne, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
- Department of Psychology, Royal Children's Hospital, Parkville, Australia
| | - Nicholas P Ryan
- Brain and Mind, Murdoch Children's Research Institute, Parkville, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
- School of Psychology, Deakin University, Burwood, Australia
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Chapados P, Provencher S, Aramideh J, Dumont É, Lugasi T, Laverdière C, Sultan S, Desjardins L. Transition Readiness Assessment Questionnaire: Skill gaps and psychosocial predictors of transition readiness among adolescents and young adults with chronic medical conditions. Child Care Health Dev 2024; 50:e13156. [PMID: 37535469 DOI: 10.1111/cch.13156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 04/26/2023] [Accepted: 07/02/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Transferring from paediatric to adult care can be challenging. Adolescents and young adults (AYAs) with chronic health conditions need to develop a specific set of skills to ensure lifelong medical follow-up due to the chronicity of their condition. The Transition Readiness Assessment Questionnaire-French version (TRAQ-FR) is a 19-item questionnaire measuring such skills. The aims of the study were to (1) describe participant characteristics and (2) identify constructs related to, and predictors of, having learned domain-specific transition readiness skills. METHODS Participants included 216 AYAs aged 14-20 years (M = 15.93; SD = 1.35; 54.1% male) recruited from five outpatient clinics in a Canadian tertiary hospital. AYAs completed the TRAQ-FR, the Pediatric Quality of Life Inventory 4.0 (PedsQL) and a sociodemographic questionnaire. Descriptive, bivariate and binary logistic regression analyses were conducted. RESULTS Overall, participants reported significantly higher scores on the Talking with Providers, Managing Daily Activities and Managing Medications subscales than on the Appointment Keeping and Tracking Health Issues subscales (F[41075] = 168.970, p < .001). At the item level, median scores (on a 5-point Likert scale) suggest that AYAs had begun practising five of the 19 skills (median scores ≥4; 'Yes, I have started doing this'), while a median score of 1 ('No, I don't know how') was found for one item ('Do you get financial help with school or work?'). At the subscale level, TRAQ-FR skills and skill gaps were related to AYAs' age, sex and PedsQL scores (ps < .05). CONCLUSION Older and female AYAs were more likely to have begun practising specific TRAQ-FR subscale skills. Better psychosocial functioning was also related to having learned specific transition readiness skills. AYAs show several gaps in transition readiness. Targeted intervention in transition readiness skill development could take into account AYAs' age, sex and psychosocial functioning for a successful transfer to adult care.
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Affiliation(s)
- Pascale Chapados
- Sainte-Justine University Health Centre, Montreal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | | | - Jennifer Aramideh
- Sainte-Justine University Health Centre, Montreal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Émilie Dumont
- Sainte-Justine University Health Centre, Montreal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Tziona Lugasi
- Sainte-Justine University Health Centre, Montreal, Quebec, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Centre, Montreal, Quebec, Canada
- Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
| | - Serge Sultan
- Sainte-Justine University Health Centre, Montreal, Quebec, Canada
- Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
- Department of Psychiatry, Université de Montréal, Montreal, Quebec, Canada
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Soo CA, Tate RL, Catroppa C, Benson S, McDonald S, Rapee RM, Anderson V. A randomized controlled trial of cognitive behavioural therapy for managing anxiety in adolescents with acquired brain injury. Neuropsychol Rehabil 2024; 34:74-102. [PMID: 36534593 DOI: 10.1080/09602011.2022.2154811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
The aim of this randomized controlled trial was to evaluate an adapted cognitive behavioural therapy (CBT) programme for treating anxiety in adolescents with acquired brain injury (ABI). Participants with ABI (12-19 years, N = 36) recruited from two sites were randomly allocated into either the intervention receiving 11 sessions of CBT (n = 19) or a wait-list control group (n = 17). The primary outcome was participants' anxiety and secondary outcomes were participants' depression, self-perception, and participation in daily activities, and parental stress, measured at (i) pre-intervention, (ii) immediately post-intervention, (iii) 2 months post-intervention and (iv) 6 months post-intervention. Repeated measures ANOVAs revealed significant treatment effects with the intervention group demonstrating greater improvements in self-reported anxiety, as well as self- and parent-reported depression from pre- to immediately post-treatment, compared to wait-list controls. Little evidence of treatment effects was found for the remaining outcomes (parent-reported anxiety, self-perception, daily participation, and parental stress). Significant improvement in self-reported anxiety found immediately post-treatment was maintained at two- and six-month follow-up. Findings provide support for adapted CBT as an effective means of reducing anxious and depressive symptomatology in adolescents with ABI compared to waitlist controls, and offer support for the use of these techniques to manage anxiety in this population.
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Affiliation(s)
- Cheryl A Soo
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Robyn L Tate
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, St Leonards, Australia
| | - Cathy Catroppa
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Suzanne Benson
- Rehabilitation Department, Children's Hospital at Westmead, Sydney, Australia
| | - Skye McDonald
- School of Psychology, University of NSW, Sydney, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Vicki Anderson
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Psychology, Royal Children's Hospital, Melbourne, Australia
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Rivella C, Zanetti A, Bertamino M, Primavera L, Moretti P, Viterbori P. Emotional and social functioning after stroke in childhood: a systematic review. Disabil Rehabil 2023; 45:4175-4189. [PMID: 36384380 DOI: 10.1080/09638288.2022.2144490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/02/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To provide an overview of the effects of pediatric stroke on emotional and social functioning in childhood. METHODS A literature review was completed in accordance with the Preferred Reporting Items for Systematic Reviews. A systematic search of studies on internalizing problems and social functioning after pediatric stroke in PsycInfo, PsycArticles, and PubMed databases was conducted from inception to November 2021. A total of 583 studies were identified, and 32 met the inclusion criteria. RESULTS The review suggests that children after stroke are at risk of developing internalizing problems and a wide range of social difficulties. Internalizing problems are often associated with environmental factors such as family functioning and parents' mental health. In addition, a higher risk of developing psychosocial problems is associated with lower cognitive functioning and severe neurological impairment. CONCLUSIONS The assessment of psychological well-being and social functioning after pediatric stroke is helpful to provide adequate support to children and their families. Future studies are needed to better investigate these domains and to develop adequate methodologies for specific interventions.Implication for rehabilitationThis paper reviews research concerning emotional and social functioning following pediatric stroke in order to provide helpful information to clinicians and families and to improve rehabilitation pathways.Emotional and social functioning should be addressed during post-stroke evaluation and follow-up, even when physical and cognitive recovery is progressing well.Care in pediatric stroke should include volitional treatment and address emotional and social issues.
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Affiliation(s)
- Carlotta Rivella
- Department of Educational Science, University of Genoa, Genoa, Italy
| | - Alice Zanetti
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marta Bertamino
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Paolo Moretti
- Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Paola Viterbori
- Department of Educational Science, University of Genoa, Genoa, Italy
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8
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Merkley TL, Halter C, Graul B, Gale SD, Junge C, Reading M, Jarvis S, Greer K, Squires C, Bigler ED, Taylor HG, Vannatta K, Gerhardt CA, Rubin KH, Stancin T, Yeates KO, Cobia D. Regional Cortical Thickness Correlates of Intellectual Abilities Differ in Children With Traumatic Brain Injury Versus Those With Orthopedic Injury in the Chronic Post-Injury Phase. J Neurotrauma 2023; 40:2063-2072. [PMID: 37294204 PMCID: PMC10623066 DOI: 10.1089/neu.2022.0524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
A decline in intellectual functioning (intelligence quotient [IQ]) is often observed following more severe forms of traumatic brain injury (TBI) and is a useful index for long-term outcome. Identifying brain correlates of IQ can serve to inform developmental trajectories of behavior in this population. Using magnetic resonance imaging (MRI), we examined the relationship between intellectual abilities and patterns of cortical thickness in children with a history of TBI or with orthopedic injury (OI) in the chronic phase of injury recovery. Participants were 47 children with OI and 58 children with TBI, with TBI severity ranging from complicated-mild to severe. Ages ranged from 8 to 14 years old, with an average age of 10.47 years, and an injury-to-test range of ∼1-5 years. The groups did not differ in age or sex. The intellectual ability estimate (full-scale [FS]IQ-2) was derived from a two-form (Vocabulary and Matrix Reasoning subtests) Wechsler Abbreviated Scale of Intelligence (WASI). MRI data were processed using the FreeSurfer toolkit and harmonized across data collection sites using neuroComBat procedures, while holding demographic features (i.e., sex, socioeconomic status [SES]), TBI status, and FSIQ-2 constant. Separate general linear models per group (TBI and OI) and a single interaction model with all participants were conducted with all significant results withstanding correction for multiple comparisons via permutation testing. Intellectual ability was higher (p < 0.001) in the OI group (FSIQ-2 = 110.81) than in the TBI group (FSIQ-2 = 99.81). In children with OI, bi-hemispheric regions, including the right pre-central gyrus and precuneus and bilateral inferior temporal and left occipital areas were related to IQ, such that higher IQ was associated with thicker cortex in these regions. In contrast, only cortical thickness in the right pre-central gyrus and bilateral cuneus positively related to IQ in children with TBI. Significant interaction effects were found in the bilateral temporal, parietal, and occipital lobes and left frontal regions, indicating that the relationship between IQ and cortical thickness differed between groups in these regions. Changes in cortical associations with IQ after TBI may reflect direct injury effects and/or adaptation in cortical structure and intellectual functioning, particularly in the bilateral posterior parietal and inferior temporal regions. This suggests that the substrates of intellectual ability are particularly susceptible to acquired injury in the integrative association cortex. Longitudinal work is needed to account for normal developmental changes and to investigate how cortical thickness and intellectual functioning and their association change over time following TBI. Improved understanding of how TBI-related cortical thickness alterations relate to cognitive outcome could lead to improved predictions of outcome following brain injury.
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Affiliation(s)
- Tricia L. Merkley
- Department of Psychology and Brigham Young University, Provo, Utah, USA
- Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - Colt Halter
- Department of Psychology and Brigham Young University, Provo, Utah, USA
| | - Benjamin Graul
- Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - Shawn D. Gale
- Department of Psychology and Brigham Young University, Provo, Utah, USA
- Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - Chase Junge
- Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - Madeleine Reading
- Department of Psychology and Brigham Young University, Provo, Utah, USA
| | - Sierra Jarvis
- Department of Psychology and Brigham Young University, Provo, Utah, USA
| | - Kaitlyn Greer
- Department of Psychology and Brigham Young University, Provo, Utah, USA
| | - Chad Squires
- Department of Psychology and Brigham Young University, Provo, Utah, USA
| | - Erin D. Bigler
- Department of Psychology and Brigham Young University, Provo, Utah, USA
- Neuroscience Center, Brigham Young University, Provo, Utah, USA
| | - H. Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kathryn Vannatta
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Departments of Pediatrics and Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Cynthia A. Gerhardt
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
- Departments of Pediatrics and Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Kenneth H. Rubin
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland, USA
| | - Terry Stancin
- MetroHealth System, Case Western Reserve University, Cleveland, Ohio, USA
| | - Keith Owen Yeates
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Derin Cobia
- Department of Psychology and Brigham Young University, Provo, Utah, USA
- Neuroscience Center, Brigham Young University, Provo, Utah, USA
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Anderson V, Hearps SJC, Catroppa C, Beauchamp MH, Ryan NP. What predicts persisting social impairment following pediatric traumatic brain injury: contribution of a biopsychosocial approach. Psychol Med 2023; 53:3568-3579. [PMID: 35189999 PMCID: PMC10277758 DOI: 10.1017/s0033291722000186] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Psychosocial deficits, such as emotional, behavioral and social problems, reflect the most common and disabling consequences of pediatric traumatic brain injury (TBI). Their causes and recovery likely differ from physical and cognitive skills, due to disruption to developing brain networks and the influence of the child's environment. Despite increasing recognition of post-injury behavioral and social problems, there exists a paucity of research regarding the incidence of social impairment, and factors predicting risk and resilience in the social domain over time since injury. METHODS Using a prospective, longitudinal design, and a bio-psychosocial framework, we studied children with TBI (n = 107) at baseline (pre-injury function), 6 months, 1 and 2-years post-injury. We assessed intellectual ability, attention/executive function, social cognition, social communication and socio-emotional function. Children underwent structural magnetic resonance imaging (MRI) at 2-8 weeks post-injury. Parents rated their child's socio-emotional function and their own mental health, family function and perceived burden. RESULTS We distinguished five social recovery profiles, characterized by a complex interplay between environment and pre- and post-TBI factors, with injury factors playing a lesser role. Resilience in social competence was linked to intact family and parent function, intact pre-injury adaptive abilities, post-TBI cognition and social participation. Vulnerability in the social domain was related to poor pre- and post-injury adaptive abilities, greater behavioral concerns, and poorer pre- and post-injury parent health and family function. CONCLUSIONS We identified five distinct social recovery trajectories post-child-TBI, each characterized by a unique biopsychosocial profile, highlighting the importance of comprehensive social assessment and understanding of factors contributing to social impairment, to target resources and interventions to children at highest risk.
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Affiliation(s)
- Vicki Anderson
- Murdoch Children's Research Institute, Flemington Road, Parkville, Victoria, 3052, Australia
- Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia
- University of Melbourne, Flemington Road, Parkville, Victoria, 3052, Australia
| | - Stephen J. C. Hearps
- Murdoch Children's Research Institute, Flemington Road, Parkville, Victoria, 3052, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Flemington Road, Parkville, Victoria, 3052, Australia
- Royal Children's Hospital, Flemington Road, Parkville, Victoria, 3052, Australia
- University of Melbourne, Flemington Road, Parkville, Victoria, 3052, Australia
| | - Miriam H. Beauchamp
- University of Montreal, P.O. Box 6128, Center-ville branch, Montreal, QC, H3C 317, Canada
- St Justine Hospital, Avenue Ellendale, Montreal, QC, Canada
| | - Nicholas P. Ryan
- Murdoch Children's Research Institute, Flemington Road, Parkville, Victoria, 3052, Australia
- Deakin University, 221 Burwood Highway, Burwood, Australia
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10
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Igier S, Valérie P. The role of familiarity with the experimenter on cognitive performance, metacognition, pro-social behaviors, and the well-being of adults with moderate to severe intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:404-418. [PMID: 35426750 DOI: 10.1177/17446295221087544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Few studies have evaluated the explanatory factors of poor performance and the effects of context in adults with intellectual disabilities. The aim of this study is to assess the role of a familiar experimenter on their cognitive performance, well-being, metacognitive experiences, and social behaviors. METHOD Participants with moderate to severe intellectual disability were recruited into two groups, one with a familiar and one with an unfamiliar experimenter. They carried out a categorization task. Before and after they reported their metacognitive experiences and level of well-being. The experimenter observed their pro-social behavior. RESULTS Performance and some social behaviors were better when the participant knew the experimenter. However, he did not affect the level of well-being. The participants' metacognitive experiences were poor, whether or not they knew the experimenter. CONCLUSIONS The familiarity of the experimenter plays a determining role, both on the participants' performance, and on their compliance with certain pro-social behavior.
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Affiliation(s)
- Suzanne Igier
- EA 2114 Psychologie des Ages de la Vie, Université François Rabelais, Tours Cedex, France
| | - Pennequin Valérie
- EA 2114 Psychologie des Ages de la Vie, Université François Rabelais, Tours Cedex, France
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11
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Igoshina E, Wu LC, Moxon-Emre I, Mabbott DJ. Social affective outcomes and brain injury in children and adolescents treated for brain tumours. THE LANCET. CHILD & ADOLESCENT HEALTH 2023:S2352-4642(23)00079-2. [PMID: 37263284 DOI: 10.1016/s2352-4642(23)00079-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/06/2023] [Accepted: 03/21/2023] [Indexed: 06/03/2023]
Abstract
In this Review we critically evaluate the empirical literature investigating the effect of paediatric brain tumours and their treatment on social affective function. We focus specifically on relations between social affective function and compromised brain structure and function associated with treatment for a paediatric brain tumour. We concentrate on emotion recognition and regulation, because these are core components of social affective function. First, we provide an overview of the literature in typically developing children and discuss the underlying brain networks thought to subserve emotion (ie, limbic system and supporting white matter microstructure). We then focus on how damage to brain structure and function after treatment for a paediatric brain tumour might be related to compromised emotion recognition and regulation-as well as broader social affective outcomes. On the basis of our review of the literature across typically developing children and those with a paediatric brain tumour, we suggest that structural changes to fronto-limbic tracts might interrupt social network neural communication in children and adolescents treated for brain tumours. A critical analysis of the reviewed literature suggests a relationship between social affective dysfunction and childhood-acquired injury to white matter microstructure. We argue that the knowledge synthesised regarding paediatric brain tumours could extend to other neurological disorders. Finally, we identify considerations for future investigation and recommend research practices to be adopted in forthcoming studies to establish causal links between brain structure and function to social affective processes.
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Affiliation(s)
- Elizaveta Igoshina
- Department of Psychology, The University of Toronto, Toronto, ON, Canada; Neurosciences and Mental Health Research Program, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Liliana C Wu
- Department of Psychology, The University of Toronto, Toronto, ON, Canada; Neurosciences and Mental Health Research Program, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Iska Moxon-Emre
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Donald J Mabbott
- Department of Psychology, The University of Toronto, Toronto, ON, Canada; Neurosciences and Mental Health Research Program, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
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Rix K, Monks CP, O'Toole S. Theory of Mind and Young Children's Behaviour: Aggressive, Victimised, Prosocial, and Solitary. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105892. [PMID: 37239617 DOI: 10.3390/ijerph20105892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/28/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023]
Abstract
Theory of mind (ToM) undergoes significant developments during childhood, particularly between the ages of four and seven years. A growing body of research has indicated that children's social understanding may be related to their social behaviour with peers, in line with Theory Theory which proposes that children's social cognition is influenced by and influences their peer interactions. The current study examined the relationship between ToM and behaviour among 193 children aged 4-7 years. Children carried out a battery of ToM tasks, and teaching staff reported on children's aggressive, prosocial, and solitary behaviour and victimisation experiences. Aggression was not directly related to ToM; prosocial behaviour was positively associated with ToM for girls but not boys. Solitary behaviour and victimisation were negatively related to ToM. When this was broken down by gender, there was only a significant association between solitary behaviour and ToM for boys. When controlling for the relationship between behaviours, the only significant predictor of ToM was solitary behaviour for boys. ToM was also a significant predictor of solitary behaviour for boys, demonstrating that there is a bidirectional relationship at play. The findings highlight the importance of looking across these four behaviour types and understanding the relationship between behaviour profiles and ToM for boys and girls separately.
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Affiliation(s)
- Katie Rix
- School of Psychology & Counselling, Faculty of Arts & Social Sciences, The Open University, Milton Keynes MK7 6AA, UK
| | - Claire P Monks
- Institute for Lifecourse Development, School of Human Sciences, University of Greenwich, London SE10 9LS, UK
| | - Sarah O'Toole
- Department of Civil, Environmental & Geomatic Engineering, Faculty of Engineering Science, University College London, London WC1E 6BT, UK
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Crook L, Riccardi JS, Ruddock HS, Ciccia A. Speech-Language Pathology Treatment of Cognitive-Communication Deficits in School-Aged Children With Traumatic Brain Injury: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1826-1841. [PMID: 37116307 DOI: 10.1044/2023_jslhr-22-00417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE The purpose of this scoping review was to synthesize the current evidence-based treatment practices used with school-aged children with any severity of traumatic brain injury (TBI) that could benefit the practice of speech-language pathologists (SLPs). METHOD A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Included studies were assigned thematic labels based on a modified version of the Rehabilitation Treatment Specification System. RESULTS A total of 27 articles that covered 16 different treatment approaches met inclusion criteria for this study. Most studies included adolescent or teenage participants with moderate-severe TBIs. Treatment targets included executive functioning (n = 15), social competence (n = 6), postconcussive symptoms (n = 5), behavior (n = 3), family functioning (n = 1), and health-related quality of life (n = 1). The majority of current interventions for school-aged children with TBI include a multidisciplinary approach and components of family involvement education. CONCLUSIONS Further research is needed on interventions that are specifically implemented by SLPs as well as protocols that include more heterogeneous samples (e.g., varied sociodemographic factors and injury severity) to allow for the development and testing of ecologically valid intervention practice. SLPs can use the results of this scoping review to individualize treatment based on the child's areas of need while considering individual characteristics and to provide person-centered intervention for children with school-aged TBI.
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Affiliation(s)
- Libby Crook
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Jessica S Riccardi
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Hannah S Ruddock
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Angela Ciccia
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
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Ramjan S, Levitch C, Sands S, Kim SY, Barnett M, Bledsoe J, Holland AA. Executive and social functioning in pediatric posterior fossa tumor survivors and healthy controls. Neurooncol Pract 2023; 10:152-161. [PMID: 36970175 PMCID: PMC10037940 DOI: 10.1093/nop/npac090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Executive and social functioning difficulty is well established in pediatric brain tumor survivors. Few studies have compared posterior fossa (PF) tumor survivors in comparison to their peers. The relationship between attention, processing speed, working memory, fatigue, and executive and social functioning was investigated to better understand the factors that impact executive and social functioning in PF tumor populations. Methods Sixteen medulloblastomas, 9 low-grade astrocytomas (LGAs), and 17 healthy controls recruited from 4 sites completed measures of working memory and processing speed, and self-reported fatigue. One parent completed questionnaires on executive and social functioning. Results There were no significant differences among all 3 groups on parent-reported executive and social functioning; of note, parents of LGA survivors expressed greater concerns regarding behavioral and cognitive regulation than did parents of medulloblastoma survivors and healthy controls. Parent-reported attention was related to parent-reported emotion, behavior, and cognitive regulation. Worse self-reported fatigue was associated with greater emotional dysregulation for the 2 PF tumor groups. Conclusions Parents of PF tumor survivors described their children as performing similarly to their peers in most facets of executive and social functioning. While LGA survivors are traditionally thought to have more favorable outcomes, our finding of parent-reported executive functioning concerns to be worse for this group highlights the importance of long-term follow-up for all PF tumor survivors. Additionally, significant effects of attention on aspects of executive functioning in PF tumor survivors may inform current clinical practice and the future development of more effective interventions.
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Affiliation(s)
- Sameera Ramjan
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Cara Levitch
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Stephen Sands
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Soo Young Kim
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Marie Barnett
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jesse Bledsoe
- Department of Psychiatry and Behavioral Sciences, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Psychiatry and Behavioral Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Alice Ann Holland
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Psychiatry, Children's Medical Center Dallas, Dallas, Texas, USA
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Abstract
OBJECTIVE Disorders of social cognition, such as difficulties with emotion perception, alexithymia, Theory of Mind (ToM), empathy and disorders of emotion regulation, are prevalent and pervasive problems across many neurological, neurodevelopmental and neuropsychiatric conditions. Clinicians are familiar with how these difficulties present but assessment and treatment has lagged behind other traditional cognitive domains, such as memory, language and executive functioning. METHOD In this paper, we review the prevalence and degree of impairment associated with disorders of social cognition and emotion regulation across a range of clinical conditions, with particular emphasis on their relationship to cognitive deficits and also real-world functioning. We reported effects sizes from published meta-analyses for a range of clinical disorders and also review test usage and available tests. RESULTS In general, many clinical conditions are associated with impairments in social cognition and emotion regulation. Effect sizes range from small to very large and are comparable to effect sizes for impairments in nonsocial cognition. Socio-emotional impairments are also associated with social and adaptive functioning. In reviewing prior research, it is apparent that the standardized assessment of social cognition, in particular, is not routine in clinical practice. This is despite the fact that there are a range of tools available and accruing evidence for the efficacy of interventions for social cognitive impairments. CONCLUSION We are using this information to urge and call for clinicians to factor social cognition into their clinical assessments and treatment planning, as to provide rigorous, holistic and comprehensive person-centred care.
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Affiliation(s)
- Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Travis Wearne
- School of Psychology, University of Western Sydney, Penrith South, Australia
| | - Michelle Kelly
- School of Psychological Sciences, University of Newcastle, Callaghan, Australia
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Zeytinoglu S, Tang A, Zeanah CH, Nelson CA, Almas AN, Fox NA. Effects of foster care intervention and caregiving quality on the bidirectional development of executive functions and social skills following institutional rearing. Dev Sci 2023; 26:e13309. [PMID: 35933686 PMCID: PMC9902572 DOI: 10.1111/desc.13309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
Institutional rearing negatively impacts the development of children's social skills and executive functions (EF). However, little is known about whether childhood social skills mediate the effects of the foster care intervention (FCG) and foster caregiving quality following early institutional rearing on EF and social skills in adolescence. We examined (a) whether children's social skills at 8 years mediate the impact of the FCG on the development of EF at ages 12 and 16 years, and (b) whether social skills and EF at ages 8 and 12 mediate the relation between caregiving quality in foster care at 42 months and subsequent social skills and EF at age 16. Participants included abandoned children from Romanian institutions, who were randomly assigned to a FCG (n = 68) or care as usual (n = 68), and a never-institutionalized group (n = 135). At ages 8, 12, and 16, social skills were assessed via caregiver and teacher reports and EF were assessed via the Cambridge Neuropsychological Test Automated Battery. Caregiving quality of foster caregivers was observed at 42 months. FCG predicted better social skills at 8 years, which in turn predicted better EF in adolescence. Higher caregiver quality in foster care at 42 months predicted better social skills at 8 and 12 years, and better EF at 12 years, which in turn predicted 16-year EF and social skills. These findings suggest that interventions targeting caregiving quality within foster care home environments may have long-lasting positive effects on children's social skills and EF.
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Affiliation(s)
- Selin Zeytinoglu
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
| | - Alva Tang
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
| | | | - Charles A. Nelson
- Boston Children’s Hospital, Harvard Medical School, Boston, MA
- Harvard Graduate School of Education, Cambridge, MA
| | - Alisa N. Almas
- School of Population and Public Health, University of British Columbia, Vancouver, BC
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
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Proceedings of the First Pediatric Coma and Disorders of Consciousness Symposium by the Curing Coma Campaign, Pediatric Neurocritical Care Research Group, and NINDS: Gearing for Success in Coma Advancements for Children and Neonates. Neurocrit Care 2023; 38:447-469. [PMID: 36759418 PMCID: PMC9910782 DOI: 10.1007/s12028-023-01673-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/03/2023] [Indexed: 02/11/2023]
Abstract
This proceedings article presents the scope of pediatric coma and disorders of consciousness based on presentations and discussions at the First Pediatric Disorders of Consciousness Care and Research symposium held on September 14th, 2021. Herein we review the current state of pediatric coma care and research opportunities as well as shared experiences from seasoned researchers and clinicians. Salient current challenges and opportunities in pediatric and neonatal coma care and research were identified through the contributions of the presenters, who were Jose I. Suarez, MD, Nina F. Schor, MD, PhD, Beth S. Slomine, PhD Erika Molteni, PhD, and Jan-Marino Ramirez, PhD, and moderated by Varina L. Boerwinkle, MD, with overview by Mark Wainwright, MD, and subsequent audience discussion. The program, executively planned by Varina L. Boerwinkle, MD, Mark Wainwright, MD, and Michelle Elena Schober, MD, drove the identification and development of priorities for the pediatric neurocritical care community.
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Honan I, Sharp N, McIntyre S, Smithers‐Sheedy H, Balde I, Quinn K, Morgan M, Rothery S, Butchers T, Laugeson E. Program evaluation of an adapted PEERS® social skills program in young adults with autism spectrum disorder and/or mild intellectual impairment and social skills difficulties. J Eval Clin Pract 2023; 29:126-135. [PMID: 35927973 PMCID: PMC10946497 DOI: 10.1111/jep.13743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 01/18/2023]
Abstract
RATIONALE, AIMS AND OBJECTIVES Social challenges are common for young adults with autism spectrum disorder (ASD) and/or mild intellectual impairment, yet few evidence-based interventions exist to address these challenges. PEERS®, the Program for the Education and Enrichment of Relational Skills, has been shown to be effective in improving the social skills of young adults with ASD; however, it requires a significant time commitment for parents of young adults. As such, this mixed-methods study aimed to investigate the experiences of young adults, parents and PEERS® social coaches participating in an adapted PEERS® program, and to evaluate its acceptability and efficacy. METHOD Young adults with ASD and/or mild intellectual impairment participated in a 16-week PEERS® program. Parents and PEERS® social coaches attended fewer, condensed sessions, where they learnt program content to support the young adults' social skill development at home and in the community. Focus groups were conducted post intervention. Quantitative pre-post assessment using the Social and Emotional Loneliness Scale for Adults, the Test of Young Adult Social Skills Knowledge, and Quality of Socialization Questionnaire-Young Adults was completed by young adults. The Social Responsiveness Scale Second Edition was completed by young adults and their parents. RESULT Qualitative results revealed that, taken together, young adults, parents and PEERS® social coaches all felt that the adapted PEERS® program was 'challenging, but worth it'. The program was acceptable with a 93% attendance rate across all sessions. Whilst young adults' perceptions of their own social functioning did not change post-intervention, their knowledge of social skills content improved significantly (p < 0.05). Parent perceptions of young adults' social responsiveness also improved (p < 0.05). CONCLUSIONS Social skill knowledge, social responsiveness, and social engagement improved significantly following the completion of the adapted PEERS® program. It was deemed acceptable and worthwhile by young adults, their parents and PEERS® social coaches.
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Affiliation(s)
- Ingrid Honan
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Nicole Sharp
- School of Health Sciences and Translational Health Research InstituteWestern Sydney UniversityPenrith SouthNew South WalesAustralia
| | - Sarah McIntyre
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Hayley Smithers‐Sheedy
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Isabelle Balde
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Kirsten Quinn
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Marita Morgan
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Sophie Rothery
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Teigan Butchers
- Cerebral Palsy Alliance/Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & HealthThe University of SydneySydneyNew South WalesAustralia
| | - Elizabeth A. Laugeson
- Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesCaliforniaUSA
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Gourlay C, Collin P, D'Auteuil C, Jacques M, Caron PO, Scherzer PB. Age differences in social-cognitive abilities across the stages of adulthood and path model investigation of adult social cognition. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:1033-1067. [PMID: 34355998 DOI: 10.1080/13825585.2021.1962789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Abstract
Accumulating evidence points toward an association between older age and performance decrements in social cognition (SC). We explored age-related variations in four components of SC: emotion recognition, theory of mind, social judgment, and blame attributions. A total of 120 adults divided into three stages (18-34 years, 35-59 years, 60-85 years) completed a battery of SC. Between and within age-group differences in SC were investigated. Path analyses were used to identify relationships among the components. Emotion recognition and theory of mind showed differences beginning either in midlife, or after. Blame attributions and social judgment did not show a significant difference. However, social judgment varied significantly within groups. Path models revealed a relationship between emotion recognition and theory of mind. Findings highlight age-related differences in some components and a link between two components. Strategies promoting social functioning in aging might help to maintain or improve these abilities over time.
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Affiliation(s)
- Catherine Gourlay
- Département De Psychologie, Université Du Québec À Montréal, Montréal, Québec, Canada
| | - Pascal Collin
- Département De Psychologie, Université Du Québec À Montréal, Montréal, Québec, Canada
| | - Camille D'Auteuil
- Département De Psychologie, Université Du Québec À Montréal, Montréal, Québec, Canada
| | - Marie Jacques
- Département De Psychologie, Université Du Québec À Montréal, Montréal, Québec, Canada
| | | | - Peter B Scherzer
- Département De Psychologie, Université Du Québec À Montréal, Montréal, Québec, Canada
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Hamet Bagnou J, Prigent E, Martin JC, Clavel C. Adaptation and validation of two annotation scales for assessing social skills in a corpus of multimodal collaborative interactions. Front Psychol 2022; 13:1039169. [PMID: 36389487 PMCID: PMC9648354 DOI: 10.3389/fpsyg.2022.1039169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 09/30/2022] [Indexed: 11/24/2022] Open
Abstract
Context Behavioral observation scales are important for understanding and assessing social skills. In the context of collaborative problem-solving (CPS) skills, considered essential in the 21st century, there are no validated scales in French that can be adapted to different CPS tasks. The aim of this study is to adapt and validate, by annotating a new video corpus of dyadic interactions that we have collected, two observational scales allowing us to qualitatively assess CPS skills: the Social Performance Rating Scale (SPRS) and the Social Skills of Collaboration Scale (SSC). Method The construct validity of these two scales was assessed by exploratory factor analysis and inter-item correlations. We also checked inter-judge agreement using inter-class correlation coefficients. Internal consistency was determined using Cronbach's alpha and convergent and divergent validity by assessing correlations between the two scales and measures of depression and alexithymia. Finally, the discriminative properties of the two scales were analyzed by comparing the scores obtained by a group of anxious individuals and a non-anxious control group. Results The results show that our two scales have excellent inter-item correlations. Internal consistency is excellent (alpha SPRS =0.90; SSC = 0.93). Inter-rater agreement ranged from moderate to high. Finally, convergent validity was significant with the alexithymia scale, as was divergent validity with the depression scale. Anxious individuals had lower scores on both scales than non-anxious individuals. Conclusion Both scales show good psychometric properties for assessing social skills relevant to different collaborative tasks. They also identify individuals with difficulties in social interaction. Thus, they could allow monitoring the effectiveness of training social skills useful in CPS.
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Affiliation(s)
- Jennifer Hamet Bagnou
- Université Paris-Saclay, CNRS, Laboratoire Interdisciplinaire des Sciences du Numérique (LISN), Orsay, France
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Hocking MC, Schultz RT, Minturn JE, Brodsky C, Albee M, Herrington JD. Reduced Fusiform Gyrus Activation During Face Processing in Pediatric Brain Tumor Survivors. J Int Neuropsychol Soc 2022; 28:937-946. [PMID: 34605383 PMCID: PMC8977397 DOI: 10.1017/s135561772100117x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The neural mechanisms contributing to the social problems of pediatric brain tumor survivors (PBTS) are unknown. Face processing is important to social communication, social behavior, and peer acceptance. Research with other populations with social difficulties, namely autism spectrum disorder, suggests atypical brain activation in areas important for face processing. This case-controlled functional magnetic resonance imaging (fMRI) study compared brain activation during face processing in PBTS and typically developing (TD) youth. METHODS Participants included 36 age-, gender-, and IQ-matched youth (N = 18 per group). PBTS were at least 5 years from diagnosis and 2 years from the completion of tumor therapy. fMRI data were acquired during a face identity task and a control condition. Groups were compared on activation magnitude within the fusiform gyrus for the faces condition compared to the control condition. Correlational analyses evaluated associations between neuroimaging metrics and indices of social behavior for PBTS participants. RESULTS Both groups demonstrated face-specific activation within the social brain for the faces condition compared to the control condition. PBTS showed significantly decreased activation for faces in the medial portions of the fusiform gyrus bilaterally compared to TD youth, ps ≤ .004. Higher peak activity in the left fusiform gyrus was associated with better socialization (r = .53, p < .05). CONCLUSIONS This study offers initial evidence of atypical activation in a key face processing area in PBTS. Such atypical activation may underlie some of the social difficulties of PBTS. Social cognitive neuroscience methodologies may elucidate the neurobiological bases for PBTS social behavior.
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Affiliation(s)
- Matthew C. Hocking
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA
- Correspondence and reprint requests to: Matthew C. Hocking, Ph.D., Division of Oncology, The Children’s Hospital of Philadelphia, 3615 Civic Center Blvd., 1427B Abramson Pediatric Research Center, Philadelphia, PA 19104, USA.
| | - Robert T. Schultz
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA
| | - Jane E. Minturn
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA
| | - Cole Brodsky
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA
| | - May Albee
- Children’s Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA 19104, USA
| | - John D. Herrington
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA
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More to the story than executive function: Effortful control soon after injury predicts long-term functional and social outcomes following pediatric traumatic brain injury in young children. J Int Neuropsychol Soc 2022; 29:325-335. [PMID: 36102333 PMCID: PMC10011017 DOI: 10.1017/s1355617722000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the impact of early traumatic brain injury (TBI) on effortful control (EC) over time and the relationship of EC and executive functioning (EF) to long-term functional and social outcomes. METHOD Parents of children (N = 206, ages 3-7) with moderate-to-severe TBI or orthopedic injuries (OIs) rated EC using the Child Behavior Questionnaire at 1 (pre-injury), 6, 12, and 18 months post-injury. Child functioning and social competence were assessed at 7 years post-injury. Mixed models examined the effects of injury, time since injury, and their interaction on EC. General linear models examined the associations of pre-injury EC and EC at 18 months with long-term functional and social outcomes. Models controlled for EF to assess the unique contribution of EC to outcomes. RESULTS Children with severe TBI had significantly lower EC than both the OI and moderate TBI groups at each post-injury time point. Both pre-injury and 18-month EC were associated with long-term outcomes. Among those with low EC at baseline, children with moderate and severe TBI had more functional impairment than those with OI; however, no group differences were noted at high levels of EC. EC had main effects on parent-reported social competence that did not vary by injury type. CONCLUSIONS Findings suggest that EC is sensitive to TBI effects and is a unique predictor of functional outcomes, independent of EF. High EC could serve as a protective factor, and as such measures of EC could be used to identify children for more intensive intervention.
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Albee M, Allende S, Cosgrove V, Hocking MC. A prospective study of social competence in survivors of pediatric brain and solid tumors. Pediatr Blood Cancer 2022; 69:e29670. [PMID: 35312152 DOI: 10.1002/pbc.29670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVES Survivors of pediatric brain tumors are at increased risk for difficulties with social competence, including poor social information processing (SIP) and peer relationships. Improved survival rates heighten the need to better understand these challenges and if they are specific to survivors of pediatric brain tumors versus survivors of other childhood cancers. METHODS Fifty-one survivors of pediatric brain tumors and 34 survivors of pediatric solid tumors completed evaluations of SIP and peer relationship quality within six months of completing treatment and one year later. Caregivers completed a measure of social skills. Linear mixed models evaluated differences between survivors of pediatric brain and solid tumors on SIP and social skills and how indices of SIP were associated with peer relationships over time. RESULTS The two groups did not differ on indices of SIP or social skills over time. A three-way interaction between measures of SIP, group, and time predicted peer relationships. Survivors of pediatric solid tumors showed a positive association between baseline social skills and theory of mind and peer relationships over time, whereas survivors of pediatric brain tumors showed an inverse association between baseline social skills and theory of mind and peer relationships over time. CONCLUSION Findings revealed unanticipated associations between baseline SIP and social skills and peer relationships over time among survivors of pediatric brain tumors. Additional research is needed to elucidate the factors most influential on peer relationships in this group to inform interventions.
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Affiliation(s)
- May Albee
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | | | - Matthew C Hocking
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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24
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Winning AM, Howard Sharp K, Ferrante AC, Ralph J, Desjardins L, Friedman DL, Young-Saleme TK, Vannatta K, Compas BE, Gerhardt CA. CNS-Directed Cancer Treatment and Child Adjustment: Moderating Effects of Maternal Parenting. J Pediatr Psychol 2022; 47:916-928. [PMID: 35303090 PMCID: PMC9372750 DOI: 10.1093/jpepsy/jsac021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine whether maternal parenting behaviors (i.e., warmth, behavioral/psychological control) moderate the association between central nervous system (CNS)-directed treatment and adjustment among pediatric cancer survivors at 3 years post-diagnosis or relapse. METHODS Three years after their child's cancer diagnosis or relapse, mothers (N = 84) reported on their child's academic and social competence, as well as their internalizing and externalizing problems. Children (N = 84; Mage = 13.21 years, 52.4% male) reported on maternal parenting behaviors. Using medical chart data, children were separated into CNS (i.e., received cranial radiation, intrathecal chemotherapy, and/or neurosurgery; N = 45) or non-CNS-directed treatment (N = 39) groups. Twelve moderation models were tested when examining two-way interactions between CNS treatment group and maternal parenting behaviors. RESULTS Children in the CNS-directed treatment group demonstrated significantly worse academic and social competence. Moderation analyses revealed four significant two-way interactions between CNS treatment group and maternal parenting behaviors when predicting children's adjustment. High levels of maternal behavioral control buffered the negative impact of CNS-directed treatment on children's social competence. In addition, maternal warmth had a contrasting effect, as CNS-directed treatment was associated with worse academic competence at high levels of warmth. Analyses with psychological control revealed that low levels of this parenting style were not protective against internalizing or externalizing problems among those with CNS-directed treatment. CONCLUSIONS Children who receive CNS-directed treatment may benefit from a different pattern of parenting during early cancer survivorship. Findings highlight the importance of considering the broader family context when conceptualizing the impact of illness-related factors on adjustment among pediatric cancer survivors.
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Affiliation(s)
- Adrien M Winning
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, USA
| | - Katianne Howard Sharp
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, USA.,The Ohio State University, USA
| | - Amanda C Ferrante
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, USA
| | - Jessica Ralph
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, USA
| | | | | | | | - Kathryn Vannatta
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, USA.,The Ohio State University, USA
| | | | - Cynthia A Gerhardt
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, USA.,The Ohio State University, USA
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25
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Perkins A, Gracey F, Kelly G, Jim J. A new model to guide identity-focused multidisciplinary rehabilitation for children and young people following acquired brain injury: I-FoRM. Neuropsychol Rehabil 2022; 32:1928-1969. [PMID: 35895321 DOI: 10.1080/09602011.2022.2100794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
A complexity of biological, psychological, environmental and systemic factors influences a child's adaption after acquired brain injury (ABI), all of which transform as the child matures. Multidisciplinary rehabilitation teams are challenged by balancing family system needs and the child's needs, whilst promoting the child's functional skills in difficult or unappealing tasks. This paper presents the conceptual basis for a model for use in childhood ABI neurorehabilitation to address these challenges. A non-systematic narrative review of literature pertinent to integrated neurorehabilitation of pediatric ABI was conducted. Contemporary models of adult and pediatric psychosocial adaptation involving identity following ABI were reviewed. Key findings were then synthesized with models of pediatric resilience and self-concept development. The resulting model describes a cyclical adaptation process whereby the child learns experientially about their self and their world after ABI. Processes of identity development play a central role - particularly emotive processes of self-evaluation - by influencing the child's motivation for participation, tolerance for challenge, self-regulation and emerging self-awareness. The model directs clinicians to use the psychosocial processes of identity development to enhance the child's willingness and capacity to engage in the daily challenges of rehabilitation. Further systematic development and evaluation of the model is needed.
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Affiliation(s)
| | - Fergus Gracey
- Department of Clinical Psychology and Psychological Therapies, University of East Anglia, Norwich, UK.,Cambridge Centre for Paediatric Neuropsychological Rehabilitation, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | | | - Jenny Jim
- The Children's Trust, Tadworth, UK.,Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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26
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The Influence of Socioeconomic Status (SES) and Processing Speed on the Psychological Adjustment and Wellbeing of Pediatric Brain Tumor Survivors. Cancers (Basel) 2022; 14:cancers14133075. [PMID: 35804846 PMCID: PMC9264789 DOI: 10.3390/cancers14133075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Processing speed (PS) is one of the most impaired functions in pediatric brain tumor survivors (PBTSs) and it has been linked to difficulties in their psychological functioning, together with other non-insult-related risk factors, such as socio-economic status (SES). Given the psychological adjustment difficulties observed in PBTS, the aim of the current study was to explore the relationship between SES and psychological functioning, measured with the Child Behavioral Checklist (CBCL) and the Strengths and Difficulties Questionnaire, and considering the contribution of PS as a mediator. The results demonstrated that the influence of SES on the CBCL total index was mediated by PS. Furthermore, PS was found to have a mediating effect on the SES–internalizing problems relationship but not on the SES–externalizing problems relationship. These findings suggest that PS may be a rehabilitation target to prevent psychological distress and should be addressed, especially for PBTSs who live in a disadvantaged situation. Abstract (1) Background: The relationship between processing speed (PS) and psychological adjustment in the healthy population is well established, as is that between low socio-economic status (SES) and psychological distress. While PS is one of the most impaired functions in pediatric brain tumor survivors (PBTSs), previous research has demonstrated that low SES may be a predictor of increased psychosocial risk in PBTSs. Given the psychological adjustment difficulties observed in PBTS, in the current study we aimed to explore the relationship between SES and psychological functioning, considering the contribution of PS as a mediator. (2) Methods: demographic and clinical data of 80 children (age range: 4–17 y.o.) were retrospectively collected. Psychological measures were the parent-compiled versions of the Child Behavioral Checklist (CBCL) and the Strengths and Difficulties Questionnaire (SDQ). Mediation analysis models were performed on psychological measures with and without the inclusion of covariates. (3) Results: The influence of SES on the CBCL total index was mediated by PS. Furthermore, PS was found to have a mediating effect on the relationship between SES and internalizing problems but not on the relationship between SES and externalizing problems. (4) Conclusions: The results suggest that PS may be a rehabilitation target for the prevention of psychological distress and should be addressed especially for PBTSs who live in a disadvantaged situation.
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27
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King G, Smart E, Bowman L, Pinto M. Social participation interventions targeting relational outcomes for young people with physical and developmental disabilities: an umbrella review and narrative synthesis. Disabil Rehabil 2022:1-14. [PMID: 35695048 DOI: 10.1080/09638288.2022.2085332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: To synthesize knowledge about social participation interventions targeting relational outcomes for young people with physical and developmental disabilities.Method: An umbrella review with a narrative synthesis was conducted to integrate findings of review articles examining social participation interventions targeting relational outcomes (e.g., peer interaction and friendships). Six databases were searched to identify reviews published between 2010 and 2021.Results: Five reviews were identified, examining participation interventions, social/community integration interventions, recreational sport programs, online peer mentorship programs, and augmentative and alternative communication interventions to promote social interaction with peers. Interventions associated with improvements in relational outcomes included group-based programs, programs involving personalized goals, arts-based programs, and multi-component social communication interventions. Recommendations for future research included better description of interventions to identify active ingredients and key mechanisms, measurement of participants' experiences, and the need for interventions to be aligned with the nature of the outcomes examined. Preliminary intervention principles are proposed to guide the design of social participation interventions: individualizing, contextualizing, and immersion in social settings.Conclusions: There are multiple pathways by which to influence the relational outcomes of young people with disabilities. There are implications for the design of social participation interventions based on an ecological/experiential and relational perspective.IMPLICATIONS FOR REHABILITATIONImprovements in relational outcomes are associated with participation in group-based programs, programs involving personalized goals, arts-based programs, and multi-component social communication interventions.Three evidence-informed principles can help guide the design of social participation interventions: (1) personalizing, (2) contextualizing, and (3) immersion in social settings.Greater attention to aligning the nature of intervention with desired outcomes is needed to more effectively measure and promote relational outcomes.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Eric Smart
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Laura Bowman
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Madhu Pinto
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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28
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Blackwell CK, Lai JS, Kallen M, Bevans KB, Davis MM, Wakschlag LS, Cella D. Measuring PROMIS® Social Relationships in Early Childhood. J Pediatr Psychol 2022; 47:573-584. [PMID: 35552428 PMCID: PMC9308389 DOI: 10.1093/jpepsy/jsac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE Apply the Patient-Reported Outcome Measurement Information System (PROMIS®) mixed-methods approach to develop and validate new parent-report measures of young children's (1-5 years) family and peer relationships that conceptually align to those for 5-17 year olds. METHODS Expert input, parent interviews, and reviews of theoretical and empirical literature were used to develop draft item pools, which were administered in two waves of panel surveys (N = 1,750). Psychometric evaluation was conducted using item response theory-based methods. Scores were normed to the general U.S. population. Initial validation analyses were conducted using Pearson's correlations and analysis of variance to examine known-group differences between children with various health conditions. RESULTS Experts and parents confirmed the content validity of existing PROMIS family and peer relationships domain frameworks and suggested adding child-caregiver interactions and empathic behaviors, respectively. Bi-factor model analysis supported sufficient unidimensionality where family and peer relationships were modeled as distinct subdomains of a broader concept, Social Relationships. The new measure was robust in discriminating young children with poor social relationships. Correlational and known-group analyses revealed positive associations with general health and well-being and negative associations with emotional and physical distress. CONCLUSIONS The PROMIS Early Childhood Parent-Report Social Relationships item bank enables clinicians and researchers a brief, efficient, and precise way to evaluate early relational health. Subdomain short forms also offer the ability to assess specific components (i.e., child-caregiver, family, and peer) for more targeted interventions and analyses.
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Affiliation(s)
- Courtney K Blackwell
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
| | - Jin-Shei Lai
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
| | - Michael Kallen
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
| | - Katherine B Bevans
- Janssen Pharmaceutical Companies of Johnson & Johnson, Global Commercial Strategy Organization, USA
| | - Matthew M Davis
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
- Lurie Children’s Hospital, Stanley Manne Children’s Research Institute, USA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
| | - David Cella
- Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences (DevSci), Northwestern University Feinberg School of Medicine, USA
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29
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McCarthy SR, Golembiewski EH, Gravholt DL, Clark JE, Clark J, Fischer C, Mulholland H, Babcock K, Montori VM, Jones A. Documentation of Psychosocial Distress and Its Antecedents in Children with Rare or Life-Limiting Chronic Conditions. CHILDREN 2022; 9:children9050664. [PMID: 35626841 PMCID: PMC9139272 DOI: 10.3390/children9050664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/21/2022] [Accepted: 04/29/2022] [Indexed: 11/16/2022]
Abstract
Children with rare or life-limiting chronic conditions and their families are at high risk of psychosocial distress. However, despite its impact on patient and family health and functioning, psychosocial distress and its antecedents may not routinely be captured in medical records. The purpose of this study was to characterize current medical record documentation practices around psychosocial distress among children with rare or life-limiting chronic conditions and their families. Medical records for patients with rare or life-limiting chronic conditions (n = 60) followed by a pediatric complex care program were reviewed. Study team members extracted both structured data elements (e.g., diagnoses, demographic information) and note narratives from the most recent visit with a clinician in the program. Psychosocial topics were analyzed using a mixed quantitative (i.e., frequency counts of topics) and qualitative approach. Topics related to psychosocial distress that were documented in notes included child and parent emotional problems, parent social support, sibling emotional or physical problems, family structure (e.g., whether parents were together), and financial concerns. However, 35% of notes lacked any mention of psychosocial concerns. Although examples of psychosocial concerns were included in some notes, none were present in over one-third of this sample. For both patients with rare or life-limiting chronic conditions and their caregivers, more active elicitation and standard documentation of psychosocial concerns may improve the ability of healthcare providers to identify and intervene on psychosocial concerns and their risk factors.
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Affiliation(s)
- Sarah R. McCarthy
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55905, USA; (E.H.G.); (D.L.G.); (V.M.M.)
- Correspondence: ; Tel.: +1-507-284-2933
| | - Elizabeth H. Golembiewski
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55905, USA; (E.H.G.); (D.L.G.); (V.M.M.)
| | - Derek L. Gravholt
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55905, USA; (E.H.G.); (D.L.G.); (V.M.M.)
| | - Jennifer E. Clark
- Department of Endocrinology, Diabetes, and Metabolism, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA;
| | - Jeannie Clark
- Mayo Clinic Children’s Center, Mayo Clinic, Rochester, MN 55905, USA; (J.C.); (C.F.)
| | - Caree Fischer
- Mayo Clinic Children’s Center, Mayo Clinic, Rochester, MN 55905, USA; (J.C.); (C.F.)
| | - Hannah Mulholland
- Section of Social Work, Mayo Clinic, Rochester, MN 55905, USA; (H.M.); (K.B.)
| | - Kristina Babcock
- Section of Social Work, Mayo Clinic, Rochester, MN 55905, USA; (H.M.); (K.B.)
| | - Victor M. Montori
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55905, USA; (E.H.G.); (D.L.G.); (V.M.M.)
- Department of Endocrinology, Diabetes, and Metabolism, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA;
| | - Amie Jones
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA;
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30
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Ankrett S, Smithson J, Limond J, Behn N, Wade SL, Wilkinson L, Adlam ALR. Understanding and supporting peer relationships in adolescents with acquired brain injury: A stakeholder engagement study. Neuropsychol Rehabil 2022:1-30. [PMID: 35443860 DOI: 10.1080/09602011.2022.2062006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Peer relationship difficulties in adolescents with acquired brain injury (ABI) are under-recognized and targets for intervention are unclear. From a social constructionist position, this study aimed to engage with stakeholders to develop a collaborative understanding of peer relationship difficulties in adolescents with ABI and seek consultation on what might be required to improve them. Focus groups and semi-structured interviews were conducted with four stakeholder groups: adolescents with ABI (n = 4); parents of adolescents with ABI (n = 7); adults who sustained an ABI in adolescence (n = 2); and specialist practitioners (n = 3). Qualitative data were analysed using thematic analysis. The analysis yielded 11 themes, grouped into two domains. The first, understanding peer relationship difficulties, included themes from "exclusion and a need to belong", to "loss of past self". The second, supporting peer relationships, comprised themes of "building understanding" and "meaningful social connection", amongst others. A logic model of stakeholder experiences of peer relationship difficulties was constructed. Difficulties with peers can increase vulnerability to feelings of loneliness, shame, and hopelessness for adolescents post-ABI. Stakeholders described that a meaningful intervention would be multi-layered, targeting change within the adolescent's environment and within the adolescent themselves. The presented logic model provides a framework for future intervention development.
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Affiliation(s)
- Scott Ankrett
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Janet Smithson
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Jenny Limond
- College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Nicholas Behn
- Division of Language and Communication Science, City, University of London, London, UK
| | - Shari L Wade
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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31
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Gordon ML, Means B, Jurbergs N, Conklin HM, Gajjar A, Willard VW. Social Problem Solving in Survivors of Pediatric Brain Tumor. J Pediatr Psychol 2022; 47:929-938. [PMID: 35286389 DOI: 10.1093/jpepsy/jsac022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Psychosocial late effects among survivors of pediatric brain tumors are common. For school-aged survivors, social skills deficits and isolation present a particular challenge. Social problem-solving is a social skill that is an important determinant of social outcomes and may yield a potential target for intervention. METHODS School-aged youth (N = 65) 8-12 years of age (10.59 ± 1.36 years; 55.4% female, 86.2% white) who were 5.23 (SD = 2.44, range 2-10.9) years post-treatment for a brain tumor completed the Attributions and Coping Questionnaire, a measure of social problem-solving that uses vignettes to assess attribution of intent, subsequent emotional response, and imagined behavioral response to an interpersonal problem. Youth also completed self-reports of social functioning (PROMIS Peer Relationships, Self-Perception Profile). A caregiver completed additional measures of child social functioning (NIH Toolbox-Emotion Measures). RESULTS Survivors attributed unpleasant situations to accidental causes (neutral attribution) and responded in ways that prioritized the friendship (appeasement) or relied on adult intervention. Self-reported social functioning was higher among those who were less likely to avoid challenging social problem-solving situations. CONCLUSIONS Findings identified characteristic social problem-solving approaches among survivors, including a tendency to attribute ambiguous situations to accidental causes and to request adult assistance and/or maintain social relationships. This may indicate a possible avenue for intervention, with a focus on increasing survivors' understanding of the causes of potentially negative peer interactions and reducing their reliance on adults.
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Affiliation(s)
- Mallorie L Gordon
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Bethany Means
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Niki Jurbergs
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Heather M Conklin
- Department of Psychology, St. Jude Children's Research Hospital, USA
| | - Amar Gajjar
- Department of Oncology, St. Jude Children's Research Hospital, USA.,Department of Pediatric Medicine, St. Jude Children's Research Hospital, USA
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32
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Khan N, Ryan NP, Crossley L, Hearps S, Catroppa C, Anderson V. Global and domain-specific self-esteem after pediatric traumatic brain injury: Contribution of injury characteristics and parent mental health. Neuropsychol Rehabil 2022; 32:1835-1853. [PMID: 35287558 DOI: 10.1080/09602011.2022.2050408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This prospective, longitudinal case-control study examined global and domain-specific aspects of self-esteem 6-months following pediatric traumatic brain injury (TBI) and evaluated the contribution of injury-related factors and parent mental health to child self-esteem. Participants included 103 children with mild-severe TBI representing consecutive admissions to the emergency department of the Royal Children's Hospital, Melbourne, Australia. Forty-three age-and-sex matched typically developing controls were recruited for comparison. Information regarding injury characteristics including age at injury and clinical indicators of TBI severity were collected for participants at recruitment, with research magnetic resonance imaging conducted 2-8 weeks later. At 6 months post-injury, children rated their global and domain-specific self-esteem (Harter Self-Perception Profile for Children), and ratings of parent mental health were collected (General Health Questionnaire). Self-esteem for behavioural and academic domains was significantly poorer for children with TBI relative to TD children. In the TBI group, higher child-rated scores of global and domain-specific aspects of self-esteem were associated with more severe TBI, presence of frontal neuropathology, younger age at injury, and lower parental symptoms of anxiety/insomnia. Given the psychological status of parents represents a potentially modifiable risk factor, it may form the target of clinical interventions designed to bolster child self-esteem following pediatric TBI.
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Affiliation(s)
- Noor Khan
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Nicholas P Ryan
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Psychology, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Cognitive Neuroscience Unit, Deakin University, Geelong, Australia
| | - Louise Crossley
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Stephen Hearps
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Cathy Catroppa
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Psychology, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Vicki Anderson
- Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Psychology, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
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33
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Gallant C, Good D. Examining the role of neuropsychology in community-based pediatric mental health care. APPLIED NEUROPSYCHOLOGY: CHILD 2022; 12:104-121. [PMID: 35184633 DOI: 10.1080/21622965.2022.2038169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Numerous investigations have demonstrated a link between neuropsychological functioning and mental health. Children with a history of neurological compromise are more vulnerable to mental illness and there is a growing literature indicating that neurocognitive functioning predicts psychosocial outcomes in adulthood. However, not much is known about how neuropsychological information is utilized in community-based mental health care. Thus, we examined what neuropsychological information is available to pediatric centers and how neuropsychological functioning relates to treatment outcomes in these settings. Two content analyses were conducted to identify mental health indicators across different intake sources and these results were compared to a structured intake. Further, a series of standardized neurocognitive and neuroemotional measures were completed and these indices were correlated with treatment outcomes. Qualitative results confirmed that neuropsychological factors are often overlooked when utilizing current approaches and that observable symptoms are a primary focus of treatment. Additionally, neurocognitive deficits were associated with self-reported interpersonal difficulties and caregivers' reports of externalizing; however, only caregiver-reported externalizing challenges correlated with treatment outcomes. Importantly, neurocognitive challenges were associated with long-term treatment responses, suggesting that these factors may be an important therapeutic target. Collectively, these findings indicate a need to incorporate neuropsychological factors in pediatric mental health treatment.
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Affiliation(s)
- Caitlyn Gallant
- Department of Psychology, Brock University, St. Catharines, Canada
| | - Dawn Good
- Department of Psychology, Brock University, St. Catharines, Canada
- Centre for Neuroscience, Brock University, St. Catharines, Canada
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34
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Cho S, Tromburg C, Forbes C, Tran A, Allapitan E, Fay-McClymont T, Reynolds K, Schulte F. Social adjustment across the lifespan in survivors of pediatric acute lymphoblastic leukemia (ALL): a systematic review. J Cancer Surviv 2022:10.1007/s11764-021-01140-5. [PMID: 34988754 DOI: 10.1007/s11764-021-01140-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/14/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The objectives of this review were to (1) summarize studies that described social adjustment in survivors of pediatric ALL across the lifespan, (2) summarize social adjustment outcomes reported across studies, and (3) examine associations between social adjustment and disease/treatment- and non-treatment-related factors. METHODS Searched databases included EMBASE (Ovid), MEDLINE (Ovid), PsycINFO (EBSCO Information Services), and Web of Science (Thomson Reuters). Eligible studies included: (1) original research; (2) published in English; (3) a diagnosis of cancer between 0 and 21 years; (4) survivors at least 5 years from diagnosis and/or 2 years from therapy completion; and (5) quantitative assessment of social adjustment. RESULTS The literature search yielded 3698 articles of which 43 were included in the final review. Risk of bias was assessed using domains adapted from the Cochrane risk-of-bias tool. Quality of evidence was evaluated following the Grading of Recommendations Assessment Development and Evaluation (GRADE) criteria. There was some evidence that school-aged and adolescent/young adult survivors experienced worse social adjustment compared to controls. There was some evidence suggesting cranial radiation therapy (CRT) is associated with social adjustment difficulties among young adult survivors. Inconsistent evidence was found for relapse, age at diagnosis and study, sex, and late effects in relation to social adjustment. CONCLUSION Survivors of pediatric ALL were at higher risk of social adjustment difficulties compared to controls. However, evidence for treatment and non-treatment risk and resilience factors require stronger evidence. IMPLICATIONS FOR CANCER SURVIVORS Information on modifiable factors that modulate social adjustment may influence targets of intervention and follow-up guidelines.
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Affiliation(s)
- Sara Cho
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada
| | - Courtney Tromburg
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Caitlin Forbes
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada
- Alberta Children's Hospital, Haematology, Oncology, and Transplant Program, Calgary, AB, Canada
| | - Andrew Tran
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Elleine Allapitan
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - Kathleen Reynolds
- Alberta Children's Hospital, Haematology, Oncology, and Transplant Program, Calgary, AB, Canada
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Fiona Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, 2202 2 St SW, Calgary, AB, T2S 3C3, Canada.
- Alberta Children's Hospital, Haematology, Oncology, and Transplant Program, Calgary, AB, Canada.
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Desjardins L, Young M, Hancock K, Lai MC, Bartels U, Vorstman J, Barrera M. Pediatric Brain Tumor Survivors' Understanding of Friendships: A Qualitative Analysis of ADOS-2 Interview Responses. J Pediatr Psychol 2022; 47:662-673. [PMID: 34981125 DOI: 10.1093/jpepsy/jsab131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pediatric brain tumor survivors (PBTS) are at risk of experiencing social competence challenges, but only a limited number of studies have used a qualitative approach to understand their social relationships. We examined PBTS responses to social interview questions within the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2), which includes questions related to their understanding of their own relationships, as well as the construct of friendship more generally. METHODS Twenty-four PBTS (ages 9-17 years; M = 14.2 years from diagnosis; 50% male; 42% received radiation treatment) completed the ADOS-2. ADOS-2 social interview responses were recorded and transcribed verbatim. Themes were derived using an inductive thematic analysis approach. RESULTS PBTS reported that they considered trust, acceptance, respect, emotional support, and spending time together to be important aspects of friendships in general. When describing their own social relationships, some PBTS noted a lack of intimacy or closeness, spending time with their friends almost exclusively at school, with structured activities outside of school being an additional basis for friendship. Challenges to their social relationships included loneliness and reliance on family for social support, experiences of teasing and bullying, social skills deficits, and lack of insight into social situations. CONCLUSION Although PBTS were able to acknowledge many important qualities of friendships in general (e.g., trust, emotional support), these were not necessarily reported in their own friendships. PBTS also appeared to have difficulty identifying whether someone was their friend. These findings offer potential opportunities for supporting PBTS in achieving friendships consistent with their conception of this important relationship.
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Affiliation(s)
- Leandra Desjardins
- Charles-Bruneau Cancer Care Centre, Sainte-Justine University Health Centre, Canada.,Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Canada
| | - Melissa Young
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, USA.,Department of Pediatrics, University of Cincinnati Medical Center, USA
| | - Kelly Hancock
- Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Canada
| | - Meng-Chuan Lai
- Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Canada
| | - Ute Bartels
- Division of Hematology/Oncology, The Hospital for Sick Children, Canada
| | - Jacob Vorstman
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Canada.,Department of Psychiatry and Autism Research Unit, The Hospital for Sick Children, Canada
| | - Maru Barrera
- Department of Psychology, Division of Hematology/Oncology, The Hospital for Sick Children, Canada
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36
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Schulte FSM, Merz EL, Russell KB, Tromburg C, Cho S, Tran A, Reynolds K, Tomfohr-Madsen L. Social adjustment in survivors of acute lymphoblastic leukemia without cranial radiation therapy. Pediatr Blood Cancer 2022; 69:e29407. [PMID: 34665517 DOI: 10.1002/pbc.29407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/08/2021] [Accepted: 09/27/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate group differences in social adjustment in survivors of pediatric acute lymphoblastic leukemia (ALL) compared to survivor siblings and controls; identify disease-related predictors of social adjustment in survivors; and explore whether executive functioning explained differences in social adjustment across groups and between disease-related predictors. METHODS Survivors of pediatric ALL (n = 38, average age at diagnosis = 4.27 years [SD = 1.97]; average time off treatment = 4.83 years [SD = 1.52]), one sibling (if available, n = 20), and one parent from each family were recruited from a long-term survivor clinic. Healthy age- and sex-matched controls (n = 38) and one parent from each family were recruited from the community. Parents completed the Behavioral Assessment System for Children, Parent Rating Scale (BASC-3) Social Withdrawal subscale as a measure of social adjustment, and the Behavior Rating Inventory of Executive Functions (BRIEF-2) as a measure of executive function for each of their children. Multilevel modeling and mediation analysis were used to achieve the study aims. RESULTS Parents reported that survivors had significantly worse social adjustment compared to controls (b = 6.34, p = .004), but not survivor siblings. Among survivors, greater time off treatment (b = 2.06, p = .058) and poorer executive functioning (b = 0.42, p = .006) were associated with worse social adjustment. Executive function did not mediate differences in social withdrawal between survivors and controls or the relationship between time off treatment and social withdrawal among survivors. CONCLUSIONS Survivors of pediatric ALL presenting to follow-up programs should be screened for difficulties with social adjustment. Future research should examine treatment- and nontreatment-related factors contributing to poorer social outcomes.
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Affiliation(s)
- Fiona S M Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Hematology, Oncology, and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Erin L Merz
- Department of Psychology, California State University, Carson, California, USA
| | - K Brooke Russell
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Courtney Tromburg
- Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Sara Cho
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Andrew Tran
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Kathleen Reynolds
- Hematology, Oncology, and Transplant Program, Alberta Children's Hospital, Calgary, Alberta, Canada.,Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
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Max JE, Troyer EA, Arif H, Vaida F, Wilde EA, Bigler ED, Hesselink JR, Yang TT, Tymofiyeva O, Wade O, Paulsen JS. Traumatic Brain Injury in Children and Adolescents: Psychiatric Disorders 24 Years Later. J Neuropsychiatry Clin Neurosci 2022; 34:60-67. [PMID: 34538075 PMCID: PMC9818773 DOI: 10.1176/appi.neuropsych.20050104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The investigators aimed to extend findings regarding predictive factors of psychiatric outcomes among children and adolescents with traumatic brain injury (TBI) from 2 to 24 years postinjury. METHODS Youths aged 6-14 years who were hospitalized following TBI from 1992 to 1994 were assessed at baseline for TBI severity and for preinjury psychiatric, adaptive, and behavioral functioning; family functioning; family psychiatric history; socioeconomic status; and intelligence within weeks of injury. Predictors of psychiatric outcomes following pediatric TBI at 3, 6, 12, and 24 months postinjury have previously been reported. In this study, repeat psychiatric assessments were completed at 24 years postinjury with the same cohort, now adults aged 29-39 years, with the outcome measure being presence of a psychiatric disorder not present before the TBI ("novel psychiatric disorder"). RESULTS Fifty participants with pediatric TBI were initially enrolled, and the long-term outcome analyses focused on data from 45 individuals. Novel psychiatric disorder was present in 24 out of 45 (53%) participants. Presence of a current novel psychiatric disorder was independently predicted by the presence of a preinjury lifetime psychiatric disorder and by severity of TBI. CONCLUSIONS Long-term psychiatric outcome (mean=23.92 years [SD=2.17]) in children and adolescents hospitalized for TBI can be predicted at the point of the initial hospitalization encounter by the presence of a preinjury psychiatric disorder and by greater injury severity.
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Affiliation(s)
- Jeffrey E. Max
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Emily A. Troyer
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Hattan Arif
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Florin Vaida
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Elisabeth A. Wilde
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Erin D. Bigler
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - John R. Hesselink
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Tony T. Yang
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Olga Tymofiyeva
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Owen Wade
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
| | - Jane S. Paulsen
- Department of Psychiatry, University of California, San Diego (Max, Troyer, Arif);Rady Children’s Hospital, San Diego (Max); Department of Psychiatry, University of Iowa, Iowa City (Max, Wade, Paulsen); Department of Family Medicine and Public Health, University of California, San Diego (Vaida); Department of Neurology, TBI and Concussion Center, University of Utah, Salt Lake City (Wilde, Bigler); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Wilde); Department
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Greer KM, Snyder A, Junge C, Reading M, Jarvis S, Squires C, Bigler ED, Popuri K, Beg MF, Taylor HG, Vannatta K, Gerhardt CA, Rubin K, Yeates KO, Cobia D. Surface-based abnormalities of the executive frontostriatial circuit in pediatric TBI. NEUROIMAGE: CLINICAL 2022; 35:103136. [PMID: 36002959 PMCID: PMC9421496 DOI: 10.1016/j.nicl.2022.103136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022] Open
Abstract
Cortical thickness of the dorsolateral prefrontal cortex is reduced in pediatric TBI. Shape abnormalities of the caudate and mediodorsal nucleus of the thalamus are a feature of pediatric TBI. Surface-based abnormalities of the dorsolateral prefrontal loop do not appear to relate to executive functioning.
Childhood traumatic brain injury (TBI) is one of the most common causes of acquired disability and has significant implications for executive functions (EF), such as impaired attention, planning, and initiation that are predictive of everyday functioning. Evidence has suggested attentional features of executive functioning require behavioral flexibility that is dependent on frontostriatial circuitry. The purpose of this study was to evaluate surface-based deformation of a specific frontostriatial circuit in pediatric TBI and its role in EF. Regions of interest included: the dorsolateral prefrontal cortex (DLPFC), caudate nucleus, globus pallidus, and the mediodorsal nucleus of the thalamus (MD). T1-weighted magnetic resonance images were obtained in a sample of children ages 8–13 with complicated mild, moderate, or severe TBI (n = 32) and a group of comparison children with orthopedic injury (OI; n = 30). Brain regions were characterized using high-dimensional surface-based brain mapping procedures. Aspects of EF were assessed using select subtests from the Test of Everyday Attention for Children (TEA-Ch). General linear models tested group and hemisphere differences in DLPFC cortical thickness and subcortical shape of deep-brain regions; Pearson correlations tested relationships with EF. Main effects for group were found in both cortical thickness of the DLPFC (F1,60 = 4.30, p = 0.042) and MD mean deformation (F1,60 = 6.50, p = 0.01) all with lower values in the TBI group. Statistical surface maps revealed significant inward deformation on ventral-medial aspects of the caudate in TBI relative to OI, but null results in the globus pallidus. No significant relationships between EF and any region of interest were observed. Overall, findings revealed abnormalities in multiple aspects of a frontostriatial circuit in pediatric TBI, which may reflect broader pathophysiological mechanisms. Increased consideration for the role of deep-brain structures in pediatric TBI can aid in the clinical characterization of anticipated long-term developmental effects of these individuals.
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Simon P, Nader-Grosbois N. Preschoolers' Empathy Profiles and Their Social Adjustment. Front Psychol 2021; 12:782500. [PMID: 34956001 PMCID: PMC8704132 DOI: 10.3389/fpsyg.2021.782500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/18/2021] [Indexed: 12/30/2022] Open
Abstract
Preschoolers face new challenges in their social life: the development of social and emotional abilities in order to have positive relationships with peers and adults. Empathy, the ability to share and understand the emotions of others, contributes to this socio-emotional adjustment. This exploratory study examines mothers and fathers' perceptions of their child's empathy and individual factors, such as age, gender, and personality, which are related to cognitive and affective empathy in 63 typically developing preschoolers. Links between children's individual characteristics (empathy and personality) and their social adjustment on the one hand and risk of developing internalized vs. externalized behaviors on the other were also investigated. Parents completed four questionnaires about their child's empathy, personality, and social (mal)adjustment. The results showed that mothers and fathers perceived their children's cognitive and affective empathy, attention to others' feelings, and social actions (such as helping), in the same way, except for emotion contagion. Gender differences appeared specifically for some components of empathy: girls were said to pay more attention to others' emotions while boys had better cognitive empathy. Moreover, children's empathy as perceived by mothers or fathers was positively linked with their age, and with personality factors (extraversion, emotional stability, agreeableness, and openness to experience). Cognitive empathy and personality were found to be partly related to higher social skills and lower externalized and internalized behaviors. The results nuanced specific links between cognitive and affective empathy and social adjustment as well as behavior problems at preschool age. These results may have some implications for future research and prevention in childhood.
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Affiliation(s)
- Poline Simon
- Chair Baron Frère in Special Education, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Nathalie Nader-Grosbois
- Chair Baron Frère in Special Education, Psychological Sciences Research Institute, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
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40
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Hearps SJC, Darling SJ, Catroppa C, Payne JM, Haritou F, Beauchamp MH, Muscara F, Anderson VA. The Paediatric Evaluation of Emotions, Relationships, and Socialisation Questionnaire (PEERS-Q): development and validation of a parent-report questionnaire of social skills for children. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1080/00049530.2021.2002126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Simone J. Darling
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Jonathan M. Payne
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Flora Haritou
- Rehabilitation, The Royal Children’s Hospital, Parkville, Australia
| | - Miriam H. Beauchamp
- Department of Psychology, University of Montreal, Montreal, Quebec, Canada
- Brain Development Research Axis, Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
| | - Frank Muscara
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Vicki A. Anderson
- Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Australia
- Psychology Service, The Royal Children’s Hospital, Parkville, Australia
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41
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Schmidt AT, Lindsey HM, Dennis E, Wilde EA, Biekman BD, Chu ZD, Hanten GR, Formon DL, Spruiell MS, Hunter JV, Levin HS. Diffusion Tensor Imaging Correlates of Resilience Following Adolescent Traumatic Brain Injury. Cogn Behav Neurol 2021; 34:259-274. [PMID: 34851864 PMCID: PMC8647770 DOI: 10.1097/wnn.0000000000000283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 11/25/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is associated with considerable mortality and morbidity in adolescents, but positive outcomes are possible. Resilience is the concept that some individuals flourish despite significant adversity. OBJECTIVE To determine if there is a relationship between resilience-promoting factors that are known to promote resilience and white matter (WM) microstructure 1 year after complicated mild TBI or moderate or severe TBI that is sustained by adolescents. METHOD We examined the relationship between performance on a self-report measure of resilience-promoting factors and WM integrity assessed by diffusion tensor imaging in a group of adolescents who had sustained either a TBI (n = 38) or an orthopedic injury (OI) (n = 23). RESULTS Immediately following injury, the individuals with TBI and the OI controls had comparable levels of resilience-promoting factors; however, at 1 year post injury, the TBI group endorsed fewer resilience-promoting factors and exhibited WM disruption compared with the OI controls. The individuals with TBI who had more resilience-promoting factors at 1 year post injury exhibited increased WM integrity, but the OI controls did not. Findings were particularly strong for the following structures: anterior corona radiata, anterior limb of the internal capsule, and genu of the corpus callosum-structures that are implicated in social cognition and are frequently disrupted after TBI. Relationships were notable for caregiver and community-level resilience-promoting factors. CONCLUSION The current findings are some of the first to indicate neurobiological evidence of previously noted buffering effects of resilience-promoting factors in individuals with TBI.
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Affiliation(s)
- Adam T. Schmidt
- Department of Psychological Sciences, Texas Tech University Campus, Lubbock, Texas
| | | | - Emily Dennis
- Department of Neurology, University of Utah, Salt Lake City, Utah
| | | | - Brian D. Biekman
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
| | - Zili D. Chu
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
| | - Gerri R. Hanten
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
| | - Dana L. Formon
- Colorado Department of Human Services, Office of Behavioral Health, Court Services Division, Denver, Colorado
| | - Matthew S. Spruiell
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
| | - Jill V. Hunter
- Department of Radiology, Baylor College of Medicine, Houston, Texas
- Department of Pediatric Radiology, Texas Children’s Hospital, Houston, Texas
| | - Harvey S. Levin
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
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42
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You Only Get One Brain: Adult Reflections on the Long-Term Impacts of Traumatic Brain Injury in Adolescence. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Background:
This research adds to scarce literature regarding adolescent experiences of traumatic brain injury (TBI). Retrospective accounts of young adults who had sustained a TBI in adolescence were analysed to explore the perceived impact this had on their lives and forming identities during this important developmental stage.
Methods:
Thirteen adults (aged 20–25 years; mean 23 years) who sustained a mild or moderate TBI during adolescence (i.e. aged 13–17 years at injury), approximately 7.7 years (range = 6.7–8.0 years) prior, participated in the research. Semi-structured individual interviews, analysed using thematic analysis, explored participants’ experiences following their TBIs.
Results:
Thematic analysis of interview data produced two categories of themes: (1) Impacts on Important Areas of Life, which included: schoolwork suffered, career opportunities became limited, struggling with work and missing out socially; and (2) Impacts on Identity: with themes including feeling ‘stupid’, feeling self-conscious, loss of social identity and being dependent.
Conclusions:
TBI sustained during adolescence can have broad impacts on important areas of life and on developing identity.
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Haebich KM, Dao DP, Pride NA, Barton B, Walsh KS, Maier A, Chisholm AK, Darke H, Catroppa C, Malarbi S, Wilkinson JC, Anderson VA, North KN, Payne JM. The mediating role of ADHD symptoms between executive function and social skills in children with neurofibromatosis type 1. Child Neuropsychol 2021; 28:318-336. [PMID: 34587865 DOI: 10.1080/09297049.2021.1976129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Children with neurofibromatosis type 1 (NF1) often experience executive dysfunction, attention deficit/hyperactivity disorder (ADHD) symptoms and poor social skills, however, the nature of the relationships between these domains in children with NF1 is unclear. This study investigated these relationships using primary caregiver ratings of executive functions, ADHD symptoms and social skills in children with NF1. Participants were 136 children with NF1 and 93 typically developing (TD) controls aged 3-15 years recruited from 3 multidisciplinary neurofibromatosis clinics in Melbourne and Sydney, Australia, and Washington DC, USA. Mediation analysis was performed on primary outcome variables: parent ratings of executive functions (Behavior Rating Inventory of Executive Function, Metacognition Index), ADHD symptoms (Conners-3/Conners ADHD Diagnostic and Statistical Manual for Mental Disorders Scales) and social skills (Social Skills Improvement System-Rating Scale), adjusting for potential confounders (full scale IQ, sex, and social risk). Results revealed significantly poorer executive functions, elevated ADHD symptoms and reduced social skills in children with NF1 compared to controls. Poorer executive functions significantly predicted elevated ADHD symptoms and poorer social skills. Elevated ADHD symptoms significantly mediated the relationship between executive functions and social skills problems although did not fully account for social dysfunction. This study provides evidence for the importance of targeting ADHD symptoms as part of future interventions aimed at promoting prosocial behaviors in children with NF1.
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Affiliation(s)
- Kristina M Haebich
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Duy P Dao
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | - Natalie A Pride
- Kids Ne Uroscience Centre, the Children's Hospital at Westmead, Sydney, Australia.,Discipline of Paediatrics & Child Health, University of Sydney, Sydney, Australia
| | - Belinda Barton
- Kids Ne Uroscience Centre, the Children's Hospital at Westmead, Sydney, Australia.,Discipline of Paediatrics & Child Health, University of Sydney, Sydney, Australia.,Children's Hospital Education Research Institute, the Children's Hospital at Westmead, Sydney, Australia
| | - Karin S Walsh
- Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Washington, DC, USA.,Departments of Pediatrics and Psychiatry, The George Washington University School of Medicine, Washington, DC, USA
| | - Alice Maier
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | - Anita K Chisholm
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Hayley Darke
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Stephanie Malarbi
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Jake C Wilkinson
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,School of Psychology, Cardiff University, Cardiff, UK
| | - Vicki A Anderson
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Kathryn N North
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
| | - Jonathan M Payne
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences,University of Melbourne, Melbourne, Australia
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Behavior Problems Following Childhood TBI: The Role of Sex, Age, and Time Since Injury. J Head Trauma Rehabil 2021; 35:E393-E404. [PMID: 32108717 DOI: 10.1097/htr.0000000000000567] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the frequency of behavioral problems after childhood traumatic brain injury (TBI) and their associations with injury severity, sex, and social environmental factors. SETTING Children's hospitals in the Midwestern/Western United States. PARTICIPANTS 381 boys and 210 girls with moderate (n = 359) and severe (n = 227) TBI, with an average age at injury of 11.7 years (range 0.3-18) who were injured ≤3 years ago. DESIGN Secondary data analysis of a multistudy cohort. MAIN MEASURES Child Behavior Checklist (CBCL) administered pretreatment. RESULTS Thirty-seven percent had borderline/clinical elevations on the CBCL Total Problem Scale, with comparable rates of Internalizing and Externalizing problems (33% and 31%, respectively). Less parental education was associated with higher rates of internalizing, externalizing, and total problems. Time since injury had a linear association with internalizing symptoms, with greater symptoms at longer postinjury intervals. Younger boys had significantly higher levels of oppositional defiant symptoms than girls, whereas older girls had significantly greater attention-deficit hyperactivity disorder symptoms than boys. CONCLUSIONS Pediatric TBI is associated with high rates of behavior problems, with lower socioeconomic status predicting substantially elevated risk. Associations of higher levels of internalizing symptoms with greater time since injury highlight the importance of tracking children over time.
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Winning AM, Moscato EL, Lehmann V, Keim MC, Rausch JR, Lipak KG, Himelhoch AC, Murphy LK, Prussien KV, Olshefski RS, Vannatta K, Compas BE, Gerhardt CA. Impact of central nervous system-directed treatment on competence and adjustment among children in early cancer survivorship. Pediatr Blood Cancer 2021; 68:e29220. [PMID: 34245215 DOI: 10.1002/pbc.29220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/12/2021] [Accepted: 06/05/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Central nervous system (CNS)-directed treatments can cause long-term academic, social, and emotional difficulties for children with cancer. However, limited research has examined the emergence of problems longitudinally and has often stratified risk by diagnosis alone. Therefore, this study compared competence and adjustment in children, who did and did not receive CNS-directed treatment, over the first 3 years following a cancer diagnosis. PROCEDURE Mothers, fathers, and children (ages 5-18 years at diagnosis) from 217 families reported on the child's competence (academic, social) and adjustment (anxious/depressed, withdrawn/depressed) near a new cancer diagnosis or relapse and 3 years later. Children were categorized into CNS-directed treatment (n = 112; including cranial radiation, intrathecal chemotherapy, and/or neurosurgery) and non-CNS-directed treatment (n = 105) groups. RESULTS At enrollment, there were few differences in competence and emotional adjustment among children based on treatment or diagnostic group. At 3 years, mothers and fathers reported poorer social competence for the CNS-directed treatment group, and fathers reported poorer school competence for the CNS-directed treatment group. Over time, father ratings of social competence increased for the non-CNS-directed treatment group, but not the CNS-directed treatment group. While father ratings of academic competence declined for the CNS-directed treatment group, mother ratings declined the most for children diagnosed with a brain tumor. All children demonstrated higher anxious/depressed scores over time. CONCLUSIONS CNS-directed treatment may be a valuable indicator to identify childhood cancer survivors at risk for poor competence during early survivorship. Follow-up screening and supportive services are recommended, as well as additional longitudinal research.
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Affiliation(s)
- Adrien M Winning
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Emily L Moscato
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Vicky Lehmann
- Department of Medical Psychology, Cancer Center Amsterdam, Amsterdam University Medical Centers, Amsterdam, USA
| | - Madelaine C Keim
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Joseph R Rausch
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Keagan G Lipak
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Alexandra C Himelhoch
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Lexa K Murphy
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Kemar V Prussien
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Randal S Olshefski
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA.,Division of Hematology/Oncology/BMT, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kathryn Vannatta
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Bruce E Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Cynthia A Gerhardt
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
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Zamani A, Ryan NP, Wright DK, Caeyenberghs K, Semple BD. The Impact of Traumatic Injury to the Immature Human Brain: A Scoping Review with Insights from Advanced Structural Neuroimaging. J Neurotrauma 2021; 37:724-738. [PMID: 32037951 DOI: 10.1089/neu.2019.6895] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Traumatic brain injury (TBI) during critical periods of early-life brain development can affect the normal formation of brain networks responsible for a range of complex social behaviors. Because of the protracted nature of brain and behavioral development, deficits in cognitive and socioaffective behaviors may not become evident until late adolescence and early adulthood, when such skills are expected to reach maturity. In addition, multiple pre- and post-injury factors can interact with the effects of early brain insult to influence long-term outcomes. In recent years, with advancements in magnetic-resonance-based neuroimaging techniques and analysis, studies of the pediatric population have revealed a link between neurobehavioral deficits, such as social dysfunction, with white matter damage. In this review, in which we focus on contributions from Australian researchers to the field, we have highlighted pioneering longitudinal studies in pediatric TBI, in relation to social deficits specifically. We also discuss the use of advanced neuroimaging and novel behavioral assays in animal models of TBI in the immature brain. Together, this research aims to understand the relationship between injury consequences and ongoing brain development after pediatric TBI, which promises to improve prediction of the behavioral deficits that emerge in the years subsequent to early-life injury.
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Affiliation(s)
- Akram Zamani
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Nicholas P Ryan
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Melbourne, Victoria, Australia.,Brain & Mind Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - David K Wright
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia
| | - Karen Caeyenberghs
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Bridgette D Semple
- Department of Neuroscience, Monash University, Melbourne, Victoria, Australia.,Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
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Parker KN, Donovan MH, Smith K, Noble-Haeusslein LJ. Traumatic Injury to the Developing Brain: Emerging Relationship to Early Life Stress. Front Neurol 2021; 12:708800. [PMID: 34484104 PMCID: PMC8416304 DOI: 10.3389/fneur.2021.708800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/22/2021] [Indexed: 12/01/2022] Open
Abstract
Despite the high incidence of brain injuries in children, we have yet to fully understand the unique vulnerability of a young brain to an injury and key determinants of long-term recovery. Here we consider how early life stress may influence recovery after an early age brain injury. Studies of early life stress alone reveal persistent structural and functional impairments at adulthood. We consider the interacting pathologies imposed by early life stress and subsequent brain injuries during early brain development as well as at adulthood. This review outlines how early life stress primes the immune cells of the brain and periphery to elicit a heightened response to injury. While the focus of this review is on early age traumatic brain injuries, there is also a consideration of preclinical models of neonatal hypoxia and stroke, as each further speaks to the vulnerability of the brain and reinforces those characteristics that are common across each of these injuries. Lastly, we identify a common mechanistic trend; namely, early life stress worsens outcomes independent of its temporal proximity to a brain injury.
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Affiliation(s)
- Kaila N. Parker
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Psychology, Behavioral Neuroscience, College of Liberal Arts, University of Texas at Austin, Austin, TX, United States
| | - Michael H. Donovan
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Psychology, Behavioral Neuroscience, College of Liberal Arts, University of Texas at Austin, Austin, TX, United States
| | - Kylee Smith
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Psychology, Behavioral Neuroscience, College of Liberal Arts, University of Texas at Austin, Austin, TX, United States
| | - Linda J. Noble-Haeusslein
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Psychology, Behavioral Neuroscience, College of Liberal Arts, University of Texas at Austin, Austin, TX, United States
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Hocking MC, Albee M, Brodsky C, Shabason E, Wang L, Schultz RT, Herrington J. Face Processing and Social Functioning in Pediatric Brain Tumor Survivors. J Pediatr Psychol 2021; 46:1267-1275. [PMID: 34313751 DOI: 10.1093/jpepsy/jsab067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Pediatric brain tumor survivors (PBTS) experience deficits in social functioning. Facial expression and identity recognition are key components of social information processing and are widely studied as an index of social difficulties in youth with autism spectrum disorder (ASD) and other neurodevelopmental conditions. This study evaluated facial expression and identity recognition among PBTS, youth with ASD, and typically developing (TD) youth, and the associations between these face processing skills and social impairments. METHODS PBTS (N = 54; ages 7-16) who completed treatment at least 2 years prior were matched with TD (N = 43) youth and youth with ASD (N = 55) based on sex and IQ. Parents completed a measure of social impairments and youth completed a measure of facial expression and identity recognition. RESULTS Groups significantly differed on social impairments (p < .001), with youth with ASD scoring highest followed by PBTS and lastly TD youth. Youth with ASD performed significantly worse on the two measures of facial processing, while TD youth and PBTS were not statistically different. The association of facial expression recognition and social impairments was moderated by group, such that PBTS with higher levels of social impairment performed worse on the expression task compared to TD and ASD groups (p < .01, η2 = 0.07). CONCLUSIONS Variability in face processing may be uniquely important to the social challenges of PBTS compared to other neurodevelopmental populations. Future directions include prospectively examining associations between facial expression recognition and social difficulties in PBTS and face processing training as an intervention for PBTS.
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Affiliation(s)
- Matthew C Hocking
- Children's Hospital of Philadelphia and The University of Pennsylvania
| | | | | | | | - Leah Wang
- Children's Hospital of Philadelphia and The University of Pennsylvania
| | - Robert T Schultz
- Children's Hospital of Philadelphia and The University of Pennsylvania
| | - John Herrington
- Children's Hospital of Philadelphia and The University of Pennsylvania
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Chaves ACS, Reis FJJ, Bandeira PM, Fernandes O, Arruda Sanchez T. Autonomic dysregulation and impairments in the recognition of facial emotional expressions in patients with chronic musculoskeletal pain. Scand J Pain 2021; 21:530-538. [PMID: 33725753 DOI: 10.1515/sjpain-2020-0132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/12/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Emotions are involved in the identification of safety cues in the environment, and are also related to social interaction through recognition of emotional facial expressions. Heart rate variability (HRV) can be an indicator of the adaptive response of the autonomic nervous system to stressful conditions, including pain. This study aimed to investigate the emotional processing in a sample of patients with chronic musculoskeletal by measuring the resting-state HRV and the ability to recognize facial emotion expressions. METHODS This cross-sectional study was composed of 40 participants with chronic musculoskeletal pain and 40 asymptomatic participants. Resting HRV was measured for 10 min. The facial emotion recognition task was presented in videos and included modification from a neutral expression to faces of fear, anger, sadness, happiness, and disgust. For the facial emotion recognition task, the hit rate (%) and response time for each emotional category were measured. RESULTS The symptomatic group had a mean high frequency (HF) lower (mean = 34.14; SD = 16.95; p<0.001) than the asymptomatic group (mean = 51.11; SD = 13.01; p<0.001). The emotional facial expressions of disgust (H (1, 80)=7.82; p<0.01), anger (H (1, 80)=13.56; p<0.01), sadness (H (1, 80)=6.58; p=0.01), and happiness (H (1, 80)=12.68; p<0.01) were those for which volunteers from the symptomatic group had a lower hit rate of correct answers compared to the asymptomatic group. The response time to corrected answers showed a major group effect (F (1.77)=21.11; p<0.001) and emotional category (F (4.308)=174.21; p<0.001), without presenting any interaction between the factors (F (4.308)=0.446; p=0.775). The symptomatic group was slower to perform the task of identifying facial emotional expression (7.066 s; SD = 1.188) than the participants in the asymptomatic group (6.298 s; SD = 1.203) for all emotional categories. CONCLUSIONS Participants with chronic musculoskeletal pain presented a lower vagal activity evidenced by HRV. Participants in the symptomatic group showed lower ability to recognize faces of disgust, anger, and sadness when compared to asymptomatic participants. Considering that individuals with low resting HF-HRV have difficulties with regulating their emotions, the lower vagal activity and lower ability to recognize faces of emotional expressions observed in chronic musculoskeletal pain may suggest alterations in emotional processing. This study may shed light on changes in the emotional processing and in the autonomic nervous system in this population.
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Affiliation(s)
- Anna C S Chaves
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Felipe J J Reis
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Pamela M Bandeira
- Postgraduate Program in Medicine (Cardiology), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Orlando Fernandes
- Postgraduate Program in Radiology, Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Tiago Arruda Sanchez
- Postgraduate Program in Medicine (Cardiology), Department of Radiology, Faculty of Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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"I'm With my People!": Perceived Benefits of Participation in a Group Social Skills Intervention for Children and Adolescent Survivors of Brain Tumors. Cancer Nurs 2021; 44:197-204. [PMID: 32000176 DOI: 10.1097/ncc.0000000000000779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Children and adolescent survivors of brain tumors may experience impairments in social competence. OBJECTIVE This qualitative randomized controlled substudy aimed to investigate the outcomes of a social skills intervention group by interviewing these children and adolescents and their caregivers following group participation. INTERVENTIONS/METHODS Children and adolescents were randomized to the Social Skills Intervention Program or the attention control group. Using purposive sampling, 12 patients (average age, 11.42 years) and 12 caregivers were interviewed following group participation. The Social Skills Intervention Program consists of eight 2-hour manualized sessions delivered weekly; each session was structured around a social skill (eg, making friends, bullying) through arts and crafts and cognitive-behavioral strategies. The sessions in the control group were structured around daily themes (eg, summer activities) doing arts and crafts. Interviews were analyzed using content analysis. RESULTS Themes unique to the intervention program included improved self-control and self-acceptance, reduced feelings of sadness, and improved problem solving. Themes common to both groups included group bonding over similar experiences, increased social confidence with peers and family, and reduced acting out. CONCLUSIONS This study uncovered additional unique intervention effects not captured by quantitative measures: improved self-control and problem solving and benefits of the group experience in general. IMPLICATIONS FOR PRACTICE Findings support the need for group socialization opportunities for children with brain tumors. Nurses can promote socializing opportunities for children and adolescent survivors of brain tumors during and after medical treatment ends to prevent social competence deterioration.
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