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Dykens EM, Roof E, Hunt-Hawkins H. The Prader-Willi syndrome Profile: validation of a new measure of behavioral and emotional problems in Prader-Willi syndrome. Orphanet J Rare Dis 2024; 19:83. [PMID: 38395848 PMCID: PMC10885615 DOI: 10.1186/s13023-024-03045-9] [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: 08/16/2023] [Accepted: 01/19/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a rare, neurodevelopmental disorder caused by the lack of expression of paternally imprinted genes on chromosome 15q11-13. PWS features a complex behavioral phenotype, including hyperphagia, anxiety, compulsivity, rigidity, repetitive speech, temper outbursts, aggressivity, and skin-picking. Questionnaires exist for measuring hyperphagia, but not for the aggregation of other problems that are distinctive to PWS. A PWS-specific tool is needed for phenotypic research, and to help evaluate treatment efficacy in future clinical trials aimed at attenuating PWS's hyperphagia and related problems. In this 4-phase study, we leveraged our expertise in PWS with feedback from families and specialists to validate the PWS Profile, a novel, informant-based measure of behavioral and emotional problems in this syndrome. RESULTS The authors developed a bank of 73 items that tapped both common and less frequent but clinically significant problems in PWS (Phase 1). An iterative feedback process with families and stakeholders was used to ensure content and construct validity (Phase 2). After adding, omitting, or revising items, in Phase 3, we pilot tested the measure in 112 participants. Results were reviewed by an international team of PWS specialists and revised again (Phase 3). The final, 57-item Profile was then administered to 761 participants (Phase 4). Principal component factor analyses (n = 873) revealed eight conceptually meaningful factors, accounting for 60.52% of test variance, and were readily interpretated as: Rigidity, Insistence; Aggressive Behaviors; Repetitive Questioning, Speech; Compulsive Behaviors; Depression, Anxiety; Hoarding; Negative Distorted Thinking; and Magical Distorted Thinking. Factors were internally consistent and showed good test-retest reliability and convergent validity with existent measures of behavioral problems. Profile factors were not related to IQ, BMI, or parental SES. Three Profile factors differed across PWS genetic subtypes. Age and gender differences were found in only one Profile factor, Hoarding. CONCLUSIONS The PWS Profile is a valid, psychometrically-sound questionnaire that already has shown responsivity to treatment in a previous clinical trial. The Profile can extend the reach of future clinical trials by evaluating the impact of novel agents not only on hyperphagia, but also on the emotional and behavioral problems that characterize PWS.
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Affiliation(s)
- Elisabeth M Dykens
- Department of Psychology and Human Development, Vanderbilt University, Vanderbilt Kennedy Center, 1 Magnolia Circle, 37203, Nashville, TN, USA.
| | - Elizabeth Roof
- Department of Psychology and Human Development, Vanderbilt University, Vanderbilt Kennedy Center, 1 Magnolia Circle, 37203, Nashville, TN, USA
| | - Hailee Hunt-Hawkins
- Department of Psychology and Human Development, Vanderbilt University, Vanderbilt Kennedy Center, 1 Magnolia Circle, 37203, Nashville, TN, USA
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Santambrogio J, Bertelli MO, Terrevazzi S, De Carolis L, Francia E, Boldoni C, Calascibetta M, Cudazzo E, Lucca C, Viganò V, Danese M, Minazzi GA, Santarone A, Bianco A, Hassiotis A, Clerici M. Cognitive dysfunction and psychopathology: a cohort study of adults with intellectual developmental disorder. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:1029-1045. [PMID: 37690814 DOI: 10.1111/jir.13077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Cognitive impairment of intellectual developmental disorders (IDD) is determined by several different combinations of specific cognitive alterations. People with IDD present a rate of mental health problems that is up to 4 times higher than that of the general population. Despite this, the relationship between specific cognitive dysfunctions and co-occurring mental disorders has not been adequately studied. The aim of the present paper is to investigate the association between specific cognitive dysfunctions and specific psychiatric symptoms and syndromes in people with IDD. METHODS One hundred and twenty adults with mild to moderate IDD living in residential facilities underwent a clinical and instrumental assessment for specific cognitive and psychopathological features. RESULTS Participants with IDD and ASD have significantly lower scores compared to those without respect to who has not the diagnosis on the Processing Speed Index (PSI) and Perceptual Reasoning Index (PRI) on the WAIS-IV and higher time scores on the TMT A. Moreover, there is a significant association between years of hospitalisation and TMT B and TMT B A time scores; the longer a participant with IDD was hospitalised, the worse their performance on the TMT. Although not statistically significant, many psychopathological clusters showed substantial cognitive profiles. CONCLUSIONS Although further research is needed, neuropsychological and IQ tests scores seem to be differently associated to various psychopathological conditions co-occurring with IDD, and with ASD especially. Cognitive assessment seems to support diagnosis and treatment of psychopathological co-occurrences in persons with IDD, also in consideration of indirect implications including a better knowledge of the patient's characteristics beyond IQ deficit.
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Affiliation(s)
- J Santambrogio
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
- Presidio Corberi, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - M O Bertelli
- Research and Clinical Center (CREA), San Sebastiano Foundation, Misericordia di Firenze, Firenze, Italy
| | - S Terrevazzi
- Presidio Corberi, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - L De Carolis
- Department of Economics, Management and Statistics, University of Milano-Bicocca, Milan, Italy
| | - E Francia
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
| | - C Boldoni
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - M Calascibetta
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - E Cudazzo
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - C Lucca
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - V Viganò
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - M Danese
- RSD Beato Papa Giovanni XXIII, Mental Health and Addiction Department, ASST Brianza, Limbiate (MB), Italy
| | - G A Minazzi
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - A Santarone
- Adele Bonolis AS.FRA. Onlus Foundation, Vedano al Lambro (MB), Italy
| | - A Bianco
- Research and Clinical Center (CREA), San Sebastiano Foundation, Misericordia di Firenze, Firenze, Italy
| | - A Hassiotis
- Division of Psychiatry, University College of London, London, UK
| | - M Clerici
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Mental Health and Addiction Department, IRCCS Ospedale San Gerardo dei Tintori, Monza, Italy
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Camblats AM, Mathey S, Robert C, Estival S, Chevalère J, Maire J, Tauber M, Laurier V, Tricot J, Mourre F, Postal V. Interference effect of food and emotional stimuli in Stroop-like tasks for children and adults with Prader-Willi Syndrome. J Clin Exp Neuropsychol 2023:1-16. [PMID: 37113059 DOI: 10.1080/13803395.2023.2207777] [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: 04/29/2023]
Abstract
Interference effect of food and emotional stimuli in Stroop-like tasks for children and adults with Prader-Willi Syndrome. The aim of this work was to study the way items related to food or emotion are processed by a population known to have difficulties with dietary restriction, namely individuals with Prader-Willi Syndrome (PWS). Given the presence of intellectual disability (ID) in PWS, our experiments were designed to examine whether these difficulties were specific to PWS or linked with their ID. Two modified Stroop tasks (i.e., a food version and an emotional version) were administered to seventy-four children (aged between 6 and 16 years old) divided into three groups (one with PWS, one with ID matched on age and Intellectual Quotient (IQ), and one healthy group matched on age) and to eighty-four adults (aged between 18 and 48 years old) distributed in the same three groups. For both tasks, a picture version was used for the children and a word version for the adults. For the food Stroop task, (Experiment 1), materials were composed of low or high-caloric food items and stimuli not related to food. The results show a food Stroop effect for children and adults with PWS that was absent in the group of healthy participants. Moreover, a food Stroop effect was also significant for adults with ID. For the emotional Stroop task (Experiment 2), materials were composed of negative, positive and neutral stimuli. The emotional Stroop effect was also obtained for children and adults with PWS as well as for the healthy group, but not for the age- and IQ-matched group. For the PWS groups, results show a preservation to process positive pictures for children and difficulties to process negative stimuli for both age-groups. These results suggest that people with PWS have difficulties in disengaging their attention when food stimuli are present in their environment and poorer abilities to process negative ones. These difficulties endure in adulthood.
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Affiliation(s)
| | - Stéphanie Mathey
- laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Christelle Robert
- laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Séverine Estival
- laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | - Johann Chevalère
- Laboratoire de Psychologie Sociale et Cognitive (LAPSCO), UMR 6024, CNRS & Université Clermont-Auvergne, Clermont-Ferrand, France
| | - Jenna Maire
- Unité de recherche CERES, Institut Catholique de Toulouse, Toulouse, France
| | - Maïthé Tauber
- Centre de Référence du Syndrome de Prader-Willi, CHU Toulouse, Toulouse, France
| | - Virginie Laurier
- Centre de Référence des maladies rares PRADORT pour le Syndrome de Prader-Willi et autres et autres Obésités Rares avec TCA, AP-HP Hôpital Marin, Hendaye, France
| | - Julie Tricot
- Centre de Référence des maladies rares PRADORT pour le Syndrome de Prader-Willi et autres et autres Obésités Rares avec TCA, AP-HP Hôpital Marin, Hendaye, France
| | - Fabien Mourre
- Centre de Référence des maladies rares PRADORT pour le Syndrome de Prader-Willi et autres et autres Obésités Rares avec TCA, AP-HP Hôpital Marin, Hendaye, France
| | - Virginie Postal
- laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
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Waite J, Beck SR, Powis L, Oliver C. The Executive Function Account of Repetitive Behavior: Evidence From Rubinstein-Taybi Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:49-65. [PMID: 36548376 DOI: 10.1352/1944-7558-128.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/29/2022] [Indexed: 06/17/2023]
Abstract
In this study, we focus on Rubinstein-Taybi syndrome (RTS) to explore the associations between executive function deficits and repetitive behaviors. Thirty individuals with RTS completed direct assessments of inhibition, working memory and set-shifting. Informants completed repetitive behavior and executive function questionnaires. Repetitive questions were associated with poorer inhibition and working memory. Stereotypy was associated with poorer inhibition. Adherence to routines was associated with poorer set-shifting, but only on the parental report measure. No other associations were evident. There is evidence of an association between specific repetitive behaviors and executive functioning in RTS, suggesting executive dysfunction may underpin behavioral difference in RTS. The findings point towards specific associations that are of interest for further research across populations in which repetitive behaviors are present.
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Affiliation(s)
- Jane Waite
- Jane Waite, College of Health and Life Sciences, School of Psychology, Aston University, Birmingham, UK
| | - Sarah R Beck
- Sarah R. Beck, Laurie Powis, and Chris Oliver, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Laurie Powis
- Sarah R. Beck, Laurie Powis, and Chris Oliver, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Chris Oliver
- Sarah R. Beck, Laurie Powis, and Chris Oliver, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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Establishing the transdiagnostic contextual pathways of emotional outbursts. Sci Rep 2022; 12:7414. [PMID: 35523842 PMCID: PMC9076826 DOI: 10.1038/s41598-022-11474-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/22/2022] [Indexed: 12/27/2022] Open
Abstract
Emotional outbursts or temper outbursts are challenging behaviours commonly experienced by people with neurodevelopmental disorders and people who have experienced childhood adversity, which can negatively impact individuals and their families. Emotional outbursts may manifest in different situations via unique pathways distinguished by context-specific differences in the regulation and expression of emotions. Caregivers (N = 268) of young people (6-25 years) with emotional outbursts completed a bespoke caregiver-report questionnaire. Potential pathways were identified by examining the patterns of antecedents and setting events related to outbursts through factor and cluster analyses. Six contextual factors were derived from the Emotional Outburst Questionnaire. Based on these factors, the responses were classified into three clusters, which may represent potential pathways of emotional outbursts. The three clusters were characterized by the increased likelihood of outbursts: (1) across all setting events and triggers; (2) in safe setting events; (3) in unsafe setting events. These potential pathways may be related to: (1) differences in sensory processing; (2) masking of emotions in unsafe environments; (3) differences in safety perception. This framework supports a transdiagnostic account of emotional outbursts and may facilitate the development of pathway-specific intervention strategies.
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Deest M, Buchholz V, Jahn K, Eberlein C, Bleich S, Frieling H. Hypomethylation of monoamine oxidase A promoter/exon 1 region is associated with temper outbursts in Prader-Willi syndrome. J Psychiatr Res 2022; 149:359-366. [PMID: 34782122 DOI: 10.1016/j.jpsychires.2021.11.024] [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: 06/24/2021] [Revised: 10/06/2021] [Accepted: 11/06/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a rare neurodevelopmental disorder caused by the absence of paternally expressed and maternally imprinted genes on chromosome 15q 11.2-13. It is associated with a certain behavioural phenotype, especially temper outbursts with verbal and physical aggression towards others. Recent studies show a promising therapeutic effect of serotonin reuptake inhibitors like sertraline on frequency and intensity of outbursts. Monoamine oxidase A (MAOA) (X p11.23) plays a crucial role in the metabolism of monoamines. Dysregulation in methylation of the CpG island spanning the promoter region and exon 1 of MAOA is implicated in impulsive and aggressive behaviour. METHODS In the present study, methylation rates of CpG dinucleotides in the MAOA promoter and exon 1 region were determined from DNA derived from whole blood samples of PWS patients (n = 32) and controls (n = 14) matched for age, sex and BMI via bisulfite sequencing. PWS patients were grouped into those showing temper outbursts, and those who do not. RESULTS Overall, PWS patients show a significant lower methylation rate at the promoter/exon 1 region than healthy controls in both sexes. Furthermore, PWS patients, male as well female with temper outbursts show a significant lower methylation rate than those without temper outbursts (p < 0.001 and p = 0.006). CONCLUSION The MAOA promoter/exon 1 region methylation seems to be dysregulated in PWS patients in sense of a hypomethylation, especially in those suffering from temper outbursts. This dysregulation probably plays a crucial role in the pathophysiology of temper outbursts in PWS.
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Affiliation(s)
- Maximilian Deest
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany.
| | - Vanessa Buchholz
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
| | - Kirsten Jahn
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
| | - Christian Eberlein
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
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Perry V, Ellis K, Moss J, Beck SR, Singla G, Crawford H, Waite J, Richards C, Oliver C. Executive function, repetitive behaviour and restricted interests in neurodevelopmental disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 122:104166. [PMID: 35016127 DOI: 10.1016/j.ridd.2021.104166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/18/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Individuals with genetic syndromes show unique profiles of repetitive behaviours and restricted interests (RRBs). The executive dysfunction account of RRBs suggests that in autistic (AUT) individuals executive function impairments underpin RRBs, but not communication and social interaction autistic characteristics. AIMS To 1) describe profiles of behavioural manifestations of executive function (EF behaviours) and 2) explore the relationship between EF behaviours and autistic traits across individuals with Cornelia de Lange (CdLS), fragile X (FXS) and Rubinstein-Taybi syndromes (RTS), and AUT individuals. METHOD Carers completed the Behavior Rating Inventory of Executive Function - Preschool Version and the Social Communication Questionnaire. Data reporting on 25 individuals with CdLS (Mage = 18.60, SD = 8.94), 25 with FXS (Mage = 18.48, SD = 8.80), 25 with RTS (Mage = 18.60, SD = 8.65) and 25 AUT individuals (Mage = 18.52, SD = 8.65) matched on chronological age and adaptive ability were included in analyses. RESULTS All groups showed impairments across EF behaviours compared to two-to-three-year-old typically developing normative samples with no differences between groups. Different EF behaviours predicted RRBs in the syndrome groups with no associations found in the AUT group. CONCLUSIONS Syndrome related differences should be considered when developing targeted interventions that focus on EF behaviours and/or RRBs in these groups.
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Affiliation(s)
- Victoria Perry
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom; Coventry and Warwickshire Partnership NHS Trust, Wayside House, Wilsons Lane, Coventry, CV6 6NY, United Kingdom
| | - Katherine Ellis
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom; School of Psychology, University of Surrey, Guildford, GU2 7XH, United Kingdom.
| | - Jo Moss
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom; School of Psychology, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - Sarah R Beck
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom
| | - Gursharan Singla
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom
| | - Hayley Crawford
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom; CMHWR and Mental Health and Wellbeing Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Jane Waite
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom; School of Health & Life Sciences, Aston University, Birmingham, B4 7ET, United Kingdom
| | - Caroline Richards
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom
| | - Chris Oliver
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom
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Behavior Problems and Social Competence in Fragile X Syndrome: A Systematic Review. Genes (Basel) 2022; 13:genes13020280. [PMID: 35205326 PMCID: PMC8871871 DOI: 10.3390/genes13020280] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 02/06/2023] Open
Abstract
Fragile X syndrome (FXS) causes intellectual disability and is the known leading cause of autism. Common problems in FXS include behavior and social problems. Along with syndromic characteristics and autism comorbidity, environmental factors might influence these difficulties. This systematic review focuses on the last 20 years of studies concerning behavior and social problems in FXS, considering environmental and personal variables that might influence both problems. Three databases were reviewed, leading to fifty-one studies meeting the inclusion criteria. Attention deficit hyperactivity disorder (ADHD) problems remain the greatest behavior problems, with behavioral problems and social competence being stable during the 20 years. Some developmental trajectories might have changed due to higher methodological control, such as aggressive behavior and attention problems. The socialization trajectory from childhood to adolescence remains unclear. Comorbidity with autism in individuals with FXS increased behavior problems and worsened social competence profiles. At the same time, comparisons between individuals with comorbid FXS and autism and individuals with autism might help define the comorbid phenotype. Environmental factors and parental characteristics influenced behavior problems and social competence. Higher methodological control is needed in studies including autism symptomatology and parental characteristics. More studies comparing autism in FXS with idiopathic autism are needed to discern differences between conditions.
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Chevalère J, Camblats AM, Laurier V, Mourre F, Estival S, Postal V. The influence of emotional contexts on mental flexibility in Prader-Willi syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:133-150. [PMID: 33491829 DOI: 10.1111/jir.12817] [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: 04/21/2020] [Revised: 10/15/2020] [Accepted: 12/18/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The present study investigated the influence of emotional contexts on mental flexibility in adults with Prader-Willi syndrome (PWS) using a voluntary task-switching paradigm that was implemented with emotionally valenced pictures. The study aims were to assess whether adults with PWS have impaired switching abilities, whether the deficit is specific to PWS or linked to intellectual disabilities, and the influence of emotional contexts on performance. METHOD The task-switching performance of 30 adults with PWS was compared with that of 30 healthy adults matched on chronological age, and to that of 30 adults with intellectual disabilities but without PWS, matched on intellectual quotient level and chronological age. Indicators of switching performance were switching cost and repetition bias. Emotional contexts were operationalised with positive, neutral and negative task-irrelevant pictures. RESULTS Adults with PWS showed a large increase in switching costs compared with the two control groups, and this effect did not vary across emotional contexts. More fine-tuned examination revealed subtle performance modulations: negative contexts tended to increase the repetition bias in all three groups while positive contexts slowed down global performance in PWS. CONCLUSIONS The results confirmed previous studies, showing impaired switching abilities in PWS over and beyond the influence of intellectual level, but revealed no robust variations in switching deficits across emotional contexts.
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Affiliation(s)
- J Chevalère
- Laboratoire de Psychologie Sociale et Cognitive (LAPSCO), UMR 6024, CNRS & Univ. Clermont-Auvergne, Clermont-Ferrand, France
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
| | - A-M Camblats
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
| | - V Laurier
- AP-HP Hôpital Marin, Hendaye, France
| | - F Mourre
- AP-HP Hôpital Marin, Hendaye, France
| | - S Estival
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
| | - V Postal
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
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Dykens EM, Roof E, Hunt-Hawkins H. 'The cure for us is a lot of things': How young people with Prader-Willi syndrome view themselves and future clinical trials. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:460-470. [PMID: 34904341 DOI: 10.1111/jar.12950] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/09/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite work on the self-identities of people with intellectual disabilities, research has yet to describe the self-perceptions of people with Prader-Willi syndrome (PWS). The perspectives of those with PWS are also important for rapidly evolving clinical trials aimed at treating symptoms of PWS. METHOD Twenty-one young people with PWS were administered a semi-structured interview that assessed how they perceive their syndrome and clinical trials. Transcribed interviews were reliably coded using content-driven, applied thematic analyses. RESULTS Five themes emerged: struggles with chronic hunger and food-seeking that impede goals and relationships; struggles with anxiety and outbursts, schedule changes and school; distancing from PWS; needs for clinical trials that cure PWS, reduce hunger or anxiety, and lead to improved outcomes; and needs for advocacy and awareness of PWS. CONCLUSIONS Findings shed new light on the self-perceptions of those with PWS and have important implications for current interventions and future clinical trials.
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Affiliation(s)
- Elisabeth M Dykens
- Department of Psychology and Human Development, Vanderbilt Kennedy Center, Vanderbilt University, Nashville, Tennessee, USA
| | - Elizabeth Roof
- Department of Psychology and Human Development, Vanderbilt Kennedy Center, Vanderbilt University, Nashville, Tennessee, USA
| | - Hailee Hunt-Hawkins
- Department of Psychology and Human Development, Vanderbilt Kennedy Center, Vanderbilt University, Nashville, Tennessee, USA
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Blackwell S, Zylberberg A, Scerif G, Miller S, Woodcock KA. Understanding the psycho-social context for a new early intervention for resistance to change that aims to strike a beneficial balance between structure and flexibility. BMC Psychiatry 2021; 21:621. [PMID: 34895178 PMCID: PMC8665637 DOI: 10.1186/s12888-021-03519-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 10/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emotional and behavioural problems linked to changes to expectations - resistance to change - are linked to disability in neurodevelopmental disorders, including autism spectrum disorder (ASD), Prader-Willi (PWS) and fragile X syndromes (FXS). Structuring routines is best practice for minimising current resistance to change. But complete structure is impractical and flexibility in early life may actually reduce later resistance by supporting cognitive development. We aimed to examine the psycho-social context of families with children at risk of developing resistance to change so as to identify design requirements for an intervention that strikes a beneficial balance between structure and flexibility. METHODS Thirty-six caregivers of children aged 4-12 years (17 ASD, 15 PWS, and 4 FXS) took part in an interview designed collaboratively with 12 professional stakeholders. RESULTS Children need to feel like they are in control of flexibility but they also need support in choice making, understanding plans (using individually tailored visuals) and anxiety reduction. Caregivers need an accessible approach that they have full control over, and which they can tailor for their child. Caregivers also need clear guidance, education and support around structure and flexibility. CONCLUSIONS We propose a digital approach which addresses the needs identified. It tackles the most perplexing challenge by presenting flexibility to children in the context of a game that children can feel they have full control over, whilst caregivers can maintain control in reality. Furthermore, individualised support for children and caregivers would be enabled.
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Affiliation(s)
- Siobhan Blackwell
- Centre for Applied Psychology, School of Psychology & Institute for Mental Health, University of Birmingham, 52 Pritchatts Road, Edgbaston, Birmingham, B15 2SA, UK
| | - Alex Zylberberg
- Centre for Applied Psychology, School of Psychology & Institute for Mental Health, University of Birmingham, 52 Pritchatts Road, Edgbaston, Birmingham, B15 2SA, UK
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Sarah Miller
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Kate A Woodcock
- Centre for Applied Psychology, School of Psychology & Institute for Mental Health, University of Birmingham, 52 Pritchatts Road, Edgbaston, Birmingham, B15 2SA, UK.
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12
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Abstract
OBJECTIVE To explore motor praxis in adults with Prader-Willi syndrome (PWS) in comparison with a control group of people with intellectual disability (ID) and to examine the relationship with brain structural measurements. METHOD Thirty adult participants with PWS and 132 with ID of nongenetic etiology (matched by age, sex, and ID level) were assessed using a comprehensive evaluation of the praxis function, which included pantomime of tool use, imitation of meaningful and meaningless gestures, motor sequencing, and constructional praxis. RESULTS Results support specific praxis difficulties in PWS, with worse performance in the imitation of motor actions and better performance in constructional praxis than ID peers. Compared with both control groups, PWS showed increased gray matter volume in sensorimotor and subcortical regions. However, we found no obvious association between these alterations and praxis performance. Instead, praxis scores correlated with regional volume measures in distributed apparently normal brain areas. CONCLUSIONS Our findings are consistent in showing significant impairment in gesture imitation abilities in PWS and, otherwise, further indicate that the visuospatial praxis domain is relatively preserved. Praxis disability in PWS was not associated with a specific, focal alteration of brain anatomy. Altered imitation gestures could, therefore, be a consequence of widespread brain dysfunction. However, the specific contribution of key brain structures (e.g., areas containing mirror neurons) should be more finely tested in future research.
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13
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Estival S, Laurier V, Mourre F, Postal V. Improvement of Planning Abilities in Adults with Prader-Willi Syndrome: A Randomized Controlled Trial. Dev Neurorehabil 2021; 24:478-493. [PMID: 34184596 DOI: 10.1080/17518423.2021.1915405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Prader-Willi Syndrome (PWS) is a neurodevelopmental genetic disorder with executive deficits. Planning is one of the impaired executive functions implied in the regulation of behavior and everyday actions. We aimed to explore the feasibility and the effectiveness of a metacognitive strategy training designed to improve planning in adults with PWS using a double-blind between-group (training versus usual care) randomized controlled trial, with computerized tests and paper-pencil ecological outcome measures targeting planning, other executive functions, and achievement of personalized goal. Results showed better performances in several executive tasks and in achievement of personalized goals after both interventions, but better improvement for the experimental group (n = 27) compared to control (n = 26) only on the task assessing planning abilities. Interviews with occupational therapists demonstrated the feasibility of this training with this population. Despite a small number of sessions, the metacognitive strategy training showed encouraging results on planning abilities of patients.
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Affiliation(s)
- Séverine Estival
- Laboratoire de Psychologie LabPsy EA4139, Université de Bordeaux, Bordeaux, France
| | | | - Fabien Mourre
- Hôpital Marin AP-HP, Unité Prader-Willi, Hendaye, France
| | - Virginie Postal
- Laboratoire de Psychologie LabPsy EA4139, Université de Bordeaux, Bordeaux, France
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14
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Schwartz L, Caixàs A, Dimitropoulos A, Dykens E, Duis J, Einfeld S, Gallagher L, Holland A, Rice L, Roof E, Salehi P, Strong T, Taylor B, Woodcock K. Behavioral features in Prader-Willi syndrome (PWS): consensus paper from the International PWS Clinical Trial Consortium. J Neurodev Disord 2021; 13:25. [PMID: 34148559 PMCID: PMC8215770 DOI: 10.1186/s11689-021-09373-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/09/2021] [Indexed: 02/06/2023] Open
Abstract
Prader-Willi syndrome (PWS) is a rare neurodevelopmental genetic disorder associated with a characteristic behavioral phenotype that includes severe hyperphagia and a variety of other behavioral challenges such as temper outbursts and anxiety. These behaviors have a significant and dramatic impact on the daily functioning and quality of life for the person with PWS and their families. To date, effective therapies addressing these behavioral challenges have proven elusive, but several potential treatments are on the horizon. However, a limiting factor for treatment studies in PWS is the lack of consensus in the field regarding how to best define and measure the complex and interrelated behavioral features of this syndrome. The International PWS Clinical Trials Consortium (PWS-CTC, www.pwsctc.org) includes expert PWS scientists, clinicians, and patient advocacy organization representatives focused on facilitating clinical trials in this rare disease. To address the above gap in the field, members of the PWS-CTC “Behavior Outcomes Working Group” sought to develop a unified understanding of the key behavioral features in PWS and build a consensus regarding their definition and description. The primary focus of this paper is to present consensus definitions and descriptions of key phenotypic PWS behaviors including hyperphagia, temper outbursts, anxiety, obsessive–compulsive behaviors, rigidity, and social cognition deficits. Patient vignettes are provided to illustrate the interrelatedness and impact of these behaviors. We also review some available assessment tools as well as new instruments in development which may be useful in measuring these behavioral features in PWS.
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Affiliation(s)
- Lauren Schwartz
- Foundation for Prader-Willi Research, Walnut, CA, USA. .,Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA.
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Parc Taulí University Hospital, Parc Taulí Research and Innovation Institute, Sabadell, Spain.,Medicine Department, Autonomous University of Barcelona, Sabadell, Spain
| | | | - Elisabeth Dykens
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University, Nashville, TN, USA
| | - Jessica Duis
- Section of Genetics & Inherited Metabolic Diseases, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stewart Einfeld
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Louise Gallagher
- Trinity College Dublin Trinity Translational Medicine Institute, St. James's Hospital, Dublin, 8, Ireland
| | - Anthony Holland
- Department of Psychiatry, Cambridge Intellectual and Developmental Disabilities Research Group, University of Cambridge, Cambridge, UK
| | - Lauren Rice
- Brain and Mind Centre
- Faculty of Health Sciences, The University of Sydney, Faculty of Medicine and Health, Camperdown, NSW, Australia
| | - Elizabeth Roof
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Parisa Salehi
- Division of Endocrinology and Diabetes, Seattle Children's, University of Washington, Seattle, WA, USA
| | - Theresa Strong
- Foundation for Prader-Willi Research, Walnut, CA, USA.,Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Bonnie Taylor
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kate Woodcock
- Centre for Applied Psychology, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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15
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Royston R, Oliver C, Howlin P, Waite J. Anxiety characteristics in individuals with Williams syndrome. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1098-1107. [PMID: 33561900 DOI: 10.1111/jar.12864] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Williams syndrome anxiety research predominantly focuses on disorder prevalence and symptomatology, categorised using standardised mental health classifications. However, the use of these assessments may not fully capture the phenotypic features of anxiety in Williams syndrome. In this study, we examined characteristics of anxiety using a formulation framework. METHOD A semi-structured interview was conducted with thirteen parents of individuals with Williams syndrome (median age: 19, age range: 12-45, 8 females). RESULTS Various anxiety triggers were reported, including anxiety triggered by phobias, uncertainty and negative emotions in others. The range of described behaviours was diverse with both avoidant and active coping strategies for anxiety management reported. CONCLUSIONS Many of the characteristics described were consistent with findings in the intellectual disability and typically developing literature, although novel information was identified. The study demonstrates the utility of a formulation framework to explore anxiety characteristics in atypical populations and has outlined new avenues for research.
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Affiliation(s)
| | | | | | - Jane Waite
- University of Birmingham, Birmingham, UK
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16
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Zagaria T, Antonucci G, Buono S, Recupero M, Zoccolotti P. Executive Functions and Attention Processes in Adolescents and Young Adults with Intellectual Disability. Brain Sci 2021; 11:brainsci11010042. [PMID: 33401550 PMCID: PMC7823832 DOI: 10.3390/brainsci11010042] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/22/2020] [Accepted: 12/31/2020] [Indexed: 11/16/2022] Open
Abstract
(1) Background: We made a comprehensive evaluation of executive functions (EFs) and attention processes in a group of adolescents and young adults with mild intellectual disability (ID). (2) Methods: 27 adolescents and young adults (14 females and 13 males) with ID, aged between 15.1 and 23 years (M = 17.4; SD = 2.04), were compared to a control group free of cognitive problems and individually matched for gender and age. (3) Results: As for EFs, individuals with ID were severely impaired on all subtests of the Behavioral Assessment of Dysexecutive Syndrome (BADS) battery. However, we also found appreciable individual differences, with eight individuals (approximately 30%) scoring within normal limits. On the attention tests, individuals with ID were not generally slower but presented specific deficits only on some attention tests (i.e., Choice Reaction Times, Color Naming and Color–Word Interference, and Shifting of Attention for Verbal and for Visual Targets).The role of a global factor (i.e., cognitive speed) was modest in contributing to the group differences; i.e., when present, group differences were selectively associated with specific task manipulations, not global differences in cognitive speed. (4) Conclusions: The study confirmed large group differences in EFs; deficits in attentional processing were more specific and occurred primarily in tasks taxing the selective dimension of attention, with performance on intensive tasks almost entirely spared.
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Affiliation(s)
- Tommasa Zagaria
- Oasi Research Institute-IRCCS, 94018 Troina, Italy; (S.B.); (M.R.)
- Correspondence:
| | - Gabriella Antonucci
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (G.A.); (P.Z.)
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy
| | - Serafino Buono
- Oasi Research Institute-IRCCS, 94018 Troina, Italy; (S.B.); (M.R.)
| | | | - Pierluigi Zoccolotti
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (G.A.); (P.Z.)
- IRCCS Santa Lucia Foundation, 00179 Rome, Italy
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17
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Davies JR, Wilkinson LS, Isles AR, Humby T. Prader-Willi syndrome imprinting centre deletion mice have impaired baseline and 5-HT2CR-mediated response inhibition. Hum Mol Genet 2020; 28:3013-3023. [PMID: 31087031 PMCID: PMC6737253 DOI: 10.1093/hmg/ddz100] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/07/2019] [Accepted: 05/10/2019] [Indexed: 12/11/2022] Open
Abstract
Prader–Willi syndrome (PWS) is a neurodevelopmental disorder caused by deletion or inactivation of paternally expressed imprinted genes on human chromosome 15q11–q13. In addition to endocrine and developmental issues, PWS presents with behavioural problems including stereotyped behaviour, impulsiveness and cognitive deficits. The PWS genetic interval contains several brain-expressed small nucleolar (sno) RNA species that are subject to genomic imprinting, including snord115 that negatively regulates post-transcriptional modification of the serotonin 2C receptor (5-HT2CR) pre-mRNA potentially leading to a reduction in 5-HT2CR function. Using the imprinting centre deletion mouse model for PWS (PWSICdel) we have previously shown impairments in a number of behaviours, some of which are abnormally sensitive to 5-HT2CR-selective drugs. In the stop-signal reaction time task test of impulsivity, PWSICdel mice showed increased impulsivity relative to wild-type (WT) littermates. Challenge with the selective 5-HT2CR agonist WAY163909 reduced impulsivity in PWSICdel mice but had no effect on WT behaviour. This behavioural dissociation in was also reflected in differential patterns of immunoreactivity of the immediate early gene c-Fos, with a blunted response to the drug in the orbitofrontal cortex of PWSICdel mice, but no difference in c-Fos activation in the nucleus accumbens. These findings suggest specific facets of response inhibition are impaired in PWSICdel mice and that abnormal 5-HT2CR function may mediate this dissociation. These data have implications for our understanding of the aetiology of PWS-related behavioural traits and translational relevance for individuals with PWS who may seek to control appetite with the new obesity treatment 5-HT2CR agonist lorcaserin.
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Affiliation(s)
- Jennifer R Davies
- Behavioural Genetics Group, MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Schools of Medicine
| | - Lawrence S Wilkinson
- Behavioural Genetics Group, MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Schools of Medicine.,Psychology, Cardiff University, Cardiff, UK
| | - Anthony R Isles
- Behavioural Genetics Group, MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Schools of Medicine
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18
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Manning KE, Beresford-Webb JA, Aman LCS, Ring HA, Watson PC, Porges SW, Oliver C, Jennings SR, Holland AJ. Transcutaneous vagus nerve stimulation (t-VNS): A novel effective treatment for temper outbursts in adults with Prader-Willi Syndrome indicated by results from a non-blind study. PLoS One 2019; 14:e0223750. [PMID: 31794560 PMCID: PMC6890246 DOI: 10.1371/journal.pone.0223750] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 09/22/2019] [Indexed: 02/02/2023] Open
Abstract
Temper outbursts are a severe problem for people with Prader-Willi Syndrome (PWS). Previous reports indicate that vagus nerve stimulation (VNS) may reduce maladaptive behaviour in neurodevelopmental disorders, including PWS. We systematically investigated the effectiveness of transcutaneous VNS (t-VNS) in PWS. Using a non-blind single case repeat measures modified ABA design, with participants as their own controls, t-VNS was evaluated in five individuals with PWS [three males; age 22-41 (M = 26.8)]. After a baseline phase, participants received four-hours of t-VNS daily for 12 months, followed by one month of daily t-VNS for two-hours. The primary outcome measure was the mean number of behavioural outbursts per day. Secondary outcomes included findings from behavioural questionnaires and both qualitative and goal attainment interviews. Four of the five participants who completed the study exhibited a statistically significant reduction in number and severity of temper outbursts after approximately nine months of daily four-hour t-VNS. Subsequent two-hour daily t-VNS was associated with increased outbursts for all participants, two reaching significance. Questionnaire and interview data supported these findings, the latter indicating potential mechanisms of action. No serious safety issues were reported. t-VNS is an effective, novel and safe intervention for chronic temper outbursts in PWS. We propose these changes are mediated through vagal projections and their effects both centrally and on the functioning of the parasympathetic nervous system. These findings challenge our present biopsychosocial understanding of such behaviours suggesting that there is a single major mechanism that is modifiable using t-VNS. This intervention is potentially generalizable across other clinical groups. Future research should address the lack of a sham condition in this study along with the prevalence of high drop out rates, and the potential effects of different stimulation intensities, frequencies and pulse widths.
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Affiliation(s)
- Katherine E. Manning
- Department of Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom
- School of Health and Social Care, University of Essex, Colchester, Essex, United Kingdom
- Essex Partnership University NHS Foundation Trust, Wickford, Essex, United Kingdom
| | - Jessica A. Beresford-Webb
- Department of Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom
- * E-mail:
| | - Lucie C. S. Aman
- Department of Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom
| | - Howard A. Ring
- Department of Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom
| | - Peter C. Watson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom
| | - Stephen W. Porges
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Chris Oliver
- School of Psychology, University of Birmingham, Birmingham, West Midlands, United Kingdom
| | - Sally R. Jennings
- Department of Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom
| | - Anthony J. Holland
- Department of Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, United Kingdom
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19
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Dykens EM, Roof E, Hunt-Hawkins H, Daniell C, Jurgensmeyer S. Profiles and trajectories of impaired social cognition in people with Prader-Willi syndrome. PLoS One 2019; 14:e0223162. [PMID: 31622356 PMCID: PMC6797185 DOI: 10.1371/journal.pone.0223162] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 09/17/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction People with Prader-Willi syndrome (PWS) have a distinctive behavioral phenotype that includes intellectual disability, compulsivity, inattention, inflexibility and insistence on sameness. Inflexibility and inattention are at odds with the cognitive flexibility and attention to social cues needed to accurately perceive the social world, and implicate problems in social cognition. This study assessed two social cognition domains in people with PWS; emotion recognition and social perception. We identified changes in social cognition over an approximate two-year time period (M = 2.23 years), relative strengths and weakness in social cognition, and correlates and predictors of social cognition. Methods Emotion recognition and social perception were examined at two time points in 94 individuals with PWS aged 5 to 62 years (M = 13.81, SD = 10.69). Tasks administered included: standardized IQ testing; parent-completed measures of inattention and inflexibility; standard emotion recognition photos (fear, sadness, anger, happy); and videotaped social perception vignettes depicting negative events with either sincere/benign or insincere/hostile interactions between peers. Results An atypical trajectory of negative emotion recognition emerged, marked by similar levels of poor performances across age, and confusion between sad and anger that is typically resolved in early childhood. Recognition of sad and fear were positively correlated with IQ. Participants made gains over time detecting social cues, but not in forming correct conclusions about the intentions of others. Accurately judging sincere intentions remained a significant weakness over time. Relative to sincere intentions, participant’s performed significantly better in detecting negative social cues, and correctly judging trickery, deceit and lying. Age, IQ, inattention, and recognition of happy and sad accounted for 29% of variance in social perception. Conclusion Many people with PWS have deficits in recognizing sad, anger and fear, and accurately perceiving the sincere intentions of other people. The impact of these deficits on social behavior and relationships need to be better understood.
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Affiliation(s)
- Elisabeth M. Dykens
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, United States of America
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University Medical Center, Nashville, TN, United States of America
- Vanderbilt Kennedy Center University Center of Excellence on Developmental Disabilities, Vanderbilt University Medical Center, Nashville, TN, United States of America
- * E-mail:
| | - Elizabeth Roof
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, United States of America
- Vanderbilt Kennedy Center University Center of Excellence on Developmental Disabilities, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Hailee Hunt-Hawkins
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, United States of America
- Vanderbilt Kennedy Center University Center of Excellence on Developmental Disabilities, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Christopher Daniell
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, United States of America
| | - Sarah Jurgensmeyer
- Vanderbilt Kennedy Center University Center of Excellence on Developmental Disabilities, Vanderbilt University Medical Center, Nashville, TN, United States of America
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20
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21
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Royston R, Oliver C, Moss J, Adams D, Berg K, Burbidge C, Howlin P, Nelson L, Stinton C, Waite J. Brief Report: Repetitive Behaviour Profiles in Williams syndrome: Cross Syndrome Comparisons with Prader-Willi and Down syndromes. J Autism Dev Disord 2019; 48:326-331. [PMID: 28980100 DOI: 10.1007/s10803-017-3319-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study describes the profile of repetitive behaviour in individuals with Williams syndrome, utilising cross-syndrome comparisons with people with Prader-Willi and Down syndromes. The Repetitive Behaviour Questionnaire was administered to caregivers of adults with Williams (n = 96), Prader-Willi (n = 103) and Down (n = 78) syndromes. There were few group differences, although participants with Williams syndrome were more likely to show body stereotypies. Individuals with Williams syndrome also showed more hoarding and less tidying behaviours than those with Down syndrome. IQ and adaptive ability were negatively associated with repetitive questioning in people with Williams syndrome. The profile of repetitive behaviour amongst individuals with Williams syndrome was similar to the comparison syndromes. The cognitive mechanisms underlying these behaviours in genetic syndromes warrant further investigation.
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Affiliation(s)
- R Royston
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - C Oliver
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - J Moss
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - D Adams
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,Griffith University, PO Box 3370, South Brisbane Qld 4101, Sidon Street, South Bank, QLD, Australia
| | - K Berg
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,School of Psychology, University of East London, AE 1.10, Stratford Campus, London, E15 4LZ, UK
| | - C Burbidge
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,Coventry and Warwickshire Partnership NHS Trust, Wayside House, Wilsons Lane, Coventry, CV6 6NY, UK
| | - P Howlin
- Department of Psychology, King's College London, Strand, London, WC2R 2L, UK.,University of Sydney, Sydney, Australia
| | - L Nelson
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - C Stinton
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,University of Warwick, Coventry, CV4 7AL, UK
| | - J Waite
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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22
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Biesmans KE, van Aken L, Frunt EMJ, Wingbermühle PAM, Egger JIM. Inhibition, shifting and updating in relation to psychometric intelligence across ability groups in the psychiatric population. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:149-160. [PMID: 30403315 PMCID: PMC7379311 DOI: 10.1111/jir.12559] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/13/2018] [Accepted: 09/27/2018] [Indexed: 06/02/2023]
Abstract
BACKGROUND Assessment of intelligence and executive function (EF) is common in complex neuropsychiatric practice. Although previous studies have shown that EF and intelligence are related, it is unknown whether these constructs relate to one another in a similar manner across different ability groups (mild intellectual disability, borderline intellectual disability and normal/high intelligence). This study therefore examines the relation between three EFs (inhibition, shifting and updating) and intelligence in a heterogeneous psychiatric sample. It is hypothesised that the strength of the relation between intelligence and the three EFs decreases when the level of intelligence increases, in accordance with Spearman's Law of Diminishing Returns. METHODS In a cross-sectional, between and within subject design, one of the three intelligence tests (Kaufman Adolescent and Adult Intelligence Test and Wechsler Adult Intelligence Scale - third and fourth editions) and several EF tests (Stroop Colour-Word Test, Trail Making Test and Spatial Working Memory task) were administered to 250 neuropsychiatric inpatients and outpatients (Mage = 39.8, standard deviation = 14.3, 52.8% male). Based upon their full-scale IQ score, patients were divided into three ability groups (mild intellectual disability, borderline intellectual disability or normal/high intelligence). The relation between EF and intelligence was assessed through analyses of the correlation pattern; groups were compared using analysis of covariance. RESULTS Analyses showed significant correlations between the constructs of EF and intelligence. A significant interaction effect was found for shifting, with highest correlations in the normal to high intelligence group, but not for inhibition and updating. CONCLUSIONS Results support a specific role for shifting in this EF-intelligence relation. The correlational pattern of updating and intelligence, as well as the differential relation of shifting and intelligence across ability groups, suggests that EF tasks may not measure distinct EFs in lower intellectual ability but rely on cognitive primitives such as processing speed. EF tasks can be considered less valid indicators of EF ability. Implications in terms of the need for development of specific tasks to measure cognition in low intellectual ability are discussed.
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Affiliation(s)
- K. E. Biesmans
- Specialist and Forensic CareSTEVIGOostrumThe Netherlands
- Centres of Excellence for Neuropsychiatry and KorsakoffVincent van Gogh Institute for PsychiatryVenrayThe Netherlands
- Donders Institute for Brain, Cognition and BehaviourRadboud UniversityNijmegenThe Netherlands
| | - L. van Aken
- Centres of Excellence for Neuropsychiatry and KorsakoffVincent van Gogh Institute for PsychiatryVenrayThe Netherlands
- Donders Institute for Brain, Cognition and BehaviourRadboud UniversityNijmegenThe Netherlands
| | - E. M. J. Frunt
- Specialist and Forensic CareSTEVIGOostrumThe Netherlands
| | - P. A. M. Wingbermühle
- Centres of Excellence for Neuropsychiatry and KorsakoffVincent van Gogh Institute for PsychiatryVenrayThe Netherlands
- Donders Institute for Brain, Cognition and BehaviourRadboud UniversityNijmegenThe Netherlands
| | - J. I. M. Egger
- Specialist and Forensic CareSTEVIGOostrumThe Netherlands
- Centres of Excellence for Neuropsychiatry and KorsakoffVincent van Gogh Institute for PsychiatryVenrayThe Netherlands
- Donders Institute for Brain, Cognition and BehaviourRadboud UniversityNijmegenThe Netherlands
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23
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Chevalère J, Jauregi J, Copet P, Laurier V, Thuilleaux D, Postal V. Investigation of the relationship between electrodermal and behavioural responses to executive tasks in Prader-Willi syndrome: An event-related experiment. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 85:229-242. [PMID: 30590308 DOI: 10.1016/j.ridd.2018.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 11/12/2018] [Accepted: 11/30/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Recent work suggests that maladaptive behaviors in genetic developmental disorders may emerge from autonomic dysfunctions impacting higher order executive functions. In Prader-Willi syndrome (PWS), executive functions are not well understood and investigations of possible underlying causes at the autonomic level are lacking. AIMS This study aimed at clarifying the status of inhibition and working memory updating functions in PWS and searched for sympathetic signatures as well as to examine their links with executive performance. METHODS AND PROCEDURES The performance of thirty adults with PWS was compared to that of thirty healthy adults on two tasks assessing inhibition and working memory updating while electrodermal activity (EDA) was recorded. OUTCOMES AND RESULTS PWS adults underperformed healthy adults in the inhibition and the working memory updating tasks and showed abnormal skin conductance responses. Distinct EDA have been found in PWS and healthy adults. Furthermore, while EDA reflected distinct cognitive processes, correlations between electrodermal and behavioural data were absent when examining the two groups separately. CONCLUSIONS AND IMPLICATIONS PWS is associated with a slight impairment of inhibition and a severe impairment of working memory updating. Furthermore, there are specific sympathetic autonomic signatures in PWS that do not present straightforward links with executive dysfunctions.
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Affiliation(s)
- J Chevalère
- Univ. Bordeaux, Laboratoire de Psychologie, EA 4139, F33076, Bordeaux, France.
| | - J Jauregi
- Euskal Herriko Unibertsitatea, Paseo de Arriola 2, 20018, San Sebastián, Spain; AP-HP Hôpital Marin, BP 40139, 64700, Hendaye, France.
| | - P Copet
- AP-HP Hôpital Marin, BP 40139, 64700, Hendaye, France.
| | - V Laurier
- AP-HP Hôpital Marin, BP 40139, 64700, Hendaye, France.
| | - D Thuilleaux
- AP-HP Hôpital Marin, BP 40139, 64700, Hendaye, France.
| | - V Postal
- Univ. Bordeaux, Laboratoire de Psychologie, EA 4139, F33076, Bordeaux, France.
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Schmitt LM, Shaffer RC, Hessl D, Erickson C. Executive Function in Fragile X Syndrome: A Systematic Review. Brain Sci 2019; 9:E15. [PMID: 30654486 PMCID: PMC6356760 DOI: 10.3390/brainsci9010015] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 12/17/2022] Open
Abstract
Executive function (EF) supports goal-directed behavior and includes key aspects such as working memory, inhibitory control, cognitive flexibility, attention, processing speed, and planning. Fragile X syndrome (FXS) is the leading inherited monogenic cause of intellectual disability and is phenotypically characterized by EF deficits beyond what is expected given general cognitive impairments. Yet, a systematic review of behavioral studies using performance-based measures is needed to provide a summary of EF deficits across domains in males and females with FXS, discuss clinical and biological correlates of these EF deficits, identify critical limitations in available research, and offer suggestions for future studies in this area. Ultimately, this review aims to advance our understanding of the underlying pathophysiological mechanisms contributing to EF in FXS and to inform the development of outcome measures of EF and identification of new treatment targets in FXS.
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Affiliation(s)
- Lauren M Schmitt
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
| | - Rebecca C Shaffer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
| | - David Hessl
- MIND Institute, Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA 95616, USA.
| | - Craig Erickson
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
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25
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Kabasakalian A, Ferretti CJ, Hollander E. Oxytocin and Prader-Willi Syndrome. Curr Top Behav Neurosci 2018; 35:529-557. [PMID: 28956320 DOI: 10.1007/7854_2017_28] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In the chapter, we explore the relationship between the peptide hormone, oxytocin (OT), and behavioral and metabolic disturbances observed in the genetic disorder Prader-Willi Syndrome (PWS). Phenotypic and genotypic characteristics of PWS are described, as are the potential implications of an abnormal OT system with respect to neural development including the possible effects of OT dysfunction on interactions with other regulatory mediators, including neurotransmitters, neuromodulators, and hormones. The major behavioral characteristics are explored in the context of OT dysfunction, including hyperphagia, impulsivity, anxiety and emotion dysregulation, sensory processing and interoception, repetitive and restrictive behaviors, and dysfunctional social cognition. Behavioral overlaps with autistic spectrum disorders are discussed. The implications of OT dysfunction on the mechanisms of reward and satiety and their possible role in informing behavioral characteristics are also discussed. Treatment implications and future directions for investigation are considered.
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Affiliation(s)
- Anahid Kabasakalian
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Casara J Ferretti
- Ferkauf Graduate School of Psychology, Yeshiva University, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Eric Hollander
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
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26
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Rice LJ, Woodcock K, Einfeld SL. The characteristics of temper outbursts in Prader-Willi syndrome. Am J Med Genet A 2018; 176:2292-2300. [PMID: 30289600 DOI: 10.1002/ajmg.a.40480] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/24/2018] [Accepted: 06/28/2018] [Indexed: 11/10/2022]
Abstract
The purpose of this study was to develop a comprehensive understanding of temper outbursts in Prader-Willi syndrome (PWS). A survey was developed from interviews conducted with individuals with PWS and their caregivers. The survey was completed by 101 primary caregivers. The findings suggest that outburst frequency decreases with age while duration increases. Adolescents exhibited more severe behaviors than children or adults. No differences were found across gender or genetic subtype. Provocations fit into three themes: goal blockage, social injustice, and difficulty dealing with change. Distracting the person or giving them space to calm down were the only management strategies judged effective. Risperidone, sertraline, and fluoxetine were the most common medications prescribed for outbursts, though parents reported only minor effects.
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Affiliation(s)
- Lauren J Rice
- The Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Kate Woodcock
- Centre for Applied Psychology, School of Psychology, University of Birmingham, Birmingham, United Kingdom.,Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Stewart L Einfeld
- The Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
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27
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Intelligence and specific cognitive functions in intellectual disability: implications for assessment and classification. Curr Opin Psychiatry 2018; 31:88-95. [PMID: 29206685 DOI: 10.1097/yco.0000000000000387] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE OF REVIEW Current diagnostic criteria for intellectual disability categorize ability as measured by IQ tests. However, this does not suit the new conceptualization of intellectual disability, which refers to a range of neuropsychiatric syndromes that have in common early onset, cognitive impairments, and consequent deficits in learning and adaptive functioning. A literature review was undertaken on the concept of intelligence and whether it encompasses a range of specific cognitive functions to solve problems, which might be better reported as a profile, instead of an IQ, with implications for diagnosis and classification of intellectual disability. RECENT FINDINGS Data support a model of intelligence consisting of distinct but related processes. Persons with intellectual disability with the same IQ level have different cognitive profiles, based on varying factors involved in aetiopathogenesis. Limitations of functioning and many biopsychological factors associated with intellectual disability are more highly correlated with impairments of specific cognitive functions than with overall IQ. SUMMARY The current model of intelligence, based on IQ, is of limited utility for intellectual disability, given the wide range and variability of cognitive functions and adaptive capacities. Assessing level of individual impairment in executive and specific cognitive functions may be a more useful alternative. This has considerable implications for the revision of the International Classification of Diseases and for the cultural attitude towards intellectual disability in general.
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28
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Strang JF, Anthony LG, Yerys BE, Hardy KK, Wallace GL, Armour AC, Dudley K, Kenworthy L. The Flexibility Scale: Development and Preliminary Validation of a Cognitive Flexibility Measure in Children with Autism Spectrum Disorders. J Autism Dev Disord 2018; 47:2502-2518. [PMID: 28527097 DOI: 10.1007/s10803-017-3152-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Flexibility is a key component of executive function, and is related to everyday functioning and adult outcomes. However, existing informant reports do not densely sample cognitive aspects of flexibility; the Flexibility Scale (FS) was developed to address this gap. This study investigates the validity of the FS in 221 youth with ASD and 57 typically developing children. Exploratory factor analysis indicates a five-factor scale: Routines/rituals, transitions/change, special interests, social flexibility, and generativity. The FS demonstrated convergent and divergent validity with comparative domains of function in other measures, save for the Generativity factor. The FS discriminated participants with ASD and controls. Thus, this study suggests the FS may be a viable, comprehensive measure of flexibility in everyday settings.
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Affiliation(s)
- John F Strang
- Center for Autism Spectrum Disorders, Children's National Health System, Washington, DC, USA. .,Children's Research Institute, Children's National Health System, Washington, DC, USA. .,Division of Pediatric Neuropsychology, Children's National Health System, Washington, DC, USA. .,Children's National Medical Center, 15245 Shady Grove Road Suite 350, Rockville, MD, 20850, USA.
| | - Laura G Anthony
- Center for Autism Spectrum Disorders, Children's National Health System, Washington, DC, USA.,Children's Research Institute, Children's National Health System, Washington, DC, USA.,Division of Pediatric Neuropsychology, Children's National Health System, Washington, DC, USA
| | - Benjamin E Yerys
- Center for Autism Research, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kristina K Hardy
- Children's Research Institute, Children's National Health System, Washington, DC, USA.,Division of Pediatric Neuropsychology, Children's National Health System, Washington, DC, USA
| | - Gregory L Wallace
- Department of Speech and Hearing Sciences, The George Washington University, Washington, DC, USA
| | - Anna C Armour
- Center for Autism Spectrum Disorders, Children's National Health System, Washington, DC, USA
| | - Katerina Dudley
- Center for Autism Spectrum Disorders, Children's National Health System, Washington, DC, USA
| | - Lauren Kenworthy
- Center for Autism Spectrum Disorders, Children's National Health System, Washington, DC, USA.,Children's Research Institute, Children's National Health System, Washington, DC, USA.,Division of Pediatric Neuropsychology, Children's National Health System, Washington, DC, USA
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29
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Rice LJ, Lagopoulos J, Brammer M, Einfeld SL. Microstructural white matter tract alteration in Prader-Willi syndrome: A diffusion tensor imaging study. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2017; 175:362-367. [DOI: 10.1002/ajmg.c.31572] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 06/27/2017] [Accepted: 07/05/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Lauren J. Rice
- Brain and Mind Centre; University of Sydney; Camperdown Australia
| | - Jim Lagopoulos
- Brain and Mind Centre; University of Sydney; Camperdown Australia
- Queensland Mind and Neuroscience Thompson Institute; University of the Sunshine Coast; Maroochydore DC Australia
| | - Michael Brammer
- Brain and Mind Centre; University of Sydney; Camperdown Australia
- Department of Neuroimaging; Institute of Psychiatry; King's College London; London UK
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30
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Haig EL, Woodcock KA. Rigidity in routines and the development of resistance to change in individuals with Prader-Willi syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:488-500. [PMID: 28266087 DOI: 10.1111/jir.12368] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 01/25/2017] [Accepted: 02/01/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Individuals with Prader-Willi syndrome (PWS) commonly show debilitating resistance to change, which has been linked to cognitive deficits in task switching. Anecdotal reports suggest that exposure to flexibility in routines during development may be beneficial for limiting subsequent resistance to change in people with PWS, which is consistent with a beneficial role of such exposure on the development of task switching, highlighted in typical children. Here, we aim to investigate the development of resistance to change in individuals with PWS and hypothesise that exposure to increased rigidity in routines will be associated with increased subsequent resistance to change. METHODS An author-compiled informant report interview and two previously validated questionnaires were administered to the caregivers of 10 individuals with PWS (5-23 years). The interview examined rigidity in routines and resistance to change across life stages defined by easily distinguishable events (before school, during primary school, during secondary school, after school, currently), using open-ended and structured yes/no and 5-point Likert questions. Open-ended data were coded using an author-compiled system. Responses from two additional informants and data from the questionnaires were used to assess inter-informant reliability and concurrent validity of the structured questions. RESULTS The validity of the interview was supported by acceptable inter-rater reliability of the open-ended coding system and inter-informant reliability, internal consistency and concurrent validity of structured questions. Descriptive analyses of ratings of behaviour change showed a pattern of increasing resistance to change over the life course for the four oldest individuals, who had all been exposed to substantial rigidity in routines before and during primary school. Furthermore, only one individual - currently in primary school - was exposed to very little rigidity in routines before and during primary school, and he had showed a decrease in resistance to change after entering primary school. Open-ended data showed that more individuals currently evidencing little resistance to change had been exposed to parent or self-imposed flexibility in routines, than those currently evidencing substantial resistance to change. However, correlational analyses on rigidity and resistance to change ratings highlighted the possibility that rigidity during primary school is most relevant for developing resistance to change. Finally, open-ended data emphasised an important beneficial role of rigidity in routines for limiting the current challenging behaviour of individuals with high resistance to change. CONCLUSION Because task switching appears to evidence a period of high developmental sensitivity during early primary school years, we propose that this period may represent a critical time when increasing flexibility in the routines of children with PWS could limit the development of resistance to change. However, a careful balance would need to be struck, given the apparent benefit of rigid routines on current behaviour. Further work in this area is much needed.
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Affiliation(s)
- E L Haig
- School of Psychology, Queen's University Belfast, Belfast, UK
| | - K A Woodcock
- School of Psychology, Queen's University Belfast, Belfast, UK
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31
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McKenna R, Rushe T, Woodcock KA. Informing the Structure of Executive Function in Children: A Meta-Analysis of Functional Neuroimaging Data. Front Hum Neurosci 2017; 11:154. [PMID: 28439231 PMCID: PMC5383671 DOI: 10.3389/fnhum.2017.00154] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 03/15/2017] [Indexed: 11/27/2022] Open
Abstract
The structure of executive function (EF) has been the focus of much debate for decades. What is more, the complexity and diversity provided by the developmental period only adds to this contention. The development of executive function plays an integral part in the expression of children's behavioral, cognitive, social, and emotional capabilities. Understanding how these processes are constructed during development allows for effective measurement of EF in this population. This meta-analysis aims to contribute to a better understanding of the structure of executive function in children. A coordinate-based meta-analysis was conducted (using BrainMap GingerALE 2.3), which incorporated studies administering functional magnetic resonance imaging (fMRI) during inhibition, switching, and working memory updating tasks in typical children (aged 6-18 years). The neural activation common across all executive tasks was compared to that shared by tasks pertaining only to inhibition, switching or updating, which are commonly considered to be fundamental executive processes. Results support the existence of partially separable but partially overlapping inhibition, switching, and updating executive processes at a neural level, in children over 6 years. Further, the shared neural activation across all tasks (associated with a proposed "unitary" component of executive function) overlapped to different degrees with the activation associated with each individual executive process. These findings provide evidence to support the suggestion that one of the most influential structural models of executive functioning in adults can also be applied to children of this age. However, the findings also call for careful consideration and measurement of both specific executive processes, and unitary executive function in this population. Furthermore, a need is highlighted for a new systematic developmental model, which captures the integrative nature of executive function in children.
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Affiliation(s)
- Róisín McKenna
- School of Psychology, Queen's UniversityBelfast, Northern Ireland
| | | | - Kate A. Woodcock
- School of Psychology, Queen's UniversityBelfast, Northern Ireland
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32
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Bull LE, Oliver C, Woodcock KA. Signalling changes to individuals who show resistance to change can reduce challenging behaviour. J Behav Ther Exp Psychiatry 2017; 54:58-70. [PMID: 27367567 DOI: 10.1016/j.jbtep.2016.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 06/03/2016] [Accepted: 06/20/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND & OBJECTIVES Several neurodevelopmental disorders are associated with resistance to change and challenging behaviours - including temper outbursts - that ensue following changes to routines, plans or expectations (here, collectively: expectations). Here, a change signalling intervention was tested for proof of concept and potential practical effectiveness. METHODS Twelve individuals with Prader-Willi syndrome participated in researcher- and caregiver-led pairing of a distinctive visual-verbal signal with subsequent changes to expectations. Specific expectations for a planned subset of five participants were systematically observed in minimally manipulated natural environments. Nine caregivers completed a temper outburst diary during a four week baseline period and a two week signalling evaluation period. RESULTS Participants demonstrated consistently less temper outburst behaviour in the systematic observations when changes imposed to expectations were signalled, compared to when changes were not signalled. Four of the nine participants whose caregivers completed the behaviour diary demonstrated reliable reductions in temper outbursts between baseline and signalling evaluation. LIMITATIONS An active control group for the present initial evaluation of the signalling strategy using evidence from caregiver behaviour diaries was outside the scope of the present pilot study. Thus, findings cannot support the clinical efficacy of the present signalling approach. CONCLUSIONS Proof of concept evidence that reliable pairing of a distinctive cue with a subsequent change to expectation can reduce associated challenging behaviour is provided. Data provide additional support for the importance of specific practical steps in further evaluations of the change signalling approach.
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Affiliation(s)
- Leah E Bull
- Cerebra Centre for Neurodevelopmental Disorders, University of Birmingham, UK
| | - Chris Oliver
- Cerebra Centre for Neurodevelopmental Disorders, University of Birmingham, UK
| | - Kate A Woodcock
- Cerebra Centre for Neurodevelopmental Disorders, University of Birmingham, UK.
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33
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Rice LJ, Lagopoulos J, Brammer M, Einfeld SL. Reduced gamma-aminobutyric acid is associated with emotional and behavioral problems in Prader-Willi syndrome. Am J Med Genet B Neuropsychiatr Genet 2016; 171:1041-1048. [PMID: 27338833 DOI: 10.1002/ajmg.b.32472] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 06/09/2016] [Indexed: 01/04/2023]
Abstract
Prader-Willi syndrome (PWS) is characterized by infantile hypotonia, hypogonadism, small hands and feet, distinct facial features and usually intellectual impairment. The disorder is associated with severe behavioral disturbances which include hyperphagia leading to morbid obesity, temper outbursts, skin-picking, and compulsive behaviors. While the brain mechanisms that underpin these disturbances are unknown these behaviors suggest a lack of inhibition and thus gamma-aminobutyric acid (GABA), the main inhibitory neurotransmitter may be implicated. In the present study, we investigated in vivo brain GABA and its relationship with emotion and behavior in individuals with PWS. Single voxel proton magnetic resonance spectroscopy (1H-MRS) was performed on 15 individuals with PWS and 15 age- and gender-matched typically developing controls. GABA levels were measured in the parieto-occipital lobe. All other metabolite levels (N-acetyl aspartate, myo-Inositol, glutathione, glutamate, and glutamine + glutamate) were measured in the anterior cingulate cortex (ACC). GABA levels were significantly lower in the participants with PWS who had clinically significant emotional and behavioral problems relative to typically developing control participants and participants with PWS who did not have emotional and behavioral problems within the clinically significant range. GABA levels were negatively correlated with total behavioral problem scores as well as temper outbursts, skin-picking, depression, social relating difficulties, and a tendency to be self-absorbed. Our data suggests that alterations of the GABAergic system may play an important role in aspects of the pathophysiology of PWS. Pathological mechanism found in PWS may be relevant to understanding the control of similar behaviors in the general population. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Lauren J Rice
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia
| | - Jim Lagopoulos
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,Queensland Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Michael Brammer
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - Stewart L Einfeld
- Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.,Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia
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34
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Whittington J, Holland A. Cognition in people with Prader-Willi syndrome: Insights into genetic influences on cognitive and social development. Neurosci Biobehav Rev 2016; 72:153-167. [PMID: 27836461 DOI: 10.1016/j.neubiorev.2016.09.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 09/01/2016] [Accepted: 09/15/2016] [Indexed: 02/03/2023]
Abstract
We present a mini-review of cognition in Prader-Willi syndrome. Studies cited include findings on general ability (IQ), IQ correlates with family members, strengths and weaknesses in cognitive profiles in genetic subtypes, attainment in literacy and numeracy, language, comprehension, modality preferences, executive functions, and social cognition. The latter includes investigations of theory of mind, emotion recognition, face processing and knowledge of social norms. Results from research on mouse models and brain imaging studies relevant to cognition are briefly discussed. The importance of these studies to understanding and managing education and behaviour in PWS and the limitations of the studies in terms of small numbers, non-representativeness, and lack of replication is also touched upon.
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Affiliation(s)
| | - Anthony Holland
- University of Cambridge, Department of Psychiatry, Cambridge, UK
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35
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Perez JD, Rubinstein ND, Dulac C. New Perspectives on Genomic Imprinting, an Essential and Multifaceted Mode of Epigenetic Control in the Developing and Adult Brain. Annu Rev Neurosci 2016; 39:347-84. [PMID: 27145912 DOI: 10.1146/annurev-neuro-061010-113708] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Mammalian evolution entailed multiple innovations in gene regulation, including the emergence of genomic imprinting, an epigenetic regulation leading to the preferential expression of a gene from its maternal or paternal allele. Genomic imprinting is highly prevalent in the brain, yet, until recently, its central roles in neural processes have not been fully appreciated. Here, we provide a comprehensive survey of adult and developmental brain functions influenced by imprinted genes, from neural development and wiring to synaptic function and plasticity, energy balance, social behaviors, emotions, and cognition. We further review the widespread identification of parental biases alongside monoallelic expression in brain tissues, discuss their potential roles in dosage regulation of key neural pathways, and suggest possible mechanisms underlying the dynamic regulation of imprinting in the brain. This review should help provide a better understanding of the significance of genomic imprinting in the normal and pathological brain of mammals including humans.
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Affiliation(s)
- Julio D Perez
- Department of Molecular and Cellular Biology, Harvard University, Howard Hughes Medical Institute, Cambridge, Massachusetts 02138;
| | - Nimrod D Rubinstein
- Department of Molecular and Cellular Biology, Harvard University, Howard Hughes Medical Institute, Cambridge, Massachusetts 02138;
| | - Catherine Dulac
- Department of Molecular and Cellular Biology, Harvard University, Howard Hughes Medical Institute, Cambridge, Massachusetts 02138;
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36
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A Novel Analog Reasoning Paradigm: New Insights in Intellectually Disabled Patients. PLoS One 2016; 11:e0149717. [PMID: 26918704 PMCID: PMC4771701 DOI: 10.1371/journal.pone.0149717] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 02/04/2016] [Indexed: 12/05/2022] Open
Abstract
Background Intellectual Disability (ID) is characterized by deficits in intellectual functions such as reasoning, problem-solving, planning, abstract thinking, judgment, and learning. As new avenues are emerging for treatment of genetically determined ID (such as Down’s syndrome or Fragile X syndrome), it is necessary to identify objective reliable and sensitive outcome measures for use in clinical trials. Objective We developed a novel visual analogical reasoning paradigm, inspired by the Progressive Raven’s Matrices, but appropriate for Intellectually Disabled patients. This new paradigm assesses reasoning and inhibition abilities in ID patients. Methods We performed behavioural analyses for this task (with a reaction time and error rate analysis, Study 1) in 96 healthy controls (adults and typically developed children older than 4) and 41 genetically determined ID patients (Fragile X syndrome, Down syndrome and ARX mutated patients). In order to establish and quantify the cognitive strategies used to solve the task, we also performed an eye-tracking analysis (Study 2). Results Down syndrome, ARX and Fragile X patients were significantly slower and made significantly more errors than chronological age-matched healthy controls. The effect of inhibition on error rate was greater than the matrix complexity effect in ID patients, opposite to findings in adult healthy controls. Interestingly, ID patients were more impaired by inhibition than mental age-matched healthy controls, but not by the matrix complexity. Eye-tracking analysis made it possible to identify the strategy used by the participants to solve the task. Adult healthy controls used a matrix-based strategy, whereas ID patients used a response-based strategy. Furthermore, etiologic-specific reasoning differences were evidenced between ID patients groups. Conclusion We suggest that this paradigm, appropriate for ID patients and developmental populations as well as adult healthy controls, provides an objective and quantitative assessment of visual analogical reasoning and cognitive inhibition, enabling testing for the effect of pharmacological or behavioural intervention in these specific populations.
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37
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Bull LE, Oliver C, Callaghan E, Woodcock KA. Increased Exposure to Rigid Routines can Lead to Increased Challenging Behavior Following Changes to Those Routines. J Autism Dev Disord 2015; 45:1569-78. [PMID: 25422033 DOI: 10.1007/s10803-014-2308-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Several neurodevelopmental disorders are associated with preference for routine and challenging behavior following changes to routines. We examine individuals with Prader-Willi syndrome, who show elevated levels of this behavior, to better understand how previous experience of a routine can affect challenging behavior elicited by disruption to that routine. Play based challenges exposed 16 participants to routines, which were either adhered to or changed. Temper outburst behaviors, heart rate and movement were measured. As participants were exposed to routines for longer before a change (between 10 and 80 min; within participants), more temper outburst behaviors were elicited by changes. Increased emotional arousal was also elicited, which was indexed by heart rate increases not driven by movement. Further study will be important to understand whether current intervention approaches that limit exposure to changes, may benefit from the structured integration of flexibility to ensure that the opportunity for routine establishment is also limited.
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Affiliation(s)
- Leah E Bull
- Cerebra Centre for Neurodevelopmental Disorders, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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38
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Puzzle Pieces: Neural Structure and Function in Prader-Willi Syndrome. Diseases 2015; 3:382-415. [PMID: 28943631 PMCID: PMC5548261 DOI: 10.3390/diseases3040382] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/04/2015] [Accepted: 12/11/2015] [Indexed: 11/17/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a neurodevelopmental disorder of genomic imprinting, presenting with a behavioural phenotype encompassing hyperphagia, intellectual disability, social and behavioural difficulties, and propensity to psychiatric illness. Research has tended to focus on the cognitive and behavioural investigation of these features, and, with the exception of eating behaviour, the neural physiology is currently less well understood. A systematic review was undertaken to explore findings relating to neural structure and function in PWS, using search terms designed to encompass all published articles concerning both in vivo and post-mortem studies of neural structure and function in PWS. This supported the general paucity of research in this area, with many articles reporting case studies and qualitative descriptions or focusing solely on the overeating behaviour, although a number of systematic investigations were also identified. Research to date implicates a combination of subcortical and higher order structures in PWS, including those involved in processing reward, motivation, affect and higher order cognitive functions, with both anatomical and functional investigations indicating abnormalities. It appears likely that PWS involves aberrant activity across distributed neural networks. The characterisation of neural structure and function warrants both replication and further systematic study.
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39
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Sheth K, Moss J, Hyland S, Stinton C, Cole T, Oliver C. The behavioral characteristics of Sotos syndrome. Am J Med Genet A 2015; 167A:2945-56. [DOI: 10.1002/ajmg.a.37373] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 08/21/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Krupa Sheth
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology; University of Birmingham; Birmingham United Kingdom
| | - Joanna Moss
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology; University of Birmingham; Birmingham United Kingdom
- Institute of Cognitive Neuroscience; University College London; London United Kingdom
| | - Sarah Hyland
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology; University of Birmingham; Birmingham United Kingdom
| | - Chris Stinton
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology; University of Birmingham; Birmingham United Kingdom
| | - Trevor Cole
- Department of Clinical Genetics; Birmingham Women's Hospital; Birmingham United Kingdom
| | - Chris Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology; University of Birmingham; Birmingham United Kingdom
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Chevalère J, Postal V, Jauregui J, Copet P, Laurier V, Thuilleaux D. Executive functions and Prader-Willi syndrome: global deficit linked with intellectual level and syndrome-specific associations. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2015; 120:215-229. [PMID: 25928434 DOI: 10.1352/1944-7558-120.3.215] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of this study was to support the growing evidence suggesting that Prader-Willi Syndrome (PWS) might present with an impairment of executive functions (EFs) and to investigate whether this impairment is specific to patients with PWS or due to their intellectual disability (ID). Six tasks were administered to assess EFs (inhibition, switching, updating, cognitive estimation, and planning) to 17 patients with PWS and 17 age-matched healthy individuals. Performance was significantly impaired in the PWS group on all EFs and after controlling for IQ level, intergroup differences remained only for switching and cognitive estimation. In conclusion, PWS seems to be associated with a global impairment of EFs that appears to be closely linked with intellectual impairment but also with the PWS itself.
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Foti F, Menghini D, Orlandi E, Rufini C, Crinò A, Spera S, Vicari S, Petrosini L, Mandolesi L. Learning by observation and learning by doing in Prader-Willi syndrome. J Neurodev Disord 2015; 7:6. [PMID: 25914757 PMCID: PMC4409733 DOI: 10.1186/s11689-015-9102-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 01/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND New competencies may be learned through active experience (learning by doing) or observation of others' experience (learning by observation). Observing another person performing a complex action accelerates the observer's acquisition of the same action, limiting the time-consuming process of learning by doing. Here, we compared learning by observation and learning by doing in individuals with Prader-Willi syndrome (PWS). It is hypothesized that PWS individuals could show more difficulties with learning by observation than learning by doing because of their specific difficulty in interpreting and using social information. METHODS The performance of 24 PWS individuals was compared with that of 28 mental age (MA)- and gender-matched typically developing (TD) children in tasks of learning a visuo-motor sequence by observation or by doing. To determine whether the performance pattern exhibited by PWS participants was specific to this population or whether it was a nonspecific intellectual disability effect, we compared the PWS performances with those of a third MA- and gender-matched group of individuals with Williams syndrome (WS). RESULTS PWS individuals were severely impaired in detecting a sequence by observation, were able to detect a sequence by doing, and became as efficient as TD children in reproducing an observed sequence after a task of learning by doing. The learning pattern of PWS children was reversed compared with that of WS individuals. CONCLUSIONS The observational learning deficit in PWS individuals may be rooted, at least partially, in their incapacity to understand and/or use social information.
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Affiliation(s)
- Francesca Foti
- Department of Psychology, "Sapienza" University of Rome, Via dei Marsi 78, 00185 Rome, Italy ; IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143 Rome, Italy
| | - Deny Menghini
- Child Neuropsychiatry Unit, Neuroscience Department, "Children's Hospital Bambino Gesù", Piazza Sant'Onofrio 4, 00100 Rome, Italy
| | - Enzo Orlandi
- Department of Psychology, "Sapienza" University of Rome, Via dei Marsi 78, 00185 Rome, Italy
| | - Cristina Rufini
- Child Neuropsychiatry Unit, Neuroscience Department, "Children's Hospital Bambino Gesù", Piazza Sant'Onofrio 4, 00100 Rome, Italy
| | - Antonino Crinò
- Pediatric and Autoimmune Endocrine Disease Unit, "Children's Hospital Bambino Gesù", Palidoro, Via Torre di Palidoro, 00050 Fiumicino, Rome, Italy
| | - Sabrina Spera
- Pediatric and Autoimmune Endocrine Disease Unit, "Children's Hospital Bambino Gesù", Palidoro, Via Torre di Palidoro, 00050 Fiumicino, Rome, Italy
| | - Stefano Vicari
- Child Neuropsychiatry Unit, Neuroscience Department, "Children's Hospital Bambino Gesù", Piazza Sant'Onofrio 4, 00100 Rome, Italy
| | - Laura Petrosini
- Department of Psychology, "Sapienza" University of Rome, Via dei Marsi 78, 00185 Rome, Italy ; IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143 Rome, Italy
| | - Laura Mandolesi
- IRCCS Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143 Rome, Italy ; Department of Motor Science and Wellness, University of Naples "Parthenope", Via Medina 40, 80133 Naples, Italy
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Roelofs RL, Visser EM, Berger HJC, Prins JB, Van Schrojenstein Lantman-De Valk HMJ, Teunisse JP. Executive functioning in individuals with intellectual disabilities and autism spectrum disorders. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:125-137. [PMID: 23931579 DOI: 10.1111/jir.12085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/08/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Executive functioning (EF) is important for adequate behavioural functioning and crucial for explaining symptoms of autism spectrum disorders (ASD) in individuals with normal intelligence, but is scarcely studied in individuals with ASD and intellectual disabilities (ID). We therefore study EF in an ID population by comparing performances on three frequently studied executive functions (shifting, inhibition and updating) between individuals with ASD and individuals without ASD. When studying ID populations, one should be aware of Spearman's Law of Diminishing Returns (SLODR), as it questions the possibility of measuring separate cognitive functions in ID populations. METHODS Six EF tasks were administered to 50 individuals with mild to borderline ID, of which half was diagnosed with ASD. In order to investigate the distinctness of the three executive functions in this ID sample, the results on the six EF tasks were subjected to principal components analysis (PCA). Subsequently, a multivariate analysis of variance (MANOVA) was performed to assess differences between the ASD and non-ASD group on shifting, inhibition and updating. RESULTS The PCA revealed the hypothesised EF trichotomy. MANOVA analysis showed no significant group differences on EF-performance. CONCLUSIONS Three separate executive functions were measured in this ID population, but despite much evidence that individuals with ASD display more behavioural problems and the proven relevance of EF in behavioural functioning, no significant group difference was found on shifting, inhibition or updating. After this first effort to achieve more insight into EF of individuals with ASD and ID the relation between behavioural problems and EF will require further study.
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Affiliation(s)
- R L Roelofs
- Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
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Tonnsen BL, Grefer ML, Hatton DD, Roberts JE. Developmental trajectories of attentional control in preschool males with fragile X syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:62-71. [PMID: 25462466 PMCID: PMC4397109 DOI: 10.1016/j.ridd.2014.09.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 09/22/2014] [Indexed: 05/31/2023]
Abstract
Attention problems are among the most impairing features associated with fragile X syndrome (FXS). However, few studies have examined behavioral development of inhibitory control in very young children with FXS. We examined attentional control in 3-6 year boys with FXS using both an experimental inhibitory control paradigm and parent-report of attention problems. Study 1 examined attentional control in FXS compared to comparison groups matched on chronological and mental age. To determine the stability of impairments over time in FXS, Study 2 examined patterns of developmental change in an expanded longitudinal sample. Across studies, males with FXS demonstrated persistent impairments in inhibitory control and parent-reported attention problems. Inhibitory control was related to, but not solely driven by, lower mental age. Although parent-rated attention problems remained stable across ages, inhibitory control improved with time. Children with more severe attention problems often displayed initially poorer inhibitory control. However, these trajectories also improved more rapidly with age. Our findings indicate that despite persistent deficits in attentional control in young children with FXS, multi-method assessment can be used to capture developmental growth that should be further supported through early, targeted intervention.
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Affiliation(s)
- Bridgette L Tonnsen
- University of South Carolina Department of Psychology, 1512 Pendleton Street, Columbia, SC 29208, USA(1)
| | - Marjorie L Grefer
- University of South Carolina Department of Psychology, 1512 Pendleton Street, Columbia, SC 29208, USA(1)
| | - Deborah D Hatton
- Vanderbilt University Department of Special Education, Peabody College, Nashville, TN 37203, USA(2)
| | - Jane E Roberts
- University of South Carolina Department of Psychology, 1512 Pendleton Street, Columbia, SC 29208, USA(1).
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Waite J, Moss J, Beck SR, Richards C, Nelson L, Arron K, Burbidge C, Berg K, Oliver C. Repetitive Behavior in Rubinstein–Taybi Syndrome: Parallels with Autism Spectrum Phenomenology. J Autism Dev Disord 2014; 45:1238-53. [DOI: 10.1007/s10803-014-2283-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Benjamin DP, Mastergeorge AM, McDuffie AS, Kover ST, Hagerman RJ, Abbeduto L. Effects of labeling and pointing on object gaze in boys with fragile X syndrome: an eye-tracking study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2658-72. [PMID: 25062097 PMCID: PMC4154990 DOI: 10.1016/j.ridd.2014.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 05/26/2023]
Abstract
We examined the visual processing of a social learning stimulus and the ways in which visual attention was distributed to objects as well as to the examiner's face during word learning under conditions that varied only in the presence or absence of a label. The goal of the current study, then, was to evaluate the effects of differentially providing pointing and labeling during exposure to a novel target object in males with fragile X syndrome (FXS) (n=14, ages 4.33-10.02), autism spectrum disorder (ASD) (n=17, ages 4.04-10.4), or typical development (TD) (n=18, ages 2.05-5.33). In particular, the present study examined attention to the examiner's face as well as target and distracter objects that were presented as video stimuli. An eye-tracker captured gaze to the video stimuli as they were shown in order to examine the way in which children with FXS, ASD, or TD distributed their gaze toward the examiner and the objects. Results indicated that no group showed increased gaze toward the target object compared to the distracter object. However, results revealed that participants with FXS showed significantly increased face gaze compared to the novel objects, whereas children with ASD and TD both showed similar amounts of relative gaze toward the face and objects. Furthermore, the act of pointing at the target object was found to increase gaze toward the target objects compared to when there was no pointing in all groups. Together, these findings suggest that social cues like those employed in a word-learning task, when presented with video, may relate to gaze in FXS in context- or task-dependent ways that are distinct from those expected during live interaction.
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Affiliation(s)
- David P Benjamin
- MIND Institute, University of California-Davis, United States; Department of Psychiatry and Behavioral Sciences, U.C. Davis School of Medicine, United States.
| | - Ann M Mastergeorge
- Division of Family Studies and Human Development, University of Arizona, United States.
| | - Andrea S McDuffie
- MIND Institute, University of California-Davis, United States; Department of Psychiatry and Behavioral Sciences, U.C. Davis School of Medicine, United States.
| | - Sara T Kover
- University of Washington, Seattle, WA, United States.
| | - Randi J Hagerman
- MIND Institute, University of California-Davis, United States; Department of Pediatrics, U.C. Davis School of Medicine, Sacramento, CA, United States.
| | - Leonard Abbeduto
- MIND Institute, University of California-Davis, United States; Department of Psychiatry and Behavioral Sciences, U.C. Davis School of Medicine, United States.
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Powis L, Oliver C. The prevalence of aggression in genetic syndromes: a review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1051-1071. [PMID: 24594523 DOI: 10.1016/j.ridd.2014.01.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 01/27/2014] [Accepted: 01/28/2014] [Indexed: 06/03/2023]
Abstract
Research into behavioural phenotypes identifies both environmental and organic factors as influencing aggression in children and adults with genetic disorders associated with intellectual disability. However, in contrast to self-injury there is a paucity of research that compares aggression across relevant syndromes. The primary aim of this review is to examine the association between aggression and genetic syndromes by analysis of prevalence studies. The review also examines the literature on the form of the behaviour and influence of environmental factors. Results imply that certain syndrome groups (Cri du Chat, Smith-Magenis, Prader-Willi, Angelman, Cornelia de Lange, and Fragile X syndromes; estimates over 70%) evidence a stronger association with aggression than others (e.g. Williams and Down syndromes; estimates below 15%). However, the strength of association is difficult to quantify due to methodological differences between studies. The results from examining form and environmental influences highlight the importance of phenotype-environment interactions. Research employing group comparison designs is warranted and future work on the assessment and intervention of aggression in genetic syndromes should consider the importance of phenotype-environment interactions.
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Affiliation(s)
- Laurie Powis
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham B15 2TT, UK
| | - Chris Oliver
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham B15 2TT, UK.
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Quintero AI, Beaton EA, Harvey DJ, Ross JL, Simon TJ. Common and specific impairments in attention functioning in girls with chromosome 22q11.2 deletion, fragile X or Turner syndromes. J Neurodev Disord 2014; 6:5. [PMID: 24628892 PMCID: PMC3995552 DOI: 10.1186/1866-1955-6-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 02/26/2014] [Indexed: 12/20/2022] Open
Abstract
Background Chromosome 22q11.2 deletion syndrome (22q11.2DS), fragile X syndrome (FXS), and Turner syndrome (TS) are complex and variable developmental syndromes caused by different genetic abnormalities; yet, they share similar cognitive impairments in the domains of numbers, space, and time. The atypical development of foundational neural networks that underpin the attentional system is thought to result in further impairments in higher-order cognitive functions. The current study investigates whether children with similar higher-order cognitive impairments but different genetic disorders also show similar impairments in alerting, orienting, and executive control of attention. Methods Girls with 22q11.2DS, FXS, or TS and typically developing (TD) girls, aged 7 to 15 years, completed an attention network test, a flanker task with alerting and orienting cues. Exploration of reaction times and accuracy allowed us to test for potential commonalities in attentional functioning in alerting, orienting, and executive control. Linear regression models were used to test whether the predictors of group and chronological age were able to predict differences in attention indices. Results Girls with 22q11.2DS, FXS, or TS demonstrated unimpaired function of the alerting system and impaired function of the executive control system. Diagnosis-specific impairments were found such that girls with FXS made more errors and had a reduced orienting index, while girls with 22q11.2DS showed specific age-related deficits in the executive control system. Conclusions These results suggest that the control but not the implementation of attention is selectively impaired in girls with 22q11.2DS, TS or FXS. Additionally, the age effect on executive control in girls with 22q11.2DS implies a possible altered developmental trajectory.
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Affiliation(s)
- Andrea I Quintero
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, 2825 50th Street, Sacramento, CA 95817, USA.
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Couzens D. Behavior Phenotype: A Synthesis of Research to Understand Age-Related Change in Behavior in Several Syndromes. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2014. [DOI: 10.1111/jppi.12066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pegoraro LFL, Steiner CE, Celeri EHRV, Banzato CEM, Dalgalarrondo P. Cognitive and behavioral heterogeneity in genetic syndromes. J Pediatr (Rio J) 2014; 90:155-60. [PMID: 24184301 DOI: 10.1016/j.jped.2013.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 06/19/2013] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE this study aimed to investigate the cognitive and behavioral profiles, as well as the psychiatric symptoms and disorders in children with three different genetic syndromes with similar sociocultural and socioeconomic backgrounds. METHODS thirty-four children aged 6 to 16 years, with Williams-Beuren syndrome (n=10), Prader-Willi syndrome (n=11), and Fragile X syndrome (n=13) from the outpatient clinics of Child Psychiatry and Medical Genetics Department were cognitively assessed through the Wechsler Intelligence Scale for Children (WISC-III). Afterwards, a full-scale intelligence quotient (IQ), verbal IQ, performance IQ, standard subtest scores, as well as frequency of psychiatric symptoms and disorders were compared among the three syndromes. RESULTS significant differences were found among the syndromes concerning verbal IQ and verbal and performance subtests. Post-hoc analysis demonstrated that vocabulary and comprehension subtest scores were significantly higher in Williams-Beuren syndrome in comparison with Prader-Willi and Fragile X syndromes, and block design and object assembly scores were significantly higher in Prader-Willi syndrome compared with Williams-Beuren and Fragile X syndromes. Additionally, there were significant differences between the syndromes concerning behavioral features and psychiatric symptoms. The Prader-Willi syndrome group presented a higher frequency of hyperphagia and self-injurious behaviors. The Fragile X syndrome group showed a higher frequency of social interaction deficits; such difference nearly reached statistical significance. CONCLUSION the three genetic syndromes exhibited distinctive cognitive, behavioral, and psychiatric patterns.
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Affiliation(s)
- Luiz F L Pegoraro
- Department of Medical Psychology and Psychiatry, Faculty of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil; Pediatric Research Center, Department of Pediatrics, Faculty of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil.
| | - Carlos E Steiner
- Department of Medical Genetics, Faculty of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil
| | - Eloisa H R V Celeri
- Department of Medical Psychology and Psychiatry, Faculty of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil
| | - Claudio E M Banzato
- Department of Medical Psychology and Psychiatry, Faculty of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil
| | - Paulo Dalgalarrondo
- Department of Medical Psychology and Psychiatry, Faculty of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil; Pediatric Research Center, Department of Pediatrics, Faculty of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil
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Pegoraro LF, Steiner CE, Celeri EH, Banzato CE, Dalgalarrondo P. Cognitive and behavioral heterogeneity in genetic syndromes. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2014. [DOI: 10.1016/j.jpedp.2013.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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