Internalizing disorders and quality of life in adolescence: evidence for independent associations

How Self-Regulation and Executive Functions Deficits Affect Quality of Life of Children/Adolescents with Emotional Regulation Disorders

BACKGROUND

Deficits in self-regulation and executive functions (EFs) frequently characterize children/adolescents with emotional regulation disorders and restrict their daily function and quality of life (QOL). These deficits are mainly manifested by neuropsychological measures in laboratory settings. This study aimed to compare self-regulation and EFs by ecological measures to reflect the implications in daily life between children with emotional regulation disorders and healthy controls and examine the relations between self-regulation, EFs and QOL in the study group.

METHODS

the participants were 49 children aged 8-18: 25 children/adolescents with emotional regulation disorders and 24 healthy children. The parents completed a socio-demographic questionnaire, the Child Behavior Checklist (CBCL), the Behavior Rating Inventory of Executive Functions (BRIEF) and the Pediatric Quality of Life Inventory (Peds-QL).

RESULTS

The study group had greater self-regulation difficulties (internalization and externalization problems), executive dysfunctions (EFdys) (including metacognition difficulties) and a lower QOL. Their internalization and externalization problems correlated with reduced EFs and QOL. Internalization predicted the physical and emotional QOLs, while metacognition predicted social and school-related QOLs.

CONCLUSIONS

Deficits in self-regulation and EFs are prevalent in children/adolescents with emotional disorders and restrict their daily function and QOL. Therefore, they should be routinely evaluated by ecological instruments to reflect daily restrictions.

The link between executive function, socio-emotional functioning and health-related quality of life in children and adolescents with mild to moderate chronic kidney disease

BACKGROUND

Children and adolescents with mild to moderate chronic kidney disease (CKD) are at high risk for mild but persistent impairment in executive functions, which have been associated with low health-related quality of life (HRQOL) among children and adolescents with chronic health conditions. However, no similar link has been established among children and adolescents with mild to moderate CKD. Given the essential role executive functions play in the development of adequate cognitive, emotional and social skills, it is essential to gain a clearer understating of the magnitude and attributes of executive functions and its link to HRQOL in order to inform appropriate medical and educational interventions for this patient population.

OBJECTIVE

The aim of this study is to examine the relationship between executive functions, socio-emotional functioning and HRQOL in children and adolescents with mild to moderate CKD.

METHODS

A cross-sectional design was used for this secondary data analysis of 199 children and adolescents (ages 6-17) with mild to moderate CKD from the United States and Canada who receive care at hospitals associated with the Chronic Kidney Disease in Children Study (CKiD).

RESULTS

The presence of impairment in executive functions and socio-emotional functioning (internalizing problems) significantly predicted lower HRQOL after controlling for key covariates (i.e., maternal education, anaemia and hypertension). Further, internalizing problems partially mediated the relationship between executive functions and HRQOL such that impairment in executive functions predicted lower HRQOL directly and indirectly by contributing to higher internalizing problems, which further contributed to low HRQOL.

CONCLUSION

This study underscores the importance of executive functions and socio-emotional functioning in the manifestation of HRQOL. Given that HRQOL is potentially compromised for many children and adolescents with mild to moderate CKD, it will be important for both clinicians and researchers to examine a range of factors, including executive functions and socio-emotional functioning, in order to optimize HRQOL.

Relación entre condición física global, coordinación motriz y calidad de vida percibida en adolescentes españoles

La sociedad actual plantea la necesidad de incorporar a la educación aquellas capacidades relacionadas con el cuerpo y su actividad motriz dentro de los márgenes de la salud, pues estas resultan determinantes para el desarrollo integral de la persona. Teniendo esto en cuenta, el objetivo del presente estudio fue analizar la relación entre la condición física global (CF), la coordinación motriz (CM) y la calidad de vida percibida (CVP) en adolescentes españoles. Para esto, se diseñó un estudio descriptivo transversal con 1037 adolescentes de 14 a 16 años de edad, y se utilizó el Cuestionario de salud SF-36 para evaluar la CVP, y la Batería de condición física relacionada con la salud para evaluar la CF global y la CM. Los resultados muestran que los sujetos con mayor CF tuvieron valores promedio más elevados en las variables de función física (p < .001), rol físico (p < .001), vitalidad (p < .05), función social (p < .001), rol emocional (p < .01), salud mental (p < .001) y calidad de vida total (p < .001); mientras que aquellos con menor CF presentaron puntuaciones superiores en dolor corporal (p < .001). Asimismo, los sujetos que mostraron mayor CM obtuvieron mejores registros en salud general, vitalidad, función social y calidad de vida total (p < .001 en todos los casos), y registros inferiores en función física y rol físico (p < .001 en ambos casos). Los resultados de este estudio sugieren que tener una mayor CF, así como una mayor CM, pueden ser variables predictoras de una mejor CVP en adolescentes españoles.

Measuring the effects on quality of life and alcohol consumption of a program to reduce binge drinking in Spanish adolescents

AIM

To present a comparison between the effects on health due to a reduction in binge drinking (BD) and health-related quality of life (HRQoL), as a result of ALERTA ALCOHOL, an intervention aimed at reducing BD in Spanish adolescents.

METHODS

A two-arm cluster randomized controlled trial was conducted with an intervention and a control group, randomized at the school level, following individuals over four months. The study population consisted of Andalusian adolescents aged 15 to 19 years who were enrolled in urban public high schools (n = 1247). Participants were assigned randomly to receive the intervention. The main outcomes studied were the number of occasions of BD in the last 30 days, which was directly obtained from the answers given by the adolescents, and HRQoL measured with the EQ-5D-5 L questionnaire. The model of estimation was the generalized estimating equations (GEE) approach.

RESULTS

The program showed a BD reduction at the 4-month follow-up, although it was not shown to significantly increase the HRQoL in adolescents who reduced the number of occasions of BD and had received the intervention. However, it was shown that those who would predictably reduce the number of occasions of BD controlled by several sociodemographic variables perceived a higher HRQoL, as did those who had a greater adherence to the program.

CONCLUSIONS

Higher adherence to a web-based computer-tailored intervention to prevent BD in adolescents has a positive effect on decreasing the number of occasions of BD in adolescents as well as on increasing participants' HRQoL, although this second effect is very small, which could be due to the short follow-up time. This fact is quite important and should be assessed extensively to corroborate the results and translate into health policy.

Amygdala-based intrinsic functional connectivity and anxiety disorders in adolescents and young adults

Anxiety disorders (AD) are the most prevalent group of psychiatric disorders in adolescents and young adults. Nevertheless, the pathophysiology of anxiety disorders is still poorly understood. This study investigated differences in the functional connectivity of intrinsic amygdala-based networks of participants with and without AD. Resting state fMRI data were obtained from 18 participants with an AD and 19 healthy comparison individuals. Psychiatric diagnosis was assessed using standardized structured interviews. The comparison between groups was carried out using functional connectivity maps from six seed regions defined using probabilistic maps bilaterally within the amygdala (basolateral, superficial and centromedial amygdala). We found significant between-group differences in five clusters, which showed aberrant functional connectivity with the left basolateral amygdala: right precentral gyrus, right cingulate gyrus, bilateral precuneus, and right superior frontal gyrus in subjects with AD as compared with the comparison subjects. For the comparison subjects, the correlations between the amygdala and the five clusters were either non-significant, or negative. The present study suggests there is an intrinsic disruption in the communication between left basolateral amygdala and a network of brain regions involved with emotion regulation, and with the default mode network in adolescents and young adults with anxiety disorders.

[Quality-of-life-related factors in adolescents]

OBJECTIVE

To determine quality of life (QoL) and its relationship to lifestyles in adolescents in high schools.

METHODS

Cross-sectional, observational study with 256 students aged 12 to 17 in Seville (Spain). Multiple linear regression models were tested (p <0.05).

RESULTS

The boys had higher scores in most of the QoL areas. The female gender was inversely related to physical, psychological, familial QoL areas and the general QoL index. Family functionality and performing physical activity were the factors most associated with better QoL in all areas. All multivariate models were statistically significant and explained from 11% of social QoL variability to 35% of the general QoL index.

CONCLUSIONS

The findings could be useful for developing interventions to promote health in schools, with the objective of promoting healthy lifestyles and QoL.