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Al-Juhani A, Alzahrani MJ, Abdullah A Z, Alnefaie AN, Alnowaisser LN, Alhadi W, Alghamdi JK, Bauthman MS. Neuroimaging and Brain-Based Markers Identifying Neurobiological Markers Associated With Criminal Behaviour, Personality Disorders, and Mental Health: A Narrative Review. Cureus 2024; 16:e58814. [PMID: 38784339 PMCID: PMC11113083 DOI: 10.7759/cureus.58814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
We begin the review by pointing to the common stigma associated with mental health issues, which often derives from a lack of understanding or incomplete knowledge. Neurobiological research provides us with a new lens to help challenge and dispel common assumptions and misunderstandings and gives an understanding of sexual behaviours that influence society. As such, it generates substantial evidence for the structural and functional asymmetry of the brains of individuals with mental disorders. However, this type of representation poses many challenges to traditional thinking and constantly provokes change in perspective and empathy towards those individuals. In the review, we go deeper into the effects of neurobiological findings on understanding criminal behaviours and personality disorders, looking further beyond behavioural health. These problems, which were once mainly discussed as moral ones or viewed from the perspective of character flaws, are analysed today through neurological considerations pointing to their complexity. When the root of bipolar disorder is revealed to be neurological, society will react with more information and understanding, hence reducing the stigmatisation and discrimination meted out to people with these problems. At a macro level, findings from neurobiology affect society in ways that go beyond individuals; social attitudes, laws, and policies about the services rendered are influenced. Operating as a catalyst within the community, neurobiological research helps to initiate social change through the creation of an informed, understanding public forum. Thus, it creates broader value for those dealing with behavioural and mental health challenges. The first and most important question of this narrative review is focused on identifying identifiable neurobiological markers that are closely related to criminal conduct, personality disorders, and mental health disorders. Through this review, we aim to present detailed insights into the neurological foundations that anchor these phenomena via a narrative analysis of contemporary literature. The potential implications are finding problems early to apply specific treatment and learning an advanced strategy for social attitudes. This will promote a more humanistic approach based on adequate information on the behavioural and mental health issues involved.
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Affiliation(s)
| | | | | | | | | | - Wajd Alhadi
- College of Medicine, King Khalid University, Abha, SAU
| | | | - Moayyad S Bauthman
- Internal Medicine, King Abdulaziz University Faculty of Medicine, Rabigh, SAU
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Sonbol HM, Sabri Y, Shahda M, Shouman EA. Evaluation of the executive functions and quality of life in a sample of Egyptian male adolescents with substance use disorder: A case-control study. DISCOVER MENTAL HEALTH 2024; 4:7. [PMID: 38436797 PMCID: PMC10912384 DOI: 10.1007/s44192-024-00060-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Adolescent substance use is a major problem that has serious medical, psychological, and legal consequences later in life. Substance use disorder is closely linked to deficits in executive functions. Impaired executive functions (EFs) have been linked to all stages of the substance use disorder (SUD) life cycle, increasing the likelihood of commencing use, escalating use more quickly, and increasing the likelihood of relapsing following treatment. The current study aimed at evaluating of the executive functions and quality of life in a sample of adolescent Egyptian males with substance use disorder. RESULTS A significantly higher mean Trail Making Test-A, B (TMT-A and TMT-B) scores among studied cases than the control group (equals lower executive functions) with a mean score of TMT-A is 74.38 versus 63.2 among controls and for TMT-B; the mean score for control is 97.22 versus 142.04 among cases. A statistically significant difference between the case and control groups on all quality of life scores measuring the following domains: general health and well-being, physical health, psychological health, social interactions, and the environment, also there has been a negative correlation between TMT-A and the environmental domain (r = - 0.279) and TMT-B with the same variable (r = - 0.414). CONCLUSIONS Substance use disorders are a major health problem among youth. Deficits in executive functions are strongly associated with adolescent substance use. The more affected executive functions are associated with more affected quality of life of these patients.
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Affiliation(s)
| | - Youmna Sabri
- Department of Psychiatry, Faculty of Medicine-Mansoura University, El-Mansoura, Egypt
| | - Mohamed Shahda
- Department of Psychiatry, Faculty of Medicine-Mansoura University, El-Mansoura, Egypt
| | - Eman Abdallah Shouman
- Department of Psychiatry, Faculty of Medicine-Mansoura University, El-Mansoura, Egypt
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Aneni K, Chen CH, Meyer J, Cho YT, Lipton ZC, Kher S, Jiao MG, Gomati de la Vega I, Umutoni FA, McDougal RA, Fiellin LE. Identifying Game-Based Digital Biomarkers of Cognitive Risk for Adolescent Substance Misuse: Protocol for a Proof-of-Concept Study. JMIR Res Protoc 2023; 12:e46990. [PMID: 37995115 DOI: 10.2196/46990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 09/06/2023] [Accepted: 10/03/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Adolescents at risk for substance misuse are rarely identified early due to existing barriers to screening that include the lack of time and privacy in clinic settings. Games can be used for screening and thus mitigate these barriers. Performance in a game is influenced by cognitive processes such as working memory and inhibitory control. Deficits in these cognitive processes can increase the risk of substance use. Further, substance misuse affects these cognitive processes and may influence game performance, captured by in-game metrics such as reaction time or time for task completion. Digital biomarkers are measures generated from digital tools that explain underlying health processes and can be used to predict, identify, and monitor health outcomes. As such, in-game performance metrics may represent digital biomarkers of cognitive processes that can offer an objective method for assessing underlying risk for substance misuse. OBJECTIVE This is a protocol for a proof-of-concept study to investigate the utility of in-game performance metrics as digital biomarkers of cognitive processes implicated in the development of substance misuse. METHODS This study has 2 aims. In aim 1, using previously collected data from 166 adolescents aged 11-14 years, we extracted in-game performance metrics from a video game and are using machine learning methods to determine whether these metrics predict substance misuse. The extraction of in-game performance metrics was guided by literature review of in-game performance metrics and gameplay guidebooks provided by the game developers. In aim 2, using data from a new sample of 30 adolescents playing the same video game, we will test if metrics identified in aim 1 correlate with cognitive processes. Our hypothesis is that in-game performance metrics that are predictive of substance misuse in aim 1 will correlate with poor cognitive function in our second sample. RESULTS This study was funded by National Institute on Drug Abuse through the Center for Technology and Behavioral Health Pilot Core in May 2022. To date, we have extracted 285 in-game performance metrics. We obtained institutional review board approval on October 11, 2022. Data collection for aim 2 is ongoing and projected to end in February 2024. Currently, we have enrolled 12 participants. Data analysis for aim 2 will begin once data collection is completed. The results from both aims will be reported in a subsequent publication, expected to be published in late 2024. CONCLUSIONS Screening adolescents for substance use is not consistently done due to barriers that include the lack of time. Using games that provide an objective measure to identify adolescents at risk for substance misuse can increase screening rates, early identification, and intervention. The results will inform the utility of in-game performance metrics as digital biomarkers for identifying adolescents at high risk for substance misuse. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46990.
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Affiliation(s)
- Kammarauche Aneni
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
- Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States
| | - Ching-Hua Chen
- Center for Computational Health, IBM Research, Yorktown Heights, NY, United States
| | - Jenny Meyer
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
- Fairfield University, Fairfield, CT, United States
| | - Youngsun T Cho
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Zachary Chase Lipton
- Machine Learning Department, School of Computer Science, Carnegie Mellon University, Pittsburg, PA, United States
| | | | - Megan G Jiao
- McGovern Medical School, UTHealth Houston, Houston, TX, United States
| | | | | | - Robert A McDougal
- Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, CT, United States
- Yale School of Public Health, New Haven, CT, United States
| | - Lynn E Fiellin
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
- Yale School of Public Health, New Haven, CT, United States
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
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Cooke JT, Schmidt AT, Garos S, Littlefield AK. The Relations Between an Inventory-Based Measure of Executive Function and Impulsivity Factors in Alcohol- and Cannabis-Relevant Outcomes. Arch Clin Neuropsychol 2023; 38:1068-1081. [PMID: 37001549 DOI: 10.1093/arclin/acad026] [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] [Accepted: 02/22/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE While the lack of relation between performance- and inventory-based executive function (EF) measures is well documented, there remains ambiguity between self-report EFs and closely related constructs (e.g., impulsivity) assessed via the same method. The degree of convergence between purported EF measures with similar yet distinct constructs contain important theoretical implications for available EF assessment strategies and their construct validity. A newer measure of EF, the Behavior Regulation Inventory of Executive Functions-Adult (BRIEF-A), allows for more direct comparisons to self-reported measures of impulsivity, such as the commonly used Urgency, Planning, Perseverance, Sensation Seeking-Positive Urgency (UPPS-P) assessment. METHOD The present study used factor analysis and hierarchical regression to explore the associations between the BRIEF-A and UPPS-P, using alcohol and cannabis consumption across various outcomes (i.e., quantity-frequency and consequences) as an external criterion. Participants were 339 undergraduate students (Mage = 19.35; Female = 63%) from a large southwestern university. RESULTS The BRIEF-A and UPPS-P demonstrated strong correlations at both higher- and lower order facets. While the BRIEF-A was a significant correlate to many substance use outcomes, these relations were generally weaker than those seen with the UPPS-P. Hierarchical regression suggested limited contributions of the BRIEF-A over and above the UPPS-P. CONCLUSIONS Overall, this study suggested substantial overlap between impulsigenic factors and EFs when measured by self-report, and limited utility of EF measures to account for unique variance with substance use outcomes in this sample.
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Affiliation(s)
- Jeffrey T Cooke
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Adam T Schmidt
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Sheila Garos
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, Texas 79409, USA
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Pollastri AR, Forchelli G, Vuijk PJ, Stoll S, Capawana MR, Bellitti J, Braaten EB, Doyle AE. Behavior ratings of executive functions index multiple domains of psychopathology and school functioning in child psychiatric outpatients. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:304-317. [PMID: 35900144 PMCID: PMC10081135 DOI: 10.1080/21622965.2022.2099743] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Behavior rating scales of executive functions (EFs) are convenient and associate with academic and other outcomes; however, prior studies indicate limited correlations with psychometric tests of EFs. To better understand their potential for clinical utility, we examined the extent to which parent ratings on the Behavior Rating Inventory of Executive Function (BRIEF) related to psychopathology constructs and psychometric test scores in a sample of N = 692 psychiatric outpatients aged 8-17. Then, in a subsample of the youth (N = 261), we related the BRIEF, psychopathology constructs, and psychometric test scores to teacher ratings of school functioning. BRIEF scales were significantly associated with multiple types of psychopathology including ADHD, autism spectrum, mood, anxiety, conduct, oppositional defiant, and psychotic disorders. While the BRIEF showed limited associations with psychometric EF tests, its Global Executive Composite score explained additional variance in teacher-reported functioning beyond what was predicted by clinical diagnoses (additional explained variance of 9.9% in study skills) and psychometric tests (additional explained variance of 2.1% in learning problems and 4.5% in study skills). The Global Executive Composite was not significantly related to teacher-rated school functioning after psychiatric symptoms were accounted for. These findings support further investigation of the unique contribution of the BRIEF in clinical practice.
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Affiliation(s)
- Alisha R. Pollastri
- Department of Psychiatry, Massachusetts General Hospital (MGH)
- Department of Psychiatry, Harvard School of Medicine (HMS)
| | - Gina Forchelli
- Department of Psychiatry, Massachusetts General Hospital (MGH)
- Department of Psychiatry, Harvard School of Medicine (HMS)
| | - Pieter J. Vuijk
- Center for Genomic Medicine, Massachusetts General Hospital (MGH)
| | - Samantha Stoll
- Department of Psychiatry, Massachusetts General Hospital (MGH)
| | - Michael R. Capawana
- Department of Psychiatry, Massachusetts General Hospital (MGH)
- Department of Psychiatry, Harvard School of Medicine (HMS)
| | - Joseph Bellitti
- Center for Genomic Medicine, Massachusetts General Hospital (MGH)
| | - Ellen B. Braaten
- Department of Psychiatry, Massachusetts General Hospital (MGH)
- Department of Psychiatry, Harvard School of Medicine (HMS)
| | - Alysa E. Doyle
- Department of Psychiatry, Massachusetts General Hospital (MGH)
- Department of Psychiatry, Harvard School of Medicine (HMS)
- Center for Genomic Medicine, Massachusetts General Hospital (MGH)
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Shepard E, Sweeney C, Thompson L, Jacobs S, Grimm J, Weyandt LL. Effectiveness of executive functioning training among heterogeneous adolescent samples: A systematic review. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:327-343. [PMID: 35914534 DOI: 10.1080/21622965.2022.2106436] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of the present systematic review was to discuss the reported efficacy of executive functioning training techniques among adolescents. A systematic review of the literature was conducted to retrieve and consolidate findings from articles evaluating executive functioning training techniques among adolescents. A total of 26 articles were located that examined the role of executive functioning training techniques among adolescents (age 10-19 years). Articles retrieved enabled comparison across psychiatric and medical diagnoses including attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), as well as adolescents with physical health concerns. Results revealed that among typically developing adolescents, executive functioning training was non-significant or yielded small effect size improvements in executive functioning as measured by behavioral and neuroimaging tasks among 62.5% of studies reviewed. In contrast, in those with medical conditions, ASD, ADHD, and conduct disorder, all but two studies reviewed yielded a medium to large effect size, supporting the effectiveness of EF training. Future research is needed to identify the long-term efficacy of these treatments, as well as their generalizability to real-world conditions.
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Affiliation(s)
- Emily Shepard
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Caroline Sweeney
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Lauren Thompson
- Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, Rhode Island, USA
| | - Sophie Jacobs
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Jessica Grimm
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Lisa L Weyandt
- Department of Psychology, Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, Rhode Island, USA
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7
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Hammud G, Avital-Magen A, Schusheim G, Barzuza I, Engel-Yeger B. How Self-Regulation and Executive Functions Deficits Affect Quality of Life of Children/Adolescents with Emotional Regulation Disorders. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1622. [PMID: 37892283 PMCID: PMC10605933 DOI: 10.3390/children10101622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023]
Abstract
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.
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Affiliation(s)
- Ginan Hammud
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel;
| | - Ayelet Avital-Magen
- Child and Adolescent Mental Health Clinic, Haemeq Medical Center, Afula 1834111, Israel
| | - Guy Schusheim
- Child and Adolescent Mental Health Clinic, Haemeq Medical Center, Afula 1834111, Israel
| | - Inbar Barzuza
- Child and Adolescent Mental Health Clinic, Haemeq Medical Center, Afula 1834111, Israel
| | - Batya Engel-Yeger
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa 3498838, Israel;
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Cavalli JM, Cservenka A, Kerr DCR, Tiberio SS, Owen LD. Ratings of executive function as a risk factor for adolescents' frequent cannabis use: A prospective longitudinal study. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:616-625. [PMID: 36355660 PMCID: PMC10169534 DOI: 10.1037/adb0000891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE We examined the extent to which behavioral ratings of children's executive function (EF) in early adolescence predicted adolescents' cannabis use, and whether associations were independent of parents' cannabis and alcohol use and adolescents' alcohol use. METHOD Participants were 198 offspring (44% boys) of 127 mothers and 106 fathers. Parents and teachers completed the Behavior Rating Inventory of Executive Function (BRIEF) at ages 11-14 years. Youth were interviewed repeatedly from ages 14 to 20 years regarding frequency of cannabis and alcohol use. Two-level models regressed dichotomous cannabis outcomes (annual, weekly, or daily use) on age at the within-person level and the random intercept of cannabis use on EF, parent substance use, and covariates (age 7 IQ indicators, child gender, parent education, and mean of ages assessed) at the between-person level. RESULTS Poorer child EF predicted significantly (p < .05) higher likelihood of weekly (b[SE] = .64[.24]) and daily (b[SE] = .65[.25]), but not annual (b[SE] = .38[.22]), cannabis use. Parent cannabis use (b[SE] = .53[.25] to .81[.39], p < .05) independently predicted all three outcomes, and effects were distinct from those explained by parent alcohol use (b[SE] = .66[.29] to .81[.35], p < .05). EF remained a significant predictor of weekly and daily cannabis use after adjusting for parental alcohol and cannabis use, and adolescents' alcohol use. CONCLUSIONS Children exhibiting poorer EF were more likely to use cannabis weekly and daily in later adolescence. Whereas literature suggests poorer EF may be a consequence of cannabis use, these findings suggest EF should be considered prior to cannabis use initiation. EF during childhood may be a fruitful prevention target. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - David C R Kerr
- School of Psychological Science, Oregon State University
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Hall AM, Keil AP, Choi G, Ramos AM, Richardson DB, Olshan AF, Martin CL, Villanger GD, Reichborn-Kjennerud T, Zeiner P, Øvergaard KR, Sakhi AK, Thomsen C, Aase H, Engel SM. Prenatal organophosphate ester exposure and executive function in Norwegian preschoolers. Environ Epidemiol 2023; 7:e251. [PMID: 37304339 PMCID: PMC10256412 DOI: 10.1097/ee9.0000000000000251] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/26/2023] [Indexed: 06/13/2023] Open
Abstract
Organophosphate esters (OPEs) are ubiquitous chemicals, used as flame retardants and plasticizers. OPE usage has increased over time as a substitute for other controlled compounds. This study investigates the impact of prenatal OPE exposure on executive function (EF) in preschoolers. Methods We selected 340 preschoolers from the Norwegian Mother, Father, and Child Cohort Study. Diphenyl-phosphate (DPhP), di-n-butyl-phosphate (DnBP), bis(2-butoxyethyl) phosphate (BBOEP), and bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) were measured in maternal urine. EF was measured using the Behavior Rating Inventory of Executive Functioning-Preschool (BRIEF-P) and the Stanford-Binet fifth edition (SB-5). EF scores were scaled so a higher score indicated worse performance. We estimated exposure-outcome associations and evaluated modification by child sex using linear regression. Results Higher DnBP was associated with lower EF scores across multiple rater-based domains. Higher DPhP and BDCIPP were associated with lower SB-5 verbal working memory (β = 0.49, 95% CI = 0.12, 0.87; β = 0.53, 95% CI = 0.08, 1.02), and higher BBOEP was associated with lower teacher-rated inhibition (β = 0.34, 95% CI = 0.01, 0.63). DPhP was associated with lower parent-reported BRIEF-P measures in boys but not girls [inhibition: boys: 0.37 (95% CI = 0.03, 0.93); girls: -0.48 (95% CI = -1.27, 0.19); emotional control: boys: 0.44 (95% CI = -0.13, 1.26); girls: -0.83 (95% CI = -1.73, -0.00); working memory: boys: 0.49 (95% CI = 0.03, 1.08); girls: -0.40 (95% CI = -1.11, 0.36)]. Fewer sex interactions were observed for DnBP, BBOEP, and BDCIPP, with irregular patterns observed across EF domains. Conclusions We found some evidence prenatal OPE exposure may impact EF in preschoolers and variation in associations by sex.
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Affiliation(s)
- Amber M. Hall
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alexander P. Keil
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Giehae Choi
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Amanda M. Ramos
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - David B. Richardson
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Andrew F. Olshan
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Chantel L. Martin
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gro D. Villanger
- Department of Child Health and Development, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Pål Zeiner
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kristin R. Øvergaard
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Amrit K. Sakhi
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Cathrine Thomsen
- Department of Food Safety, Division of Climate and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Heidi Aase
- Department of Child Health and Development, Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Stephanie M. Engel
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Arwood Z, Nooner KB. Adverse Childhood Experiences and Binge Drinking in Adolescence: the Role of Impulsivity and PTSD Symptoms. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2023; 9:30-41. [PMID: 38239412 PMCID: PMC10795711 DOI: 10.1007/s40817-022-00135-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022]
Abstract
Background The present study examines impulsivity and posttraumatic stress disorder (PTSD) symptoms as factors that may help understand the relationship between adverse childhood experiences (ACEs) and adolescent binge drinking. Methods Data were drawn from a subset of adolescents (N = 285) ages 12-22 from the National Consortium on Alcohol & Neurodevelopment in Adolescence (NCANDA). Impulsivity and PTSD symptoms were each predicted to moderate the relationship between ACEs and binge drinking. Results The positive relationship between PTSD symptoms and binge drinking was stronger when impulsivity was included. The positive relationship between ACEs and binge drinking was also strengthened when accounting for PTSD symptoms. Conclusion Our results provide evidence that impulsivity and PTSD symptoms may increase the risk for binge drinking during adolescence, including following ACEs. Interventions targeting PTSD symptoms and impulsivity could be valuable tools in preventing adolescent binge drinking.
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Affiliation(s)
- Zjanya Arwood
- Department of Psychology, University of North Carolina Wilmington, 601 South College Rd., Wilmington, NC 28409, USA
| | - Kate B. Nooner
- Department of Psychology, University of North Carolina Wilmington, 601 South College Rd., Wilmington, NC 28409, USA
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Riccio CA, Jimenez EM, Schwartz J, Chien HY. Do parent and self-report rating scales of executive function measure the same constructs with adolescents? APPLIED NEUROPSYCHOLOGY. CHILD 2022; 11:212-219. [PMID: 32567369 DOI: 10.1080/21622965.2020.1780129] [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] [Indexed: 06/11/2023]
Abstract
OBJECTIVE There are numerous measures of executive function (EF), yet the multiple definitions and constructions of EF suggest that these measures may not be measuring the same construct or domains within EF. The purpose of this study was to examine the concurrent validity of the BRIEF and the CEFI parent and self-report forms with adolescents. METHOD Adolescent participants, ages 12-17 years, were recruited using a snowball method with recruitment targeting individuals from under-represented groups, as well as the general population. The resulting sample consisted of 52 cases with parent report. The adolescents were predominantly female (55.77%) and white (40.38%) with a mean age of 14.56 (1.72). RESULTS For parent and adolescent self-report on both the BRIEF and CEFI, mean global scores were within the average range. To examine whether the two rating scales were measuring the same underlying constructs of EF, a multi-trait-multi-method (MTMM) model was conducted using correlated traits correlated methods (CTCM) and correlated traits uncorrelated methods (CTUM). CONCLUSION While the global scores obtained for the instruments measure EF similarly, there is less consistency in how the subdomains parse out and are labeled for each of the two scales. Implications for practice are discussed.
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Tapert SF, Eberson-Shumate S. Alcohol and the Adolescent Brain: What We've Learned and Where the Data Are Taking Us. Alcohol Res 2022; 42:07. [PMID: 35465194 PMCID: PMC8999519 DOI: 10.35946/arcr.v42.1.07] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This article is part of a Festschrift commemorating the 50th anniversary of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Established in 1970, first as part of the National Institute of Mental Health and later as an independent institute of the National Institutes of Health, NIAAA today is the world's largest funding agency for alcohol research. In addition to its own intramural research program, NIAAA supports the entire spectrum of innovative basic, translational, and clinical research to advance the diagnosis, prevention, and treatment of alcohol use disorder and alcohol-related problems. To celebrate the anniversary, NIAAA hosted a 2-day symposium, "Alcohol Across the Lifespan: 50 Years of Evidence-Based Diagnosis, Prevention, and Treatment Research," devoted to key topics within the field of alcohol research. This article is based on Dr. Tapert's presentation at the event. NIAAA Director George F. Koob, Ph.D., serves as editor of the Festschrift.
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Affiliation(s)
- Susan F Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, California
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Lannoy S, Pfefferbaum A, Le Berre AP, Thompson WK, Brumback T, Schulte T, Pohl KM, De Bellis MD, Nooner KB, Baker FC, Prouty D, Colrain IM, Nagel BJ, Brown SA, Clark DB, Tapert SF, Sullivan EV, Müller-Oehring EM. Growth trajectories of cognitive and motor control in adolescence: How much is development and how much is practice? Neuropsychology 2022; 36:44-54. [PMID: 34807641 PMCID: PMC9995176 DOI: 10.1037/neu0000771] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Executive control continues to develop throughout adolescence and is vulnerable to alcohol use. Although longitudinal assessment is ideal for tracking executive function development and onset of alcohol use, prior testing experience must be distinguished from developmental trajectories. METHOD We used the Stroop Match-to-Sample task to examine the improvement of processing speed and specific cognitive and motor control over 4 years in 445 adolescents. The twice-minus-once-tested method was used and expanded to four test sessions to delineate prior experience (i.e., learning) from development. A General Additive Model evaluated the predictive value of age and sex on executive function development and potential influences of alcohol use on development. RESULTS Results revealed strong learning between the first two assessments. Adolescents significantly improved their speed processing over 4 years. Compared with boys, girls enhanced ability to control cognitive interference and motor reactions. Finally, the influence of alcohol use initiation was tested over 4 years for development in 110 no/low, 110 moderate/heavy age- and sex-matched drinkers; alcohol effects were not detected in the matched groups. CONCLUSIONS Estimation of learning effects is crucial for examining developmental changes longitudinally. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Alderson Myers AB, Arienzo D, Molnar SM, Marinkovic K. Local and network-level dysregulation of error processing is associated with binge drinking. NEUROIMAGE-CLINICAL 2021; 32:102879. [PMID: 34768146 PMCID: PMC8591397 DOI: 10.1016/j.nicl.2021.102879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 01/22/2023]
Abstract
Go/NoGo performance does not differ between binge (BDs) and light drinkers. BDs show greater BOLD activity to inhibition errors primarily in prefrontal areas. Greater functional connectivity in the frontal cortex correlates with drinking. Observed increase in error-related activity may serve a compensatory role. This is consistent with allostatic hyperexcitability reflecting neuroadaptation.
Binge drinking refers to the pattern of alcohol consumption that brings blood alcohol levels to or above legal intoxication levels. Commonly practiced by young adults, it is associated with neurofunctional alterations, raising health-related concerns. Executive deficits may contribute to the inability to refrain from excessive alcohol intake. As a facet of cognitive control, error processing allows for flexible modification of behavior to optimize future outcomes. It is highly relevant to addiction research, as a failure to inhibit excessive drinking results in relapses, which is a hallmark of alcohol use disorder. However, research on local and system-level neural underpinnings of inhibition failures as a function of binge drinking is limited. To address these gaps, functional magnetic resonance imaging (fMRI) was used to examine local changes and interregional functional connectivity during response inhibition errors on a Go/NoGo task. Young adult binge drinkers (BDs) performed equally well as light drinkers (LDs), a group of demographically matched individuals who drink regularly but in low-risk patterns. In contrast, BDs exhibited greater fMRI activity to inhibition errors contrasted with correct NoGo trials in the rostral anterior (rACC) and posterior cingulate cortices (PCC), as well as right middle frontal gyrus (R-MFG). Furthermore, BDs showed increased connectivity between the rACC and right lateral prefrontal cortex, in addition to greater connectivity between the R-MFG and the left ventrolateral and superior frontal cortices. Imaging indices were positively correlated only with alcohol-related measures, but not with those related to moods, disposition, or cognitive capacity. Taken together, greater error-related activity and expanded functional connectivity among prefrontal regions may serve a compensatory role to maintain efficiency of inhibitory control. Aligned with prominent models of addiction, these findings accentuate the importance of top-down control in maintaining low-risk drinking levels. They provide insight into potentially early signs of deteriorating cognitive control functions in BDs and may help guide intervention strategies aimed at preventing excessive drinking habits.
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Affiliation(s)
- Austin B Alderson Myers
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA.
| | - Donatello Arienzo
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA.
| | - Sean M Molnar
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA.
| | - Ksenija Marinkovic
- Department of Psychology, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA; Department of Radiology, University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA.
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Mennis J, Li X, Meenar M, Coatsworth JD, McKeon TP, Mason MJ. Residential Greenspace and Urban Adolescent Substance Use: Exploring Interactive Effects with Peer Network Health, Sex, and Executive Function. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041611. [PMID: 33567686 PMCID: PMC7914774 DOI: 10.3390/ijerph18041611] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 11/16/2022]
Abstract
While urban greenspace is increasingly recognized as important to mental health, its role in substance use is understudied. This exploratory study investigates the interaction of greenspace with peer network health, sex, and executive function (EF) in models of substance use among a sample of disadvantaged, urban youth. Adolescents and their parents were recruited from a hospital in the mid-Atlantic region of the U.S. Residential greenspace at the streetscape level was derived from analysis of Google Street View imagery. Logistic regression models were used to test the moderating effect of greenspace on the association between peer network health and substance use, as well as additional moderating effects of sex and EF. The significant negative association of peer network health with substance use occurred only among youth residing in high greenspace environments, a moderating effect which was stronger among youth with high EF deficit. The moderating effect of greenspace did not differ between girls and boys. Greenspace may play an important role in moderating peer influences on substance use among disadvantaged, urban adolescents, and such moderation may differ according to an individual's level of EF. This research provides evidence of differences in environmental susceptibility regarding contextual mechanisms of substance use among youth, and it informs the development of targeted substance use interventions that leverage social and environmental influences on adolescent substance use.
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Affiliation(s)
- Jeremy Mennis
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA 19122, USA; (X.L.); (T.P.M.)
- Correspondence:
| | - Xiaojiang Li
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA 19122, USA; (X.L.); (T.P.M.)
| | - Mahbubur Meenar
- Department of Geography, Planning, and Sustainability, Rowan University, Glassboro, NJ 08028, USA;
| | - J. Douglas Coatsworth
- Center for Behavioral Health Research, University of Tennessee, Knoxville, TN 37996, USA; (J.D.C.); (M.J.M.)
| | - Thomas P. McKeon
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA 19122, USA; (X.L.); (T.P.M.)
| | - Michael J. Mason
- Center for Behavioral Health Research, University of Tennessee, Knoxville, TN 37996, USA; (J.D.C.); (M.J.M.)
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Luciana M. Risks versus consequences of adolescent and young adult substance use: A focus on executive control. CURRENT ADDICTION REPORTS 2020; 7:453-463. [PMID: 33816055 PMCID: PMC8014909 DOI: 10.1007/s40429-020-00341-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW This review examines the role of executive control processes in the liability for substance misuse and whether substance use, once initiated, leads to subsequent decrements as proposed by neurotoxicity models of substance use disorder (SUD). RECENT FINDINGS As indicated by a number of recent meta-analyses, executive control processes, which include working memory, cognitive flexibility and numerous aspects of attentional, behavioral and emotional control, are impaired in the context of active SUD. Longitudinal studies of behaviorally disinhibited children, individuals with familial risks for SUD, and twins within whom genetic versus environmental influences on behavior can be modeled robustly indicate that relatively poor control is a vulnerability factor for early substance use initiation, binge patterns of use, and subsequent SUD. Evidence of further declines in executive control, once substance use is initiated, is mixed, although a growing number of neuroimaging studies indicate that frontostriatal, frontolimbic, and frontocerebellar systems are altered as a consequence of use. SUMMARY Together these patterns suggest strategies for identifying children and adolescents at high risk for SUD, avenues through which substance-related neurotoxicities can be more reliably detected, and the need to structure prevention efforts in a manner that is developmentally appropriate and perhaps personalized to individual vulnerabilities.
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Affiliation(s)
- Monica Luciana
- Department of Psychology, University of Minnesota, Minneapolis MN, 55455 USA
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Silveira S, Shah R, Nooner KB, Nagel BJ, Tapert SF, de Bellis MD, Mishra J. Impact of Childhood Trauma on Executive Function in Adolescence-Mediating Functional Brain Networks and Prediction of High-Risk Drinking. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:499-509. [PMID: 32299789 DOI: 10.1016/j.bpsc.2020.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/07/2020] [Accepted: 01/22/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Childhood trauma is known to impart risk for several adverse life outcomes. Yet, its impact during adolescent development is not well understood. We aimed to investigate the relationships among childhood trauma, functional brain connectivity, executive dysfunction (ED), and the development of high-risk drinking in adolescence. METHODS Data from the National Consortium on Alcohol and Neurodevelopment in Adolescence (sample size = 392, 55% female) cohort were used. This included resting-state functional magnetic resonance imaging at baseline, childhood trauma and ED self-reports, and detailed interviews on alcohol and substance use collected at baseline and at 4 annual follow-ups. We used longitudinal regression analyses to confirm the relationship between childhood trauma and ED, identified the mediating functional brain network hubs, and used these linkages to predict future high-risk drinking in adolescence. RESULTS Childhood trauma severity was significantly related to ED in all years. At baseline, distributed functional connectivity from hub regions in the bilateral dorsal anterior cingulate cortex, right anterior insula, right intraparietal sulcus, and bilateral pre- and postcentral gyri mediated the relationship between childhood trauma and ED. Furthermore, high-risk drinking in follow-up years 1-4 could be predicted with high accuracy from the trauma-affected functional brain networks that mediated ED at baseline, together with age, childhood trauma severity, and extent of ED. DISCUSSION Functional brain networks, particularly from hub regions important for cognitive and sensorimotor control, explain the relationship between childhood trauma and ED and are important for predicting future high-risk drinking. These findings are relevant for the prognosis of alcohol use disorders.
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Affiliation(s)
- Sarita Silveira
- Department of Psychiatry, University of California San Diego, La Jolla, California; Neural Engineering and Translation Labs, University of California San Diego, La Jolla, California
| | - Rutvik Shah
- Department of Psychiatry, University of California San Diego, La Jolla, California; Neural Engineering and Translation Labs, University of California San Diego, La Jolla, California
| | - Kate B Nooner
- Department of Psychology, University of North Carolina, Wilmington, North Carolina
| | - Bonnie J Nagel
- Departments of Psychiatry and Behavioral Neuroscience, Oregon Health and Science University, Portland, Oregon
| | - Susan F Tapert
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Michael D de Bellis
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Jyoti Mishra
- Department of Psychiatry, University of California San Diego, La Jolla, California; Neural Engineering and Translation Labs, University of California San Diego, La Jolla, California
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Adolescent-Reported Sleep/Wake Patterns in the Relationships Between Inhibitory Control and Internalizing and Externalizing Problems. J Dev Behav Pediatr 2019; 40:679-685. [PMID: 31299032 DOI: 10.1097/dbp.0000000000000707] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Youth with poorer inhibitory control are more likely to experience internalizing and externalizing problems, placing them at risk for poorer psychological, academic, and social functioning. Modifying inhibitory control is challenging; therefore, research is needed to identify alternative targets to reduce internalizing and externalizing problems in youth. Sleep/wake patterns may serve as alternative targets, given their relationships with poorer inhibitory control and greater internalizing and externalizing problems. This study examines the mediating role of sleep/wake patterns in the relationships between youth inhibitory control and internalizing and externalizing problems. METHOD One hundred fifty-five adolescent (ages 12-15 years) and parent dyads completed the Behavioral Rating Inventory of Executive Function, Pediatric Symptom Checklist, and Adolescent Sleep-Wake Scale, short version. Bootstrapped mediations examined indirect relationships between inhibitory control and internalizing and externalizing through sleep/wake patterns. RESULTS Analyses revealed that problematic sleep/wake patterns partially mediated the relationship between poorer inhibitory control and greater internalizing, explaining 19% of the variance in internalizing problems. In addition, problematic sleep/wake patterns partially mediated the relationship between poorer inhibitory control and greater externalizing, explaining 58% of the variance in externalizing problems. CONCLUSION The results suggest that sleep/wake patterns may be a mechanism through which deficits in inhibitory control increase youth risk for internalizing and externalizing problems. Because sleep/wake patterns are frequently modified through adoption of health behaviors conducive to good sleep, assessing for problematic patterns in adolescents who present with internalizing and externalizing problems may offer providers a relatively modifiable target to reduce the emotional and behavioral problems of youth with poorer inhibitory control abilities.
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Bos DJ, Silver BM, Barnes ED, Ajodan EL, Silverman MR, Clark-Whitney E, Tarpey T, Jones RM. Adolescent-Specific Motivation Deficits in Autism Versus Typical Development. J Autism Dev Disord 2019; 50:364-372. [PMID: 31625010 DOI: 10.1007/s10803-019-04258-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Differences in motivation during adolescence relative to childhood and adulthood in autism was tested in a cross-sectional study. 156 Typically developing individuals and 79 individuals with autism ages 10-30 years of age completed a go/nogo task with social and non-social cues. To assess age effects, linear and quadratic models were used. Consistent with prior studies, typically developing adolescents and young adults demonstrated more false alarms for positive relative to neutral social cues. In autism, there were no changes in attention across age for social or non-social cues. Findings suggest reduced orienting to motivating cues during late adolescence and early adulthood in autism. The findings provide a unique perspective to explain the challenges for adolescents with autism transitioning to adulthood.
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Affiliation(s)
- Dienke J Bos
- The Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA.
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Benjamin M Silver
- The Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
- The Center for Autism and the Developing Brain, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Emily D Barnes
- The Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
- The Center for Autism and the Developing Brain, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Eliana L Ajodan
- The Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
- The Center for Autism and the Developing Brain, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Melanie R Silverman
- The Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
- The Center for Autism and the Developing Brain, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Elysha Clark-Whitney
- The Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
- The Center for Autism and the Developing Brain, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Thaddeus Tarpey
- Division of Biostatistics, Department of Population Health, NYU School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA
| | - Rebecca M Jones
- The Sackler Institute for Developmental Psychobiology, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
- The Center for Autism and the Developing Brain, Department of Psychiatry, Weill Cornell Medicine, New York, NY, 10065, USA
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Sanvisens A, Sanjeevan I, Zuluaga P, Túnez A, de Francisco A, Papaseit E, García-Eroles L, Muga R. Five-Year Incidence of Hospital-Based Emergencies Related to Acute Recreational Intoxication in Minors. Alcohol Clin Exp Res 2019; 43:2179-2186. [PMID: 31454093 DOI: 10.1111/acer.14166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 07/19/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Alcohol or other drug (AOD) intoxication in minors is a public health challenge. We characterized underage patients admitted to an emergency department (ED) with acute, recreational AOD intoxication. METHODS We conducted a 5-year (2012 to 2016) analysis of minors admitted to the only hospital-based pediatric ED in an urban area. Episodes of AOD intoxication were selected using ICD-9-CM diagnostic codes. Sociodemographics, substance use and clinical characteristics, laboratory parameters, and discharge dispositions were collected through the revision of clinical charts. RESULTS A total of 266 admissions related to recreational AOD intoxication in 258 patients occurred during the study period. Among the 258 patients, 127 (49.2%) were men, median age 16 years [IQR: 15 to 17 years], and 234 (90.7%) of episodes were alcohol-related. At admission, 202/256 (78.9%) patients had a Glasgow Coma Scale ≥ 13 points, the median systolic and diastolic blood pressure was 109 mmHg (IQR: 101 to 118 mmHg) and 67 mmHg (IQR: 60 to 73 mmHg), respectively, and the median blood glucose level was 112 mg/dl (IQR: 99 to 127 mg/dl). Only 72/258 (27.9%) patients underwent urine screening (22/72 (30.5%) were positive for cannabis), and only 30/258 (11.6%) were tested for blood ethanol (median: 185 mg/dl, IQR: 163 to 240 mg/dl). There was a trend in admissions occurring early in the morning of weekend days, and 249 (96.5%) patients were discharged home the day of admission. CONCLUSIONS Though the severity of AOD intoxication seems to be mild to moderate, assessment of substance exposure is low and may underestimate polydrug use in underage populations.
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Affiliation(s)
- Arantza Sanvisens
- From the, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Institut Germans Trias i Pujol-IGTP, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Irina Sanjeevan
- Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Paola Zuluaga
- From the, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Institut Germans Trias i Pujol-IGTP, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Adrià Túnez
- From the, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Institut Germans Trias i Pujol-IGTP, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Antonio de Francisco
- Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Esther Papaseit
- Department of Pharmacology, Hospital Universitari Germans Trias i Pujol, Institut Germans Trias i Pujol-IGTP, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Luis García-Eroles
- Department of Health Information Systems, Generalitat de Catalunya, Barcelona, Spain
| | - Robert Muga
- From the, Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Institut Germans Trias i Pujol-IGTP, Universitat Autònoma de Barcelona, Badalona, Spain
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Boksa P, Joober R. Who should be "controls" in studies on the neurobiology of psychiatric disorders? J Psychiatry Neurosci 2018; 43. [PMID: 30125246 PMCID: PMC6158024 DOI: 10.1503/jpn.180128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Patricia Boksa
- From the Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Que., Canada
| | - Ridha Joober
- From the Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Que., Canada
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