Comparing Cognitive Disengagement Syndrome Growth in Youth With and Without Spina Bifida

OBJECTIVE

Cognitive disengagement syndrome (CDS; formally known as sluggish cognitive tempo), difficulties with social engagement, and lower levels of autonomy have been identified as maladaptive comorbidities in youth with spina bifida (SB). This study compared growth curves of CDS for youth with and without SB and examined whether these trajectories were associated with later functioning.

METHODS

Longitudinal data spanning 8 years included youth with SB (n = 68, Mage = 8.34) and a demographically matched sample of typically developing (TD) peers (n = 68, Mage = 8.49). Adolescents, along with their caregivers and teachers, reported on youth social skills, behavioral functioning, and CDS. Growth curve models were examined by comparing CDS trajectories by SB status.

RESULTS

Growth curves indicated that youth with SB had higher levels of teacher-reported CDS at ages 8 and 9, but growth curves were relatively stable for both groups. When predicting social skills, higher levels of teacher-reported (but not mother-reported) CDS at baseline predicted worse social functioning for both youth with and without SB in adolescence. For the slope findings, higher rates of mother-reported CDS over time predicted worse social skills (β = -0.43) and lower levels of youth decision-making (β = -0.43) for the SB group, while higher rates of teacher-reported CDS predicted worse social skills for the TD group.

CONCLUSION

Next steps include understanding the impact that impaired social functioning and restricted autonomy have on youth with and without SB due to CDS to inform interventions. Additionally, advocacy for increased awareness of CDS-related impairment is needed, particularly for youth with chronic health conditions.

Diabetes-related events in adolescents and young adults: opportunities for psychosocial interventions

This study was conducted to evaluate predictive factors of diabetes-related emergency room (ER) visits and hospitalizations among adolescents and young adults (AYA) with type 1 diabetes (T1D). Baseline demographic, medical, and psychosocial variables were collected for 177 AYA with T1D. Medical records were reviewed to identify ER visits and hospitalizations related to diabetes. Those with diabetes-related events had significantly higher hemoglobin A1c (A1c) values at baseline (p = 0.0001) and during an average 3.36 years of follow-up (p < 0.0001). Participants with events were more likely to have Medicaid or no insurance vs. private insurance (p = 0.0006) and were more likely to be on multiple daily injections vs. insulin pumps (p = 0.0159). Participants with events reported greater diabetes impact on their lives and their parents reported less autonomy in AYA with events (p = 0.0435). These results suggest that when participants were transferring from pediatric to adult care services, factors such as A1c, insurance status and diabetes treatment are associated with diabetes-related events. Further research is needed to elucidate a causative relationship and develop focused interventions to reduce diabetes-related events during this high-risk time. Autonomy should be further explored to determine its role in diabetes-related events during this transition period.

Parenting Styles and Parent-Adolescent Relationships: The Mediating Roles of Behavioral Autonomy and Parental Authority

The parent–adolescent relationship has been a classic research topic, and researchers have found that parenting styles (e.g., authoritative, authoritarian) are closely related to various qualities of parent-adolescent relationships (e.g., cohesion, conflict). However, little empirical work has addressed how these variables correlate with each other in mainland China, nor has prior research addressed internal psychological mechanisms. The present study investigated the associations between parenting styles and parent–adolescent relationship factors, examined the mediating effects of adolescents’ expectations of behavioral autonomy and beliefs about parental authority, and explored whether adolescent gender moderated these effects. Results from a sample of 633 Chinese adolescents (7th grade: M_age = 13.50 ± 0.62 years, 9th grade: M_age = 15.45 ± 0.67 years, 11th grade: M_age = 17.30 ± 0.75 years) suggested similar levels of parent–adolescent conflict frequency for all parenting styles. However, for parent–adolescent conflict intensity, youth of neglectful and authoritarian parents reported higher levels compared to those with indulgent parents. The highest levels of cohesion with both parents were reported by adolescents with authoritative parents, followed by indulgent, authoritarian and neglect parenting styles. Cohesion with mothers for youth with authoritative or indulgent mothers was higher for girls than boys. Adolescents’ expectation for behavioral autonomy mediated the links between parenting style and conflict, whereas adolescents’ beliefs about the legitimacy of parental authority mediated the links between parenting style and cohesion; some of these mediating effects differed by gender. Findings highlight the importance of studying potential effects of adolescents’ values and attitudes within the family system in specific cultural contexts.