Differences In Behavioral Symptoms Research Articles

Sex Differences in Behavioral Symptoms and the Levels of Circulating GFAP, Tau, and NfL in Patients With Traumatic Brain Injury.

Traumatic brain injury (TBI) affects millions of Americans each year and has been shown to disproportionately impact those subject to greater disparities in health. Female sex is one factor that has been associated with disparities in health outcomes, including in TBI, but sex differences in biomarker levels and behavioral outcomes after TBI are underexplored. This study included participants with both blunt and blast TBI with majority rating their TBI as mild. Time since injury was 5.4 (2.0, 15.5) years for females and 6.8 (2.4, 11.3) years for males. The aim of this cross sectional study is to investigate the relationship between postconcussive, depression, and post-traumatic stress disorder (PTSD) symptoms, as well as health related quality of life (HRQOL), and the levels of glial fibrillary acidic protein (GFAP), total tau (t-tau), neurofilament light chain (NfL), and ubiquitin C-terminal hydrolase-L1 (UCH-L1). Behavioral outcomes were evaluated with the Neurobehavioral Symptom Inventory (NSI), Patient Health Questionnaire-9 (PHQ-9), PTSD Checklist- Civilian Version (PCL-C), short form (SF)-36, and plasma levels of total tau, GFAP, NfL, and UCHL-1 measured with the Simoa-HDX. We observed that females had significantly higher levels of GFAP and tau (ps < 0.05), and higher PHQ-9 scores, NSI total scores, NSI- vestibular, NSI-somatosensory, NSI-affective sub-scale scores (ps < 0.05)), than males. In addition, females had lower scores in HRQOL outcomes of role limitations due to emotional problems, vitality, emotional well-being, social functioning, and pain compared to males (ps < 0.05). Correlation analysis showed positive associations between levels of tau and the NSI-total and NSI-cognitive sub-scale scores (ps < 0.05) in females. No significant associations were found for NfL or GFAP with NSI scores. For female participants, negative correlations were observed between tau and NfL concentrations and the SF-36 physical function subscale (ps < 0.05), as well as tau and the social function subscale (p < 0.001), while GFAP levels positively correlated with role limitations due to emotional problems (p = 0.004). No significant associations were observed in males. Our findings suggest that sex differences exist in TBI-related behavioral outcomes, as well as levels of biomarkers associated with brain injury, and that the relationship between biomarker levels and behavioral outcomes is more evident in females than males. Future studies are warranted to corroborate these results, and to determine the implications for prognosis and treatment. The identification of candidate TBI biomarkers may lead to development of individualized treatment guidelines.

Behavioral and Cognitive Characteristics of Females and Males With Autism in the Simons Simplex Collection

To examine differences in behavioral symptoms and cognitive functioning between males and females with autism spectrum disorder (ASD). We analyzed data from 2,418 probands with autism (304 females and 2,114 males) included in the Simons Simplex Collection. Sex differences were evaluated across measures of autism symptoms, cognitive and motor functioning, adaptive behavior, and associated behavior problems. Measurement bias was examined using latent variable models of symptoms. Unadjusted and propensity-adjusted analyses were computed to ensure that sex differences were not due to unbalanced sampling. Moderator and mediator analyses evaluated whether sex differences were modified by clinical characteristics or were driven by cognitive ability. Females with ASD had greater social communication impairment, lower levels of restricted interests, lower cognitive ability, weaker adaptive skills, and greater externalizing problems relative to males. Symptom differences could not be accounted for by measurement differences, indicating that diagnostic instruments captured autism similarly in males and females. IQ reductions mediated greater social impairment and reduced adaptive behavior in females with ASD, but did not mediate reductions in restricted interests or increases in irritability. A specific female ASD phenotype is emerging that cannot be accounted for by differential symptom measurement. The present data suggest that the relatively low proportion of high-functioning females may reflect the effect of protective biological factors or may be due to under-identification. Additional carefully accrued samples are needed to confirm the present pattern and to evaluate whether observed sex ratios in high-functioning cases are reduced if female-specific indicators of restricted interests are included.

123I-5-IA-85380 SPECT Imaging of Nicotinic Acetylcholine Receptor Availability in Nonsmokers: Effects of Sex and Menstrual Phase

The study of the effects of sex and hormones on brain chemistry and neurotransmission is of increasing importance as evidence emerges of sex differences in behavioral symptoms and treatment response in neuropsychiatric disorders. The nicotinic acetylcholine receptor (nAChR) system has been implicated in a variety of psychiatric disorders, including tobacco smoking, for which there is strong evidence supporting sex differences in behaviors and response to smoking cessation treatments. We examined the availability of nAChR containing the beta(2) subunit in healthy men and women and the influence of menstrual phase among women. Ten men and 19 women nonsmokers underwent one (123)I-5-IA-85380 ((123)I-5-IA) SPECT scan and one MRI scan. A subset of 9 women, aged 18-39 y, underwent a second (123)I-5-IA scan. These 9 women were scanned during the early follicular (days 4-7 in 8 subjects and day 11 in 1 subject) and mid-luteal (days 19-25) phases of their menstrual cycle. Hormone levels were measured in all women to confirm the phase of the cycle. Regional brain activity (kBq/cm(3)) was higher (39%-54%) in women than in men nonsmokers. When regional brain activity was normalized to total plasma parent to correct for individual differences in radiotracer metabolism (V(T)'), differences of 10%-16% were observed, with women greater than men. In contrast, when regional brain activity was normalized to free plasma parent (V(T)), there was less than a 4% difference by sex in regional brain beta(2)-nAChR availability. These sex differences in kBq/cm(3) and V(T)' resulted from significantly higher levels of total plasma parent, free fraction (f(1)), and free plasma parent in women than in men nonsmokers. No differences in plasma measures or brain beta(2)-nAChR availability were observed across the menstrual cycle for any outcome measure. Overall, these findings demonstrate no significant difference in brain beta(2)-nAChR availability between men and women nonsmokers or across the menstrual cycle. Importantly, these findings demonstrate sex differences in radiotracer metabolism and plasma protein binding and highlight the critical need to measure plasma radiotracer levels and f(1) in studies that include both sexes.

Comparison of behavioral and psychological symptoms in early‐onset and late‐onset Alzheimer's disease

When comparing with early-onset Alzheimer's disease (EO-AD) and late-onset Alzheimer's disease (LO-AD), some symptomatological differences in clinical features can be seen between them. Rapid progression, more severe language problems or visuospatial dysfunction occur more often in EO-AD patients. However, there have been very few reports about the differences in behavioral and psychological symptoms between these two groups. The aim of this study was to demonstrate the differences in behavioral symptoms between EO-AD and LO-AD groups. Three hundred and seven consecutive outpatients with AD were put into an EO-AD group (46 patients) or a LO-AD group (261 patients). Comprehensive assessment batteries, including the Neuropsychiatric Inventory (NPI), were administered at the first medical assessment. Significant differences were found between the EO-AD and LO-AD groups in terms of NPI total score (EO-AD: 10.3 +/- 10.9, LO-AD: 17.8 +/- 17.0, p = 0.004) and number of patients who experienced each NPI subscale score (delusion; EO-AD: 13.0%, LO-AD: 50.6%, p < 0.001). There were no differences in cognitive functions or dementia severity between two groups. In EO-AD, behavioral and psychological symptoms are relatively fewer than LO-AD at the first medical assessment.

Behavioral and psychological symptoms of dementia in an Indian population: comparison between Alzheimer's disease and vascular dementia

Differential patterns of brain lesions in patients with Alzheimer's disease (AD) or vascular dementia (VaD) can result in differing clinical courses and presentations. Thirty patients with AD were compared with 29 patients with VaD for differences in behavioral symptoms using the Behavioral Pathology in Alzheimer's Disease (BEHAV-AD) rating scale. Patients with AD had significantly more delusions, hallucinations, anxieties and phobias and caregiver distress than patients with VaD. Behavioral symptoms in both AD and VaD exhibit specific longitudinal patterns. An understanding of the pattern can aid the treating physician in giving appropriate advice to caregivers regarding the course of the illness and also help them in planning appropriate interventions.

Long-Term Attention Problems in Children With Traumatic Brain Injury

To examine long-term attention problems and their cognitive correlates after childhood traumatic brain injury (TBI). Data were drawn from a prospective, longitudinal study conducted between 1992 and 2002. Participants included 41 children with severe TBI, 41 with moderate TBI, and 50 with orthopedic injury (OI), who were all between 6 and 12 years of age at the time of injury. Parent ratings of attention problems were obtained at a long-term follow-up on average 4 years post-injury and compared with ratings of premorbid attention problems obtained shortly after injury. At the long-term follow-up, children also completed several cognitive tests of attention and executive functions. Hierarchical linear and logistic regression analyses indicated that the severe TBI group displayed significantly more attention problems than the OI group at 4 years post-injury, both behaviorally and cognitively, after controlling for race, socioeconomic status, and premorbid attention problems. At long-term follow-up, 46% of the severe TBI group displayed significant attention problems on the Child Behavior Checklist, as opposed to 26% of the OI group (odds ratio=3.38; 95% confidence interval, 1.15-9.94). On the Attention-Deficit/Hyperactivity Disorder Rating Scale, 20% of the severe TBI group displayed clinically significant attention problems compared with 4% in the OI group (odds ratio=9.59; 95% confidence interval, 1.24-73.99). However, group differences in behavioral symptoms were significantly larger for children with more premorbid symptoms than for children with fewer premorbid problems. Measures of executive functions were significantly related to behavioral attention problems, after controlling for group membership, race, and socioeconomic status. Childhood TBI exacerbates premorbid attention problems. Long-term behavioral symptoms of attention problems are related to the cognitive deficits in attention and executive functions that often occur in association with childhood TBI.

Stage-Specific Prevalence of Behavioral Symptoms in Alzheimer's Disease in a Multi-Ethnic Community Sample

The authors extended previous studies of the stage-specific prevalence of behavioral pathology to members of ethnic minority groups. Behavioral symptoms and their relationship to severity of Alzheimer's disease (AD) were examined in 125 heterogeneous minority elderly patients interviewed with a modified CERAD protocol, with behavioral symptoms scored on the caregiver-rated BEHAVE-AD Rating Scale. Behavioral disturbances were extremely common, occurring in 98% of the sample; the most common was activity disturbances (89%), followed by paranoid and delusional ideation (72%), aggressivity (64%), anxieties and phobias (61%), depressive symptoms (50%), sleep disturbances (43%), and hallucinations (34%). As in white patients, overall behavioral symptoms were most frequent among patients with moderate and severe dementia. Preliminary evidence supports the possibility of ethnic differences in behavioral profiles; Blacks showed lower affective, anxiety, and sleep symptoms than Asians and Hispanics, and lower total BEHAVE-AD scores than Hispanics. Inquiry in larger, population-based samples will be needed to determine whether the ethnic differences in behavioral symptoms of AD found here are robust and replicable.

Early-onset conduct problems: does gender make a difference?

Baseline assessments of 64 girls and 158 boys (aged 4-7 years) diagnosed with oppositional defiant disorder (ODD) or early-onset conduct problems, or both, were examined for gender-linked differences in behavioral symptoms. Child variables, parenting variables, and family variables were correlated with teacher reports of externalizing problems at school and independent observations of externalizing problems at home before treatment to determine whether there were any gender-specific differences in risk factors. Follow-up data (1-2 years posttreatment) were also examined for any gender differences in predictors of treatment outcome. Results indicated significant gender differences in behavioral symptoms according to independent home observations. However, reports of gender differences in behavioral symptoms were influenced by the gender of the reporting agent. The only gender-specific risk factor found was father "negativity," which was correlated with boys' behavior at home but not girls' behavior. Concerning differences in treatment outcome, variables regarding parents' psychological states and parenting style were the best predictors for girls but not for boys.

Early-onset conduct problems: Does gender make a difference?

Baseline assessments of 64 girls and 158 boys (aged 4-7 years) diagnosed with oppositional defiant disorder (ODD) or early-onset conduct problems, or both, were examined for gender-linked differences in behavioral symptoms. Child variables, parenting variables, and family variables were correlated with teacher reports of externalizing problems at school and independent observations of externalizing problems at home before treatment to determine whether there were any gender-specific differences in risk factors. Follow-up data (1-2 years posttreatment) were also examined for any gender differences in predictors of treatment outcome. Results indicated significant gender differences in behavioral symptoms according to independent home observations. However, reports of gender differences in behavioral symptoms were influenced by the gender of the reporting agent. The only gender-specific risk factor found was father negativity, which was correlated with boys' behavior at home but not girls' behavior. Concerning differences in treatment outcome, variables regarding parents' psychological states and parenting style were the best predictors for girls but not for boys.

Emotional and temperamental correlates of Type A in children and adolescents

Emotional and behavioral correlates of Type A behavior in children and adolescents were examined in 184 fifth-, seventh-, and ninth-grade students, classified as high or low Type A, using self-report, teacher ratings (fifth grade only), and structured interview procedures. Measures included the Hunter-Wolf A-B Rating Scale, Behavioral Symptoms of Stress Inventory, Dimensions of Temperament Survey, Desire for Control Scale, Eysenck Personality Inventory, and the Multiple Affect Adjective Checklist. High Type A children reported significantly more stressed-related behaviors, higher levels of depression, anger, anxiety, and cognitive disorganization, and greater reactivity than Low Type A. No differences were found on measures of temperament (activity level, attention span, adaptibility, and rhythmicity), desire for control, or introversion-extroversion. Females, in general, reported significantly more behavioral stress symptoms. However, no other gender differences were found. Possible reasons for reported differences between Type A children and adults are discussed, along with gender differences in behavioral symptoms. Need for multiple measures of Type A across situation is considered along with need for controlled longitudinal studies of Type A components and the influence of contexts.