Functioning Of Young People Research Articles

The course of neuropsychological functioning in young people with attenuated vs discrete mental disorders.

Clinical staging of mental disorders is designed to facilitate the selection of stage-appropriate interventions, early in the course of illness. Neuropsychological performance, particularly at early stages of mental disorder, is a strong predictor of medium-term functional outcomes. Despite this, the longitudinal examination of neuropsychological profiles in early stages of illness is poorly researched. Thus, we examined baseline and longitudinal neuropsychological profiles of young patients with attenuated syndromes vs those with discrete disorders. Neuropsychological testing of 497 help-seeking young people (21.2 ± 3 years; 56% female). Clinical staging, assigned separately from testing, rated 262 individuals as "attenuated syndrome" (stage 1b) and 235 as "discrete" or "persistent" disorder (stage 2+). Follow-up testing was undertaken in 170 individuals (54% at stage 1b) after 19.8 ± 9 months (range: 3 to 51 months). At baseline, attenuated and discrete/persistent disorders significantly differed in 4 of the 9 neuropsychological measures (verbal learning, verbal memory, visual memory and set shifting). Despite this, both groups showed similar improvement in neuropsychological functioning at follow-up, particularly in processing speed, sustained attention and visual memory. Longitudinal improvement in cognition corresponded with increases in socio-occupational functioning. The degree of baseline neuropsychological dysfunction discriminates those with attenuated syndromes from those with a discrete/persistent disorder. Furthermore, improvement in neuropsychological functioning corresponded with improvement in clinical and functional status, despite stage of illness. This suggests that neuropsychological functioning remains relatively stable in young people with a mental illness and may be a critical window for intervention.

Associations between metabolic syndrome and reduced lung function in young people

To reveal possible associations between metabolic syndrome (MS) and reduced lung function. In 2013-016, a cross-sectional survey was conducted in 908 Novosibirsk dwellers, which included spirometry to evaluate external respiratory function (ERF). For the detection of MS, the investigators used the 2009 All-Russian Research Society of Cardiologists criteria: waist circumference (WC) > 80 cm for women and >94 cm for men in combination with two of the following criteria: blood pressure (BP) ≥130/85 mm Hg, triglycerides (TG) ≥1.7 mmol/l, high-density lipoproteins (HDL) cholesterol <1.0 mmol/l for men and <1.2 mmol/l for women, low-density lipoprotein (LDL) cholesterol >3.0 mmol/l, and glucose ≥6.1 mmol/l. The mean values of WC were significantly greater with a forced expiratory volume in one second (FEV1) <80% than those with a FEV1 of ≥80% in both men (p=0.002) and women (p=0.050); in women, the mean values of WS were higher than those with a FEV1/forced vital capacity (FVC) <70% than those with a FEV1/FVC of ≥70% (p=0.047); the mean systolic and diastolic BP levels were significantly more with reductions in FEV1 and FVC, and the level of HDL cholesterol was significantly lower than that with a FEV1 of < 80% in men only. Significant correlations were found between FEV1 and all components of MS in men, between the majority of components of MS and FVC in men, between WC, BP, and FEV1/FVC in men and women, between plasma glucose levels and FEV1/FVC in women. Linear regression analysis revealed significant inverse correlations of FEV1 with TG, glucose, BP; those of FVC with TG, glucose; at the same time a positive association with HDL cholesterol in men, and only a negative correlation of FEV1/FVC with WC. The revealed associations between MS and reduced lung function can most likely be explained by the greater prevalence of both MS and its components (hypertension, hypertriglyceridemia, hyperglycemia, LDL hypercholesterolemia) among Novosibirsk men. This is consistent with the assertion that the decline in ERF, particularly FEV1, may be a marker of future cardiovascular disease morbidity and mortality.

O129 Intellectual functioning and P300 potential in adolescents with newly diagnosed multiple sclerosis

Objectives EBM literature offers no data on cognitive impairment in patients diagnosed with MS in childhood and adolescence. The aim of the study was to assess intellectual function in children and adolescents with MS. Methods The study involved 17 children aged 11.5–17 years with newly diagnosed MS hospitalized in the Department of Pediatric Neurology, Jagiellonian University in Cracow. All patients underwent neuropsychological and neurophysiological examination (endogenous evoked P300 potential). The cognitive and emotional functioning was assessed using the Wechsler tests (Polish edition), DUM (a visual learning test), and clinical trials of memory, attention, executive functioning and praxis. The P300-induced auditory stimulus examination was performed on the KeyPoint Natus in accordance with the International Federation for Clinical Neurophysiology recommendations. The results received were evaluated per own standards and following parameters were recognised as abnormal: prolongation of P300 wave above 2 SD and/or decrease in the amplitude of more than 50%. Results The neuropsychological results show that none of the examined children with newly diagnosed MS had visuospatial difficulties. The immediate auditory memory span is very well developed in all patients (above average). The study found a slight increase in P300 latency (321.76 ± 21.70 ms), higher amplitude (13.93 ± 8.63 uV), and a shorter period of reaction time (324.93 ± 163.68 ms) compared to the control group (the latency −298.14 ± 38.76 ms, the amplitude of −9.64 ± 7.32 uV,the reaction time −380.11 ± 79.94 ms). Discussion The results obtained are consistent with those of the references. Conclusions: 1 Patients with newly diagnosed MS in childhood and adolescence do not show significant cognitive impairments in neuropsychological examination. 2. The active demyelinating process in the initial period of the disease does not impair cognitive functioning as assessed with P300. Significance: The proper functioning of young people with newly diagnosed MS is found.

An Exploration of Social Functioning in Young People with Eating Disorders: A Qualitative Study.

Previous research indicates adults with eating disorders (EDs) report smaller social networks, and difficulties with social functioning, alongside demonstrating difficulties recognising and regulating emotions in social contexts. Concurrently, those recovered from the illness have discussed the vital role offered by social support and interaction in their recovery. To date, little is known about the social skills and social networks of adolescents with EDs and this study aimed to conduct focus groups to explore the social functioning of 17 inpatients aged 12–17. Data were analysed using thematic analysis and six core themes were identified: group belonging, self-monitoring, social sensitivity, impact of hospitalisation, limited coping strategies and strategies for service provision. Key areas for service provision were: management of anxiety, development and/or maintenance of a social network and development of inter and intrapersonal skills. The most salient finding was that adolescents with EDs reported social difficulties which appeared to persist over and above those typically experienced at this point in the lifespan and therefore a key area for future focus is the development of appropriate coping strategies and solutions to deal with these reported difficulties.

Adversity in childhood linked to elevated striatal dopamine function in adulthood

Childhood adversity increases the risk of psychosis in adulthood. Theoretical and animal models suggest that this effect may be mediated by increased striatal dopamine neurotransmission. The primary objective of this study was to examine the relationship between adversity in childhood and striatal dopamine function in early adulthood. Secondary objectives were to compare exposure to childhood adversity and striatal dopamine function in young people at ultra high risk (UHR) of psychosis and healthy volunteers. Sixty-seven young adults, comprising 47 individuals at UHR for psychosis and 20 healthy volunteers were recruited from the same geographic area and were matched for age, gender and substance use. Presynaptic dopamine function in the associative striatum was assessed using 18F-DOPA positron emission tomography. Childhood adversity was assessed using the Childhood Experience of Care and Abuse questionnaire. Within the sample as a whole, both severe physical or sexual abuse (T63=2.92; P=0.005), and unstable family arrangements (T57=2.80; P=0.007) in childhood were associated with elevated dopamine function in the associative striatum in adulthood. Comparison of the UHR and volunteer subgroups revealed similar incidence of childhood adverse experiences, and there was no significant group difference in dopamine function. This study provides evidence that childhood adversity is linked to elevated striatal dopamine function in adulthood.

Aggio et al. Respond to "Lessons for Research on Cognitive Aging".

We thank Dr. Belsky (1) for his interest in our study (2), in which we investigated associations between physical activity and cognitive function in young people. He raises several important issues on the role of physical activity as a public health strategy in the prevention of cognitive decline. The issue of “neuroselection,” wherein individuals with better cognitive function are more likely to engage in healthy behaviors such as physical activity and refrain from unhealthy ones such as smoking, is a potential source of bias in observational studies. The alternative hypothesis is that of “neuroprotection,” in which engagement in healthy behaviors is likely to lead to enhanced cognitive development. We agree that confounding by pre-existing characteristics is a general problem in any epidemiologic work. Indeed, the children in our accelerometry sample typically came from wealthier families and had parents with higher levels of education than did those excluded from the analysis. Neuroselection may also explain the associations observed between physical activity and cognitive function. Longitudinal studies provide an opportunity to investigate whether cognitive function at baseline is associated with positive health behaviors in later life. For example, children with better cognitive function demonstrate higher fitness levels in adulthood (3). One potential mechanism may be that individuals with superior cognitive function are better able to interpret and respond to health advice than are individuals with lower cognitive function (4). The basis of the neuroselection hypothesis is that individuals with higher cognitive function elect to live healthier lives. However, in our study (2), physical activity was measured at age 7 years, meaning that if the neuroselection argument were true, children with higher cognitive function would already be selecting to be active at this early age. Children's knowledge of healthy behaviors is limited in this age group (5), which suggests that young children may not be able to correctly identify healthy behaviors regardless of cognitive ability. Moreover, during early childhood, self-selection of healthy behaviors may be restricted because of the low levels of autonomy due to school policy and parental restrictions. Physical activity at this age is predominantly influenced by parents and the school environment (6, 7). Therefore, participation in healthy behaviors among young children is largely determined by their parents’ and teachers’ decisions rather than their own. Adolescents and young adults have high levels of independence and therefore the ability to respond to new information independently. Together, these points suggest that the process of neuroselection is more likely to occur from adolescence onwards than in childhood. Further longitudinal studies with multiple repeated measures of health behaviors and cognitive function throughout childhood and adolescence are needed to address this hypothesis. Dr. Belsky raises an important point relating to the inconsistent effects of exercise on cognitive function that have been observed in recent randomized trials. This suggests that successful interventions may need to utilize physical activity in ways that also engage the brain. Indeed, this also emphasizes the main finding from our study, which was the importance of the context of physical activity and sedentary behavior in their associations with cognitive function. There is also research demonstrating the importance of context on other health outcomes. Notably, in a recent prospective study, childhood membership in a club was associated with a lower risk of mortality in adulthood that was independent of physical activity levels (8). In summary, physical activity is a potential public health strategy for the prevention of neurodegenerative diseases, and early life may represent a crucial period for intervention. Further investigation on effects of specific types and domains of activity is warranted.

Effectiveness of Essence of Chicken in Improving Cognitive Function in Young People Under Work-Related Stress: A Randomized Double-Blind Trial.

Work-related stress (WS) can result in considerable and extensive changes in physiological and psychological performance. WS beyond the optimal levels induces anxiety, confusion, exhaustion, and burnout. Chronic WS affects neurocognitive performance, particularly attention and visuospatial memory. Essence of chicken (EC) has been reported to improve neurocognitive function after mental stress.To investigate the beneficial effects of EC in improving neurocognitive performance under WS, we conducted a randomized, double blind trial. Total 102 young workers in New Taipei City with high WS, evaluated using the Individual Subjective Perception Job Stress Scale scores (>36 for job leaders and 33 for nonleaders) were recruited. Fifty-one participants received 70 mL of EC and 51 received a placebo daily for 2 weeks. Blood tests and neurocognitive assessment were performed before treatment, at the end of treatment, and 2 weeks after treatment.EC improved the performance of participants with high depression scores in the form-color associative memory test, used for assessing short-term memory. Although creatinine and glutamic-pyruvic transaminase (GPT) levels increased in week 2, but the levels returned to the baseline in week 4. Blood urea nitrogen (BUN) levels decreased in week 4.EC significantly improved short-term memory in participants with high WS and concomitant depressive mood, although it slightly increased GPT and creatinine levels and reduced BUN levels. The long-term treatment effects of EC warrant further investigation.

A longitudinal study of risk and protective factors associated with successful transition to secondary school in youth with ADHD: prospective cohort study protocol.

BackgroundAttention-Deficit/Hyperactivity Disorder (ADHD) has a significant impact on child and adolescent development, especially in relation to school functioning and academic outcomes. Despite the transition to high school being a potentially critical period for children with ADHD, most research in this period has focused on academic outcomes. This study aims to extend previous research by describing academic, school engagement, behaviour and social-emotional outcomes for young people with ADHD in the first and third years of high school and to identify risk and protective factors predictive of differing outcomes across these four domains.Methods and designThe Moving Up study is a longitudinal, prospective cohort study of children with ADHD as they transition and adjust to high school (age 12–15 years). Data are collected through direct assessment and child, parent and teacher surveys. The primary outcome is academic achievement, obtained by linking to standardised test results. Secondary outcomes include measures of behaviour, ADHD symptoms, school engagement (attitudes and attendance), and social and emotional functioning, including depressive symptoms. The mean performance of the study cohort on each outcome measure will be compared to the population mean for same aged children, using t-tests. Risk and protective factors to be examined using multiple regression include a child, family and school factors know to impact academic and school functioning.DiscussionThe Moving up study is the first Australian study prospectively designed to measure a broad range of student outcomes for children with ADHD during the high school transition period. Examining both current (cross sectional) and earlier childhood (longitudinal) factors gives us the potential to learn more about risk and protective factors associated with school functioning in young people with ADHD. The richness and depth of this information could lead to more targeted and effective interventions that may alter academic and wellbeing trajectories for young people at risk of poor outcomes.The study is approved by The Royal Children’s Hospital Melbourne Human Research Ethics Committee (33206). Findings will be disseminated through peer-reviewed journals and conference presentations.

Gender features of sensorimotor function in young people with motor asymmetry

We have examined 745 healthy young adults aged 21,4±2,6 (including 493 men and 252-women) by using the appliance «Computer movements measurer». Having investigated the sexual features of sensor-motor function taking into account the motor asymmetry we have found that the most likely (p&lt;0,05) differences between the central (switch of central units), subcortical (movement cycle durability) and medullary (reaction time to light) mechanisms of movements appear in left-handed women. The significant results show that there is the polynomial relationship between the left and right hand accuracy measures by taking into account the motor asymmetry in both men and women.

Neuropsychological and social cognitive function in young people at genetic risk of bipolar disorder.

Impairments in key neuropsychological domains (e.g. working memory, attention) and social cognitive deficits have been implicated as intermediate (endo) phenotypes for bipolar disorder (BD), and should therefore be evident in unaffected relatives. Neurocognitive and social cognitive ability was examined in 99 young people (age range 16-30 years) with a biological parent or sibling diagnosed with the disorder [thus deemed to be at risk (AR) of developing BD], compared with 78 healthy control (HC) subjects, and 52 people with a confirmed diagnosis of BD. Only verbal intelligence and affective response inhibition were significantly impaired in AR relative to HC participants; the BD participants showed significant deficits in attention tasks compared with HCs. Neither AR nor BD patients showed impairments in general intellectual ability, working memory, visuospatial or language ability, relative to HC participants. Analysis of BD-I and BD-II cases separately revealed deficits in attention and immediate memory in BD-I patients (only), relative to HCs. Only the BD (but not AR) participants showed impaired emotion recognition, relative to HCs. Selective cognitive deficits in the capacity to inhibit negative affective information, and general verbal ability may be intermediate markers of risk for BD; however, the extent and severity of impairment in this sample was less pronounced than has been reported in previous studies of older family members and BD cases. These findings highlight distinctions in the cognitive profiles of AR and BD participants, and provide limited support for progressive cognitive decline in association with illness development in BD.

Higher Education Curriculum and the Capability and Functioning of Young People in Nigeria

The demand for higher education among young people has resulted in the huge number of candidates seeking enrollment into higher institutions of learning in Nigeria. The population has consistently increased without a corresponding expansion in educational infrastructure and adjustment in curriculum. Drawing from Amartya Sen’s theory of capabilities and functioning, this paper argues that the population of young people with tertiary education represents a cohort whose capabilities and functioning are at variance with local development needs. The paper further expands the argument by asserting that tertiary educational curriculum, in its current state, is shallow and is a major contributor to the poor state of enrollment for tertiary education and the poor state of youth unemployment in the country. It recommends a re-structuring of the tertiary education system and adjustment to curriculum to meet local industrial demand.

Changes in psychological distress and psychosocial functioning in young people visiting headspace centres for mental health problems.

To examine changes in psychological distress and psychosocial functioning in young people presenting to headspace centres across Australia for mental health problems. Analysis of routine data collected from headspace clients who had commenced an episode of care between 1 April 2013 and 31 March 2014, and at 90-day follow-up. A total of 24034 people aged 12-25 years who had first presented to one of the 55 fully established headspace centres for mental health problems during the data collection period. Main reason for presentation, types of therapeutic services provided, Kessler Psychological Distress Scale (K10) scores, and Social and Occupational Functioning Assessment Scale (SOFAS) scores. Most headspace mental health clients presented with symptoms of depression and anxiety and were likely to receive cognitive behaviour therapy (CBT). Younger males were more likely than other age- and sex-defined groups to present for anger and behavioural problems, while younger females were more likely to present for deliberate self-harm. From presentation to last assessment, over one-third of clients had significant improvements in psychological distress (K10) and a similar proportion in psychosocial functioning (SOFAS). Sixty per cent of clients showed significant improvement on one or both measures. Data regarding outcomes for young people using mental health care services similar to headspace centres are scarce, but the current results compare favourably with those reported overseas, and show positive outcomes for young people using headspace centres.

The relationship between sleep-wake cycle and cognitive functioning in young people with affective disorders.

Although early-stage affective disorders are associated with both cognitive dysfunction and sleep-wake disruptions, relationships between these factors have not been specifically examined in young adults. Sleep and circadian rhythm disturbances in those with affective disorders are considerably heterogeneous, and may not relate to cognitive dysfunction in a simple linear fashion. This study aimed to characterise profiles of sleep and circadian disturbance in young people with affective disorders and examine associations between these profiles and cognitive performance. Actigraphy monitoring was completed in 152 young people (16–30 years; 66% female) with primary diagnoses of affective disorders, and 69 healthy controls (18–30 years; 57% female). Patients also underwent detailed neuropsychological assessment. Actigraphy data were processed to estimate both sleep and circadian parameters. Overall neuropsychological performance in patients was poor on tasks relating to mental flexibility and visual memory. Two hierarchical cluster analyses identified three distinct patient groups based on sleep variables and three based on circadian variables. Sleep clusters included a ‘long sleep’ cluster, a ‘disrupted sleep’ cluster, and a ‘delayed and disrupted sleep’ cluster. Circadian clusters included a ‘strong circadian’ cluster, a ‘weak circadian’ cluster, and a ‘delayed circadian’ cluster. Medication use differed between clusters. The ‘long sleep’ cluster displayed significantly worse visual memory performance compared to the ‘disrupted sleep’ cluster. No other cognitive functions differed between clusters. These results highlight the heterogeneity of sleep and circadian profiles in young people with affective disorders, and provide preliminary evidence in support of a relationship between sleep and visual memory, which may be mediated by use of antipsychotic medication. These findings have implications for the personalisation of treatments and improvement of functioning in young adults early in the course of affective illness.

Social functioning trajectories of young first-episode psychosis patients with and without cannabis misuse: a 30-month follow-up study.

The aim of the study was to investigate trajectories of social functioning in young people with first-episode psychosis (FEP) with and without cannabis misuse using a secondary analysis of data from the Episode-II trial. Forty-two young people with FEP and comorbid cannabis use disorder were compared with 39 young people with FEP but without a cannabis use disorder. Social functioning was assessed every 6 months during a 30-month follow-up. Multilevel linear growth curve modeling was used to compare the social functioning trajectories over time for those with and without cannabis misuse. Cannabis misuse was not associated with social functioning at baseline assessment. Over a 30-month follow-up, FEP patients without cannabis disorder showed significant improvements in their social functioning, whereas patients with cannabis misuse at baseline displayed no such improvement. Patients with and without cannabis misuse differed significantly in their levels of social functioning after 24 months. Similar results were obtained after adjusting for potential confounders (i.e., age, gender, negative symptoms, premorbid functioning, DSM-IV diagnoses, baseline social functioning and other substance use). In the context of a specialized early intervention service, patients with cannabis misuse at baseline did not attain the improvements in social outcomes observed in their counterparts without cannabis misuse. There is a need to develop effective interventions to reduce cannabis misuse to ultimately improve social outcomes in young people with psychosis.

Bases 2013 Abstracts

Previous literature has shown a small but positive effect of exercise on cognitive function in young people (Chang et al [2012]. Brain Research, 1453, 87-101), though this relationship is complicated by factors such as the mode, intensity and duration of exercise, the components of cognitive function examined and the timing of the cognitive tests relative to exercise. Specifically, bilateral coordinative exercise (exercise with a greater cognitive involvement) has been demonstrated to improve subsequent attention in adolescents (Budde et al [2008]. Neuroscience Letters, 441, 229-223). The aim of the present study was to examine the effects of a circuit of aerobic and coordinative exercises on Stroop test performance in adolescents. Following approval from the institutions ethical advisory committee, 34 adolescents (age: 13.2±0.3 years; height: 155.4±6.0 cm; body mass: 50.2±9.9 kg) completed a familiarisation session followed by two (exercise and resting) experimental trials. Sixty minutes following provision of an ad libitum breakfast (matched for subsequent experimental trial), participants completed the 15 min bout of exercise or continued to rest. The exercise consisted of a circuit of 10 exercises (alternate aerobic and coordinative exercises), each completed for 1 min with 30 s rest between stations. The Stroop test, measuring attention and executive function, was completed 30 min pre-, 5 min post- and 60 min post-exercise. Heart rate during the exercise was 158±15 beats.min-1. Response times were not different across the morning on the exercise and resting trials, between the baseline and complex levels of the Stroop test (trial by session time by test level interaction, P=0.408). However, there was a significant trial by session time by test level interaction for accuracy on the Stroop test (P=0.039).Upon further analysis, this was due to an improvement in accuracy 5 min post-exercise on the baseline level of the Stroop test (exercise + 2.1%, resting -1.8 %; trial by session time interaction, P=0.010), an effect which was not evident on the complex level (trial by session time interaction, P=0.543). The findings of the present study suggest that the accuracy of attention and executive function (as assessed by the Stroop test) is enhanced immediately following circuits based exercise in adolescents, but that this effect is not evident 60 min post-exercise. There was no effect of the circuits based exercise on response times on the Stroop test. These results have implications for school policy makers, given the importance of cognitive function (and in particular executive function) for academic performance.

Frontoparietal function in young people with dysthymic disorder (DSM-5: Persistent depressive disorder) during spatial working memory

BackgroundDysthymic disorder (DD) is a depressive disorder characterised by persistent low and/or irritable mood and has been identified as a major risk factor for developing major depressive disorder (MDD). MDD and DD have been associated with executive function difficulties of working memory and attention. Little is known about how executive function networks in the brain are affected in children and adolescents with MDD and even less in DD. This study used fMRI and two spatial working memory paradigms to investigate associated brain function in young people with DD and an age-, gender- and IQ- matched typically developing group. MethodsNineteen male patients with DD (mean age 11.2±1.5 years) diagnosed according to DSM-IV criteria and 16 typically developing boys (mean age 10.5±1.1 years) performed a mental rotation and a delay-match to sample (DMTS) task while undergoing fMRI. All participants were medication-naïve at the time of testing. ResultsCompared to typically developing young people, the DD group showed less activation in left frontal regions including left ventro- and dorsolateral prefrontal cortices (PFC) during mental rotation. Medial frontal regions including dorsomedial PFC, anterior cingulate cortex and frontal pole also showed relatively reduced activation. During the DMTS task patients showed significantly more activation in the right precuneus and posterior cingulate cortex. LimitationsThis was a cross-sectional study with a small sample limiting the generalizability of the results. ConclusionsThe results complement previous findings in adults with MDD that have shown differential activation of left PFC regions during working memory tasks. Additionally, altered function of cortical midline structures in young patients with DD was identified. This supports findings in children, adolescents and adults with MDD suggesting that the pathophysiology of depressive disorders extends to DD as a risk factor for MDD and exhibits continuity over the lifespan.

Psychometric properties of outcome measures for children and adolescents with brachial plexus birth palsy: a systematic review

The aim of this review was to evaluate the psychometric properties of outcome measures used to quantify upper limb function in children and adolescents with brachial plexus birth palsy (BPBP). Eleven electronic databases were searched to identify studies on the effects of conservative management to improve upper limb function in young people with BPBP. Outcome measures used in these studies were extracted and used in a subsequent search to identify studies that evaluated the psychometric properties of these measures. The methodological quality of these studies was rated using a standardized critical appraisal tool. Thirty-three outcome measures and 12 psychometric studies were identified. Nine outcome measures had some psychometric evidence, which was variable in quality. The outcome measures which seem to have the most robust psychometric properties include the Active Movement Scale, Assisting Hand Assessment, Pediatric Evaluation of Disability Index, and the Pediatric Outcomes Data Collection Instrument. Further research is required to determine the psychometric properties of outcome measures used for children and adolescents with BPBP. Caution is required when interpreting the results of commonly used outcome measures in this population owing to their relatively unknown psychometric properties.

Progressive resistance training and mobility‐related function in young people with cerebral palsy: a randomized controlled trial

The aim of this study was to investigate whether individualized resistance training improves the physical mobility of young people with cerebral palsy (CP). Forty-eight participants with spastic diplegic CP (26 males, 22 females; mean age 18y 1mo, SD 1y 11mo) classified as level II or III on the Gross Motor Function Classification System were allocated randomly to progressive resistance training or usual-care control. Resistance training was completed twice weekly for 12 weeks at a community gymnasium under the supervision of a physiotherapist. Exercises were based on instrumented gait analysis and targeted muscles contributing to walking difficulties. Outcomes at 12 weeks and 24 weeks included objective measures of mobility (6-min walk test, instrumented gait analysis, and Gross Motor Function Measure dimensions D and E), participant-rated measures of mobility (Functional Mobility Scale and Functional Assessment Questionnaire), and muscle performance. The strength of targeted muscles increased by 27% (95% CI 8-46%) compared with control group. There were no between-group differences in any objective measure of mobility at 12 weeks (6-min walk test: mean difference 0.1m; 95% CI -21 to 21m) or at 24 weeks. Participant-rated mobility improved (Functional Mobility Scale at 5m: mean 0.6 units; 95% CI 0.1-1.1 units; Functional Assessment Questionnaire: 0.8 units; 95% CI 0.1-1.6 units) compared with control group at 12 weeks. Individualized progressive resistance training increased strength in adolescents and young adults with spastic diplegic CP. Despite participant-rated benefits, the increased strength did not result in objective improvements in mobility.

Effect of omega-3 fatty acids for indicated prevention of young patients at risk for psychosis: When do they begin to be effective?

The results of a recent double-blind, randomized, placebo-controlled trial performed in 81 young patients at ultra-high risk for psychosis indicated that a 12-week intervention of 1.2g/day of ω-3 polyunsaturated fatty acids (PUFA) significantly reduced the risk of transition to psychosis and improved positive, negative and general symptoms as well as functioning. The aim of this post-hoc analysis was to determine at which time point ω-3 PUFAs start to significantly differ from placebo in improving psychopathology and functioning in young people at risk of developing psychosis. Analyses were performed using the mixed model repeated-measures analysis of variance. Compared to placebo, ω-3 PUFAs' significant effects on the amplitude of the reduction in General and Total PANSS scores are evident after the first four weeks of treatment; a reduction of positive symptoms and a lower mean PANSS positive score were apparent after eight weeks, whereas the significant drop in negative symptoms and the significant change and higher mean scores in global functioning occur later at 12weeks. The delay of onset of ω -3 PUFAs seems comparable to that of antipsychotics and antidepressants.

Protective processes: the function of young people's implicit theories of crime in offending behaviour

Despite development in high-risk environments, many youths are resilient and do not engage in antisocial behaviour and crime. Research on human traits such as intelligence and morality, suggest that the implicit theories (ITs) people have about the controllability of their behaviour, as either fixed (entity beliefs) or malleable (incremental beliefs) may play a part in successful behavioural outcomes. Using this as a framework, the function of ITs about crime in successful adolescent development was investigated among 422 ‘at-risk’ youths. Incremental ITs of criminality were found to significantly predict less self-reported involvement in youth offending, controlling for academic attainment. Entity ITs, conversely, were associated with an increased rate of participation in deviant behaviour. Further analysis revealed that incremental ITs of criminality moderated the negative effects of associating with delinquent peers on adolescent behaviour. The results demonstrate the direct and indirect protective function of incremental ITs of criminality for youths at risk and highlight the value of investigating further the protective processes that are involved in preventing youth crime.