Level Of General Functioning Research Articles

Contextuality of cognitive control deficits in alcohol dependence — pro et contra

Cognitive impairment, including cognitive control, mediates the negative social consequences of alcohol-related behavior, but few studies have examined these processes in the Russian speaking population using modern and standardized assessment methods. Thus, the aim of the study was to examine the features of cognitive control (inhibition of automatic response) and the general level of cognitive functioning in a Russianspeaking sample of alcohol-dependent individuals (AD) using quantitative assessment methods. Materials and Methods. 111 individuals diagnosed with alcohol dependence (F10.30) and 27 healthy participants were examined by using the Brief Assessment of Cognitive Functioning in Affective Disorders Battery (BAC-A) and additional tests of cognitive control (Stroop test with incongruent stimuli, Stroop test with alcohol-associated stimuli). The statistical methods were U-Mann-Whitney test, Spearman correlation coefficient, two-stage least squares regression. Results. In the AD group the indices of cognitive functioning were significantly lower in all parameters except for the subtests of verbal memory and digit sequence (p<0,05). The model of the relationship between the parameters of general cognitive functioning and cognitive control reveals that the index of incongruence to alcohol-related stimuli was a significant predictor of sampe affiliation. Discussion. The obtained results may indicate the presence of impairments of speed of mental processes, planning , verbal fluency and response inhibition function in the group of individuals with AD. In the studied group, the automatic response inhibition function mediates the general cognitive functioning only within the relevant contextual stimuli.

Effects of intermittent theta burst stimulation add-on to dialectical behavioral therapy in borderline personality disorder: results of a randomized, sham-controlled pilot trial

AbstractDialectical behavioral therapy (DBT) and repetitive transcranial magnetic stimulation (rTMS) are both effective in borderline personality disorder (BPD). We hypothesized that intermittent theta burst stimulation (iTBS), a modified rTMS protocol that provides unilateral stimulation to the left dorsolateral prefrontal cortex, would enhance the effects of DBT and reduce BPD-specific symptoms more than sham stimulation. We performed a single-blind, randomized, sham-controlled pilot study to evaluate iTBS as an add-on to 8-week DBT for BPD in routine inpatient treatment. A total of 53 BPD patients were randomly assigned to either iTBS (n = 25) or sham stimulation (n = 28) in weeks 4–8 of DBT; 40 patients were eligible for inclusion in the analyses according to pre-specified criteria (≥ 16 of 20 iTBS sessions). The primary endpoint was change on the 23-item Borderline Symptom List; secondary endpoints were changes in depressive symptoms and general level of functioning. A mixed model repeated measures analysis with a 2 × 2 factorial between-subjects design showed no significant effect of add-on iTBS treatment, but a distinct trend was observed in favor of iTBS (Cohen’s d = 0.23 for group difference). We found a main effect of DBT with and without iTBS over time, indicating efficacy of 8 weeks’ DBT (d = 0.89–1.12). iTBS may be beneficial as an add-on to DBT in the long term and warrants further evaluation in larger studies. Trial registration Registered at drks.de (no. DRKS00020413) on January 13, 2020.

Assessment of frontal lobe functions in a sample of male cannabis users currently in abstinence: correlations with duration of use and their functional outcomes

BackgroundPrevious research literature reported different results regarding the long-term effects that cannabis use can exert on the frontal lobe neurocognitive functions of its users. Another body of research suggested that cannabis use negatively affects the person’s general level of occupational and psychosocial functioning consequently to these alterations. Some other research results did not support these findings. To date, it is still debatable whether chronic cannabis use triggers negative neurocognitive effects in chronic users even after a period of abstinence. Research data exploring consequent adverse outcomes on the general individual occupational and psychosocial functioning is not yet conclusive.ResultsWe conducted this study to examine the residual neurocognitive effects of cannabis use, whether it is affected by duration of cannabis use before abstinence, and its relation to individual’s global assessment of functioning exhibited in the person’s occupational and social life whether it’s family or friends. Our sample comprised 80 male participants (18–45 years old) who were grouped into 4 groups (3 groups with different durations of use and a control group), with no significant difference between the four studied groups regarding age, education, and socioeconomic level. The Kruskal Wallis test was used to test the significance of differences in the distribution of total frontal lobe battery results and the general assessment of function scores using GAF scores between study groups. Post hoc testing was performed to adjust for multiple comparisons using Bonferroni method.ConclusionData analysis showed that cannabis users experienced general functional disturbances that encompass impairments in social and occupational life aspects. These impairments in function are correlated with the presence of neurocognitive deficits even after a period of abstinence. Both having significant positive correlation with longer duration of cannabis use.

Increasing psychological flexibility is associated with positive therapy outcomes following a transdiagnostic ACT treatment.

Increasing psychological flexibility is considered an important mechanism of change in psychotherapy across diagnoses. In particular, Acceptance and Commitment Therapy (ACT) primarily aims at increasing psychological flexibility in order to live a more fulfilling and meaningful life. The purpose of this study is to examine 1) how psychological flexibility changes during an ACT-based treatment in a transdiagnostic day hospital and 2) how this change is related to changes in symptomatology, quality of life, and general level of functioning. 90 patients of a psychiatric day hospital participated in the study. Psychological flexibility, symptomatology, and quality of life were assessed at three measurement time points (admission, discharge, and 3-month follow-up). The level of functioning was assessed at admission and discharge. Differences in psychological flexibility were tested via two-sided paired samples t-tests. Correlations of residualized change scores were calculated to detect associations between changes in psychological flexibility and other outcomes. Psychological flexibility increased significantly from pre-treatment to post-treatment (d = .43, p <.001) and from pre-treatment to follow-up (d = .54, p <.001). This change was significantly correlated to a decrease in symptomatology (r = .60-.83, p <.001) and an increase in most dimensions of quality of life (r = -.43 - -.75, p <.001) and general level of functioning (r =-.34, p = .003). This study adds further evidence for psychological flexibility as a transdiagnostic process variable of successful psychotherapy. Limitations are discussed.

Numerosity comparison, cognitive strategies, and general cognitive functioning in older people.

Studies have shown age-related differences in numerical cognition, for example, in the level of numerosity comparison ability. Moreover, some studies point out individual differences in the cognitive strategies employed during the performance of numerosity comparison tasks and reveal that they are related to the aging process. One probable cause of these differences is the level of cognitive functioning. The aim of our study was to determine the relationships among numerosity comparison ability, the cognitive strategies utilized in the performance of numerosity comparison tasks and the general cognitive functioning in older people. Forty-seven elderly people participated in the study. The participants were examined using overall cognitive functioning scales and computerized numerosity comparison task. The results showed many correlations between the participants' level of cognitive functioning and the percent of correct responses (PCR) and response time (RT) during numerosity comparison, as well as with the cognitive strategies applied by the participants. Task correctness was positively related to the level of performance in the attention and executive function tasks. In contrast, the long-term memory resources index and visuospatial skills level were negatively correlated with RT regarding numerosity comparison task performance. The level of long-term memory resources was also positively associated with the frequency of use of more complex cognitive strategies. Series of regression analyses showed that both the level of general cognitive functioning and the cognitive strategies employed by participants in numerosity comparison can explain 9-21 percent of the variance in the obtained results. In summary, these results showed significant relationships between the level of cognitive functioning and proficiency in numerosity comparison measured in older people. Moreover, it has been shown that cognitive resources level is related to the strategies utilized by older people, which indicates the potential application for cognitive strategy examinations in the development of new diagnostic tools.

Factor analysis of neuropsychological domains in a preschool clinic

ABSTRACT Introduction The clinical practice of preschool neuropsychology assumes that our assessment tools are measuring underlying neuropsychological functions, and that these functions are negatively impacted by early life neurological injury, disease, and disorder. This study hypothesized that general intellectual capacity and specific cognitive skills, both “broad” neuropsychological domains and “specific” subdomains within those broader clusters, would be differentiable in a preschool-age clinical population. Methods Using neuropsychological data from 580 children (6 and 71 months) seen for a clinical neuropsychological evaluation in the Preschool and Infant Neuropsychological Testing (PINT) Clinic, exploratory factor analyses (EFA) were conducted. Results: A one-factor model provided a good fit when considering verbal, nonverbal, and adaptive functions. Consideration of one- versus two-factor solutions for broad neuropsychological domains indicated that a 2-factor solution provided a significantly better fit for the data. Factor 1 was defined by motor, language, and nonverbal reasoning abilities; Factor 2 was defined by inhibitory control and attention. Further consideration of specific neuropsychological functions also supported a 2-factor solution. Factor 1 (“thinking”) was defined by nonverbal reasoning, receptive language, and expressive language; Factor 2 (“processing”) was defined by impulse control, inhibitory control, inattention, visual-motor integration, and visuo-constructional abilities. Motor skills cross-loaded onto both factors. Secondary analyses suggest these models provide the best fit for preschool-aged children with > 70 overall intellectual functioning and no comorbid medical diagnosis. Conclusions In a clinical sample of preschool-age children, neuropsychological assessment data appears to assess a general level of intellectual capacity or functioning. Further differentiation between assessing “thinking” (knowledge and reasoning skills) and “processing” (cognitive attention and processing of information) can be considered clinically. Next steps include more recent clinical sample replication, consideration of whether neuropsychological profiles are detectable in the preschool-age range and whether the results of early life assessment are predictive of future functioning.

3 Latent Wechsler Profiles in Presurgical Pediatric Epilepsy

Objective:The Pediatric Epilepsy Research Consortium (PERC) Epilepsy Surgery Database Project is a multisite collaborative that includes neuropsychological evaluations of children presenting for epilepsy surgery. There is some evidence for specific neuropsychological phenotypes within epilepsy (Hermann et al, 2016); however, this is less clear in pediatric patients. As a first step, we applied an empirically-based subtyping approach to determine if there were specific profiles using indices from the Wechsler scales [Verbal IQ (VIQ), Nonverbal IQ (NVIQ), Processing Speed Index (PSI), Working Memory Index (WMI)]. We hypothesized that there would be at least four profiles that are distinguished by slow processing speed and poor working memory as well as profiles with significant differences between verbal and nonverbal reasoning abilities.Participants and Methods:Our study included 372 children (M=12.1 years SD=4.1; 77.4% White; 48% male) who completed an age-appropriate Wechsler measure, enough to render at least two index scores. Epilepsy characteristics included 84.4% with focal epilepsy (evenly distributed between left and right focus) and 13.5% with generalized or mixed seizure types; mean age of onset = 6.7 years, SD = 4.5; seizure frequency ranged from daily to less than monthly; 53% had structural etiology; 71% had an abnormal MRI; and mean number of antiseizure medications was two. Latent profile analysis was used to identify discrete underlying cognitive profiles based on intellectual functioning. Demographic and epilepsy characteristics were compared among profiles.Results:Based on class enumeration procedures, a 3-cluster solution provided the best fit for the data, with profiles characterized by generally Average, Low Average, or Below Average functioning. 32.8% were in the Average profile with mean index scores ranging from 91.7-103.2; 47.6% were in the Low Average profile with mean index ranging from 80.7 to 84.5; and 19.6% were in the Below Average profile with mean index scores ranging from 55.0-63.1. Across all profiles, the lowest mean score was the PSI, followed by WMI. VIQ and NVIQ represented relatively higher scores for all three profiles. Mean discrepancy between indices within a profile was as large as 11.5 IQ points. No demographics or epilepsy characteristics were significantly different across cognitive phenotypes.Conclusions:Latent cognitive phenotypes in a pediatric presurgical cohort were differentiated by general level of functioning; however, across profiles, processing speed was consistently the lowest index followed by working memory. These findings across phenotypes suggest a common relative weakness which may result from a global effect of antiseizure medications and/or the widespread impact of seizures on neural networks even in a largely focal epilepsy cohort; similar to adult studies with temporal lobe epilepsy (Hermann et al, 2007). Future work will use latent profile analysis to examine phenotypes across other domains relevant to pediatric epilepsy including attention, naming, motor, and memory functioning. These findings are in line with collaborative efforts towards cognitive phenotyping which is the aim of our PERC Epilepsy Surgery Database Project that has already established one of the largest pediatric epilepsy surgery cohorts.

Üniversite öğrencilerinin fonksiyonel besinlere yönelik tutum, davranış ve bilgi düzeyinin değerlendirilmesi

Aim: In this study, it was aimed to determine the knowledge level of students studying at a public university in Malatya, about functional foods, and to evaluate the factors affecting their attitudes and behaviors.&#x0D; Material and methods: A total of 618 individuals, 363 women and 255 men, studying at universities in Malatya were included in the study. Research data were collected by face-to-face survey method. The questionnaire consists of questions about demographic characteristics, questions about eating habits, questions about general health, anthropometric measurements (body weight, height) and functional foods knowledge level and food preference scale sections. The data were analyzed using the SPSS program.&#x0D; Results: The mean age of the individuals participating in the study was 23.15±4.25 years. It was determined that 65.04% of the individuals had heard the term functional food before. It was determined that the YETBİD-Basic Nutritional Knowledge Scores were higher in females (54.66±8.85) than males (51.14±8.22) (p=0.031). Individuals' knowledge attitude scale confidence subheading score for functional foods was found to be higher in women (3.95±1.04) than in men (3.15±1.04) (p=0.044). It was observed that as the basic nutrition score increased in both women and men, the score of the attitude scale towards functional foods also increased. In the multiple regression, it was determined that the total score of the attitude scale towards functional foods was significantly affected by the variables of female gender, duration of education, basic nutrition score, and food preference score (p

Theta burst stimulation add on to dialectical behavioral therapy in borderline-personality-disorder: methods and design of a randomized, single-blind, placebo-controlled pilot trial

Specialized psychotherapeutic treatments like dialectical behavioral therapy (DBT) are recommended as first treatment for borderline personality disorder (BPD). In recent years, studies have emerged that focus on repetitive transcranial magnetic stimulation (rTMS) in BPD. Both have independently demonstrated efficacy in the treatment of BPD. Intermitted theta burst stimulation (iTBS), a modified design of rTMS, is thought to increase the excitability of neurons and could be a supplement to psychotherapy in addition to being a standalone treatment. However, no studies to date have investigated the combination of DBT and rTMS/iTBS. This study protocol describes the methods and design of a randomized, single-blinded, sham-controlled clinical pilot study in which BPD patients will be randomly assigned to either iTBS or sham during four consecutive weeks (20 sessions in total) in addition to standardized DBT treatment. The stimulation will focus on the unilateral stimulation of the left dorsolateral prefrontal cortex (DLPFC), which plays an important role in the control of impulsivity and risk-taking. Primary outcome is the difference in borderline symptomatology, while secondary target criteria are depressive symptoms, general functional level, impulsivity and self-compassion. Statistical analysis of therapy response will be conducted by Mixed Model Repeated Measurement using a 2 × 2-factorial between-subjects design with the between-subject factor stimulation (TMS vs. Sham) and the within-subject factor time (T0 vs. T1). Furthermore, structural magnetic resonance imaging (MRI) will be conducted and analyzed. The study will provide evidence and insight on whether iTBS has an enhancing effect as add-on to DBT in BPD.Trial registration: drks.de (DRKS00020413) registered 13/01/2020.

Deprescribing in primary care without deterioration of health-related outcomes: A real-life, quality improvement project.

Medication reviews focusing on deprescribing can reduce potentially inappropriate medication; however, evidence regarding effects on health-related outcomes is sparse. In a real-life quality improvement project using a newly developed chronic care model, we investigated how a general practitioner-led medication review intervention focusing on deprescribing affected health-related outcomes. We performed a before-after intervention study including care home residents and community-dwelling patients affiliated with a large Danish general practice. The primary outcomes were changes in self-reported health status, general condition and functional level from baseline to 3-4 months follow-up. Of the 105 included patients, 87 completed the follow-up. From baseline to follow-up, 255 medication changes were made, of which 83% were deprescribing. Mean self-reported health status increased (0.55 [95% CI: 0.22 to 0.87]); the proportion with general condition rated as 'average or above' was stable (0.06 [95% CI: -0.02 to 0.14]); and the proportion with functional level 'without any disability' was stable (-0.05 [95% CI: -0.09 to 0.001]). In conclusion, this general practitioner-led medication review intervention was associated with deprescribing and increased self-reported health status without the deterioration of general condition or functional level in real-life primary care patients. The results should be interpreted carefully given the small sample size and lack of control group.

METHOD OF ASSESSING THE EFFICIENCY OF ENSURING INFORMATION SECURITY OF THE EDUCATIONAL INFORMATION SYSTEM

In the modern conditions of the development of information technologies, the issue of ensuring information security is becoming more and more relevant. Information has become a key resource that affects the success and stability of the functioning of organizations, enterprises and institutions. Despite the fact that a significant part of efforts is aimed at creating and maintaining effective information protection systems, the issue of assessing their effectiveness remains relevant and important. The article examines a complex methodology for assessing the effectiveness of information security, which is based on the use of modern approaches and tools for analyzing the security of information systems. The proposed methodology covers various aspects of information security, including technical, organizational, procedural and human factors. The evaluation of efficiency is based on a complex analysis of multiple indicators, which allows to obtain an objective picture of the state of information security of the organization. The main part of the methodology is the development and application of mathematical models that allow quantitative assessment of the level of information security. Such models take into account various factors, including the level of technical protection of information systems, information security policy, the level of training of personnel, response to incidents and other important aspects. In addition, the article considers the issue of optimizing costs for ensuring information security by applying economic models and approaches. The proposed methodology includes several stages: determination of key security indicators, data collection and analysis, development of mathematical models for performance evaluation, interpretation of results and development of recommendations for increasing the level of protection. An important component of the methodology is a systematic approach that allows taking into account the interaction of various elements of the information security system and their impact on the overall level of protection. The practical application of the developed methodology makes it possible to timely identify vulnerabilities in the information security system, optimize the costs of its provision, increase the overall level of security of the organization and reduce the risks associated with information threats. The results of the study confirm the effectiveness of the proposed approach and demonstrate its applicability in various fields of activity, including business, public sector, education and other areas. Thus, the proposed methodology for assessing the effectiveness of information security is an important tool for organizations seeking to ensure reliable protection of their information. Its use contributes to increasing the level of information security, which, in turn, has a positive effect on the general level of functioning and stability of organizations in the face of modern challenges and threats.

The Role of Illness Severity and Emotional Distress in General and Cognitive Rehabilitation of Individuals with Post-COVID-19

Background and aims: Emotional distress is widespread among individuals recovering from COVID-19. The present study examined the relationships between illness severity and emotional distress and the outcomes of a general and cognitive rehabilitation program. Methods: Participants were 61 post-acute COVID-19 patients who participated in a multidisciplinary rehabilitation program. Data were collected at admission and discharge, 6 months later. Medical evaluations and self-reported emotional, neuropsychological and functional measures were used. Results: Mild illness was associated with higher levels of self-reported anxiety and depression and with lower self-reported executive functioning. Elevated anxiety levels and lower cognitive profile at admission were significantly linked to poorer cognitive outcomes, but not to motor or general functioning level at discharge. Conclusions: The results of the study indicate the significance of monitoring emotional characteristics, particularly anxiety, in post-COVID-19 individuals during multidisciplinary rehabilitation.

Aptitudes, Capabilities, and Interests of Children with Autism Spectrum Disorder

Some individuals with autism spectrum disorder (ASD), may display some areas of talent that are in contrast with their overall low level of general functioning. The aim of this study was to investigate the frequency of special abilities (aptitudes, capabilities, and interests) in a sample population of individuals with ASD. One in ten persons with ASD has special abilities in varying degrees. Researchers used to consider special abilities unimportant. However, this is an area of research for scientists and educators who are making attempts to understand the complexities and intricacies of the human mind. There have been reports of individuals who have intellectual disabilities and challenges, yet possess extraordinary abilities in reading, arithmetic, calendar calculations, art, or music. The study investigates the percentage and frequency of special abilities as reported by parents and teachers in a sample population of individuals with ASD in Singapore using a quantitative methodology. Parents and teachers were given questionnaires to ascertain this occurrence.

Exercise addiction measured at a naturalistic marathon-event – associations of the EAI with the general level of functioning, affect and performance parameters

ABSTRACT Endurance sports carry a high risk of exercise addiction (EA) compared to other physical activities. Previous research has established a link between EA and depressive symptoms. The aim of this study was to evaluate a sample of amateur marathoners concerning risk of EA and investigate the relationship to fitness measures, affect and the general level of functioning. We included 72 (19.4% female) marathon runners. The Exercise Addiction Inventory (EAI), the global assessment of functioning (GAF), the international physical activity questionnaire (IPAQ), the Beck-Depression Inventory (BDI) and the Positive and Negative Affect Schedule (PANAS) were assessed alongside demographic measures, maximum oxygen uptake (cardio pulmonary exercise test), BMI and training volume. In this sample five individuals at-risk could be identified (6.94%). No significant associations were found regarding demographics and EA. Higher values of EA were associated with a reduced level of general functioning (r = −.35; p = .003), higher values of depressive symptoms (r = .36; p = .003) and negative affect (r = .27; p = .022) while no increased training volume or higher performance were observed. A regression analysis identified the IPAQ as predictor for risk of EA (PANAS-NA marginally significant). Marathon running at the amateur level showed a lower risk of developing an exercise addiction than expected. Important associations of EA could be identified in our study (IPAQ, PANAS-NA, GAF, BDI). Trial registration: German Clinical Trials Register identifier: DRKS00012496.

ДОСВІД ВИКОРИСТАННЯ ШКАЛИ ЗАГАЛЬНОЇ ОЦІНКИ ФУНКЦІОНУВАННЯ ДЛЯ ДІАГНОСТИКИ І ПЛАНУВАННЯ ПСИХОТЕРАПІЇ В НАРКОЛОГІЧНІЙ ПРАКТИЦІ

Significant consequences of alcohol abuse give grounds to classify alcohol dependence as a medical and social pathology that poses a danger to society. The number of patients registered in medical dispensaries in Ukraine reaches 1 million. Recurrences of the disease during the year after treatment are observed in 60-75% of patients with alcohol dependence. The problem is exacerbated by the medical and social consequences of alcohol abuse in the form of increased mental and physical illness, trauma, suicide attempts and aggressive behavior, criminal acts. This renders the search for new therapeutic approaches to the treatment of alcohol dependence relevant. The aim of the study was to examine the feasibility and effectiveness of using the global assessment of functioning scale (GAFS) to diagnose the dynamics of social functioning of patients with alcohol dependence. The study of the dynamics in the level of general functioning with the use of GAFS in the main and control groups yielded the following results. There was a significant increase in psychological, social and professional functioning in 74.0% of patients in whom a system of treatment and prophylactic measures was applied as compared to 46.7% of patients in the comparison group (χ2 = 6.062, p &lt;0.05). A follow-up study showed that the number of persistent remissions was by 2 times higher in the main group than in the comparison group, 54.0% and 23.3%, respectively (p &lt;0.001).

Dynamics of clinical features of schizoid personality disorder first diagnosed in military age

The dynamics of the schizoid personality disorder of 45 conscripts recognized as unfit or partially fit for the military service was investigated. Anamnesis was studied, the severity of the mental disorders and the quality of social adaptation at the time of the call and over the next five years were assessed. Two types of the schizoid personality disorder have been identified: expansive and sensitive. For recruits with a predominance of the sensitive traits (32 (71.11%) people) were characterized by: formally intact intelligence, high level of education, isolation, disinterest in establishing, or maintaining close friendships, difficulties in the social interaction with strangers, avoidance of sexual contacts. Those surveyed with expansive character traits (13 (28.89%) people) were distinguished by a lower intellectual level, decisiveness, high capacity for work, egocentricity; relations with others were distinguished by the formality and an inability to empathize. Both groups were united by the features such as: social isolation, discomfort when communicating with people, inability to form emotional ties with others, underdeveloped empathy, detachment from the real goals, and turning to the sphere of inner experiences. Follow-up analysis in 5-year dynamics showed that the main psychopathological manifestations of the sensitive and expansive types (excessive sensitivity and asthenic affect, emotional coldness and stenic affect) are smoothed out, but they are complicated by the other additional symptoms (originality of hobbies, subjectivism of thinking, weakening of the activity of the mental processes, addictive manifestations) ... A distinct decrease in the level of general functioning in some patients may indicate a possible adverse pathomorphosis: schizoid personality disorder schizotypal personality disorder schizotypal disorder. The study indicates the feasibility of developing the therapeutic measures (pharmacological, psychocorrectional, social rehabilitation) in relation to the young patients suffering from schizoid personality disorder due to the further complication of the psychopathological picture, and the appearance of signs of an endogenous process in the several patients.

Gender Differences in Peer Influence on Autistic Traits in Special Needs Schools-Evidence From Staff Reports.

Children and adolescents with an intellectual disability (ID) and autistic traits often attend special needs schools where they are surrounded by peers with diverse characteristics. Given the role that peers can play in social development, we examined whether autistic traits development in students with ID and high levels of such characteristics are influenced by the level of autistic traits among the schoolmates they like most. Furthermore, we investigated the degree to which this peer influence susceptibility depends on students’ gender. A longitudinal design, with data collection points at the beginning and the end of a school year, was used. Staff reported on 330 students with high levels of autistic traits (20.6% girls; age 10.17 years, SD = 3.74) who attended 142 classrooms in 16 Swiss special needs schools. Results showed that students’ future individual level of autistic traits (T2) was not predicted by the autistic traits level of preferred peers (T1), controlling for individual autistic traits at T1, level of general functioning, gender, and age. However, the peer effect was significantly moderated by students’ gender, indicating that girls but not boys were susceptible to peer influence. These findings are discussed in terms of implications for understanding autistic traits development and directions of support for children and adolescents in their peer context.

Stationäre psychodynamische Therapie bei Kindern und Jugendlichen mit komplexer ADHS: Ergebnisse einer naturalistischen klinischen Studie

The Attention deficit/hyperactivity disorder (ADHD) is a common mental disorder in childhood and adolescence. However, it is a very heterogeneous disorder with subgroups of patients with mild symptoms and others with severe and complex impairments. Patients suffering from complex ADHD are usually characterized by multiple developmental disorders and impaired personality development. Due to the multimodal origin of the disorder, multimodal treatment approaches aimed at reducing the various deficits are usually indicated. The current study evaluated a multimodal inpatient psychodynamic treatment (PDT) for children and adolescents suffering from ADHD. 47 patients (age 9-17 years) were included in the study. Next to complex impairments (comorbid mental disorders, deficits regarding psychic structure, learning disorders and sensorimotor integration disorders), a high number of adverse childhood experiences (M = 11.71) was particularly remarkable in the sample. The PDT led to significant improvements regarding ADHD symptoms and general level of functioning. However, first symptom improvements were already evident at the end of the waiting period. For ten patients who participated in the follow-up assessment effects remained stable six months after treatment. Due to the high drop-out rate, however, the study results have to be regarded as preliminary.

Quality of life and family function are poorest when both patients with heart failure and their caregivers are depressed.

Patients with heart failure (HF) and their family caregivers commonly experience depressive symptoms associated with low quality of life (QOL) at the individual level. However, there is a lack of knowledge about how QOL and family function are associated with depressive symptoms at the dyad level. The aim of this article is to compare QOL and family function among dyads stratified by depressive symptoms. Outpatients with HF and their primary caregivers completed the Beck Depression Inventory-II for depressive symptoms, the Short Form 36 for physical and mental QOL, and the McMaster Family Assessment Device for a family function. Analysis of variance was used to compare QOL and family function among the four dyad groups. A total of 91 dyads were categorized into four groups: neither member having depressive symptoms (43.9%), only the caregiver having depressive symptoms (13.2%), only the patient having depressive symptoms (23.1%), and both members having depressive symptoms (20.9%). Dyads without depressive symptoms had the highest levels of physical and mental QOL among the groups. The dyads with both members having depressive symptoms had the lowest levels of physical and mental QOL (P < 0.001) and the lowest levels of general family functioning, problem-solving ability, and communication ability (P < 0.001). Intermediate levels of QOL were seen in dyads with only one member having depressive symptoms, and a similar pattern of intermediate scores was found in all three subscales of family function. Dyads with both members having depressive symptoms may be at greatest risk of having poor QOL and low family functioning.

Assessment of the upper limb of the tetraplegic patient

The aim of our study is to describe the assessment of the upper limb in tetraplegic patients to follow his (her) neurological progression and to define the medical or surgical treatment program. We selected upper limb assessment tools and scales for tetraplegic patients described in the medical literature through a PubMed search over the last four decades. For each method, we present the implementation rules and its metrological properties, including its validity in French. We selected five clinical scales for functional evaluation of grasping, as well as four scales for evaluating the overall function of these patients. Finally, we identified three complementary precision assessment tools. The AIS (ASIA Impairment Scale) classification describes the level and the severity of the spinal cord lesion. The Giens classification is more practical for describing the upper limb in middle and low tetraplegia. Impairments can be assessed with most common generic scales and nonspecific measurement devices: range of motion, strength, sensory loss, spasticity, joint pain. Measurement of pinch and grip strength is widely used and easy to perform. The Capabilities of Upper Extremity (CUE) and the Jebsen Taylor Test are the best validated and usable scales. At a general functional level, the Spinal Cord Independence Measure (SCIM) is the most relevant scale in these patients. Motor nerve blocks, electromyography, movement analysis and echography are promising additional methods. Assessment of the upper limb of tetraplegic patients relies both on generic and specific assessment tools and scales.