Attentional differences in audiovisual face perception between full- and preterm very low birthweight toddlers.

AIM: To investigate whether rightward attention to the mouth during audiovisual speech perception may be a behavioural marker for early brain development, we studied very preterm and low birthweight (VLBW) and typically developing (TD) toddlers. METHODS: We tested the distribution of gaze points in Japanese-learning TD and VLBW toddlers when exposed to talking, silent and mouth moving faces at 12, 18 and 24 months (corrected age). Each participant was categorised based upon the area they gazed at most (Eye-Right, Eye-Left, Mouth-Right, Mouth-Left) per stimulus per age. A log-linear model was applied to three-dimensional contingency tables (region, side and group). RESULTS: VLBW toddlers showed fewer gaze points than TD toddlers. At 12 months, more VLBW toddlers than TD toddlers showed left attentional bias toward any one face; however, this difference in attention asymmetry receded somewhat by 24 months. In talking condition, TD toddlers showed right attentional bias from 12 to 24 months, whereas VLBW toddlers showed such bias upon reaching 24 months. Additionally, more TD toddlers than VLBW toddlers attended to the mouth. CONCLUSION: Delays in exhibiting the attentional bias for an audiovisual face or general faces displayed by typically developing children might suggest differential developmental timing for hemispheric specialisation or dominance.

Difficulty in disengaging from threat and temperamental negative affectivity in early life: a longitudinal study of infants aged 12-36 months.

BACKGROUND: Attention disengagement is reportedly influenced by perceiving a fearful facial expression even in the first year of life. In the present study, we examined whether individual differences in disengaging from fearful expressions predict temperamental negative affectivity. METHOD: Twenty-six infants were studied longitudinally at 12, 18, 24, and 36 months, using an overlap paradigm and two temperament questionnaires: the Japanese versions of the revised Infant Behavior Questionnaire and Early Childhood Behavior Questionnaire. RESULTS: The infants fixated significantly more frequently to fearful than to happy or neutral faces. The attentional bias to threat (i.e., the number of fixed responses on fearful faces divided by the total number of fixed responses on faces) at 12 months was significantly positively correlated with negative affect at 12 months, and its relations with negative affect measured later in development was in the expected positive direction at each age. In addition, a moderation analysis indicates that the orienting network and not the executive network marginally moderated the relation between early attentional bias and later fear. CONCLUSIONS: The results suggest that at 12 months, infants with more negative affectivity exhibit greater difficulty in disengaging their attention from fearful faces. We also found evidence that the association between parent-reported fear and disengagement might be modulated in the second year, perhaps because of the differences in temperamental control networks.

Attentional asymmetry in orienting and alertness and its relationship to temperament: A longitudinal study of infants aged 6-24 months.

Previous research suggests that difficulties in orienting to visual stimuli directed by the right hemisphere are related to parental reports of distress and may be an early sign of autism spectrum disorder (ASD). One possible reason for this difficulty is infants' ability to achieve high levels of alertness, which also depends on the right hemisphere. This study examines the relationship between phasic alertness and asymmetry in visual orienting in typically-developing 6-24-month-old infants using the overlap paradigm. Participants were given a spatially non-directive warning signal shortly before the onset of the peripheral target. The signal reduced latencies in both overlap and no-overlap conditions. No main effects of age and visual field or interaction were found. However, results confirm the negative association between temperamental soothability and disengagement difficulty toward the left visual field at 6 months. This is discussed from the viewpoint of early left visual field attentional bias in relation to social cognition.

Early development of attentional disengagement and phasic alertness.

Attention development is a critical foundation for cognitive abilities. This study examines the relationship between phasic aspects of alertness and disengagement in infants, using the overlap paradigm. Research shows that visual disengagement in overlap condition is modulated by auditory cues in 6-year-olds. Our participants were aged 6 months (N = 20), 12 months (N = 27), and 24 months (N = 14). Phasic alertness during overlap and no-overlap tasks was manipulated using a spatially nondirective warning signal shortly before onset of the peripheral target. Responses in overlap condition were slower and fewer than in no-overlap condition. The signal showed a tendency to reduce latencies in both overlap and no-overlap conditions. While our hypothesis that the warning signal might be more effective in younger infants was not supported, we confirmed the association reported in previous studies between temperamental soothability and disengagement latencies in infancy.

Attentional bias assessed by a facial expression cuing paradigm in infants.

To disambiguate infants' attentional bias towards fearful facial expressions, we applied a facial expression cueing paradigm to 36 6-month-old and 33 12-month-old infants, with 21 infants taking part at both ages. Infants made saccades towards a peripheral target preceded by a happy, fearful, or neutral cue directing their attention to the target location (congruent) or the wrong location (incongruent). The results show that infants were faster to respond when shown a fearful (vs. happy) face as a congruent cue, which is consistent with previous studies referring to fearful vigilance, while an incongruent fearful cue reduces attention shifts to the target on the opposite side of the monitor to a greater extent than an incongruent happy cue at 12 months, implying that a fearful facial expression prolongs attentional disengagement or is associated with a greater narrowing of attention. Additionally, the latencies of 6-month-olds were significantly faster than those of 12-month-olds in a congruent condition. The relationship between attentional bias and temperamental disposition was examined using the Infant Behavior Questionnaire-Revised. High temperamental orienting scores partly correlated with attentional bias at 12 months. The contributions of attentional brain networks to socio-cognitive and emotional development are also discussed.

Burnout Study of Clinical Nurses in Vietnam: Development of Job Burnout Model Based on Leiter and Maslach's Theory.

PURPOSE: This study aimed to create a Vietnamese version of both the Maslach Burnout Inventory-General Survey (MBI-GS) and Areas of Worklife Scale (AWS) to assess the burnout state of Vietnamese clinical nurses and to develop a causal model of burnout of clinical nurses. METHODS: We conducted a descriptive design using a cross-sectional survey. The questionnaire was hand divided directly by nursing departments to 500 clinical nurses in three hospitals. Vietnamese MBI-GS and AWS were then examined for reliability and validity. We used the revised exhaustion +1 burnout classification to access burnout state. We performed path analysis to develop a Vietnamese causal model based on the original model by Leiter and Maslach's theory. RESULTS: We found that both scales were reliable and valid for assessing burnout. Among nurse participants, the percentage of severe burnout was 0.7% and burnout was 15.8%, and 17.2% of nurses were exhausted. The best predictor of burnout was "on-duty work schedule" that clinical nurses have to work for 24 hours. In the causal model, we also found similarity and difference pathways in comparison with the original model. CONCLUSION: Vietnamese MBI-GS and AWS were applicable to research on occupational stress. Nearly one-fifth of Vietnamese clinical nurses were working in burnout state. The causal model suggested a range of factors resulting in burnout, and it is necessary to consider the specific solution to prevent burnout problem.

Evaluation of cognitive and social functioning in patients requiring long-term inpatient psychiatric care using the International Classification of Functioning, Disability, and Health: a large-scale, multi-institutional observational study.

PURPOSE: We comprehensively evaluated cognitive and social functioning in patients requiring long-term inpatient psychiatric care using the International Classification of Functioning, Disability, and Health. METHOD: We surveyed 1967 patients receiving long-term inpatient psychiatric care. Patients were further categorized into an old long-stay group (n = 892, >5 years in hospitals) and a new long-stay group (n = 1075, 1-5 years in hospitals). We obtained responses for all the International Classification of Functioning, Disability, and Health items in domain b (Body Functions) and domain d (Activities and Participation). We estimated weighted means for each item using the propensity score to adjust for confounding factors. RESULTS: Responses were received from 307 hospitals (response rate of hospitals: 25.5%). Cognitive and social functioning in the old long-stay group was more severely impaired than in the new long-stay group. No statistically significant differences were observed regarding the International Classification of Functioning, Disability, and Health items associated with basic activities of daily living between the two groups. CONCLUSION: Combined therapy consisting of cognitive remediation and rehabilitation on social functioning for this patient population should be started from the early stage of hospitalization. Non-restrictive, independent environments may also be optimal for this patient population. Implications for rehabilitation Rehabilitation of cognitive and social functioning for patients requiring long-term inpatient psychiatric care should be started in the early stages of hospitalization. In psychiatric fields, the International Classification of Functioning, Disability, and Health checklist could facilitate individualized rehabilitation planning by allowing healthcare professionals to visually assess the comprehensive functioning of each patient using graphics such as radar charts.

Infant eye and head movements toward the side opposite the cue in the anti-saccade paradigm.

BACKGROUND: The anti-saccade task, when people must respond in the direction opposite to a visual stimulus, has been used as a marker of operation of the frontal cortical oculomotor area. However, early development of oculomotor control has been little studied with the infant anti-saccade paradigm, and a few studies did not recognize anti-saccades in infants in light of the results of adult anti-saccade. Since the characteristics of infant eye movements are little known, applying the criteria used in adult study is by no means the best way to study infant anti-saccade. As it is indicated that coordinated eye and head movements often enable infants to control the direction of their gaze, head movements should be examined as an infant orienting response. The aim of this study was to address how infants used eye and head movements during the anti-saccade paradigm. To distinguish infants' responses, we also investigated eye and head movements during a task for an inhibition of return. Inhibition of return, in which delayed responses occur in the direction to which attention had previously been oriented, has been thought to mark activity of the superior colliculus. Since the superior colliculus is thought to develop much earlier in life than the frontal lobes, we thought it useful to compare these task performances during infancy. METHODS: Infants were divided into three groups according to age. Anti-saccade and inhibition-of-return tasks were given. Their eye and head movements during tasks were independently recorded by the corneal reflection method in the head-free condition. RESULTS: Younger infants tended to initiate eye movement less than older ones in both tasks. In the anti-saccade task, responses opposite to the cue tended to show longer latency than responses to the cue. Infants made faster responses toward the side opposite the cue when it was to the right than when it was left of fixation. Regarding the comparison of responses toward the side opposite the cue between two tasks, the leftward eye movement was faster than the leftward head movements in the inhibition-of-return task, while no difference of latency was observed between eye and head movements in the anti-saccade task. A qualitative analysis of the trajectory of these responses revealed that head movement trajectories were steeper in the anti-saccade than in the inhibition-of-return task. CONCLUSION: Younger infants move head and eyes together, with head movements frequently starting first. On the other hand, both the leftward latency difference between eye and head and gentle trajectories of head in inhibition of return indicate that eye movements are more predominant over head movements in the inhibition-of-return task than in the anti-saccade task. This would suggest an earlier developing inhibition-of-return mechanism.

Evaluation of diagnostic criteria for panic attack using item response theory: findings from the National Comorbidity Survey in USA.

BACKGROUND: The dichotomous diagnostic systems such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) lose much important information concerning what each symptom can offer. This study explored the characteristics and performances of DSM-IV and ICD-10 diagnostic criteria items for panic attack using modern item response theory (IRT). METHODS: The National Comorbidity Survey used the Composite International Diagnostic Interview to assess 14 DSM-IV and ICD-10 panic attack diagnostic criteria items in the general population in the USA. The dimensionality and measurement properties of these items were evaluated using dichotomous factor analysis and the two-parameter IRT model. RESULTS: A total of 1213 respondents reported at least one subsyndromal or syndromal panic attack in their lifetime. Factor analysis indicated that all items constitute a unidimensional construct. The two-parameter IRT model produced meaningful and interpretable results. Among items with high discrimination parameters, the difficulty parameter for "palpitation" was relatively low, while those for "choking," "fear of dying" and "paresthesia" were relatively high. Several items including "dry mouth" and "fear of losing control" had low discrimination parameters. LIMITATIONS: The item characteristics of diagnostic criteria among help-seeking clinical populations may be different from those that we observed in the general population and deserve further examination. CONCLUSIONS: "Paresthesia," "choking" and "fear of dying" can be thought to be good indicators of severe panic attacks, while "palpitation" can discriminate well between cases and non-cases at low level of panic attack severity. Items such as "dry mouth" would contribute less to the discrimination.

Relations between Temperament, Sensory Processing, and Motor Coordination in 3-Year-Old Children.

Poor motor skills and differences in sensory processing have been noted as behavioral markers of common neurodevelopmental disorders. A total of 171 healthy children (81 girls, 90 boys) were investigated at age 3 to examine relations between temperament, sensory processing, and motor coordination. Using the Japanese versions of the Children's Behavior Questionnaire (CBQ), the Sensory Profile (SP-J), and the Little Developmental Coordination Disorder Questionnaire (LDCDQ), this study examines an expanded model based on Rothbart's three-factor temperamental theory (surgency, negative affect, effortful control) through covariance structure analysis. The results indicate that effortful control affects both sensory processing and motor coordination. The subscale of the LDCDQ, control during movement, is also influenced by surgency, while temperamental negative affect and surgency each have an effect on subscales of the SP-J.

The temporal relationship between reduction of early imitative responses and the development of attention mechanisms.

BACKGROUND: To determine whether early imitative responses fade out following the maturation of attentional mechanisms, the relationship between primitive imitation behaviors and the development of attention was examined in 4-month-old infants. They were divided into high and low imitators, based on an index of imitation. The status of attention was assessed by studying inhibition of return (IOR). Nine-month-old infants were also tested to confirm the hypothesis. RESULTS: The IOR latency data replicate previous results that infants get faster to produce a covert shift of attention with increasing age. However, those 4-month-olds who showed less imitation had more rapid saccades to the cue before target presentation. CONCLUSION: The cortical control of saccade planning appears to be related to an apparent drop in early imitation. We interpret the results as suggesting a relationship between the status of imitation and the neural development of attention-related eye movement.

Variable coordination of eye and head movements during the early development of attention: a longitudinal study of infants aged 12-36 months.

This longitudinal study investigated the effects of attentional development on peripheral stimulus localization by analyzing the eye and head movements of toddlers as they matured from 12 to 36 months. On each trial of an experiment, a central fixation point and a 30° peripheral stimulus were presented, such that in the gap condition the fixation disappeared 300 ms before the peripheral stimulus, whereas in the no-overlap condition it disappeared simultaneously as the peripheral stimulus, and in the overlap condition the fixation remained present when the peripheral target occurred. Results showed that eye and head movement latencies were highly correlated in all conditions and ages. However, at 12 months, head movements were as fast as eye movements, whereas during the subsequent development, eye movements became increasingly faster than head movements. These findings are indicative of a transition between 12 and 36 months due either to a change in attentional control, or to changes in the size of the visual field in which only eye movements occur.

Individual differences in disengagement of fixation and temperament: longitudinal research on toddlers.

It has been suggested that a shift occurs in the brain's control system from the orienting network in infancy to the executive network by the age of 3-4 years; however, there has been little empirical evidence of this shift during toddlerhood. Therefore, the present study examined how the orienting system in infancy is related to an effortful control system at a later age. Children were assessed longitudinally at 12, 18, 24, and 36 months of age, using a gap-overlap task in which dynamic geometrical-shape stimuli were presented. Parents completed temperament questionnaires about the children at each age. A delayed-gratification task was also given to 36-month-olds. Overall, saccadic latencies in the gap-overlap task were significantly faster at 36 months. At all ages, responses were slower during overlap trials than during gap or no-overlap trials. Longer latencies in the overlap condition were associated with low temperamental orienting/regulation scores at 12 months but with high effortful control scores at 18 and 24 months. The associations at 18 and 24 months are thought to represent a genuine positive association between effortful control and sustained and focused attention.

Symptom indicator of severity of depression in cancer patients: a comparison of the DSM-IV criteria with alternative diagnostic criteria.

OBJECTIVE: The objective of this study was to explore the performances of several diagnostic criteria items for judging the severity of major depression among cancer patients. METHOD: Using modern item response theory, we examined the performances of the diagnostic criteria outlined by the DSM-IV and two sets of conceptual diagnostic criteria (the Endicott and the Cavanaugh criteria) in a series of 728 cancer patients who had been diagnosed with major depression using an inclusive approach. RESULTS: While all the DSM-IV diagnostic criteria, including feelings of worthlessness and suicidal ideation, had a low ability for discriminating the severity of depression, two proposed items (not participating in medical care and social withdrawal) appeared to be good markers of moderately severe major depressive disorder among cancer patients. In addition, the items "fearfulness or depressed appearance in face or body posture" and "brooding, self-pity or pessimism" may be good markers for mild major depressive disorders, while the item "cannot be cheered up, doesn't smile, no response to good news or funny situations" may be a good marker for severe major depressive disorder. CONCLUSIONS: The findings of the present study suggest that alternative criteria may have utility in diagnosing depression severity in cancer patients.