Parenting by individuals with fetal alcohol spectrum disorders and neurobehavioral outcomes in their offspring.

BACKGROUND: The neurobehavioral health impairments associated with prenatal alcohol exposure are now known to persist through adulthood. However, little is known about how these impairments affect individuals' parenting abilities and the neurobehavioral health of their offspring. This study compares parents with fetal alcohol spectrum disorder (FASD) with socioeconomically matched, nonexposed parents on measures of parenting and family support and assesses the neurobehavioral health of the children in both groups. METHODS: Forty-nine parent-child dyads were recruited from a longitudinal cohort of low socioeconomic status. Measures included the Parenting Styles and Dimensions Questionnaire, Family Support Scale, an in-depth psychosocial history, the Pediatric Symptom Checklist (PSC; parent and child reports), the Achenbach Child Behavior Checklist (CBCL), a screening psychiatric evaluation of the child, the NIH Toolbox Cognition Battery for Children, The Vineland Adaptive Behavior Scales-Third Edition caregiver rating form, and the Traumatic Events Screening Inventory (parent and child reports). RESULTS: Cognitive functioning was impaired for both offspring of parents with FASD ( x ¯ = 81.1, SD = 13.0) and control parents ( x ¯ = 79.9, SD = 16.1), but despite similar impairments, children of parents with FASD were less likely to have an Individualized Education Plan than controls. Adaptive functioning was adequate for both groups ( x ¯ = 92.1, SD = 15.4 in exposed vs. x ¯ = 94.3, SD = 12.3 in controls) and CBCL and PSC scores in both groups were within normal limits. Parents in both groups showed a predominantly authoritative parenting style. Despite a similar frequency of adverse childhood experiences in both groups, parents with FASD were less likely to recognize their child's adverse experiences. CONCLUSION: Parents with FASD display notable strengths including a predominantly authoritative parenting style. However, parents with FASD underrecognize child trauma and underutilize developmental services compared to socioeconomically matched controls, despite similar neurocognitive impairments. Impairments in adaptive functioning in parents with FASD may translate into difficulties with child-parent communication and limit both insight into neurobehavioral problems and advocacy skills. There is a need to identify and support parents with FASD to optimize their parenting abilities in the context of their individual strengths and difficulties.

Generalizable prediction of childhood ADHD symptoms from neurocognitive testing and youth characteristics.

Childhood attention-deficit/hyperactivity disorder (ADHD) symptoms are believed to result from disrupted neurocognitive development. However, evidence for the clinical and predictive value of neurocognitive assessments in this context has been mixed, and there have been no large-scale efforts to quantify their potential for use in generalizable models that predict individuals' ADHD symptoms in new data. Using data drawn from the Adolescent Brain Cognitive Development Study (ABCD), a consortium that recruited a diverse sample of over 10,000 youth (ages 9-10 at baseline) across 21 U.S. sites, we develop and test cross-validated machine learning models for predicting youths' ADHD symptoms using neurocognitive abilities, demographics, and child and family characteristics. Models used baseline demographic and biometric measures, geocoded neighborhood data, youth reports of child and family characteristics, and neurocognitive tests to predict parent- and teacher-reported ADHD symptoms at the 1-year and 2-year follow-up time points. Predictive models explained 15-20% of the variance in 1-year ADHD symptoms for ABCD Study sites that were left out of the model-fitting process and 12-13% of the variance in 2-year ADHD symptoms. Models displayed high generalizability across study sites and trivial loss of predictive power when transferred from training data to left-out data. Features from multiple domains contributed meaningfully to prediction, including neurocognition, sex, self-reported impulsivity, parental monitoring, and screen time. This work quantifies the information value of neurocognitive abilities and other child characteristics for predicting ADHD symptoms and provides a foundational method for predicting individual youths' symptoms in new data across contexts.

Mechanism-based groups of children with ADHD are associated with distinct domains of impairment.

Person-oriented analyses are commonly used to identify subgroups of children with mental health conditions in the hopes that they will meaningfully inform the taxonomy, assessment, and treatment of psychological disorder. However, whether these data-driven groups are demonstrably better at predicting important aspects of adaptive functioning than standard DSM taxonomy has not been established. Using Attention-Deficit-Hyperactivity-Disorder (ADHD) as a model condition, we utilized dimensions of personality and cognitive ability to identify person-centered profiles of school-aged children (N=246) and evaluated the association of these profiles with critical areas of adaptive functioning. A single profile ("Conscientious") represented non-ADHD controls and was characterized by faster drift rate and higher executive functioning scores. Three profiles ("Disagreeable," "Negative Emotionality," and "Extraverted") were identified for children with ADHD. Drift rate, but not executive functioning, distinguished among ADHD profiles, which were also distinctly associated with comorbid externalizing and internalizing psychopathology, social skills, and academic achievement. In contrast, the Diagnostic and Statistical Manual (DSM) presentations were not informative and showed similar patterns of impairment across domains. Person-centered profiles of children with ADHD are associated with distinct adaptive functioning deficits and may be useful in informing clinical practice.

Neural correlates of working memory's suppression of aversive olfactory distraction effects.

Human cognitive performance is often disrupted by distractions related to aversive stimuli and affective states, but, paradoxically, there is also evidence to suggest that high working memory demands reduce the impact of aversive distraction. Previous empirical work suggests this latter effect occurs because working memory demands reduce attention to off-task processes, but the brain regions that mediate this effect remain uncertain. The current study utilizes a novel distraction manipulation involving unpleasant odorants to identify neural structures that buffer performance from aversive distraction under high working memory demands, and to clarify their connectivity in this context. Twenty-one healthy young adults (12 women) completed a verbal n-back task under two levels of load and were concurrently exposed to either room air or aversive odorants. Three brain regions displayed increases in neural responses to olfactory distractors under high load only; the left dorsolateral prefrontal cortex, the left ventrolateral prefrontal cortex and right cerebellar Crus I. Of these regions, only the ventrolateral prefrontal cortex also displayed context-specific connectivity with a region thought to be involved in off-task processes: the dorsomedial prefrontal cortex. Overall, results suggest that, under high working memory demands, areas of the prefrontal cortex and cerebellum shield cognition from aversive distraction, potentially through interactions with brain structures involved in off-task processes.

Making the Most of It: Application of Planned Missingness Design to Increase the Efficiency of Diagnostic Assessment.

Multimethod assessment is recommended as "best practice" in clinical assessment and is often implemented through the combined use of symptom rating scales and structured interviews. While this approach increases confidence in the validity of assessment, it also increases burden, expense, and leads to the accumulation of redundant information. To address this problem, we evaluate the use a planned missingness design within the framework of adult Attention Deficit/Hyperactivity Disorder (ADHD) assessment. In a sample of 169 young adults, we fit a two-method measurement (TMM) model using ADHD symptoms obtained from rating scales and a structured diagnostic interview. Based on an estimated 8:1 differential between the cost of conducting an in-person diagnostic interview vs. completing questionnaires online, we conducted a series of Monte Carlo simulations to determine the utility of combining TMM with a planned missingness design. We find that even when costs are kept constant, statistical power of the TMM/planned missingness design was equal to the power that would have been obtained had nearly twice the number of participants with complete data been recruited. Conversely, costs could be decreased by 20-25%, while maintaining statistical power equivalent to a design with complete data. Our results suggest the TMM design is a promising technique for reducing the cost and burden of diagnostic assessment within research settings.

A diffusion-model analysis of timing deficits among children with ADHD.

OBJECTIVE: Deficits in the ability to perceive time have been proposed as an etiologic mechanism in the development of the cognitive and behavioral characteristics associated with ADHD. However, previous studies testing the presence of timing deficits have produced idiosyncratic results. This is in large part due to the underutilization of insights from basic timing research, and from the inherent difficulty that arises when a single index of performance (i.e., reaction time [RT] or accuracy) is used to index the health of what is essentially a multiple-component process. The current article utilizes a diffusion model approach to isolate the component processes involved in timing (i.e., internal clock speed, decision-making speed, speed/accuracy trade-off strategies, and nondecision time) using a well-validated timing task. METHOD: Fifty children with ADHD and 32 non-ADHD controls aged 8-12 completed a temporal bisection procedure. RESULTS: Diffusion model parameters indicated that both the internal clock and decision-making speeds were slower among children with ADHD. However, the strength of evidence for slowed decision making far outweighed evidence for a slower internal clock. CONCLUSIONS: Slower evidence accumulation during decision making is domain-general deficit in ADHD. Such slowing is consistent with adaptive-gain theories, which posit that a suboptimal ratio of neural signal-to-noise is characteristic of children with ADHD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

5-HT1a Receptor Involvement in Temporal Memory and the Response to Temporal Ambiguity.

It has previously been demonstrated that rats trained on the peak-interval procedure to associate two different cues with two different fixed interval schedules will generate a scalar peak function at an intermediate time when presented with the compound cue. This response pattern has been interpreted as resulting from the simultaneous retrieval of different temporal memories, and a consequential averaging process to resolve the ambiguity. In the present set of studies, we investigated the role that serotonin 1a receptors play in this process. In Experiment 1, rats were trained on a peak-interval procedure to associate the interoceptive states induced by saline and the 5-HT1a agonist, 8-OH-DPAT, with a 5 s or 20 s fixed-interval schedule signaled by the same tone cue (counter-balanced). While peak functions following administration of saline were centered at the appropriate time (5 s or 20 s), peak functions following administration of the agonist were centered around 7 s, irrespective of the reinforced time during training, suggesting agonist-induced disruption in selective temporal memory retrieval, resulting in increased ambiguity regarding the appropriate time at which to respond. In Experiment 2, rats were trained in a peak-interval procedure to associate a tone cue with a 10 s fixed interval and a light cue with a 20 s fixed interval. Administration of the 5-HT1a antagonist, WAY-100635, had no impact on timing when single cues were presented, but altered the intermediate, scalar, response to the stimulus compound, suggesting antagonist-induced disruption in the processes used to deal with temporal memory ambiguity. Together, these data suggest that manipulations of 5HT transmission at the 5-HT1a receptor cause changes in the temporal pattern of responding that are consistent with alterations in temporal memory processes and responses to temporal ambiguity.

Is Poor Working Memory a Transdiagnostic Risk Factor for Psychopathology?

In contrast to historical conceptualizations that framed psychological disorders as distinct, categorical conditions, it is now widely understood that co- and multi-morbidities between disorders are extensive. As a result, there has been a call to better understand the dimensional liabilities that are common to and influence the development of multiple psychopathologies, as supported and exemplified by the National Institutes of Mental Health (NIMH) Research Domain Criteria (RDoC) framework. We use a latent variable SEM approach to examine the degree to which working memory deficits represent a cognitive liability associated with the development of common and discrete dimensions of psychopathology. In a sample of 415 community recruited children aged 8-12 (n = 170 girls), we fit a bi-factor model to parent reports of behavior from the DISC-4 and BASC-2, and included a latent working memory factor as a predictor of the internalizing, externalizing, and general "p-factor." We found that both the general "p-factor" and externalizing (but not internalizing) latent factor were significantly associated with working memory. When a bi-factor model of externalizing symptomology was fit to further explore this relationship, working memory was only correlated with the general externalizing dimension; correlation with specific inattention, hyperactive/impulsive, and oppositional factors did not survive once the general externalizing dimension was taken into consideration. These findings held regardless of the sex of the child. Our results suggest that working memory deficits represent both a common cognitive liability for mental health disorders, and a specific liability for externalizing disorders.

Using the Diffusion Model to Explain Cognitive Deficits in Attention Deficit Hyperactivity Disorder.

Slow, variable, and error-prone performance on speeded reaction time (RT) tasks has been well documented in childhood ADHD, but equally well documented is the context-dependent nature of those deficits, particularly with respect to event rate. As event rates increase (or, as the interstimulus intervals become shorter), RTs decrease, a pattern of performance that has long been interpreted as evidence that cognitive deficits in ADHD are a downstream consequence of a fundamental difficulty in the regulation of arousal to meet task demands. We test the extent to which this is a misinterpretation of the data that occurs when RT and accuracy are considered separately, as is common in neurocognitive research. In two samples of children aged 8-10 with (N = 97; 33 girls) and without (N = 39; 26 girls) ADHD, we used the diffusion model, an influential computational model of RT, to examine the effect of event rate on inhibitory control in a go-no-go task. Contrary to longstanding belief, we found that fast event rates slowed the rate at which children with ADHD accumulated evidence to make a decision to "no-go", as indexed by drift rate. This in turn resulted in a higher proportion of failed inhibits, and occurred despite increased task engagement, as reflected by changes in the starting point of the decision process. Thus, although faster event rates increased task engagement among children with ADHD, the increased engagement was unable to counteract the concurrent slowing of processing speed to "no-go" decisions. Implications for theoretical models of ADHD and treatments are discussed.