Health-Related Quality of Life in Mexican Children and Adolescents with Non-Syndromic Craniosynostosis.

OBJECTIVE: Assess the Health-Related Quality of Life in children and adolescents with non-syndromic craniosynostosis and compare it with participants without craniosynostosis. DESIGN: Non-experimental, cross-sectional design. SETTING: The assessment was done remotely and the instrument was sent via chat or email. PATIENTS/PARTICIPANTS: Participants (ages 8-17) with non-syndromic craniosynostosis (n = 27) and without craniosynostosis (n = 26). MAIN OUTCOME MEASURE(S): We used an adapted version for the Mexican population of the Health-Related Quality of Life Questionnaire for Children and Adolescents -KIDSCREEN-52. RESULTS: All scores were in the average clinical range and both groups scored similarly in all domains except those with craniosynostosis were significantly lower in the Social Support and Peers domain (rpb = 0.48). CONCLUSIONS: Children and adolescents with non-syndromic craniosynostosis reported similar Health-Related Quality of Life as the control group, except for the Social Support domain, which should be investigated in future studies.

Exploratory study of the prevalence of food addiction and its relationship with executive functioning, depression, and reinforcement sensitivity in a sample of Mexican adults.

Introduction: The study of food addiction (FA) has become relevant due to its high prevalence, the negative impact on quality of life, and its association with neuropsychological and psychiatric symptoms. Several studies have provided scientific support for these associations, however, the results are contradictory. Additionally, studies have unsuccessfully elucidated the true nature of the failures in executive functioning in people with FA symptomatology, particularly when it comes to executive deficits. Therefore, the purpose of this research was to establish whether the presence of executive dysfunction, depressive symptoms and binge eating problems, as well as high reward sensitivity entails a greater severity in FA traits and high body mass index (BMI) in a sample of Mexican adults. Methods: The sample consisted of Mexican men and women between 21-59 years (n = 36); who completed self-report questionnaires and performance tests to measure the study variables. Additionally, BMI was estimated with self-reported height and weight. Results: Our results showed that a high number of FA symptoms were associated with higher executive dysfunction scores, greater reward sensitivity, and more severe depressive and binge eating problems. Furthermore, factors that are more strongly associated with higher scores of FA include severe executive deficits, greater activation of the punishment avoidance system, and persistence in the search for reward when the depressive symptoms increased. The factors that best explained changes in the estimated BMI of women were a decreased crystallized intellectual capacity and the inability to control food intake as the number of FA symptoms increased. Discussion: In summary, the cognitive functioning profile characterized by general failure of the executive functioning, as well as a greater activation of the Punishment Avoidance System and persistence in the search for reward, were associated with greater severity of FA symptoms, especially when the depressive symptomatology was severe. In parallel, the psychopathology in participants associated with FA confirms the contribution of anxious and depressive symptomatology and borderline personality traits which could facilitate the expression of clinically relevant FA symptoms in women. Finally, we found that decreased crystallized intellectual capacity and inability to control food intake were linked to higher BMI when the number of FA symptoms increased.

Cognitive performance in preschoolers with non-syndromic craniosynostosis undergoing surgery: A comparison with typically developing children.

This study aimed to determine the cognitive profile of preschool children undergoing surgery to correct non-syndromic craniosynostosis, compare them with typically developing children, and analyze possible cognitive deficits in the most prevalent subtypes: sagittal and unicoronal. Thirty-one children aged 3 years to 5 years and 11 months with non-syndromic craniosynostosis (11 sagittal, 9 unicoronal, 4 metopic, 3 lambdoid, 4 multisutural) who underwent surgery were compared with thirty-one typically developing children. The Wechsler Preschool and Primary Scale of Intelligence-Third Edition (WPPSI-III) was used to assess cognitive function. Children with non-syndromic craniosynostosis scored below the typically developing children in the Verbal Intelligence Quotient (VIQ) and Full-Scale Intelligence Quotient (FISQ). When specific subtypes were compared, children with sagittal synostosis scored similarly to the typically developing children; in contrast, children with unicoronal synostosis had lower performance in the Processing Speed Quotient and FISQ. The proportion of participants scoring below one standard deviation on the VIQ, General Language Composite, and FISQ was greater in the non-syndromic craniosynostosis group. This study supports the finding that children with non-syndromic craniosynostosis, particularly those with unicoronal synostosis, have more cognitive difficulties than those with normal development. Assessing cognition at preschool age in children with non-syndromic craniosynostosis is important in order to detect difficulties before they become more apparent at school age.

Neurocognition in Bipolar and Depressive Schizoaffective Disorder: A Comparison with Schizophrenia.

INTRODUCTION: Schizoaffective disorder (SA) is classified into bipolar (bSA) and depressive (dSA) subtypes. Although clinical differences between both have been reported, there is no clear information regarding their specific cognitive profile. OBJECTIVE: To compare neurocognition between SA subtypes and schizophrenia (SC). METHODS: A total of 61 patients were assessed and divided into 3 groups: 35 SC, 16 bSA, and 10 dSA. All participants signed an informed consent letter. The MATRICS Consensus Cognitive Battery, Central and South American version was used to assess neurocognition. The study was performed at the Instituto Nacional de Psiquiatría "Ramón de la Fuente". Participants were identified by specialized psychiatrists. Trained neuropsychologists carried out the clinical and cognitive assessment, which lasted 2 h approximately. RESULTS: The cognitive assessment showed a significant difference in Trail Making Test part A subtest (F[2,58] = 4.043; p = 0.023]. Post hoc analyses indicated that dSA obtained a significantly higher score than SC (MD = -11.523; p = 0.018). The f test showed a large effect size (f = 0.401). No statistical differences were observed regarding other cognitive variables. CONCLUSIONS: The cognitive profile of SA subtypes and SC is similar since no differences were found in most subtests. However, dSA may be less impaired than SC in measures of processing speed. Further research with larger samples must be conducted.

A Parenting Program to Reduce Disruptive Behavior in Hispanic Children with Acquired Brain Injury: A Randomized Controlled Trial Conducted in Mexico.

Children with acquired brain injury (ABI) are at risk of impairments in self-regulation and disruptive behavior. We aimed to investigate the effectiveness of the Signposts program to reduce disruptive behavior and improve self-regulation in Hispanic children with ABI, and reduce parental stress and improve parenting practices. Using a randomized controlled trial design, we assigned children (n = 71) and their parents to Signposts or generic telephone support. Blinded assessors conducted assessments at pre-intervention, immediately post-intervention, and at 3 months post-intervention. Signposts was effective in reducing dysfunctional parenting practices. Further, when analyzing participants at risk of behavioral disturbance (n = 46), Signposts was effective in reducing child disruptive behavior in the home environment and emotional self-regulation. No differences were found for parental stress, parent sense of competence, child disruptive behaviors at school, and child cognitive and behavioral self-regulation. The reduction in disruptive behavior was associated with the implementation of authoritative parenting practices (external regulation), and not associated with child self-regulation.

How Do Parents Influence Child Disruptive Behavior After Acquired Brain Injury? Evidence From a Mediation Model and Path Analysis.

OBJECTIVES: Children with acquired brain injury (ABI) can present with disruptive behavior, which is often a consequence of injury and parent factors. Parent factors are associated with child disruptive behavior. Furthermore, disinhibition in the child also leads to disruptive behavior. However, it is unclear how these factors interact. We investigated whether parental factors influence child disruptive behavior following ABI and how these factors interact. METHODS: Parents of 77 children with ABI participated in the study. Parent factors (executive dysfunction, trait-anxiety), potential intervention targets (dysfunctional parenting practices, parental stress, child disinhibition), and child disruptive behavior were assessed. A hypothetical model based on the literature was tested using mediation and path analysis. RESULTS: Mediation analysis revealed that child disinhibition and dysfunctional parenting practices mediated the association of parent factors and child disruptive behavior. Parents' executive dysfunction mediated the association of dysfunctional parenting practices, parental stress and parent trait-anxiety. Parenting practices mediated the association of executive dysfunction and child disruptive behavior. Path analysis indices indicated good model adjustment. Comparative and Tucker-Lewis Index were >0.95, and the root mean square error of approximation was 0.059, with a chi-square of 0.25. CONCLUSIONS: A low level of parental trait-anxiety may be required to reduce dysfunctional parenting practices and child disinhibition. Impairments in child disinhibition can be exacerbated when parents present with high trait-anxiety. Child disinhibition is the major contributor of disruptive behavior reported by parents and teachers. The current study provides evidence of parent anxiety and child disinhibition as possible modifiable intervention targets for reducing child disruptive behavior. (JINS, 2019, 25, 237-248).

Parenting and the dysregulation profile predict executive functioning in children with acquired brain injury.

Background: Children with acquired brain injury (ABI) present with high rates of psychological disorders commonly accompanied by deficits in hot and cold executive functions (EFs). Impairments in EFs have been reported to precede mental health problems. Moreover, children who are vulnerable to developing mental health problems in adulthood frequently present with a dysregulation profile in childhood, characterized by impairments in cognitive, behavioral and emotional regulation. Objective: To identify profiles of behaviors associated with impairment in hot and cold EFs and compare injury factors, environmental stressors and dysregulation profile between them. Methods: A latent profile analysis was conducted with 77 children with ABI aged between 6 and 12. Injury factors, child IQ, environmental stressors and the dysregulation profile were compared between these behavioral profiles. Logistic regressions were conducted to predict profile membership. Results: Two profiles were identified: Profile M, with mild deficits (1-2 SD above the mean) in working memory and social skills, and profile C, presenting clinically significant deficits (2-3 SD above the mean) in shift, initiate, working memory, planning and social skills and mild deficits in inhibit, emotional control and task monitor. Proximal environmental stressors (dysfunctional parenting practices, parental stress, parent's executive dysfunction, anxiety-trait, and depressive symptoms) and dysregulation symptoms predicted profile membership, whereas injury factors, child IQ and distal environmental stressors did not. Conclusion: Following ABI, children with profile C are at risk of mental health problems and present with more proximal stressors. The dysregulation profile may be useful as a proxy for risk for later mental health problems in children with ABI.

A Systematic Review of Interventions for Hot and Cold Executive Functions in Children and Adolescents With Acquired Brain Injury.

Objective: We investigated interventions, which aimed to improve cold and hot executive functions (EFs) in children and adolescents with a diagnosis of acquired brain injury (ABI). Methods: The following electronic databases were searched: Medline, CINAHL, PsycINFO, and Pubmed. The database filters limited the search to articles published between 1990 and July 2017 in English or Spanish, including children and adolescents. Articles were read and classified according to the levels of evidence of the Australian National Health and Medical Research Council and the Downs and Black checklist was used for Measuring Study Quality. Results: Thirty studies are reported in this systematic review. Level of evidence, quality of the studies, characteristics of the participants, interventions implemented, and outcomes are described. Conclusions: The study of rehabilitation for executive dysfunction in children with ABI is emerging. Although few high-quality intervention studies exist in this area, which limits conclusions regarding intervention efficacy, results of existing studies suggest that education for parents may be an important component of intervention. Moreover, caregiver involvement may improve the effectiveness of hot EFs rehabilitation interventions, while high intervention session frequency may be important in improving cold EFs. Positive behavior supports and specific training based on a cognitive model provided some promising findings, which require further evaluation.

Feasibility and effectiveness of a parenting programme for Mexican parents of children with acquired brain injury-Case report.

BACKGROUND: Acquired brain injury (ABI) during childhood typically causes behaviour problems in the child and high levels of stress in the family. OBJECTIVES: (1) To investigate the feasibility and effectiveness of a parenting programme to: improve behaviour and self-regulation (SR) in Mexican children with ABI, enhance parenting skills, and decrease parental stress in parents of children with ABI; (2) to explore the impact of parent SR on child. METHODS: Case study design with four participants post-ABI, aged 7-12 years, recruited in Mexico City. A parenting programme (Signposts for Building Better Behaviour) was delivered and provided parents with strategies to manage child behaviour. Child behaviour, child self-regulation, parental stress and parenting practices were measured before, immediately post-intervention, and three months post-intervention. RESULTS: At immediate and three months post-intervention improvements in parenting skills, reduction in parental stress, and improvement in child behaviour were identified. CONCLUSIONS: The programme is feasible in a Mexican population and was effective in improving parenting skills and reducing stress in parents of children with ABI, as well as improving child behaviour and behavioural SR. These domains continue improving three months after the intervention. The improvements in challenging behaviour at home did not transfer to the school environment.

Regulación Emocional En Pacientes Con Esquizofrenia: Un Estudio Piloto / Emotion Regulation In Schizophrenia Patients: A Pilot Study

RESUMEN Antecedentes: Se ha reportado que los pacientes con esquizofrenia presentan alteraciones en el procesamiento emocional, específicamente en la percepción de emociones. Sin embargo, poco se sabe sobre otros aspectos de este proceso, como la regulación emocional. Objetivo: Evaluar y comparar la regulación emocional y neurocognición en pacientes con esquizofrenia y sujetos control, así como identificar correlaciones entre regulación emocional, neurocognición y datos demográficos. Método: Se evaluaron nueve pacientes (GE) y nueve controles (GC). Se obtuvieron datos demográficos, para evaluar regulación emocional se utilizó la Prueba de Inteligencia Emocional Mayer-Salovey Caruso, sección Manejo de Emociones y se realizó una breve evaluación neurocognitiva. Resultados: El GE tuvo un desempeño significativamente inferior que el GC en la prueba de regulación emocional y en neurocognición (p<.05). No se encontraron correlaciones entre regulación emocional, neurocognición, datos demográficos y clínicos. Discusión y conclusión: Los pacientes con esquizofrenia presentan menor capacidad de regulación emocional y alteraciones en la neurocognición. Estos resultados son consistentes con lo descrito en la literatura.

ABSTRACT Background: It has been reported that schizophrenia patients display emotional processing impairments, specifically in the emotion perception domain. However, less is known about other domains of emotional processing, like emotion regulation. Objective: The aim of this study was to assess and compare emotion regulation abilities and neurocognition in schizophrenia patients and healthy controls, as well as to identify correlations between emotion regulation, neurocognition and demographic data. Methods: 9 patients (GE) and 9 controls (GC) were recruited. Demographic data was obtained. To assess emotion regulation, the Mayer-Salovey-Caruso Emotional Intelligence Test -Managing Emotions section- was administered. Finally, a brief neurocognitive assessment was conducted. Results: The GE showed significant poorer performance than the GC in the emotion regulation test as well as in the neurocognitive assessment (p < .05). No correlations were identified between emotion regulation, neurocognition, demographic and clinical data. Discussion and conclusion: Schizophrenia patients show emotion regulation impairment, as well as neurocognitive deficits. Our results are consistent with other studies.

Social Cognition in Schizophrenia, Unaffected Relatives and Ultra- High Risk for Psychosis: What Do We Currently Know?

INTRODUCTION: Schizophrenia patients show impairments in social cognition (SC), which is a set of cognitive processes that underlie social interactions. The research about SC in schizophrenia has identified four main domains: Theory of mind (ToM), social perception, attributional style and emotional processing. The present review aims to summarize the most recent and consistent findings about SC in patients with schizophrenia, unaffected relatives and ultra-high risk for psychosis individuals (UHR), as well as its association with clinical variables and functional outcome. METHODS: A systematic PsycINFO and Pubmed/Medline databases search was conducted. RESULTS: ToM impairments have been observed in schizophrenia patients, unaffected relatives and UHR. Emotional processing disturbance has been consistently reported in schizophrenia patients and UHR. ToM and emotional processing have been correlated with symptomatology and functional outcome. However, inconsistencies have been found across studies that assess ToM and emotional processing as predictors of psychosis. Social perception and attributional style are affected in schizophrenia, but the research in at- risk populations is scarce, and their relationship with symptoms or functional outcome is not clear. CONCLUSIONS: All domains of SC are impaired in schizophrenia. Non affected relatives and UHR also display deficits of SC. More research must be conducted to assess the reliability of SC domains as endophenotypes or predictors of conversion to psychosis in at-risk populations.

Parenting program versus telephone support for Mexican parents of children with acquired brain injury: A blind randomized controlled trial.

INTRODUCTION: Acquired brain injury (ABI) during childhood typically causes behavior problems in the child and high levels of stress in the family. The aims of this study are: (1) to investigate the effectiveness and feasibility of a parenting intervention in improving behavior and self-regulation in Mexican children with ABI compared to telephone support; (2) to investigate the effectiveness and feasibility of a parenting intervention in improving parenting skills, parent self-efficacy and decreasing parental stress in parents of children with ABI compared to telephone support. Our secondary aims are (1) to explore the impact that parent characteristics have on the intervention outcomes; (2) to investigate if changes are maintained 3 months after the intervention. METHODS: The research design is a blind randomized controlled trial (RCT). Eligible participants include children with a diagnosis of ABI, between 6 and 12 years of age, and their parents. Sixty-six children and their parents will be randomly allocated to either a parenting program group or telephone support group. The parenting program involves six face-to-face weekly group sessions of 2.5 h each. Participants in the control group receive an information sheet with behavioral strategies, and six weekly phone calls, in which strategies to improve academic skills are provided. Children and their parents are evaluated by blind assessors before the intervention, immediately after the intervention and 3-months post-intervention. DISCUSSION: This study will be the first to evaluate the efficacy and feasibility of a parenting program for Mexican parents of children with ABI. TRIAL IDENTIFIER: ACTRN12617000360314.

Funcionamiento cognoscitivo en la diabetes tipo 2: una revisión / Cognitive function in type 2 diabetes: a review

The aim of this work is to offer an updated review of the major cognitive difficulties that appear in Type 2 Diabetes Mellitus (T2DM), and its association with the patient compliance related factors proposed by the Panamerican Health Organization (PAHO), such as characteristics of patient, of the disease and of treatment. The review included electronic databases search (PubMed, Psy-cINFO and SpringerLink) from January 2000 to December 2011, predominating research from the United States, Canada, Holland, UK, Japan, Mexico and Germany. Most of the reviewed articles identified that factors which have shown to be associated with cognitive functioning in T2DM include: glycemic fluctuations, disease duration and pharmacological treatment. As for the changes that occur in the Central Nervous System (CNS), to date there is no consensus as to whether these are purely degenerative, vascular or a combination of both. Most affected cognitive abilities are: verbal memory, working memory, verbal fluency, attention, mental planning and psychomotor speed. The latter have been related with frontal, temporal and hyppo-campal structure functioning, which are also compromised on T2DM. In the cognitive aspect, it is reported that T2DM is a risk factor for developing mild cognitive impairment. Also, chronicity of this condition associated with hypertension, inadequate glycemic control, and macrovascular complications increases the odds for vascular dementia to occur. It is concluded that even though some risk factors of the cognitive deficiencies have been identified on T2DM, it is important to determine how they interact, and to what degree they affect overall cognitive performance, and specific functions in this population.

El objetivo de este trabajo es ofrecer una revisión actualizada de las principales dificultades cognoscitivas que se presentan en la Diabetes mellitus tipo 2 (DM2) y su asociación con factores relacionados con la adherencia terapéutica propuestos por la Organización Panamericana de la Salud para las enfermedades crónicas como: las características del paciente, de la enfermedad y del tratamiento. La revisión se basó en una búsqueda en las bases de datos PubMed, PsycINFO y SpringerLink. Se abarcó el periodo de enero de 2000 hasta diciembre de 2011, y predominaron las investigaciones procedentes de los Estados Unidos de América, Canadá, Holanda, Inglaterra, el Japón, México y Alemania. En la mayoría de los estudios consultados se identificó que las fluctuaciones glicémicas, la duración de la enfermedad y el tipo de tratamiento farmacológico son los factores que más se han asociado con el funcionamiento cognoscitivo en la DM2. En cuanto a los cambios que se producen en el Sistema Nervioso Central (SNC), hasta la fecha no hay consenso en cuanto a si estos son exclusivamente degenerativos, vasculares o si son una combinación entre ambos. En el aspecto cognoscitivo, se ha reportado que la DM2 es un factor de riesgo para desarrollar deterioro cognoscitivo leve y que la cronicidad de esta condición, asociada a hipertensión, a un control glicémico inadecuado y a complicaciones macrovasculares aumenta la posibilidad de desarrollar demencia vascular. Las habilidades cognoscitivas más referidas como afectadas son memoria verbal y de trabajo, fluidez verbal, atención, planificación mental y velocidad psicomotora, las cuales se han relacionado con el funcionamiento de estructuras frontales, temporales e hipocámpicas, que en la DM2 también se encuentran comprometidas. Se concluye que a pesar de que se han identificado algunos factores de riesgo de las deficiencias cognoscitivas en la DM2, es importante que se determine cómo interactúan y en qué grado influyen estos factores en el rendimiento cognoscitivo global y en funciones específicas en esta población.

Reduced P3a amplitudes in antipsychotic naïve first-episode psychosis patients and individuals at clinical high-risk for psychosis.

Event related potentials (ERP) associated with early sensory information processing have been proposed as possible vulnerability markers for psychosis. Compared to other ERPs reported in schizophrenia research, like Mismatch Negativity (MMN), little is known about P3a, an ERP related to novelty detection. The aim of this study was to analyze the MMN-P3a complex in 20 antipsychotic naïve first-episode psychosis patients (FEP), 23 antipsychotic naïve individuals at clinical high-risk for psychosis (CHR) and 24 healthy controls. The MMN-P3a amplitudes and latencies were obtained during a passive auditory mismatch frequency deviant ERP paradigm and analyzed in frontal and central scalp regions. There were no significant differences in MMN amplitude between groups. There was a significant group difference in P3a due to reduced amplitude (F[2,64] = 3.7, p = 0.03) in both CHR and FEP groups (Mean difference (MD) = 0.39, p = 0.04 and MD = 0.49, p = 0.02, respectively) compared to the control group and this effect was most prominent on the right side (Group × laterality effect: MD = 0.57, p < 0.01 and MD = 0.58, p < 0.01, respectively). No significant differences were observed for MMN or P3a latencies between groups. Although a P3a decrement in chronic schizophrenia and FEP has been previously reported, our results suggest that this novelty detection impairment is present even in pre-psychosis stages in antipsychotic naïve subjects. This study supports the evidence that P3a could represent a neurophysiological vulnerability marker for the development of psychosis.

Cognitive and executive functions in ADHD.

INTRODUCTION: Some studies have reported that attention-deficit/hyperactivity disorder (ADHD) children show alterations in different cognitive functions. Recently, a deficiency in the executive functions (EF) is proposed as the cause underlying all of these symptoms. However discrepancies exist about these findings. OBJECTIVE: Assessment of cognitive and executive functions of subjects with both ADHD hyperactive-impulsive type and combined type, in order to reveal their neuropsychological characteristics and analyze if those functions are related to hyperactive-impulsive behavior. METHOD: Neuropsychological Battery, Stroop test, Wisconsin Card Sorting test and London Tower test were applied to 51 children between 7 and 12 years old (25 controls and 26 ADHD). RESULTS: ADHD children showed worst performance in sustained attention, rapid serial naming of figures and colors, comprehension of written instructions, word dictation, number comparison, arithmetical problems, visual working memory, long term memory and the scores of WCST. Variables related to hyperactivity-impulsivity were: errors and decreased velocity in rapid serial naming of colors and figures, comprehension of written instructions, arithmetical problems and the scores of total errors, perseverating errors and perseverating responses of WCST. CONCLUSION: ADHD children show a great variety of cognitive deficiencies and had deficit only in some domains of executive functions. These deficiencies could explain to some extent the hyperactive and impulsive behavior.

[Mismatch Negativity (MMN) and schizophrenia: a revision]. / Mismatch Negativity (MMN) y esquizofrenia: una revisión.

The Mismatch Negativity (MMN) is an auditory Event- Related Potential which is generated as an automatic cerebral response to any change in the auditory stimulation that exceeds a limit corresponding to the discrimination threshold. It has been widely and consistently reported that patients with recent and chronic schizophrenia display smaller MMN amplitudes, suggesting that this component may be related with alteration in sensory memory and stimuli integration capacities, which seem to increase with the disease progression. Recently, new research areas have emerged, and studies of MMN of relatives of patients with schizophrenia have been conducted in order to assess the MMN efficacy as an endophenotype. Likewise, there have been MMN studies in schizophrenia prodromes or clinical high risk subjects, aiming to know if there are cerebral processing disturbances prior to the onset of the disease. The results of these studies have been promising, suggesting the presence of auditory stimuli processing disturbances in this population. These disturbances are subtle and seem to increase as the disease appears. The MMN component may be a very effective electrophysiological tool that provides information about the automatic auditory processing in schizophrenia related to its chronicity. It may also be a relative reliable index of genetic vulnerability and clinical risk for developing schizophrenia. Nevertheless, it is necessary to continue performing studies to get comparable and replicable studies in the future that could confirm the information about MMN utility.