ABSTRACT
Our study aimed to understand the impact of cocaine dependence on high-risk decision-making abilities in individuals with the human immunodeficiency virus (HIV) and individuals with cocaine dependence. We recruited 99 participants (27 HIV/Cocaine, 20 HIV Only, 26 Cocaine Only, and 26 Healthy Controls). The Iowa Gambling Task (IGT) was applied to assess decision-making abilities. Independent and interactive effects of HIV status and cocaine dependence were examined using 2 × 2 factorial ANCOVA with premorbid IQ (WRAT-4: WR) as the covariate. We found cocaine dependence had a significant adverse effect on overall IGT performance (p = 0.015). We also found individuals who were HIV-positive tended to have less total money at the end of the game than individuals who were HIV-negative (p = 0.032), suggesting individuals living with HIV had less focus on long-term gains and more focus on short-term gains. Our findings highlight the significant impact of cocaine dependence on decision-making abilities and the difficulty individuals with HIV have in adequately weighing the cost and benefits of their decisions and making appropriate changes for the future.
Subject(s)
Cocaine-Related Disorders/psychology , Cocaine/adverse effects , Decision Making , HIV Infections/psychology , Adult , CD4 Lymphocyte Count , Case-Control Studies , Cocaine-Related Disorders/complications , Cocaine-Related Disorders/physiopathology , Cocaine-Related Disorders/virology , Female , Games, Experimental , HIV Infections/complications , HIV Infections/physiopathology , HIV Infections/virology , Humans , Male , Middle Aged , Neuropsychological Tests , Viral LoadABSTRACT
Approximately 470,000 children (birth to 18 years old) are affected by Epilepsy (CDC in Epilepsy. https://www.cdc.gov/epilepsy/index.html, 2018). Since the initial findings in the 1970s, Sensorimotor Rhythm (SMR) has been continuously utilized for the treatment of seizures. Studies have consistently demonstrated that SMR reduces the frequency and severity of seizure activity. Although a mix of pediatric cases, adolescents and adults have been sampled in previous studies, no age effects have been reported. There continues to be a lack of research in the area of neurofeedback for the treatment of epilepsy in the pediatric population. To date, no randomized control trial specific to pediatric epilepsy has been published. The existing research regarding the use of neurofeedback in the treatment of epilepsy provides strong evidence that neurofeedback training might be an effective treatment for pediatric epilepsy. However, existing studies are not specific to the pediatric population. Moreover, there is a lack of rigor in the studies in which the effects of neurofeedback in children and adolescents with epilepsy are documented. Therefore, based on the current literature, there is not enough evidence to state that neurofeedback is efficacious for the treatment of pediatric epilepsy. However, the APBB criteria for evidence-based practices indicate that neurofeedback for pediatric epilepsy is Possibly Efficacious (Level 2). Future research in which a randomized controlled trial approach is utilized will greatly help to increase support for the use of neurofeedback as an efficacious treatment for epilepsy.
Subject(s)
Epilepsy/therapy , Neurofeedback , Outcome Assessment, Health Care , Adolescent , Child , HumansABSTRACT
Short duration of sleep and poor sleep quality have been linked to poor attention and impulse control in children. We aimed to determine the longitudinal predictive value of sleep quantity and quality during early childhood on objective and caregiver-report measures of attention, impulse control, and executive function in children at age 8 years. We used data from the Health Outcomes and Measures of the Environment (HOME) Study, a pregnancy and birth cohort. Caregivers reported on their child's sleep at ages 2, 2.5, 3, 4, and 5 years. Analysis included 410 participants. We used longitudinal growth curve models of early childhood sleep patterns to predict neurobehavioral functioning at age 8 years. Sleep problems did not predict any of our outcome measures at age 8 years. Sleep duration trended shorter as children matured, so predictive models examined both intercept and slope. Children with the least decline in sleep duration across early childhood had fewer impulsive errors at age 8 years on a continuous performance test (unadjusted p = .013; adjusted p = .013). Children with shorter duration of sleep across early childhood had worse caregiver-reported behavioral regulation at age 8 years (unadjusted p = .002; adjusted p = .043). Neither sleep duration slope nor intercept predicted inattention or metacognitive skills at age 8 years (p > .05). Total sleep time across early childhood predicts behavior regulation difficulties in school-aged children. Inadequate sleep during early childhood may be a marker for, or contribute to, poor development of a child's self-regulatory skills.
ABSTRACT
INTRODUCTION: Our study aimed to understand the independent and combined effects of cocaine dependence and HIV status across aspects of verbal memory. METHOD: Our sample consisted of a total of 102 individuals: 28 individuals living with HIV and cocaine dependence (HIV+/CD), 28 individuals who are HIV-negative with cocaine dependence (HIV-/CD), 20 individuals living with HIV without cocaine dependence (HIV+/ND), and 26 individuals who are HIV-negative without cocaine dependence (HIV-/ND). We utilized the Hopkins Verbal Learning Test-Revised Version (HVLT-R) to assess components of verbal memory, including encoding, recall, and recognition. A 2 (HIV: Yes/No) × 2 (Cocaine: Yes/No) MANCOVA on Total and Delayed Recall while controlling for premorbid intelligence was conducted. We used a Kruskal-Wallis H test to examine retrieval and recognition. RESULTS: The combination of HIV and cocaine dependence amplified deficits on Total Recall. We found comparably poor performance across Delayed Recall between all three clinical groups. People living with HIV without cocaine dependence demonstrated intact recognition, whereas those with cocaine dependence had poor recognition. CONCLUSIONS: HIV and cocaine both impacted verbal memory. However, there are potential subtle differences in the role cocaine versus HIV has on the memory process. People living with HIV without cocaine dependence recognized significantly more words than they could freely recall. In contrast, cocaine dependence impacted recognition in HIV and non-HIV groups. These performance patterns suggest HIV may be associated with retrieval deficits, whereas cocaine dependence may be associated with encoding deficits. Further research assessing these specific components of the memory process will help clarify these potential differences.