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OBJECTIVE: Cognitive Disengagement Syndrome (CDS; previously called Sluggish Cognitive Tempo) refers to a constellation of cognitive and motor behaviors characterized by a predisposition toward mind wandering (cognitive subdomain) and slowed motor behavior (hypoactive). While there are a number of studies linking CDS traits to greater global impairment in children with attention-deficit/hyperactivity disorder (ADHD) and autistic children, there are few studies examining the prevalence and impact of CDS traits in autistic children with co-occurring ADHD (Autistic+ADHD). The current study explored CDS traits in autistic children with and without co-occurring ADHD, children with ADHD, and neurotypical children. METHODS: Participants were 196 children between 3- and 7-years-of-age comprising four groups: Neurotypical (N = 44), ADHD (N = 51), Autistic (N = 55), and Autistic+ADHD (N = 46). CDS traits, social and communication skills, repetitive behaviors, and sensory processing were all assessed via parent report. RESULTS: Children diagnosed with ADHD, autistic children, and Autistic+ADHD children exhibited similar levels of overall CDS traits. However, when explored separately, Autistic+ADHD children had higher cognitive CDS trait scores compared to children with ADHD alone. Both overall CDS traits and the cognitive subdomain were associated with greater social difficulties, particularly social withdrawal, higher levels of repetitive behaviors, and more sensory sensitivities, regardless of diagnosis. CONCLUSIONS: Findings suggest that CDS traits may be an additional factor directly impact functional outcomes in both autistic and ADHD children. As such, clinicians should be assessing CDS traits in addition to other clinical domains associated with ADHD and autism when developing intervention plans for young neurodiverse children.
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OBJECTIVE: To assess the relationships of prenatal and childhood smoke exposure with specific neurodevelopmental and behavioral problems during early childhood. STUDY DESIGN: A subsample (n = 386) of mother-child dyads from the Newborn Epigenetic Study (NEST) prebirth cohort participated in the study. Cotinine concentrations were used to objectively measure prenatal and childhood smoke exposure when youth were aged 3-13 years. Multivariable regression models were used to estimate associations of prenatal and childhood cotinine concentrations with performance on the National Institutes of Health (NIH) Toolbox and attention-deficit/hyperactivity disorder and behavioral symptoms, measured using the Behavior Assessment System for Children, 2nd edition (BASC-2). RESULTS: After adjusting for confounders, childhood cotinine concentrations were associated with poorer cognitive performance on tasks measuring cognitive flexibility (B = -1.29; P = .03), episodic memory (B = -0.97; P = .02), receptive language development (B = -0.58; P = .01), and inhibitory control and attention (B = -1.59; P = .006). Although childhood cotinine concentration was associated with higher levels of attention problems (B = 0.83; P = .004) on the BASC-2, after adjustment for confounders, the association is nonsignificant. Although associations for maternal cotinine concentrations were null, an interaction was detected between prenatal and childhood cotinine concentrations on the NIH Toolbox Picture Vocabulary Task (P = .02). CONCLUSIONS: Our findings suggest that childhood tobacco smoke exposure may lead to poorer attention regulation and language acquisition, complex visual processing ability, and attention problems.
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Transtorno do Deficit de Atenção com Hiperatividade , Efeitos Tardios da Exposição Pré-Natal , Poluição por Fumaça de Tabaco , Recém-Nascido , Feminino , Gravidez , Adolescente , Humanos , Pré-Escolar , Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Cotinina , Poluição por Fumaça de Tabaco/efeitos adversos , CogniçãoRESUMO
BACKGROUND/OBJECTIVES: Sleep measures, such as duration and onset timing, are associated with adiposity outcomes among children. Recent research among adults has considered variability in sleep and wake onset times, with the Sleep Regularity Index (SRI) as a comprehensive metric to measure shifts in sleep and wake onset times between days. However, little research has examined regularity and adiposity outcomes among children. This study examined the associations of three sleep measures (i.e., sleep duration, sleep onset time, and SRI) with three measures of adiposity (i.e., body mass index [BMI], waist circumference, and waist-to-height ratio [WHtR]) in a pediatric sample. SUBJECTS/METHODS: Children (ages 4-13 years) who were part of the U.S. Newborn Epigenetic STudy (NEST) participated. Children (N = 144) wore an ActiGraph for 1 week. Sleep measures were estimated from actigraphy data. Weight, height, and waist circumference were measured by trained researchers. BMI and WHtR was calculated with the objectively measured waist and height values. Multiple linear regression models examined associations between child sleep and adiposity outcomes, controlling for race/ethnicity, child sex, age, mothers' BMI and sleep duration. RESULTS: When considering sleep onset timing and duration, along with demographic covariates, sleep onset timing was not significantly associated with any of the three adiposity measures, but a longer duration was significantly associated with a lower BMI Z-score (ß = -0.29, p < 0.001), waist circumference (ß = -0.31, p < 0.001), and WHtR (ß = -0.38, p < 0.001). When considering SRI and duration, duration remained significantly associated with the adiposity measures. The SRI and adiposity associations were in the expected direction, but were non-significant, except the SRI and WHtR association (ß = -0.16, p = 0.077) was marginally non-significant. CONCLUSIONS: Sleep duration was consistently associated with adiposity measures in children 4-13 years of age. Pediatric sleep interventions should focus first on elongating nighttime sleep duration, and examine if this improves child adiposity outcomes.
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Adiposidade , Sono , Adolescente , Adulto , Índice de Massa Corporal , Criança , Pré-Escolar , Humanos , Recém-Nascido , Obesidade , Circunferência da CinturaRESUMO
As children age, they can learn increasingly complex features of environmental structure-a key prerequisite for adaptive decision-making. Yet when we tested children (N = 304, 4-13 years old) in the Children's Gambling Task, an age-appropriate variant of the Iowa Gambling Task, we found that age was negatively associated with performance. However, this paradoxical effect of age was found only in children who exhibited a maladaptive deplete-replenish bias, a tendency to shift choices after positive outcomes and repeat choices after negative outcomes. We found that this bias results from sensitivity to incidental nonrandom structure in the canonical, deterministic forms of these tasks-and that it would actually lead to optimal outcomes if the tasks were not deterministic. Our results illustrate that changes in decision-making across early childhood reflect, in part, increasing sensitivity to environmental structure.
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Tomada de Decisões , Jogo de Azar , Adolescente , Criança , Pré-Escolar , Humanos , Aprendizagem , Testes NeuropsicológicosRESUMO
INTRODUCTION: Many children suffer from secondhand smoke exposure (SHSe), which leads to a variety of negative health consequences. However, there is no consensus on how clinicians can best query parents for possible SHSe among children. We employed a data-driven approach to create an efficient screening tool for clinicians to quickly and correctly identify children at risk for SHSe. METHODS: Survey data from mothers and biospecimens from children were ascertained from the Neurodevelopment and Improving Children's Health following Environmental Tobacco Smoke Exposure (NICHES) study. Included were mothers and their children whose saliva were assayed for cotinine (n = 351 pairs, mean child age = 5.6 years). Elastic net regression predicting SHSe, as indicated from cotinine concentration, was conducted on available smoking-related questions and cross-validated with 2015-2016 National Health and Nutrition Examination Survey (NHANES) data to select the most predictive items of SHSe among children (n = 1670, mean child age = 8.4 years). RESULTS: Answering positively to at least one of the two final items ("During the past 30 days, did you smoke cigarettes at all?" and "Has anyone, including yourself, smoked tobacco in your home in the past 7 days?") showed area under the curve = .82, and good specificity (.88) and sensitivity (.74). These results were validated with similar items in the nationally representative NHANES sample, area under the curve = .82, specificity = .78, and sensitivity = .77. CONCLUSIONS: Our data-driven approach identified and validated two items that may be useful as a screening tool for a speedy and accurate assessment of SHSe among children. IMPLICATIONS: The current study used a rigorous data-driven approach to identify questions that could reliably predict SHSe among children. Using saliva cotinine concentration levels as a gold standard for determining SHSe, our analysis employing elastic net regression identified two questions that served as good classifier for distinguishing children who might be at risk for SHSe. The two items that we validated in the current study can be readily used by clinicians, such as pediatricians, as part of screening procedures to quickly identify whether children might be at risk for SHSe.
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Poluição por Fumaça de Tabaco , Criança , Pré-Escolar , Cotinina/análise , Humanos , Inquéritos Nutricionais , Pais , Saliva/química , Poluição por Fumaça de Tabaco/efeitos adversosRESUMO
The authors sought to determine whether providing a rapid-access ambulatory psychiatry encounter correlated with emergency department utilization during a 6-month follow-up period. Electronic medical records of patients who accessed ambulatory psychiatric care through an urgent care psychiatry clinic that offers treatment exclusively on a walk-in basis over a 1-year period (N = 157) were reviewed retrospectively to track emergency department encounters with and without a psychiatric chief complaint in the 6 months before and after the initial psychiatry evaluation. Among patients who had not previously received ambulatory psychiatric care (N = 88), emergency department utilization decreased from 0.68 visits per patient to 0.36, and this difference was statistically significant (p = 0.0147). No statistically significant differences were found between the average number of emergency department encounters in the 6 months before and after the rapid-access ambulatory psychiatry encounter, regardless of chief complaint, when all patients were included in the analysis. Providing a rapid-access ambulatory psychiatry encounter may reduce subsequent emergency department utilization among patients who have not previously received ambulatory psychiatric care.
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Serviço Hospitalar de Emergência , Psiquiatria , Assistência Ambulatorial , Registros Eletrônicos de Saúde , Humanos , Estudos RetrospectivosRESUMO
INTRODUCTION: Both prenatal smoke exposure and depression have been linked to lower birth weight, a risk factor for morbidity and mortality. Few studies have looked at the interaction between these risk factors and none have used a biomarker to objectively measure prenatal smoke exposure. The current study sought to examine independent and interactive effects of cotinine and depression on birth weight. The effect of race was also explored. METHOD: Data were drawn from a prospective study of pregnant women (N = 568) in the southeastern United States. Maternal demographic, health information, depressive symptoms, and birth data were collected via self-report and medical record abstraction. Prenatal blood samples were assayed for cotinine. RESULTS: Controlling for covariates, multiple regression analyses indicated that both cotinine and depressive symptoms independently predicted lower birth weight and a significant interaction was also observed. Upon probing the interaction, a negative association between cotinine levels and birth weight was found in the context of higher depression but not lower depression scores. Similarly, logistic regression analyses revealed a significant interaction between cotinine and depression, such that cotinine predicted having a baby less than 2500 g among women who fell above the indicated cutoff score. African American women had the highest levels of cotinine and lowest weight babies; however, race was not a significant moderator. CONCLUSIONS: Results suggest prenatal smoke exposure has a greater negative effect on birth weight for women endorsing co-occurring depressive symptoms. Findings can inform targeted interventions and assist medical providers with identifying women at increased risk for poor perinatal outcomes. IMPLICATIONS: Despite the common occurrence of smoking during pregnancy and prenatal depression, the interaction between these risk factors on birth weight has rarely been examined. Further, the extant results have been mixed, likely due in part to difficulties in measurement. The current study was the first to use prenatal cotinine to assess bias-free, continuous levels of prenatal smoke exposure. Results indicate that prenatal cotinine was a significant predictor of birth weight only in the context of maternal depressive symptoms. These findings have important implications for mitigating negative perinatal outcomes for pregnant women and their children.
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Peso ao Nascer/efeitos dos fármacos , Depressão/complicações , Recém-Nascido de Baixo Peso , Exposição Materna/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/etiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Adolescente , Adulto , Biomarcadores/sangue , Cotinina/sangue , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/patologia , Estudos Prospectivos , Fatores de Risco , Adulto JovemRESUMO
Preclinical studies demonstrate that environmentally-induced alterations in inflammatory cytokines generated by the maternal and fetal immune system can significantly impact fetal brain development. Yet, the relationship between maternal cytokines during gestation and later cognitive ability and executive function remains understudied. Children (nâ¯=â¯246) were born of mothers enrolled in the Newborn Epigenetic Study - a prospective pre-birth cohort in the Southeastern US. We characterized seven cytokines [IL-1ß, IL-4,IL-6, IL-12p70, IL-17A, tumor necrosis factor-α (TNFα), and interferon-γ (IFNγ)] and one chemokine (IL-8) from maternal plasma collected during pregnancy. We assessed children's cognitive abilities and executive functioning at a mean age of 4.5 (SDâ¯=â¯1.1) years. Children's DAS-II and NIH toolbox scores were regressed on cytokines and the chemokine, controlling for maternal age, race, education, body mass index, IQ, parity, smoking status, delivery type, gestational weeks, and child birth weight and sex. Higher IL-12p70 (ßIL-12p70 = 4.26, pâ¯=â¯0.023) and IL-17A (ßIL-17A = 3.70, pâ¯=â¯0.042) levels were related to higher DAS-II GCA score, whereas higher IL-1ß (ßIL-1B = -6.07, pâ¯=â¯0.003) was related to lower GCA score. Higher IL-12p70 was related to higher performance on NIH toolbox measures of executive functions related to inhibitory control and attention (ßIL-12p70 = 5.20, pâ¯=â¯0.046) and cognitive flexibility (ßIL-12p70 = 5.10, pâ¯=â¯0.047). Results suggest that dysregulation in gestational immune activity are associated with child cognitive ability and executive functioning.
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Cognição/fisiologia , Função Executiva/fisiologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Adulto , Peso ao Nascer , Índice de Massa Corporal , Quimiocinas/análise , Quimiocinas/sangue , Criança , Pré-Escolar , Cognição/efeitos dos fármacos , Estudos de Coortes , Citocinas/análise , Citocinas/sangue , Citocinas/metabolismo , Função Executiva/efeitos dos fármacos , Feminino , Desenvolvimento Fetal/imunologia , Desenvolvimento Fetal/fisiologia , Humanos , Recém-Nascido , Masculino , Mães , Gravidez , Estudos ProspectivosRESUMO
This study examined whether physiological and behavioral indicators of emotion dysregulation assessed over the course of Multisystemic Therapy (MST) were related to treatment response. Participants were 180 ethnically diverse adolescents (n=120 males), ranging in age from 12 to 17 years. Treatment response was assessed through therapist report and official arrest records. Changes in cortisol reactivity and changes in scores on a behavioral dysregulation subscale of the Child Behavior Checklist were used as indicators of emotion dysregulation. Hierarchical linear modeling analyses examined whether a less favorable treatment response was associated with cortisol reactivity measures (a) collected early in treatment and (b) over the course of treatment, as well as with behavioral reports of emotion dysregulation reported (c) early in treatment, and (d) over the course of treatment. Sex was explored as a moderator of these associations. Results indicated that both cortisol and behavioral indices of emotion dysregulation early in treatment and over the course of therapy predicted treatment responsiveness. This relationship was moderated by sex: girls were more likely to evidence a pattern of increasing emotion regulation prior to successful therapy response. The results lend further support to the notion of incorporating emotion regulation techniques into treatment protocols for delinquent behavior.
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BACKGROUND: Psychopathic traits are associated with increases in antisocial behaviors such as aggression and are characterized by reduced empathy for others' distress. This suggests that psychopathic traits may also impair empathic pain sensitivity. However, whether psychopathic traits affect responses to the pain of others versus the self has not been previously assessed. METHOD: We used whole-brain functional magnetic resonance imaging to measure neural activation in 14 adolescents with oppositional defiant disorder or conduct disorder and psychopathic traits, as well as 21 healthy controls matched on age, gender, and intelligence. Activation in structures associated with empathic pain perception was assessed as adolescents viewed photographs of pain-inducing injuries. Adolescents imagined either that the body in each photograph was their own or that it belonged to another person. Behavioral and neuroimaging data were analyzed using random-effects analysis of variance. RESULTS: Youths with psychopathic traits showed reduced activity within regions associated with empathic pain as the depicted pain increased. These regions included rostral anterior cingulate cortex, ventral striatum (putamen), and amygdala. Reductions in amygdala activity particularly occurred when the injury was perceived as occurring to another. Empathic pain responses within both amygdala and rostral anterior cingulate cortex were negatively correlated with the severity of psychopathic traits as indexed by PCL:YV scores. CONCLUSIONS: Youths with psychopathic traits show less responsiveness in regions implicated in the affective response to another's pain as the perceived intensity of this pain increases. Moreover, this reduced responsiveness appears to predict symptom severity.
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Tonsila do Cerebelo/fisiopatologia , Nível de Alerta/fisiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Empatia/fisiologia , Giro do Cíngulo/fisiopatologia , Dor/fisiopatologia , Adolescente , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Gânglios da Base/fisiologia , Gânglios da Base/fisiopatologia , Criança , Feminino , Humanos , Masculino , Neuralgia/etiologia , Neuralgia/fisiopatologia , Testes Neuropsicológicos , Dor/psicologia , Traumatismos dos Nervos Periféricos/complicações , Traumatismos dos Nervos Periféricos/fisiopatologia , Escalas de Graduação PsiquiátricaRESUMO
Background: There has been limited examination of the association between parenting stress and child weight-related behaviors. We aimed to determine whether parenting stress is associated with child weight-related behaviors, including physical activity, screen time, diet, sedentary time, and eating in the absence of hunger (EAH). Secondarily, we assessed association between parenting stress and child weight status. Methods: Mother-child dyads (N = 291) enrolled in the Newborn Epigenetic STudy (NEST), a longitudinal cohort study, completed surveys to describe parenting stress, and child diet. Children participated in the EAH task and wore accelerometers to assess sedentary time and physical activity. Child weight status was assessed using measured height and weight. Outcomes and exposures were examined using generalized linear models and restricted cubic splines as appropriate based on linear lack-of-fit test. Results: Child sedentary time and vegetable consumption were inversely associated with parenting stress (Total Stress B = -0.78; 95% confidence interval [CI]: -1.35 to -0.20; p = 0.017; and Total Stress adjusted odds ratio [aOR] = 0.98; 95% CI: 0.99 to 1.00; p = 0.022, respectively). Child screen time was directly associated with parenting stress (Total Stress = aOR 1.01; 95% CI: 1.00-1.02; p = 0.032). Fast-food intake was nonlinearly associated with parenting stress. There was no evidence of association between parenting stress and child EAH, physical activity, or weight status. Associations between parenting stress and child weight-related behaviors were not moderated by race or family structure. Conclusions: Parenting stress was associated with important child weight-related behaviors but not weight status. Management of parenting stress may represent a reasonable adjunct to family-based behavioral interventions.
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Poder Familiar , Obesidade Infantil , Criança , Comportamento Infantil , Comportamento Alimentar , Humanos , Recém-Nascido , Estudos Longitudinais , Obesidade Infantil/epidemiologia , Comportamento Sedentário , Inquéritos e QuestionáriosRESUMO
There has been a long controversy concerning whether the amygdala's response to emotional stimuli is automatic or dependent on attentional load. Using magnoencephalography and an advanced beamformer source localization technique, we found that amygdala automaticity was a function of time: while early amygdala responding to emotional stimuli (40-140 ms) was unaffected by attentional load, later amygdala response (280-410 ms), subsequent to frontoparietal cortex activity, was modulated by attentional load.
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Tonsila do Cerebelo/fisiologia , Atenção/fisiologia , Encéfalo/fisiologia , Emoções/fisiologia , Adulto , Feminino , Humanos , Magnetoencefalografia , Masculino , Vias Neurais/fisiologia , Testes Neuropsicológicos , Tempo de Reação , Processamento de Sinais Assistido por Computador , Fatores de Tempo , Percepção Visual/fisiologia , Adulto JovemRESUMO
BACKGROUND: Psychopathy is characterized by profound affective deficits, including shallow affect and reduced empathy. Recent research suggests that these deficits may apply particularly to negative emotions, or to certain negative emotions such as fear. Despite increased focus on the cognitive and neural underpinnings of psychopathy, little is known about how psychopathy is associated with emotional deficits across a range of emotions. In addition, the relationship between psychopathy and the subjective experience of emotion has not yet been assessed. METHODS: Eighteen 10-17-year-olds with psychopathic traits and 24 comparison children and adolescents reported on their subjective experiences of emotion during five recent emotionally evocative life events, following a paradigm developed by Scherer and colleagues (Scherer & Wallbott, 1994). Group comparisons were then performed to assess variations in subjective experiences across emotions. RESULTS: As predicted, psychopathy was associated with reductions in the subjective experience of fear relative to other emotions. Children and adolescents with psychopathic traits reported fewer symptoms associated with sympathetic nervous system arousal during fear-evoking experiences. CONCLUSIONS: Rather than being related to uniformly impoverished emotional experience, psychopathic traits appear to be associated with greater deficits in subjective experiences of fear. This pattern of responding supports and extends previous observations that psychopathy engenders deficits in fear learning, physiological responses to threats, and the recognition of fear in others.
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Transtorno da Personalidade Antissocial/fisiopatologia , Emoções Manifestas/fisiologia , Medo/fisiologia , Adolescente , Transtorno da Personalidade Antissocial/diagnóstico , Nível de Alerta/fisiologia , Criança , Emoções/fisiologia , Empatia/fisiologia , Medo/psicologia , Feminino , Humanos , Entrevista Psicológica , Masculino , Rememoração Mental/fisiologia , Autorrelato , Inquéritos e QuestionáriosRESUMO
We used functional magnetic resonance imaging (fMRI) to investigate dysfunction in the amygdala and orbitofrontal cortex in adolescents with disruptive behavior disorders and psychopathic traits during a moral judgment task. Fourteen adolescents with psychopathic traits and 14 healthy controls were assessed using fMRI while they categorized illegal and legal behaviors in a moral judgment implicit association task. fMRI data were then analyzed using random-effects analysis of variance and functional connectivity. Youths with psychopathic traits showed reduced amygdala activity when making judgments about legal actions and reduced functional connectivity between the amygdala and orbitofrontal cortex during task performance. These results suggest that psychopathic traits are associated with amygdala and orbitofrontal cortex dysfunction. This dysfunction may relate to previous findings of disrupted moral judgment in this population.
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Tonsila do Cerebelo/irrigação sanguínea , Transtorno da Personalidade Antissocial , Transtornos de Deficit da Atenção e do Comportamento Disruptivo , Julgamento , Princípios Morais , Córtex Pré-Frontal/irrigação sanguínea , Adolescente , Análise de Variância , Transtorno da Personalidade Antissocial/patologia , Transtorno da Personalidade Antissocial/fisiopatologia , Transtorno da Personalidade Antissocial/psicologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/patologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia , Mapeamento Encefálico , Criança , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Vias Neurais/irrigação sanguínea , Oxigênio/sangue , Inventário de Personalidade , Escalas de Graduação PsiquiátricaRESUMO
Offspring of mothers with posttraumatic stress disorder (PTSD) are at higher risk for a range of negative developmental outcomes, including differing forms of psychopathology. This study suggests that the multigenerational impact of trauma may be partially attributed to increased levels of stress experienced by these offspring during childhood and adolescence. Diagnostic interviews were conducted with over 800 women and their offspring. Experiences of stress were assessed using multiple measures. Results indicate that offspring of mothers with PTSD or high levels of PTSD symptoms experienced higher levels of lifetime exposure to major stress, η(2) = .02, current chronic stress due to family relations, η(2) = .01, and a higher level of objectively rated recent episodic life stress, η(2) = .01, compared to offspring of women without PTSD. These findings remained significant after controlling for maternal history of depression.
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Filho de Pais com Deficiência/psicologia , Mães/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/epidemiologia , Adolescente , Feminino , Humanos , Entrevista Psicológica , Masculino , Relações Mãe-Filho , Queensland/epidemiologiaRESUMO
The ability to maximize rewards and minimize the costs of obtaining them is vital to making advantageous explore/exploit decisions. Exploratory decisions are theorized to be greater among individuals with attention-deficit/hyperactivity disorder (ADHD), potentially due to deficient catecholamine transmission. Here, we examined the effects of ADHD status and methylphenidate, a common ADHD medication, on explore/exploit decisions using a 6-armed bandit task. We hypothesized that ADHD participants would make more exploratory decisions than controls, and that MPH would reduce group differences. On separate study days, adults with (n = 26) and without (n = 23) ADHD completed the bandit task at baseline, and after methylphenidate or placebo in counter-balanced order. Explore/exploit decisions were modeled using reinforcement learning algorithms. ADHD participants made more exploratory decisions (i.e., chose options without the highest expected reward value) and earned fewer points than controls in all three study days, and methylphenidate did not affect these outcomes. Baseline exploratory choices were positively associated with hyperactive ADHD symptoms across all participants. These results support several theoretical models of increased exploratory choices in ADHD and suggest the unexplained variance in ADHD decisions may be due to less value tracking. The inability to suppress actions with little to no reward value may be a key feature of hyperactive ADHD symptoms.
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Transtorno do Deficit de Atenção com Hiperatividade , Estimulantes do Sistema Nervoso Central , Metilfenidato , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Humanos , Metilfenidato/uso terapêutico , Reforço Psicológico , RecompensaRESUMO
Smoke-free home rules restrict smoking in the home, but biomarkers of secondhand smoke exposure are needed to help understand the association between smoke-free homes and child secondhand smoke exposure. Participants (n = 346) were majority Black/African American mother-child dyads from a longitudinal study in North Carolina. Mothers completed questionnaires on household smoking behaviors and rules, and child saliva samples were assayed for secondhand smoke exposure. Regression models used smoke-free home rules to predict child risk for secondhand smoke exposure. Children in households with smoke-free home rules had less salivary cotinine and risk for secondhand smoke exposure. After controlling for smokers in the household, home smoking rules were not a significant predictor of secondhand smoke exposure. Compared to children in households with no smokers, children in households with at least one smoker but a non-smoking mother (OR 5.35, 95% CI: 2.22, 13.17) and households with at least one smoker including a smoking mother (OR 13.73, 95% CI: 6.06, 33.28) had greater risk for secondhand smoke exposure. Results suggest smoke-free home rules are not sufficient to fully protect children from secondhand smoke exposure, especially in homes with smokers. Future research should focus on how household members who smoke can facilitate the prevention of child secondhand smoke exposure.
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Poluição por Fumaça de Tabaco , Criança , Feminino , Humanos , Estudos Longitudinais , Relações Mãe-Filho , North Carolina , Saliva/química , Poluição por Fumaça de Tabaco/análiseRESUMO
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) symptoms have been linked with eating behaviors and obesity adolescence and young adulthood. Yet, little is known about whether these associations occur during early childhood and few studies have examined these associations prospectively. OBJECTIVES: To assess magnitude and direction of associations between childhood ADHD symptoms and eating behaviors. METHODS: Participants were from the Newborn Epigenetics Study (N = 470, M age = 4 years). Multivariable linear regression models were used to examine cross-sectional associations between ADHD symptoms and eating behaviors. Latent Change Score (LCS) modeling was performed to examine prospective association among a subset of children with available follow-up data. (N = 100, M age = 7 years). RESULTS: The cross-sectional results showed that attention problem (AP) and hyperactivity (HY) were positively associated with food responsiveness, emotional overeating, desire to drink, and slowness in eating. AP, but not HY, was inversely associated with enjoyment of food. Results of the LCS models revealed AP and HY were both positively associated with prospective changes in emotional overeating and satiety responsiveness. AP was further positively associated with prospective changes in food responsiveness. The reverse relationship predicting changes in ADHD symptoms from earlier assessments of eating behaviors was not significant. CONCLUSION: Results suggest a link between ADHD symptoms and obesity-related eating behaviors in early childhood, highlighting the need to address self-regulation and healthy eating behaviors in the prevention of childhood obesity.
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Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Comportamento Alimentar/psicologia , Obesidade Infantil/etiologia , Adolescente , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Hiperfagia/psicologia , Masculino , Obesidade Infantil/prevenção & controle , Estudos Prospectivos , Adulto JovemRESUMO
BACKGROUND: A reduced willingness to perform effort based on the magnitude and probability of potential rewards has been associated with diminished dopamine function and may be relevant to attention-deficit/hyperactivity disorder (ADHD). Here, we investigated the influence of ADHD status and methylphenidate on effort-based decisions. We hypothesized that ADHD participants would make fewer high-effort selections than non-ADHD subjects, and that methylphenidate would increase the number of high-effort selections. Furthermore, we hypothesized there would be associations among ADHD severity and methylphenidate-related changes in effort-based and attentional performance across all participants. METHODS AND PARTICIPANTS: ADHD (nâ¯=â¯23) and non-ADHD (nâ¯=â¯23) adults completed the Effort Expenditure for Rewards Task in which participants select between low-effort and high-effort options to receive monetary rewards at varying levels of reward magnitude and probability. A test of attentional performance was also completed. RESULTS: Overall, participants made more high-effort selections as potential reward magnitude and probability increased. ADHD participants did not make fewer high-effort selections than non-ADHD participants, but ADHD participants showed greater methylphenidate-related increases in high-effort selections. ADHD participants had worse attentional performance than non-ADHD participants. ADHD severity was associated with methylphenidate-related changes in high-effort selections, but not changes in attentional performance. CONCLUSIONS: These results indicate that methylphenidate increases the willingness to perform effort in individuals with ADHD, possibly due to disorder-related motivational deficits. This provides support for theories of insufficient effort allocation among individuals with ADHD. TRIAL REGISTRATION: Clinicaltrials.gov Identifier, NCT02630017.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Atenção/efeitos dos fármacos , Estimulantes do Sistema Nervoso Central/uso terapêutico , Metilfenidato/uso terapêutico , Recompensa , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Estimulantes do Sistema Nervoso Central/administração & dosagem , Feminino , Voluntários Saudáveis/psicologia , Humanos , Masculino , Metilfenidato/administração & dosagem , Motivação/efeitos dos fármacos , Testes Neuropsicológicos , Tempo de Reação , Índice de Gravidade de Doença , Análise e Desempenho de Tarefas , Adulto JovemRESUMO
BACKGROUND: Traditional methods for recruiting and maintaining contact with participants in cohort studies include print-based correspondence, which can be unidirectional, labor intensive, and slow. Leveraging technology can substantially enhance communication, maintain engagement of study participants in cohort studies, and facilitate data collection on a range of outcomes. OBJECTIVE: This paper provides an overview of the development process and design of a cohort management platform (CMP) used in the Newborn Epigenetic STudy (NEST), a large longitudinal birth cohort study. METHODS: The platform uses short message service (SMS) text messaging to facilitate interactive communication with participants; it also semiautomatically performs many recruitment and retention procedures typically completed by research assistants over the course of multiple study follow-up visits. RESULTS: Since February 2016, 302 participants have consented to enrollment in the platform and 162 have enrolled with active engagement in the system. Daily reminders are being used to help improve adherence to the study's accelerometer wear protocol. At the time of this report, 213 participants in our follow-up study who were also registered to use the CMP were eligible for the accelerometer protocol. Preliminary data show that texters (138/213, 64.8%), when compared to nontexters (75/213, 35.2%), had significantly longer average accelerometer-wearing hours (165.6 hours, SD 56.5, vs 145.3 hours, SD 58.5, P=.01) when instructed to wear the devices for 1 full week. CONCLUSIONS: This platform can serve as a model for enhancing communication and engagement with longitudinal study cohorts, especially those involved in studies assessing environmental exposures.