Stability of Executive Functioning of Moderately-Late Preterm and Full-Term Born Children at Ages 11 and 19: The TRAILS Cohort Study.

Moderately-late preterm-born children (MLPs, 32-36 weeks gestational age, GA) have poorer executive functioning (EF) at primary school age than full-term children (FTs). Evidence is lacking on their EF in adolescence, but for early preterm-born children, this has been shown to be much poorer. We, therefore, compared EF of MLPs and FTs at ages 11 and 19 and assessed development between these ages. We obtained data from TRAILS, a community-based prospective cohort study in the northern Netherlands, on 98 MLPs and 1832 FTs. We assessed EF by the Amsterdam Neuropsychological Tasks (ANT) at ages 11 and 19 years and computed gender-specific z-scores on reaction time and accuracy. We compared baseline speed, pattern search, working memory, sustained attention, inhibition, and attentional flexibility of MLPs and FTs crude, and adjusted for small-for-GA status, socioeconomic status, and estimated intelligence. MLPs and FTs performed similarly on all EF components at ages 11 and 19, except for the speed, but not the accuracy measure of attentional flexibility. This was slightly poorer for MLPs than FTs at age 19 (adjusted B 0.25; 95% confidence interval: 0.00 to 0.50; p = 0.047), but not at age 11 (adjusted B -0.02; -0.19 to 0.22; p = 0.87). Differences in EF between MLPs and FTs did not change significantly from age 11 to 19. MLPs had comparable EF on most components as FTs, with only attentional flexibility at age 19 developing slightly poorer for MLPs than for FTs. These findings suggest the effects of MLP birth on long-term EF to be small.

Executive functioning before and after onset of alcohol use disorder in adolescence. A TRAILS study.

INTRODUCTION: The aim of the present study was to investigate whether executive functioning (EF) in early adolescence predicted alcohol use disorder (AUD) in late adolescence and whether adolescents with AUD differed in maturation of EF from controls without a diagnosis. METHODS: We used the data from the Tracking Adolescents' Individual Lives Survey (TRAILS), a cohort of 2230 Dutch adolescents. Working memory, inhibition, and attention were measured at ages 11 and 19. At age 19, lifetime DSM-IV diagnoses were determined, resulting in a control group (n = 1111) and two AUD groups, i.e., alcohol abusers (n = 381) and alcohol dependents (n = 51). Regression analyses assessed whether EF at age 11 predicted the transition to AUD in late adolescence and whether AUD affected maturation of EF from age 11 to 19. RESULTS: EF in early adolescence did not predict AUD in late adolescence. A significant interaction effect emerged between gender and alcohol dependence for shift attention (ß = 0.12, SE=0.36), with girls showing smaller maturational rates. This effect remained significant after controlling for alcohol intake (ages 16 and 19) and comorbid psychiatric disorders. DISCUSSION: Our results do not replicate the finding that EF in early adolescence is a significant predictor of AUD in late adolescence. Furthermore, for the majority of tasks, adolescents with AUD do not differ in EF maturation over the course of adolescence. Alcohol dependent girls however, show less maturation of shift attention. This is independent of the quantity of alcohol intake, which could suggest that non-normative maturation of EF is associated with the behavioural components of AUD.

Adolescent Heavy Drinking Does Not Affect Maturation of Basic Executive Functioning: Longitudinal Findings from the TRAILS Study.

BACKGROUND AND AIMS: Excessive alcohol use is assumed to affect maturation of cognitive functioning in adolescence. However, most existing studies that have tested this hypothesis are seriously flawed due to the use of selective groups and/or cross-sectional designs, which limits the ability to draw firm conclusions. This longitudinal study investigated whether patterns of alcohol use predicted differences in maturation of executive functioning in adolescence. Additionally, gender was tested as a possible moderator. METHODS: We used data from the Tracking Adolescents' Individual Lives Survey (TRAILS), which comprises a cohort of 2,230 Dutch adolescents. Maturation of executive functioning was measured by assessing the standardized improvement on each of four basic executive functions (i.e., inhibition, working memory, and shift- and sustained attention) between ages 11 and 19. Participants were assigned to one of six (heavy) drinking groups (i.e., non-drinkers, light drinkers, infrequent heavy drinkers, increased heavy drinkers, decreased heavy drinkers, and chronic heavy drinkers). We conducted linear regression analyses, and adjusted for relevant confounders. RESULTS: The six drinking groups did not reveal significant differences in maturation between drinking groups. E.g., maturation executive functioning of chronic heavy drinkers in comparison to non-drinkers; inhibition: B = -0.14, 95% CI [-0.41 to 0.14], working memory: B = -0.03, 95% CI [-0.26 to 0.21], shift attention: B = 0.13, 95% CI [-0.17 to 0.41], sustained attention: B = 0.12, 95% CI [-0.60 to 0.36]. Furthermore, gender was not found to be a significant moderator. CONCLUSIONS: Four years of weekly heavy drinking (i.e., chronic heavy drinkers) did not result in measurable impairments in four basic executive functions. Thus, regular heavy drinking in adolescence does not seem to affect these basic behavioural measures of executive functioning.

On the Development of Implicit and Control Processes in Relation to Substance Use in Adolescence.

Adolescence is a period in which brain structures involved in motivation and cognitive control continue to develop and also a period in which many youth begin substance use. Dual-process models propose that, among substance users, implicit or automatically activated neurocognitive processes gain in relative influence on substance use behavior, while the influence of cognitive control or reflective processes weakens. There is evidence that a variety of implicit cognitive processes, such as attentional bias, biased action tendencies (approach bias), memory bias and at a neural level, cue reactivity, are associated with adolescent substance use. The impact of these implicit processes on the further development of addictive behaviors appears to depend on moderating factors, such as (premorbid) executive control functions. Clear negative effects of adolescent substance use on executive control functions generally have not been found using behavioral tasks, although some studies have identified subtle and specific effects on cognitive functioning.

Executive functioning shows differential maturation from early to late adolescence: longitudinal findings from a TRAILS study.

OBJECTIVE: Maturation of executive functioning (EF) is topical, especially in relation to adolescence, yet longitudinal research covering early and late adolescence is lacking. This, however, is a prerequisite for drawing conclusions on normal cognitive development, and understanding deviant maturation. The aim of this study is to longitudinally investigate 6 subcomponents of EF in early (mean age 11) and late adolescence (mean age 19) and to investigate the influence of sex and socioeconomic status (SES). METHOD: We used data of the TRacking Adolescents' Individual Lives Survey (TRAILS). A number of 2,217 participants carried out tasks of the Amsterdam Neuropsychological Tasks (ANT), measuring Focused Attention, Inhibition, Sustained Attention, Speed of Processing, Working Memory, and Shift Attention. RESULTS: Linear growth model with individual varying times of observation showed significant slopes for all 6 measures. Sex differences were found for the majority of the measures, where boys showed more maturation. Maturation was influenced by SES for Sustained Attention and Inhibition. CONCLUSION: Results show that significant maturation takes place for all the measured subcomponents over adolescence. Overall, girls show better baseline performance and smaller maturational rates, suggesting more mature skills in early adolescence. Maturation is only influenced by SES for Sustained Attention and Inhibition. Findings underline that for making statements about EF maturation in adolescence, it is essential to look at subcomponents. Furthermore, sex differences are an important factor when investing (ab)normal maturation of EF.

The development of sucking patterns in preterm, small-for-gestational age infants.

OBJECTIVE: To determine whether the development of sucking patterns in small-for-gestational age (SGA) preterm infants differs from appropriate-for-gestational age (AGA) preterm infants. STUDY DESIGN: We assessed sucking patterns in 15 SGA and 34 AGA preterms (gestational age

Development of sucking patterns in pre-term infants with bronchopulmonary dysplasia.

BACKGROUND: Pre-term infants with bronchopulmonary dysplasia (BPD) are at risk of acquiring brain abnormalities. Combined with ongoing breathing difficulties, this may influence the development of their sucking patterns. OBJECTIVE: To determine the longitudinal development of sucking patterns from birth until 10 weeks' post-term age in pre-term infants with and without BPD. METHODS: The sucking patterns of 16 pre-term infants with BPD and 15 pre-term infants without BPD were prospectively assessed with the Neonatal Oral-Motor Assessment Scale. The infants were matched for gestational age (<30 weeks). We recorded approximately 12 feeding episodes per infant, from 34 until 50 weeks' post-menstrual age. We diagnosed the infants' sucking patterns as normal, dysfunctional, or disorganized. Then, we examined the development of the sucking patterns in relation to relevant clinical characteristics. RESULTS: Thirty (21%) of 142 feeding episodes of the pre-term infants with BPD and 36 (23%) of 156 of those without BPD were diagnosed as normal (non-significant). Of the abnormal patterns, 3 were diagnosed as dysfunctional and 229 as disorganized. Before term-equivalent age, definitely abnormal sucking patterns were more prevalent in the pre-term infants with BPD than in those without BPD: 69 (49%) and 47 (30%) episodes, respectively (χ(2) = 10.7, p < 0.01). In particular, the abnormal patterns including the item 'incoordination', defined as the inability to coordinate sucking and swallowing with breathing, were more prevalent: 36 and 15%, respectively (χ(2) = 6.37, p < 0.05). There was no difference between the two groups regarding the age at which they acquired normal sucking patterns. Relevant clinical characteristics did not influence the development of the sucking patterns. CONCLUSIONS: The developmental characteristic of sucking patterns in infants with BPD was that these infants were unable to coordinate swallowing with breathing. This was the case especially prior to term-equivalent age; after term-equivalent age, the development of sucking closely resembled that of pre-term infants without BPD.

Sucking patterns in fullterm infants between birth and 10 weeks of age.

OBJECTIVE: Coordinating sucking, swallowing and breathing to achieve effective sucking is a complex process and even though sucking is essential for nutrition, little is known about sucking patterns after birth. Our objective was to study sucking patterns in healthy fullterm infants and to describe the age-specific variations. METHOD: We studied the sucking patterns of 30 healthy, fullterm infants longitudinally from 2 or 3 days after birth to 10 weeks of age. During this time we recorded five to seven feeding episodes that we assessed off-line with the Neonatal Oral-Motor Assessment Scale (NOMAS). RESULTS: We found a normal sucking pattern on the second or third day after birth in 27 out of 30 infants. During the following weeks we found abnormal sucking patterns in 23 out of 171 feeding episodes (14%) and normal patterns in 148 episodes (86%). Altogether, between 38 and 50 weeks' postmenstrual age (10 weeks after birth), 10 infants displayed a deviating, arrhythmical sucking pattern. Dysfunctional sucking patterns and problems of coordinating sucking, swallowing and breathing did not occur. Birth weight, gestational age, type of labour and gender did not influence sucking patterns. Arrhythmical sucking was seen more often in bottle-fed infants. CONCLUSION: Our study demonstrated that practically all healthy fullterm infants started off with a normal sucking pattern soon after birth. One-third of the infants displayed one or more deviating episodes up to the age of 10 weeks. Apart from bottle-feeding, no other factors were found that influenced sucking patterns.

The Odor Awareness Scale: a new scale for measuring positive and negative odor awareness.

The Odor Awareness Scale (OAS) is a questionnaire designed to assess individual differences in awareness of odors in the environment. The theory that odor awareness can be distinguished in awareness of negative (to be avoided) odors and positive (to be approached) odors was tested using confirmatory factor analysis (CFA) on the 34-item questionnaire after completion by 525 respondents. CFA (after deletion of 2 items) showed good fit of the 2-factor theory, resulting in a positive awareness subscale (11 items, Cronbach's alpha = .77) and a negative awareness subscale (21 items, Cronbach's alpha = .80). Furthermore, reports of sickness from environmental odors were correlated with the negative odor awareness factor, not the positive odor awareness factor. Respondents scoring high on the overall sum score of the OAS showed significantly better olfactory performance on an odor perception test battery than respondents with a low score. These results suggest a causal relation between awareness of potentially negative odors, olfactory performance and experiencing health effects from environmental odor exposure, that warrants further investigation.