Exploring grandiose narcissism among surgeons: a comparative analysis.

The concept of narcissism encompasses various personality traits, including cognitive, emotional and behavioural characteristics, which often lead to difficulties in maintaining a healthy self-esteem. This study examines the prevalence of narcissism traits (Admiration and Rivalry) in the surgical profession and their association with age, gender and professional experience. A total of 1390 participants (408 women, 982 men) took part in an online survey. The results show that female participants have significantly lower levels of rivalry than male colleagues. Additionally, age was found to be inversely correlated with both facets of narcissism, demonstrating that levels of narcissism decrease as age increases. Participants who are still in education tend to show higher levels of both facets. These results improve our understanding of personality traits in surgery and provide valuable insights for researchers and practitioners.

[Externalizing problem behavior with friends in adolescence: What role do factors of callous-unemotional traits play?] / Externalisierendes Problemverhalten mit Freund:innen im Jugendalter: Welche Rolle spielen Faktoren der emotionalen Unbeteiligtheit?

INTRODUCTION: Affective impairments/disorders are one explanation as to why adolescents exhibit externalizing problem behavior (rule-breaking and dissocial behavior). Impaired affect is a core feature of callous-unemotional traits (CU traits). CU traits are composed of three factors: Callousness (lack of empathy and remorse), Uncaring (indifferent attitude toward task performance and the feelings of others), and Unemotional (superficial or flattened affect). Externalizing problem behaviors mostly occur in groups during adolescence. Therefore, it is important to consider the relationship between CU traits and externalizing problem behaviors that are exhibited explicitly in collaboration with or in the presence of friends. This perspective has been lacking in research on CU traits. The present study aims to fill this research gap. METHODS: Self-report data were collected between June 2021 and March 2023 from N = 169 adolescents (54% female; M = 14.95 years) using a set of questionnaires that could be completed online or as a paper-pencil version. In addition to CU traits (ICU) the set of questionnaires included assessments of rule-breaking and dissocial behavior with friends (CBCL: YSR 11-18 R). RESULTS: Only the subscale Callousness contributes to the explanation of externalizing problem behaviors with friends (6% variance explained). DISCUSSION: The results indicate that the three factors of CU-traits should be considered separately. In addition, when examining externalizing problem behavior, one should consider whether it is exhibited alone or together with or in the presence of friends. Limitations of the study, ideas for further research, and practical implications are discussed.

Cognitive development in children with new-onset Rolandic epilepsy and Rolandic discharges without seizures: Focusing on intelligence, visual perception, working memory and the role of parents' education.

PURPOSE: Our aim was to assess intelligence, visual perception and working memory in children with new-onset Rolandic epilepsy (RE) and children with Rolandic discharges without seizures (RD). METHODS: The participants in the study were 12 children with RE and 26 children with RD aged 4 to 10 years (all without medication and shortly after diagnosis) and 31 healthy controls. Their cognitive performance was assessed using the German versions of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III), the Wechsler Intelligence Scale for Children (WISC-IV), the Developmental Test of Visual Perception-2 (DTVP-2), the Developmental Test of Visual Perception-Adolescent and Adult (DTVP-A) (each according to age) and the Word Order, Hand Movements and Spatial Memory subtests of the German version of the Kaufman Assessment Battery for Children (K-ABC). RESULTS: The comparison of the entire group of children with RE/RD and the control group conducted in the first step of our analysis revealed a weaker performance of the children with RE/RD in all cognitive domains. Significant deficits, however, were found exclusively in the RD group. Compared to the controls, they performed significantly weaker regarding IQ (full scale IQ: p < 0.001; verbal IQ: p < 0.001; performance IQ: p = 0.002; processing speed: p = 0.005), visual perception (general visual perception: p = 0.005; visual-motor integration: p = 0.002) and working memory (WISC working memory: p = 0.002 and K-ABC Word Order (p = 0.010) and Hand Movements (p = 0.001) subtests. Also, the children without seizures scored significantly lower than those with seizures on the WISC Working Memory Index (p = 0.010) and on the K-ABC Word Order (p = 0.021) and Hand Movements (p = 0.027) subtests. Further analysis of our data demonstrated the particular importance of the family context for child development. Significant cognitive deficits were found only in children with RD from parents with lower educational levels. This group consistently scored lower compared to the control group regarding IQ (full scale IQ: p < 0.001; verbal IQ: p < 0.001; performance IQ: p = 0.012; processing speed: p = 0.034), visual perception (general visual perception: p = 0.018; visual-motor integration: p = 0.010) and auditory working memory (WISC working memory: p = 0.014). Furthermore, compared to the children with RE, they performed significantly weaker on verbal IQ (p = 0.020), auditory working memory consistently (WISC working memory: p = 0.027; K-ABC: Word Order: p = 0.046) as well as in one of the K-ABC spatial working memory subtests (Hand Movements: p = 0.029). Although we did not find significant deficits in children with new-onset RE compared to healthy controls, the performance of this group tended to be weaker more often. No statistically significant associations were observed between selected clinical markers (focus types: centrotemporal/other foci/laterality of foci and spread of Rolandic discharges) and cognitive test results. Except for spatial working memory, we also found no evidence that the age of our patients at the time of study participation was of significant importance to their cognitive performance. CONCLUSIONS: Our study provides some evidence that children with Rolandic discharges, with and without seizures, may be at higher risk of cognitive impairment. In addition to medical care, we emphasise early differentiated psychosocial diagnostics to provide these children and their families with targeted support if developmental problems are present.

Measurement Invariance of the WISC-V across a Clinical Sample of Children and Adolescents with ADHD and a Matched Control Group.

Measurement invariance of the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) 10-primary subtest battery was analyzed across a group of children and adolescents with ADHD (n = 91) and a control group (n = 91) matched by sex, age, migration background, and parental education or type of school. First, confirmatory factor analyses (CFAs) were performed to establish the model fit for the WISC-V second-order five-factor model in each group. A sufficiently good fit of the model was found for the data in both groups. Subsequently, multigroup confirmatory factor analyses (MGCFAs) were conducted to test for measurement invariance across the ADHD and control group. Results of these analyses indicated configural and metric invariance but did not support full scalar invariance. However, after relaxing equality constraints on the Vocabulary (VC), Digit Span (DS), Coding (CD), Symbol Search (SS), and Picture Span (PS) subtest intercepts as well as on the intercepts of the first-order factors Working Memory (WM) and Processing Speed (PS), partial scalar invariance could be obtained. Furthermore, model-based reliability coefficients indicated that the WISC-V provides a more precise measurement of general intelligence (e.g., represented by the Full-Scale IQ, FSIQ) than it does for cognitive subdomains (e.g., represented by the WISC-V indexes). Group comparisons revealed that the ADHD group scored significantly lower than the control group on four primary subtests, thus achieving significantly lower scores on the corresponding primary indexes and the FSIQ. Given that measurement invariance across the ADHD and the control group could not be fully confirmed for the German WISC-V, clinical interpretations based on the WISC-V primary indexes are limited and should only be made with great caution regarding the cognitive profiles of children and adolescents with ADHD.

Does the Association between Preschool Media Use and Language Difficulties at School Entry Vary by First Language of the Child and Parental Education?

BACKGROUND: Both media use and social background affect children's language development. The aim of this study was to explore the association between media use and different aspects of language difficulties (grammar, auditory memory, articulation) and social background (first language (FL), parental education (PE)) in more detail. METHODS: We analyzed data from 4015 children from the 2013/14 school entry examination in a Western German city. Media use, FL, and PE were assessed by social history, and language difficulties by sociopediatric screening. We calculated Prevalence Ratios with a 95% Confidence Interval for language difficulties by media use and FL/PE; compared models with and without interaction terms; and estimated the predicted prevalence of language difficulties by media use and FL/PE. RESULTS: Children with non-German FL/low PE had a higher media use and more language difficulties. However, the gradual association between media use and grammatical abilities/recommendation of training was more pronounced in children with German FL and medium/high PE. e.g., especially in the preposition subtest. CONCLUSIONS: The association between media use and language difficulties varies regarding different aspects of social background and language difficulties. Still, extensive media use is linked with language difficulties for all children. The media competence of young families remains crucial in times of digitalization.

Accounting for Intraindividual Profiles in the Wechsler Intelligence Scales Improves the Prediction of School Performance.

IQ scores are often used to predict school performance. However, for children with learning disabilities, the predictive validity of IQ scores appears to be low. In the fourth and fifth versions of the Wechsler Intelligence Scales for Children (WISC), new ancillary indices were introduced. The General Ability Index (GAI) is a broad measure of fluid reasoning with verbal, visual-spatial, and figural test items. By contrast, the Cognitive Proficiency Index (CPI) combines different executive functions known to be frequently affected in children with dyslexia, ADHD, or combined learning disorders. To date, there is little evidence to demonstrate that these measures improve the prediction of school performance beyond the Full-scale IQ (FSIQ). We therefore used lasso regression to explore the predictive validity of these measures for school grades. The analyzed samples were taken from the German standardization samples of the WISC-IV and the WISC-V. In most cases, the prediction of school performance was not considerably improved by taking the GAI or the CPI into account. However, when the individual discrepancy between the CPI and the GAI was high, the FSIQ lost its predictive validity in elementary school. In this subgroup of children, reading and writing skills were best predicted by the CPI, whereas math skills were limited by the lowest score (i.e., the minimum out of the CPI and the GAI).

Structural Equation Modeling of Common Cognitive Abilities in Preschool-Aged Children Using WPPSI-IV and BRIEF-P.

Various studies have addressed the relationship between intelligence and executive functions (EF). There is widespread agreement that EF in preschool children is a unitary construct in which the subordinate factors of Updating, Inhibition, and Shifting are still undifferentiated and correlate moderately with a general factor of intelligence (g). The aim of this study is to investigate the common structural relationship between these two constructs using confirmatory factor analysis. Furthermore, we intend to close the gap of more daily life-associated executive functions and replicate findings in preschool-aged children. Data from a sample of N = 124 average developed children without severe impairments (aged 4 years 0 months-6 years 11 months) were analyzed using the data pool of the standardization and validation studies on the German Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition. Additionally, Executive functions were assessed using a standardized parent-completed questionnaire (BRIEF-P) on their children's everyday behavior. A second-order factor solution revealed that a model with a loading of the common factor of general intelligence (g-factor) onto the EF factor fits the data best. To specify possible method effects due to different sources of measurements, a latent method factor was generated. The results indicate a heterogeneous method effect and a decreasing factor loading from g on to EF while controlling for the method factor.

The Role of Cognitive Skills, Sex, and Parental Education for Social-Emotional Skills: A Cross-Sectional Study on the WPPSI-IV Performances of Children Aged 3 to 5 Years.

BACKGROUND: Current research suggests that knowledge about the relationship between cognition and social-emotional skills in preschoolers is important to better understand child development. The present study investigated possible effects of cognitive skills measured by the Wechsler Primary and Preschool Scale-Fourth Edition (WPPSI-IV), children's sex, and parental educational level on social--emotional skills measured by the Developmental Test 6 Months to 6 Years-Revision (ET 6-6 R) for children aged 3 to 5. METHODS: Statistical analyses were based on a sample of N = 93 children (47 females, 46 males). First, bivariate correlations among relevant WPPSI-IV index scores, the ET social-emotional quotient, children's sex, and parental educational level were calculated to identify possible significant associations between the variables under investigation. Subsequently, two multiple regression analyses were conducted to test for the hypothesized main effects of cognitive skills, children's sex, and parental educational level on social-emotional skills. Finally, a moderated multiple regression analysis was carried out to investigate whether possible effects of cognitive skills on social-emotional skills were moderated by children's sex and parental educational level. RESULTS: Regression analyses indicated that visual-spatial skills measured by the WPPSI-IV and children's sex have both a small but significant main effect on social-emotional skills. The main effect of sex was due to the fact that, on average, females achieved higher scores on the measure of social-emotional skills than males. CONCLUSIONS: The present findings suggest that the WPPSI-IV represents a suitable test battery for the assessment of those cognitive skills, which might play a reasonable role in social-emotional development.

Cognitive Profiles of Adolescent Inpatients with Substance Use Disorder.

The prevalence of substance abuse is high during adolescence, and several studies have linked the use of alcohol and cannabis in adolescence to different cognitive impairments. To investigate whether specific cognitive deficits can be observed in adolescents with substance use disorder (SUD), we compared the cognitive profiles of inpatient adolescents diagnosed with SUD to a control group matched for sex, age and educational status. The inpatient adolescents received diagnoses of cannabis use disorder, alcohol use disorder or both. We compared the WISC-V profiles of 22 inpatients (45.5% female, Mage: 14.5; SD: 0.8) and the WAIS-IV profiles of 27 inpatients (44.4% female, Mage: 17.1; SD: 0.9) to 49 matched control participants with no diagnosed SUD. At the time of testing, participants were hospitalized for treatment of their SUD and were abstinent for a period of at least 6 weeks. To gain greater power, we jointly analyzed the Verbal Comprehension Index, Working Memory Index, Processing Speed Index and Full Scale IQ as assessed by WISC-V and WAIS-IV. The clinical group performed significantly worse than the control group on all the above indices. When only the group of inpatients was observed, in a model with the factors sex, educational status, presence of a comorbid diagnosis of depression and the number of comorbid diagnoses, only the factor educational status was significantly associated with the Full Scale IQ, whereas the factors sex and a comorbid diagnosis of depression in this group were associated with the Processing Speed Index. The results show that adolescents diagnosed with SUD (cannabis and/or alcohol) display broad cognitive impairments after 6 weeks of abstinence. Future research is required to further explore the role of comorbid diagnoses.

Children's Motivation Profiles in Sports and Physical Activities: A Latent Profile Analysis and Self-Determination Theory Approach.

Using latent profile analysis and self-determination theory, the present study aimed to examine younger children's motivation profiles in sports and physical activities and the relations of those profiles to various predictors and achievement outcomes. A total of 1,116 German children from Grade 2 participated in this study. Latent-profile-analysis solutions based on five behavioral-regulation types covered in self-determination theory (i.e., intrinsic, identified, introjected, external, amotivation) were tested. Results favored a three-profile solution, showing three theoretically meaningful and distinct motivation profiles labeled "amotivated," "non-self-determined," and "self-determined." Older children and children with a lower physical self-concept were more likely to be members of the amotivated profile relative to the other profiles than younger children and children with a higher physical self-concept. Furthermore, children of the self-determined profile demonstrated the best physical performance in various motor-skills tests.

Self-regulation in preschool: Are executive function and effortful control overlapping constructs?

The concepts of executive function (EF) and effortful control (EC) are strikingly similar. EF originate from neurocognitive research and are described as an accumulation of cognitive processes that serve the goal-oriented self-regulation (SR) of an individual. EC originates from temperament research and is defined as the efficiency of executive attention, including the ability to inhibit a dominant response, to activate a subdominant response, to proceed in a planned manner and to recognize conflicts or errors. The aim of this article was to examine the association between the constructs of EF and EC at the preschool-age. Eighty-eight children (49 female; M-age = 3.93 years, SD = .78) were tested with a computerized battery designed to assess EF at 3-6 years of age (EF Touch). Children's parents completed questionnaires assessing EF impairments (BRIEF-P) and EC (CBQ). Associations between the constructs and their conceptual overlap were analyzed using correlations and confirmatory factor analyses. We found significant correlations between EF and EC measures. A one-factor confirmatory model fitted the data very well and indicated that EF and EC are indeed overlapping and highly similar constructs. Therefore, our results show that measures of EC and EF have substantial overlap in preschoolers and suggest an integrated model of self-regulation.

Experiences and Perceived Self-Efficacy in Distance Learning Among Teachers of Students With Special Educational Needs.

The COVID-19 pandemic has had a great impact on school learning so far, creating a new and potentially stressful situation during school closures for teachers and students. The sudden switch to distance learning might have been especially hard to cope with for students with special educational needs (SEN). Teachers of student with SEN might thus face greater obstacles when establishing and dealing with distance learning. Teachers' self-efficacy (TSE) is a well-known factor for students' academic achievement and motivation. Little is yet known about TSE in distance learning, especially not with students with SEN. The present study aimed to investigate the experiences and the perceived TSE in distance learning of teachers teaching students with SEN at special schools and inclusive schools during the COVID-19 pandemic in Germany during June 2020 and January 2021. N = 96 teachers from both special schools and inclusive schools were involved in the study and were asked to complete a self-report online questionnaire. The study follows an exploratory design to give a first overview of the experiences of teachers of students with SEN and their TSE during the school closures and distance learning. Results showed that no major difference in overall teaching experiences could be found between teachers teaching at special schools or inclusive schools. The identification of difficulties in reading at distance and the support of students with difficulties in reading at distance was perceived by the teachers as most difficult. Difficulties in writing was being rated significantly less easy to identify at distance than difficulties in mathematics. Further, the support of students with difficulties in mathematics was perceived as being significant more challenging than the identification of difficulties in mathematics. TSE in distance learning was rather low, regardless if the teachers taught at a special school or inclusive school in this time period. TSE correlated positively with the perceived goodness of identification of difficulties and support of students with difficulties in reading, writing, and mathematics. Possible reasons and implications are discussed as well as implications of the overall results for distance learning of students with SEN.

Revisiting the Factor Structure of the German WISC-V for Clinical Interpretability: An Exploratory and Confirmatory Approach on the 10 Primary Subtests.

With the exception of a recently published study and the analyses provided in the test manual, structural validity is mostly uninvestigated for the German version of the Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V). Therefore, the main aim of the present study was to examine the latent structure of the 10 WISC-V primary subtests on a bifurcated extended population-representative German standardization sample (N=1,646) by conducting both exploratory (EFA; n=823) and confirmatory (CFA; n=823) factor analyses on the original data. Since no more than one salient subtest loading could be found on the Fluid Reasoning (FR) factor in EFA, results indicated a four-factor rather than a five-factor model solution when the extraction of more than two suggested factors was forced. Likewise, a bifactor model with four group factors was found to be slightly superior in CFA. Variance estimation from both EFA and CFA revealed that the general factor dominantly accounted for most of the subtest variance and construct reliability estimates further supported interpretability of the Full Scale Intelligence Quotient (FSIQ). In both EFA and CFA, most group factors explained rather small proportions of common subtest variance and produced low construct replicability estimates, suggesting that the WISC-V primary indexes were of lower interpretive value and should be evaluated with caution. Clinical interpretation should thus be primarily based on the FSIQ and include a comprehensive analysis of the cognitive profile derived from the WISC-V primary indexes rather than analyses of each single primary index.

Children's Physical Self-Concept, Motivation, and Physical Performance: Does Physical Self-Concept or Motivation Play a Mediating Role?

The present study aimed to examine the relations between physical self-concept, intrinsic and extrinsic motivation as well as physical performance of 1,082 children aged 7-8 years. The central objective of this study was to contrast a mediation model assuming physical self-concept as a mediator of the relations between both types of motivation and physical performance to a mediation model assuming both types of motivation as mediators of the relations between physical self-concept and physical performance. Physical self-concept and both types of motivation were measured by using self-reported questionnaires, while physical performance was measured with 10 motor skill tests. All tests were carried out during regular school hours (8-12 A.M.) by qualified test personnel. Beyond correlation analyses, structural equation modeling (SEM) was performed to find evidence for the predictive relations between the variables under study. Results showed that physical self-concept was significantly positively related to both types of motivation and physical performance (all p < 0.001). In contrast, results of SEM revealed that only physical self-concept (p < 0.001) and intrinsic motivation (p < 0.05) were significantly positively linked to physical performance. Furthermore, physical self-concept proved to significantly mediate the relations of both types of motivation to physical performance (p < 0.001), while only intrinsic motivation, but not extrinsic motivation, proved to significantly mediate the relation between physical self-concept and physical performance (p < 0.05). These results suggest that school-based or extracurricular interventions targeted at improving younger children's physical performance only by means of an increased level of physical activity or by external factors without supporting children's physical self-concept and intrinsic motivation may have less or no effects on their physical performance.

[Evaluation of the Language-related Domain of the Pediatric Developmental Screening Instrument for Preschool Health Examinations (SOPESS): Results from the Prospective Child Health Survey ikidS]. / Evaluation der Sprachaufgaben des sozialpädiatrischen Entwicklungsscreenings für Schuleingangsuntersuchungen (SOPESS): Ergebnisse der prospektiven Kindergesundheitsstudie ikidS.

PURPOSE OF THE STUDY: Developmental delays at school enrollment can affect early educational achievement. Thus, diagnosis and treatment prior to school entry are important. In Germany, SOPESS - a pediatric developmental screening instrument for preschool health examinations (PHE) - was introduced in several federal states. We investigated the relationships between the results of the language-related domain of the SOPESS and later academic language competencies at the end of first grade. PROCEDURES: Data of the population-based cohort study ikidS (Rhineland Palatinate; Germany) and the PHE provided by public health authorities were linked at individual level. The relationship between the SOPESS-language risk score (range: 0 to 6, higher values indicate more developmental delay) and class teacher-based ratings of academic language competencies (range: -4 to+4, higher values indicate better competencies) was investigated with linear regression models and adjusted for several socio-economic and medical language predictors (e. g. age at school entry, gender, parental education, migration background, hearing disorder). The additional benefits of the SOPESS-language risk score was analyzed using analysis of variance. RESULTS: In total, 1357 children (48% girls, age at PHE 4.9-7.2 years) were included. A clear negative relationship between the SOPESS-language risk score and competencies in spoken and written language was found. Mean academic language competencies decreased with increasing SOPESS-language risk level from 0.8 (SD=1.7) at a risk score of 0 to-3.2 (SD=0.9) at a risk score of 6. The relationship persisted after adjusting for other language predictors. Analysis of variance showed significant benefits of the SOPESS-language risk score, even when further language predictors were considered. CONCLUSIONS: There was a clear relationship between results of the SOPESS-language screening and later academic language competencies. Hence, the language-related domain of the SOPESS may be useful for further recommendations of tailored special educational and medical support services, especially if additional socio-economic and medical factors are considered.

Executive functions and intelligence from the CHC theory perspective: Investigating the correspondence between the WAIS-IV and the NAB Executive Functions Module.

Substantial overlap between executive functions (EFs) and intelligence has been reported. Yet further research is required with respect to how the specific components of the two constructs are interrelated. The present study was aimed at exploring the relationship between EFs and intelligence by examining the latent structure of the Wechsler Adult Intelligence Scale (WAIS-IV) and the Executive Functions Module from the Neuropsychological Assessment Battery (NAB). The aim was also to test the correspondence of the two measures to the Cattell-Horn-Carroll (CHC) theory. 205 healthy participants, aged 18-89 years, were administered the NAB and WAIS-IV. Confirmatory factor analysis (CFA) was employed to explore the latent constructs underlying the two test batteries. Models based on the current WAIS-IV index structure showed worse model fit than models based on the CHC theory. In particular, factors representing broad CHC abilities comprehension knowledge (Gc), fluid reasoning (Gf), visual processing (Gv), processing speed (Gs), and working memory capacity (Gwm) proved model fit improvement. The best model fit, however, provided a five-factor model combining the Gf and Gwm abilities into one factor and additionally including a retrieval fluency (Gr) factor. The results demonstrate strong relationships between the WAIS-IV and the NAB Executive Functions Module and suggest substantial overlap between EFs and intelligence within the CHC framework. Nevertheless, according to the recent update of the CHC theory, the NAB fluency tasks may represent a distinct EF factor comprising Gr abilities independent from the WAIS-IV.

Measurement Invariance Across Gender on the Second-Order Five-Factor Model of the German Wechsler Intelligence Scale for Children-Fifth Edition.

The present study investigated measurement invariance across gender on the German Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V). The higher order model that was preferred by the test publishers was tested on a population-representative German sample of 1,411 children and adolescents aged between 6 and 16 years. Confirmatory factor analyses were conducted to test for measurement invariance. As soon as partial scalar invariance could be established by freeing nonequivalent subtest intercepts, results demonstrated that 11 out of 15 subtest scores have the same meaning for male and female children. These findings support interpretable comparisons of the WISC-V test scores between males and females but only in due consideration of partial scalar invariance and with respect to the underlying factor structure. Despite this, however, results did not support the overall structural validity of the higher order model. Thus, replacing the former Perceptual Reasoning factor by Fluid Reasoning and Visual Spatial may be considered inappropriate due to the redundancy of the FRI as a separate factor. Results also indicated that the WISC-V provides stronger measurement of general intelligence (Full Scale IQ) than measurements of cognitive subdomains (WISC-V indexes). Interpretative emphasis should thus be placed on the Full Scale IQ rather than the WISC-V indexes.

Fatigue in pediatric liver transplant recipients and its impact on their quality of life.

The aim of the study was to investigate the occurrence of fatigue in 100 pediatric liver transplant recipients aged 2-18 years and its impact on their health-related quality of life (HRQL). HRQL and fatigue were measured using the PedsQL 4.0 Inventory and the PedsQL Multidimensional Fatigue Scale, which encompasses three subscales: general fatigue, sleep/rest fatigue, and cognitive fatigue. The impact of the different domains of fatigue and of clinical and sociodemographic factors on the HRQL was identified with stepwise multiple regression analyses. Parent proxy-reports were available for all 100 participants (2-18 years), and child self-reports were available for 71 patients (8-18 years). Across all domains, participants and their parents reported significantly more fatigue than healthy peers in a large PedsQL validation study. Thirty-seven percent of patients and 57% of parents scored clinically relevant levels of fatigue. In the multiple regression analyses, none of the clinical and sociodemographic factors contributed to the HRQL for child self-report. Only general and cognitive fatigue were significant predictors of patients' HRQL, explaining 66% of the variance in the PedsQL total score. For parent proxy-report, general and cognitive fatigue also significantly predicted child's HRQL. Further predictors were child's age and family income. The regression model explained 65% of the variance. These findings demonstrate the importance of assessing fatigue during regular follow-up examinations. Further research is urgently needed to better understand the underlying mechanisms of fatigue. Improvement of fatigue symptoms is essential for better HRQL, for cognitive functioning, and for school achievement.

[Associations between cognitive performance in a dementia screening test (SKT) and an intelligence test (WAIS IV) : Which deficits in cognitive performance in old age indicate a possible pathological deterioration process?] / Zusammenhänge zwischen den kognitiven Leistungen in einem Demenzscreening (SKT) und in einem Intelligenztest (WAIS-IV) : Welche kognitiven Leistungseinbußen im Alter sprechen für einen möglichen pathologischen Abbauprozess?

BACKGROUND: Which deficits in cognitive performance indicate the onset of a pathological deterioration process in older persons? AIM AND OBJECTIVES: Based on an established dementia screening test in elderly adults, a differentiation can be made between healthy cognitive performance and the onset of pathological deficits in performance (in the sense of mild cognitive impairment). The aim of the study was to investigate whether cognitive decline assessed with a dementia screening instrument is reflected in an intelligence test for adults. The dementia screening measured disorders in memory and attention, the intelligence testing battery measured information processing, working memory, perceptual reasoning, logical thinking and verbal comprehension. MATERIAL AND METHODS: A total of 253 cognitively healthy, self-dependent and non-dementia persons (129 women and 124 men), aged between 60 and 91 years (M = 71.98 years; SD = ±7.13) were tested with the complete Wechsler adult intelligence scale (WAIS-IV) and the short performance test (SKT), based on the new normalization from 2015. The SKT enables an assessment of the degree of cognitive deterioration based on coloring codes of traffic lights. Green indicates normal aging, yellow mild cognitive impairment and red stands for abnormal cognitive aging. RESULTS AND CONCLUSION: There were significant correlations between the total SKT score as a measure of total cognitive impairment and the indices of the WAIS-IV, such as information processing, working memory and perceptual reasoning. No significant covariation was found for verbal comprehension. The results suggest that in old age cognitive deterioration starts with reduced speed of information processing and impairment in the working memory log before deficits in memory are present. This finding was reflected in significant mean differences between the subjects in the category green versus yellow in the indices information processing and working memory. Under these aspects there were medium effect strengths (d = 0.60) and the second largest (insignificant) differences were shown in working memory (d = 0.39).