Parent-Child Interaction Therapy with Toddlers: A Community-based Randomized Controlled Trial with Children Aged 14-24 Months.

Objective: Children with early-onset behavioral issues are at high risk for ongoing behavioral, psychological, and social issues.Method: This study examined the efficacy of the first phase of Parent-Child Interaction Therapy with Toddlers, Child-Directed Interaction - Toddler, using a randomized control design. Sixty-six mother-toddler dyads (Child Mage = 19.13 months; 63% male; 34% from a non-English speaking background) referred to a community-based child behavior clinic in Australia received CDI-T immediately or were assigned to a waitlist control condition. At baseline (Time 1) and post-treatment/post-waitlist (Time 2), mothers completed questionnaires (Child Behavior Checklist, Edinburgh Postnatal Depression Scale, Parenting Stress Index - Short Form) and participated in a structured parent-child dyadic play-based interaction later coded using the Dyadic Parent-Child Interaction Coding System and the Emotional Availability Scales.Results: Compared to those who did not receive treatment, mother-child dyads who received the intervention showed significantly better parenting skills (increases in positive parenting skills and decreases in negative parenting skills), emotional availability (increases in parental sensitivity and parental non-intrusiveness), child behavior (decreases in externalizing and internalizing behaviors) and parental perceptions of child difficulty.Conclusions: Results suggest that the CDI-T phase of PCIT-T is a promising intervention for toddlers presenting with behavioral issues. Future studies should be conducted to assess efficacy in other settings and to assess longer-term outcomes.

Callous-Unemotional Traits and Disorganized Attachment: Links with Disruptive Behaviors in Toddlers.

Children with callous-unemotional (CU) traits and children with disorganized attachment patterns are at heightened risk of poor psychological outcomes but little is known about the overlap between these constructs and their unique contributions to conduct problems in early childhood. This study examined associations between CU traits, disorganized attachment, and conduct problem (CP) severity in a sample of clinic-referred toddlers with behavioral problems. Mother-child dyads (n = 56; mean child age 19.50 months) completed parent-report questionnaires, a dyadic play session, and the Strange Situation Procedure to assess child attachment pattern. Significant positive associations were found between CU traits and disorganized attachment, independent of CP severity. CU traits but not disorganized attachment predicted CP severity. Results indicate that among toddlers with clinic-referred disruptive behavior problems, there are clear links between CU traits and attachment disorganization. Of the two constructs, however, CU traits appear to be most salient in the expression of CPs.

Parent-Child Interaction Therapy with Toddlers in a community-based setting: Improvements in parenting behavior, emotional availability, child behavior, and attachment.

Parent-Child Interaction Therapy with Toddlers (PCIT-T) is a new attachment-based parenting intervention designed to meet the needs of children aged 12-24 months presenting with challenging behaviors. This study examined outcomes of the first phase of PCIT-T, Child Directed Interaction-Toddler (CDI-T), 4-months post treatment. Participants were 56 toddlers (Child Mage = 19.13 months) referred to receive CDI-T over an 8-week period at an Australian community-based child behavior treatment clinic for treatment of difficult toddler behaviors. Participants completed questionnaires and observational measures at baseline (Time 1), post-treatment (Time 2), and 4-month follow-up (Time 3). At both Time 2 and Time 3, there were statistically significant increases in observed positive parenting skills and emotional availability and decreases in negative parenting behaviors and child noncompliance. There were also significant improvements in parent-reported child externalizing and internalizing behaviors, parental stress, and maternal depression. There was a pattern of a shift away from attachment insecurity and attachment disorganization. Results suggest that the CDI-T phase of PCIT-T is a promising intervention for toddlers presenting with behavioral issues. Future studies should be conducted to assess efficacy in other settings, using larger samples and utilizing randomized controlled designs.

La terapia de interacción progenitor-niño con niños pequeñitos (PCIT-T) es una nueva intervención de crianza con base en la afectividad y diseñada para cubrir las necesidades de niños de edad de 12 a 24 meses que enfrentan retos de comportamiento. Este estudio examinó los resultados de la primera fase de PCIT-T, Interacción Dirigida del Niño - Niño Pequeñito (CDI-T), 4 meses después del tratamiento. Participaron 56 niños pequeñitos (Edad promedio del niño = 19.13 meses) que habían sido referidos para recibir el CDI-T en un período de 8 semanas en una clínica en Australia con base comunitaria de tratamiento de comportamiento del niño, dedicada al tratamiento de comportamientos difíciles de niños pequeñitos. Los participantes completaron cuestionarios y medidas de observación al momento básico (Primer momento), posteriormente al tratamiento (Segundo momento) y en el seguimiento a los 4 meses (Tercer momento). Tanto en el momento segundo como en el tercero, se dieron mejorías estadísticamente significativas en cuanto a las observadas habilidades positivas de crianza y la disponibilidad emocional y disminuciones en cuanto a las conductas de crianza negativas y la falta de obediencia del niño. También se dieron mejorías significativas en los comportamientos de externalización e internalización del niño según el reporte del progenitor, el estrés de los padres y la depresión materna. Se dio un patrón de alejarse de la inseguridad de la afectividad y la desorganización de la afectividad. Los resultados sugieren que la fase CDI-T del PCIT-T es una intervención prometedora para niños pequeñitos que presentan asuntos de comportamiento. Futuros estudios deben llevarse a cabo para evaluar la efectividad en otros escenarios, usando grupos muestras más grandes y utilizando diseños de control al azar.

La thérapie d'interaction parent-enfant avec un jeune enfant (en anglais Parent-child interaction therapy with Toddlers, soit PCIT-T) est une nouvelle intervention de parentage basée sur l'attachement, conçue afin de remplir les besoins d'enfants âgés de 12 à 24 mois qui présentent des comportements difficiles. Cette étude a examiné les résultats de la première phase de PCIT-T, l'Interaction Dirigée vers l'Enfant - Petit Enfant (Child Directed Interaction - Toddler, soit CDI-T), à 4 mois après le traitement. Les participants ont consisté en 56 jeunes enfants (âgeM de l'Enfant = 19,13 mois) envoyés consulter afin de recevoir une CDI-T sur une période de 8 semaines dans une clinique de traitement du comportement de l'enfant communautaire en Australie, spécialisé dans le traitement de comportements difficiles de jeunes enfants. Les participants ont rempli des questionnaires et des mesures d'observation au niveau de référence (Temps 1), après le traitement (Temps 2) et au suivi de 4 mois (Temps 3). A la fois au Temps 2 et 3 on a noté des augmentations statistiquement significatives dans les compétences positives observées de parentage et la disponibilité émotionnelle ainsi que des baisses dans les comportements négatifs de parentage et le refus d'obéir. On a aussi noté des améliorations importantes dans l'externalisation de l'enfant rapportée par le parent et les comportements d'internalisation, le stress parental et la dépression maternelle. On a observé une tendance se détachant de l'insécurité de l'attachement et de la désorganisation de l'attachement. Les résultats suggèrent que la phases CDI-T de la PCIT-T est une intervention prometteuse pour les jeunes enfants présentant des problèmes de comportement. Des études futures devraient être faites afin d'évaluer l'efficacité d'autres contextes, en utilisant des échantillons plus larges et en utilisant des plans d'étude contrôlées randomisées.

PD-1 suppresses protective immunity to Streptococcus pneumoniae through a B cell-intrinsic mechanism.

Despite the emergence of the programmed cell death 1 (PD-1):PD-1 ligand (PD-L) regulatory axis as a promising target for treating multiple human diseases, remarkably little is known about how this pathway regulates responses to extracellular bacterial infections. We found that PD-1(-/-) mice, as well as wild-type mice treated with a PD-1 blocking Ab, exhibited significantly increased survival against lethal Streptococcus pneumoniae infection following either priming with low-dose pneumococcal respiratory infection or S. pneumoniae-capsular polysaccharide immunization. Enhanced survival in mice with disrupted PD-1:PD-L interactions was explained by significantly increased proliferation, isotype switching, and IgG production by pneumococcal capsule-specific B cells. Both PD-L, B7-H1 and B7-DC, contributed to PD-1-mediated suppression of protective capsule-specific IgG. Importantly, PD-1 was induced on capsule-specific B cells and suppressed IgG production and protection against pneumococcal infection in a B cell-intrinsic manner. To our knowledge, these results provide the first demonstration of a physiologic role for B cell-intrinsic PD-1 expression in vivo. In summary, our study reveals that B cell-expressed PD-1 plays a central role in regulating protection against S. pneumoniae, and thereby represents a promising target for bolstering immunity to encapsulated bacteria.

The role of human ventral visual cortex in motion perception.

Visual motion perception is fundamental to many aspects of visual perception. Visual motion perception has long been associated with the dorsal (parietal) pathway and the involvement of the ventral 'form' (temporal) visual pathway has not been considered critical for normal motion perception. Here, we evaluated this view by examining whether circumscribed damage to ventral visual cortex impaired motion perception. The perception of motion in basic, non-form tasks (motion coherence and motion detection) and complex structure-from-motion, for a wide range of motion speeds, all centrally displayed, was assessed in five patients with a circumscribed lesion to either the right or left ventral visual pathway. Patients with a right, but not with a left, ventral visual lesion displayed widespread impairments in central motion perception even for non-form motion, for both slow and for fast speeds, and this held true independent of the integrity of areas MT/V5, V3A or parietal regions. In contrast with the traditional view in which only the dorsal visual stream is critical for motion perception, these novel findings implicate a more distributed circuit in which the integrity of the right ventral visual pathway is also necessary even for the perception of non-form motion.

Exogenous spatial attention: evidence for intact functioning in adults with autism spectrum disorder.

Deficits or atypicalities in attention have been reported in individuals with autism spectrum disorder (ASD), yet no consensus on the nature of these deficits has emerged. We conducted three experiments that paired a peripheral precue with a covert discrimination task, using protocols for which the effects of covert exogenous spatial attention on early vision have been well established in typically developing populations. Experiment 1 assessed changes in contrast sensitivity, using orientation discrimination of a contrast-defined grating; Experiment 2 evaluated the reduction of crowding in the visual periphery, using discrimination of a letter-like figure with flanking stimuli at variable distances; and Experiment 3 assessed improvements in visual search, using discrimination of the same letter-like figure with a variable number of distractor elements. In all three experiments, we found that exogenous attention modulated visual discriminability in a group of high-functioning adults with ASD and that it did so in the same way and to the same extent as in a matched control group. We found no evidence to support the hypothesis that deficits in exogenous spatial attention underlie the emergence of core ASD symptomatology.

IL-17 producing CD4+ T cells mediate accelerated ischemia/reperfusion-induced injury in autoimmunity-prone mice.

Elements of the innate and adaptive immune response have been implicated in the development of tissue damage after ischemic reperfusion (I/R). Here we demonstrate that T cells infiltrate the intestine of C57BL/6 mice subjected to intestinal I/R during the first hour of reperfusion. The intensity of the T cell infiltration was higher in B6.MRL/lpr mice subjected to intestinal I/R and reflected more severe tissue damage than that observed in control mice. Depletion of T cells limited I/R damage in B6.MRL/lpr mice, whereas repletion of B6.MRL/lpr lymph node-derived T cells into the I/R-resistant Rag-1(-/-) mouse reconstituted tissue injury. The tissue-infiltrating T cells were found to produce IL-17. Finally, IL-23 deficient mice, which are known not to produce IL-17, displayed significantly less intestinal damage when subjected to I/R. Our data assign T cells a major role in intestinal I/R damage by virtue of producing the pro-inflammatory cytokine IL-17.

Abnormal emotional reactivity in depression: Contrasting theoretical models using neurophysiological data.

Several theoretical models of aberrant emotional experiences in depression have been suggested. These models include potentiated reactivity to negatively-valenced stimuli, attenuated reactivity to positively-valenced stimuli, and attenuated emotional reactivity across contexts (termed emotion-context insensitivity). It is unclear if these models apply uniquely to depression or if they can explain other closely related symptoms, such as anxiety or general negative affect. The current study (N = 122) is the first to utilize structural equation modeling (SEM) techniques on neurophysiological data (event-related potentials, or ERPs) to empirically compare these theoretical models, thereby integrating perspectives from clinical psychology with affective neuroscience and advanced statistical techniques. We recorded ERPs during a passive viewing emotional task. Correlational analyses revealed several small, non-significant negative relationships between depression symptoms and emotional reactivity to both pleasant and unpleasant stimuli. However, SEM analyses revealed significantly attenuated emotional reactivity, to both pleasant and unpleasant stimuli, for depressive symptomatology. These relationships were specific to depression and did not apply to anxiety or internalizing symptoms broadly. Model comparisons revealed support for the emotional-context insensitivity hypothesis. Findings from this study are evidence in support of marrying novel techniques (here, SEM and ERPs) to test important theoretical questions regarding internalizing symptomatology.

Differential effects of state and trait mindfulness on the late positive potential.

Mindfulness is an effective emotion regulation strategy, and its principles have formed the basis for several psychotherapies. Of interest is how a mindful perspective changes not only the subjective experience of emotion, but also neural activity involved in emotional processing. In a previous event-related potential (ERP) study, trait mindfulness was linked with reduced neural activity in response to affective stimuli, as measured by the late positive potential (LPP). Building on this result, we investigated how both state (i.e., task-induced) and trait mindfulness would jointly affect the LPP in a large adult sample (N = 118). First, participants passively viewed affective images while ERP data were recorded. Participants were then instructed to adopt a mindful perspective and viewed a second, equivalent set of images. We hypothesized that the LPP would be reduced from the passive viewing to the mindful viewing condition. Contrary to our hypothesis, task-induced mindfulness increased LPP amplitude relative to passive viewing across all image types, suggesting that state mindfulness increases motivated attention to stimuli, regardless of affective valence and arousal. Trait mindfulness did not correlate with LPP amplitude in either the passive or mindful viewing conditions. As an unexpected finding, gender moderated the association between trait mindfulness and LPP amplitude to emotional images during mindful viewing. We propose that state and trait mindfulness impact emotional processing through different neural mechanisms and discuss implications for mindfulness as an emotion regulation strategy. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Anti-ribonucleoprotein antibodies mediate enhanced lung injury following mesenteric ischemia/reperfusion in Rag-1(-/-) mice.

Natural Abs and autoantibodies bind antigens displayed by ischemia-conditioned tissues, followed by complement activation and enhanced tissue injury during reperfusion. Anti-ribonucleoprotein (RNP) Ab is associated with lung disease in patients with autoimmune disease but it is not known whether these abs contribute to lung injury. Mesenteric I/R in mice leads to local and remote lung injury. Accordingly, we used this model to investigate whether anti-RNP Abs would reconstitute I/R damage with prominent lung damage in injury-resistant Rag1(-/-) animals. Rag1(-/-) mice injected with anti-RNP Ab containing serum and subjected to mesenteric I/R suffered greater intestinal injury than control-treated and sham-operated animals. The magnitude of the reconstituted damage was anti-RNP Ab titer-dependent. Anti-RNP Ab-treated animals demonstrated a dose-dependent increase in lung histologic injury scores compared to control and sham animals. Anti-RNP mediated injury was shown to be complement dependent. These experiments reveal a novel mechanism whereby anti-RNP Abs contributes to the development of pulmonary pathology in patients with autoimmune diseases following exposure of remote organs to I/R injury.

Normal binocular rivalry in autism: implications for the excitation/inhibition imbalance hypothesis.

Autism is characterized by disruption in multiple dimensions of perception, emotion, language and social cognition. Many hypotheses for the underlying neurophysiological basis have been proposed. Among these is the excitation/inhibition (E/I) imbalance hypothesis, which states that levels of cortical excitation and inhibition are disrupted in autism. We tested this theory in the visual system, because vision is one of the better understood systems in neuroscience, and because the E/I imbalance theory has been proposed to explain hypersensitivity to sensory stimuli in autism. We conducted two experiments on binocular rivalry, a well-studied psychophysical phenomenon that depends critically on excitation and inhibition levels in cortex. Using a computational model, we made specific predictions about how imbalances in excitation and inhibition levels would affect perception during two aspects of binocular rivalry: mixed perception (Experiment 1) and traveling waves (Experiment 2). We found no significant differences in either of these phenomena between high-functioning adults with autism and controls, and no evidence for a relationship between these measurements and the severity of autism. These results do not conclusively rule out an excitation/inhibition imbalance in the visual system of those with autism, but they suggest that such an imbalance, if it exists, is likely to be small in magnitude.

Endogenous spatial attention: evidence for intact functioning in adults with autism.

Rapid manipulation of the attention field (i.e. the location and spread of visual spatial attention) is a critical aspect of human cognition, and previous research on spatial attention in individuals with autism spectrum disorders (ASD) has produced inconsistent results. In a series of three psychophysical experiments, we evaluated claims in the literature that individuals with ASD exhibit a deficit in voluntarily controlling the deployment and size of the spatial attention field. We measured the spatial distribution of performance accuracies and reaction times to quantify the sizes and locations of the attention field, with and without spatial uncertainty (i.e. the lack of predictability concerning the spatial position of the upcoming stimulus). We found that high-functioning adults with autism exhibited slower reaction times overall with spatial uncertainty, but the effects of attention on performance accuracies and reaction times were indistinguishable between individuals with autism and typically developing individuals in all three experiments. These results provide evidence of intact endogenous spatial attention function in high-functioning adults with ASD, suggesting that atypical endogenous attention cannot be a latent characteristic of autism in general.

Decay-accelerating factor attenuates remote ischemia-reperfusion-initiated organ damage.

Complement activation contributes to the expression of local and remote organ injury in animal models of ischemia-reperfusion (IR). We demonstrate here that a soluble form of decay-accelerating factor (DAF) protects normal C57Bl/6 and autoimmunity-prone B6.MRL/lpr mice subjected to hindlimb IR from remote intestinal and lung injury without affecting the degree of local skeletal muscle injury. In addition, DAF treatment attenuates remote organ injury in mice subjected to mesenteric IR. Soluble DAF allowed the deposition of complement 3 in local and remote injury sites while it limited the presence of terminal membrane attack complex and did not increase animal susceptibility to sepsis. These data provide evidence that soluble DAF might offer clinical benefit to patients suffering remote intestinal or lung damage in response to muscle or other organ injury.

Anti-phospholipid antibodies restore mesenteric ischemia/reperfusion-induced injury in complement receptor 2/complement receptor 1-deficient mice.

Complement receptor 2-deficient (Cr2(-/-)) mice are resistant to mesenteric ischemia/reperfusion (I/R) injury because they lack a component of the natural Ab repertoire. Neither the nature of the Abs that are involved in I/R injury nor the composition of the target Ag, to which recognition is lacking in Cr2(-/-) mice, is known. Because anti-phospholipid Abs have been shown to mediate fetal growth retardation and loss when injected into pregnant mice, we performed experiments to determine whether anti-phospholipid Abs can also reconstitute I/R injury and, therefore, represent members of the injury-inducing repertoire that is missing in Cr2(-/-) mice. We demonstrate that both murine and human monoclonal and polyclonal Abs against negatively charged phospholipids can reconstitute mesenteric I/R-induced intestinal and lung tissue damage in Cr2(-/-) mice. In addition, Abs against beta2 glycoprotein I restore local and remote tissue damage in the Cr2(-/-) mice. Unlike Cr2(-/-) mice, reconstitution of I/R tissue damage in the injury-resistant Rag-1(-/-) mouse required the infusion of both anti-beta2-glycoprotein I and anti-phospholipid Ab. We conclude that anti-phospholipid Abs can bind to tissues subjected to I/R insult and mediate tissue damage.