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1.
J Int Neuropsychol Soc ; 30(5): 499-522, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38251679

RESUMO

OBJECTIVE: "Ecological validity" (EV) is classically defined as test's ability to predict real-world functioning, either alone or together with test's similarity to real-world tasks. In neuropsychological literature on assessment of executive functions (EF), EV is conceptualized inconsistently, leading to misconceptions about the utility of tests. The goal of this systematic review was to examine how EV is conceptualized in studies of EF tests described as ecologically valid. METHOD: MEDLINE and PsychINFO Databases were searched. PRISMA guidelines were observed. After applying inclusion and exclusion criteria, this search yielded 90 articles. Deductive content analysis was employed to determine how the term EV was used. RESULTS: About 1/3 of the studies conceptualized EV as the test's ability to predict functional outcomes, 1/3 as both the ability to predict functional outcome and similarity to real-world tasks, and 1/3 were either unclear about the meaning of the term or relied on notions unrelated to classical definitions (e.g., similarity to real-world tasks alone, association with other tests, or the ability to discriminate between populations). CONCLUSIONS: Conceptualizations of the term EV in literature on EF assessment vary grossly, subsuming the notions of criterion, construct, and face validity, as well as sensitivity/specificity. Such inconsistency makes it difficult to interpret clinical utility of tests that are described as ecologically valid. We call on the field to require that, at minimum, the term EV be clearly defined in all publications, or replaced with more concrete terminology (e.g., criterion validity).


Assuntos
Função Executiva , Testes Neuropsicológicos , Humanos , Função Executiva/fisiologia , Testes Neuropsicológicos/normas , Reprodutibilidade dos Testes
2.
J Int Neuropsychol Soc ; 30(4): 350-359, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38465734

RESUMO

OBJECTIVE: Extensive research shows that tests of executive functioning (EF) predict instrumental activities of daily living (IADLs) but are nevertheless often criticized for having poor ecological validity. The Modified Six Elements Test (MSET) is a pencil-and-paper test that was developed to mimic the demands of daily life, with the assumption that this would result in a more ecologically valid test. Although the MSET has been extensively validated in its ability to capture cognitive deficits in various populations, support for its ability to predict functioning in daily life is mixed. This study aimed to examine the MSET's ability to predict IADLs assessed via three different modalities relative to traditional EF measures. METHOD: Participants (93 adults aged 60 - 85) completed the MSET, traditional measures of EF (Delis-Kaplan Executive Function System; D-KEFS), and self-reported and performance-based IADLs in the lab. Participants then completed three weeks of IADL tasks at home, using the Daily Assessment of Independent Living and Executive Skills (DAILIES) protocol. RESULTS: The MSET predicted only IADLs completed at home, while the D-KEFS predicted IADLs across all three modalities. Further, the D-KEFS predicted home-based IADLs beyond the MSET when pitted against each other, whereas the MSET did not contribute beyond the D-KEFS. CONCLUSIONS: Traditional EF tests (D-KEFS) appear to be superior to the MSET in predicting IADLs in community-dwelling older adults. The present results argue against replacing traditional measures with the MSET when addressing functional independence of generally high-functioning and cognitive healthy older adult patients.


Assuntos
Atividades Cotidianas , Transtornos Cognitivos , Humanos , Idoso , Atividades Cotidianas/psicologia , Testes Neuropsicológicos , Função Executiva , Vida Independente
3.
Ann Behav Med ; 57(8): 676-686, 2023 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-37163736

RESUMO

BACKGROUND: Executive functioning (EF) predicts better Type 1 diabetes (T1D) management in the high-risk years after high school, but the daily self-regulation processes involved are unclear. PURPOSE: To examine whether EF is associated with daily self-regulation that minimizes one's exposure or buffers adverse reactions to daily diabetes problems, and to determine whether these patterns become stronger during the transition out of high school. METHODS: A measurement burst design with convenience sampling was used. Seniors in high school with T1D (N = 207; 66% female) completed self-report (i.e., Behavioral Rating Inventory of Executive Functioning) and performance measures of EF (i.e., Delis-Kaplan Executive Function System). A 14-day daily diary assessing self-regulation failures, diabetes problems, affect, and indicators of diabetes management was completed at baseline and 1 year later. RESULTS: Correlations and multilevel modeling were conducted. Lower self-reported EF problems were associated with lower average levels of daily self-regulation failures, and these variables were associated with fewer daily diabetes problems. In contrast, better EF performance was unrelated to average daily self-regulation failures, and was unexpectedly associated with more frequent diabetes problems in year 2. Equally across years, on days participants reported lower than their average levels of daily self-regulation failures, they had fewer diabetes problems, regardless of EF. On days with lower than average diabetes problems, participants reported better diabetes management indicators. EF generally did not buffer daily associations in either year. CONCLUSIONS: Regardless of EF, promoting daily self-regulation may prevent diabetes problems and promote T1D management in daily life at this high-risk transitional time.


Type 1 diabetes (T1D) requires daily self-regulation (e.g., remembering to check blood glucose; regulating emotions, thoughts, and behaviors when diabetes problems arise). These processes draw on executive function (EF) abilities, which may be challenged after high school, when youth experience many life transitions while managing diabetes more independently from parents. The study examined how EF is associated with daily diabetes management as youth transition out of high school. Seniors in high school with T1D completed measures of EF and two 14-day daily diaries, one in the senior year and one the following year. Each evening, participants completed an online survey reporting on self-regulation failures (e.g., forgetting to test blood glucose), diabetes problems, and diabetes management over the past 24 hr. Those with better self-reported EF had lower self-regulation failures and fewer diabetes problems on average. On days with lower self-regulation failures, participants had fewer diabetes problems. On days with fewer diabetes problems, participants reported lower negative emotions, higher confidence in diabetes management, and better self-care behaviors and blood glucose levels. These daily associations occurred regardless of EF. Providing youth with training in self-regulation to prevent daily diabetes problems may promote T1D management during this high-risk transition.


Assuntos
Diabetes Mellitus Tipo 1 , Autocontrole , Humanos , Feminino , Adulto , Masculino , Diabetes Mellitus Tipo 1/terapia , Função Executiva/fisiologia , Autorrelato
4.
J Int Neuropsychol Soc ; 29(9): 850-858, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37057862

RESUMO

OBJECTIVE: Research shows that cognitively healthy older adults with mild executive function (EF) weaknesses are vulnerable to the negative impacts of life complexity (or daily busyness) when performing instrumental activities of daily living (IADLs). However, past research assessed life complexity only at one timepoint, not capturing daily fluctuations. Importantly, fluctuations in busyness can themselves have deleterious impacts on functioning. This study extended past research by examining whether (1) variability in daily busyness would be more detrimental than level of busyness to performance of IADLs, and (2) EF assessed at home would moderate deleterious impact of busyness on IADLs. METHOD: Fifty-two community-dwelling older adults aged 60 to 95 completed daily IADL tasks and daily measures of EF and busyness via ecological momentary assessment, independently at home for 18 days. RESULTS: (1) In a subset of participants with mild EF weaknesses, high variability in busyness across days was associated with fewer tasks completed correctly; and (2) across all participants (regardless of EF), high levels of daily busyness were associated with fewer tasks completed on time. CONCLUSIONS: Findings indicate that high variability in daily busyness, potentially reflecting a lack of daily routine, was associated with IADL errors among cognitively healthy older adults with mild EF weaknesses. Additionally, consistently high levels of busyness were associated with failures to complete tasks, or failures to complete them on time, regardless of EF. These results further support the Contextually Valid Executive Assessment (ConVExA) model, which posits that EF and contextual factors interact to predict functional outcomes.

5.
J Int Neuropsychol Soc ; 29(1): 105-109, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-34879885

RESUMO

OBJECTIVE: The COVID-19 pandemic exacerbated gender disparities in some academic disciplines. This study examined the association of the pandemic with gender authorship disparities in clinical neuropsychology (CN) journals. METHOD: Author bylines of 1,018 initial manuscript submissions to four major CN journals from March 15 through September 15 of both 2019 and 2020 were coded for binary gender. Additionally, authorship of 40 articles published on pandemic-related topics (COVID-19, teleneuropsychology) across nine CN journals were coded for binary gender. RESULTS: Initial submissions to these four CN journals increased during the pandemic (+27.2%), with comparable increases in total number of authors coded as either women (+23.0%) or men (+25.4%). Neither the average percentage of women on manuscript bylines nor the proportion of women who were lead and/or corresponding authors differed significantly across time. Moreover, the representation of women as authors of pandemic-related articles did not differ from expected frequencies in the field. CONCLUSIONS: Findings suggest that representation of women as authors of peer-reviewed manuscript submissions to some CN journals did not change during the initial months of the COVID-19 pandemic. Future studies might examine how risk and protective factors may have influenced individual differences in scientific productivity during the pandemic.


Assuntos
COVID-19 , Publicações Periódicas como Assunto , Masculino , Humanos , Feminino , Pandemias , Autoria , Neuropsicologia , Bibliometria
6.
Diabetes Spectr ; 36(1): 33-40, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36818410

RESUMO

Managing type 1 diabetes involves coordinating complex daily behaviors that may rely on the cognitive abilities of people with diabetes (PWD) and spouses, especially as couples collaborate surrounding diabetes care. The aims of the study were to examine whether 1) the cognitive abilities of PWD and their spouses predicted lower A1C, 2) collaborating with a spouse with higher cognitive abilities was especially beneficial for PWD with lower cognitive abilities, and 3) the benefit of the cognitive abilities of PWD and their spouse occurred through better self-care. Couples (n = 199) were recruited with one member diagnosed with type 1 diabetes (PWD 52% female sex, average age 46.81 years, average duration of diabetes 27 years; spouses 48% female sex; average age 46.40 years). PWD and spouses completed fluid (trail making tests from the Delis-Kaplan Executive Function System) and crystallized (information subtest from the Wechsler Adult Intelligence Scale-4th Edition) ability tests. PWD rated their spouse's collaboration in diabetes and reported self-care behaviors through surveys. A1C was assessed as a measure of blood glucose through a blood assay. Multiple regressions revealed that spouses' crystallized ability was the only statistically significant predictor, with higher values associated with lower A1C (t = -2.17, P <0.05). The interaction of crystallized ability of PWD × spouse crystallized ability × collaboration indicated that PWD with lower ability tended to benefit more when they collaborated with a spouse who scored higher in ability (t = -2.21, P <0.05). Mediational analyses indicated that spouses' crystallized ability was associated with lower A1C through better self-care behaviors of PWD (B = 0.03, SE = 0.01, P <0.01). We conclude that PWD benefit from the cognitive abilities of their spouses through better self-care behaviors that are important for maintaining lower A1C across adulthood.

7.
J Int Neuropsychol Soc ; 28(9): 974-983, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-34666858

RESUMO

OBJECTIVE: Executive functioning (EF) is known to be associated with performance of instrumental activities of daily living (IADLs). However, prior research has found that the degree to which EF fluctuates was more predictive of self-reported cognitive and IADL lapses than was average EF performance. One source of such EF fluctuations is engagement in an emotion regulation strategy known as expressive suppression (ES). Importantly, ES has also been shown to relate to IADL performance, presumably due to its impact on EF. However, past research is limited due to assessing IADLs only in the laboratory or via self-report. The present study examined (a) the association of daily EF and ES fluctuations with performance of actual IADL tasks in participants' homes, and (b) whether any significant association between ES fluctuations and daily IADLs would be mediated by daily EF variability. METHOD: Participants were 52 older adults aged 60 to 95. Over the course of 18 days while at home, participants completed daily IADL tasks as well as daily measures of EF and ES via ecological momentary assessment. RESULTS: Contrary to our hypothesis, average EF across days predicted at-home IADLs above and beyond daily EF variability, which itself was also predictive. ES variability also predicted daily IADLs, and this association was fully mediated by average daily EF. CONCLUSIONS: Daily fluctuations in ES appear to have a deleterious impact on performance of IADLs at home, likely due to the impact of such fluctuations on EF, although the average level of EF capacity is also important.


Assuntos
Regulação Emocional , Vida Independente , Atividades Cotidianas/psicologia , Idoso , Função Executiva/fisiologia , Humanos , Testes Neuropsicológicos
8.
J Int Neuropsychol Soc ; 27(10): 1004-1014, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33632370

RESUMO

OBJECTIVES: Meta-tasking (MT) is an aspect of executive functioning (EF) that involves the ability to branch (i.e., to apply "if-then" rules) and to effectively interleave sub-goals of one task with sub-goals of another task. As such, MT is crucial for successful planning, coordination, and execution of multiple complex tasks in daily life. Traditional tests of EF fail to adequately measure MT. This study examined whether Condition 4 of the Color-Word Interference Test (CWIT-4; the inhibition/switching condition that requires branching) predicted MT beyond Condition 3 (CWIT-3; inhibition-only condition) and beyond other subtests from the Delis-Kaplan Executive Function System (D-KEFS) that have a switching condition. METHOD: Ninety-eight non-Hispanic white community-dwelling older adults completed the first four subtests of the D-KEFS and an ecologically valid measure of MT. RESULTS: Time to completion and total errors on CWIT-4 accounted for variance in MT above and beyond CWIT-3 and beyond the switching conditions of other D-KEFS subtests. Results remained virtually unchanged when controlling for demographics and general cognitive status. CONCLUSIONS: Among older adults, CWIT-4 is more strongly associated with MT than other D-KFES tasks. Future research should examine whether CWIT-4 relates to lapses in instrumental activities of daily living among older adults above and beyond other EF tests.


Assuntos
Atividades Cotidianas , Vida Independente , Idoso , Função Executiva , Humanos , Inibição Psicológica , Testes Neuropsicológicos
9.
J Int Neuropsychol Soc ; 26(4): 353-363, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31822304

RESUMO

OBJECTIVES: To examine the contributions of two aspects of executive functioning (executive cognitive functions and behavioral control) to changes in diabetes management across emerging adulthood. METHODS: Two hundred and forty-seven high school seniors with type 1 diabetes were assessed at baseline and followed up for 3 years. The baseline assessment battery included performance-based measures of executive cognitive functions, behavioral control, IQ estimate (IQ-est), and psychomotor speed; self-report of adherence to diabetes regimen; and glycated hemoglobin (HbA1c) assay kits as a reflection of glycemic control. RESULTS: Linear and quadratic growth curve models were used to simultaneously examine baseline performance on four cognitive variables (executive cognitive functions, behavioral control, IQ, and psychomotor speed) as predictors of indices of diabetes management (HbA1c and adherence) across four time points. Additionally, general linear regressions examined relative contributions of each cognitive variable at individual time points. The results showed that higher behavioral control at baseline was related to lower (better) HbA1c levels across all four time points. In contrast, executive cognitive functions at baseline were related to HbA1c trajectories, accounting for increasingly more HbA1c variance over time with increasing transition to independence. IQ-est was not related to HbA1c levels or changes over time, but accounted instead for HbA1c variance at baseline (while teens were still living at home), above and beyond all other variables. Cognition was unrelated to adherence. CONCLUSIONS: Different aspects of cognition play a different role in diabetes management at different time points during emerging adulthood years.


Assuntos
Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/fisiopatologia , Função Executiva/fisiologia , Hemoglobinas Glicadas/metabolismo , Inteligência/fisiologia , Cooperação do Paciente , Desempenho Psicomotor/fisiologia , Adolescente , Doença Crônica , Diabetes Mellitus Tipo 1/terapia , Feminino , Humanos , Masculino
10.
J Int Neuropsychol Soc ; 25(1): 29-38, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30362445

RESUMO

OBJECTIVES: Expressive suppression (ES) is an emotion-regulation strategy that is associated with poorer performance on subsequently administered tests of executive functioning (EF). It is not known, however, how far into the future ES interferes with EF. This study examined whether (a) ES negatively affects performance on EF tests repeated 1 year after the initial administration (presumably through interference with learning, leading to a reduced practice effect), and (b) whether such an effect, if seen, is unique to EF or whether it also affects lower-order cognitive processes needed for EF test performance. METHODS: Sixty-six non-demented community-dwelling older adults were randomly assigned to either an ES group or control group. Executive and non-executive tests were administered before and immediately following the exposure to an emotionally evocative video, and then again at 1-year follow-up. Groups were compared at 1-year follow-up on tests of EF and lower-order processes, to examine whether the previously demonstrated impact of ES on EF is evident only immediately following the experimental manipulation (Franchow & Suchy, 2017), or also at 1-year follow-up. RESULTS: The results showed that participants who engaged in ES continued to exhibit poorer performance on EF tests 1 year later. This effect was not present for performance on tests of lower-order processes. CONCLUSIONS: These results suggest that the use of ES before an EF task can interfere with the ability to benefit from exposure to that task, thereby negatively affecting future performance. (JINS, 2019, 25, 29-38).


Assuntos
Envelhecimento/fisiologia , Regulação Emocional/fisiologia , Função Executiva/fisiologia , Desempenho Psicomotor/fisiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Vida Independente , Masculino , Pessoa de Meia-Idade
11.
J Int Neuropsychol Soc ; 25(7): 718-728, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31148529

RESUMO

OBJECTIVES: Expressive suppression (i.e., effortful regulation of overt affect) has a deleterious impact on executive functioning (EF). This relationship has potential ramifications for daily functioning, especially among older adults, because a close relationship exists between EF and functional independence. However, past research has not directly examined whether expressive suppression impacts instrumental activities of daily living (IADL). The present study examined this association among older adults. METHODS: One hundred ten community-dwelling older adults completed a self-report measure of acute (past 24 hr) and chronic (past 2 weeks) expressive suppression, a timed test of IADL, and the Behavioral Dyscontrol Scale as a measure of EF. RESULTS: High chronic expressive suppression was related to slow IADL performance beyond covariates (age, IQ, depression), but only for individuals with low EF. High acute expressive suppression was associated with lower accuracy on IADL tasks beyond covariates (IQ, depression), but this association was fully explained by EF. CONCLUSIONS: The current results suggest that expressive suppression is associated with less efficient and more error-prone IADL performance. EF fully accounted for the relationship between acute expressive suppression and IADL performance, showing that suppression is a risk factor for both poorer EF performance and functional lapses in daily life. Furthermore, individuals with weaker EF may be particularly vulnerable to the effect of chronic expressive suppression. (JINS, 2019, 25, 718-728).


Assuntos
Atividades Cotidianas , Envelhecimento/fisiologia , Regulação Emocional/fisiologia , Função Executiva/fisiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Vida Independente , Masculino , Fatores de Risco , Autorrelato
12.
J Pediatr Psychol ; 44(8): 970-979, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-31095317

RESUMO

OBJECTIVE: To examine (a) changes in parental involvement across early emerging adulthood, (b) whether yearly fluctuations in parental involvement were associated with adherence and glycated hemoglobin (HbA1c) over time, and (c) whether higher involvement was more beneficial for those with poorer executive function (EF). METHODS: A total of 228 high school seniors (M age = 17.76) with type 1 diabetes reported on mothers' and fathers' acceptance, knowledge of diabetes activities, disclosure to mothers and fathers regarding diabetes, and adherence at four yearly time points. At baseline, participants completed performance-based measures of EF. HbA1c was collected from assay kits. RESULTS: Growth curve models revealed significant declines in disclosure to fathers and mothers' and fathers' knowledge of diabetes activities; no changes were found in mothers' or fathers' acceptance nor disclosure to mothers. Multilevel models indicated significant between-person effects for nearly all aspects of parental involvement with more acceptance, knowledge, and disclosure associated with better HbA1c and adherence. Within-person effects for disclosure to fathers, and mothers' and fathers' knowledge indicated that in years when emerging adults perceived higher amounts of these types of involvement (compared with their own average), HbA1c was lower. Within-person effects were found for acceptance to mothers, disclosure to mothers and fathers, and mothers' diabetes knowledge for adherence. Disclosure to fathers and mothers' knowledge of diabetes activities were especially beneficial for HbA1c for those with poorer EF performance. CONCLUSIONS: Parental involvement in diabetes management remains important during the high-risk time of emerging adulthood, especially for those with poorer EF.


Assuntos
Disfunção Cognitiva/etiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/terapia , Função Executiva , Poder Familiar , Pais , Cooperação do Paciente , Adolescente , Adulto , Função Executiva/fisiologia , Feminino , Seguimentos , Humanos , Masculino , Adulto Jovem
13.
Ann Behav Med ; 52(5): 406-411, 2018 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-29684134

RESUMO

Background: Executive functioning (EF) describes a set of neurocognitive processes critical to enacting complex health behaviors. However, theoretical frameworks for understanding sexual risk behavior have generally neglected neurocognitive constructs, and beyond a few studies of individuals selected for high substance use, the literature contains virtually no research on this topic with other adults at risk for HIV infection, such as men who have sex with men (MSM). Purpose: This study tested whether EF was associated with condomless anal intercourse (CAI) among MSM. Methods: Seventy MSM completed cognitive tests assessing EF at two time points-baseline, and approximately 30 min later after engaging in a stressful interpersonal task. Men also reported their sexual behaviors over the past 3 months, including the frequency of CAI. Results: Baseline EF was unrelated to CAI. However, CAI was associated with the degree to which performance improved from baseline to post-stressor administration. Compared with norms for practice effects, men who reported CAI improved less than expected from baseline to post-stressor EF performance, whereas men who reported no CAI exhibited a more normative practice effect. Conclusions: MSM with histories of greater sexual risk improved less than anticipated from baseline to post-stressor on tests of EF, suggesting that they might be more cognitively depleted by the stressful interpersonal task they engaged in between administrations. It is possible that certain individuals struggle to maintain executive control in stressful interpersonal situations, a finding that could contribute to the difficulty some individuals face executing precautionary behaviors during a sexual encounter.


Assuntos
Preservativos , Função Executiva/fisiologia , Homossexualidade Masculina , Relações Interpessoais , Assunção de Riscos , Estresse Psicológico/fisiopatologia , Sexo sem Proteção/fisiologia , Adolescente , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
J Int Neuropsychol Soc ; 23(4): 341-351, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-28287061

RESUMO

OBJECTIVES: Accurate detection of executive dysfunction in neuropsychological assessments is complicated by the fact that executive functioning (EF) is vulnerable to temporary disruption (i.e., lapses), with more frequent lapses in older adulthood. Effortful regulation of affect (i.e., expressive suppression) is a well-known source of executive lapses in younger adults, but the generalizability of this depleting effect to older adults is unknown. The purpose of this study was to (1) determine whether EF is subject to depletion via expressive suppression and (2) to examine whether this effect is unique to EF, or whether it also applies to lower-order component processes in older adults. METHODS: Ninety-seven non-demented, community-dwelling older adults were randomly assigned to either an expressive suppression group or control group. We compared performance of the groups on a battery of tests measuring EF and component processes both before and after exposure to emotionally evocative stimuli. RESULTS: Consistent with the hypothesized depletion effect, suppressing participants showed an attenuated practice effect on post-manipulation EF relative to controls, while performance on lower-order component processes was unaffected by suppression. CONCLUSIONS: These results suggest that depletion contributes to executive lapses in older adulthood. (JINS, 2017, 23, 341-351).


Assuntos
Envelhecimento Cognitivo/fisiologia , Emoções/fisiologia , Função Executiva/fisiologia , Inibição Psicológica , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
J Int Neuropsychol Soc ; 23(3): 204-213, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28065206

RESUMO

OBJECTIVES: Good glycemic control is an important goal of diabetes management. Late adolescents with type 1 diabetes (T1D) are at risk for poor glycemic control as they move into young adulthood. For a subset of these patients, this dysregulation is extreme, placing them at risk for life-threatening health complications and permanent cognitive declines. The present study examined whether deficiency in emotional decision making (as measured by the Iowa Gambling Task; IGT) among teens with T1D may represent a neurocognitive risk factor for subsequent glycemic dysregulation. METHODS: As part of a larger longitudinal study, a total of 241 high-school seniors (147 females, 94 males) diagnosed with T1D underwent baseline assessment that included the IGT. Glycated hemoglobin (HbA1c), which reflects glycemic control over the course of the past 2 to 3 months, was also assessed at baseline. Of the 241,189 (127 females, 62 males, mean age=17.76, mean HbA1c=8.11) completed HbA1c measurement 1 year later. RESULTS: Baseline IGT performance in the impaired range (per norms) was associated with greater dysregulation in glycemic control 1 year later, as evidenced by an average increase in HbA1c of 2%. Those with normal IGT scores (per norms) exhibited a more moderate increase in glycemic control, with an HbA1c increase of 0.7%. Several IGT scoring approaches were compared, showing that the total scores collapsed across all trials was most sensitive to change in glycemic control. CONCLUSIONS: IGT assessment offers promise as a tool for identifying late adolescents at increased risk for glycemic dysregulation. (JINS, 2017, 23, 204-213).


Assuntos
Glicemia/fisiologia , Tomada de Decisões/fisiologia , Diabetes Mellitus Tipo 1 , Jogos Experimentais , Adolescente , Afeto/fisiologia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/fisiopatologia , Diabetes Mellitus Tipo 1/psicologia , Feminino , Seguimentos , Hemoglobinas Glicadas/metabolismo , Humanos , Modelos Lineares , Masculino , Análise de Componente Principal , Adulto Jovem
16.
J Int Neuropsychol Soc ; 22(6): 671-81, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27333538

RESUMO

Objectives Growing evidence demonstrates that (a) executive functioning (EF) becomes deleteriously affected by engagement in the emotion regulation strategy known as expressive suppression and (b) EF shows considerable functional and neuroanatomical overlap with motor output. The current study aimed to bridge these two literatures by examining the relationships between naturally occurring expressive suppression and several different aspects of motor output, including action planning, action learning, and motor-control speed and accuracy. In addition, we investigated whether any identified relationships could be explained by EF. Methods Fifty-one healthy young adults completed selected subtests from the Delis-Kaplan Executive Function System as indices of EF, a self-report measure of expressive suppression, and a computerized motor sequencing task (Push Turn Taptap task; PTT) designed to assess action planning, action learning, and motor control speed and accuracy. Results Hierarchical regressions using each aspect of PTT performance as the dependent variable revealed that higher than usual self-reported expressive suppression on the day of testing (relative to the 2 weeks preceding testing) was associated with longer action-planning latencies. This relationship was fully explained by EF. No other PTT variables related to expressive suppression on the day of testing. Conclusions These results suggest that increased expressive suppression in daily life is associated with slower action planning, an aspect of motor output that is reliant on EF, highlighting the importance of factors that lead to intra-individual fluctuations in EF and motor performance. (JINS, 2016, 22, 671-681).


Assuntos
Emoções/fisiologia , Função Executiva/fisiologia , Desempenho Psicomotor/fisiologia , Autocontrole , Pensamento/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
17.
J Int Neuropsychol Soc ; 22(4): 453-66, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26790693

RESUMO

Although cognitive decline is typically associated with decreasing practice effects (PEs) (presumably due to declining memory), some studies show increased PEs with declines in cognition. One explanation for these inconsistencies is that PEs reflect not only memory, but also rebounds from adapting to task novelty (i.e., novelty effect), leading to increased PEs. We examined a theoretical model of relationships among novelty effects, memory, cognitive decline, and within-session PEs. Sixty-six older adults ranging from normal to severely impaired completed measures of memory, novelty effects, and two trials each of Wechsler Adult Intelligence Scale, 4 th Edition Symbol Search and Coding. Interrelationships among variables were examined using regression analyses. PEs for Symbol Search and Coding (a) were related to different proposed PE components (i.e., memory and novelty effects), such that novelty effect predicted Symbol Search PE (R2 =.239, p<.001) and memory predicted Coding PE (R2 =.089, p=.015), and (b) showed different patterns across stages of cognitive decline, such that the greatest cognitive decline was associated with smallest Coding PE (R2 =.125, p=.004), whereas intermediate cognitive decline was associated with the greatest Symbol Search PE (R2 =.097, p=.040). The relationship between cognitive decline and PE for Symbol Search was partially mediated by novelty effect among older adults with abnormal cognitive decline (model R2 =.286, p<.001). These findings (a) suggest that PE is not a unitary construct, (b) offer an explanation for contradictory findings in the literature, and (c) highlight the need for a better understanding of component processes of PE across different neuropsychological measures.


Assuntos
Transtornos Cognitivos/reabilitação , Terapia Cognitivo-Comportamental/métodos , Testes Neuropsicológicos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Memória/fisiologia , Pessoa de Meia-Idade , Análise de Regressão , Aprendizagem Verbal/fisiologia , Escalas de Wechsler
18.
Psychol Res ; 80(6): 997-1019, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26409468

RESUMO

Two competing theoretical models of individual differences in executive functioning (EF) were examined: the Prefrontal Convexity Model and the Hemispheric Asymmetry Model. Neurologically healthy individuals (N = 315; mean age 20.8) completed a modified switching task (MST) and the Attention Network Test (ANT) in a single testing session. Data analysis was conducted in two phases. In the first phase (model identification), latent profile analysis was applied to MST variables measuring the abilities to form, switch, and maintain mental sets under conditions designed to tax left or right hemisphere resources. In the second phase (model validation), participant clusters obtained from the first phase were compared on the ANT. The Model Identification phase yielded a 3-profile solution consistent with the Hemispheric Asymmetry Model. Profile 1 (N = 203) was characterized by average EF performances. Profile 2 (N = 43) revealed a set maintenance weakness under non-verbal conditions. Profile 3 (N = 38) demonstrated weaknesses in cognitive flexibility combined with poor executive performances under verbal conditions. The Model Validation phase confirmed group differences. Profile 1 demonstrated average EF performances. Profile 2 demonstrated distractibility and decreased alertness, consistent with a right hemisphere weakness. Profile 3 demonstrated cognitive rigidity in the absence of external cues, consistent with a left hemisphere weakness. Individual differences in EF appear to follow a Hemispheric Asymmetry Model of EF among neurologically healthy adults. Investigating the relationship between hemispherically mediated executive functions and other individual difference factors known to confer health risk or resilience could inform numerous disciplines within the field of psychology.


Assuntos
Atenção/fisiologia , Função Executiva/fisiologia , Individualidade , Córtex Pré-Frontal/fisiologia , Desempenho Psicomotor/fisiologia , Adulto , Feminino , Humanos , Masculino , Memória de Curto Prazo/fisiologia , Tempo de Reação/fisiologia , Comportamento Social , Adulto Jovem
19.
Psychol Res ; 79(4): 590-608, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24941914

RESUMO

Previous studies have shown that verbalization, in the form of self-guided instruction, is an effective cognitive strategy used to enhance motor skill acquisition and performance. However, past research has not explicitly examined which aspects of motor output are affected (whether beneficially or deleteriously) by verbalization. In the current study, we conducted two separate experiments in which a total of 80 healthy participants, aged 18-27, completed a novel motor sequence learning task. Half of the participants in each experiment were pre-trained in the sequence using verbalization, while the other half was either trained motorically, or not trained at all. Rote memorization of verbal labels facilitated motor sequence learning, motor control, and action maintenance, but not action planning of the motor sequence. Potential underlying mechanisms as well as clinical implications are discussed.


Assuntos
Atividade Motora/fisiologia , Desempenho Psicomotor/fisiologia , Aprendizagem Seriada/fisiologia , Comportamento Verbal/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
20.
J Pediatr Psychol ; 39(9): 1038-48, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25064802

RESUMO

OBJECTIVE: To examine whether individual differences and intraindividual (within-person day-to-day) fluctuations in late adolescents' self-regulation were associated with daily adherence to the type 1 diabetes regimen. METHODS: 110 school seniors (M age = 17.78 years) and their mothers assessed adolescents' skills underlying self-regulation (executive function, attention, self-control, behavioral inhibition and activation, emotion regulation) and adherence, with glycosylated hemoglobin from medical records. Teens completed daily diaries reporting self-regulation failures surrounding monitoring blood glucose, adherence, and number of blood glucose checks each day for 14 days. RESULTS: Hierarchical Linear Models indicated that better daily adherence was associated with teen and mother reports of better self-regulation skills and teens' reports of fewer daily self-regulation failures. Daily adherence was unrelated to temperamental differences in behavioral inhibition and activation. CONCLUSIONS: Results indicate that both individual and intraindividual differences in self-regulation contribute to daily adherence highlighting the importance of daily self-regulatory challenges to adherence.


Assuntos
Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Individualidade , Cooperação do Paciente/estatística & dados numéricos , Autoimagem , Autocontrole/psicologia , Adolescente , Comportamento do Adolescente/psicologia , Glicemia/análise , Automonitorização da Glicemia , Feminino , Hemoglobinas Glicadas , Humanos , Masculino , Cooperação do Paciente/psicologia , Autocuidado/psicologia
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