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Department/Unit:Child and Adolescent Psychiatry

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Socioeconomic disparities in neurocognitive development in the first two years of life

Noble, Kimberly G; Engelhardt, Laura E; Brito, Natalie H; Mack, Luke J; Nail, Elizabeth J; Angal, Jyoti; Barr, Rachel; Fifer, William P; Elliott, Amy J
Socioeconomic status (SES) is strongly associated with cognition and achievement. Socioeconomic disparities in language and memory skills have been reported from elementary school through adolescence. Less is known about the extent to which such disparities emerge in infancy. Here, 179 infants from socioeconomically diverse families were recruited. Using a cohort-sequential design, 90 infants were followed at 9 and 15 months, and 89 were followed at 15 and 21 months. SES disparities in developmental trajectories of language and memory were present such that, at 21 months of age, children of highly educated parents scored approximately .8 standard deviations higher in both language and memory than children of less educated parents. The home language and literacy environment and parental warmth partially accounted for disparities in language, but not memory development.
PMCID:4821066
PMID: 25828052
ISSN: 1098-2302
CID: 3024022

The intergenerational transmission of ethnic essentialism: how parents talk counts the most

Segall, Gili; Birnbaum, Dana; Deeb, Inas; Diesendruck, Gil
The present study analyzed the role of parents as potential sources of children's essentialist beliefs about ethnicity. We tested 76 parent-child (5-year-olds) dyads of Jewish Israeli parents from three social groups, defined by the kindergartens children attended: national religious, secular, or Jewish-Arab integrated. We assessed parents' and children's beliefs, and parents' usage of ethnic attitudinal and categorization markers in a book-reading activity. Overall, national religious parents manifested the strongest ethnic essentialism and endorsement of anti-negotiations with Palestinians, and were the most likely to express negative attitudes and mark ethnic categories in their conversations with their children. Moreover, regression analyses revealed that ethnic categorization in parents' speech was the most reliable predictor of children's ethnic essentialism. Ethnic essentialism is transmitted to children not via explicit communication of intergroup beliefs or attitudes, but rather via the sheer marking of categories in ways that resonate with children's own intuitive ways of conceptualizing the social world.
PMID: 25212249
ISSN: 1467-7687
CID: 4379352

Sensation-to-cognition cortical streams in attention-deficit/hyperactivity disorder

Carmona, Susana; Hoekzema, Elseline; Castellanos, Francisco X; Garcia-Garcia, David; Lage-Castellanos, Agustin; Van Dijk, Koene R A; Navas-Sanchez, Francisco J; Martinez, Kenia; Desco, Manuel; Sepulcre, Jorge
We sought to determine whether functional connectivity streams that link sensory, attentional, and higher-order cognitive circuits are atypical in attention-deficit/hyperactivity disorder (ADHD). We applied a graph-theory method to the resting-state functional magnetic resonance imaging data of 120 children with ADHD and 120 age-matched typically developing children (TDC). Starting in unimodal primary cortex-visual, auditory, and somatosensory-we used stepwise functional connectivity to calculate functional connectivity paths at discrete numbers of relay stations (or link-step distances). First, we characterized the functional connectivity streams that link sensory, attentional, and higher-order cognitive circuits in TDC and found that systems do not reach the level of integration achieved by adults. Second, we searched for stepwise functional connectivity differences between children with ADHD and TDC. We found that, at the initial steps of sensory functional connectivity streams, patients display significant enhancements of connectivity degree within neighboring areas of primary cortex, while connectivity to attention-regulatory areas is reduced. Third, at subsequent link-step distances from primary sensory cortex, children with ADHD show decreased connectivity to executive processing areas and increased degree of connections to default mode regions. Fourth, in examining medication histories in children with ADHD, we found that children medicated with psychostimulants present functional connectivity streams with higher degree of connectivity to regions subserving attentional and executive processes compared to medication-naive children. We conclude that predominance of local sensory processing and lesser influx of information to attentional and executive regions may reduce the ability to organize and control the balance between external and internal sources of information in ADHD. Hum Brain Mapp 36:2544-2557, 2015. (c) 2015 Wiley Periodicals, Inc.
PMCID:4484811
PMID: 25821110
ISSN: 1097-0193
CID: 1640172

The Power of Positivity: Predictors of Relationship Satisfaction for Parents of Children with Autism Spectrum Disorder

Ekas, Naomi V; Timmons, Lisa; Pruitt, Megan; Ghilain, Christine; Alessandri, Michael
The current study uses the actor-partner interdependence model to examine the predictors of relationship satisfaction for mothers and fathers of children with autism spectrum disorder. Sixty-seven couples completed measures of optimism, benefit finding, coping strategies, social support, and relationship satisfaction. Results indicated that parent's positive strengths predicted better personal relationship satisfaction. Moreover, parents' benefit finding, use of emotional support, and perceived social support from their partner also predicted their partner's relationship satisfaction. The results of this study highlight the importance of focusing on positive factors that can enhance relationship quality. Implications for the development of parent-focused interventions are discussed.
PMID: 25601217
ISSN: 1573-3432
CID: 5603352

Paediatric use of melatonin (Author reply to D. J. Kennaway) [Letter]

Bruni, Oliviero; Alonso-Alconada, Daniel; Besag, Frank; Biran, Valerie; Braam, Wiebe; Cortese, Samuele; Moavero, Romina; Parisi, Pasquale; Smits, Marcel; Van der Heijden, Kristiaan; Curatolo, Paolo
PMID: 25981980
ISSN: 1532-2130
CID: 1590542

Intervention to reduce PTSD in 0-5 year olds with burns [Meeting Abstract]

Stoddard, Jr F J; Kim, A; Murphy, J M; Chedekel, D S; White, G; Williams, B C; Saxe, G N; Man, J K; Canenguez, K; Sheridan, R L
Introduction: The objective of this study was to use two interventions to decrease PTSD and PTSD symptomatology in young burned children as measured by the Posttraumatic Stress Disorder Semi-Structured Interview and Observational Report, or PTSDSSI (Sheeringa et al., 1994; 2003). The PTSDSSI was an appropriate instrument for evaluating PTSD in young children because its use elsewhere informed the DSM 5 diagnostic subtype, "PTSD in Children 6 Years and Younger" (APA, 2013). The PTSDSSI also requires parent observation of symptoms appropriate for young children-such as children's posttraumatic play, distressing dreams, withdrawal and irritibility; with a maximal score of 38. The Intervention group in this study received either the DEF (Distress, Emotional Support, and Family Functioning protocol) or the DEF+COPE (Creating Opportunities for Parent Empowerment program). Outcomes of child stress were compared with a Non-Intervention, control group. Methods: Children aged 0-5 years old admitted for an acute burn or for reconstructive surgery and their families, who speak English or Spanish, were eligible. The DEF consists of an initial meeting with caregivers to identify distress or support from an interview and offer clinical referrals for the family, and can be found online on nctsnet.org. The COPE (Melnyk, 2004) provides a workbook to increase parents' knowledge of typical behaviors and emotions children display in hospital and advice on how to participate more directly in child's care. Parents completed the PTSDSSI after their child's admission and at 6 month follow-up, to measure child stress. The 6-month change scores of the PTSDSSI were analyzed for three symptom clusters: re-experiencing(B), numbing/avoidance(C), and hyperarousal(D). Results: Although results did not reach statistical significance in this small sample, there was a clear trend of larger decreases in PTSD symptoms for children in the intervention group as compared to children in the control group. Conclusions: Both forms of intervention appear to have aided in the reduction child stress as measured by the PTSDSSI. Future studies with larger samples should explore both types of intervention. Applicability of Research to Practice: The psychosocial interventions outlined have clear benefits that should be taken into consideration when providing care to children with burns. (Figure presented)
EMBASE:71949468
ISSN: 1559-047x
CID: 1702492

Imaging-Based Features of Headaches in Chiari Malformation Type I

Alperin, Noam; Loftus, James R; Oliu, Carlos J; Bagci, Ahmet M; Lee, Sang H; Ertl-Wagner, Birgit; Sekula, Raymond; Lichtor, Terry; Green, Barth A
BACKGROUND:Suboccipital cough-induced headaches are considered a hallmark symptom of Chiari malformation type I (CMI). However, non--Valsalva-related suboccipital headaches and headaches in other locations are also common in CMI. The diagnostic significance and the underlying factors associated with these different headaches types are not well understood. OBJECTIVE:To compare cranial morphology and hydrodynamics in 3 types of headaches in CMI to better understand the pathophysiological basis for the different headache characteristics. METHODS:Twenty-two cranial physiological and morphological measures were obtained with specialized magnetic resonance imaging scans from 63 symptomatic pretreated CMI patients, 40 with suboccipital headaches induced by Valsalva maneuvers (34 women; age, 36 ± 10 years), 15 with non--Valsalva-related suboccipital headaches (10 women; age, 33 ± 9 years), 8 with nonsuboccipital non--Valsalva-induced headaches (8 women; age, 39 ± 13 years), and 37 control subjects (24 women; age, 36 ± 12 years). Group differences were identified with the use of the 2-tailed Student t test. RESULTS:Posterior cranial fossa markers of CMI were similar among the 3 headache subtypes. However, the Valsalva-related suboccipital headaches cohort demonstrated a significantly lower intracranial compliance index than the non--Valsalva-related suboccipital headaches cohort (7.5 ± 3.4 vs 10.9 ± 4.9), lower intracranial volume change during the cardiac cycle (0.48 ± 0.19 vs 0.61 ± 0.16 mL), and higher magnetic resonance imaging--derived intracranial pressure (11.1 ± 4.3 vs 7.7 ± 2.8 mm Hg; P = .02). The Valsalva-related suboccipital headaches cohort had smaller intracranial and lateral ventricular volumes compared with the healthy cohort. The non--Valsalva-related suboccipital headaches cohort had reduced venous drainage through the jugular veins. CONCLUSION/CONCLUSIONS:Valsalva-induced worsening of occipital headaches appears to be related to a small intracranial volume rather than the smaller posterior cranial fossa. This explains the reduced intracranial compliance and corresponding higher pressure measured in CMI patients with headaches affected by Valsalva maneuvers.
PMCID:4854289
PMID: 25812067
ISSN: 1524-4040
CID: 5761522

Effect of an early perinatal depression intervention on long-term child development outcomes: follow-up of the Thinking Healthy Programme randomised controlled trial

Maselko, Joanna; Sikander, Siham; Bhalotra, Sonia; Bangash, Omer; Ganga, Nima; Mukherjee, Satadru; Egger, Helen; Franz, Lauren; Bibi, Amina; Liaqat, Rakhshanda; Kanwal, Misbah; Abbasi, Tayyaba; Noor, Maryam; Ameen, Nida; Rahman, Atif
BACKGROUND: Perinatal depression has been linked with deleterious child development outcomes, yet maternal depression interventions have not been shown to have lasting effects on child development, and evidence is not available from countries of low or middle income. In the Thinking Healthy Programme cluster-randomised controlled trial, a perinatal depression intervention was assessed in Pakistan in 2006-07. The intervention significantly reduced depression levels 12 months post partum compared with a control. We aimed to assess the effect of this same intervention on the cognitive, socioemotional, and physical development of children at around age 7 years. METHODS: Mother-child dyads who participated in the Thinking Healthy Programme cluster-randomised controlled trial were interviewed when the index child was about 7 years old. A reference group of 300 mothers who did not have prenatal depression and, therefore, did not receive the original intervention, was enrolled with their children at the same time. The primary cognitive outcome was the score on the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV); primary socioemotional outcomes included scores on the Strengths and Difficulties Questionnaire (SDQ) and the Spence Children's Anxiety Scale (SCAS); and primary physical outcomes were height-for-age, weight-for-age, and body-mass index (BMI)-for-age Z scores. Generalised linear modelling with random effects to account for clustering was the main method of analysis. Analyses were by intention to treat. The Thinking Healthy Programme cluster-randomised trial was registered at ISRCTN.com, number ISRCTN65316374. FINDINGS: Of 705 participating mother-child dyads interviewed at the end of the Thinking Healthy Programme randomised controlled trial, 584 (83%) dyads were enrolled. 289 mothers had received the intervention and 295 had received a control consisting of enhanced usual care. The mean age of the children was 7.6 years (SD 0.1). Overall, cognitive, socioemotional, or physical development outcomes did not differ between children in the intervention or control groups whose mothers had prenatal depression. When compared with the reference group of children whose mothers did not have prenatal depression, the Thinking Healthy Programme trial children had worse socioemotional outcomes; mean scores were significantly higher on the SDQ for total difficulty (11.34 vs 10.35; mean difference 0.78, 95% CI 0.09-1.47; p=0.03) and on the SCAS for anxiety (21.33 vs 17.57; mean difference 2.93, 1.15-4.71; p=0.0013). Cognitive and physical outcomes did not differ. INTERPRETATION: Our findings show that cognitive, socioemotional, and physical developmental outcomes of children at age 7 years whose mother had prenatal depression did not differ between those who received the Thinking Healthy Programme intervention and those who received the control. Further investigation is needed to understand what types of complex interventions or approaches are needed for long-term gains in maternal and child wellbeing. Prolonged, detailed, and frequent follow-up is warranted for all interventions. FUNDING: Grand Challenges Canada (Government of Canada), Saving Brains programme.
PMID: 26303558
ISSN: 2215-0374
CID: 2101652

Teacher-Child Interaction Training: A Pilot Study With Random Assignment

Fernandez, Melanie A; Adelstein, Jonathan S; Miller, Samantha P; Areizaga, Margaret J; Gold, Dylann C; Sanchez, Amanda L; Rothschild, Sara A; Hirsch, Emily; Gudino, Omar G
Teacher-Child Interaction Training (TCIT), adapted from Parent-Child Interaction Therapy (PCIT), is a classroom-based program designed to provide teachers with behavior management skills that foster positive teacher-student relationships and to improve student behavior by creating a more constructive classroom environment. The purpose of this pilot study was to evaluate TCIT in more classrooms than previously reported in the literature, with older children than previously reported, using random assignment of classrooms to TCIT or to a no-TCIT control condition and conducting all but two sessions within the classroom to enhance feasibility. Participants included 11 kindergarten and first grade classroom teachers and their 118 students from three urban, public schools in Manhattan, with five classrooms randomly assigned to receive TCIT and six to the no-TCIT control condition. Observations of teacher skill acquisition were conducted before, during, and after TCIT for all 11 teachers, and teacher reports of student behavior were obtained at these same time points. Teacher satisfaction with TCIT was assessed following training. Results suggested that after receiving TCIT, teachers increased rates of positive attention to students' appropriate behavior, decreased rates of negative attention to misbehavior, reported significantly less distress related to student disruptive behavior, and reported high satisfaction with the training program. Our study supports the growing evidence-base suggesting that TCIT is a promising approach for training teachers in positive behavior management strategies and for improving student disruptive behavior in the classroom.
PMID: 26163711
ISSN: 1878-1888
CID: 1681832

A comparison of hippocampal volume and integrity: Which is the better predictor of cognitive decline? [Meeting Abstract]

Bruno, D; Ciarleglio, A; Grothe, M J; Nierenberg, J; Bachman, A; Teipel, S J; Petkova, E; Sidtis, J; Adrenkani, B; Pomara, N
Background: Volumetric analyses of MRI data have been employed to predict conversion to Alzheimer's disease (AD), and individuals with preclinical AD tend to show atrophy in the right medial temporal lobe, which includes the hippocampus. In this study, we set out to compare a volumetric measurement of the hippocampus to a newly developed measure of hippocampal integrity in their respective potential for prediction of generalized cognitive performance (MMSE) over time. Methods: Ninety participants, who were cognitively intact at baseline and aged 60 or older, were recruited for a study on major depressive disorder (MDD) and tested twice, over three years. Linear regression models were applied to the data with the change in MMSE score as outcome, and hippocampal integrity (HI), hippocampal volume (HV), age and MDD status among the predictors. HI was measured for the left and right hippocampi as the ratio of the parenchymal voxels to the total number of voxels in an automatically determined hippocampus ROI. The ROI was determined by local affine registration of 65 previously delineated hippocampus atlases to the test subject. HVs were extracted from MRI images using an automated volumetric approach. Results: Change in MMSE performance was significantly predicted by both integrity and volume: greater HI and HV values were associated with less decline. However, when comparing predictors' contributions to the models, HI was slightly better than HV for the right side, and explained more of the variance in MMSE performance; HI and HV contributions were largely comparable for the left side. Conclusions: More research is needed to evaluate whether hippocampal integrity or hippocampal volume is a more accurate predictor of cognitive decline, but tentative results from this study appear to suggest that right side HI measures have the potential to be sensitive to future changes in general cognitive ability
EMBASE:72125347
ISSN: 1552-5260
CID: 1924872