| 1. |
- Foley, Sarah, et al.
(författare)
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Family Function and Child Adjustment Difficulties in the COVID-19 Pandemic : An International Study
- 2021
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Ingår i: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:21
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- To estimate specific proximal and distal effects of COVID-19-related restrictions on families on children’s adjustment problems, we conducted a six-site international study. In total, 2516 parents from Australia, China, Italy, Sweden, the United Kingdom, and the United States of America living with a young child (Mage = 5.77, SD = 1.10, range = 3 to 8 years, 47.9% female) completed an online survey between April and July 2020. The survey included the Strengths and Difficulties Questionnaire and family risk factors (parent distress, parent–child conflict, couple conflict, and household chaos) as well as a scale to index COVID-19-related family disruption. Our analyses also included public data on the stringency of national restrictions. Across the six sites, parental responses indicated elevated levels of hyperactivity, conduct, and emotion problems in children from families characterized by heightened levels of parent distress, parent–child conflict, and household chaos. In contrast, increased peer problems were more strongly related to COVID-19-related social disruption and stringency measures. Mediation models demonstrated that associations between COVID-19 social disruption and child difficulties could be explained by parental distress. Taken together, these results suggest that although the experience of the pandemic differed across countries, associations between COVID-19-related family experiences and child adjustment difficulties were similar in their nature and magnitude across six different contexts. Programs to support family resilience could help buffer the impact of the pandemic for two generations.
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| 2. |
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| 3. |
- Forslund, Tommie, et al.
(författare)
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Disorganized attachment representations, externalizing behavior problems, and socioemotional competences in early school-age
- 2020
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Ingår i: Attachment & Human Development. - : Informa UK Limited. - 1461-6734 .- 1469-2988. ; 22:4, s. 448-473
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Tidskriftsartikel (refereegranskat)abstract
- Multifactorial research must examine if disorganized attachment is specifically associated with either ODD- or ADHD-symptoms,and the mechanisms through which disorganization may become associated with externalizing problems. The present short-term longitudinal study therefore examined attachment representations, and several competences important for socio-emotional functioning, in relation to ODD- and ADHD-symptoms at T1 (N = 105, M age = 80 months) and T2 (N = 80, M age = 104 months). There was a main effect of disorganized attachment on ODD-symptoms at both time points but not on ADHD-symptoms. Disorganized children also showed lowered attention to facial expressions, a diminished ability to discriminate facial expressions, and elevated emotional reactivity. Emotional reactivity mediated the link between disorganization and ODD-symptoms at T1, but not at T2. The findings support disorganized attachment as a risk-factor for ODD-symptoms rather than ADHD-symptoms, and suggest that disorganization may become associated with ODD-symptoms through broad effects on multiple competences.
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| 4. |
- Frick, Matilda, et al.
(författare)
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Disrupted Attention to Other’s Eyes is Linked to Symptoms of ADHD in Childhood
- 2023
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Ingår i: Child Psychiatry and Human Development. - : Springer. - 0009-398X .- 1573-3327. ; 54:4, s. 973-984
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Tidskriftsartikel (refereegranskat)abstract
- Attention-deficit/hyperactivity disorder (ADHD) is associated with impaired social interaction. Other’s eyes are important for understanding the social world. Here, we examined concurrent and longitudinal links between attention to other’s eyes and symptoms of ADHD and comorbid externalizing and internalizing symptoms. Eighty-two 8 to 13-year-old children (40% with ADHD) participated. The latency to a first gaze shift to and away from the eye region of human faces, when primed to look at either the eyes or the mouth, was recorded with eye tracking. Parents rated ADHD, externalizing and internalizing symptoms at the time of testing and at 2-year follow-up. The results show that longer looking at the eyes before reorienting was specifically associated with concurrent and future symptoms of inattention, even when accounting for comorbid symptoms. We conclude that the temporal microstructure of attention to other’s eyes is altered in children with symptoms of ADHD, which may contribute to social impairments.
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| 5. |
- Frick, Matilda, et al.
(författare)
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Mind-wandering in children with and without ADHD
- 2020
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Ingår i: British Journal of Clinical Psychology. - : John Wiley & Sons. - 0144-6657 .- 2044-8260. ; 59:2, s. 208-223
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Mind-wandering (MW) is a commonly experienced phenomenon, characterized by focus of attention drifting away from the present situation to intrinsically originated thoughts. Studies in adults show that MW is related to ADHD symptoms, but this association is understudied in children. We set out to investigate the associations of MW in children with and without ADHD and to simultaneously validate the self-report Mind Excessively Wandering Scale (MEWS) in children. Design We used a cross-sectional, correlational, design to examine the research questions. Methods The sample consisted of 82 children (61 boys) aged 8?13 years (m = 10.46), of which 35 had a diagnosis of ADHD. Children rated MW; parents and teachers rated ADHD symptoms, emotion regulation and academic achievement. Working memory was assessed with Digit Span. Results MW was positively related to ADHD symptoms, and the MEWS could differentiate between cases and controls with a sensitivity of 0.71 and specificity of 0.81. Psychometric properties of the MEWS were satisfactory. In addition, MW contributed independently to working memory (R2? = .05, p = .01) and emotion regulation (R2? = .04, p = .04) beyond ADHD symptoms. Conclusions MW is elevated in children with ADHD and contributes to functional domains. The MEWS is a valid tool for assessing MW in children, and the results are mostly comparable to that of adults (Mowlem et al., 2016, Journal of Attention Disorders, 23, 624), suggesting a similar relationship of MW to ADHD across the lifespan. Practitioner points Spontaneous mind-wandering is elevated in children with ADHD compared to children without a diagnosis. Elevated spontaneous mind-wandering predicts lower working memory, emotion regulation and academic achievement beyond ADHD symptoms, IQ and socio-economic status. Clinicians should consider evaluating excessive spontaneous mind-wandering and targeting it as an important outcome when treating children with ADHD. The MEWS is a valid tool for assessing excessive mind-wandering in children.
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| 6. |
- Heeman, Emma J., et al.
(författare)
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Predicting emotion regulation in typically developing toddlers : Insights into the joint and unique influences of various contextual predictors
- 2024
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Ingår i: International Journal of Behavioral Development. - 0165-0254 .- 1464-0651.
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Tidskriftsartikel (refereegranskat)abstract
- Emotion regulation (ER) is a source of risk and resilience for psychological development and everyday functioning. Despite extensive research on various early contextual predictors of child ER capacity, few studies have integrated them into the same study. Therefore, our longitudinal study investigated the joint and independent contributions of several prominent contextual predictors of child ER capacity. We followed typically developing children and their caregivers (N = 118, 47% girls) at three time points (children ages 10, 12, and 18 months). At 10 months, mothers reported household chaos, social support, and parenting stress, and maternal sensitivity was observed and coded with the Ainsworth’s Maternal Sensitivity Scales. At 12 months, child–mother attachment security was assessed using the Strange Situation Procedure. Finally, at 18 months, child ER was obtained with a Laboratory Temperament Assessment Battery frustration task. Correlational analyses revealed that household chaos and maternal sensitivity were significantly positively associated with child ER. Multiple regression analyses showed independent effects of household chaos and maternal sensitivity on child ER. Our partly counterintuitive results underscore the significance of cumulative risk and protective factors for ER development and suggest that household chaos and maternal sensitivity may contribute uniquely to better ER in typical toddlerhood.
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| 7. |
- Hendry, Alexandra, et al.
(författare)
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Atypical Development of Attentional Control Associates with Later Adaptive Functioning, Autism and ADHD Traits
- 2020
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Ingår i: Journal of autism and developmental disorders. - : Springer Nature. - 0162-3257 .- 1573-3432. ; 50:11, s. 4085-4105
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Tidskriftsartikel (refereegranskat)abstract
- Autism is frequently associated with difficulties with top-down attentional control, which impact on individuals’ mental health and quality of life. The developmental processes involved in these attentional difficulties are not well understood. Using a data-driven approach, 2 samples (N = 294 and 412) of infants at elevated and typical likelihood of autism were grouped according to profiles of parent report of attention at 10, 15 and 25 months. In contrast to the normative profile of increases in attentional control scores between infancy and toddlerhood, a minority (7–9%) showed plateauing attentional control scores between 10 and 25 months. Consistent with pre-registered hypotheses, plateaued growth of attentional control was associated with elevated autism and ADHD traits, and lower adaptive functioning at age 3 years.
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| 8. |
- Hendry, Alexandra, et al.
(författare)
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Inhibitory control and problem solving in early childhood : Exploring the burdens and benefits of high self-control
- 2022
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Ingår i: Infant and Child Development. - : John Wiley & Sons. - 1522-7227 .- 1522-7219. ; 31:3
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Tidskriftsartikel (refereegranskat)abstract
- Low inhibitory control (IC) is sometimes associated with enhanced problem-solving amongst adults, yet for young children high IC is primarily framed as inherently better than low IC. Here, we explore associations between IC and performance on a novel problem-solving task, amongst 102 English 2- and 3-year-olds (Study 1) and 84 Swedish children, seen at 18-months and 4-years (Study 2). Generativity during problem-solving was negatively associated with IC, as measured by prohibition-compliance (Study 1, both ages, Study 2 longitudinally from 18-months). High parent-reported IC was associated with poorer overall problem-solving success, and greater perseveration (Study 1, 3-year-olds only). Benefits of high parent-reported IC on persistence could be accounted for by developmental level. No concurrent association was observed between problem-solving performance and IC as measured with a Delay-of-Gratification task (Study 2, concurrent associations at 4-years). We suggest that, for young children, high IC may confer burden on insight- and analytic-aspects of problem-solving.
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| 9. |
- Jónsdóttir, Lilja K., et al.
(författare)
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A challenge to the expected : Lack of longitudinal associations between the early caregiving environment, executive functions in toddlerhood, and self-regulation at 6 years
- 2024
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Ingår i: Developmental Science. - 1363-755X .- 1467-7687.
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Tidskriftsartikel (refereegranskat)abstract
- Previous research and theory indicate an importance of the quality of the early caregiving environment in the development of self-regulation. However, it is unclear how attachment security and maternal sensitivity, two related but distinct aspects of the early caregiving environment, may differentially predict self-regulation at school start and whether a distinction between hot and cool executive function is informative in characterizing such predictions through mediation. In a 5-year longitudinal study (n = 108), we examined these associations using measures of maternal sensitivity and attachment security at 10–12 months, executive function at 4 years, and self-regulation at 6 years. Surprisingly, and despite methodological rigor, we found few significant bivariate associations between the study variables. We found no credible evidence of a longitudinal association between maternal sensitivity or attachment security in infancy and self-regulation at 6 years, or between executive function at 4 years and self-regulation at 6 years. The lack of bivariate longitudinal associations precluded us from building mediation models as intended. We discuss our null findings in terms of their potential theoretical implications, as well as how measurement type, reliability, and validity, may play a key role in determining longitudinal associations between early caregiving factors and later self-regulation and related abilities.
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| 10. |
- Kleberg, Johan L., et al.
(författare)
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Can auditory warning signals normalize eye movements in children with ADHD?
- 2020
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Ingår i: European Child and Adolescent Psychiatry. - : Springer Nature. - 1018-8827 .- 1435-165X. ; 29:12, s. 1635-1644
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Tidskriftsartikel (refereegranskat)abstract
- Attenuated baseline arousal has been hypothesized to underlie symptoms of attention deficit/hyperactivity disorder (ADHD). A behavioral signature of reduced baseline arousal is an increased beneficiary effect of warning signals in reaction tasks. This paradoxical effect is believed to be caused by a temporary increase in arousal induced by warning signals. In a preregistered study, we tested the hypothesis that children with high levels of ADHD symptoms would be hyperresponsive to warning signals in a well-established visual attention task (the gap/overlap paradigm). Previous studies using this task have found slower and more variable saccadic reaction times in children with ADHD compared to typically developing children, suggesting that these eye movement metrics are candidate biomarkers. We examined 71 children, of which 1/3 had a diagnosis of ADHD, using both dimensional analyses and group comparisons. Previously reported findings of reduced saccadic latency and increased latency variability were replicated. Importantly, saccadic latency was normalized by auditory warning signals. Analyses of pupil dilation, a physiological index of arousal and locus coeruleus-noradrenergic activity, confirmed that warning signals led to enhanced arousal. Our findings are novel and contribute to our understanding of arousal and attention in ADHD and have implications for treatment and interventions.
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| 11. |
- Kleberg, Johan Lundin, et al.
(författare)
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Eye-movement indices of arousal predict ADHD and comorbid externalizing symptoms over a 2-year period
- 2023
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Attention-deficit/hyperactivity disorder (ADHD) follows a variable course across childhood. Disrupted arousal has been hypothesized to underlie core symptoms as well as comorbid internalizing and externalizing conditions. The current study examined eye-movement and pupil-dilation metrics indexing arousal as longitudinal predictors of ADHD, externalizing, and internalizing symptoms over a 2-year period. Participants aged 8–13 years (N = 54, 30% with a diagnosis of ADHD) completed a modified version of the gap-overlap task including arousal-inducing auditory warning signals. Parents rated symptoms at the time of testing and at 2 years follow-up. Phasic alerting (reaction-time reduction after alerting cues) is an index of arousal. Here, larger phasic alerting effects predicted higher ADHD-symptom levels 2 years later. Blunted pupil-dilation responses predicted externalizing symptoms at T2, controlling for ADHD and externalizing at T1. Our results support the theory that ADHD is associated with altered arousal. Blunted arousal reactivity may be a longitudinal risk factor for externalizing problems in children with ADHD symptoms.
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| 12. |
- Kleberg, Johan L., et al.
(författare)
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Increased pupil dilation to happy faces in children with hyperactive/impulsive symptoms of ADHD
- 2021
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Ingår i: Development and psychopathology (Print). - : Cambridge University Press. - 0954-5794 .- 1469-2198. ; 33:3, s. 767-777
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Tidskriftsartikel (refereegranskat)abstract
- Attention-deficit/hyperactivity disorder (ADHD) is associated with disrupted emotional processes including impaired regulation of approach behavior and positive affect, irritability, and anger. Enhanced reactivity to emotional cues may be an underlying process. Pupil dilation is an indirect index of arousal, modulated by the autonomic nervous system and activity in the locus coeruleus-noradrenergic system. In the current study, pupil dilation was recorded while 8- to 12- year old children (n = 71, 26 with a diagnosis of ADHD and 45 typically developing), viewed images of emotional faces. Parent-rated hyperactive/impulsive symptoms were uniquely linked to higher pupil dilation to happy, but not fearful, angry, or neutral faces. This was not explained by comorbid externalizing symptoms. Together, these results suggest that hyperactive/impulsive symptoms are associated with hyperresponsiveness to approach-related emotional cues across a wide range of symptom severity.
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| 13. |
- Konke, Linn Andersson, et al.
(författare)
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How Does Temperament in Toddlers at Elevated Likelihood for Autism Relate to Symptoms of Autism and ADHD at Three Years of Age?
- 2022
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Ingår i: Journal of autism and developmental disorders. - : Springer Science and Business Media LLC. - 0162-3257 .- 1573-3432. ; 52, s. 995-1006
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Tidskriftsartikel (refereegranskat)abstract
- The current study investigated longitudinal associations between parent-rated temperament, observed exuberance and accelerometer activity level at 18-months and symptoms of ASD and ADHD at 36-months in a sample of 54 children at elevated likelihood for ASD. For the specific parent-rated temperament scales, most observed significant associations appeared to be specific for either ASD or ADHD symptoms. Indeed, by controlling for overlapping symptoms a different pattern of associations emerged. These results illustrate how temperamental measures may signal risk for later ASD versus ADHD symptomatology in infants at elevated likelihood for ASD. In addition, they indicate the potential of adopting a broader view on neurodevelopmental disorders by investigating not only ASD traits, but also co-occurring disorders such as ADHD in samples of elevated likelihood for ASD.
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| 14. |
- Lundin Kleberg, Johan, et al.
(författare)
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Williams syndrome : reduced orienting to other's eyes in a hypersocial phenotype
- 2023
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Ingår i: Journal of autism and developmental disorders. - : Springer Nature. - 0162-3257 .- 1573-3432. ; 53:7, s. 2786-2797
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Tidskriftsartikel (refereegranskat)abstract
- Williams syndrome (WS) is a rare genetic condition associated with high sociability, intellectual disability, and social cognitive challenges. Attention to others' eyes is crucial for social understanding. Orienting to, and from other’s eyes was studied in WS (n = 37, mean age = 23, age range 9–53). The WS group was compared to a typically developing comparison participants (n = 167) in stratified age groups from infancy to adulthood. Typically developing children and adults were quicker and more likely to orient to eyes than the mouth. This bias was absent in WS. The WS group had reduced peak saccadic velocities, indicating hypo-arousal. The current study indicates reduced orienting to others’ eyes in WS, which may affect social interaction skills.
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| 15. |
- McCracken, Lance M., 1962-, et al.
(författare)
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Health, well-being, and persisting symptoms in the pandemic : What is the role of psychological flexibility?
- 2022
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Ingår i: Journal of Contextual Behavioral Science. - : Elsevier. - 2212-1447. ; 26, s. 187-192
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Tidskriftsartikel (refereegranskat)abstract
- Finding psychological factors that can reduce the substantial impact of COVID-19 on mental and physical health is important. Here we replicate and expand a previous study regarding the role of psychological flexibility (PF) in this context. We employed a comprehensive and well validated measure of PF and examined its role in relation to health outcomes and persistent post COVID-19 symptoms. 1174 participants completed standardized measures of depression, anxiety, insomnia and the Multidimensional Psychological Flexibility Inventory (MPFI), and reported the presence of persistent symptoms associated with "long COVID." All PF and psychological inflexibility (PI) facets, except for acceptance, correlated with the three mental health outcomes and with persistent symptoms. PF and PI accounted for significant variance in depression, anxiety, and insomnia after adjusting for background and health status variables. A notable finding was the particularly stronger correlations obtained for the PI facets. Our findings emphasize the potentially mitigating effects of PF on mental ill health, as well as the particularly aggravating effects of PI, in the pandemic context. A novel finding is the significant association of PI with persisting symptoms of COVID.
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| 16. |
- McCracken, Lance M., 1962-, et al.
(författare)
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Psychological impact of covid-19 in the Swedish population : Depression, anxiety, and insomnia and their associations to risk and vulnerability factors
- 2020
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Ingår i: European psychiatry. - : Royal College of Psychiatrists. - 0924-9338 .- 1778-3585. ; 63:1
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Tidskriftsartikel (refereegranskat)abstract
- Background:The 2019 coronavirus disease (COVID-19) pandemic, with its associated restrictions on daily life, is like a perfect storm for poor mental health and wellbeing. The purpose of this study was therefore to examine the impacts of COVID-19 on mental health and wellbeing during the ongoing pandemic in Sweden.Method:Standardized measures of depression, anxiety, and insomnia as well as measures of risk and vulnerability factors known to be associated with poor mental health outcomes were administered through a national, online, cross-sectional survey (n = 1,212; mean age 36.1 years; 73% women).Result:Our findings show significant levels of depression, anxiety, and insomnia in Sweden, at rates of 30%, 24.2%, and 38%, respectively. The strongest predictors of these outcomes included poor self-rated overall health and a history of mental health problems. The presence of COVID-19 symptoms and specific health and financial worries related to the pandemic also appeared important.Conclusions:The impacts of COVID-19 on mental health in Sweden are comparable to impacts shown in previous studies in Italy and China. Importantly, the pandemic seems to impose most on the mental health of those already burdened with the impacts of mental health problems. These results provide a basis for providing more support for vulnerable groups, and for developing psychological interventions suited to the ongoing pandemic and for similar events in the future.
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| 17. |
- McCracken, Lance, 1962-, et al.
(författare)
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The role of psychological flexibility in the context of COVID-19 : Associations with depression, anxiety, and insomnia
- 2021
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Ingår i: Journal of Contextual Behavioral Science. - : Elsevier. - 2212-1447. ; 19, s. 28-35
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Tidskriftsartikel (refereegranskat)abstract
- Evidence for detrimental impacts of the COVID-19 pandemic on mental health and well-being around the world is now accumulating. As it does a next step is to understand how such effects can be mitigated, such as by studying psychological capacities that may afford people immunity against these impacts. In this study, we explore psychological flexibility (PF) and grit as potential resilience factors in the context of COVID-19. Standardized measures of depression, anxiety, and insomnia as well as measures of PF (committed action and inflexibility) and grit (perseverance of effort and consistency of interest) were administered through a large scale national online survey (N = 1102; mean age 36,9 years; 75% women). As predicted, the results show both PF and grit to be negatively associated with symptoms of depression, anxiety, and insomnia. Further, regression models including relevant background variables and both sets of resilience factors showed that total variance accounted for in symptoms of depression, anxiety, and insomnia was substantial, 50.5%, 49.5%, and 28.8%, respectively, with the PF components accounting for most of the explained variance in mental health. We conclude that PF and to a lesser extent grit may be important psychological resilience factors against mental health problems in the context of COVID-19. Our findings are practically important as they point to malleable public health targets during the ongoing pandemic of COVID-19 and in the event of similar widespread health threats in the future.
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| 18. |
- Psouni, Elia, et al.
(författare)
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Anxiety among Fathers in the Postnatal Period : Links to Depression, Attachment Insecurity and Emotion regulation
- 2021
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Ingår i: Journal of Affective Disorders Reports. - : Elsevier. - 2666-9153. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recent research has established postnatal anxiety as a common mental health problem among fathers, yet our knowledge regarding its underlying mechanisms is limited. The aim of the present study was to assess postnatal anxiety symptoms in fathers, to investigate comorbidity with postnatal depressive symptoms, and to examine the unique and shared contribution of attachment and emotion regulation as potential underlying mechanisms of postnatal anxiety, as compared to postnatal depression. Methods: A community sample of fathers (N=186) of infants 1-18 months were assessed with the Perinatal Anxiety Screening Scale (PASS), the Edinburgh Gotland Depression Scale (EGDS), the Attachment Style Questionnaire (ASQ-SF), and the Emotion Regulation Questionnaire (ERQ). Assessment was based on self-reports. Results: Over 30% of fathers reported high levels of postnatal anxiety, and a majority reported in addition burdening depressive symptoms. The strongest unique predictor for both outcomes was attachment anxiety, also after controlling for previous paternal mental health problems, and concurrent maternal depression. Emotion regulation strategy did not predict postnatal anxiety, but cognitive reappraisal predicted depressive symptoms negatively. For both anxiety and depression, the severity of symptoms in the one condition uniquely explained variance in the other condition. Limitations: The use of self-report measures does not allow clinical diagnosis. The unavoidable self-selected bias in recruitment posits limits to generalization. Conclusion: Despite high comorbidity between the two mental health outcomes, predictors of postnatal anxiety differ from those of postnatal depression in fathers, suggesting different underlying mechanisms and a need for distinct treatment approaches.
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| 19. |
- Rydell, Ann-Margret, et al.
(författare)
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ADHD symptoms and callous-unemotional traits as predictors of violent media use in adolescence
- 2021
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Ingår i: Scandinavian Journal of Psychology. - : John Wiley & Sons. - 0036-5564 .- 1467-9450. ; 62:1, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- We investigated ADHD symptoms and CU traits as predictors of violent media use in adolescence, controlling for delinquency and ODD symptoms. The effects on of disinhibition and arousal to negative stimuli, core characteristics of ADHD symptoms and CU traits, and of gender were investigated. At age 15, 88 adolescents, 50 % boys reported on CU traits, ADHD symptoms and delinquency. Parents rated the adolescents' CU traits, ADHD- and ODD symptoms. At age 16, adolescents reported on their media habits and performed tests of disinhibition and arousal to negative stimuli. Boys had higher levels of CU traits and violent media use and girls had higher levels of arousal to negative pictures. CU traits and inattention symptoms predicted violent media use, the latter association applying only to boys, with CU traits being the strongest predictor. Low arousal to threat pictures explained variance in violent media use, above CU traits. Attraction to violent media seems affected by problem behaviors, with CU traits coming forth as especially important.
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| 20. |
- Rydell, Ann-Margret, et al.
(författare)
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Behavior problems, social relationships, and adolescents' future orientation : Links from middle to late adolescence
- 2024
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Ingår i: Journal of Adolescence. - : John Wiley & Sons. - 0140-1971 .- 1095-9254.
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionAs adolescents leave high school, plans for the future are of great importance. Future orientation reflects positive thoughts regarding further education, employment, and family life. While future orientation has been found to affect behavior problems, the influence of behavior problems on future orientation is mainly unknown. Positive parent−child and peer relations may boost positive outlooks, but the interplay of behavior problems and social relations for future orientation remains to be studied.MethodsParticipants were 485 adolescents, 54% girls, living in Mid-Sweden. At age 15, parents and adolescents rated ADHD- and internalizing symptoms, parents rated ODD-symptoms, and adolescents rated their relationship with parents and peers. At age 18, adolescents rated future orientation regarding education, employment, and family, and reported on delinquent acts.ResultsLow levels of inattention symptoms and of delinquency were important for all higher future orientation aspects. In contrast, higher levels of hyperactive-impulsive symptoms were associated with more positive outlooks on work and family life. Relationships with parents and peers were stronger predictors of future outlooks, compared with behavior problems. There were few interaction effects of behavioral symptoms and social relationship quality.ConclusionsBehavior problems in middle adolescence may negatively affect future outlooks. However, positive social relations, especially relations with peers, seem more important for optimistic views than behavior problems and thus may have a compensatory effect. The clinical implications should be to address the young person's social world, in the case of misgivings about the future, also in the presence of problematic behaviors.
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| 21. |
- Söderström, Helena, et al.
(författare)
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Neurocognition and mean radiotherapy dose to vulnerable brain structures : new organs at risk?
- 2023
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Ingår i: Radiation Oncology. - : Springer Nature. - 1748-717X. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Children with brain tumors are at high risk of neurocognitive decline after radiotherapy (RT). However, there is a lack of studies on how RT doses to organs at risk (OARs) impacts neurocognition. The aim of this study was to examine dose-risk relationships for mean RT dose to different brain structures important for neurocognitive networks. We explored previously established OARs and potentially new OARs. Methods: A sample of 44 pediatric brain tumor survivors who had received proton and/or photon RT were included. Correlations between mean RT doses to OARs and IQ were analyzed. Previously established OARs were cochleae, optic chiasm, optic nerve, pituitary gland, hypothalamus, hippocampus and pons. Potential new OARs for RT-induced neurocognitive decline were cerebellum, vermis and thalamus. Results: Mean RT dose to different OARs correlated with several IQ subtests. Higher mean RT dose to cochleae, optic nerve, cerebellum, vermis and pons was correlated with lower performance on particularly full-scale IQ (FIQ), Perceptual Reasoning (PRI), Working Memory (WMI) and Processing Speed Index (PSI). Higher mean RT dose to hippocampus correlated with lower performance on processing speed and working memory. For those receiving whole brain RT (WBRT), higher mean RT dose to the pituitary gland correlated with lower performance on working memory. Conclusion: A high dose-risk correlation was found between IQ subtests and mean RT dose in established and potential new OARs. Thus, in the lack of validated dose constraints for vulnerable brain structures, a parsimonious approach in RT planning should be considered to preserve neurocognitive networks.
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| 22. |
- Söderström, Helena, et al.
(författare)
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Neurocognitive Functions Before and After Radiotherapy in Pediatric Brain Tumor Survivors
- 2022
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Ingår i: Pediatric Neurology. - : Elsevier. - 0887-8994 .- 1873-5150. ; 133, s. 21-29
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Tidskriftsartikel (refereegranskat)abstract
- Background The numbers of pediatric brain tumor survivors are increasing due to improved treatment protocols and multimodal treatments. Many survivors have neurocognitive sequelae, especially after radiotherapy. Neuropsychologic assessment is therefore essential to interpret clinical outcome, evaluate treatments protocol, and implement rehabilitation interventions. The overall aim of this study was to describe neurocognitive functions before and after radiotherapy. We also aimed to explore potential confounding risk factors that could affect the interpretation of radiotherapy-induced neurocognitive decline. Methods Fifty pediatric brain tumor survivors who had received radiotherapy (five years or more ago) were included. Clinical characteristics, potential confounding risk factors, radiotherapy plans, and neurocognitive functions on intelligence quotient (IQ) and neuropsychologic measurements were analyzed before and after radiotherapy. Results Neurocognitive functions were affected before radiotherapy and were progressively aggravated thereafter. The last neuropsychologic assessment after radiotherapy varied between two and 139 months. Nineteen patients were tested five years after radiotherapy, and 90% of them performed ≥1 S.D. below the normative mean on IQ measurements. Several potential confounding risk factors including those induced by radiotherapy were associated with lower performance on perceptual function, working memory, and processing speed. Longer time after radiotherapy was particularly associated with lower performance on working memory and processing speed. Importantly, the neuropsychologic assessments revealed more comprehensive problems than could be inferred from IQ measurements alone. Conclusions Our study underpins the importance of systematic and structured neuropsychologic assessment before and after radiotherapy. The timing of the assessment is important, and potential confounding risk factors need to be identified to better evaluate radiotherapy-induced neurocognitive decline.
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