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49 Examining Associations Between Intelligence and Adaptive Functioning in Adults with Down Syndrome at Risk for Alzheimer's Disease
- Sheliza Ali, Jordan Harp, Allison M. Caban-Holt, Brandon Dennis, Elizabeth Head, Jennifer Wells, Frederick Schmitt
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 256-257
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Objective:
Individuals with Down syndrome (DS) experience intellectual disability, such that measures of cognitive and adaptive functioning are near the normative floor upon evaluation. Individuals with DS are also at increased risk for Alzheimer's disease (AD) beginning around age 40; and test performances and adaptive ratings at the normative floor make it difficult to detect change in cognition and functioning. This study first assessed the range of raw intelligence scores and raw adaptive functioning of individuals with DS at the normative floor. Next, we assessed whether those raw intelligence scores were predictive of raw adaptive functioning scores, and by association, whether they may be meaningful when assessing change in individuals with a lower baseline of cognitive functioning.
Participants and Methods:Participants were selected from a cohort of 117 adults with DS in a longitudinal study examining AD risk. Participants (n=96; M=40.9 years-old, SD=10.67; 57.3% female) were selected if they had both a completed measure of IQ (Kaufmann Brief Intelligence Test; KBIT2) and informant ratings of adaptive functioning (Vineland Adaptive Behavior Scales; VABS-II). Multiple regression was conducted predicting VABS-II total raw score using K-BIT2 total raw score, while controlling for age.
Results:A slight majority (57.3%) of the sample had a standardized IQ score of 40 with the majority (95.7%) having a standardized score at or below 60. Additionally, 85.3% of the sample had a standard VABS-II score at or below 60. Within the normative floor for the KBIT2 (IQ=40), there was a normal distribution and substantial range of both KBIT2 raw scores (M = 31.19, SD = 13.19, range: 2 to 41) and VABS-II raw scores (M = 406.33, SD = 84.91, range: 198 to 569). Using the full sample, age significantly predicted raw VABS-II scores (ß = -.283, p = .008). When KBIT2 raw scores were included in the model, age was no longer an independently significant predictor. KBIT2 raw scores significantly predicted raw VABS-II scores (ß = .689, p < .001). Age alone accounted for 8.0% of variance in VABS-II raw scores and KBIT2 raw scores accounted for 43.8% additional variance in VABS-II raw scores. This relationship was maintained when the sample was reduced to individuals at the normative floor (n = 51) where KBIT2 raw scores accounted for 23.7% of the variance in raw VABS-II scores (ß = .549, p < .001).
Conclusions:The results indicate that meaningful variability exists among raw intelligence test performances that may be masked by scores at the normative floor. Further, the variability in raw intelligence scores is associated with variability in adaptive functioning, such that lower intelligence scores are associated with lower ratings of adaptive functioning. Considering this relationship would be masked by a reduction of range due to norming, these findings indicate that raw test performances and adaptive functioning ratings may have value when monitoring change in adults with DS at risk for AD.
Evaluating variation in pre-operative evaluation and planning for children undergoing atrial or ventricular septal defect repair
- Catherine C. Dawson-Gore, Andrew Well, Scott Wallace, Elizabeth Teisberg, Christopher Born, Kathleen Carberry, Erin Gottlieb, Dudley Byron Holt, Charles D. Fraser, Jr., Carlos M. Mery
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- Journal:
- Cardiology in the Young / Volume 34 / Issue 1 / January 2024
- Published online by Cambridge University Press:
- 13 June 2023, pp. 164-170
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Background:
CHD care is resource-intensive. Unwarranted variation in care may increase cost and result in poorer health outcomes. We hypothesise that process variation exists within the pre-operative evaluation and planning process for children undergoing repair of atrial septal defect or ventricular septal defect and that substantial variation occurs in a small number of care points.
Methods:From interviews with staff of an integrated congenital heart centre, an initial process map was constructed. A retrospective chart review of patients with isolated surgical atrial septal defect and ventricular septal defect repair from 7/1/2018 through 11/1/2020 informed revisions of the process map. The map was assessed for points of consistency and variability.
Results:Thirty-two surgical atrial septal defect/ventricular septal defect repair patients were identified. Ten (31%) were reviewed by interventional cardiology before surgical review. Of these, 6(60%) had a failed catheter-based closure and 4 (40%) were deemed inappropriate for catheter-based closure. Thirty (94%) were reviewed in case conference, all attended surgical clinic, and none were admitted prior to surgery. The process map from interviews alone identified surgery rescheduling as a point of major variability; however, chart review revealed this was not as prominent a source of variability as pre-operative interventional cardiology review.
Conclusions:Significant variation in the pre-operative evaluation and planning process for surgical atrial septal defect/ventricular septal defect patients was identified. If such process variation is widespread through CHD care, it may contribute to variations in outcome and cost previously documented within CHD surgery. Future research will focus on determining whether the variation is warranted or unwarranted, associated health outcomes and cost variation attributed to these variations in care processes.
Differential physiological sensitivity to child compliance behaviors in abusing, neglectful, and non-maltreating mothers
- Jessica Norman Wells, Elizabeth A. Skowron, Carolyn M. Scholtes, David S. DeGarmo
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- Journal:
- Development and Psychopathology / Volume 32 / Issue 2 / May 2020
- Published online by Cambridge University Press:
- 07 May 2019, pp. 531-543
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We examined time-ordered associations between children's compliance behavior and maternal respiratory sinus arrhythmia (RSA) in a sample of 127 child-maltreating (physical abuse, physical neglect, emotional abuse) and 94 non-maltreating mothers and their preschool-aged children. Child prosocial and aversive compliance behaviors and maternal RSA were continuously collected during a joint challenge task. Child behavior and mother RSA were longitudinally nested within-person and subjected to multilevel modeling (MLM), with between-person child maltreatment subtype and level of inconsistent parenting modeled as moderators. Both child maltreatment type and inconsistent parenting moderated the effects of child compliance on maternal RSA. Increases in children's prosocial compliance behaviors led to decreasing RSA in physically abusive mothers 30s later (i.e., increasing arousal), but predicted increases in non-maltreating mothers’ RSA (i.e., increasing calm). Inconsistent parenting (vacillating between autonomy-support and strict control) also moderated the effects of children's compliance behavior on maternal physiology, weakening the effects of child prosocial compliance on subsequent maternal RSA. These findings highlight variations in mothers’ physiological sensitivity to their children's prosocial behavior that may play a role in the development of coercive cycles, and underscore the need to consider individual differences in parents’ physiological sensitivity to their children to effectively tailor interventions across the spectrum of risk.
Contributors
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- By Núria Duran Adroher, Sergio Aguilar-Gaxiola, Jordi Alonso, Ali Obaid Al-Hamzawi, Laura Helena Andrade, Matthias C. Angermeyer, James Anthony, Corina Benjet, Guilherme Borges, Joshua Breslau, Evelyn J. Bromet, Ronny Bruffaerts, Brendan Bunting, Huibert Burger, José Miguel Caldas de Almeida, Graça Cardoso, Somnath Chatterji, Wai Tat Chiu, Giovanni de Girolamo, Ron de Graaf, Peter de Jonge, Koen Demyttenaere, John Fayyad, Alize J. Ferrari, Silvia Florescu, Anne M. Gadermann, Meyer Glantz, Jen Green, Michael J. Gruber, Oye Gureje, Josep Maria Haro, Yanling He, Steven G. Heeringa, Hristo Hinkov, Chiyi Hu, Yueqin Huang, Irving Hwang, Robert Jin, Elie G. Karam, Norito Kawakami, Ronald C. Kessler, Lola Kola, Viviane Kovess-Masféty, Michael C. Lane, Carmen Lara, William LeBlanc, Sing Lee, Jean-Pierre Lépine, Daphna Levinson, Zhaorui Liu, Gustavo Loera, Herbert Marschinger, Katie A. McLaughlin, Maria Elena Medina-Mora, Elizabeth Miller, Samuel D. Murphy, Aimee Nasser Karam, Matthew K. Nock, Mark A. Oakley Browne, Siobhan O’Neill, Johan Ormel, Beth-Ellen Pennell, Maria V. Petukhova, José Posada-Villa, Rajesh Sagar, Mohammad Salih Khalaf, Nancy A. Sampson, Kathleen Saunders, Michael Schoenbaum, Kate M. Scott, Soraya Seedat, Victoria Shahly, Dan J. Stein, Hisateru Tachimori, Nezar Ismet Taib, Adley Tsang, T. Bedirhan Üstün, Maria Carmen Viana, Gemma Vilagut, Michael R. Von Korff, J. Elisabeth Wells, Harvey A. Whiteford, David R. Williams, Ben Wu, Miguel Xavier, Alan M. Zaslavsky
- Edited by Jordi Alonso, Universitat Pompeu Fabra, Barcelona, Somnath Chatterji, World Health Organization, Geneva, Yanling He
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- Book:
- The Burdens of Mental Disorders
- Print publication:
- 09 May 2013, pp ix-xii
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2 - Structural Brain Magnetic Resonance Imaging of Typically Developing Children and Adolescents
- from Part I - Biological And Cognitive Perspective
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- By Jay N. Giedd, Armin Raznahan, Nancy R. Lee, Catherine Weddle, Maria Liverpool, Michael Stockman, Elizabeth M. Wells, Liv Clasen, Jonathan Blumenthal, Rhoshel K. Lenroot, Francois Lalonde, Child Psychiatry Branch, National Institute of Mental Health
- Edited by Eric Amsel, Weber State University, Utah, Judith Smetana, University of Rochester, New York
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- Book:
- Adolescent Vulnerabilities and Opportunities
- Published online:
- 07 October 2011
- Print publication:
- 19 September 2011, pp 23-40
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Summary
Magnetic resonance imaging (MRI) provides unprecedented access to the anatomy and physiology of the human brain and has launched a new era of pediatric neuroscience. Because it does not use ionizing radiation, it is safe not only for single scans of children, but for repeated scans throughout the course of maturation. In this chapter, we will summarize results to date from an ongoing longitudinal brain MRI project that has been underway at the Child Psychiatry Branch (CPB) of the National Institute of Mental Health (NIMH) since being initiated by Dr. Markus Krusei in 1989. The design of the study is for volunteers to visit the NIMH at approximately two-year intervals for (1) genetic analysis; (2) cognitive/emotional/behavioral assessment; and (3) brain imaging.
The data presented here are the quantitative morphology (i.e., size and shape) results from our typically developing participants between the ages of three and twenty-seven years. The findings will be grouped by tissue type (i.e., gray matter, white matter, cerebrospinal fluid) or structure/region (i.e. total and lobar volumes, caudate, ventricles, etc.) and shown as a function of age separately for boys and girls. To promote independence of the sample data points for the non-twin analyses, only one subject was chosen per family. The particular person chosen from a given family was based on an attempt to optimize the age and gender distribution of the sample and was done blind to knowledge of their imaging results. Unless otherwise indicated, the results in the following sections are from the most recent analyses of the CPB data consisting of 829 scans from 387 subjects, ages 3 to 27 years.
Contributors
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- By R. J. Aitken, Gokhan Akkoyunlu, David F. Albertini, Christiani A. Amorim, R. A. Anderson, Baris Ata, Pedro N. Barri, Mohamed A. Bedaiwy, Rosita Bergström, Veronica Bianchi, Montserrat Boada, Paolo Boffetta, Andrea Borini, Karina Braga Ribeiro, Peter R. Brinsden, Ralph L. Brinster, Jason G. Bromer, A. L. Caplan, Chian Ri-Cheng, Ina N. Cholst, A. Ciobanu, Megan Clowse, Ana Cobo, Susannah C. Copland, John K. Critser, B. J. Curry, Giuseppe Del Priore, M. De Vos, Marie-Madeleine Dolmans, Javier Domingo, Jacques Donnez, David H. Edgar, Nanette R. Elster, Carol Fabian, Gregory M. Fahy, Tommaso Falcone, Debra Friedman, Jill P. Ginsberg, Debra A. Gook, Julie R. Gralow, Elizabeth Grill, Sebastien Gouy, Xu Han, Lisa M. Harlan-Williams, Outi Hovatta MD, Wayland Hsiao, Zhongwei Huang, E. Isachenko, V. Isachenko, Roy A. Jensen, I. I. Katkov, S. Samuel Kim, Jennifer Klemp, Larissa A. Korde, R. Kreienberg, Srinivasan Krishnamurthy, Juergen Liebermann, J. Ryan Martin, Elizabeth A. McGee, Marie McLaughlin, P. Mathevet, D. Meirow, Philippe Morice, Steven F. Mullen, Kutluk Oktay, Pasquale Patrizio, Antonio Pellicer, Pinki K. Prasad, Kenny A. Rodriguez-Wallberg, Erin Rohde, Allison B. Rosen, Zev Rosenwaks, María Sánchez, R. Sanchez, Glenn L. Schattman, Peter N. Schlegel, Einat Shalom-Paz, Lonnie D. Shea, Gunapala Shetty, Jill Simmons, Carrie A. Smith, J. Smitz, Miquel Solé, Jean Squifflet, Shane R. Stecklein, Jerome F. Strauss, David J. Tagler, Seang Lin Tan, Evelyn E. Telfer, Sreedhar Thirumala, Michael J. Tucker, Catherine Uzan, Anne Van Langendonckt, Anna Veiga, W. H. B. Wallace, Wenjia Wang, Brent Waters, Dagan Wells, Teresa K. Woodruff, Erik Woods, Christine Wyns
- Edited by Jacques Donnez, Université Catholique de Louvain, Belgium, S. Samuel Kim, University of Kansas
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- Book:
- Principles and Practice of Fertility Preservation
- Published online:
- 04 February 2011
- Print publication:
- 03 February 2011, pp x-xiv
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11 - Recommendations for properly conducted lineup identification tasks
- Edited by David Frank Ross, Boise State University, Idaho, J. Don Read, University of Lethbridge, Alberta, Michael P. Toglia, State University of New York
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- Book:
- Adult Eyewitness Testimony
- Published online:
- 04 August 2010
- Print publication:
- 25 March 1994, pp 223-244
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Summary
An eyewitness takes the stand and describes salient aspects of an event that he or she witnessed several months earlier. Then, in the hush of the courtroom, points to the defendant and says “That's him. That's the man I saw.” Simple, clean, and convincing. And therein rests the problem; what appears to be a simple identification is in fact the result of a series of complex and potentially unreliable social and cognitive events that began unfolding several months earlier when the event was originally witnessed.
This chapter, and much of the empirical research on which it is based, operates on an assumption that there are two sources of unreliability in eyewitness accounts. First, there are some inherent limitations in human information processing. These limitations exist at sensory levels (for example, Sperling, 1960), attentional levels (for example, Broadbent, 1958; Deutsch & Deutsch, 1963; Triesman, 1964), and memory levels (for example, Miller, 1956; Atkinson & Shiffrin, 1968). But inaccuracies in eyewitness accounts are not entirely attributable to human imperfections in sensation, perception, and memory. The second source of inaccuracy in eyewitness accounts can be attributed to the methods the justice system uses to obtain information from eyewitnesses. The work of Elizabeth Loftus on the effects of misleading questions serves to make this point (see Loftus, 1979; and this volume). The account one gets from an eyewitness depends very much on the methods used to solicit the information.
The study of how to improve eyewitness accuracy by manipulating the methods used to obtain information from eyewitnesses is known as a systemvariable approach to eyewitness research (Wells, 1978).