A Growth Mixture Modeling Study of Learning Trajectories in an Extended Computerized Working Memory Training Programme Developed for Young Children Diagnosed With Attention-Deficit/Hyperactivity Disorder

This study explored (1) whether growth mixture modeling (GMM) could identify different trajectories of learning efficiency during a working memory (WM) training programme for young children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), compared with a typically developing (TD) control group, and (2) if learning trajectories and outcomes were different for simple and complex training tasks. Children completed simple visuospatial short-term memory (VSSTM) and complex visuospatial WM (VSWM) tasks for 15 min a day, 5 days a week, and for 8 weeks. Parent-reported executive functioning, and children's WM and attention control, educational achievement, and IQ were measured prior to (T1), immediately following (T2) and 3 months after training (T3). GMM analysis showed that WM training was represented as one learning curve, and there was no difference for the trajectories of the ADHD and TD groups. The learning trajectory for the VSSTM tasks across groups was represented as one learning curve and for the VSWM tasks there were three learning curves. Learning for the VSSTM tasks and for most children in the VSWM tasks was characterized by an inverted-U shape, indicating that training was effective for up to 15 sessions, was stable and declined thereafter, highlighting an optimal training timeframe. For the VSWM tasks, the two remaining groups showed either a U-shaped or a high inverted U-shaped trajectory, with the latter group achieving the highest T1T2 change score (i.e., children showed a lower starting point and the most gain in terms of learning and post-training performance). There were no broader benefits of training at post-test or follow-up. Further research should explore who would benefit most from intensive cognitive training, as well as the potential benefits for mental health and well-being

The association between hope, marital status, depression and persistent pain in men and women following cardiac surgery

Background Cardiac surgery is a major life event, and outcomes after surgery are associated with men’s and women’s ability to self-manage and cope with their cardiac condition in everyday life. Hope is suggested to impact cardiac health by having a positive effect on how adults cope with and adapt to illness and recommended lifestyle changes. Methods We did a secondary analysis of 416 individuals (23% women) undergoing elective coronary artery bypass graft and/or valve surgery between March 2012 and September 2013 enrolled in randomized controlled trial. Hope was assessed using The Herth Hope Index (HHI) at three, six and 12 months following cardiac surgery. Linear mixed model analyses were performed to explore associations after cardiac surgery between hope, marital status, depression, persistent pain, and surgical procedure. Results For the total sample, no statistically significant difference between global hope scores from 3 to 12 months was observed (ranging from 38.3 ± 5.1 at 3 months to 38.7 ± 5.1 at 12 months), and no differences between men and women were observed at any time points. However, 3 out of 12 individual items on the HHI were associated with significantly lower scores in women: #1) I have a positive outlook toward life, #3) I feel all alone, and #6) I feel scared about my future. Over the study period, diminished hope was associated with older age, lower education, depression prior to surgery, and persistent pain at all measurement points. Isolated valve surgery was positively associated with hope. While neither sex nor marital status, as main effects, demonstrated significant associations with hope, women who were divorced/widowed/single were significantly more likely to have lower hope scores over the study period. Conclusion Addressing pain and depression, and promoting hope, particularly for women living alone may be important targets for interventions to improve outcomes following cardiac surgery