The role of primary school composition in affective decision-making: A prospective cohort study

PURPOSE: School-level characteristics are known to be associated with pupils’ academic and cognitive ability but also their socioemotional development. This study examines, for the first time, whether primary school characteristics are associated with pupils’ affective decision-making too. METHODS: The sample included 3,141 children participating in the Millennium Cohort Study with available data on their school’s characteristics, according to the National Pupil Database, at age 7 years. Decision-making was measured using the Cambridge Gambling Task at age 11 years. We modelled data using a series of sex-stratified linear regression analyses of decision-making (risk‐taking, quality of decision‐making, risk adjustment, deliberation time, and delay aversion) against four indicators of school composition (academic performance and proportions among pupils who are native speakers of English, are eligible for free school meals and have special educational needs). RESULTS: After adjustment for individual and family-level confounding, schools with a higher average academic performance showed more delay aversion among males, and among females, higher deliberation time and lower risk-taking. Schools with proportionally more native English speakers had higher deliberation time among males. Schools with proportionally more pupils eligible for free school meals showed lower scores on quality of decision-making among males. Schools with proportionally more children with special educational needs showed better quality of decision-making among males and lower risk-taking among females. CONCLUSION: The findings of this study can be used to target support for primary schools. Interventions aiming to support lower-achieving schools and those with less affluent intakes could help to improve boys’ affective decision-making

Reciprocal associations between affective decision-making and mental health in adolescence

Poor affective decision-making has been shown to associate cross-sectionally with poor mental health in clinical populations. However, evidence from general population samples is scarce. Moreover, whether decision-making is prospectively linked to mental health in youth in the general population and whether such associations are reciprocal have yet to be examined. The present study examined bidirectional associations between various aspects of affective decision-making and emotional and behavioural problems at ages 11 and 14 years in 13,366 members of the Millennium Cohort Study. Decision-making (delay aversion, deliberation time, quality of decision-making, risk adjustment, risk-taking) and emotional (emotional symptoms, peer problems) and behavioural (conduct problems, hyperactivity/inattention) problems were measured using the Cambridge Gambling Task and the Strengths and Difficulties Questionnaire, respectively. Results of cross-lagged panel models adjusted for confounding revealed a negative reciprocal association between hyperactivity and quality of decision-making but also positive reciprocal associations between conduct problems and delay aversion, and between peer problems and deliberation time. Emotional problems and peer problems predicted a decrease in risk-taking, conduct problems predicted an increase in risk-taking, and hyperactivity predicted an increase in delay aversion and deliberation time. Furthermore, hyperactivity and conduct problems predicted less risk adjustment, and risk adjustment predicted fewer peer problems. The results suggest that behavioural problems are prospectively linked to greater risk-taking and lower risk adjustment in adolescence. Moreover, adolescents with behavioural problems tend to make poorer decisions and be more delay-averse, but also poorer quality of decision-making and increased delay aversion are associated with more behavioural problems over time

The role of inflammatory markers and cortisol in the association between early social cognition abilities and later internalising or externalising problems: Evidence from a U.K. birth cohort

Objective: Deficits in social cognition are associated with internalising (emotional and peer problems) and externalising (conduct problems and hyperactivity/inattention) symptoms in youth. It has been suggested that stress may be one of the mechanisms underlying these associations. However, no empirical studies have investigated if physiological stress can explain the prospective associations between social cognition deficits and internalising and externalising symptoms in the general youth population. This study addressed this question and focused on two indicators of physiological stress, dysregulated diurnal cortisol patterns and systemic inflammation. Method: Participants were 714 individuals from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population-based birth cohort. Bayesian structural equation modelling was used to investigate a) the associations of social cognition abilities at ages 8, 11, and 14 years with internalising and externalising problems at age 17 years and b) the potential mediating effects of cortisol parameters at age 15 years and inflammatory markers [interleukin 6 (IL-6) and C-reactive protein (CRP)] at ages 9 and 16 years. Results: We found that social cognition difficulties were associated with later internalising and externalising problems. Flattened diurnal cortisol slope was associated with hyperactivity/inattention problems two years later. Lower morning cortisol partially mediated the direct association between social communication deficits at 8 years and hyperactivity/inattention and conduct problems at 17 years, even after adjustments for inflammation and confounders (for hyperactivity/inattention: indirect effect = 0.07, 95% CI [0.00, 0.18], p = .042; for conduct problems: indirect effect = 0.04, 95% CI [0.00, 0.11], p = .040). We did not find a significant association between systemic inflammation and social cognition difficulties, internalising problems, or externalising problems. Conclusion: Our findings suggest that part of the effect of social communication difficulties in childhood on externalising problems in adolescence was mediated by lower morning cortisol. Hence, our study indicates that the hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis may be one of the physiological mechanisms linking some social cognition deficits to externalising problems

The effect of urban greenspace on adolescent sleep patterns

We investigated the effects of long-term greenspace deprivation on sleep during adolescence. Using data from a UK birth cohort, we studied deviations from age-recommended sleep duration through Time Use Diaries. Our sample (N = 1370; 53% female) of urban adolescents had been exposed to the same levels of neighbourhood greenspace from birth up to age 14 years when their time use was tracked. We factored in sex and ethnicity, family income, long-term illness, sharing of a bedroom, access to a garden, as well as air pollution and perceived area safety. Even after full adjustment, there was a significant interaction between greenspace availability and income when predicting sleep duration, such that low-income adolescents living in the greyest urban areas were found to sleep more than the 8–10 h recommended for their age group, while the inverse was true for their counterparts living in areas with more greenspace

MRI efficacy in diagnosing internal lesions of the knee: a retrospective analysis

BACKGROUND: Many surgeons tend to believe that MRI is an accurate, non invasive diagnostic method, enough to lead to decisions for conservative treatment and save a patient from unnecessary arthroscopy. We conducted a retrospective study to investigate the accuracy of the MRI of the knee for the detection of injuries of the meniscus, cruciate ligaments and articular cartilage, in comparison with the preoperative clinical examination and intraoperative findings. Between May 2005 and February 2006 102 patients after clinical examination were diagnosed with meniscal or cruciate injury and underwent definitive treatment with arthroscopy. 46 of these patients fulfilled the inclusion criteria. The accuracy, sensitivity, specificity, negative and positive predictive values of the MRI findings were correlated with the lesions identified during arthroscopy. The diagnostic performance of the initial clinical examination was also calculated for the meniscal and cruciate ligament injuries. RESULTS: The accuracy for tears of the medial, lateral meniscus, anterior and posterior cruciate ligaments and articular cartilage was 81%, 77%, 86%, 98% and 60% respectively. The specificity was 69%, 88%, 89%, 98% and 73% respectively. The positive predictive value was 83%, 81%, 90%, 75% and 53% respectively. Finally, the clinical examination had significant lower reliability in the detection of these injuries. CONCLUSION: MRI is very helpful in diagnosing meniscal and cruciate ligament injuries. But in a countable percentage reports with false results and in chondral defects its importance is still vague. The arthroscopy still remains the gold standard for definitive diagnosis

Towards a clinical staging for bipolar disorder: defining patient subtypes based on functional outcome.

BACKGROUND: The functional outcome of Bipolar Disorder (BD) is highly variable. This variability has been attributed to multiple demographic, clinical and cognitive factors. The critical next step is to identify combinations of predictors that can be used to specify prognostic subtypes, thus providing a basis for a staging classification in BD. METHODS: Latent Class Analysis was applied to multiple predictors of functional outcome in a sample of 106 remitted adults with BD. RESULTS: We identified two subtypes of patients presenting "good" (n=50; 47.6%) and "poor" (n=56; 52.4%) outcome. Episode density, level of residual depressive symptoms, estimated verbal intelligence and inhibitory control emerged as the most significant predictors of subtype membership at the p<0.05 level. Their odds ratio (OR) and confidence interval (CI) with reference to the "good" outcome group were: episode density (OR=4.622, CI 1.592-13.418), level of residual depressive symptoms (OR=1.543, CI 1.210-1.969), estimated verbal intelligence (OR=0.969; CI 0.945-0.995), and inhibitory control (OR=0.771, CI 0.656-0.907). Age, age of onset and duration of illness were comparable between prognostic groups. LIMITATIONS: The longitudinal stability or evolution of the subtypes was not tested. CONCLUSIONS: Our findings provide the first empirically derived staging classification of BD based on two underlying dimensions, one for illness severity and another for cognitive function. This approach can be further developed by expanding the dimensions included and testing the reproducibility and prospective prognostic value of the emerging classes. Developing a disease staging system for BD will allow individualised treatment planning for patients and selection of more homogeneous patient groups for research purposes

Subcortical volumes across the lifespan: Data from 18,605 healthy individuals aged 3–90 years

Age has a major effect on brain volume. However, the normative studies available are constrained by small sample sizes, restricted age coverage and significant methodological variability. These limitations introduce inconsistencies and may obscure or distort the lifespan trajectories of brain morphometry. In response, we capitalized on the resources of the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) Consortium to examine age-related trajectories inferred from crosssectional measures of the ventricles, the basal ganglia (caudate, putamen, pallidum, and nucleus accumbens), the thalamus, hippocampus and amygdala using magnetic resonance imaging data obtained from 18,605 individuals aged 3–90 years. All subcortical structure volumes were at their maximum value early in life. The volume of the basal ganglia showed a monotonic negative association with age thereafter; there was no significant association between age and the volumes of the thalamus, amygdala and the hippocampus (with some degree of decline in thalamus) until the sixth decade of life after which they also showed a steep negative association with age. The lateral ventricles showed continuous enlargement throughout the lifespan. Age was positively associated with inter-individual variability in the hippocampus and amygdala and the lateral ventricles. These results were robust to potential confounders and could be used to examine the functional significance of deviations from typical age-related morphometric patterns

Cortical thickness across the lifespan: Data from 17,075healthy individuals aged 3–90 years

Delineating the association of age and cortical thickness in healthy individuals is criti-cal given the association of cortical thickness with cognition and behavior. Previousresearch has shown that robust estimates of the association between age and brainmorphometry require large-scale studies. In response, we used cross-sectional datafrom 17,075 individuals aged 3–90 years from the Enhancing Neuroimaging Geneticsthrough Meta-Analysis (ENIGMA) Consortium to infer age-related changes in corticalthickness. We used fractional polynomial (FP) regression to quantify the associationbetween age and cortical thickness, and we computed normalized growth centilesusing the parametric Lambda, Mu, and Sigma method. Interindividual variability wasestimated using meta-analysis and one-way analysis of variance. For most regions,their highest cortical thickness value was observed in childhood. Age and corticalthickness showed a negative association; the slope was steeper up to the thirddecade of life and more gradual thereafter; notable exceptions to this general patternwere entorhinal, temporopolar, and anterior cingulate cortices. Interindividual vari-ability was largest in temporal and frontal regions across the lifespan. Age and its FPcombinations explained up to 59% variance in cortical thickness. These results mayform the basis of further investigation on normative deviation in cortical thicknessand its significance for behavioral and cognitive outcomes.Instituto de Salud Carlos III PI02049

The effect of urban greenspace on adolescent sleep patterns

We investigated the effects of long-term greenspace deprivation on sleep during adolescence. Using data from a UK birth cohort, we studied deviations from age-recommended sleep duration through Time Use Diaries. Our sample (N = 1370; 53% female) of urban adolescents had been exposed to the same levels of neighbourhood greenspace from birth up to age 14 years when their time use was tracked. We factored in sex and ethnicity, family income, long-term illness, sharing of a bedroom, access to a garden, as well as air pollution and perceived area safety. Even after full adjustment, there was a significant interaction between greenspace availability and income when predicting sleep duration, such that low-income adolescents living in the greyest urban areas were found to sleep more than the 8–10 h recommended for their age group, while the inverse was true for their counterparts living in areas with more greenspace

Comparative Evaluation of Child Behavior Checklist-Derived Scales in Children Clinically Referred for Emotional and Behavioral Dysregulation

Background: We recently developed the Child Behavior Checklist-Mania Scale (CBCL-MS), a novel and short instrument for the assessment of mania-like symptoms in children and adolescents derived from the CBCL item pool and have demonstrated its construct validity and temporal stability in a longitudinal general population sample. Objective: The aim of this study was to evaluate the construct validity of the 19-item CBCL-MS in a clinical sample and to compare its discriminatory ability to that of the 40-item CBCL-dysregulation profile (CBCL-DP) and the 34-item CBCL-Externalizing Scale. Methods: The study sample comprised 202 children, aged 7–12 years, diagnosed with DSM-defined attention deficit hyperactivity disorder (ADHD), conduct disorder (CD), oppositional defiant disorder (ODD), and mood and anxiety disorders based on the Diagnostic Interview Schedule for Children. The construct validity of the CBCL-MS was tested by means of a confirmatory factor analysis. Receiver operating characteristics (ROC) curves and logistic regression analyses adjusted for sex and age were used to assess the discriminatory ability relative to that of the CBCL-DP and the CBCLExternalizing Scale. Results: The CBCL-MS had excellent construct validity (comparative fit index = 0.97; Tucker–Lewis index = 0.96; root mean square error of approximation = 0.04). Despite similar overall performance across scales, the clinical range scores of the CBCL-DP and the CBCL-Externalizing Scale were associated with higher odds for ODD and CD, while the clinical range scores of the CBCL-MS were associated with higher odds for mood disorders. The concordance rate among the children who scored within the clinical range of each scale was over 90%. Conclusion: CBCL-MS has good construct validity in general population and clinical samples and is therefore suitable for both clinical practice and research