Irritability moderates the association between cognitive flexibility task performance and related prefrontal cortex activation in young children

The association between cognitive flexibility and related neural functioning has been inconsistent. This is particularly true in young children, where previous studies have found heterogenous results linking behavior and neural function, raising the possibility of unexplored moderators. The current study explored the moderating role of dimensional irritability in the association between cognitive flexibility task performance and prefrontal activation in young children. A total of 106 3- to 7-year-old children were recruited to complete a custom-designed, child-adapted, cognitive flexibility task, and 98 of them were included in the data analysis. The children\u27s dorsolateral prefrontal cortex activation was monitored using functional near-infrared spectroscopy, and their levels of irritability were reported by parents using the MAP-DB Temper Loss subscale. Results indicated that the mean reaction time of the cognitive flexibility task was negatively correlated with concurrent prefrontal activation. No evidence was found for the association between task accuracy and prefrontal activation. Moreover, irritability moderated the association between the mean reaction time and prefrontal activation. Children high in irritability exhibited a stronger negative association between the mean reaction time and related prefrontal activation than children low in irritability. The moderating model suggested a novel affective-cognitive interaction to investigate the associations between cognitive task performance and their neural underpinnings

Neural Correlates of Emotion Regulation in Preschool Children with and without Disruptive Behavior Disorders.

Risk for chronic and persistent externalizing behavior problems may depend on how well preschool children learn to manage emotional challenges. The mobilization of executive function skills to achieve adaptive goals in emotion-laden contexts may be essential for developing competent emotion regulation in early childhood. To date, empirical support for an integrated executive function-emotion regulation mechanism has been primarily limited to examining general associations between the two constructs. Moreover, how the brains of preschoolers with externalizing behavior problems respond to emotional challenges is an under-explored area of research. The central goal of this dissertation was to elucidate how cognitive micro-processes, and their neural correlates, underpin emerging emotion regulation and early onset externalizing behavior problems. The three studies presented in this dissertation examined Event Related Potential (ERP) components recorded from preschool children with and without externalizing behavior problems. Across studies, all children completed an adapted go no-go task and received performance-contingent, emotionally-valenced feedback. In Study 1, I examined the ERP components Error Related Negativity (ERN), Error Positivity (Pe), and Feedback Related Negativity (FRN) in non-disordered preschool children. Study 1 results revealed that typical preschool children show clear ERN, Pe, and FRN components. Furthermore, contrary to other studies, preschool children showed larger FRN amplitudes following negative feedback than following positive feedback. In Study 2, I compared the amplitudes of the ERN, Pe, FRN, and Inhibitory-N2 components in preschool children clinically referred for Disruptive Behavior Disorders and typical peers. Study 2 results revealed that clinically referred children showed significantly smaller Inhibitory-N2 and Pe waveforms at specific sites. In Study 3, I examined how ERN, Pe, FRN, and Inhibitory-N2 amplitudes related to parent-rated emotion reactivity and regulation in clinically referred and typical preschoolers. Results showed that, overall, smaller Pe and Inhibitory-N2 amplitudes related to poorer parent-rated emotion reactivity and regulation, respectively. However, the relation between ERP component amplitudes and parent rating differed within clinically referred versus typical peers. Across studies, results support an expanded theoretical neurobiological model of emerging emotion regulation and risk for externalizing behavior problems. Implications for understanding, preventing, and intervening with early onset externalizing behavior problems are discussed.PHDPsychologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/108718/1/grabell_1.pd

Neural correlates of early deliberate emotion regulation: Young children\u27s responses to interpersonal scaffolding.

Deliberate emotion regulation, the ability to willfully modulate emotional experiences, is shaped through interpersonal scaffolding and forecasts later functioning in multiple domains. However, nascent deliberate emotion regulation in early childhood is poorly understood due to a paucity of studies that simulate interpersonal scaffolding of this skill and measure its occurrence in multiple modalities. Our goal was to identify neural and behavioral components of early deliberate emotion regulation to identify patterns of competent and deficient responses. A novel probe was developed to assess deliberate emotion regulation in young children. Sixty children (age 4-6 years) were randomly assigned to deliberate emotion regulation or control conditions. Children completed a frustration task while lateral prefrontal cortex (LPFC) activation was recorded via functional near-infrared spectroscopy (fNIRS). Facial expressions were video recorded and children self-rated their emotions. Parents rated their child\u27s temperamental emotion regulation. Deliberate emotion regulation interpersonal scaffolding predicted a significant increase in frustration-related LPFC activation not seen in controls. Better temperamental emotion regulation predicted larger LPFC activation increases post- scaffolding among children who engaged in deliberate emotion regulation interpersonal scaffolding. A capacity to increase LPFC activation in response to interpersonal scaffolding may be a crucial neural correlate of early deliberate emotion regulation

Early risk pathways to physical versus relational peer aggression: The interplay of externalizing behavior and corporal punishment varies by child sex

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142456/1/ab21744.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142456/2/ab21744_am.pd

The role of skin trauma in the distribution of morphea lesions: A cross-sectional survey of the Morphea in Adults and Children cohort IV

Background: Skin trauma may play a role in the development of morphea lesions. The association between trauma and the distribution of cutaneous lesions has never been examined to our knowledge. Objective: We sought to determine whether patients enrolled in the Morphea in Adults and Children (MAC) cohort exhibit skin lesions distributed in areas of prior (isotopic) or ongoing (isomorphic) trauma. Methods: This was a cross-sectional analysis of the MAC cohort. Results: Of 329 patients in the MAC cohort, 52 (16%) had trauma-associated lesions at the onset of disease. Patients with lesions in an isotopic distribution had greater clinical severity as measured by a clinical outcome measure (mean modified Rodnan Skin Score of 13.8 vs 5.3, P = .004, 95% confidence interval 3.08-13.92) and impact on life quality (mean Dermatology Life Quality Index score 8.4 vs 4.1, P = .009, 95% confidence interval 1.18-7.50) than those with an isomorphic distribution. Most frequent associated traumas were chronic friction (isomorphic) and surgery/isotopic. Limitations: Recall bias for patient-reported events is a limitation. Conclusion: Of patients in the MAC cohort, 16% developed initial morphea lesions at sites of skin trauma. If these findings can be confirmed in additional series, they suggest that elective procedures and excessive skin trauma or friction might be avoided in these patients

Differential associations of early callous‐unemotional, oppositional, and ADHD behaviors: multiple domains within early‐starting conduct problems?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111790/1/jcpp12326.pd

Skin Cancer Education Interventions for Primary Care Providers: A Scoping Review

Primary care physicians (PCPs) are often the first line of defense against skin cancers. Despite this, many PCPs do not receive a comprehensive training in skin conditions. Educational interventions aimed at skin cancer screening instruction for PCPs offer an opportunity to detect skin cancer at earlier stages and subsequent improved morbidity and mortality. A scoping review was conducted to collect data about previously reported skin cancer screening interventions for PCPs. A structured literature search found 51 studies describing 37 unique educational interventions. Curriculum elements utilized by the interventions were divided into categories that would facilitate comparison including curriculum components, delivery format, delivery timing, and outcome measures. The interventions varied widely in design, including literature-based interventions, live teaching sessions, and online courses with durations ranging from 5 min to 24 months. While several interventions demonstrated improvements in skin cancer knowledge and competency by written exams, only a few revealed positive clinical practice changes by biopsy review or referral analysis. Examining successful interventions could aid in developing a skin cancer detection curriculum for PCPs that can produce positive clinical practice and population-based changes in the management of skin cancer

The impact of culture on physiological processes of emotion regulation: a comparison of US and Chinese preschoolers

Cognitive determinants of emotion regulation, such as effortful control, have been hypothesized to modulate young children's physiological response to emotional stress. It is unknown, however, whether this model of emotion regulation generalizes across Western and non‐Western cultures. The current study examined the relation between both behavioral and questionnaire measures of effortful control and densely sampled, stress‐induced cortisol trajectories in U.S. and Chinese preschoolers. Participants were 3‐ to 5‐ year‐old children recruited from the United States (N = 57) and Beijing, China (N = 60). Consistent with our hypothesis, U.S. children showed a significant negative relation between maternal‐rated inhibitory control and both cortisol reactivity and recovery. However, this was not replicated in the Chinese sample. Children in China showed a significant positive relation between maternal‐rated attentional focusing and cortisol reactivity that was not seen in the U.S. Results suggest that children who reside in Western and non‐Western cultures have different predictors of their emotion‐related stress response.We compared associations between specific effortful control subcomponents and stress‐induced cortisol trajectories in preschool children residing in the U.S. and China. U.S. preschoolers showed an expected negative association between maternal‐rated inhibitory control with cortisol reactivity and recovery. In contrast, Chinese preschoolers showed a positive association between maternal‐rated attentional focusing and cortisol reactivity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111122/1/desc12227.pd

Sexual Abuse-Current Medico-legal, Forensic and Psychiatric Aspects

Abstract Violence against women and minors is a worldwide problem that has not yet been sufficiently acknowledged. There are many obstacles especially when sexual abuses have to be evaluated. These problems are present both when victims of sexual abuse are evaluated and when sex offenders are dealt with, especially when the offenders are juvenile sex offenders (JSO). These issues give cause for great concern about prognosis, and the resulting psychosocial implications, and call for a special effort from the scientific community in identifying appropriate prevention and treatment methods. This chapter is divided into two parts. The first part deals with the forensic and psychiatric features, such as diagnostic and therapeutic/rehabilitative strategies for JSO, while the second part analyzes the legal–medicine aspects related to rape/sexual assault in a European context

Using Wearable Devices and Machine Learning to Forecast Preschool Tantrums and Identify Clinically Significant Variants

Difficulty differentiating early symptoms of psychopathology from normative misbehavior is a significant challenge for researchers, providers, and caregivers, and is a longstanding obstacle to more effective early assessment and intervention. The proposed study will use wearable devices and a machine learning approach to record naturally occurring tantrums in preschool children in order to identify early psychopathology and predict tantrums before they occur. The anticipated products of this project will be algorithms designed to shift the field toward the development of automated, home-based, early mental health detection and intervention