The roles of sex and gender in child and adolescent mental health

Neurodevelopmental and mental health disorders are common in children and young people, and frequently continue to be impairing into adulthood. Biological sex and gender identity are important factors in the likelihood of the development, referral and diagnosis of these disorders, as well as sources of clinical heterogeneity. In this editorial, we highlight that the aetiology of neurodevelopmental and mental health disorders in young people is complex and multi-faceted. Emerging evidence has implicated sex and gender as playing an important role in understanding the onset and course of psychopathology in childhood and adolescence. Here, we underline the significance of continuing to actively study the roles of sex and gender in the context of outlining potential future research directions and understanding how best to support children and young people

Pupillometric and saccadic measures of affective and executive processing in anxiety

Anxious individuals report hyper-arousal and sensitivity to environmental stimuli, difficulties concentrating, performing tasks efficiently and inhibiting unwanted thoughts and distraction. We used pupillometry and eye-movement measures to compare high vs. low anxious individuals hyper-reactivity to emotional stimuli (facial expressions) and subsequent attentional biases in a memory-guided pro- and antisaccade task during conditions of low and high cognitive load (short vs. long delay). High anxious individuals produced larger and slower pupillary responses to face stimuli, and more erroneous eye-movements particularly following long delay. Low anxious individuals? pupillary responses were sensitive to task demand (reduced during short delay), whereas high anxious individuals' were not. These findings provide evidence in anxiety of enhanced, sustained and inflexible patterns of pupil responding during affective stimulus processing and cognitive load that precede deficits in task performance

It's all in the eyes: subcortical and cortical activation during grotesqueness perception in autism

Atypical face processing plays a key role in social interaction difficulties encountered by individuals with autism. In the current fMRI study, the Thatcher illusion was used to investigate several aspects of face processing in 20 young adults with high-functioning autism spectrum disorder (ASD) and 20 matched neurotypical controls. “Thatcherized” stimuli were modified at either the eyes or the mouth and participants discriminated between pairs of faces while cued to attend to either of these features in upright and inverted orientation. Behavioral data confirmed sensitivity to the illusion and intact configural processing in ASD. Directing attention towards the eyes vs. the mouth in upright faces in ASD led to (1) improved discrimination accuracy; (2) increased activation in areas involved in social and emotional processing; (3) increased activation in subcortical face-processing areas. Our findings show that when explicitly cued to attend to the eyes, activation of cortical areas involved in face processing, including its social and emotional aspects, can be enhanced in autism. This suggests that impairments in face processing in autism may be caused by a deficit in social attention, and that giving specific cues to attend to the eye-region when performing behavioral therapies aimed at improving social skills may result in a better outcome

The impact of cognitive load on processing efficiency and performance effectiveness in anxiety: evidence from event-related potentials and pupillary responses

Anxiety has been associated with poor attentional control, as reflected in lowered performance on experimental measures of executive attention and inhibitory control. Recent conceptualisations of anxiety propose that individuals who report elevated anxiety symptoms worry about performance and will exert greater cognitive effort to complete tasks well, particularly when cognitive demands are high. Across two experiments, we examined the effect of anxiety on task performance and across two load conditions using (1) measures of inhibitory control (behavioural reaction times and eye-movement responses) and (2) task effort with pupillary and electrocortical markers of effort (CNV) and inhibitory control (N2). Experiment 1 used an oculomotor-delayed-response task that manipulated load by increasing delay duration to create a high load, relative to a low load, condition. Experiment 2 used a Go/No-Go task and load was manipulated by decreasing the No-Go probabilities (i.e., 20% No-Go in the high load condition and 50% No-Go in the low load condition). Experiment 1 showed individuals with high (vs. low) anxiety made more antisaccade errors across load conditions, and made more effort during the high load condition, as evidenced by greater frontal CNV and increased pupillary responses. In Experiment 2, individuals with high anxiety showed increased effort (irrespective of cognitive load), as characterised by larger pupillary responses. In addition, N2 amplitudes were sensitive to load only in individuals with low anxiety. Evidence of reduced performance effectiveness and efficiency across electrophysiological, pupillary, and oculomotor systems in anxiety provides some support for neurocognitive models of frontocortical attentional dysfunction in anxiety

Evaluating the effectiveness of a school-based cognitive behavioural therapy intervention for anxiety in adolescents diagnosed with autism spectrum disorder

This study evaluated the effectiveness of a school-based Cognitive Behavioural Therapy (CBT) on symptoms of anxiety, social worry and social responsiveness, and indices of attentional control and attentional biases to threat in adolescents diagnosed with Autism Spectrum Disorder. Thirty-five young people (11–14 years; IQ > 70) with ASD and elevated teacher or parent reported anxiety were randomly assigned to 6 sessions of the Exploring Feelings CBT intervention (Attwood in Exploring feelings (anxiety). Future Horizons, Arlington, 2004) (n = 18) or a wait-list control group (n = 17). The intervention (compared to the wait-list control) group showed positive change for parent, teacher and self-reported anxiety symptoms, and more marginal effects of increased teacher-reported social responsiveness. The discussion highlights the potential value and limitations of school-based CBT for young people with ASD

Individual differences in search and monitoring for color targets in dynamic visual displays

Many jobs now involve the monitoring visual representations of data that change over time. Monitoring dynamically changing displays for the onset of targets can be done in two ways: detecting targets directly post their onset or predicting their onset from the prior state of distractors. In the present study, participants? eye movements were measured as they monitored arrays of 108 colored squares whose colors changed systematically over time. Across three experiments, the data show that participants detected the onset of targets both directly and predictively. Experiments 1 and 2 showed that predictive detection was only possible when supported by sequential color changes that followed a scale ordered in color space. Experiment 3 included measures of individual differences in working memory capacity (WMC) and anxious affect and a manipulation of target prevalence in the search task. It found that predictive monitoring for targets, and decisions about target onsets, were influenced by interactions between individual differences in verbal and spatial WMC and intolerance of uncertainty, a characteristic that reflects worry about uncertain future events. The results have implications for the selection of individuals tasked with monitoring dynamic visual displays for target onsets

Spaced Retrieval Practice: Can Restudying Trump Retrieval?

We investigated spaced retrieval and restudying in 3 preregistered, online experiments. In all experiments, participants studied 40 Swahili–English word pair translations during an initial study phase, restudied intact pairs or attempted to retrieve the English words to Swahili cues twice in three spaced practice sessions, and then completed a final cued-recall test. All 5 sessions were separated by 2 days. In Experiment 1, we manipulated the response format during retrieval (covert vs. overt) and the test list structure (blocked vs. intermixed covert/overt retrieval trials). A memory rating was required on all trials (retrieval: “Was your answer correct?”; restudy: “Would you have remembered the correct translation?”). Response format had no effect on recall, but surprisingly, final test performance for restudied items exceeded both the overt and covert retrieval conditions. In Experiment 2, we manipulated the requirement to make a memory rating. If a memory rating was required, final test restudy performance exceeded retrieval performance, replicating Experiment 1. However, the pattern was descriptively reversed if no rating was required. In Experiment 3, the memory rating was removed altogether, and we examined recall performance for items restudied versus retrieved once, twice, or thrice. Performance improved with practice, and retrieval performance exceeded restudy performance in all conditions. The reversal of the typical retrieval practice effect observed in Experiments 1 and 2 is discussed in terms of theories of reactivity of memory judgments

Assessment of the point-of-care Cholestech Lipid Analyser for lipid screening in Aboriginal communities

Cardiovascular disease is the leading cause of mortality in Aboriginal Australians. Screening for cardiovascular disease risk factors, notably elevated blood lipids, is urgently needed. The small portable Cholestech machine (Point-of-Care Diagnostics) can enzymatically measure total cholesterol, triglyceride and HDL cholesterol (without the prior need for precipitation of other lipoproteins)on 35 microlitres of capillary or veinous whole blood in under 5 minutes. It also calculates LDL cholesterol. Its suitability for use in Aboriginal communities was assessed. With its simple operation, fully automated nature, sound analytic performance and ability to produce a full lipid profile in under 5 minutes, the Cholestech would be suitable for the Aboriginal health care setting

The Differential Effect of Anxiety and ADHD Symptoms on Inhibitory Control and Sustained Attention for Threat Stimuli: A Go/No-Go Eye-Movement Study

Objective: This study examined the synergistic effects of ADHD and anxiety symptoms on attention and inhibitory control depending on the emotional content of the stimuli. Method: Fifty-four typically developing individuals (27 children/adolescents and 27 adults) completed an eye-movement based emotional Go/No-Go task, using centrally presented (happy, angry) faces and neutral/symbolic stimuli. Sustained attention was measured through saccade latencies and saccadic omission errors (Go trials), and inhibitory control through saccadic commission errors (No-Go trials). ADHD and anxiety were assessed dimensionally. Results: Elevated ADHD symptoms were associated with more commission errors and slower saccade latencies for angry (vs. happy) faces. In contrast, angry faces were linked to faster saccade onsets when anxiety symptoms were high, and this effect prevailed when both anxiety and ADHD symptoms were high. Conclusion: Social threat impacted performance in individuals with sub-clinical anxiety and ADHD differently. The effects of anxiety on threat processing prevailed when both symptoms were high

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