Emotion regulation in adolescent females with bulimia nervosa: an information processing perspective

Although the increased attention to affect regulation in bulimia nervosa is encouraging, most theoretical models describing the relationship between binge-eating and emotion dysregulation neglect to place their observations in the context of the growing knowledge base on normal emotional development. Because the nature of abnormal functioning is best understood in relation to normal development, integrating these fields of research would identi@ deficient skills in bulimia nervosa, suggesting new avenues for treatment. The present study compared 16 adolescent girls with a DSM-IV diagnosis of bulimia nervosa to 16 age- and SES-matched girls without a psychiatric disorder, on three aspects of the information processing model (Garber, Braafladt, & Zeman, 1991) of emotional regulation, a model chosen for its description of the numerous skills that comprise normative emotion regulation. Because they share conceptual characteristics, girls with bulimia were also compared to 16 age- and SES-matched girls with a DSM-IV diagnosis of unipolar depression. Diagnosed girls were recruited from treatment programs at a large Midwestern medical center and nondiagnosed participants were recruited through advertisements in a local newspaper. The study took place over a six month period. Emotion regulation skills were assessed through questionnaire and interview measures, as well as response latencies to various questions. Compared to those with depression and those without a disorder, girls with bulimia: described poor awareness of emotional states; displayed difficulty discriminating between emotional states; exhibited nonspecific verbal labels to describe their feelings; displayed a limited repertoire of emotion regulation strategies and ability to access these strategies under high emotional arousal. Compared to girls without a diagnosis, girls with bulimia: reported decreased motivation to express negative emotion to others; took longer to describe their emotional state; evaluated themselves as less competent at implementing strategies to decrease their emotional state; and, rated the expected outcome of their strategies as less effective in decreasing their emotional state. These findings suggest adolescent females with bulimia may rely on binge-eating and purging in an environment of inadequate emotion regulation skills. Treatment implications of these findings include interventions targeted towards remediating deficient skills. Longitudinal research is recommended to clarify the role of these deficiencies

Adolescent Health Services: Missing Opportunities

Examines the status of adolescents' health and health services, including critical needs, promising models, and components for improving disease prevention and health promotion. Recommends better primary care, coordinated policy, and expanded coverage

Patterns of expressed emotion in adolescent eating disorders

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135121/1/jcpp12594.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135121/2/jcpp12594_am.pd

A Method Impact Assessment Framework for User Experience Evaluations with Children

Based upon a review of the literature, this paper presents a Method Impact Assessment Framework. Theoretically synthesized, the framework offers five dimensions: (1) the role of the child, (2) the user experience construct, (3) system, (4) epistemological perspective, (5) Practical and Ethical Concerns. Although other dimensions could have been construed, these were judged to be the most pertinent to understanding evaluation methods with children. The framework thus provides a critical lens in which evaluation methods can be assessed by the Children Computer Interaction (CCI) Community to inform method selection

Working Ethically in Participatory Research with Children

In this paper we present the ABCD framework for working ethically with children and young people in participatory design studies. This framework covers A – Agreement and consent made between all participants and interested parties; B – Behaviour of the research team towards the activities, requiring them to examine their motivations and to be honest in their interactions with children; C – Classroom experience in participatory sessions during which children are encouraged to discuss the nature of their participation, and D – Dissemination of the work and planning appropriate follow on activities to ensure that children are informed about the outputs from their contributions. We discuss the process by which we developed the framework, the challenges raised by working in this way with children and the role of values in participatory research

Neurocognitive Effects of Repetitive Transcranial Magnetic Stimulation in Adolescents with Major Depressive Disorder

Objectives: It is estimated that 30–40% of adolescents with major depressive disorder (MDD) do not receive full benefit from current antidepressant therapies. Repetitive transcranial magnetic stimulation (rTMS) is a novel therapy approved by the US Food and Drug Administration to treat adults with MDD. Research suggests rTMS is not associated with adverse neurocognitive effects in adult populations; however, there is no documentation of its neurocognitive effects in adolescents. This is a secondary post hoc analysis of neurocognitive outcome in adolescents who were treated with open-label rTMS in two separate studies. Methods: Eighteen patients (mean age, 16.2 ± 1.1 years; 11 females, 7 males) with MDD who failed to adequately respond to at least one antidepressant agent were enrolled in the study. Fourteen patients completed all 30 rTMS treatments (5 days/week, 120% of motor threshold, 10 Hz, 3,000 stimulations per session) applied to the left dorsolateral prefrontal cortex. Depression was rated using the Children’s Depression Rating Scale-Revised. Neurocognitive evaluation was performed at baseline and after completion of 30 rTMS treatments with the Children’s Auditory Verbal Learning Test (CAVLT) and Delis–Kaplan Executive Function System Trail Making Test. Results: Over the course of 30 rTMS treatments, adolescents showed a substantial decrease in depression severity. Commensurate with improvement in depressive symptoms was a statistically significant improvement in memory and delayed verbal recall. Other learning and memory indices and executive function remained intact. Neither participants nor their family members reported clinically meaningful changes in neurocognitive function. Conclusion: These preliminary findings suggest rTMS does not adversely impact neurocognitive functioning in adolescents and may provide subtle enhancement of verbal memory as measured by the CAVLT. Further controlled investigations with larger sample sizes and rigorous trial designs are warranted to confirm and extend these findings

Machine-learning assessed abdominal aortic calcification is associated with long-term fall and fracture risk in community-dwelling older Australian women

Abdominal aortic calcification (AAC), a recognized measure of advanced vascular disease, is associated with higher cardiovascular risk and poorer long-term prognosis. AAC can be assessed on dual-energy X-ray absorptiometry (DXA)-derived lateral spine images used for vertebral fracture assessment at the time of bone density screening using a validated 24-point scoring method (AAC-24). Previous studies have identified robust associations between AAC-24 score, incident falls, and fractures. However, a major limitation of manual AAC assessment is that it requires a trained expert. Hence, we have developed an automated machine-learning algorithm for assessing AAC-24 scores (ML-AAC24). In this prospective study, we evaluated the association between ML-AAC24 and long-term incident falls and fractures in 1023 community-dwelling older women (mean age, 75 ± 3 years) from the Perth Longitudinal Study of Ageing Women. Over 10 years of follow-up, 253 (24.7%) women experienced a clinical fracture identified via self-report every 4–6 months and verified by X-ray, and 169 (16.5%) women had a fracture hospitalization identified from linked hospital discharge data. Over 14.5 years, 393 (38.4%) women experienced an injurious fall requiring hospitalization identified from linked hospital discharge data. After adjusting for baseline fracture risk, women with moderate to extensive AAC (ML-AAC24 ≥ 2) had a greater risk of clinical fractures (hazard ratio [HR] 1.42; 95% confidence interval [CI], 1.10–1.85) and fall-related hospitalization (HR 1.35; 95% CI, 1.09–1.66), compared to those with low AAC (ML-AAC24 ≤ 1). Similar to manually assessed AAC-24, ML-AAC24 was not associated with fracture hospitalizations. The relative hazard estimates obtained using machine learning were similar to those using manually assessed AAC-24 scores. In conclusion, this novel automated method for assessing AAC, that can be easily and seamlessly captured at the time of bone density testing, has robust associations with long-term incident clinical fractures and injurious falls. However, the performance of the ML-AAC24 algorithm needs to be verified in independent cohorts. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR)

Feasibility of wearable activity tracking devices to measure physical activity and sleep change among adolescents with chronic pain—a pilot nonrandomized treatment study

PurposePersonal informatics devices are being used to measure engagement in health behaviors in adults with chronic pain and may be appropriate for adolescent use. The aim of this study was to evaluate the utilization of a wearable activity tracking device to measure physical activity and sleep among adolescents attending a three-week, intensive interdisciplinary pain treatment (IIPT) program. We also assessed changes in physical activity and sleep from baseline to the treatment phase.MethodsParticipants (57.1% female, average age 15.88, SD = 1.27) wore an activity tracking device three weeks prior to starting and during the treatment program.ResultsOf 129 participants contacted, 47 (36.4%) agreed to participate. However, only 30 (64%) complied with the instructions for using the device prior to programming and during program participation. Preliminary analyses comparing averages from 3-weeks pre-treatment to 3-weeks during treatment indicated increases in daily overall activity minutes, daily step counts, and minutes of moderate to vigorous physical activity (by 353%), as well as a corresponding decrease in sedentary minutes. There was more missing data for sleep than anticipated.ConclusionsWearable activity tracking devices can be successfully used to measure adolescent physical activity in-person, with more difficulty obtaining this information remotely. Adolescents with chronic pain experience improvements in objective measurements of physical activity over the course of a 3-week IIPT program. Future studies may want to spend more time working with pediatric patients on their understanding of how to use trackers for sleep and physical activity

Small CCI – Exploring App Evaluation with Preschoolers

Child-Computer Interaction (CCI) is predominantly studied with school aged children. Working with preschool children, generally unable to read or write, involves addressing many challenges around planning, recruitment, and interpretation of findings. There are few examples in the literature of the challenges faced when conducting evaluations of technology with preschool children and very few evaluations conducted for commercial software companies. Our case study paper describes a six-week, twelve session, evaluation study of a commercial app (Lingokids) with children aged three and four in two nursery (preschool / kindergarten) schools. We describe challenges we met and describe how we adapted our plans to fit the context. We show how we were able to explore engagement and learning without gathering any personal data. With our practical tips and reflections, we hope our work will encourage others to work with young children in ways that respect their limited ability to understand assent and participation