Associations between cognition and internalizing problems in young adults with early-onset schizophrenia: A 13-year follow-up study

The present follow-up study examines the associations between cognition and parent-rated internalizing problems among adolescents with early-onset schizophrenia (EOS) at baseline (T1) and self-rated internalizing problems 13 years later (T2). Twelve individuals (8 male/4 female) with EOS and 30 healthy controls (16 male/14 female) were included in the study. All were between 12 and 18 years of age at T1. Internalizing problems were measured with the Achenbach System of Empirically Based Assessment Internalizing Scale. Cognition was examined with a neuropsychological test battery measuring auditory attention/working memory, visuomotor processing, cognitive flexibility and verbal memory. Compared to healthy controls, the EOS group had significant cognitive deficits and more internalizing problems both at T1 and T2. There was no correlation between parent-rated internalizing problems at T1 and self-rated internalizing problems at T2 in the EOS group. However, deficits in auditory attention/working memory at T1 were significantly associated with internalizing problems at T2. A focus on improving the treatment of cognitive impairments may be important in preventing the development of internalizing problems in young patients with schizophrenia. The small sample size of the study is a limitation and further research is recommended.acceptedVersio

ADHD in girls and boys – gender differences in co-existing symptoms and executive function measures

Background: ADHD is diagnosed and treated more often in males than in females. Research on gender differences suggests that girls may be consistently underidentified and underdiagnosed because of differences in the expression of the disorder among boys and girls. One aim of the present study was to assess in a clinical sample of medication naïve boys and girls with ADHD, whether there were significant gender x diagnosis interactions in co-existing symptom severity and executive function (EF) impairment. The second aim was to delineate specific symptom ratings and measures of EF that were most important in distinguishing ADHD from healthy controls (HC) of the same gender. Methods: Thirty-seven females with ADHD, 43 males with ADHD, 18 HC females and 32 HC males between 8 and 17 years were included. Co-existing symptoms were assessed with self-report scales and parent ratings. EF was assessed with parent ratings of executive skills in everyday situations (BRIEF), and neuropsychological tests. The three measurement domains (co-existing symptoms, BRIEF, neuropsychological EF tests) were investigated using analysis of variance (ANOVA) and random forest classification. Results: ANOVAs revealed only one significant diagnosis x gender interaction, with higher rates of self-reported anxiety symptoms in females with ADHD. Random forest classification indicated that co-existing symptom ratings was substantially better in distinguishing subjects with ADHD from HC in females (93% accuracy) than in males (86% accuracy). The most important distinguishing variable was self-reported anxiety in females, and parent ratings of rule breaking in males. Parent ratings of EF skills were better in distinguishing subjects with ADHD from HC in males (96% accuracy) than in females (92% accuracy). Neuropsychological EF tests had only a modest ability to categorize subjects as ADHD or HC in males (73% accuracy) and females (79% accuracy). Conclusions: Our findings emphasize the combination of self-report and parent rating scales for the identification of different comorbid symptom expression in boys and girls already diagnosed with ADHD. Self-report scales may increase awareness of internalizing problems particularly salient in females with ADHD

Adolescence internalizing problems as a mediator between autism diagnosis in childhood and quality of life in emerging adults with and without autism: a 10-year longitudinal study

© The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License.Background Individuals with autism tend to have a reduced quality of life across their lifespan. This reduced quality of life may be a result of autism traits, mental distress, and poor person/environment fit. In this longitudinal study, we looked at the role of adolescence internalizing and externalizing problems in mediating the relationship between having an autism diagnosis from childhood and perceived quality of life as emerging adults.Methods A total of 66 participants in a group of emerging adults with autism (mean age 22.2 years), and without autism (mean age 20.9 years) were assessed in three assessment waves (T1 at 12 years, T2 at 14 years, and T3 at 22 years of age). Parents filled out the Child Behavior Checklist at T2 and participants filled out the Perceived Quality of Life Questionnaire at T3. Total and indirect effects were tested in serial mediation analysis.Results The results showed that internalizing problems fully mediated the association between childhood autism diagnosis and the quality of life in emerging adulthood, while externalizing problems did not.Conclusion Our findings suggest that attention to adolescent internalizing problems is important to improve the later quality of life for emerging adults with autism.publishedVersio

Attention-deficit/hyperactivity disorder persistence from childhood into young adult age: a 10-year longitudinal study

Problems with executive function (EF) are considered a hallmark of Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). However, little is known about the developmental pathway of everyday EF in these two groups, and whether the two groups follow a similar or different developmental course. In this longitudinal study, children and adolescents with ADHD (n = 84, Mage = 11.6, SD = 2.0), ASD (n = 38, Mage = 12.0, SD = 2.3), and typically developing children (TDC; n = 50, Mage = 11.6, SD = 2.0) were clinically diagnosed and assessed with parent-ratings of everyday EF at baseline and at two-year followup (97% retention). Results showed that both individuals with ADHD and individuals with ASD displayed elevated levels of everyday EF problems relative to the TDC at baseline (Hedges g = 1.99 to 2.99). Over the two-year period, everyday EF improved in individuals with ADHD relative to the TDC, whereas individuals with ASD displayed no improvement relative to the TDC. At two-year followup, individuals with ADHD and individuals with ASD continued to display elevated levels of everyday EF problems relative to the TDC (Hedges g = 1.61 to 3.19).submittedVersio

A seven-year longitudinal study of the association between neurocognitive function and basic self-disorders in schizophrenia

IntroductionBasic self-disorders (SDs) and neurocognitive impairments are fundamental trait-like aspects of schizophrenia spectrum disorders. There has been little research on the association between SDs and neurocognitive impairments in schizophrenia, and no longitudinal studies have investigated if they are related. The aim of this study was to investigate the association between SDs and neurocognitive function in a follow-up study of patients with schizophrenia.MethodsSDs and neurocognition were examined in 35 patients with schizophrenia during their first treatment and 7 years later (mean 7.1, SD 0.42). SDs were examined with the Examination of Anomalous Self-Experience (EASE) instrument. The neurocognitive examination included assessments of psychomotor speed, executive- and memory functions.ResultsPoorer executive functions at baseline were significantly associated with more SDs 7 years later and smaller reductions in SDs over time. There were no significant associations between other neurocognitive functions and SDs.DiscussionExecutive functions are important for self-regulation, and impairments in these functions in everyday life may have an impact on the development and/or persistence of SDs

Trauma in childhood and adolescence and impaired executive functions are associated with uncertain reflective functioning in mothers with substance use disorder

© 2019 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).Aims: Impairments in reflective functioning are known to have adverse effects on the ability to display sensitive parenting as a caregiver. Several factors are associated with impairments in reflective functioning, such as impaired executive functioning and experienced trauma. We investigated how these factors contribute to an impaired reflective functioning style, such as pathological certain or uncertain reflective functioning. Extreme scores on these two subscales reflect two kinds of impairments in reflective functioning. We assessed executive functions, reflective functioning, and trauma in 43 mothers diagnosed with substance use disorders (SUD). Methods: Certain or uncertain reflective functioning were assessed using the Reflective Functioning Questionnaire 8 (RFQ-8). Executive functions and trauma were assessed by administering various questionnaires, interviews and neuropsychological tests. Results: High uncertain reflective functioning was more than six times as common (odds ratio) in mothers reporting high amounts of trauma in childhood and adolescence compared with mothers reporting low amounts of trauma. Impaired executive functions were also significantly associated with high uncertain reflective functioning. Certain reflective functioning did, however, not show any significant associations. Conclusion: When the SUD mothers give information about relational trauma in childhood and adolescence, it might therefore be worth investigating and addressing the potential tendency to have an uncertain reflective functioning style.publishedVersio

Similar impairments shown on a neuropsychological test battery in adolescents with high-functioning autism and early onset schizophrenia: A two-year follow-up study

Introduction: Cognitive impairments are common in both Autism Spectrum Disorders (ASD) and schizophrenia, but it is unclear whether the pattern of difficulties is similar or different in the two disorders. This cross-sectional and longitudinal study compared the neuropsychological functioning in adolescents with ASD with adolescents with Early Onset Schizophrenia (EOS). Methods: At baseline and at two-year follow-up, participants were assessed with a brief neuropsychological test battery measuring executive functions, visual and verbal learning, delayed recall and recognition and psychomotor speed. Results: We found similar levels of neuropsychological impairment across groups and over time in the adolescents with ASD or EOS. Adolescents in both groups did not improve significantly on verbal learning, verbal delayed recall, visual learning, visual delayed recall or visual delayed recognition, and both groups performed poorer on verbal recognition. Both groups improved on measures of psychomotor processing and executive functions. Conclusion: The findings suggest that it may be difficult to differentiate adolescents with EOS and ASD based on neuropsychological task performance. An implication of the results is that adolescents with either disorder may benefit from a similar approach to the treatment of cognitive impairment in the disorders.acceptedVersio

High levels of the openness trait are associated with better parental reflective functioning in mothers with substance use disorders

Aims: Mothers with substance use disorders (SUD) often show impairments in parental reflective functioning (PRF), which may have adverse effects on their capacity for sensitive caregiving. Parenting personality is also associated with caregiving. However, no studies have investigated how these individual factors may contribute to variance in PRF in mothers with SUD. In this study PRF and personality were assessed in 43 mothers with SUD. Methods: PRF was assessed by the Parent Development Interview. Personality traits were assessed by the Revised Neuroticism-Extraversion-Openness Personality Inventory. Results: The results indicate that higher levels of the Openness trait are associated with better PRF. Conclusion Mothers low in Openness may need more specific and situational training in interpreting mental states in their children. Highly open mothers with SUD will likely need more help distinguishing the child’s mental states from their own, and might need help to maintain mutuality and regulating the intensity of their responses to the child’s behavior.publishedVersio