Pseudoacromegaly

© 2018 Elsevier Inc. Individuals with acromegaloid physical appearance or tall stature may be referred to endocrinologists to exclude growth hormone (GH) excess. While some of these subjects could be healthy individuals with normal variants of growth or physical traits, others will have acromegaly or pituitary gigantism, which are, in general, straightforward diagnoses upon assessment of the GH/IGF-1 axis. However, some patients with physical features resembling acromegaly – usually affecting the face and extremities –, or gigantism – accelerated growth/tall stature – will have no abnormalities in the GH axis. This scenario is termed pseudoacromegaly, and its correct diagnosis can be challenging due to the rarity and variability of these conditions, as well as due to significant overlap in their characteristics. In this review we aim to provide a comprehensive overview of pseudoacromegaly conditions, highlighting their similarities and differences with acromegaly and pituitary gigantism, to aid physicians with the diagnosis of patients with pseudoacromegaly.PM is supported by a clinical fellowship by Barts and the London Charity. Our studies on pituitary adenomas and related conditions received support from the Medical Research Council, Rosetrees Trust and the Wellcome Trust

An introduction to the special issue on sleep

This is part of an edited special issue (Gradisar and Tilton-Weaver, Eds.) that is published online only. The address is: https://www.sciencedirect.com/science/article/pii/S0140197118301581</p

All in the Family: Within-Family Differences in Parental Monitoring and Adolescent Information Management

This article used a sample of 2 adolescents per family to (a) examine the extent to which parental monitoring and adolescent information management are characteristics of families or of dyads and (b) replicate past research on parental monitoring and adolescent information management using models that distinguish differences between families from differences within them. Within- and between-family differences were examined as a function of parents (positive and negative parenting, immigration status), individual and peer-reported problem behavior, and adolescent characteristics (age, gender) in a sample of 300 Swedish families with 2 siblings each (aged 10 to 19). Parents’ self-reports of their monitoring of siblings and of their adolescents’ information management were consistently more similar than adolescents’ self-reports or reports on parents. Siblings’ reports of parental monitoring and self-reports of routine and personal information management were modestly related to one another. Reports of secrecy, however, were statistically independent. Results predicting between-sibling differences are consistent with those obtained from longitudinal studies of one sibling per family: adolescents who engage in problem behavior are more secretive and disclose less information to parents. Their parents report them to be more secretive. Siblings who engage in delinquency report lower parent solicitation and control. Siblings’ reports of both positive and negative parenting were associated with within-family differences in parental monitoring and their own information management. The results reinforce previous findings on the important role adolescents play in their own socialization. Differences between adolescent and parent reports highlight important methodological biases that may obscure key processes in family communication

Insomnia symptoms and non-suicidal self-injury in adolescence : understanding temporal relations and mechanisms

We propose a theoretical model of insomnia symptoms and non-suicidal self-injury (NSSI) that posits bidirectional linkages. We hypothesised that heightened depressive symptoms and impulsivity that result from insomnia increase NSSI. We also posit that the shame associated with NSSI triggers repetitive negative thinking, in turn increasing insomnia. Using three longitudinal waves of questionnaire data collected annually from a sample of Swedish adolescents (n = 1,457; Mage = 13.2, SD = 0.43; 52.7% boys), we assessed the mediating role of depressive symptoms, impulsivity, rumination, and worry on the link between insomnia and NSSI. After controlling for depressive symptoms, we found that insomnia was related to increases in NSSI from the second to the third time point (ß23 = 0.09, p = .01). NSSI was consistently related to increased insomnia (ß12 = 0.09, p = .01; ß23 = 0.11, p &lt; .001). In addition, depressive symptoms (ßind = 0.01, p = .02), but not impulsivity (ßind = 0.01, p = .09), mediated the path from insomnia to increased NSSI. Neither worry (ßind = 0.00, p = .59) nor rumination (ßind = 0.00, p = .96) mediated the link between NSSI and increased insomnia. We conclude that NSSI and insomnia maintain each other over time. Thus, screening adolescents for insomnia symptoms may help identify those at risk of NSSI. Although depression seems to explain why insomnia is a risk factor for NSSI, further studies should investigate why NSSI plays a role in the maintenance of insomnia. This understanding will lay the foundation for intervention

Have authoritarian parenting practices and roles changed in the last 50 years?

This study examined changes in authoritarian parenting practices and family roles in Sweden over the last 50 years. Data came from 3 cohorts (1958, 1981, and 2011) of young to middle-age adults living in a suburb of Stockholm who answered questions about how they were raised (N1958 = 385, N1981 = 207, N2011 = 457). The results showed a dramatic decrease in parents' directive control. Also, over time, parents increasingly allowed children to express anger toward them. Parents' roles changed from stereotyped versions of fathers as decision makers and mothers as caregivers to both parents sharing decisions and garnering respect from children. Overall, the results suggest that authoritarian parenting practices have declined dramatically and moved toward more egalitarian family environments. Virtually all these changes in parental practices and parental roles happened between the last 2 cohorts

Shyness as protective factor in the link between advanced maturity and early adolescent problem behavior

Advanced maturity in early adolescence has previously been linked with several problem behaviors. In this study, we examine whether shyness and gender might moderate this link. The participants were 787 early adolescents (Mage = 13.73; 401 girls and 386 boys), followed for one year. We conducted moderation analyses with shyness and gender as moderators of the links between advanced maturity and problem behaviors (drunkenness and intercourse) and between one problem behavior and another. Protective effects of shyness were found for both boys and girls. For high-risk behaviors (risky drinking behaviors and one-night stands) protective effects were found for boys. Controlling for romantic involvement did not alter the moderation effects, thus failing to support the idea that protection was due to shy youths not being drawn into advanced peer groups by romantic partners. Thus, shyness might serve as protective factor against problem behaviors in early adolescence

Shyness as protective factor in the link between advanced maturity and early adolescent problem behavior

Advanced maturity in early adolescence has previously been linked with several problem behaviors. In this study, we examine whether shyness and gender might moderate this link. The participants were 787 early adolescents (Mage = 13.73; 401 girls and 386 boys), followed for one year. We conducted moderation analyses with shyness and gender as moderators of the links between advanced maturity and problem behaviors (drunkenness and intercourse) and between one problem behavior and another. Protective effects of shyness were found for both boys and girls. For high-risk behaviors (risky drinking behaviors and one-night stands) protective effects were found for boys. Controlling for romantic involvement did not alter the moderation effects, thus failing to support the idea that protection was due to shy youths not being drawn into advanced peer groups by romantic partners. Thus, shyness might serve as protective factor against problem behaviors in early adolescence

Shyness as protective factor in the link between advanced maturity and early adolescent problem behavior

Advanced maturity in early adolescence has previously been linked with several problem behaviors. In this study, we examine whether shyness and gender might moderate this link. The participants were 787 early adolescents (Mage = 13.73; 401 girls and 386 boys), followed for one year. We conducted moderation analyses with shyness and gender as moderators of the links between advanced maturity and problem behaviors (drunkenness and intercourse) and between one problem behavior and another. Protective effects of shyness were found for both boys and girls. For high-risk behaviors (risky drinking behaviors and one-night stands) protective effects were found for boys. Controlling for romantic involvement did not alter the moderation effects, thus failing to support the idea that protection was due to shy youths not being drawn into advanced peer groups by romantic partners. Thus, shyness might serve as protective factor against problem behaviors in early adolescence

Can parental monitoring and peer management reduce the selection or influence of delinquent peers? Testing the question using a dynamic social network approach.

We tested whether parents can reduce affiliation with delinquent peers through 3 forms of peer management: soliciting information, monitoring rules, and communicating disapproval of peers. We examined whether peer management interrupted 2 peer processes: selection and influence of delinquent peers. Adolescents’ feelings of being overcontrolled by parents were examined as an additional moderator of delinquent selection and influence. Using network data from a community sample (N = 1,730), we tested whether selection and influence processes varied across early, middle, and late adolescent cohorts. Selection and influence of delinquent peers were evident in all 3 cohorts and did not differ in strength. Parental monitoring rules reduced the selection of delinquent peers in the oldest cohort. A similar effect was found in the early adolescent cohort, but only for adolescents who did not feel overcontrolled by parents. Monitoring rules increased the likelihood of selecting a delinquent friend among those who felt overcontrolled. The effectiveness of communicating disapproval was also mixed: in the middle adolescent network, communicating disapproval increased the likelihood of an adolescent selecting a delinquent friend. Among late adolescents, high levels of communicating disapproval were effective, reducing the influence of delinquent peers for adolescents reporting higher rates of delinquency. For those who reported lower levels of delinquency, high levels of communicating disapproval increased the influence of delinquent peers. The results of this study suggest that the effectiveness of monitoring and peer management depend on the type of behavior, the timing of its use, and whether adolescents feel overcontrolled by parents