Developmental Aspects of Self-Regulation in Germany and Chile: Links among Maternal Warmth, Children’s Self-Regulation, and Social Competence

The present study investigated relations among maternal warmth, children’s self-regulation (i.e., behavior and emotion regulation), and prosocial behavior. The assumed relations were studied in Germany and Chile, two socialization contexts differing in socio-economic and cultural factors. The sample consisted of 76 German and 167 Chilean fourth graders, their mothers, and teachers. Maternal warmth was rated by mothers with the Parenting Practice Questionnaire (PPQ). Children reported the use of emotion regulation strategies on the Questionnaire for the Measurement of Stress and Coping in Children and Adolescents (SSKJ 3-8). Mothers’ and teachers’ ratings on the Strengths and Difficulties Questionnaire (SDQ) were used to measure children’s behavior regulation and prosocial behavior. Regression analyses revealed positive relations of maternal warmth to children’s problem-oriented emotion regulation and of behavior regulation to prosocial behavior in Germany and in Chile. Moreover, mediation analyses revealed indirect positive effects of self-regulation on the relations between maternal warmth and prosocial behavior. These indirect effects occurred for different aspects of self-regulation in Germany (i.e., behavior regulation) and in Chile (i.e., problem-oriented emotion regulation). Results are discussed from a cultural informed developmental perspective

Glucocorticoid-endocannabinoid interaction in cardiac surgical patients: relationship to early cognitive dysfunction and late depression

Background: Endocannabinoids (ECs) are rapidly acting immune-modulatory lipid-signaling molecules that are important for adaptation to stressful and aversive situations. They are known to interact with glucocorticoids and other stress-responsive systems. Maladaptation to acute or chronic stress represents a major risk factor for the development of psychiatric disorders. In the present study, we administered stress doses of hydrocortisone in a prospective, randomized, placebo-controlled double-blind study in patients undergoing cardiac surgery (CS) to examine the relationship between the use of glucocorticoids, plasma EC levels, and the occurrence of early postoperative cognitive dysfunction (delirium) and of later development of depression. Methods: We determined plasma levels of the ECs anandamide and 2-arachidonoylglycerol (2-AG) in CS patients of the hydrocortisone (n=56) and the placebo group (n=55) preoperatively, at postoperative day (POD) 1, at intensive care unit discharge, and at 6 months after CS (n=68). Postoperative delirium was diagnosed according to Diagnostic and Statistical Manual of the American Psychiatric Association IVth Edition (DSM-IV) criteria, and depression was determined by validated questionnaires and a standardized psychological interview (Structured Clinical Interview for DSM-IV). Results: Stress doses of hydrocortisone did not affect plasma EC levels and the occurrence of delirium or depression. However, patients who developed delirium on POD 1 had significantly lower preoperative 2-AG levels of the neuroprotective EC 2-AG (median values, 3.8 vs. 11.3 ng/ml; p=0.03). Preoperative 2-AG concentrations were predictive of postoperative delirium (sensitivity=0.70; specificity=0.69; cutoff value=4.9 ng/ml; receiver operating characteristic curve area=0.70; 95% confidence interval=0.54-0.85). Patients with depression at 6 months after CS (n=16) had significantly lower anandamide and 2-AG levels during the perioperative period. Conclusions: A low perioperative EC response may indicate an increased risk for early cognitive dysfunction and long-term depression in patients after CS. Glucocorticoids do not seem to influence this relationship

The Added Value of Analyzing Pooled Health-Related Quality of Life Data: A Review of the EORTC PROBE Initiative

BACKGROUND: The European Organisation for Research and Treatment of Cancer (EORTC) Patient-Reported Outcomes and Behavioural Evidence (PROBE) initiative was established to investigate critical topics to better understand health-related quality of life (HRQOL) of cancer patients and to educate clinicians, policy makers, and healthcare providers. METHODS: The aim of this paper is to review the major research outcomes of the pooled analysis of HRQOL data along with the clinical data. We identified 30 pooled EORTC randomized controlled trials (RCTs), 18 NCIC-Clinical Trials Group RCTs, and two German Ovarian Cancer Study Group RCTs, all using the EORTC QLQ-C30. All statistical tests were two-sided. RESULTS: Evidence was found that HRQOL data can offer prognostic information beyond clinical measures and improve prognostic accuracy in cancer RCTs (by 5.9%-8.3%). Moreover, models that considered both patient- and clinician-reported scores gained more prognostic overall survival accuracy for fatigue (P < .001), vomiting (P = .01), nausea (P < .001), and constipation (P = .01). Greater understanding of the association between symptom and/or functioning scales was developed by identifying physical, psychological, and gastrointestinal clusters. Additionally, minimally important differences in interpreting HRQOL changes for improvement and deterioration were found to vary across different patient populations and disease stages. Finally, HRQOL scores are statistically significantly affected by deviations from the intended time point at which the questionnaire is completed. CONCLUSIONS: The use of existing pooled data shows that it is possible to learn about general aspects of cancer HRQOL and methodology. Our work shows that setting up international pooled datasets holds great promise for understanding patients' unmet psychosocial needs and calls for additional empirical investigation to improve clinical care and understand cancer through retrospective HRQOL analyses

The effects of age on health-related quality of life in cancer populations: A pooled analysis of randomized controlled trials using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 involving 6024 cancer patients.

Cancer incidence increases exponentially with advancing age, cancer patients live longer than in the past, and many new treatments focus on stabilizing disease and HRQOL. The objective of this study is to examine how cancer affects patients' HRQOL and whether their HRQOL is age-dependent.Data from 25 EORTC randomized controlled trials was pooled. EORTC QLQ-C30 mean scores for the cancer cohort and five general population cohorts were compared to assess the impact of cancer on patients' HRQOL. Within the cancer cohort, multiple linear regressions (two-sided level P-value = 0.05 adjusted for multiple testing.) were used to investigate the association between age and HRQOL, adjusted for gender, WHO performance status (PS), distant metastasis and stratified by cancer site. A difference of 10 points on the 0-100 scale was considered clinically important.Cancer patients generally have worse HRQOL compared to the general population, but the specific HRQOL domains impaired vary with age. When comparing the cancer versus the general population, young cancer patients had worse financial problems, social and role functioning, while the older cancer groups had more appetite loss. Within the cancer cohort, HRQOL was worse with increasing age for physical functioning and constipation, and better with increasing age for social functioning, insomnia and financial problems (all p < 0.05).HRQOL is impaired in cancer patients compared to the general population, but the impact on specific HRQOL domains varies by age. Within the cancer population, some HRQOL components improve with age while others deteriorate. Optimal care for older cancer patients should target HRQOL domains most relevant to this population

Neuroimaging-based classification of PTSD using data-driven computational approaches: A multisite big data study from the ENIGMA-PGC PTSD consortium

Background: Recent advances in data-driven computational approaches have been helpful in devising tools to objectively diagnose psychiatric disorders. However, current machine learning studies limited to small homogeneous samples, different methodologies, and different imaging collection protocols, limit the ability to directly compare and generalize their results. Here we aimed to classify individuals with PTSD versus controls and assess the generalizability using a large heterogeneous brain datasets from the ENIGMA-PGC PTSD Working group. Methods: We analyzed brain MRI data from 3,477 structural-MRI; 2,495 resting state-fMRI; and 1,952 diffusion-MRI. First, we identified the brain features that best distinguish individuals with PTSD from controls using traditional machine learning methods. Second, we assessed the utility of the denoising variational autoencoder (DVAE) and evaluated its classification performance. Third, we assessed the generalizability and reproducibility of both models using leave-one-site-out cross-validation procedure for each modality. Results: We found lower performance in classifying PTSD vs. controls with data from over 20 sites (60 % test AUC for s-MRI, 59 % for rs-fMRI and 56 % for D-MRI), as compared to other studies run on single-site data. The performance increased when classifying PTSD from HC without trauma history in each modality (75 % AUC). The classification performance remained intact when applying the DVAE framework, which reduced the number of features. Finally, we found that the DVAE framework achieved better generalization to unseen datasets compared with the traditional machine learning frameworks, albeit performance was slightly above chance. Conclusion: These results have the potential to provide a baseline classification performance for PTSD when using large scale neuroimaging datasets. Our findings show that the control group used can heavily affect classification performance. The DVAE framework provided better generalizability for the multi-site data. This may be more significant in clinical practice since the neuroimaging-based diagnostic DVAE classification models are much less site-specific, rendering them more generalizable

The Role of Maternal Parenting for Children’s Behavior Regulation in Environments of Risk

This study investigates the role of maternal parenting and subjective theories for associations between environmental risk and children’s behavior regulation combining a qualitative and quantitative approach. Mothers of 113 primary school children (M = 10.06, SD = 0.86) in Germany completed questionnaires on parenting, environmental risk, and their child’s behavior regulation. To test for associations, we applied hierarchical regression models. Further, we conducted nine focus groups in settings of high and low environmental risk and used thematic analysis. Maternal warmth showed positive associations with children’s behavior regulation. Restrictive maternal control and children’s behavior regulation were related negatively. The negative association between environmental risk and children’s behavior regulation was partly explained by restrictive maternal control. When maternal warmth was added into the model on environmental risk, restrictive maternal control, and children’s behavior regulation, both maternal parenting practices lost its significant associations with children’s behavior regulation. Qualitative findings gave insights into parents’ subjective theories, suggesting adverse peer effects as possible explanation for the relation between environmental risk and children’s behavior regulation. The results are discussed in terms of their contribution to theoretical considerations on behavior regulation development in different environmental risk settings.publishe

The Role of Culture and Contextual Risk for Maternal Parenting and Children’s Behavior Regulation in Chile and Germany

Children’s behavior regulation development takes place in diverse sociocultural settings. In this study, we take a multilayer ecological perspective and examine cross-cultural as well as intra-cultural similarities and differences in relations between different aspects of contextual risks (i.e., family and neighborhood risk), maternal restrictive control, and children’s behavior regulation in Chile and Germany. One hundred sixty-seven mothers of primary school children in Chile and 109 mothers in Germany (total sample M (child age) = 10.01 years) completed questionnaires on family risk, parenting practices, and their child’s behavior regulation. Mothers in Germany rated children’s behavior regulation significantly higher than mothers in Chile. Further, in both cultural contexts (Chile, Germany), the higher the family risk, the higher was the use of maternal restrictive control and the lower the child’s behavior regulation. In Chile, after including maternal restrictive control, the relation between family risk and children’s behavior regulation remained significant. In Germany, in contrast, there was no direct significant relation between family risk and children’s behavior regulation, instead we found a significant indirect pathway via maternal restrictive control. Further, we investigated the moderating role of neighborhood risk, as distal contextual risk, for the relation between family risk and maternal restrictive control as well as for the relation between maternal restrictive control and children’s behavior regulation. We found no significant overall moderated mediation effect. However, findings in Chile and Germany revealed a conditional indirect effect indicating that family risk and behavior regulation were indirectly related via maternal restrictive control only when neighborhood risk was high. This underlines the need for an integrative consideration of the cultural context as well as family risk and neighborhood risk when investigating the role of maternal parenting for children’s behavior regulation development.publishe

Children's Self-Regulation and School Achievement in Cultural Contexts : The Role of Maternal Restrictive Control

Self-regulation can be developed through parent-child interactions and has been related to developmental outcomes, e.g., such as educational achievement. This study examined cross-cultural differences and similarities in maternal restrictive control, self-regulation (i.e., behavior and emotion regulation) and school achievement and relations among these variables in Germany and Chile. Seventy-six German and 167 Chilean fourth graders, their mothers, and their teachers participated. Mothers and teachers rated children's behavior regulation with a subscale of the Strengths and Difficulties Questionnaire. Children reported their use of emotion regulation strategies on the Questionnaire for the Measurement of Stress and Coping. Mothers rated maternal restrictive control by answering the Parenting Practice Questionnaire. School achievement was assessed by grades for language and mathematics. Results showed higher behavior regulation of German children in comparison to Chilean children and a higher preference of restrictive parental control in Chilean mothers than in German mothers. Regression analyses revealed positive relations between children's behavior regulation and school achievement in Germany and in Chile. Further, in both cultural contexts, maternal restrictive control was related negatively to behavior regulation and positively to anger-oriented emotion regulation. In sum, the study showed the central function of behavior regulation for school achievement underlining negative relations of maternal restrictive control with children's self-regulation and school achievement in diverse cultural contexts. Culturally adapted interventions related to parenting practices to promote children's behavior regulation may assist in also promoting children's school achievement.publishe

Children’s emotion regulation, behavior regulation, and mathematics achievement : A longitudinal mediation model

The present study investigated direct as well as indirect relations between children’s emotion regulation (anger- and avoidant-oriented strategies), behavior regulation, and mathematics achievement in a longitudinal study during the transition from primary to secondary school in Germany. Participants were 76 primary school students attending grade four at Time 1, of whom 51 participated again as secondary school students attending grade five at Time 2, as well as children’s mothers and teachers. Anger- and avoidant-oriented emotion regulation strategies at Time 1 were negatively associated to behavior regulation at Time 2. Behavior regulation at Time 2 was positively related to mathematics achievement at Time 2. There were no direct relations between emotion regulation (anger- and avoidant-oriented strategies) at Time 1 and mathematics achievement at Time 2. However, we found significant indirect negative effects between emotion regulation (anger- and avoidant-oriented strategies) at Time 1 and mathematics achievement at Time 2 via behavior regulation at Time 1. Thus, anger- and avoidant-oriented emotion regulation at Time 1 indirectly affected mathematics achievement negatively at Time 2 via behavior regulation at Time 2. This study confirms the complex structure of self-regulatory processes and underlines the importance of specific emotion regulation strategies for mathematics achievement.publishe

PISA 2018

Mit der PISA-Studie werden grundlegende Kompetenzen von Fünfzehnjährigen gegen Ende der Pflichtschulzeit erfasst. Ziel ist es, Aussagen darüber zu treffen, wie gut die Jugendlichen auf eine erfolgreiche Teilhabe an der modernen Gesellschaft vorbereitet sind. Die Ergebnisse der PISA-Studie ermöglichen alle drei Jahre den internationalen Vergleich von Kompetenzen Fünfzehnjähriger in den Bereichen Naturwissenschaften, Mathematik und Lesen und damit Aussagen über die Wirksamkeit von Bildungssystemen. Der nationale Berichtsband stellt die Ergebnisse der Schülerinnen und Schüler in Deutschland aus der PISA-Studie 2018 vor und setzt sie in Relation zu den Ergebnissen in anderen Staaten. Der Schwerpunkt der Erhebungen und Auswertungen liegt dabei auf der Lesekompetenz. Die Rahmenkonzeption der Lesekompetenz wurde für die PISA-Studie 2018 im Vergleich zu den vorigen Runden einer Revision unterzogen und berücksichtigt nun die sich verändernde Lesepraxis, die mit der Nutzung digitaler Medien einhergeht. Es werden leistungsbezogene Variablen genauso wie motivationale Orientierungen, Einstellungen und Verhalten erfasst, die für die Lesekompetenz wichtig sein können. Daneben wird der Beitrag der sozialen Herkunft und des Zuwanderungshintergrunds für die Lesekompetenzen untersucht. Darüber hinaus werden die Kompetenzen der Jugendlichen in der Mathematik und den Naturwissenschaften vorgestellt und diskutiert