Side of motor symptom onset predicts sustained attention deficits and motor improvements after attention training in Parkinson's disease.

OBJECTIVE: Parkinson's disease (PD) side of motor symptom onset has been associated with distinct cognitive deficits; individuals with left-side onset (LPD) show more visuospatial impairments, whereas those with right-side onset (RPD) show more verbal impairments. Non-spatial attention is a critical cognitive ability associated with motor functioning that is right hemisphere lateralized but has not been characterized with regard to PD side of onset. We compared individuals with LPD and RPD on non-spatial attention tasks and examined differential responses to a 4-week sustained attention training program. METHOD: Participants included 9 with LPD and 12 with RPD, who performed both brief and extended go/no-go continuous performance tasks and an attentional blink task. Participants also engaged in an at-home sustained attention training program, Tonic and Phasic Alertness Training (TAPAT), 5 days/week for 4 weeks. We assessed cognitive and motor symptoms before and after training, and after a 4-week no-contact period. RESULTS: At baseline, participants with LPD exhibited worse performance than those with RPD on the extended continuous performance task, indicating specific deficits in sustaining attention. Poorer attention was associated with worse clinical motor scores. Notably, side of onset had a significant effect on clinical motor changes after sustained attention training, with only LPD participants improving after training, and 4/9 showing clinically meaningful improvements. CONCLUSIONS: Compared to RPD, participants with LPD had poorer sustained attention pre-training and were more likely to improve on clinical motor functioning after sustained attention training. These findings support mechanistic differences between LPD and RPD and suggest potential differential treatment approaches.

Racial Socialization, Private Regard, and Behavior Problems in African American Youth: Global Self-Esteem as a Mediator.

Racial socialization messages appear to have varying impacts on the adjustment of African American youth. To further explore this, we examined how two types of racial socialization messages might influence African American youth internalizing and externalizing behavior. The Youth Self Report was used to measure these behavior outcomes. Given that racial socialization messages may not be directly linked to behavior outcomes, we considered private regard, an aspect of racial identity, to serve as a mediator. Additionally, we examined global self-esteem as a mediator of the complex dynamic between racial socialization messages and behavior outcomes. Adolescents in our study completed paper assessments. Majority of the participants were female (56 %) and reside in a metropolitan area in the Mid-Atlantic region. Adolescent's ages ranged from 14 to 17 years with the average age being 15 years old. Path analysis revealed cultural pride and alertness to discrimination messages varied in their relation to private regard. Results also indicated a strong linkage between private regard, global self-esteem, and internalizing behaviors. Interestingly, the linkage between private regard, global self-esteem and externalizing behaviors was not as robust. Further, private regard appeared to directly and indirectly impact externalizing behaviors. The implications of these findings for racial socialization strategies, identity development (racial and global) as it pertains to behavior problems for African American adolescents are discussed.

Observed Racial Socialization and Maternal Positive Emotions in African American Mother-Adolescent Discussions About Racial Discrimination.

This study examined patterns of (a) observed racial socialization messages in dyadic discussions between 111 African American mothers and adolescents (Mage  = 15.50) and (b) mothers' positive emotions displayed during the discussion. Mothers displayed more advocacy on behalf of their adolescents in response to discrimination by a White teacher than to discrimination by a White salesperson. Mothers displayed consistent emotional support of adolescents' problem solving across both dilemmas but lower warmth in response to the salesperson dilemma. Findings illustrate evidence of the transactional nature of racial socialization when presented with adolescents' racial dilemmas. The role of adolescent gender in mothers' observed racial socialization responses is also discussed. A framework for a process-oriented approach to racial socialization is presented.