The mental health of high school students returning to in-class lessons.

OBJECTIVES: It is known that lockdown alters the mental health of children in general and adolescents in particular. Here, we surveyed the mental health of high school students returning to in-class lessons after the pandemic. We compared an "anxious-depressed" group with a "neither anxious nor depressed" group with regard to perceived self-efficacy. METHODS: Students from a high school in the Rhône-Alpes region of France participated in a mental health survey. After the students had been given a study information sheet and had agreed to participate, they filled out three paper-based questionnaires the State-Trait Anxiety Inventory for Children (STAI-C), the Center for Epidemiological Studies-Depression (CES-D) self-questionnaire, and the Self-Efficacy Questionnaire for Children (SEQ-C) on an anonymous basis. RESULTS: A total of 709 datasets were analyzed. The participants' mean±standard deviation age was 15.89±0.93. The group comprised 438 girls, 251 boys, and 20 participants who did not state their sex. Compared with the boys, the girls had significantly higher scores in the STAI-C and CES-D questionnaires. According to the SEQ-C, the boys felt significantly more effective than the girls overall and for social efficacy and emotional efficacy. In contrast, the boys and girls did not differ regarding the academic efficacy score. Our main findings were that 53% (n=379) of the high school students were reportedly free of anxiety or depression, 28% (n=198) showed symptoms of subclinical anxiety and depression, and 19% (n=131) showed symptoms of clinical anxiety or depression. We compared the "anxious-depressed" group with the "neither anxious nor depressed" group: the former group was mainly composed of girls, whereas there were nearly as many boys as girls in the latter group. After adjustment for sex, the overall self-efficacy and the academic, social and emotional efficacy scores were found to be lower in the "anxious-depressed" group. The sex difference was null for social efficacy, small for overall efficacy and academic efficacy, and moderate for emotional efficacy. CONCLUSIONS: Overall, 47% of the study participants reported subclinical anxiety and/or a depression. It appears that anxiety and depression are linked to self-efficacy: the self-efficacy score was lower in the "anxious-depressed" group than in the "neither anxious nor depressed" group.

Comprehensive assessment of executive functioning following childhood severe traumatic brain injury: clinical utility of the child executive functions battery.

Objectives: To perform a detailed description of executive functioning following moderate-to-severe childhood traumatic brain injury (TBI), and to study demographic and severity factors influencing outcome. Methods: A convenience sample of children/adolescents aged 7-16 years, referred to a rehabilitation department after a TBI (n = 43), was compared to normative data using a newly developed neuropsychological test battery (Child Executive Functions Battery-CEF-B) and the BRIEF. Results: Performance in the TBI group was significantly impaired in most of the CEF-B subtests, with moderate to large effect sizes. Regarding everyday life, patients were significantly impaired in most BRIEF clinical scales, either in parent or in teacher reports. Univariate correlations in the TBI group did not yield significant correlations between the CEF-B and socio-economic status, TBI severity, age at injury, or time since injury. Conclusion: Executive functioning is severely altered following moderate-to-severe childhood TBI and is best assessed using a combination of developmentally appropriate neuropsychological tests and behavioral ratings to provide a comprehensive understanding of children's executive functions.

Assessment of everyday executive functioning using the BRIEF in children and adolescents treated for brain tumor.

Objective: Childhood brain tumors (BTs) and their treatment often negatively affect development of executive functions. Previous studies have reported executive functions deficits, particularly through questionnaires of daily life. This study aimed to assess executive functioning in everyday life following pediatric BT, in a larger and more histologically diverse sample than previously, and to study clinical and demographic factors influencing outcome.Methods: Assessment of executive functioning using parent ratings of the Behavior Rating Inventory of Executive Function (BRIEF), in a large sample of children treated for various BT (n = 153). Clinical and demographic factors were: age at diagnostic, age at assessment, parental education level, radiation therapy.Results: Significant difficulties were found in the 3 composite indices and in the majority of the BRIEF subscales. The highest level of difficulties was observed in the Working Memory subscale. Older age at assessment and younger age at diagnosis were significantly associated with higher levels of parent-reported difficulties, particularly for metacognition.Conclusions: Parents of children treated for BT report widespread and persistent deficits in executive functions that negatively affect their everyday functioning. Including analysis of all clinical scales and composite indices allows a more comprehensive approach and enables to specify the patients' executive profile.

A study of the Repeated Actions Diary in patients suffering from obsessive compulsive disorder.

The structured Repeated Action Diary (RAD) collects in vivo data on compulsions and their various characteristics. Certain compulsions (i.e., those ending because the patient feels certain that it is safe to stop) are then compared with uncertain compulsions. The compulsion profile in patients with obsessive compulsive disorder (OCD) was assessed by using the RAD. Thirty-two patients from two sources participated in the study. Before pooling the two subgroups, we checked that they did not differ significantly with regard to demographic and clinical variables. Patients reported several categories of compulsion. The most frequently reported compulsions were washing and checking. In a given person, checking compulsions (in contrast to washing compulsions) were often produced by several different obsessions. Almost all the patients reported repeating the compulsions because of a need to feel sure. There were far more "certain" compulsions than "uncertain" compulsions. The number of repetitions was significantly lower for certain compulsions than for uncertain compulsions. The person felt greater relief from guilt and responsibility and a greater decrease in discomfort at the end of a compulsive episode for certain compulsions than for uncertain compulsions. In conclusion, the need to ritualize (prompted by uncertainty, i.e., potential danger) might explain the maintenance (or posttreatment recurrence) of OCD in many patients. The need for certainty in the completion of a compulsion may be worth considering as a therapeutic tool. The development of an approach based on the need for certainty might help to improve treatment outcomes.

Effect of social leisure activities on object naming in healthy aging A multimodal approach.

Environmental factors contribute to the constitution and maintenance of the cognitive reserve and partially explain the variability of cognitive performance in older individuals. We assessed the role of leisure activities - social and individual - on the access to lexico-semantic representations evaluated through a task of object naming (ON). We hypothesize that compared to individual, social leisure activities explain better the ON performance in the older adults, which is explained by a mechanism of neural reserve. Our results in older adults indicate (a) a significant correlation between leisure social activities and the response time for ON, (b) a significant correlation between link the neural activity of the left superior and medial frontal (SmFG) for ON and leisure social activities. Interestingly, the activity of the left SmFG partially mediates the relationship between social activities and OD performance. We suggest that social leisure activities may contribute to maintain ON performances in healthy aging, through a neural reserve mechanism, in relation with left SmFG activity. This region is typically involved in the access to semantic representations, guided by the emotional state. These results open interesting perspectives on the role of social leisure activities on lexical production during aging.

Behavioral evidence for a differential modulation of semantic processing and lexical production by aging: a full linear mixed-effects modeling approach.

The effect of normal aging on lexical production and semantic processing was evaluated in 72 healthy participants. Four tasks were used, picture naming (PN), picture categorization (PC), numerical judgment (NJ), and color judgment (CJ). The dependence of reaction time (RT) and correct responses with age was accounted by mixed-effects models. Participants underwent neuropsychological testing for verbal, executive, and memory functions. The RTs increase significantly with age for all tasks. After parceling out the non-specific cognitive decline, as reflected by the NJ task, the RT for the PN task decreases with age. Behavioral data were interpreted in relation with neuropsychological scores. Our results suggest that (a) naming becomes more automatic and semantic processing slightly more difficult with age, and (b) a non-specific general slowdown of cognitive processing occurs with age. Lexical production remained unaltered, based on compensatory automatic processes. This study also suggests a possible slowdown of semantic processing, even in normal aging.

Aging Modulates the Hemispheric Specialization during Word Production.

Although older adults exhibit normal accuracy in performing word retrieval and generation (lexical production; e.g., object naming), they are generally slower in responding than younger adults. To maintain accuracy, older adults recruit compensatory mechanisms and strategies. We focused on two such possible compensatory mechanisms, one semantic and one executive. These mechanisms are reflected at inter- and intra-hemispheric levels by various patterns of reorganization of lexical production cerebral networks. Hemispheric reorganization (HR) changes were also evaluated in relation to increase naming latencies. Using functional magnetic resonance imaging (fMRI), we examined 27 healthy participants (from 30 years to 85 years) during an object naming task, exploring and identifying task-related patterns of cerebral reorganization. We report two main results. First, we observed a left intra-hemispheric pattern of reorganization, the left anterior-posterior aging (LAPA) effect, consisting of supplementary activation of left posterior (temporo-parietal) regions in older adults and asymmetric activation along the left fronto-temporal axis. This pattern suggests that older adults recruit posterior semantic regions to perform object naming. The second finding consisted of bilateral recruitment of frontal regions to maintain appropriate response times, especially in older adults who were faster performers. This pattern is discussed in terms of compensatory mechanism. We suggest that aging is associated with multiple, co-existing compensation and reorganization mechanisms and patterns associated with lexical production.

Ecological Assessment of Everyday Executive Functioning at Home and at School Following Childhood Traumatic Brain Injury Using the BRIEF Questionnaire.

OBJECTIVES: To describe dysexecutive symptoms in children with traumatic brain injury (TBI) using the Behavior Rating Inventory of Executive Function (BRIEF); to compare parent- and teacher-ratings, to analyze the differential impairment in the BRIEF subscales, and factors influencing outcome. PARTICIPANTS: Children aged 5 to 18 years 11 months, referred to a rehabilitation department following TBI. OUTCOME MEASURES: Parent- and teacher reports of the BRIEF. RESULTS: A total of 194 patients participated in the study: mild (n = 13), moderate (n = 12), severe (n = 169); mean 4.92 (standard deviation = 3.94) years post-injury. According to parent ratings (n = 193), all BRIEF subscales and indices were significantly elevated (23.8%-48% in the clinical range). The Working Memory subscale score was significantly higher than all other subscales. Results of teacher ratings (n = 28) indicated similar significantly elevated scores in all subscales (39.3%-57.2% in the clinical range). No significant difference was found between parent and teacher ratings, which were significantly correlated. Regression analyses indicated that, in children with severe TBI, parental BRIEF overall and metacognition indices were significantly predicted by younger age at injury and older age at assessment, whereas no significant predictor of behavioral regulation index was identified. DISCUSSION AND CONCLUSION: This study highlights significant executive dysfunction in everyday life several years after childhood TBI, evident in home and school environments.

Intrusive thoughts in patients with obsessive compulsive disorder and non-clinical participants: a comparison using the International Intrusive Thought Interview Schedule.

The International Intrusive Thought Interview Schedule (IITIS) was used to assess and compare the unwanted intrusive thoughts (UITs) reported in a group of patients with obsessive compulsive disorder (OCD) and a non-clinical group. Although all participants reported at least one type of intrusion, OCD patients experienced more intrusive thoughts than non-clinical participants, and this difference was statistically significant. In the OCD group, intrusive thoughts were more frequent, interfered more with daily life, were considered to be more important to get out of the mind, and were more difficult to stop than in non-clinical participants. The two groups did not differ significantly in terms of five appraisals of the most distressing intrusive thought. One appraisal (importance) was used far more by the OCD group than the non-clinical group. For three appraisals (intolerance of anxiety, need to control, and intolerance of uncertainty), the difference was smaller. Only two of the strategies for controlling the most upsetting intrusive thought (ritual and avoidance) were of value in differentiating between the two groups. The IITIS (an instrument used to assess intrusions in non-clinical samples) appears to be of value for the assessment of patients with OCD.

Ecological approach of executive functions using the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C): Developmental and validity study.

INTRODUCTION: Ecological assessment of executive functions (EF) with tasks simulating everyday-life difficulties in children remains poorly developed. The Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C) is one of the rare tools proposed in this perspective, for which developmental and convergent validity are, however, rather limited. The objectives of this study were to explore EF development using the BADS-C, while considering the effect of gender and parental education as well as controversial relationships between intelligence and EF. We also aimed to examine to what extent the BADS-C could reflect EF of children in everyday life, as reported by their parents on questionnaires. METHOD: A group of 120 healthy children aged from 7 to 12 years was recruited. Their executive performance was examined by means of the BADS-C, and their intellectual efficiency was tested with the Wechsler intelligence scales. Rating of EF in everyday life was simultaneously carried out by children's parents, using two questionnaires: the Dysexecutive Questionnaire for Children (DEX-C) of the BADS-C and the Behavior Rating Inventory of Executive Function (BRIEF). RESULTS: Results showed a significant effect of age on BADS-C subtests, with inconsistencies from one subtest to another. Gender effect on EF performance was nonsignificant. Weak correlations were found between EF scores and parental education or intelligence quotient. Lastly, while the two questionnaires of everyday-life EF were strongly correlated with each other, their links with BADS-C subtests scores were weak. CONCLUSIONS: This study shows differentiated developmental curves on BADS-C, reflecting a variable implication of executive resources according to subtests. The limited relations between BADS-C performance and sociodemographic variables or IQ could be due to the fact that executive difficulties are moderate in healthy children at this age. Moreover, the capacity of the BADS-C to reflect EF as perceived by the child's relatives in everyday life remains questionable.

Multigroup confirmatory factor analysis and structural invariance with age of the Behavior Rating Inventory of Executive Function (BRIEF)--French version.

The parent and teacher forms of the French version of the Behavioral Rating Inventory of Executive Function (BRIEF) were used to evaluate executive function in everyday life in a large sample of healthy children (N = 951) aged between 5 and 18. Several psychometric methods were applied, with a view to providing clinicians with tools for score interpretation. The parent and teacher forms of the BRIEF were acceptably reliable. Demographic variables (such as age and gender) were found to influence the BRIEF scores. Confirmatory factor analysis was then used to test five competing models of the BRIEF's latent structure. Two of these models (a three-factor model and a two-factor model, both based on a nine-scale structure) had a good fit. However, structural invariance with age was only obtained with the two-factor model. The French version of the BRIEF provides a useful measure of everyday executive function and can be recommended for use in clinical research and practice.

Evaluating short-term and working memory in older adults: French normative data.

Short-term and working memory (WM) capacities are subject to change with ageing, both in normal older adults and in patients with degenerative or non-degenerative neurological disease. Few normative data are available for comparisons of short-term and WM capacities in the verbal, spatial and visual domains. To provide researchers and clinicians with a set of standardised tasks that assess short-term and WM using verbal and visuospatial materials, and to present normative data for that set of tasks. The present study compiled normative French data for three short-term memory tasks (verbal, visual and spatial simple span tasks) and two WM tasks (verbal and spatial complex span tasks) obtained from 445 healthy older adults aged between 55 and 85 years. Our data reveal main effects of age, education level and gender on older adults' short-term and WM performances. Equation-based normalisation can therefore be used to take these factors into account. The results provide a set of cut-off scores for five standardised tasks that can be used to determine the presence of short-term or WM impairment in older adults.

[Deficits in inhibitory processes in normal aging and patients with Alzheimer's disease: a review]. / Déficits des processus inhibiteurs dans le vieillissement normal et la maladie d'Alzheimer.

Empirical data suggest that inhibitory processing is impaired in normal aging. A decrease in inhibitory processing may also play an important role in the cognitive changes occurring in the early stages of Alzheimer's disease. The comparison of inhibitory deficits in Alzheimer's disease and normal aging emphasizes the need to discriminate quantitative changes in inhibitory functioning from qualitative changes which may be specifically related to the disease process. Inhibitory deficits in normal old adults and patients with Alzheimer's disease, suggest different levels of implication of the inhibitory processes. In the cognitive literature, the construct of inhibition, frequently used, is however difficult to define as it refers to many different phenomena. The question of whether or not inhibitory processes are to be considered as a single unit is challenging, and many authors suppose the existence of several distinct inhibitory mechanisms. A taxonomy of inhibition, based on proposals from Nigg and Soltzfus et al., is proposed to facilitate studies of inhibitory dysfunction. Such approach allows a clarification between inhibition deficits specific to normal aging and to Alzheimer's disease.