Effect of transcatheter aortic valve replacement on left atrial function.

OBJECTIVES: To investigate the effect of transcatheter aortic valve replacement on left atrial volumetric function and left atrial volume for the prediction of adverse outcomes. METHODS: This is a retrospective analysis of 121 patients in sinus rhythm who underwent TAVR for severe AS. Maximum LA volume index (LAVI max), minimum LA volume index (LAVI min), and "pre-A" volume index (LAVIpre-A, the volume before atrial contraction) were measured by biplane Simpson's method at baseline, 1 month, and 1 year. The reservoir function, conduit function, booster pump function were calculated. All patients were followed for new-onset of atrial fibrillation, hospitalization and all-cause mortality. RESULTS: The reservoir function, conduit function and booster function before TAVR were 46%, 21%, 32%, respectively. LA volumetric function assessment demonstrated that reservoir function, conduit function increased over the time (all P < 0.01). There was no difference in booster function after TAVR (P = 0.18). Baseline markedly enlarged LA was significantly increased for AF (HR: 4.72; 95% CI, 1.11-20.13, P = 0.04). In addition, There was a progressive decrease in LAVI max (P = 0.02) and RVSP (P = 0.03) over the time in non-AF group but not in AF group (P = 0.62 and P = 0.65, respectively). Although, the proportion of high left ventricular filling pressure decreased in both groups but a marked decrease was noted in non AF group in compared with AF group. CONCLUSION: Reservoir function, conduit function increased over time. Lack of negative LA remodeling post TAVR was associated with higher incidence of AF.

Gating Out Misinformation: Can Young Children Follow Instructions to Ignore False Information?

The current study investigated the effects of misinformation on children's memory reports after practice with the logic-of-opposition instruction at time of test. Four- and 6-year-old children participated in a play event in Session 1. During a two-week delay, parents presented their children with either misinformation or correct information about the play event. Prior to a memory interview in Session 2, some misled children were given a developmentally appropriate logic-of-opposition instruction to not report information provided by their parents. Results indicated that children were misled by the incorrect information, but that the logic-of-opposition instruction aided in the children's retrieval of the original memory, particularly for the 6-year-olds. Implications of the results for memory malleability and social demand effects in children are discussed.

"That never happened": adults' discernment of children's true and false memory reports.

Adults' evaluations of children's reports can determine whether legal proceedings are undertaken and whether they ultimately lead to justice. The current study involved 92 undergraduates and 35 laypersons who viewed and evaluated videotaped interviews of 3- and 5-year-olds providing true or false memory reports. The children's reports fell into the following categories based on a 2 (event type: true vs. false) × 2 (child report: assent vs. denial) factorial design: accurate reports, false reports, accurate denials, and false denials. Results revealed that adults were generally better able to correctly judge accurate reports, accurate denials, and false reports compared with false denials: For false denials, adults were, on average, "confident" that the event had not occurred, even though the event had in fact been experienced. Participant age predicted performance. These findings underscore the greater difficulty adults have in evaluating young children's false denials compared with other types of reports. Implications for law-related situations in which adults are called upon to evaluate children's statements are discussed.

Executive functions in young males with fragile X syndrome in comparison to mental age-matched controls: baseline findings from a longitudinal study.

The performance of 54 boys with fragile X syndrome (FXS), ages 7 to 13 years, was compared to that of a group of typically developing boys who were matched on mental age (MA) and ethnicity across multiple measures of executive function (EF). Boys with FXS varied in their ability to complete EF measures, with only 25.9% being able to complete a set-shifting task and 94.4% being able to complete a memory for word span task. When compared to the control group, and controlling for MA and maternal education, boys with FXS showed significant deficits in inhibition, working memory, cognitive flexibility/set-shifting, and planning. No group differences were observed in processing speed. Mental age significantly impacted performance on working memory, set-shifting, planning, and processing speed tasks for both groups. In boys with FXS, MA significantly predicted performance on working memory and set-shifting tasks. Our findings suggest that deficits in EF in boys with FXS are not solely attributable to developmental delays but, rather, present as a true array of neurocognitive deficits.

Memory skills of boys with fragile X syndrome.

Multiple aspects of memory were examined in 42 boys with fragile X syndrome and a comparison group of 42 typically developing boys matched on MA. Working memory, incidental memory, and deliberate memory were assessed with a battery that included both free-recall and recognition tasks. Findings indicated that boys with fragile X syndrome performed more poorly than their matches on most measures. The exception was free recall, in which their accuracy was equal to that of the control participants. Results from analyses of a subset of boys with fragile X syndrome who exhibit characteristics of autism and their MA matches, though preliminary, support the conclusion that memory deficits are especially marked in boys who have fragile X syndrome and evidence autistic behaviors.

Children's false memory and true disclosure in the face of repeated questions.

The current study was designed to investigate children's memory and suggestibility for events differing in valence (positive or negative) and veracity (true or false). A total of 82 3- and 5-year-olds were asked repeated questions about true and false events, either in a grouped order (i.e., all questions about a certain event asked consecutively) or in a nongrouped order (i.e., questions about a certain event were interspersed with questions about other events). Interviewer gender was also varied. Individual differences, including attachment style, inhibition, and behavioral adjustment, were examined as potential predictors of memory and suggestibility. Results revealed significant age, valence, and veracity effects on children's memory reports. Path analysis demonstrated that individual differences in behavioral problems and inhibitory ability predicted children's provision of inaccurate information. Implications for psychological theory and legal application are discussed.

Developmental differences in the effects of repeated interviews and interviewer bias on young children's event memory and false reports.

The present study investigated developmental differences in the effects of repeated interviews and interviewer bias on children's memory and suggestibility. Three- and 5-year-olds were singly or repeatedly interviewed about a play event by a highly biased or control interviewer. Children interviewed once by the biased interviewer after a long delay made the most errors. Children interviewed repeatedly, regardless of interviewer bias, were more accurate and less likely to falsely claim that they played with a man. In free recall, among children questioned once after a long delay by the biased interviewer, 5-year-olds were more likely than were 3-year-olds to claim falsely that they played with a man. However, in response to direct questions, 3-year-olds were more easily manipulated into implying that they played with him. Findings suggest that interviewer bias is particularly problematic when children's memory has weakened. In contrast, repeated interviews that occur a short time after a to-be-remembered event do not necessarily increase children's errors, even when interviews include misleading questions and interviewer bias. Implications for developmental differences in memory and suggestibility are discussed.

Academic skills of boys with fragile X syndrome: profiles and predictors.

The academic achievement of boys with fragile X syndrome and the relation between several predictive factors and academic performance are reported. Boys with fragile X syndrome displayed significant deficits in all academic skill areas. Relative strengths were observed in general knowledge, reflecting the ability to integrate experiential information. In contrast, relative weaknesses were observed in prewriting skills and visuospatial-processing abilities. The rate of academic growth slowed over time, and the decrease in rate was more pronounced in measures of core academic skills (e.g., prereading and math skills) than in broad-based tasks. Nonverbal IQ and FMR protein expression were not associated with the level or rate of change; however, autistic behavior and maternal education were related to academic achievement scores.

Mapping nonverbal IQ in young boys with fragile X syndrome.

This study examines the developmental changes in nonverbal intellectual functioning evident in males with fragile X syndrome (FXS) measured by the Leiter International Performance Scales-Revised (Leiter-R). The Leiter-R provides both IQ scores and associated growth scores which permit the examination of both age-based IQ scores and overall intellectual growth. Participants were 45 males with full mutation FXS and ranged in age from 4.0 to 13.8 years. Each child was assessed annually using the Leiter-R as part of a larger longitudinal battery for an average of 3.5 assessments per child and a range of 2-6 assessments, representing a total of 156 assessment occasions. Longitudinal analyzes of Leiter scores consisted primarily of hierarchical linear modeling, with the impact of chronological age, maternal education, fragile X mental retardation 1 protein (FMRP), autistic behaviors also being assessed. Findings revealed a significant linear decline in nonverbal IQ scores, with no effects of maternal education, autistic behaviors, or FMRP on mean level or rate of change in IQ scores over time. The decline slowed significantly around 8 years of age, but scores continued to decline into the 12th year of age. In contrast, a significant linear increase was observed in Leiter-R growth scores, which was negatively influenced by autistic behaviors. The rate of increase did not change over time, and neither mean level nor rate of increase was influenced by maternal education or FMRP levels. These findings suggest that declines in IQ are the result of steady, but suboptimal intellectual growth, rather than a true deterioration in overall intellectual functioning.

Adult attachment style and parental responsiveness during a stressful event.

Despite widespread use of self-report measures of adult attachment, relatively little research has explored the predictive utility of these measures in the domain of parent-child relationships. The present study examined the association between self-reported attachment style and parental responsiveness during a stressful event. Children and their parents were observed while children received an inoculation at a county immunization clinic. Children's reactions to the inoculation were rated and parents' responsiveness was assessed with the Emotional Availability Scales (EAS). Results revealed that children of parents scoring high on self-reported attachment avoidance were more distressed during the inoculation than children of parents scoring low on avoidance. Moreover, parents high on avoidance were less responsive when children were highly distressed, whereas this pattern was reversed among parents scoring low on avoidance. Finally, the influence of adult attachment on parental behavior and children's distress was found to be independent of children's temperament and parental personality. These findings suggest that self-report adult attachment measures may be useful in the domain of parent-child relationships.

The role of attachment and cognitive inhibition in children's memory and suggestibility for a stressful event.

There has been increasing interest in children's abilities to report memories of and resist misleading suggestions about distressing events. Individual differences among children and their parents may provide important insight into principles that govern children's eyewitness memory and suggestibility for such experiences. In the present study, 51 children between the ages of 3 and 7 years were interviewed about an inoculation after a delay of approximately 2 weeks. Results indicated that parents' attachment Avoidance was associated with children's distress during the inoculation. Parental attachment Anxiety and the interaction between parental Avoidance and children's stress predicted children's memory for the inoculation. Cognitive inhibition was also a significant predictor of children's memory errors and suggestibility. Theoretical implications concerning effects of stress and individual differences on children's eyewitness memory and suggestibility are discussed.

Children's memories of experienced and nonexperienced events following repeated interviews.

The present study compared 3- and 5-year-olds' reports of a true or false play interaction following repeated interviews. Final interviews were conducted either by the same researcher or by a new researcher. Age-related improvements in performance were evident. Also, 3-year-olds questioned repeatedly about an entirely false event made more errors in response to specific questions than 3-year-olds questioned repeatedly about false details of a true event. Five-year-olds who were questioned about the false event, however, were particularly accurate when answering questions about never-experienced body touch. Interviewer familiarity was associated with decreases in the amount of narrative detail 5-year-olds provided in free-recall and with increases in 3-year-olds' accuracy in response to direct questions. Both errors and response latency on a cognitive matching task were related to children's suggestibility.

Nearly 4 years after an event: children's eyewitness memory and adults' perceptions of children's accuracy.

OBJECTIVE: The current study examined children's eyewitness memory nearly 4 years after an event and the ability of adults to evaluate such memory. METHOD: In Phase 1, 7- and 10-year olds were interviewed about a past event after a nearly 4-year delay. The interview included leading questions relevant to child abuse as well as statements designed to implicate the original confederate. In Phase 2, laypersons and professionals watched a videotaped interview (from Phase 1) that they were misled to believe was from an ongoing abuse investigation. Respondents then rated the child's accuracy and credibility, and the probability that the child had been abused. RESULTS: In Phase 1, few significant age differences in memory accuracy were found, perhaps owing in part to small sample size. Although children made a variety of commission errors, none claimed outright to have been abused. Nevertheless, some of the children's answers (e.g., saying that their picture had been taken, or that they had been in a bathtub) might cause concern in a forensic setting. In Phase 2, professional and nonprofessional respondents were unable to reliably estimate the overall accuracy of children's statements. However, respondents were able to reasonably estimate the accuracy of children's answers to abuse questions. Respondents were also more likely to think that 7-year olds compared to 10-year olds had been abused. Professionals were significantly less likely than nonprofessionals to believe that credible evidence of abuse existed. Professionals who indicated personal experience with child abuse or a close relationship with an abuse victim were more likely to rate children as abused. A gender bias to rate boys as more accurate than girls was apparent among laypersons but not professionals. CONCLUSIONS: Children were generally resistant to suggestions that abuse occurred during a long-ago generally forgotten event, but some potentially concerning errors were made. Both professionals and non-professionals had difficulty estimating the accuracy of children's reports, but adults were more likely to rate children as accurate if the children answered abuse-related questions correctly. Training and personal experience were associated with adults' ratings of children's reports. Implications for evaluations of child abuse reports are discussed.