Cognitive recovery of children and adolescents with moderate to severe TBI during inpatient rehabilitation.

OBJECTIVE: Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children and adolescents. This study examines the early cognitive-linguistic recovery of pediatric patients who sustained TBI and required inpatient rehabilitation and investigates the contribution of various demographic, clinical, and preinjury factors to recovery. METHODS: A retrospective chart review of children and adolescents, ages 3-20 years, admitted to an inpatient rehabilitation unit. Acute outcomes were assessed at admission and discharge using the WeeFIM and CALS. Premorbid measures of behavioral and emotional functioning were also collected. RESULTS: One hundred and one children and adolescents (mean age = 12.31, SD = 4.46) diagnosed with TBI requiring inpatient rehabilitation were included. Patients displayed significant improvements on cognitive-linguistic skills and functional independence between admission and discharge, with medium to large effect sizes. Premorbid behavioral-emotional functioning was not found to be associated with early cognitive recovery. CONCLUSION: Results suggest that significant functional improvements can be expected for pediatric patients with TBI during inpatient rehabilitation. Consistent with previous literature, injury severity was significantly related to acute outcomes. In conjunction with the WeeFIM, the CALS appears to be a meaningful complement for assessing and monitoring cognitive-linguistic skills during inpatient rehabilitation.Implications for RehabiliationOur study provides support for the utility of the CALS to assess cognitive recovery during inpatient rehabilitation following moderate to severe TBI.Injury severity and not pre-injury functioning or demographic variables was related to worse scores on the CALS at discharge.Using a measure sensitive to change over admission, such as the CALS, can inform treatment planning.

Social Problems in Children: Exploring the Contribution of Triarchic Traits and Parenting.

Social problems are transdiagnostically relevant in the development of various forms of psychopathology. It is thus important to consider contributing factors both at the individual and contextual level. Among 110 children (Mage = 8.85 years), we examined the contribution of triarchic trait dimensions (boldness, meanness, disinhibition) and parenting to the explanation of social problems. Using existing parent-report scales, triarchic scale-level representations were developed and validated. Significant main effects emerged for all three trait dimensions; meanness and disinhibition positively, boldness negatively, associated with social problems. Higher levels of disinhibition and meanness were associated with increased social problems in the context of higher levels of negative, or decreased levels of positive parenting; boldness acted as a protective factor in these contexts. Results suggest that the triarchic trait dimensions (1) can be studied in children, (2) act as risk and protective factors, and (3) interact with parenting to contribute to social problems.

Mother-son discrepant reporting on parenting practices: The contribution of temperament and depression.

Despite low to moderate convergent correlations, assessment of youth typically relies on multiple informants for information across a range of psychosocial domains including parenting practices. Although parent-youth informant discrepancies have been found to predict adverse youth outcomes, few studies have examined contributing factors to the explanation of informant disagreements on parenting practices. The current study represents the first investigation to concurrently examine the role of mother and son's self-reported affective dimensions of temperament and depression as pathways to informant discrepancies on parenting practices. Within a community sample of 174 mother-son dyads, results suggest that whereas mother's self-reported temperament evidenced no direct effects on discrepancies, the association between the product term of mother's negative and positive temperament and discrepancies on positive parenting was fully mediated by mother's depression (a mediated moderation). In contrast, son's self-reported temperament evidenced both direct and indirect effects, partially mediated by depression, on rating discrepancies for positive parenting. All told, both son's self-reported affective dimensions of temperament and depression contributed to the explanation of discrepant reporting on parenting practices; only mother's self-reported depression, but not temperament, uniquely contributed. Results highlight the importance of considering both parent and youth's report in the investigation of informant discrepancies on parenting practices. (PsycINFO Database Record

Anxious and Depressive Symptomatology Among Male Youth: The Joint and Interactive Contribution of Temperament and Executive Functioning.

Few studies have investigated the combined effects of temperament and executive functioning (EF) on anxious and depressive symptomatology in youth. The current study is the first to investigate the joint and interactive contribution of mother- and youth self-reported affective dimensions of temperament and EF to the explanation of anxious and depressive symptomatology. Participants included 174 adolescent males (M age = 13.6 ± 1.35). Results confirmed the joint and interactive contribution of temperament in the explanation of anxious and depressive symptomatology. Further, EF contributed to the explanation of anxious/depressive symptomatology via interaction with youth-, but not mother-reported, temperament; it was not a unique predictor. Results support the need to consider both affective dimensions of temperament and EF in etiological models of anxious and depressive symptomatology, which has implications for identifying at-risk youth and developing early intervention and targeted problem-specific prevention programs.

Associations among emergency room visits, parenting styles, and psychopathology among pediatric patients with sickle cell.

BACKGROUND: To examine associations between frequency of emergency room (ER) visits and various parenting styles, both conjointly and interactively, and psychopathological outcomes among pediatric patients with sickle cell disease (SCD). PROCEDURES: Ninety-eight parents/caregivers of 6- to 18-year-old patients with SCD completed instruments assessing parenting style, child psychopathology, and reported on the frequency of ER visits during the previous year. RESULTS: ER visits were found to significantly explain Withdrawn/Depressed problems and parenting styles were found to incrementally contribute to the explanation of all forms of psychopathology. Further, Permissive parenting was found to explain Rule Breaking Behavior for those patients with low ER visit frequency but not for those with high ER visit frequency. CONCLUSIONS: Results of the current study confirm the importance of considering both the frequency of ER visits and parenting style in the explanation of psychopathology among pediatric patients with SCD. Results have important implications for both research and treatment.

Impulsivity moderates the association between racial discrimination and alcohol problems.

Alcohol use among university students is a serious public health concern, particularly among minority students who may use alcohol to cope with experiences of racial discrimination. Although the impact of racial discrimination on alcohol use has been well-established, individual differences in factors that may act to either attenuate or exacerbate the negative effects of racial discrimination are largely unknown. One potentially fruitful individual differences trait that has repeatedly been found to predict alcohol problems is the multidimensional personality trait of impulsivity. Nonetheless, the ways in which various aspects of impulsivity interact with racial discrimination is yet unknown. The current study, therefore, examined the joint and interactive contribution of racial discrimination and impulsivity in the prediction of alcohol consumption among racial minority university students. Participants included 336 Black/African-American and Asian/Asian-American university students. Results revealed both racial discrimination and impulsivity to be significantly associated with alcohol problems. Further, individuals' responses to racial discrimination were not uniform. Specifically, the association between racial discrimination and alcohol problems was moderated by lack of Premeditation; racial discrimination was most strongly predictive of alcohol problems for those who reported low level of premeditation. Findings from the present study highlight the importance of investigating risk factors for alcohol problems across multiple levels of the ecology as individual personality traits appear to relate to how one might respond to the experience of racial discrimination.