Perinatal risk factors and neurocognitive outcomes in children and adolescents with sickle cell disease.

BACKGROUND: The literature on cognitive and academic outcomes for children with sickle cell disease (SCD) who experience perinatal risk factors is limited. We aimed to evaluate if low birthweight (LBW), gestational age, and history of neonatal intensive care unit (NICU) admission were associated with neurocognitive functioning, grade retention, or receipt of early intervention or formal educational support in children with SCD. PROCEDURES: This prospective birth cohort study included 336 participants, ages 8-18, with SCD, who received cognitive testing as part of standard of care and whose caregivers completed behavioral rating scales. Multivariable generalized linear regression models were used to examine associations between perinatal risks and outcome variables, after adjusting for demographic and medical covariates. RESULTS: The prevalence of NICU admission and LBW were 12.03% and 13.50%, respectively. Lower birthweight, earlier gestational age, and NICU admission were associated with worse working memory performance and receipt of early intervention services. Lower birthweight and NICU admission were also associated with slower processing speed. History of NICU admission was associated with caregiver ratings of hyperactivity and emotional dysregulation. The effects of perinatal risk factors on neurocognitive, academic, or educational outcomes were not dependent on SCD genotype. CONCLUSIONS: History of LBW or NICU admission was associated with worse cognitive outcomes and increased use of early intervention services among children with SCD. Early identification of perinatal risk factors will help identify children who will benefit from formal developmental or neuropsychological evaluations to manage the comorbidity of SCD and perinatal risks and facilitate increased intervention.

Examining the influence of pain and fatigue on neurocognitive functioning in adolescents and young adults with sickle cell disease.

Pain and fatigue are among the most common and impactful complications of sickle cell disease (SCD). Individuals with SCD are also more likely to have neurocognitive deficits. Previous studies have suggested that pain and fatigue might influence neurocognitive functioning in patients with SCD. However, these studies are limited by small sample sizes and inadequate measurement of cognitive performance. The present study aimed to investigate the relationship between pain and fatigue with neurocognitive functioning using performance-based measures of neurocognition. Pain and fatigue were not associated with neurocognitive performance. Implications and directions for future research are discussed.

Is Humor a Meaning Making Process? Investigating the Effects of Absurd Humor and Mortality Salience on Meaning in Life, Moral Identity, Belongingness, and Belief in a Just World.

Both mortality salience and absurd humor have been found to elicit fluid compensation - the automatic process of strengthening unrelated beliefs in response to a meaning threat. Previous research has suggested that perceiving absurd humor to be funny decreases people's tendency to fluid compensate, suggesting that humor is a meaning-making process. However, these results may have been confounded by mortality salience effects. Furthermore, few studies have investigated the effects of absurd humor and mortality salience on multiple beliefs. In the current study, we aimed to conceptually replicate previous research on the fluid compensatory effects of absurd humor and mortality salience under more stringent conditions and in response to a wider variety of beliefs. Participants (N = 590) recruited via MTurk were randomly assigned to a reading condition and thereafter completed a series of measures of meaning in life, moral identity, belongingness, and belief in a just world. Participants found humor in each reading condition and did not fluid compensate, suggesting that humor is a meaning-making process. Implications and directions for meaning making and humor research are discussed.