Missed meal boluses and poorer glycemic control impact on neurocognitive function may be associated with white matter integrity in adolescents with type 1 diabetes.

Background: The notion that pediatric type 1 diabetes impacts brain function and structure early in life is of great concern. Neurological manifestations, including neurocognitive and behavioral symptoms, may be present from childhood, initially mild and undetectable in daily life. Despite intensive management and technological therapeutic interventions, most pediatric patients do not achieve glycemic control targets for HbA1c. One of the most common causes of such poor control and frequent transient hyperglycemic episodes may be lifestyle factors, including missed meal boluses. Objective: The aim of this study was to assess the association between specific neurocognitive accomplishments-learning and memory, inhibition ability learning, and verbal and semantic memory-during meals with and without bolusing, correlated to diffusion tensor imaging measurements of major related tracts, and glycemic control in adolescents with type 1 diabetes compared with their healthy siblings of similar age. Study design and methods: This is a case-control study of 12- to 18-year-old patients with type 1 diabetes (N = 17, 8 male patients, diabetes duration of 6.53 ± 4.1 years) and their healthy siblings (N = 13). All were hospitalized for 30 h for continuous glucose monitoring and repeated neurocognitive tests as a function of a missed or appropriate pre-meal bolus. This situation was mimicked by controlled, patient blinded manipulation of lunch pre-meal bolus administration to enable capillary glucose level of <180 mg/dl and to >240 mg/d 2 hours after similar meals, at a similar time. The diabetes team randomly and blindly manipulated post-lunch glucose levels by subcutaneous injection of either rapid-acting insulin or 0.9% NaCl solution before lunch. A specific neurocognitive test battery was performed twice, after each manipulation, and its results were compared, along with additional neurocognitive tasks administered during hospitalization without insulin manipulation. Participants underwent brain imaging, including diffusion tensor imaging and tractography. Results: A significant association was demonstrated between glycemic control and performance in the domains of executive functions, inhibition ability, learning and verbal memory, and semantic memory. Inhibition ability was specifically related to food management. Poorer glycemic control (>8.3%) was associated with a slower reaction time. Conclusion: These findings highlight the potential impairment of brain networks responsible for learning, memory, and controlled reactivity to food in adolescents with type 1 diabetes whose glycemic control is poor.

Cognitive strategies for managing cheating: The roles of cognitive abilities in managing moral shortcuts.

Cheating and immorality are highly researched phenomena, likely due to their great impact. However, little research has examined the real-time cognitive mechanisms that are involved in cheating and conflict management. Much of the cheating research to date concentrates on binary cheating; however, in more prevalent real-world scenarios, people often engage in more ambiguous self-serving mistakes. To execute such self-serving decisions, one may make use of conflict-management strategies to help balance an internal struggle between gain and self-concept. We propose that to enact such strategies one must employ sufficient cognitive resources. To test this, we employed a simple effortful control task that allows for comparisons of gain and no-gain errors, isolating self-serving mistakes while recording gaze and response-time measures. Findings revealed that individuals can make use of conflict management strategies that mimicked errors made inadvertently. Two strategies included gaze avert and quick response times during gain blocks, whereby participants simulated out-of-control-like behaviors while engaging in self-serving mistakes, plausibly as a method of self-justification. Strategy use was dependent upon individuals' cognitive abilities. Participants reporting high inhibitory control abilities were able to use gaze aversion to engage in self-serving mistakes, while those reporting high attention resources were able to employ faster response times when making more profitable errors. Taken together, this paper contributes to (1) the debate on whether honesty/dishonesty is the dominant response, (2) the debate on self-control and inhibition on cheating, and (3) the understudied area of cognitive justifications to maintain a positive self-concept.

Participant-experimenter rapport in experimental settings: A test case of executive functions among children with ADHD.

There is a growing interest in the effects of social engagement on cognition, yet, research on the effects of social engagement with the experimenter in empirical contexts has been sparse. During an experiment, the experimenter and participant form a dyad, establishing a certain level of rapport-a sense of a positive and congruent relationship. This rapport is thought to promote performance by providing a comfortable testing environment, thereby reducing resource demand, and enhancing participant engagement and willingness to exert effort to perform. The current study sought to better understand the role of rapport by examining the effects of perceived rapport on effortful control, that is, inhibition and shifting, in an experimental setting among children with and without attention-deficit/hyperactivity disorder (ADHD). Forty-nine children (9 to 12 years old) were divided into two groups based on ADHD classification (i.e., typically developing children, n = 27; children with ADHD, n = 22). Participants completed the day/night Stroop task and the Wisconsin Card Sorting Task following a short rapport-building conversation with the experimenter. Later, both participant and experimenter filled the CHARM questionnaire reporting the rapport constructed during the experiment. Results show moderating effects of ADHD on the relationship between perceived rapport quality and congruency, and participant's executive functions performance. Specifically, children with ADHD showed higher susceptibility to rapport quality and were impervious to the effects of rapport congruency. Results highlight the importance of rapport with the experimenter in experimental research and suggest incorporating considerations concerning rapport, both in designing the experimental paradigm as well as an independent factor affecting task performance and outcome. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Cheating behavior in children: Integrating gaze allocation and social awareness.

Children's cheating and factors supporting honesty are not well understood. The current work explored variables involved in children's cheating through eye-tracking and an implicit manipulation in which extrinsic awareness of the effects of one's behaviors on others was primed. Participants played a computer game with the option for a monetary gain in which they could earn more if they selectively erred in response to more profitable stimuli. Results show that children cheat by making selective effort toward more profitable errors; however, extrinsic awareness inhibits these cheating behaviors. Importantly, gaze toward children's earnings mediates this relationship, suggesting that extrinsic awareness mitigates an impulsive looking pattern, which in turn results in less cheating. Findings suggest that an implicit manipulation, highlighting the potential implications of one's actions for others, seems to effectively suppress cheating among children. Furthermore, attention toward earnings offers a cognitive process that acts to mediate the effect of this manipulation on cheating. Taken together, this framework suggests psychoneurocognitive and social processes that influence cheating in children, offering a direction for future implicit intervention techniques to support honest performance.

Brainstem as a developmental gateway to social attention.

BACKGROUND: Evolution preserves social attention due to its key role in supporting survival. Humans are attracted to social cues from infancy, but the neurobiological mechanisms for the development of social attention are unknown. An evolutionary-based, vertical-hierarchical theoretical model of self-regulation suggests that neonatal brainstem inputs are key for the development of well-regulated social attention. METHODS: Neonates born preterm (N = 44, GA 34 w.) were recruited and diagnosed at birth as a function of their auditory brainstem evoked responses (ABR). Participants enrolled in a prospective 8-year-long, double-blind, follow-up study comparing participants with brainstem dysfunctions and well-matched controls. Groups had comparable fetal, neonatal, and familial characteristics. Methods incorporated EEG power analysis and gaze tracking during the Attention Network Test (ANT, four cue types, and two targets) and a Triadic Gaze Engagement task (TGE, three social cue levels). RESULTS: Results showed that neonatal brainstem compromise is related to long-term changes in Alpha- and Theta-band power asymmetries (p < .034, p < .016, respectively), suggesting suppressed bottom-up input needed to alert social attention. Gaze tracking indicated dysregulated arousal-modulated attention (p < .004) and difficulty in gaze engagement to socially neutral compared to nonsocial cues (p < .012). CONCLUSIONS: Integrating models of Autism and cross-species data with current long-term follow-up of infants with discrete neonatal brainstem dysfunction suggests neonatal brainstem input as a gateway for bottom-up regulation of social attention.