Imitation and pantomime in high-functioning adolescents with autism spectrum disorders

A study was designed to test 2 alternative hypotheses--a symbolic hypothesis and an executive function hypotheses--for the imitation and pantomime deficits found in previous studies of autism. The subjects were 17 adolescent high-functioning subjects with autism spectrum disorders and 15 clinical comparison subjects who were matched on chronological age and verbal IQ. Meaning and sequence were manipulated in facial and manual imitation tasks. Sequence was manipulated in the pantomime and control tasks. Recognition memory and motor control tasks were matched to the experimental tasks. The results provided no support for the symbolic deficit hypothesis; meaning aided rather than hindered the performance of the group with autism. Partial support for the executive deficit hypothesis was found. There were no group differences on motor control tasks, and few on the memory control tasks, arguing against deficits in motor initiation, basic motor coordination, or visual recognition memory.     

Premorbid adjustment as predictor of outcome in schizophrenia: results of a prospective study

The present prospective follow-up study of 163 schizophrenic patients admitted to hospital for the first time examined the relationship between premorbid adjustment and different measures of the 3-year course and outcome. The same instruments had been used in all phases of the study. The Premorbid Adjustment Scale was used to assess premorbid social functioning. Outcome measures were positive symptoms, negative symptoms, social disability and number of rehospitalizations. The results of the multiple regression analyses showed that premorbid adjustment was the strongest overall predictor of outcome. Premorbid adjustment was significantly associated with negative symptoms and social disability over the 3-year course of illness. In a further step, we examined the relationship between good, moderate and poor premorbid adjustment and the course of positive symptoms, negative symptoms and social disability within the first 3 years after index admission. The most important finding was that premorbid functioning showed a stronger correlation with the course of negative symptoms and social disability than with the course of positive symptoms. Poor premorbid social functioning implies a poor social course of the illness. Female subjects showed better premorbid functioning than male subjects. Good premorbid adjustment was strongly associated with an acute onset of the illness, and poor premorbid adjustment with an insidious onset.     

On developing self-concepts: a controlled study of children and adolescents with autism

This study employed the self-understanding interview of Damon and Hart (1988) to assess the self-concepts of two groups of children and adolescents: a group of individuals with autism and a group of nonautistic mentally retarded individuals who were matched for age and for verbal ability. On the basis of an hypothesis concerning the interpersonal origins of social and psychological self-concepts (Hobson, 1990; Neisser, 1988), it was predicted that the participants with autism would show a relative dearth of such concepts in their talk about themselves. In accordance with our predictions, there was a significant group difference in the number and quality of statements that fell into the social category of self-concept; contrary to our predictions, however, there was no group difference in the number of statements that fell into the psychological category. In addition, although there were not significant group differences in the overall production of verbally expressed concepts concerning self-attributes of a physical, active, or psychological kind, even within these categories individuals with autism made fewer references to social interactions or qualities. These results are discussed with regard to theories of self-concept development in typically developing as well as autistic and mentally retarded individuals, and with reference to the limitations of interpersonal understanding ("theory of mind") in people with autism.     

Understanding of emotional experience in autism: Insights from the personal accounts of high-functioning children with autism.

In this study, the authors investigate emotional understanding in autism through a discourse analytic framework to provide a window into children's strategies for interpreting emotional versus nonemotional encounters and consider the implications for the mechanisms underlying emotional understanding in typical development. Accounts were analyzed for thematic content and discourse structure. Whereas high-functioning children with autism were able to discuss contextually appropriate accounts of simple emotions, their strategies for interpreting all types of emotional (but not nonemotional) experiences differed from those used by typically developing children. High-functioning children with autism were less inclined to organize their emotional accounts in personalized causal-explanatory frameworks and displayed a tendency to describe visually salient elements of experiences seldom observed among comparison children. Findings suggest that children with autism possess less coherent representations of emotional experiences and use alternative strategies for interpreting emotionally evocative encounters. Discussion focuses on the significance of these findings for informing the nature of emotional dysfunction in autism as well as implications for theories of emotional understanding in typical development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive match as a predictor of psychotherapy outcome.

63 cognitively matched or unmatched patient–therapist pairs were followed in a double-blind methodology utilizing the Interpersonal Discrimination Test (IDT) as a measure of cognitive match between each pair. Premature termination occurred for 60% of the unmatched pairs and for 24% of the matched pairs. The Global Assessment Scale indicated a significantly faster rate of improvement for the remaining matched pairs at the 12-wk mark. Unmatched pairs eventually reached similar endpoints with final termination outcome measures being unable to distinguish between the 2 groups. Findings demonstrate the ability of the cognitive-match methodology, and specifically the ability of the IDT, to predict higher rates of early and dissatisfied terminations when patients and therapists are unmatched in cognitive structure. Findings confirm an earlier finding by J. E. Carr (1970) of greater improvement after 12 wks of treatment for matched vs mismatched patient–therapist pairs. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Major depressive disorder: a prospective study of residual subthreshold depressive symptoms as predictor of rapid relapse

BACKGROUND: The study tested whether level of recovery from major depressive episodes (MDEs) predicts duration of recovery in unipolar major depressive disorder (MDD) patients. METHODS: MDD patients seeking treatment at five academic centers were followed naturalistically for 10 years or longer. Patients were divided on the basis of intake MDE recovery into residual depressive symptoms (SSD; N=82) and asymptomatic (N=155) recovery groups. They were compared on time to first episode relapse/recurrence, antidepressant medication, and comorbid mental disorders. Recovery level was also compared to prior history of recurrent MDEs ( > 4 lifetime episodes) as a predictor of relapse/recurrence. RESULTS: Residual SSD compared to asymptomatic recovery patients relapsed to their next MDE > 3 times faster (median=68 vs. 23 weeks) and to any depressive episode > 5 times faster (median=33 vs. 184 weeks). Residual SSD recovery status was significantly associated with early episode relapse (OR=3.65) and was stronger than history of recurrent MDEs (OR=1.64). Rapid relapse in the SSD group could not be attributed to higher comorbidity or lower antidepressant treatment. LIMITATIONS: Although inter-rater agreement on weekly depressive symptom ratings was very high (ICC > 0.88), some error may exist in assigning recovery levels. Antidepressant treatments were recorded, but were not controlled. CONCLUSIONS: MDE recovery is a powerful predictor of time to episode relapse/recurrence. Residual SSD recovery is associated with very rapid episode relapse which supports the idea that SSD is an active state of illness. Asymptomatic recovery is associated with prolonged delay in episode recurrence. These findings of this present study have important implications for the goals of treatment of MDD and for defining true MDE recovery.     

Anger as a predictor of aggression among incarcerated adolescents.

This study examined the validity of trait anger as a predictor of aggressive behavior among juvenile offenders. Two standard self-report anger scales were administered to 65 recently incarcerated male adolescents. These youths were followed prospectively for physical and verbal aggression during 3 months of subsequent incarceration. Anger scores were not correlated with participant history of violent offending or staff ratings of anger. However, anger scores from both instruments were predictive of subsequent physical and verbal aggression. For example, the Trait Anger scale successfully classified 66% of juvenile offenders into high and low aggressive groups; receiver operating characteristic analysis obtained an effect size of .72. These results support the predictive validity of self-reported anger in identifying juvenile offenders at risk for institutional aggression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Obesity as a prospective predictor of depression in adolescent females.

Objective: Both obesity and depression are prominent during adolescence, and it is possible that obesity is a trigger for adolescent depression. The purpose of this paper is to evaluate whether overweight or obese status contributes to the development of depression in adolescent girls. Design: Participants were 496 adolescent girls who completed interview based measures of depression and had their height and weight measured at four yearly assessments. Repeated measures logistic regressions with generalized estimating equations were used to evaluate whether overweight or obese status were associated with major depression or an increase in depressive symptoms the following year. Main Outcome Measures: Major depression and depressive symptoms were evaluating using a modified version of the K-SADS interview. Overweight and obese status was determined by using standardized protocols to measure height and weight. Results: Results showed that obese status, not overweight status, was associated with future depressive symptoms, but not major depression. This study demonstrated that obesity is a risk factor for depressive symptoms, but not for clinical depression. Conclusions: As depressive symptoms are considered along the spectrum of depression with clinical depression at the high end, these results suggest that weight status could be considered a factor along the pathway of development of depression in some adolescent females. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression as a predictor of perceived social support and demand: A componential approach using a prospective sample of older adults.

This study examined the relationship of the cognitive, mood, and somatic components of depression on perceptions of social support and social demand among older adults (n = 851) over two years. Factor-analyses confirmed the factor structure of our multicomponential model of depression. Results supported our proposal that interpersonal specificity, as measured by depressive cognition about self and others, is important to predicting changes in perceived support and demand over time. Each component of depression was related to social support and social demand cross-sectionally, whereas only the cognitive component of depression predicted changes in support and demand prospectively. Future research should consider the pathways linking depressive cognition to perceived support and demand. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Electrodermal activity as a predictor of social functioning in female schizophrenics

Twenty-nine female schizophrenics and 20 female controls were presented with a series of moderately intense tones in a standard orienting habituation paradigm while skin conductance was monitored. Premorbid adjustment and symptoms were also rated, and the schizophrenics were observed 2 years later. The total schizophrenic group was divided into a good-outcome group and a poor-outcome group. Good social functioning outcome required both self-supporting ability in the job market and at least a minimal social life. The poor-outcome group had a significantly higher skin-conductance level and frequency of spontaneous skin-conductance fluctuations than the control group, whereas the few patients with good outcome did not differ from controls. These results are contrary to previous findings with a group of schizophrenic men in which poor social functioning was associated with low electrodermal activity. This discrepancy is discussed in terms of sex differences in schizophrenic disorder.     

Adolescent personality as a prospective predictor of parenting: An interactionist perspective.

This study examined personality during adolescence as a predictor of later parenting of toddler-aged offspring. On the basis of empirical research on the timing of parenthood and the interactionist model (Conger & Donnellan, 2007), we examined age at parenthood and family socioeconomic status (SES) as mediators of the relation between personality and parenting. Participants were 228 emerging adults from an ongoing longitudinal study of the transition to adulthood. Later entry into parenthood and higher SES accounted for the association between personality characteristics and lower levels of harsh parenting and higher levels of positive parenting. Consistent with the interactionist model, both personality characteristics and SES-linked variables were related to interpersonal processes in families. The findings suggest that promoting adaptive personality traits during childhood and adolescence may help delay early entry into parenthood, promote higher SES, and, indirectly, foster more positive parenting of young children. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive impairment and social distress as different pathways to depression in the elderly: a cross-sectional study

BACKGROUND: The qualities of visual perception and of motor reaction to the visual stimulus have never been studied in reference to the type of video-camera system (2-D vs 3-D) used during laparoscopy. METHODS: The study was designed in two parts. The first evaluated the ability of the eye to discriminate how objects are spaced relative to one another. The second investigated the motor reaction to the visual stimulus in an environment where depth was the preponderent cue. The tests were performed in a pelvi-trainer in which were inserted different modules built either for visual observation (Part 1) or for evaluation of motor ability (Part 2). Variables studied during Part 1 were the time required to do the test and the number of errors committed during its performance. The variable evaluated during Part 2 was the time needed to terminate the test. Each of these two parts of the study were completed alternating the 2-D and 3-D systems. A total of 304 observations were recorded. Statistics used were the paired t-test, the independent group t-test, and the Newman-Keuls multiple comparisons test. RESULTS: Results of Part 1 of the study confirm that visual perception varies significantly among individuals (n = 10) (p < 0.05) and that a true 3-D video-camera system facilitates visual perception when compared to a 2-D system (p < 0.001). Results of Part 2 of the study also show significant differences among participants (n = 9)(p < 0.05). The true 3-D system allowed significantly faster motor performances than the 2-D system (p < 0.001). CONCLUSION: Our experiment shows that the 3-D system allowed significant improvements in the execution of the evaluated parameters. Also noted were significant differences among participants in term of visual and motor skills.     

Cognitive outcome after coronary artery bypass: a one-year prospective study

BACKGROUND: Cognitive deficits have been reported in patients after coronary artery bypass grafting, but the incidence of these deficits varies widely. We studied prospectively the incidence of cognitive change and whether the changes persisted over time. METHODS: Cognitive testing was done preoperatively and 1 month and 1 year postoperatively in 127 patients undergoing coronary artery bypass grafting. Tests were grouped into eight cognitive domains. A change of 0.5 standard deviation or more at 1 month and 1 year from patient's preoperative Z score was the outcome measure. RESULTS: We identified four main outcomes for each cognitive domain: no decline; decline and improvement; persistent decline; and late decline. Only 12% of patients showed no decline across all domains tested; 82% to 90% of patients had no decline in visual memory, psychomotor speed, motor speed, and executive function; 21% and 26% had decline and improvement in verbal memory and language; approximately 10% had persistent decline in the domains of verbal memory, visual memory, attention, and visuoconstruction; and 24% had late decline (between 1 month and 1 year) in visuoconstruction. CONCLUSIONS: This study establishes that the incidence of cognitive decline varies according to the cognitive domain studied and that some patients have persistent and late cognitive changes in specific domains after coronary artery bypass grafting.     

Risperidone treatment of children and adolescents with pervasive developmental disorders: a prospective open-label study

OBJECTIVE: To investigate the short-term safety and efficacy of risperidone in the treatment of children and adolescents with pervasive developmental disorders. METHOD: This was a 12-week, prospective, systematic, open-label trial that included 18 subjects (15 boys and 3 girls) with a mean age of 10.2 +/- 3.7 years. The sample included 11 subjects with autistic disorder, 3 with Asperger's disorder, 1 with childhood disintegrative disorder, and 3 with pervasive developmental disorder not otherwise specified. Fourteen subjects had comorbid mental retardation. Behavioral ratings were obtained during two baseline visits and again after 12 weeks of risperidone treatment. RESULTS: The optimal dose of risperidone for the 18 subjects was 1.8 +/- 1.0 mg/day. On the basis of the global improvement item of the Clinical Global Impression Scale, 12 of 18 subjects were considered responders. Significant improvement was seen in measures of interfering repetitive behavior, aggression and impulsivity, and some elements of impaired social relatedness. The most common side effect was weight gain (range 10 to 35 lb). CONCLUSIONS: These preliminary results suggest that risperidone may be effective for improving interfering behavioral symptoms in some children and adolescents with pervasive developmental disorders. Double-blind, placebo-controlled studies are needed before definitive statements of safety and efficacy can be made.     

Chronic daily headache in children and adolescents: a 2-year prospective study

The newer generation of antifungal agents such as itraconazole and terbinafine are more effective than the older therapies, griseofulvin and ketoconazole, in the treatment of dermatophyte pedal onychomycosis. Itraconazole can be administered as continuous dosing, 200 mg per day for 3 months, or in the form of pulse therapy, 200 mg twice a day for 1 week per month for 3 consecutive months. Terbinafine is given as continuous dosing, 250 mg per day for 3 months.     

Supreme Court decision making: Cognitive style as a predictor of ideological consistency of voting.

An integrative complexity coding system was used to explore the relations between cognitive style and political ideology among US Supreme Court justices who served on the Court between 1964 and 1978. The integrative complexity of case opinions that Ss authored during their 1st terms on the Court and the overall liberalism–conservatism of their voting records throughout their tenure were assessed. Consistent with past work on cognitive style and political ideology, Ss with liberal and moderate voting records exhibited more integratively complex styles of thought in their early case opinions than did those with conservative voting records. Unexpectedly, these relationships between cognitive style and ideology were more powerful on cases involving economic conflicts of interest than on cases involving civil liberties and rights issues. Results remain significant after controlling for a variety of demographic and background characteristics of the Ss (e.g., age, religion, quality of law school attended) and characteristics of the judicial opinions scored for integrative complexity (unanimous or split-Court, majority–minority status of opinion). Possible explanations for the results and processes that limit the cross-issue generality of relationships between cognitive style and ideology are discussed. (60 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

T wave alternans as a predictor of recurrent ventricular tachyarrhythmias in ICD recipients: prospective comparison with conventional risk markers

INTRODUCTION: The current standard for arrhythmic risk stratification is electrophysiologic (EP) testing, which, due to its invasive nature, is limited to patients already known to be at high risk. A number of noninvasive tests, such as determination of left ventricular ejection fraction (LVEF) or heart rate variability, have been evaluated as additional risk stratifiers. Microvolt T wave alternans (TWA) is a promising new risk marker. Prospective evaluation of noninvasive risk markers in low- or moderate-risk populations requires studies involving very large numbers of patients, and in such studies, documentation of the occurrence of ventricular tachyarrhythmias is difficult. In the present study, we identified a high-risk population, recipients of an implantable cardioverter defibrillator (ICD), and prospectively compared microvolt TWA with invasive EP testing and other risk markers with respect to their ability to predict recurrence of ventricular tachyarrhythmias as documented by ICD electrograms. METHODS AND RESULTS: Ninety-five patients with a history of ventricular tachyarrhythmias undergoing implantation of an ICD underwent EP testing, assessment of TWA, as well as determination of LVEF, baroreflex sensitivity, signal-averaged ECG, analysis of 24-hour Holter monitoring, and QT dispersion from the 12-lead surface ECG. The endpoint of the study was first appropriate ICD therapy for electrogram-documented ventricular fibrillation or tachycardia during follow-up. Kaplan-Meier survival analysis revealed that TWA (P < 0.006) and LVEF (P < 0.04) were the only significant univariate risk stratifiers. EP testing was not statistically significant (P < 0.2). Multivariate Cox regression analysis revealed that TWA was the only statistically significant independent risk factor. CONCLUSIONS: Measurement of microvolt TWA compared favorably with both invasive EP testing and other currently used noninvasive risk assessment methods in predicting recurrence of ventricular tachyarrhythmias in ICD recipients. This study suggests that TWA might also be a powerful tool for risk stratification in low- or moderate-risk patients, and needs to be prospectively evaluated in such populations.     

Salary as a predictor of salary: A 20-year study.

This study investigated the value of using salary after a few yr. in an organization as a predictor of, and therefore as an intermediate criterion for, salary at a later date. Salary data were collected for each yr. of the 20-yr. careers of 52 aircraft engineers. The salaries were combined to yield yearly distributions, 1 for beginning salary and 1 for each yr. of experience. The resulting distributions were intercorrelated and the following results obtained: (a) 92% of the intercorrelations were significant at the .01 level, (b) correlations between equidistant yr. became larger as tenure increased, and (c) the variance of salaries increased with increasing tenure. It is concluded that salary early in a man's career can be used as an intermediate criterion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counselor cognitive complexity of self-reported emotional experience as a predictor of accurate empathic understanding.

40 social workers (aged 23–68 yrs) completed the WAIS Vocabulary scale, a self-report of emotional experience, and a demographic questionnaire. Accurate empathic understanding was operationalized as accurate identification of emotions expressed in audiotaped, simulated client statements. A significant positive correlation was found between cognitive complexity of self-reported emotional experience and accurate empathic understanding. Methodological difficulties encountered in the measurement of cognitive structure of emotional experience and accurate empathic understanding are discussed. Implications for future study of the conceptual processing of emotion are noted. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group self-identification as a prospective predictor of drug use and violence in high-risk youth.

This study provides a 1-year prospective analysis of group self-identification as a predictor of adolescent drug use and violence. Youth identified with discrete groups. In most comparisons, 1 year later, a high-risk group reported greater levels of drug use and violence-related exposure than other groups, and the statistical relation between group self-identification and drug use or violence remained after baseline assessment of the drug use or violence measure was controlled for. This is the 1st study to demonstrate that group self-identification is a significant prospective predictor of drug use and other problem behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)